Pediatric jellyfish envenomation in the Mediterranean Sea
Bibliographic record
Abstract
BACKGROUND: Several species of jellyfish native to the western Indian Ocean have entered the Mediterranean Sea through the Suez Canal. Since the late 1980s, each summer Rhopilema nomadica forms swarms as long as 100 km in the southeastern Levant and since the millennium aggregations of additional nonnative jellyfish have been sighted. The aim of this study was to evaluate children seen in the emergency department after jellyfish envenomations and to establish patterns of toxicity associated with this organism. METHODS: A retrospective chart review was performed of all children presenting after jellyfish envenomations to the pediatric emergency department during the jellyfish swarming seasons (June-August) between 2010 and 2015. Extracted data included age, location of envenomation, pain scores, local and systemic manifestations, treatment provided in the emergency department and hospital, and disposition. RESULTS: Forty-one patients fulfilled the inclusion criteria; their ages ranged from 1 to 16 years and the median age was 9.4 years. Clinical manifestations were evident in all patients. Pain, present in 100% of patients, and an erythematous, whip-like, linear rash present in 87.8%, were the most common manifestations. The majority of 'burns' associated with jellyfish stings were first and second degree. The upper limb was affected in 34% and the lower limb was affected in 61% of cases. One patient suffered a sting to the abdomen and three patients suffered a sting to the face. Treatment in the emergency department included pain control, with nonsteroidal anti-inflammatory drugs and opiates, and antihistamines and topical corticosteroids in some cases. Nearly 49% of patients were seen during the summer of 2015 alone and seven patients in this group needed hospitalization. Reasons for hospitalization included systemic symptoms such as fever, chills, tachycardia, and muscle spasms. Two patients developed severe cellulitis, one patient had an anaphylactic reaction, and one was admitted to the ICU after suffering an anaphylactic reaction to a sting sustained while surfing. CONCLUSION: The prevalence of the jellyfish swarms and the severity of clinical manifestations because of their envenomations suggest that it should be considered as a health hazard in the Mediterranean Sea. We call for public health authorities in affected countries to initiate a health hazards database, familiarize medical and healthcare staff with the clinical syndromes, train medical and healthcare staff` in appropriate treatment, and initiate and continue public awareness campaigns.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.013 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".