Drift Algal Accumulation in Ice Scour Pits Provides an Underestimated Ecological Subsidy in a Novel Antarctic Soft-Sediment Habitat.

Ice scouring is one of the strongest agents of disturbance in nearshore environments at high latitudes. In depths, less than 20 m, grounding icebergs reshape the soft-sediment seabed by gouging furrows called ice pits. Large amounts of drift algae (up to 5.6 kg/m2) that would otherwise be transported to deeper water accumulate inside these features, representing an underestimated subsidy. Our work documents the distribution and dimensions of ice pits in Fildes Bay, Antarctica, and evaluates their relationship to the biomass and species composition of algae found within them. It also assesses the rates of deposition and advective loss of algae in the pits. The 17 ice pits found in the study area covered only 4.2% of the seabed but contained 98% of drift algal biomass, i.e., 60 times the density (kg/m2) of the surrounding seabed. Larger ice pits had larger and denser algal accumulations than small pits and had different species compositions. The accumulations were stable over time: experimentally cleared pits regained initial biomass levels after one year, and advective loss was less than 15% annually. Further research is needed to understand the impacts of ice scouring and subsequent algal retention on ecosystem functioning in this rapidly changing polar environment.

Bedside Methods for Transpyloric Feeding Tube Insertion in Hospitalized Children: A Systematic Review of Randomized and non-Randomized Trials.

PROBLEM: Enteral nutrition is a critical component of therapy for many hospitalized children. Some children, especially those with critical illness, require post-pyloric enteral nutrition, but placement of post-pyloric feeding tubes poses challenges, necessitating costly fluoroscopy procedures and delaying initiation of enteral nutrition. There is no established standard method for pediatric transpyloric tube placement at the bedside. ELIGIBILITY CRITERIA: We searched for trials that assessed the efficacy of methods for transpyloric tube placement at the bedside. Studies that evaluated gastric insufflation, prokinetic agents, pH guided devices, and electromagnetic devices with an objective of bedside transpyloric tube placement in children ages one month to 18 years were included. RESULTS: After each author independently reviewed the search results, we agreed on fourteen articles for inclusion, consisting of six randomized controlled trials, five quasi-experimental studies, and three cohort studies. Intervention protocols varied, both within and between studies, with most trials incorporating more than one variable in the intervention. CONCLUSIONS: The heterogeneity of the research does not provide clear direction about best practices. All interventions demonstrated some efficacy, with the exception of erythromycin. Gastric insufflation, the most prevalent intervention studied, is safe and at least moderately effective. The research demonstrates the positive impact of a small, trained team of personnel for the insertion of a transpyloric tube. IMPLICATIONS: High quality studies with clear protocols evaluating a single variable are needed in order to establish a bedside transpyloric tube placement protocol. We recommend studies on the efficacy of a dedicated team for this procedure.

An Outbreak Investigation of Scombrotoxin Fish Poisoning Illnesses in the United States Linked to Yellowfin Tuna Imported from Vietnam-2019.

ABSTRACT: Scombrotoxin fish poisoning (SFP) is caused by the ingestion of certain fish species with elevated concentrations of histamine due to decomposition. In fall 2019, the U.S. Food and Drug Administration (FDA) was notified of 51 SFP cases including two hospitalizations from 11 states through the FDA consumer complaint system or directly from state partners. A case patient was defined as an individual who experienced a histamine-type reaction after consumption of tuna imported from Vietnam and an illness onset between 14 August and 24 November 2019. A traceback investigation was initiated at 19 points of service to identify a common tuna source. The FDA and state partners collected 34 product samples throughout the distribution chain, including from a case patient's home, points of service, distributors, and the port of entry. Samples were analyzed for histamine by sensory evaluation and/or chemical testing. Case patients reported exposure to tuna imported from Vietnam. The traceback investigation identified two Vietnamese manufacturers as the sources of the tuna. Twenty-nine samples were confirmed as decomposed by sensory evaluation and/or were positive for elevated histamine concentrations by chemical testing. Both Vietnamese companies were placed on an import alert. Seven U.S. companies and one Vietnamese company initiated voluntary recalls. The FDA released public communication naming the U.S. importers to help suppliers and distributors identify the product and effectuate the foreign company's recall. This SFP outbreak investigation highlights the complexities of the federal outbreak response, specifically related to imported food. Cultural considerations regarding imported foods should be addressed during outbreak responses when timing is critical. Collaboration with countries where confidentiality agreements are not in place can limit information sharing and the speed of public health responses.