Malnutrition and Nutrition Support in Latin American PICUs: The Nutrition in PICU (NutriPIC) Study.

OBJECTIVES: To characterize the nutritional status of children admitted to Latin American (LA) PICUs and to describe the adequacy of nutrition support in reference to contemporary international recommendations. DESIGN: The Nutrition in PICU (NutriPIC) study was a combined point-prevalence study of malnutrition carried out on 1 day in 2021 (Monday 8 November) and a retrospective cohort study of adequacy of nutritional support in the week preceding. SETTING: Four-one PICUs in 13 LA countries. PATIENTS: Patients already admitted to the PICU of 1 month to 18 years old on the study day were included in the point-prevalence study. For the retrospective arm, we included patients receiving nutritional support on the study day and with a PICU length of stay (LOS) greater than or equal to 72 hours. Exclusion criteria were being a neonate, conditions that precluded accurate anthropometric measurements, and PICU LOS greater than 14 days. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Of 316 patients screened, 5 did not meet age criteria. There were 191 of 311 patients who were included in the point-prevalence study and underwent anthropometric evaluation. Underweight and length for age less than -2 z scores were present in 42 of 88 children (47.7%) and 41 of 88 children (46.6%) less than 24 months old, and 14 of 103 (13.6%) and (23/103) 22.3% of 103 children greater than or equal to 24 months, respectively. Evidence of obesity (body mass index > 2 z score) was present in 7 of 88 children (5.7%) less than 24 months old and 13 of 103 children (12.6%) greater than or equal to 24 months. In the 115 of 311 patients meeting criteria for the retrospective arm, a total of 98 patients reported complete nutritional data. The 7-day median (interquartile range) adequacy for delivered versus recommended enteral energy and protein requirement was 114% (75, 154) and 99% (60, 133), respectively. CONCLUSIONS: The NutriPIC study found that in 2021 malnutrition was highly prevalent especially in PICU admissions of less than 24 months old. Retrospectively, the 7-day median nutritional support appears to meet both energy and protein requirements.

Abundance and distribution patterns of cetaceans and their overlap with vessel traffic in the Humboldt Current Ecosystem, Chile.

The Humboldt Current Ecosystem (HCE) is one of the most productive marine ecosystems, sustaining one of the largest fishing industries in the world. Although several species of cetaceans are known to inhabit these productive waters, quantitative assessments of their abundance and distribution patterns are scarce and patchy. Here, we present the first abundance and distribution estimates for fin whale (Balaenoptera physalus), southeast Pacific blue whales (Balaenoptera musculus), sperm whale (Physeter macrocephalus), dusky dolphin (Lagenorhynchus obscurus), and common dolphin (Delphinus spp.) in the entire Chilean portion of the HCE. Line transect surveys were conducted during 2016-2021 between 18° S and 41° S and up to ~ 200 km offshore, and data were analyzed using distance sampling methods. Group counts were modelled as a function of environmental variables using single step Bayesian Binomial N-mixture model (BNMM), which allows full uncertainty propagation between model components. By using spatially explicit predictions of cetacean densities and observed vessel densities in the HCE, we provide quantitative assessments on the relative probability of cetaceans encountering vessels (RPCEV). Dusky dolphin and fin whale showed the largest distribution overlap with industrial and artisanal fishery fleets. Our results highlight areas where effort should be prioritized to address the extant but unquantified negative interactions between vessels and cetaceans in Chilean HCE.

A first assessment of the distribution and abundance of large pelagic species at Cocos Ridge seamounts (Eastern Tropical Pacific) using drifting pelagic baited remote cameras.

Understanding the link between seamounts and large pelagic species (LPS) may provide important insights for the conservation of these species in open water ecosystems. The seamounts along the Cocos Ridge in the Eastern Tropical Pacific (ETP) ocean are thought to be ecologically important aggregation sites for LPS when moving between Cocos Island (Costa Rica) and Galapagos Islands (Ecuador). However, to date, research efforts to quantify the abundance and distribution patterns of LPS beyond the borders of these two oceanic Marine Protected Areas (MPAs) have been limited. This study used drifting-pelagic baited remote underwater video stations (BRUVS) to investigate the distribution and relative abundance of LPS at Cocos Ridge seamounts. Our drifting-pelagic BRUVS recorded a total of 21 species including elasmobranchs, small and large teleosts, dolphins and one sea turtle; of which four species are currently threatened. Depth of seamount summit was the most significant driver for LPS richness and abundance which were significantly higher at shallow seamounts (< 400 m) compared to deeper ones (> 400m). Distance to nearest MPA was also a significant predictor for LPS abundance, which increased at increasing distances from the nearest MPA. Our results suggest that the Cocos Ridge seamounts, specifically Paramount and West Cocos which had the highest LPS richness and abundance, are important aggregation sites for LPS in the ETP. However, further research is still needed to demonstrate a positive association between LPS and Cocos Ridge seamounts. Our findings showed that drifting pelagic BRUVS are an effective tool to survey LPS in fully pelagic ecosystems of the ETP. This study represents the first step towards the standardization of this technique throughout the region.

Identifying genetic lineages through shape: An example in a cosmopolitan marine turtle species using geometric morphometrics.

The green turtle (Chelonia mydas) is a globally distributed marine species whose evolutionary history has been molded by geological events and oceanographic and climate changes. Divergence between Atlantic and Pacific clades has been associated with the uplift of the Panama Isthmus, and inside the Pacific region, a biogeographic barrier located west of Hawaii has restricted the gene flow between Central/Eastern and Western Pacific populations. We investigated the carapace shape of C. mydas from individuals of Atlantic, Eastern Pacific, and Western Pacific genetic lineages using geometric morphometrics to evaluate congruence between external morphology and species' phylogeography. Furthermore, we assessed the variation of carapace shape according to foraging grounds. Three morphologically distinctive groups were observed which aligned with predictions based on the species' lineages, suggesting a substantial genetic influence on carapace shape. Based on the relationship between this trait and genetic lineages, we propose the existence of at least three distinct morphotypes of C. mydas. Well-defined groups in some foraging grounds (Galapagos, Costa Rica and New Zealand) may suggest that ecological or environmental conditions in these sites could also be influencing carapace shape in C. mydas. Geometric morphometrics is a suitable tool to differentiate genetic lineages in this cosmopolitan marine species. Consequently, this study opens new possibilities to explore and test ecological and evolutionary hypotheses in species with wide morphological variation and broad geographic distribution range.

Sample acidification has a predictable effect on isotopic ratios of particulate organic matter along the Chilean coast.

RATIONALE: Stable isotopes of carbon and nitrogen have proved to be valuable tools for researchers working across the different subfields of ecology. However, the chemical pretreatment of samples prior to analytical determination of stable isotope ratios can influence the results, and therefore conclusions regarding the ecology of the taxon or system under study. Here, we determined the effect of vapor acidification with concentrated HCl on the δ13 C and δ15 N values of particulate organic matter (POM), which are commonly used as baselines for studies of trophic ecology, or to understand oceanographic patterns. METHODS: Samples of marine POM were obtained along a large-scale latitudinal gradient (ca 3000 km) along the Chilean coast, along with a range of oceanographic variables thought to potentially influence inorganic carbon at each sampling location. A random subset of 50 samples was divided into two parts: one acidified by HCl fumigation treatment, and the other acting as a control. We compared paired differences in δ13 C and δ15 N values measured by continuous flow isotope ratio mass spectrometry and used a model selection approach to examine which oceanographic factor best explained shifts in values following acid treatment. RESULTS: Acidification resulted in statistically significant reductions in both δ13 C and δ15 N values, but the effect was relatively small. The model that best explained the differences between acidified and non-acidified δ13 C values included depth, salinity and sea-surface temperature at the sampling point. A regression of acidified on non-acidified δ13 C values shows that the treatment effect was strongest on samples more depleted in 13 C. CONCLUSIONS: The differences between δ13 C and δ15 N values in acidified and non-acidified samples are linear and predictable. This implies that the nature of the POM and its possible alteration during the acid treatment are important factors that support the reliable determination of the values of δ13 C and δ15 N of POM.

Population structure and phylogeography reveal pathways of colonization by a migratory marine reptile (Chelonia mydas) in the central and eastern Pacific.

Climate, behavior, ecology, and oceanography shape patterns of biodiversity in marine faunas in the absence of obvious geographic barriers. Marine turtles are an example of highly migratory creatures with deep evolutionary lineages and complex life histories that span both terrestrial and marine environments. Previous studies have focused on the deep isolation of evolutionary lineages (>3 mya) through vicariance; however, little attention has been given to the pathways of colonization of the eastern Pacific and the processes that have shaped diversity within the most recent evolutionary time. We sequenced 770 bp of the mtDNA control region to examine the stock structure and phylogeography of 545 green turtles from eight different rookeries in the central and eastern Pacific. We found significant differentiation between the geographically separated nesting populations and identified five distinct stocks (F ST = 0.08-0.44, P < 0.005). Central and eastern Pacific Chelonia mydas form a monophyletic group containing 3 subclades, with Hawaii more closely related to the eastern Pacific than western Pacific populations. The split between sampled central/eastern and western Pacific haplotypes was estimated at around 0.34 mya, suggesting that the Pacific region west of Hawaii has been a more formidable barrier to gene flow in C. mydas than the East Pacific Barrier. Our results suggest that the eastern Pacific was colonized from the western Pacific via the Central North Pacific and that the Revillagigedos Islands provided a stepping-stone for radiation of green turtles from the Hawaiian Archipelago to the eastern Pacific. Our results fit with a broader paradigm that has been described for marine biodiversity, where oceanic islands, such as Hawaii and Revillagigedo, rather than being peripheral evolutionary "graveyards", serve as sources and recipients of diversity and provide a mechanism for further radiation.

Prevalence of functional gastrointestinal disorders in women who report domestic violence to the police.

BACKGROUND & AIMS: Retrospective studies found an association between past sexual, physical, or psychological abuse and functional gastrointestinal disorders (FGIDs). However, there are no studies evaluating such an association concurrently with the ongoing abuse. Our aim was to investigate the prevalence of the main FGIDs, functional dyspepsia and irritable bowel syndrome, in 70 women reporting a situation of domestic violence to the police and to evaluate the level of psychological distress and its relationship with the presence of FGID. METHODS: Through an interview between a social worker and the woman reporting abuse, digestive symptoms, psychological status, and type of abuse were recorded. These data were matched against police records. Functional dyspepsia and irritable bowel syndrome were diagnosed according to Rome II criteria. RESULTS: Seventy-one percent of the women had an FGID: 67% functional dyspepsia, 47% irritable bowel syndrome, and 43% both. In two thirds of the cases, FGID onset occurred simultaneously with or soon after abuse onset. Only 34% of the women had sought medical attention for FGID symptoms. No differences were found between women with or without FGID regarding age and type or duration of abuse; psychological distress tended to be more severe in the group of women with FGIDs. CONCLUSIONS: Most women who suffer domestic violence (reported to the police) have functional dyspepsia and/or irritable bowel syndrome and also have elevated psychological distress. This has important implications, not only for comprehensive health care of women in a situation of abuse, but also for medical treatment of women with FGIDs.