Large size (>100-μm) microplastics are not biomagnifying in coastal marine food webs of British Columbia, Canada

Microplastics (MPs) contamination in marine environments is of increasing concern, as plastic particles are globally ubiquitous across ecosystems. A large variety of aquatic taxa ingest MPs, but the extent to which animals accumulate and transfer MPs through food webs is largely unknown. In this study, we quantified MP uptake in bivalves, crabs, echinoderms, and fish feeding at different trophic levels at three sites on southern Vancouver Island. We paired stable-isotope food web analysis with MP concentrations in digestive tracts across all trophic levels and in fish livers. We then used Bayesian generalized linear mixed models to explore whether bioaccumulation and biomagnification were occurring. Our results showed that MPs (100-5000 μm along their longest dimension) are not biomagnifying in marine coastal food webs, with no correlation between the digestive tract or fish liver MP concentrations and trophic position of the various species. Ecological traits did, however, affect microplastic accumulation in digestive tracts, with suspension feeder and smaller-bodied planktivorous fish ingesting more MPs by body weight. Trophic transfer occurred between prey and predator for rockfish, but higher concentrations in full stomachs compared with empty ones suggested rapid excretion of ingested MPs. Collectively, our findings suggested the movement of MP through marine food webs is facilitated by species-specific mechanisms, with contamination susceptibility a function of species biology, not trophic position. Furthermore, the statistical methods we employ, including machine learning for classifying unknown particles and a probabilistic way to account for background contamination, are universally applicable to the study of microplastics. Our findings advance understanding of how MPs enter and move through aquatic food webs, suggesting that lower-trophic-level animals are more at risk of ingesting >100-μm MPs, relative to higher-trophic-level animals. Our work also highlights the need to advance the study of <100-μm MPs, which are still poorly understood and may need to be considered separately in ecological risk assessments.

Increase in Rate of Hospitalizations for Pediatric Intentional Acetaminophen Ingestion at a Single Center During the COVID-19 Pandemic

OBJECTIVES

Social disruption due to COVID-19 has detrimentally affected American adolescents' emotional well-being. Within our system, pediatric acetaminophen ingestions increased in 2020, compared with previous years. We sought to evaluate the rate of hospitalizations for acetaminophen self-harm ingestions and self-harm of adolescents during the COVID-19 pandemic.

STUDY DESIGN

We identified patients (aged 0-23) from billing data with diagnosis of acetaminophen ingestion with self-harm intent (ICD-10 code T391X2A), from a multicenter urban, quaternary health care system. We performed retrospective chart review from 2016 to 2020 and performed statistics using a generalized estimating equation (GEE) logistic regression model.

RESULTS

From 2016 to 2020, there were 25 790 discharges of adolescents with 65 acetaminophen self-harm ingestion and 148 self-harm discharges. Of the 65 acetaminophen patients, 75% identified as female and 54% identified as non-white; 71% with Medicaid insurance. The proportion of acetaminophen ingestion and self-harm admissions increased from 0.13% in 2016 to 0.46% by 2020 and 0.42% in 2016 to 0.73% by 2020, respectively. The odds of acetaminophen ingestion admission increased by 28% each additional year (odds ratio = 1.28; 95% confidence interval: 1.08, 1.53; P = .006). There was not enough evidence to conclude that the log-odds of a self-harm ingestion were linearly related to time (P = .06).

CONCLUSIONS

Acetaminophen ingestion for self-harm has significantly increased, while overall self-harm has increased to a lesser, nonsignificant degree. Primarily females of color and those with Medicaid insurance are affected. It is important to note this growing, disturbing trend, and to continue to screen for depression in our adolescent community and ensure access to mental health resources.

Toxicological Assessment of Cellulose Nanomaterials: Oral Exposure

Cellulose nanomaterials (CNMs) have emerged recently as an important group of sustainable bio-based nanomaterials (NMs) with potential applications in multiple sectors, including the food, food packaging, and biomedical fields. The widening of these applications leads to increased human oral exposure to these NMs and, potentially, to adverse health outcomes. Presently, the potential hazards regarding oral exposure to CNMs are insufficiently characterised. There is a need to understand and manage the potential adverse effects that might result from the ingestion of CNMs before products using CNMs reach commercialisation. This work reviews the potential applications of CNMs in the food and biomedical sectors along with the existing toxicological in vitro and in vivo studies, while also identifying current knowledge gaps. Relevant considerations when performing toxicological studies following oral exposure to CNMs are highlighted. An increasing number of studies have been published in the last years, overall showing that ingested CNMs are not toxic to the gastrointestinal tract (GIT), suggestive of the biocompatibility of the majority of the tested CNMs. However, in vitro and in vivo genotoxicity studies, as well as long-term carcinogenic or reproductive toxicity studies, are not yet available. These studies are needed to support a wider use of CNMs in applications that can lead to human oral ingestion, thereby promoting a safe and sustainable-by-design approach.

Multispecies Assessment of Anthropogenic Particle Ingestion in a Marine Protected Area

We have applied a multispecies ecosystem approach to analyse the ingestion of anthropogenic particles (AP) in the gastrointestinal tract of 313 individuals (17 fish species and 8 invertebrate species) from pelagic, demersal and benthic habitats in a marine protected area off the Western Mediterranean (Cabrera National Park). We have quantified and characterized the ingestion at several taxonomic levels of fish, sea urchins, sea cucumbers, bivalves, and jellyfish in relation to biotic/abiotic factors based on taxonomic groups, trophic guilds (functional groups) and habitats. AP ingestion occurrence ranged from 26 to 100% with no significant differences among taxonomic groups. The fish within the MPA showed an overall ingestion occurrence ranging from 0 to 100%, the echinoderms from 29 to 100%, the bivalves from 72 to 96% and the jellyfish 36% ingestion. The ecosystem approach applied to evaluate overall AP ingestion within the species reported that for trophic guilds, the omnivorous species ingested the highest amounts of anthropogenic items, while herbivores ingested significantly fewer items than all other trophic guilds. Moreover, no significant differences were found amongst habitats, indicating a homogeneous spatial distribution of APs at all studied habitats. The multispecies approach provided insight into the high APs exposure to species within Cabrera MPA, highlighting the potential harm linked with marine litter that threatens marine biodiversity.

Incineration-Generated Polyethylene Micro-Nanoplastics Increase Triglyceride Lipolysis and Absorption in an In Vitro Small Intestinal Epithelium Model

Despite mounting evidence of micro-nanoplastics (MNPs) in food and drinking water, little is known of the potential health risks of ingested MNPs, and nothing is known of their potential impact on nutrient digestion and absorption. We assessed the effects of environmentally relevant secondary MNPs generated by incineration of polyethylene (PE-I), on digestion and absorption of fat in a high fat food model using a 3-phase in vitro simulated digestion coupled with a tri-culture small intestinal epithelium model. The presence of 400 μg/mL PE-I increased fat digestion by 33% and increased fat absorption by 147 and 145% 1 and 2 h after exposure. Analysis of the PE-I lipid corona during digestion revealed predominantly triacylglycerols with enrichment of fatty acids in the small intestinal phase. Protein corona analysis showed enrichment of triacylglycerol lipase and depletion of β-casein in the small intestinal phase. These findings suggest digestion of triacylglycerol by lipase on the surface of lipid-coated MNPs as a potential mechanism. Further studies are needed to investigate the mechanisms underlying the greater observed increase in fat absorption, to verify these results in an animal model, and to determine the MNP properties governing their effects on lipid digestion and absorption.

Accidental ingestion of 3% hydrogen peroxide in the neonatal period

Hydrogen peroxide (H₂O₂₎ is an oxidizing agent. High concentrations of H₂O₂ are used in the chemical industry, and 3% concentrations are used in household disinfectants. Severe H₂O₂ toxicity occurs with a 35% concentration. After poisoning with H₂O₂, corrosive damage occurs. We describe a 3-day-old male who ingested H₂O₂ accidentally and was treated with supportive care. Hydrogen peroxide intoxication usually occurs in adults accidentally. This is the first report of a newborn case of H₂O₂ ingestion.

Using Postmeal Measures and Manipulations to Investigate Hippocampal Mnemonic Control of Eating Behavior

Episodic meal-related memories provide the brain with a powerful mechanism for tracking and controlling eating behavior because they contain a detailed record of recent energy intake that likely outlasts the physiological signals generated by feeding bouts. This review briefly summarizes evidence from human participants showing that episodic meal-related memory limits later eating behavior and then describes our research aimed at investigating whether hippocampal neurons mediate the inhibitory effects of meal-related memory on subsequent feeding. Our approach has been inspired by pioneering work conducted by Ivan Izquierdo and others who used posttraining manipulations to investigate memory consolidation. This review describes the rationale and value of posttraining manipulations, how Izquierdo used them to demonstrate that dorsal hippocampal (dHC) neurons are critical for memory consolidation, and how we have adapted this strategy to investigate whether dHC neurons are necessary for mnemonic control of energy intake. I describe our evidence showing that ingestion activates the molecular processes necessary for synaptic plasticity and memory during the early postprandial period, when the memory of the meal would be undergoing consolidation, and then summarize our findings showing that neural activity in dHC neurons is critical during the early postprandial period for limiting future intake. Collectively, our evidence supports the hypothesis that dHC neurons mediate the inhibitory effects of ingestion-related memory on future intake and demonstrates that post-experience memory modulation is not confined to artificial laboratory memory tasks.

Assessment of the Radiological Health Risk Due to the 226Ra Content in Drinking Water from the Calabria Region, Southern Italy

In this article, the authors report experimental results obtained for the assessment of the ²²⁶Ra content in 80 drinking water samples from the Calabria region, Southern Italy. The activity concentration, measured with the Perkin Elmer Tricarb 4910 TR Liquid Scintillation Counter (LSC) setup, was compared with the reference values reported in the Italian Legislative Decree 28/2016 in order to evaluate any possible radiological health hazards for the population in terms of ²²⁶Ra content due to the ingestion of the investigated drinking water. The obtained results put in evidence that the average ²²⁶Ra specific activity is lower than the LSC minimum detectable activity (MDA) in all cases, thus, excluding any radiological risk. They also represent the main reference for the investigated area and can be used as a baseline to extend this investigation to the whole region.

Toxicologic Concerns with Current Medical Nanoparticles

Nanotechnology is one of the scientific advances in technology. Nanoparticles (NPs) are small materials ranging from 1 to 100 nm. When the shape of the supplied nanoparticles changes, the physiological response of the cells can be very different. Several characteristics of NPs such as the composition, surface chemistry, surface charge, and shape are also important parameters affecting the toxicity of nanomaterials. This review covered specific topics that address the effects of NPs on nanomedicine. Furthermore, mechanisms of different types of nanomaterial-induced cytotoxicities were described. The distributions of different NPs in organs and their adverse effects were also emphasized. This review provides insight into the scientific community interested in nano(bio)technology, nanomedicine, and nanotoxicology. The content may also be of interest to a broad range of scientists.

Identifying contamination versus ingestion in hair testing, with cocaine as example

When developing a procedure to identify external contamination of hair as opposed to drug that is in hair from ingestion, there are components of the process that must be considered in the final method. A method that does not achieve the objective may be missing one or more of these elements: choice of solvent, a drug-binding agent, ratio of solvent to hair, temperature, time, intactness of the hair, and establishing, for the chosen method, a criterion based on the drug contents of the wash and hair that indicates the hair may be contaminated.

Mechanical compensation in the evolution of the early hominin feeding apparatus

Australopiths, a group of hominins from the Plio-Pleistocene of Africa, are characterized by derived traits in their crania hypothesized to strengthen the facial skeleton against feeding loads and increase the efficiency of bite force production. The crania of robust australopiths are further thought to be stronger and more efficient than those of gracile australopiths. Results of prior mechanical analyses have been broadly consistent with this hypothesis, but here we show that the predictions of the hypothesis with respect to mechanical strength are not met: some gracile australopith crania are as strong as that of a robust australopith, and the strength of gracile australopith crania overlaps substantially with that of chimpanzee crania. We hypothesize that the evolution of cranial traits that increased the efficiency of bite force production in australopiths may have simultaneously weakened the face, leading to the compensatory evolution of additional traits that reinforced the facial skeleton. The evolution of facial form in early hominins can therefore be thought of as an interplay between the need to increase the efficiency of bite force production and the need to maintain the structural integrity of the face.

Human Health Risk Assessment from Lead Exposure through Consumption of Raw Cow Milk from Free-Range Cattle Reared in the Vicinity of a Lead-Zinc Mine in Kabwe

Lead (Pb) contamination in the environment affects both humans and animals. Chronic exposure to Pb via dietary intake of animal products such as milk from contaminated areas poses a health risk to consumers; therefore, the present study investigated Pb contamination in cow milk and its health risk impact on humans through consumption of milk from cattle reared in the proximity of a Pb−Zn mine in Kabwe, Zambia. Fresh milk samples were collected from cows from Kang’omba (KN), Kafulamse (KF), Mpima (MP), Mukobeko (MK), and Munga (MN) farming areas. Pb determination was performed using Graphite Flame Absorption Atomic Spectrophotometry (GFAAS). Cow milk Pb levels showed different concentration patterns according to season, distance, and location of the farms from the Pb−Zn mine. The overall mean Pb levels were ranged 0.60−2.22 µg/kg and 0.50−4.24 µg/kg in the wet and dry seasons, respectively. The mean Pb concentration, chronic daily intake (CDIs), target hazard quotients (THQs), and incremental lifetime cancer risk (ILCR) results obtained were all within the permissible limits of 20 µg/kg, 3 and 12.5 µg/kg-BW/day, <1 and 10−4 to10−6, respectively. In conclusion, although Pb was detected in milk from cows reared in Kabwe, the health risk effects of Pb exposure associated with the consumption of milk in both adults and children were negligible.

Fate and Effects of Macro- and Microplastics in Coastal Wetlands

Coastal wetlands trap plastics from terrestrial and marine sources, but the stocks of plastics and their impacts on coastal wetlands are poorly known. We evaluated the stocks, fate, and biological and biogeochemical effects of plastics in coastal wetlands with plastic abundance data from 112 studies. The representative abundance of plastics that occurs in coastal wetland sediments and is ingested by marine animals reaches 156.7 and 98.3 items kg^-1, respectively, 200 times higher than that (0.43 items kg^-1) in the water column. Plastics are more abundant in mangrove forests and tidal marshes than in tidal flats and seagrass meadows. The variation in plastic abundance is related to climatic and geographic zones, seasons, and population density or plastic waste management. The abundance of plastics ingested by pelagic and demersal fish increases with fish length and dry weight. The dominant characteristics of plastics ingested by marine animals are correlated with those found in coastal wetland sediments. Microplastics exert negative effects on biota abundance and mangrove survival but positive effects on sediment nutrients, leaf drop, and carbon emission. We highlight that plastic pollution is widespread in coastal wetlands and actions are urged to include microplastics in ecosystem health and degradation assessment.

Impacts of ingested MWCNT-Embedded nanocomposites in Japanese medaka (Oryzias latipes)

Polymer nanocomposites combine the versatile, lightweight characteristics of polymers with the properties of nanomaterials. Polyethylene terephthalate glycol (PETG) is commonly used in polymer additive manufacturing due to its controllable transparency, high modulus, and mechanical properties. Multi-walled carbon nanotubes (MWCNTs) add tensile strength, electrical conductivity, and thermal stability. The increased use of nanocomposites has led to concern over potential human health risks. We assessed morphologic alterations to determine impacts of ingested abraded nanocomposites compared to its component materials, pristine MWCNTs (1000 mg/L) and PETG. Adult transparent Japanese medaka (Oryzias latipes) were administered materials via oral gavage in 7 doses over 16 days. In vivo observations revealed altered livers and gallbladders following exposure to pristine MWCNTs and nanocomposites. Subsequent histologic sections showed fish exposed to pristine MWCNTs had highly altered biliary structures, and exposure to nanocomposites resulted in hepatocellular alteration. Thyroid follicle proliferation was also observed in fish exposed to materials containing MWCNTs. Transmission electron microscopy of livers showed that hepatocytes of fish exposed to MWCNTs had widespread swelling of rough endoplasmic reticulum, pronounced lysosomal activity, and swelling of intrahepatic biliary passageways. Fish exposed to nanocomposites had areas of degenerated hepatocytes with interspersed cellular debris. Each analysis showed that fish exposed to pristine PETG were most similar to controls. These results suggest that MWCNTs are the source of toxicity in abraded nanocomposite materials but that nanocomposites may also have some unique effects. The similarities of many teleost and mammalian tissues are such that these findings may indicate human health risks.

Microplastic contamination in Great Lakes fish

Freshwater ecosystems, generally adjacent to human population and more contaminated relative to adjacent marine ecosystems, are vulnerable to microplastic contamination. We sampled 7 species of fish from Lake Ontario and Lake Superior and assessed their gastrointestinal (GI) tracts to quantify ingested microplastics and other anthropogenic particles. A subset of the microparticles were chemically analyzed to confirm polymer types and anthropogenic origins. We documented the highest concentration of microplastics and other anthropogenic microparticles ever reported in bony fish. We found 12,442 anthropogenic microparticles across 212 fish (8 species) from nearshore Lake Ontario, 943 across 50 fish (1 species) from Humber River, and 3094 across 119 fish (7 species) from Lake Superior. Fish from Lake Ontario had the greatest mean abundance of anthropogenic microparticles in their GI tracts (59 particles/fish [SD 104]), with up to 915 microparticles in a single fish. Fish from Lake Superior contained a mean [SD] of 26 [74] particles/fish, and fish from Humber River contained 19 [14] particles/fish. Most particles were microfibers. Overall, ≥90% of particles were anthropogenic, of which 35-59% were microplastics. Polyethylene (24%), polyethylene terephthalate (20%), and polypropylene (18%) were the most common microplastics. Ingestion of anthropogenic particles was significantly different among species within Lake Ontario (p < 0.05), and the abundance of anthropogenic particles increased as fish length increased in Lake Ontario (ρ = 0.62). Although we cannot extrapolate the concentration of microplastics in the water and sediments of these fish, the relatively high abundance of microplastics in the GI tracts of fish suggests environmental exposure may be above threshold concentrations for risk.

Spontaneous Partial Percutaneous Extrusion of Swallowed Metallic long Spoon: A Case Report

Foreign body ingestion is a commonly encountered clinical challenge. Most of these objects pass spontaneously, but long objects could be retained leading to uncommon complications. There seem to be no record of percutaneous extrusion of ingested spoon in literature. We report a case of 20 year old lady who swallowed a long metallic spoon. It got retained in the stomach for a month without obstructive symptoms, until the tail end of it eroded onto the skin. It was retrieved through an open gastrotomy. Patient had an uneventful postoperative recovery. Clinicians should be mindful that ingested large foreign bodies may be delayed in presentation. Whereas our index patient had open surgery, minimally invasive retrieval approaches could be considered when comparable cases are encountered.

A Methodology for Calculation of Internal Dose Following Exposure to Radioactive Fallout from the Detonation of a Nuclear Fission Device

ABSTRACT

The purpose of this paper is to provide a methodology for the calculation of internal doses of radiation following exposure to radioactive fallout from the detonation of a nuclear fission device. Reliance is on methodology previously published in the open literature or in reports not readily available, though some new analysis is also included. Herein, we present two methodologic variations: one simpler to implement, the other more difficult but more flexible. The intention is to provide in one place a comprehensive methodology. Pathways considered are (1) the ingestion of vegetables and fruits contaminated by fallout directly, (2) the ingestion of vegetables and fruits contaminated by continuing deposition by rain- or irrigation-splash and resuspension, (3) the ingestion of vegetables and fruits contaminated by absorption of radionuclides by roots after tillage of soil, (4) the non-equilibrium transfer of short-lived radionuclides through the cow-milk and goat-milk food chains, (5) the equilibrium transfer of long lived radionuclides through milk and meat food chains, and (6) inhalation of descending fallout. Uncertainty in calculated results is considered. This is one of six companion papers that describe a comprehensive methodology for assessing both external and internal dose following exposures to fallout from a nuclear detonation. Input required to implement the dose-estimation model for any particular location consists of an estimate of the post-detonation external gamma-exposure rate and an estimate of the time of arrival of the fallout cloud. The additional data required to make such calculations are included in the six companion papers.

Parameter Values for Estimation of Internal Doses from Ingestion of Radioactive Fallout from Nuclear Detonations

ABSTRACT

This paper suggests values or probability distributions for a variety of parameters used in estimating internal doses from radioactive fallout due to ingestion of food. Parameters include those needed to assess the interception and initial retention of radionuclides by vegetation, translocation of deposited radionuclides to edible plant parts, root uptake by plants, transfer of radionuclides from vegetation into milk and meat, transfer of radionuclides into non-agricultural plants and wildlife, and transfer from food and drinking water to mother's milk (human breast milk). The paper includes discussions of the weathering half-life for contamination on plant surfaces, biological half-lives of organisms, food processing (culinary factors), and contamination of drinking water. As appropriate, and as information exists, parameter values or distributions are specific for elements, chemical forms, plant types, or other relevant characteristics. Information has been obtained from the open literature and from publications of the International Atomic Energy Agency. These values and probability distributions are intended to be generic; they should be reviewed for applicability to a given location, time period, or season of the year, as appropriate. In particular, agricultural practices and dietary habits may vary considerably both with geography and over time in a given location.

Endoscopic, laboratory, and clinical findings and outcomes of caustic ingestion in adults; a retrospective study

Aim

Compared to the prevalence and complications, there is still limited evidence in this regard.

Background

With an incidence rate of 200,000 cases annually and the induction of numerous complications, caustic ingestion imposes a significant burden on the healthcare system. Apart from being fatal in some cases, this injury affects its victims' quality of life as it is followed by many gastrointestinal problems. This injury mainly occurs accidentally among children, whereas in adults, it often occurs with suicidal intentions. Despite recent advances in internal medicine, gastroenterology, and toxicology, this type of injury remains a debilitating and, in some cases, fatal disorder for its victims.

Methods

This study retrospectively evaluated the clinical, laboratory, and endoscopic findings of 150 patients admitted to a referral center of toxicology and forensic medicine and assessed factors associated with each type of injury.

Results

The findings indicated a mortality rate as high as 7.3% in this population. Age, pH, and previous medical conditions were associated with more complications. Higher degrees of injury were also significantly associated with higher mortality. No significant difference was observed between types of corrosive substances.

Conclusion

It seems that the most effective intervention for controlling caustic ingestion injuries would be psychiatric support, primary healthcare, and household education.

Cardiac and respiratory arrest in a 12-year-old girl with acute permethrin oral toxicity: A case report

Permethrin (PER) is widely employed as the most frequently used type I synthetic pyrethroid insecticide. Despite its worldwide application, reports of pediatric toxicity following permethrin administration are scarce. The present report describes the case of a 12-year-old girl with cardiac and respiratory arrest resulting from self-induced oral toxicity by permethrin.

Occurrence of Disinfection By-Products in Swimming Pools in the Area of Thessaloniki, Northern Greece. Assessment of Multi-Pathway Exposure and Risk

This study investigated the occurrence of disinfection by-products (DBPs) (trihalomethanes (THMs), haloacetic acids (HAAs), halonitriles (HANs), halonitromethane (TCNM) and haloketones (HKs)) in different type of swimming pools in the area of Thessaloniki, northern Greece by employing the EPA methods 551.1 and 552.3. Moreover, general water quality parameters (pH, residual chlorine, dissolved organic carbon, UV₂₅₄ absorption, total nitrogen, alkalinity and conductivity) were also measured. The concentrations of DBPs showed great variability among swimming pools as well as within the same pool between sampling campaigns. HAAs exhibited the highest concentrations followed by THMs, HANs, TCNM and HKs. Exposure doses for four age groups (3–<6 y, 6–<11 y, 11–<16 y and adults) were calculated. Route-specific exposures varied among DBPs groups. Inhalation was the dominant exposure route to THMs and TCNM (up to 92–95%). Ingestion and dermal absorption were the main exposure routes to HAAs (40–82% and 18–59%, respectively), depending on the age of swimmers. HANs contributed up to 75% to the calculated cytotoxicity of pool water. Hazard indices for different exposure routes were <1, suggesting non-carcinogenic risk. Inhalation posed the higher carcinogenic risk for THMs, whereas risk via oral and dermal routes was low. Ingestion and dermal contact posed the higher risk for HAAs. Risk management strategies that minimise DBPs exposure without compromising disinfection efficiency in swimming pools are necessary.

Foreign Body Ingestion in Children: Epidemiological, Clinical Features and Outcome in a Third Level Emergency Department

Ingestion of foreign bodies is a frequent pediatric cause of access to the Emergency Department (ED). The aim of this study was to determine the epidemiological and clinical features of pediatric patients with a diagnosis of foreign body ingestion and to identify the factors associated with an urgent invasive procedure or hospitalization. This is a retrospective study conducted on a population of 286 pediatric patients (0-17 years) evaluated for foreign body ingestion at the Pediatric ED of "Fondazione Policlinico Universitario A. Gemelli, IRCSS" between October 2014 and June 2019. Data concerning age and gender, underlying diseases, type of foreign body, symptoms and signs, instrumental tests, specialist visits, treatment and outcome were analyzed. The majority of foreign bodies were coins (23%). Symptoms recurred in 50% of the foreign bodies with esophageal localization and between the 92 (32%) patients with symptoms the most common was vomiting (7%). X-rays was performed in 61% of patients. Among all patients, 253 patients (88.8%) had been discharged, 21 (7%) had been hospitalized, and four (1.4%) were sent to an outpatient facility. Besides, 17 (5.9%) patients had been transferred to the Observation Unit. Of the hospitalized patients (21 (7.3%)), clinical observation was performed for 57% and endoscopic procedure for 45%. Our data confirm that the ESPGHAN-ESGE guidelines application prevents interventions that are not necessary, avoiding diagnostic and therapeutic delays.

Comparison of three Coxiella burnetii infectious routes in mice

Evidence suggests that Coxiella burnetii, which is shed in the milk, urine, feces, and birth products of infected domestic ruminants, can lead to Q fever disease following consumption of unpasteurized dairy products; however, C. burnetii is not believed to be a major gastrointestinal pathogen. Most infections are associated with inhalation of aerosols generated from the excreta of domestic ruminants. We recently demonstrated that C. burnetii delivered by oral gavage (OG) resulted in dissemination and an immune response; however, it is unclear how infection via the oral route compares to other well-established routes. Therefore, we delivered three strains of C. burnetii (representing three pertinent sequence types in the United States, such as ST16, ST20, and ST8) to immunocompetent mice in four doses via aerosol challenge (AC), intraperitoneal injection (IP), or OG. Low dose (10^5) of ST16 by OG was insufficient to cause infection, yet doses 1,000- or 100-fold lower by IP or AC, respectively, induced a robust immune response and dissemination. Despite being able to induce an immune response in a dose-dependent manner, administration of C. burnetii via OG is the least efficient route tested. Not only were the immune responses and bacterial loads diminished in mice exposed by OG relative to AC or IP, the efficiency of transmission was also inferior. High doses (10^8) were not sufficient to ensure transmission to 100% of the ST20 or ST8 cohorts. These results may provide some basis for why ingestion of C. burnetii as a mode of Q fever transmission is not often reported.

Grit your teeth and chew your food: Implications of food material properties and abrasives for rates of dental microwear formation in laboratory Sapajus apella (Primates)

Dental microwear analysis has been employed in studies of a wide range of modern and fossil animals, yielding insights into the biology/ecology of those taxa. Some researchers have suggested that dental microwear patterns ultimately relate back to the material properties of the foods being consumed, whereas others have suggested that, because exogenous grit is harder than organic materials in food, grit should have an overwhelming impact on dental microwear patterns. To shed light on this issue, laboratory-based feeding experiments were conducted on tufted capuchin monkeys [Sapajus apella] with dental impressions taken before and after consumption of different artificial foods. The foods were (1) brittle custom-made biscuits laced with either of two differently-sized aluminum silicate abrasives, and (2) ductile custom-made "gummies" laced with either of the two same abrasives. In both cases, animals were allowed to feed on the foods for 36 hours before follow-up dental impressions were taken. Resultant casts were analyzed using a scanning electron microscope. We asked five questions: (1) would the animals consume different amounts of each food item, (2) what types of dental microwear would be formed, (3) would rates of dental microwear differ between the consumption of biscuits (i.e., brittle) versus gummies (i.e., ductile), (4) would rates of dental microwear differ between foods including larger- versus smaller-grained abrasives, and (5) would rates of dental microwear differ between molar shearing and crushing facets in the animals in these experiments? Results indicated that (1) fewer biscuits were consumed when laced with larger-grained abrasives (as opposed to smaller-grained abrasives), but no such difference was observed in the consumption of gummies, (2) in all cases, a variety of dental microwear features was formed, (3) rates of dental microwear were higher when biscuits versus gummies were consumed, (4) biscuits laced with larger-grained abrasives caused a higher percentage of new features per item consumed, and (5) the only difference between facets occurred with the processing of biscuits, where crushing facets showed a faster rate of wear than shearing facets. These findings suggest that the impact of exogenous grit on dental microwear is the result of a dynamic, complex interaction between (at the very least) grit size, food material properties, and time spent feeding - which is further evidence of the multifactorial nature of dental microwear formation.