Epidemiological Characterization of Patients in the First Eight Weeks Following Detection of SARS-CoV-2 B.1.1.529 (omicron) Variant in Cuba.

INTRODUCTION: In November 2021, omicron-a new SARS-CoV-2 variant-was identified in South Africa and almost immediately, WHO declared it a 'variant of concern'. In view of its rapid worldwide spread and its imminent introduction in Cuba, genomic surveillance was strengthened. OBJECTIVE: Describe cases during the first eight epidemiological weeks (epiweeks) of SARS-CoV-2 infection attributable to omicron variant in Cuba by clinical and epidemiological variables. METHODS: From epiweek 48, 2021 to epiweek 4, 2022, 288 nasopharyngeal swabs were processed for sequencing of a 1836 bp fragment of the S gene. Variants were identified according to GISAID database and confirmed by phylogenetic analysis. Variants' association with clinical and epidemiological outcomes was assessed. RESULTS: The first cases of omicron variant were imported, mostly from African countries and the United States. During the period studied, omicron was detected in 83.0% (239/288) of cases processed, while the delta variant was found in 17.0% (49/288). Most persons infected with omicron were symptomatic (63.2%; 151/239) and fully vaccinated (65.3%; 156/239); severe cases and deaths occurred mainly among patients aged ≥65 years (92.9%; 13/14), and 12 of these deaths occurred in fully vaccinated persons (92.3%; 12/13). Omicron spread rapidly throughout the country (from 10% of cases in epiweek 48, 2021, to 100% by epiweek 4, 2022), displacing the formerly predominant delta variant. CONCLUSIONS: Omicron's rapid expansion in Cuba was associated with increased incidence but not with a higher case fatality rate. The relatively milder disease in those infected with this variant could be influenced by the high vaccination coverage, along with the natural immunity acquired as a consequence of previous virus infection.

Genetic diversification of an invasive honey bee ectoparasite across sympatric and allopatric host populations.

Invasive parasites are major threats to biodiversity. The honey bee ectoparasite, Varroa destructor, has shifted host and spread almost globally several decades ago. This pest is generally considered to be the main global threat to Western honey bees, Apis mellifera, although the damages it causes are not equivalent in all its new host's populations. Due to the high virulence of this parasite and the viruses it vectors, beekeepers generally rely on acaricide treatments to keep their colonies alive. However, some populations of A. mellifera can survive without anthropogenic mite control, through the expression of diverse resistance and tolerance traits. Such surviving colonies are currently found throughout the globe, with the biggest populations being found in Sub-Saharan Africa and Latin America. Recently, genetic differences between mite populations infesting surviving and treated A. mellifera colonies in Europe were found, suggesting that adaptations of honey bees drive mite evolution. Yet, the prevalence of such co-evolutionary adaptations in other invasive populations of V. destructor remain unknown. Using the previous data from Europe and novel genetic data from V. destructor populations in South America and Africa, we here investigated whether mites display signs of adaptations to different host populations of diverse origins and undergoing differing management. Our results show that, contrary to the differences previously documented in Europe, mites infesting treated and untreated honey bee populations in Africa and South America are genetically similar. However, strong levels of genetic differentiation were found when comparing mites across continents, suggesting ongoing allopatric speciation despite a recent spread from genetically homogenous lineages. This study provides novel insights into the co-evolution of V. destructor and A. mellifera, and confirms that these species are ideal to investigate coevolution in newly established host-parasite systems.

When a Tritrophic Interaction Goes Wrong to the Third Level: Xanthoxylin From Trees Causes the Honeybee Larval Mortality in Colonies Affected by the River Disease.

The "River Disease" (RD), a disorder impacting honeybee colonies located close to waterways with abundant riparian vegetation (including Sebastiania schottiana, Euphorbiaceae), kills newly hatched larvae. Forager bees from RD-affected colonies collect honeydew excretions from Epormenis cestri (Hemiptera: Flatidae), a planthopper feeding on trees of S. schottiana. First-instar honeybee larvae fed with this honeydew died. Thus, we postulated that the nectars of RD-affected colonies had a natural toxin coming from either E. cestri or S. schottiana. An untargeted metabolomics characterization of fresh nectars extracts from colonies with and without RD allowed to pinpoint xanthoxylin as one of the chemicals present in higher amounts in nectar from RD-affected colonies than in nectars from healthy colonies. Besides, xanthoxylin was also found in the aerial parts of S. schottiana and the honeydew excreted by E. cestri feeding on this tree. A larva feeding assay where xanthoxylin-enriched diets were offered to 1st instar larvae showed that larvae died in the same proportion as larvae did when offered enriched diets with nectars from RD-colonies. These findings demonstrate that a xenobiotic can mimic the RD syndrome in honeybee larvae and provide evidence of an interspecific flow of xanthoxylin among three trophic levels. Further, our results give information that can be considered when implementing measures to control this honeybee disease.

Intra-Colonial Viral Infections in Western Honey Bees (Apis Mellifera).

RNA viruses play a significant role in the current high losses of pollinators. Although many studies have focused on the epidemiology of western honey bee (Apis mellifera) viruses at the colony level, the dynamics of virus infection within colonies remains poorly explored. In this study, the two main variants of the ubiquitous honey bee virus DWV as well as three major honey bee viruses (SBV, ABPV and BQCV) were analyzed from Varroa-destructor-parasitized pupae. More precisely, RT-qPCR was used to quantify and compare virus genome copies across honey bee pupae at the individual and subfamily levels (i.e., patrilines, sharing the same mother queen but with different drones as fathers). Additionally, virus genome copies were compared in cells parasitized by reproducing and non-reproducing mite foundresses to assess the role of this vector. Only DWV was detected in the samples, and the two variants of this virus significantly differed when comparing the sampling period, colonies and patrilines. Moreover, DWV-A and DWV-B exhibited different infection patterns, reflecting contrasting dynamics. Altogether, these results provide new insight into honey bee diseases and stress the need for more studies about the mechanisms of intra-colonial disease variation in social insects.

Parasites and RNA viruses in wild and laboratory reared bumble bees Bombus pauloensis (Hymenoptera: Apidae) from Uruguay.

Bumble bees (Bombus spp.) are important pollinators insects involved in the maintenance of natural ecosystems and food production. Bombus pauloensis is a widely distributed species in South America, that recently began to be managed and commercialized in this region. The movement of colonies within or between countries may favor the dissemination of parasites and pathogens, putting into risk while populations of B. pauloensis and other native species. In this study, wild B. pauloensis queens and workers, and laboratory reared workers were screened for the presence of phoretic mites, internal parasites (microsporidia, protists, nematodes and parasitoids) and RNA viruses (Black queen cell virus (BQCV), Deformed wing virus (DWV), Acute paralysis virus (ABCV) and Sacbrood virus (SBV)). Bumble bee queens showed the highest number of mite species, and it was the only group where Conopidae and S. bombi were detected. In the case of microsporidia, a higher prevalence of N. ceranae was detected in field workers. Finally, the bumble bees presented the four RNA viruses studied for A. mellifera, in proportions similar to those previously reported in this species. Those results highlight the risks of spillover among the different species of pollinators.

Same-day discharge on laparoscopic Roux-en-Y gastric bypass patients: an outcomes review.

INTRODUCTION: The objective of this research was to study safety and outcomes in patients who underwent laparoscopic Roux-en-Y gastric bypass (LRYGB) on an ambulatory outpatient basis. As the prevalence of morbid obesity increases, more patients are opting for surgical weight loss as a means to combat their chronic disease. There are several studies demonstrating the safety and feasibility of select patients undergoing LRYGB on a 23-h outpatient basis, but few studies exist regarding the safety and efficacy of these procedures being performed on an ambulatory outpatient basis. METHODS: A retrospective review was completed on all patients who underwent a laparoscopic gastric bypass procedure from 2008 to 2018 at a single outpatient ambulatory surgery center. Median BMI was 46.7 kg/m2. Inclusion criteria included age > 18 and < 65, ASA class less than 3, completion of a bariatric surgery preparation program, no history of major cardiovascular events, and no prior major open abdominal operations. Exclusion criteria included males > 55 years, BMI > 55 for men, and BMI > 60 for women. Operations included primary LRYGB procedures. We determined 30-day post-operative morbidity and mortality for all patients. RESULTS: There were 398 patients who underwent a LRYGB on an ambulatory basis. After thorough chart review, a total of 362 patients were included. The majority were women (315, 87%). The median age was 42 (range 19-65). Seven (1.93%) patients were directly admitted to the hospital, while 13 (3.59%) patients were admitted to the hospital after initial discharge. There were 3 (0.83%) leaks, 4 (1.11%) bleeds requiring transfusion, no wound infections, 1 (0.28%) obstruction, one (0.28%) venous thrombotic event and/or pulmonary embolism, and 9 (2.49%) reoperations. There were zero deaths. CONCLUSIONS: This study demonstrates that laparoscopic Roux-en-Y gastric bypass is both feasible and safe when performed on select patients on an ambulatory outpatient basis.

Behavioral Genetics of the Interactions between Apis mellifera and Varroa destructor.

The western honeybee Apis mellifera exhibits a diverse set of adaptations in response to infestations by its most virulent disease-causing agent, the ectoparasitic mite Varroa destructor. In this study, we investigated the effect of honeybee pupae genotype on the expression of four host and parasite traits that are associated with the reproductive phase of the mite in the brood of its host. We first phenotyped cells containing bee pupae to assess their infestation status, their infestation level, the reproductive status of the mites, and the recapping of cells by adult workers. We then genotyped individual pupae with five microsatellites markers to compare these phenotypes across full sister groups. We found that the four phenotypes varied significantly in time but did not across the subfamilies within the colonies. These findings show that V. destructor mites do not differentially infest or reproduce on some particular honeybee patrilines, and that workers do not target preferentially specific pupae genotypes when performing recapping. These findings bring new insights that can help designing sustainable mite control strategies through breeding and provide new insights into the interactions between A. mellifera and V. destructor.

Microbiology can be comic.

For microbiologists, the importance of microorganisms in our daily lives and their impact on our well-being is evident. However, microbiology literacy in our society is far from being enough for individuals to make informed choices and to demand actions based on that information. The vaccine hesitation movement and the alarming increase in antimicrobial resistance due to overuse and misuse of antibiotics are just two examples of how much work is needed to make our society literate in topics related to microbiology. Considering the challenges of communicating a discipline surrounded by misconceptions, which studies the role of living organisms that cannot be seen in plain sight, we need to explore different strategies to effectively contribute to microbiology literacy in our society. Here, we will comment on the use of comics for such a task.

Estado de los parámetros de habla en usuarios con enfermedad pulmonar obstructiva crónica (EPOC), reporte de una serie de casos / State of speech parameters in subjects with chronic obstructive pulmonary disease (COPD): a case-series report

Objetivo: Caracterizar los parámetros de habla en pacientes con enfermedad pulmonar obstructiva crónica (EPOC). Materiales y métodos: Serie de casos prospectiva. En todos los pacientes se realizó una evaluación de los siguientes parámetros del habla: tiempo máximo fonatorio, control motor oral, articulación, lectura, diadococinesias verbales y habla automática. Todos ellos fueron descritos a través de media, mediana y desviación estándar con el software SPSS versión 23. Resultados: Al estudio ingresaron 20 sujetos (7 hombres y 13 mujeres), edad promedio 64,4±9,1 años. En cuanto a los parámetros de habla se observó una reducción en tiempo máximo de fonación (TMF) en /s/ 6,58±6,76; /a/7,29±5,08; /i/8,24±5,72, lo mismo ocurrió en las tareas de repetición /pa/12,60±3,36; /ta/13,40±3,4, /ka/12±4,11 y número de palabras por minuto 109±26,25. Conclusiones: Los resultados de este estudio sugieren que los pacientes con EPOC presentan un deterioro en los parámetros del habla, lo que representa una posibilidad de ampliar investigaciones en esta línea y con ello considerar el habla en atención clínica integral

Objective: To characterize the speech parameters in patients with chronic obstructive pulmonary disease (COPD). Materials and methods: A prospective case-series study. All patients underwent an evaluation of the following speech parameters: maximum phonation time, oral-motor control, articulation, reading, verbal diadochokinesia, and automatic speech. The mean, median and standard deviation of these parameters were determined using SPSS software version 23. Results: Twenty (20) subjects (7 males and 13 females) whose average age was 64.4 ± 9.1 years entered the study. The speech parameters showed a reduction in the maximum phonation time (MPT) in /s/ 6.58 ± 6.76, /a/ 7.29 ±5.08, /i/ 8.24 ± 5.72. The same happened in the repetition tasks: /pa/ 12.60 ± 3.36, /ta/ 13.40 ± 3.4, /ka/ 12 ±4.11, and the number of words per minute accounted for 109 ± 26.25. Conclusions: The study results suggest that patients with COPD show an impairment in speech parameters. This represents an opportunity to increase research on this topic and thus consider the speech in the comprehensive clinical care.

Revisión de caso clínico desde una mirada sistémica / Clinical case review from a systemic view: clinical meeting

Paciente ELENA, 21 años. embarazo 27 semanas, separada, 4 intentos suicidas previos. Fue usuaria del programa de salud mental infantil y adulto Hospital el Pino (HEP). Hospitalizada en H. de día el año 2017. Año 2013, Alucinaciones auditivas y visuales y desajustes conductuales: Grita, rompe cosas, se pega en la cabeza. Comienza a aislarse y a faltar al colegio y atribuye sus síntomas a consumo de marihuana. Principales focos de terapia son: Disminuir situaciones de crisis y adherencia al tratamiento. Presenta mala adherencia a controles y fármacos de salud mental. Se deriva a Hospital de día. Rorschach muestra desarrollo anormal de la personalidad con rasgos histriónicos, juicio de realidad conservado y dificultad en capacidad de empatizar. Salud mental adulto: (Julio, 2015): Heridas autolíticas (cortes y rasguños), Ideas pasivas de muerte. Intervenciones desde hospital de día: Manejo de crisis, trabajar en vínculo simbiótico con madre; recibe atención por psiquiatra, terapeuta ocupacional, psicólogo y nutricionista, incluyendo intervenciones en equipo. Controles en ambulatorio (Nov 2015): Impresiona mayor conciencia de enfermedad. Abandona fármacos al sentirse mejor. Foco orientado a: Autorregulación emocional y entrenamiento cognitivo para manejo de síntomas ansiosos.

ELENA, 21 years old. Pregnancy 27 weeks, separate, 4 previous suicide attempts. She was a member of the children and mental health program Hospital el Pino (HEP). Hospitalized in Day Hospital in year 2017. 2013: Auditory and visual hallucinations and behavioral maladjustments: Screams, breaks things, hits herself in the head. She begins to isolate and to miss to the school and attributes her symptoms to consumption of marijuana. Main focuses of therapy are: To reduce crisis situations and adherence to treatment. She has poor adherence to mental health drugs and controls. She is derived to day hospital. Rorschach shows abnormal personality development with histrionic traits, a reality-preserved judgment, and difficulty in empathizing. Adult mental health: (July, 2015): Self-injuries (cuts and scratches), Passive death ideas. Interventions in day hospital: Crisis management, working in symbiotic relationship with mother; receives attention by psychiatrist, occupational therapist, psychologist and nutritionist, Including team interventions. Outpatient Control (Nov 2015): Increased awareness of illness. Abandon drugs because of feeling better. Focus oriented to: Emotional self-regulation and cognitive training for the management of anxious symptoms.

Epormenis cestri secretions in Sebastiania schottiana trees cause mass death of honey bee Apis mellifera larvae in Uruguay.

For more than 60 years, sporadic cases of massive summer honey bee larvae mortality in colonies located near freshwater systems with abundant riparian vegetation have been reported in Uruguay. This odd phenomenon, known as "River disease" by beekeepers, can lead to colony death by depopulation. The aim of this study was to detect the causes of larvae death. Different experiments and analyses were performed using affected apiaries located between two important water courses. 1 day old larvae were the most susceptible and substances that killed the larvae were present in the nectar but not in the pollen. A palynological analysis of nectar samples showed that bees collect this resource from commonly pollinated floral species in the country. However, abundant fungi spores and conidia were found, which indicates that the bees also collected honeydews. In the riparian vegetation, bees were observed collecting the secretions of the planthopper Epormenis cestri on Sebastiania schottiana trees. It was found that the mortality period of larvae overlaps with the presence of E. cestri. Larvae maintained in the laboratory were fed (i) nectar from healthy colonies, (ii) nectar from affected colonies, and (iii) secretions of E. cestri. The mortality of the larvae that received nectar from colonies affected with River disease and secretions of E. cestri was higher than the mortality of those receiving nectar from healthy colonies. This represents the first report of planthopper honeydew causing mass larval mortality in honey bees.

Metalloprotease production by Paenibacillus larvae during the infection of honeybee larvae.

American foulbrood is a bacterial disease of worldwide distribution that affects larvae of the honeybee Apis mellifera. The causative agent is the Gram-positive, spore-forming bacterium Paenibacillus larvae. Several authors have proposed that P. larvae secretes metalloproteases that are involved in the larval degradation that occurs after infection. The aim of the present work was to evaluate the production of a metalloprotease by P. larvae during larval infection. First, the complete gene encoding a metalloprotease was identified in the P. larvae genome and its distribution was evaluated by PCR in a collection of P. larvae isolates from different geographical regions. Then, the complete gene was amplified, cloned and overexpressed, and the recombinant metalloprotease was purified and used to generate anti-metalloprotease antibodies. Metalloprotease production was evaluated by immunofluorescence and fluorescence in situ hybridization. The gene encoding a P. larvae metalloprotease was widely distributed in isolates from different geographical origins in Uruguay and Argentina. Metalloprotease was detected inside P. larvae vegetative cells, on the surface of P. larvae spores and secreted to the external growth medium. Its production was also confirmed in vivo, during the infection of honeybee larvae. This protein was able to hydrolyse milk proteins as described for P. larvae, suggesting that could be involved in larval degradation. This work contributes to the knowledge of the pathogenicity mechanisms of a bacterium of great economic significance and is one step in the characterization of potential P. larvae virulence factors.

Paenibacillus larvae enolase as a virulence factor in honeybee larvae infection.

Paenibacillus larvae is a gram-positive spore-forming bacteria, causative agent of American Foulbrood (AFB), a severe disease affecting larvae of the honeybee Apis mellifera. In an attempt to detect potential virulence factors secreted by P. larvae, we identified an enolase among different secreted proteins. Although this protein is a cytosolic enzyme involved in glycolytic pathways, it has been related to virulence. The aim of the present work was to evaluate its role during the infection of honeybee larvae. Toxicity assays showed that enolase was highly toxic and immunogenic to honeybee larvae. Its production was detected inside P. larvae vegetative cells, on the surface of P. larvae spores and secreted to the external growth medium. P. larvae enolase production was also confirmed in vivo, during the infection of honeybee larvae. This protein was able to hydrolyze milk proteins as described for P. larvae, suggesting that could be involved in larval degradation, maybe through the plasmin(ogen) system. These results suggest that P. larvae enolase may have a role in virulence and could contribute to a general insight about insect-pathogen interaction mechanisms.