Presence of pharmaceutical contaminants of emerging concerns in two rivers of western Cuba and their relationship with the extracellular enzymatic activity of microbial communities

In recent years, the concern derived from the presence of emerging contaminants in the environment and the possible effects on the One Health trilogy has increased. This study determined the concentration of pharmaceutical contaminants of emerging concern and their relationship with the extracellular enzymatic activity of microbial communities from two rivers in western Cuba. Two sampling stations were analyzed; one in the Almendares River (urban) and the other in the San Juan River (rural), taking into account the pollution sources that arrive at these stations and previous physicochemical characterizations. Extracellular protease, acid phosphatase, alkaline phosphatase, lipase, and catalase activities in water and sediments were determined and correlated with contaminants of emerging concern determined by liquid chromatography with mass spectrometry. This study evidenced the presence of different pharmaceutical contaminants found in the categories of antihypertensives, stimulants, anti-inflammatories, and antibiotics in both rivers. Concentrations of contaminants of emerging concern were greater in the Almendares River compared to the San Juan River. In addition, through the canonical redundancy analysis, the influence of these contaminants on the extracellular enzymatic activities of microbial communities was documented, where in most cases they inhibit protease, phosphatase, and lipase activities and enhance catalase activity in response to oxidative stress. The present investigation constitutes the first report in Cuba of the presence of pharmaceutical contaminants of emerging concern and one of the few works that exist in the Latin American region.

An island 'endemic' born out of hybridization between introduced lineages

Humans have profoundly impacted the distribution of plant and animal species over thousands of years. The most direct example of these effects is human-mediated movement of individuals, either through translocation of individuals within their range or through the introduction of species to new habitats. While human involvement may be suspected in species with obvious range disjunctions, it can be difficult to detect natural versus human-mediated dispersal events for populations at the edge of a species' range, and this uncertainty muddles how we understand the evolutionary history of populations and broad biogeographical patterns. Studies combining genetic data with archaeological, linguistic and historical evidence have confirmed prehistoric examples of human-mediated dispersal; however, it is unclear whether these methods can disentangle recent dispersal events, such as species translocated by European colonizers during the past 500 years. We use genomic DNA from historical museum specimens and historical records to evaluate three hypotheses regarding the timing and origin of Northern Bobwhites (Colinus virginianus) in Cuba, whose status as an endemic or introduced population has long been debated. We discovered that bobwhites from southern Mexico arrived in Cuba between the 12th and 16th centuries, followed by the subsequent introduction of bobwhites from the southeastern USA to Cuba between the 18th and 20th centuries. These dates suggest the introduction of bobwhites to Cuba was human-mediated and concomitant with Spanish colonial shipping routes between Veracruz, Mexico and Havana, Cuba during this period. Our results identify endemic Cuban bobwhites as a genetically distinct population born of hybridization between divergent, introduced lineages.

The global, regional, and national burden of foreign bodies from 1990 to 2019: a systematic analysis of the global burden of disease study 2019

BACKGROUND

Foreign bodies (FBs) are a common emergency in medical institutions, that can occur in any area and among people of any age, which are common public health problems. Understanding the epidemiological characteristics of FBs is crucial for their prevention and control. The purpose of this study was to analyze the epidemiological characteristics of FBs worldwide through the data from the Global Burden of Disease Study 2019 (GBD 2019).

METHODS

We obtained data from the GBD 2019, which is an important public database to understand the disease burden of FBs. Joinpoint was used to analyze temporal trends in the incidence and death trends of FBs, which is widely used to study the long-term temporal trend of the burden of diseases. SaTScan was used to detect spatial-temporal clusters of pulmonary aspiration and foreign body in the airway (PAFBA), which is based on a Poisson model, scanning the number of people and diseases in the study area to obtain the spatial-temporal clusters of diseases.

RESULTS

Globally, the age-standardized incidence rate (ASIR) and the age-standardized death rate (ASDR) of FBs in 2019 were 869.23/100,000 (679.92/100,000-1120.69/100,000) and 1.55/100,000 (1.41/100,000-1.67/100,000), respectively. The ASIR and ASDR showed downtrends with average annual percent changes (AAPCs) of -0.31% and - 1.47% from 1990 to 2019. Of note, the ASIR showed an uptrend during 2010-2019, especially in high, high-middle, and middle SDI regions. Stratified analysis by age group showed that ASIR increased in each age group in recent years. From 1990 to 2019, the ASDR in the over-70 age group showed an uptrend worldwide, especially in high and high-middle SDI regions. In different types of FBs, the ASDR of PAFBA was the highest. The death burden of PAFBA was mainly clustered in 82 countries during 1993-2007, such as Canada, Cuba, and Mexico.

CONCLUSION

The most important goal is to improve public awareness and emergency knowledge of FBs through publicity methods, such as the internet or offline activities, and to improve laws and regulations. Additionally, different age groups need different targeted measures, such as strengthening the care of children, caring for elderly individuals, improving necessary monitoring programs and reporting systems, conducting effective hazard assessments, and publicity and education activities.

Seventeen-year study reveals fluctuations in key ecological indicators on two reef crests in Cuba

Reef crests in the Caribbean have lost approximately 80% of the foundational habitat-forming coral Acropora palmata (Lamarck, 1816), with declines registered as early as the 1950s mainly from anthropogenic causes. We studied two reef crests in the northwestern region of Cuba over 17 years (2005 to 2021) to evaluate temporal changes in coral cover, dominated by A. palmata, and their potential drivers. The density of A. palmata generally showed a negative trend at both reefs, with the lowest density recorded in 2021 at 0.2 ± 0.05 col. m-2 at Playa Baracoa and 1.0 ± 0.1 col. m-2 at Rincon de Guanabo. The mean size of the colonies in the two reefs also decreased over time. In Playa Baracoa, the mean diameter of A. palmata colonies decreased from 2012 at 67 ± 5.9 cm to 2013 at 34 ± 2.2 cm, whereas in Rincon de Guanabo, a change in diameter was evident from 2015 at 44.3 ± 2.3 to 2021 at 21.6 ± 0.9 cm. Adult colonies (10 cm-50 cm diameter) predominated in most years on both reefs. The populations of A. palmata on both reefs were healthy, with an average of 70% colonies in good condition during the study period. However, A. palmata cover decreased by almost half by 2021, to 8.6% in Playa Baracoa and 16.8% in Rincon de Guanabo. By contrast, macroalgal cover increased two-fold to 87.1% in Playa Baracoa and four-fold to 77.2% in Rincon de Guanabo. The density of the sea urchin Diadema antillarum was higher in Playa Baracoa than in Rincon de Guanabo. The highest densities were 2.8 ± 0.2 ind. m-2 in Playa Baracoa in 2005 and 0.1 ± 0.03 ind. m-2 in Rincon de Guanabo in 2008. Although our results show an overall decline of A. palmata (density and percent cover) and an increase in macroalgae, these two reef crests are in better condition than most reefs in the Caribbean in terms of the density and health of A. palmata populations, and the density of D. antillarum at Playa Baracoa. Our results are important in establishing a management plan to ensure the condition of these reef crests does not degrade further.

Mechanisms and Challenges

Cuba faces a dilemma between continuing its current portfolio of biotechnology drugs and vaccines with lower profitability or renewing its product portfolio with the associated costs and risks.

Havana syndrome: a scoping review of the existing literature

Since 2016, numerous American and Canadian diplomats and secret (intelligence) agents in Cuba, China, and other places in the world have experienced an abrupt onset of unusual clinical symptoms including, tinnitus, visual problems, vertigo, and cognitive difficulties, after they encountered strange sounds; this has been called "Havana syndrome" (HS). MEDLINE, Scopus, and Ovid databases from 2016 until 24 September 2021 were systematically searched for the related published manuscripts. The following search strategy was implemented: "Havana syndrome" OR "Neurological Symptoms and US Diplomats". The primary search yielded 120 publications. Only five original studies and 18 non-original articles were considered to be relevant. While these studies provided a constellation of signs and symptoms for HS, none provided a good level of evidence. In conclusion, Havana syndrome is a nonspecific neurological illness with an unidentified causative factor(s), an acute phase of auditory-vestibular symptoms and a chronic phase of nonspecific neurobehavioral symptoms. This syndrome should be considered and investigated as a health concern, and not as a political issue.

BioHabana 2022: Preventive and Immunotherapeutic Strategies Against COVID-19 and Cancer in Cuba

The convergence of life sciences with neurosciences, nanotechnology, data management, and engineering has caused a technological diversification of the biotechnology, pharmaceutical, and medical technology industries, including the phenomenon of digital transformation, which has given rise to the so-called Fourth Industrial Revolution (Industry 4.0). Confronting the COVID-19 pandemic revealed the outstanding response capacity of the scientific community and the biopharmaceutical industry, based on a multidisciplinary and interinstitutional approach that has achieved an unprecedented integration in the history of biomedical science. Cuba, a small country, with scarce material resources, has had remarkable success in controlling the disease, which also highlights the impact of social factors. This report presents a summary of the most relevant presentations of selected topics during the scientific meeting, "BioHabana 2022: Cancer Immunotherapy and the COVID-19 Pandemic," which was held in Havana Cuba in April 2022.

Environmental DNA-based biomonitoring of Cuban Crocodylus and their accompanying vertebrate fauna from Zapata Swamp, Cuba

Crocodylians globally face considerable challenges, including population decline and extensive habitat modification. Close monitoring of crocodylian populations and their habitats is imperative for the timely detection of population trends, especially in response to management interventions. Here we use eDNA metabarcoding to identify the Critically Endangered Crocodylus rhombifer and the Vulnerable C. acutus, as well as vertebrate community diversity, in Cuba's Zapata Swamp. We tested four different primer sets, including those used previously in Crocodylus population genetic and phylogenetic research, for their efficiency at detecting crocodylian eDNA. We detected C. rhombifer eDNA in 11 out of 15 sampled locations within its historical geographic distribution. We found that data analyses using the VertCOI primers and the mBRAVE bioinformatics pipeline were the most effective molecular marker and pipeline combination for identifying this species from environmental samples. We also identified 55 vertebrate species in environmental samples across the four bioinformatics pipelines- ~ 85% known to be present in the Zapata ecosystem. Among them were eight species previously undetected in the area and eight alien species, including known predators of hatchling crocodiles (e.g., Clarias sp.) and egg predators (e.g., Mus musculus). This study highlights eDNA metabarcoding as a powerful tool for crocodylian biomonitoring within fragile and diverse ecosystems, particularly where fast, non-invasive methods permit detection in economically important areas and will lead to a better understanding of complex human-crocodile interactions and evaluate habitat suitability for potential reintroductions or recovery programs for threatened crocodylian species.

The diversification of Caribbean Buxus in time and space: elevated speciation rates in lineages that accumulate nickel and spreading to other islands from Cuba in non-obligate ultramafic species

BACKGROUND AND AIMS

The genus Buxus has high levels of endemism in the Caribbean flora, with ~50 taxa. In Cuba, 82 % grow on ultramafic substrates and 59 % are nickel (Ni) accumulators or Ni hyperaccumulators. Hence it is an ideal model group to study if this diversification could be related to adaptation to ultramafic substrates and to Ni hyperaccumulation.

METHODS

We generated a well-resolved molecular phylogeny, including nearly all of the Neotropical and Caribbean Buxus taxa. To obtain robust divergence times we tested for the effects of different calibration scenarios, and we reconstructed ancestral areas and ancestral character states. Phylogenetic trees were examined for trait-independent shifts in diversification rates and we used multi-state models to test for state-dependent speciation and extinction rates. Storms could have contributed to Cuba acting as a species pump and to Buxus reaching other Caribbean islands and northern South America'.

KEY RESULTS

We found a Caribbean Buxus clade with Mexican ancestors, encompassing three major subclades, which started to radiate during the middle Miocene (13.25 Mya). Other Caribbean islands and northern South America were reached from ~3 Mya onwards.

CONCLUSIONS

An evolutionary scenario is evident in which Buxus plants able to grow on ultramafic substrates by exaptation became ultramafic substrate endemics and evolved stepwise from Ni tolerance through Ni accumulation to Ni hyperaccumulation, which has triggered species diversification of Buxus in Cuba. Storms could have contributed to Cuba acting as a species pump and to Buxus reaching other Caribbean islands and northern South America'.

Morphometric responses of two zooxanthellate octocorals along a water quality gradient in the Cuban northwestern coast

Octocoral abundance is increasing on Caribbean reefs, and one of the possible causes is their vertical morphological plasticity that allows them to grow above the substrate to reduce the effect of processes that occur in it (e.g., scour by sediments) as well as adapt to environmental gradients. The aim of this study was to determine the morphometric response of two octocorals species (Eunicea flexuosa and Plexaura kükenthali) with different life strategies in a water quality gradient. The research was carried out between 2008 and 2016 on eight forereefs of northwest Cuba. Different morphometric indicators were measured in the colonies of both species found within a belt transect (100 x 2 m) randomly located at each site. The lowest means in height, diameter, number of terminal branches/colony, cover index, and least arborescent colonies of E. flexuosa were detected at the sites with the greatest anthropogenic pollution. The water quality gradient did not explain the variability of the five morphometric indicators of P. kükenthali. However, hydrodynamic stress was the factor that most negatively affected the morphometry of this species. The chronic effect of poor water quality over time resulted in more small sized colonies of E. flexuosa at the polluted site, probably due to higher mortality. The size distribution of P. kükenthali also showed the same trend but at the sites with greater hydrodynamic stress. These results show that the morphometric response of octocorals along a water quality gradient is species-specific. This study suggests that poor water quality decreases the size and thus availability of habitat provided by octocorals sensitive to that factor (e.g., E. flexuosa) while other tolerant species (e.g., P. kükenthali) could provide the habitat of several organisms in a scenario of increasing anthropogenic pollution.

Economic Sanctions Affecting Household Food and Nutrition Security and Policies to Cope With Them: A Systematic Review

BACKGROUND

This review was conducted to identify the impact of economic sanctions on household food and nutrition security and policies to cope with them in countries exposed to sanctions.

METHODS

The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines 2020 were used to identify, select, appraise, and synthesize studies. Electronic databases in addition to Persian ones have been systematically searched for all related documents published until March 2022. Exclusion criteria were: lack of data related to food insecurity in countries subject to sanction and very low quality of the article. The quality of included studies was assessed using the Joanna Briggs Institute (JBI) Critical Appraisal checklists. The results were presented as qualitative and quantitative syntheses.

RESULTS

Of 1428 identified studies, 36 publications remained in the review, which belong to Iran (n=8), Cuba (n=8), Russia (n=7), Iraq (n=7), and Haiti (n=6), respectively. Declining gross domestic product (GDP), devaluation of the national currency, and the quality of food, increase in inflation, unemployment, and consumer prices, infant and under 5 years mortality, energy, and protein deficiency, and the poverty rate were reported as sanction consequences. The most important strategies to improve food security were the humanitarian assistance provided by the international community (Haiti), equity and priority for vulnerable groups mainly by expanding the healthcare system (Cuba), adopting a food ration system in the oil-for-food program, and fixing the price of food baskets (Iraq), import substitution and self-sufficiency (Russia), support domestic production, direct and indirect support and compensation packages for vulnerable households (the approach of resistance economy in Iran).

CONCLUSION

Due to the heterogeneity of studies, meta-analysis was not possible. Since inadequate physical and economic food access caused by sanctions affects especially disadvantaged and vulnerable groups, planning to improve food security and providing support packages for these groups seems necessary.

Trends of legacy and emerging organic contaminants in a sediment core from Cienfuegos Bay, Cuba, from 1990 to 2015

Legacy and emerging organic pollutants pose an ever-expanding challenge for the marine environment. This study analysed a dated sediment core from Cienfuegos Bay, Cuba, to assess the occurrence of polychlorinated biphenyls (PCBs), organochlorine pesticides (OCPs), polybrominated diphenyl ethers (PBDEs), alternative halogenated flame retardants (aHFRs), organophosphate esters (OPEs), and phthalates (PAEs) from 1990 to 2015. The results evidence the continuing presence of historical regulated contaminants (PCBs, OCPs, and PBDEs) in the southern basin of Cienfuegos Bay. PCB contamination declined since 2007, likely in response to the gradual global phasing out of PCB containing materials. There have been relatively consistent low accumulation rates for OCPs and PBDEs at this location (in 2015 approximately 1.9 and 0.26ng/cm²/year, respectively, with 2.8ng/cm²/year for Σ₆PCBs), with indications of recent local DDT use in response to public health emergencies. In contrast, sharp increases are observed between 2012 and 2015 for the contaminants of emerging concern (PAEs, OPEs, and aHFRs), and in the case of two PAEs (DEHP and DnBP) the concentrations were above the established environmental effect limits for sediment dwelling organisms. These increasing trends reflect the growing global usage of both alternative flame retardants and plasticizer additives. Local drivers for these trends include nearby industrial sources such as a plastic recycling plant, multiple urban waste outfalls, and a cement factory. The limited capacity for solid waste management may also contribute to the high concentrations of emerging contaminants, especially plastic additives. For the most recent year (2015), the accumulation rates for Σ₁₇aHFRs, Σ₁₉PAEs, and Σ₁₇OPEs into sediment at this location were estimated to be 10, 46 000, and 750ng/cm²/year, respectively. This data provides an initial survey of emerging organic contaminants within this understudied region of the world. The increasing temporal trends observed for aHFRs, OPEs, and PAEs highlights the need for further research concerning the rapid influx of these emerging contaminants.

Palpigrades from Cuba (Arachnida: Palpigradi: Eukoeneniidae)

The knowledge of palpigrades in Cuba is limited to the species Eukoenenia orghidani, discovered and described from Cueva de Bellamar. In this work, a survey for palpigrades in the suburbs of La Habana, Cuba revealed three species, Eukoenenia berlesei, Eukoenenia florenciae and a new species described here as Eukoenenia glandulosa sp. nov. Interestingly, the three species coexist in the microspaces of wet soil. A total of 16 arthropod species were identified living in the same microhabitat as the palpigrades.

Dengue outbreak amongst travellers returning from Cuba-GeoSentinel surveillance network, January-September 2022

Increasing numbers of travellers returning from Cuba with dengue virus infection were reported to the GeoSentinel Network from June to September 2022, reflecting an ongoing local outbreak. This report demonstrates the importance of travellers as sentinels of arboviral outbreaks and highlights the need for early identification of travel-related dengue.

Aedes albopictus (Skuse) dispersion in Havana City, Cuba, 1995-2018

Various arboviruses are transmitted to humans by mosquitoes, particularly Aedes aegypti and Aedes albopictus, two invasive and frequently sympatric species. The objective of this study was to evaluate the dispersion and the behavior of Ae. albopictus in relation to houses and its association with other mosquitoes in the province of Havana, Cuba. All water-containing deposits in the houses or vacant lots in urban and peri‑urban municipalities of the province of Havana were sampled during the two study periods: 1995-1999 and 2010-2018. The following patterns in the presence of Ae. albopictus in the study area were observed: a persistent absence of Ae. albopictus in one of the municipalities; a rapid dispersion in the second period, staring from the absence of vector in the first period, in tow other municipalities; and a sustained decrease in the dispersion of Ae.albopictus in two other municipalities. The peripheral municipalities noted the highest presence of Ae. albopictus, but few associations with other mosquitoes. However, overall, we found an increase in this association when comparing the period 2010-2018 with the first period. Ae. albopictus was present in 8% (2016) to 21.5% (2013) inside the houses with an average of 15%, which evidences an initial domiciliation of the species. The results obtained in this work show an initiation of domiciliation of Ae. albopictus in the urban area of the province of Havana. This is important to alert the National Control Program to strengthen the entomological monitoring of Ae. albopictus, and not only Ae. aegypti. The follow-up of this domiciliation is important to guide control efforts, knowing its role as a vector of different arboviruses.

Heavy metals concentration, pollution indexes, and health risk assessment of urban road dust in the historical center of Havana, Cuba

In recent years, the historical center of Old Havana has been under a serious restoration movement which could increase the heavy metal concentrations in street dusts and thus severely impact humans in the area. Therefore, the aim of this work is to study the heavy metal concentrations, pollution indexes, and health risk assessment of urban road dusts from the city in order to assess if this restoration movement is harmful to the citizens and visitors. Street road dust samples were collected at 33 stations for the determination of some heavy metals (Co, Ni, Cu, Zn, and Pb) concentrations using an X-ray fluorescence (XRF) instrument. The mean concentration values of the elements Co, Ni, Cu, Zn, and Pb were 7.0 mg.kg^-1, 60.6 mg.kg^-1, 73.6 mg.kg^-1, 548.7 mg.kg^-1, and 60.8 mg.kg^-1, respectively. Zn and Pb showed higher values of the background. The study of the enrichment factor (EF), the pollution index (IP), and the integral pollution index (IPI) showed some stations with high values of contamination near construction places. Zn was identified as the major pollutant and correlated to the biggest construction places of the municipality at that moment. However, the hazard index (HI) and carcinogenic risk (CR) values do not show the risk of getting non-carcinogenic or carcinogenic diseases associated with the analyzed pollutants. Therefore, it was safely concluded that the big reconstruction movement does not represent a health problem.

To dream or not to dream in Havana: multi-criteria decision-making for material and energy recovery from municipal solid wastes

Currently, solid waste management strategies in Havana are outdated. This paper aimed to select the most suitable alternative for integrating material recovery facilities (MRF) with waste-to-energy technologies in the city of Havana, Cuba. Seven scenarios were considered: combustion, gasification, and hydrothermal carbonization (HTC) with and without carbon capture, and anaerobic digestion (AD). The selection was based on environmental, techno-economic, and social parameters using an analytic hierarchy process (AHP) as a multi-criteria decision-making tool (MCDM). The MCDM-AHP accounted for qualitative criteria (based on experts' judgments) and quantitative (based on Aspen Plus simulation models). From the MRF, 63% of the input recyclable materials were recovered, representing an energy saving of 256 kW-h/t_MSW. The AHP results showed that environmental criteria had the highest priority, resulting in ~63% and ~73% higher than social and techno-economic criteria, respectively. Likewise, from the techno-economic, environmental, and social sub-criteria analysis, investment risk, pollution, and work safety had the major concern compared with the other sub-criteria levels. Overall, MRF+AD was the most suitable scenario (21% preference) for treating Havana's municipal solid waste (MSW), followed by combustion and gasification with carbon capture, respectively. This study confirms that AD is a preference option for emerging economies like Cuba, mainly due to low environmental pollution, high social acceptance, and financial stability in the long term.

Neoadjuvant Trastuzumab and Pertuzumab in Combination with Standard Chemotherapy for HER2-Positive Early Breast Cancer: Real-World Practice in Cuba

PURPOSE

Dual HER2 blockade chemotherapy is the standard of care for localized HER2+ breast cancer (BC). However, despite the efficacy of neoadjuvant therapy, relapses occurring in around 10% of patients highlight the need to improve its clinical approach. Therefore, this study aimed to evaluate the effectiveness/safety of neoadjuvant therapy with subcutaneous (SC) trastuzumab- pertuzumab chemotherapy (real world) to extend the evidence, which comes mainly from clinical trials (selected population; intravenous [IV] trastuzumab).

MATERIALS AND METHODS

A prospective, longitudinal, observational study in a Cuban hospital.

POPULATION

women aged ≥18 years with histologically confirmed HER2+ early-stage BC (2017-2021) eligible for neoadjuvant treatment (IV pertuzumab, SC trastuzumab, taxane-based chemotherapy). The aim was to determine the pathological complete response (pCR) rate to this scheme, its safety, and the impact of patient's characteristics on the outcomes.

RESULTS

Eighty-seven women were included: n=29 (DPT [docetaxel-IV pertuzumab- SC trastuzumab 600 mg; 4 cycles]); n=58 (ddAC-DPT [dose-dense anthracycline-based scheme+DPT]; 8 cycles). The median age was 57 years (range 30-83), ECOG 0: 97%. Time from diagnosis to treatment (median) was 28 days. The overall pCR rate was 62.1% (55.2%, DPT; 66.5%, ddAC-DPT; p =0.351); HR+, 47.7% vs. HR-, 76.7% (p=0.006). There were no statistically significant differences based on nodal status, stage, or Ki-67 levels. Overall, 94.2% of patients experienced ≥1 adverse event related to treatment, all of them grade 1-3 and more common with ddAC-DPT. The main cause of treatment delays (n=19; ddAC-DPT, 16; DPT, 3) was treatment-related toxicities.

CONCLUSION

Neoadjuvant trastuzumab (SC) and pertuzumab plus chemotherapy for HER2+ early-stage BC showed benefits in a real-life setting, with an acceptable safety profile.

Liguus Landscapes: Amateur Liggers, Professional Malacology, and the Social Lives of Snail Sciences

Malacologists took notice of tree snails in the genus Liguus during the last decades of the nineteenth century. Since then, Liguus have undergone repeated shifts in identity as members of species, states, shell collections, backyard gardens, and engineered wildernesses. To understand what Liguus are, this paper examines snail enthusiasts, collectors, researchers, and conservationists-collectively self-identified as Liggers-in their varied landscapes. I argue that Liguus, both in the scientific imaginary and in the material landscape, mediated knowledge-making processes that circulated among amateur and professional malacologists across the United States and Cuba during the twentieth century. Beginning with an examination of early Liggers' work in Florida and Cuba, this paper demonstrates how notions of taxonomy and biogeography informed later efforts to understand Liguus hybridization and conservation. A heterogeneous community of Liggers has had varied and at times contradictory commitments informed by shifting physical, social, and scientific landscapes. Genealogizing those commitments illuminates the factors underpinning a decision to undertake the until now little-chronicled large-scale and sustained transplantation of every living Floridian form of Liguus fasciatus into Everglades National Park. The social history of Liggers and Liguus fundamentally blurs distinctions between professional scientists and amateur naturalists. The experiences of a diverse cast of Liggers and their Liguus snails historicize the complex character of human-animal relations and speak to the increasing endangerment of many similarly range-restricted invertebrates.

Validation and application of the Insulin Treatment Appraisal Scale in Cuban patients with type 2 diabetes mellitus

INTRODUCTION

The purpose of this study was to validate the Insulin Treatment Appraisal Scale (ITAS) in the Cuban population with type 2 diabetes mellitus.

MATERIAL AND METHODS

A cross-sectional, multicentre analytical study was performed in Cuba from February 2020 to April 2021; 199 patients were surveyed in a hospital institution and in primary healthcare. We used the Insulin Treatment Appraisal Scale, consisting of 20 items, with a minimum score of 20 points and a maximum of 100, where the higher the score, the worse the perception of insulin therapy. The validity of the instrument was determined by means of an exploratory factor analysis. The internal consistency and reliability of the scale were calculated by means of Cronbach's alpha coefficient. A K-means cluster analysis was performed to establish a cut-off point for poor perception of insulin therapy.

RESULTS

The exploratory factor analysis supported the validity of the instrument, with a Cronbach's alpha of 0.747. There were statistically significant differences between patients under insulin and non-insulin treatment in terms of the answers given in all items of the scale. The total mean score obtained was 51.96 ± 10.78, and it was lower in insulin users compared to those who used other drugs (49.79 ± 10.07 vs 55.09 ± 11.12). A score ≥65 was proposed as a cut-off point for poor perception of insulin therapy. A positive relationship was found between the body mass index values and the total score of the scale. Being female and current treatment not involving insulin were factors associated with low perception of insulin therapy.

CONCLUSIONS

The instrument proved to be valid for the population in which it was applied. Insulin users turned out to be the ones with the best perception about its use. A cut-off point of ≥65 points for poor perception of insulin treatment was proposed for evaluation and comparison in future studies in other patient populations.

Lessons from Building a Sustainable Healthcare Exchange between the Netherlands and Cuba

Over the past ten years, seven Dutch Universities have built a sustainable exchange with seven institutes in Cuban healthcare. The exchange was initiated by the Leiden University Medical Centre and the University of Medical Sciences of Havana. Cooperation with Cuba was chosen as Cuba has excellent primary healthcare and has a strong focus on prevention and public health. These were considered important due to the major contribution of non-communicable diseases to morbidity and mortality in the Netherlands. Exchanges have occurred with Dutch health professionals and students visiting Cuban healthcare institutions and Cuban postgraduate students studying in the Netherlands. There has been an increased awareness of the importance of public health and prevention in Dutch professional organizations following the exchange. The exchange has also helped to break the scientific and economic US blockade of Cuba and resulted in joint publications. In this review we described the process, key aspects, results and lessons learned in this process. Collaboration between Cuba (a middle income) and the Netherlands (a high-income country) is possible.

Characterization of Insecticide Resistance in Aedes aegypti from the Zoological Garden of Havana, Cuba

Chemical control of Aedes aegypti continues to be an indispensable alternative to preventing dengue, Zika, and chikungunya outbreaks. The Havana Zoological Garden requires constant vigilance because its special characteristics help in the spread of the causal agents of diseases transmitted by mosquitoes, which put the health of visitors at risk. The goals of this study were to determine the level of susceptibility and insecticide resistance mechanisms in the Ae. aegypti population. Temephos susceptibility in larvae was evaluated with bioassays using the World Health Organization's methodology, and susceptibility of adult mosquitoes was determined by the impregnated bottle bioassay, recommended by the Centers for Disease Control and Prevention. Resistance mechanisms were determined with biochemical assays. Mosquito larvae from the Havana Zoo were found resistant to temephos, which was associated with the activity of the enzymes α- and β-esterases and mixed function oxidases but not glutathione-S-transferase. Adult mosquitoes were susceptible to pyrethroid (lambda-cyhalothrin, deltamethrin, and cypermethrin), organophosphate (chlorpyrifos), and carbamate (bendiocarb). Temephos resistance detected in the mosquito population from the Havana Zoo is an alert for the Vector Control Program, which must take measures to manage their resistance, relying on the surveillance carried out by Cuba's medical entomology laboratories.

Community Narrative as a Borderlands Praxis: Anzaldúa's Mestiza Consciousness as Explored in Cortez's Sexile

I apply Gloria Anzaldúa's "borderlands theory" to Jamie Cortez's Sexile, an HIV/AIDS prevention publication created as a first-person narrative of the journey of queer, trans activist Adela Vasquez who fled to the US from Cuba in 1980. I argue that Sexile is a borderlands text and operationalizes Anzaldúa's mestiza consciousness at various levels- ranging from the essence of the text and what its existence represents to the literary techniques used in the telling of Adela's narrative. In the first half of this paper, I explore Anzaldúa's borderlands theory and the ethos of Sexile as a text, including Vázquez's story as inherently a borderland narrative; as a product of democratized knowledge; the praxis of the text's creation; and the technology of the graphic novel. Throughout the second half, I look more closely at the content of the text using close reading to explore notions of the "borderland" represented throughout Adela's narrative. Through both its content and the praxis of creation, Sexile represents the power of graphic medicine in illustrating the nuances of narratives at the interstices of marginalized identities and captures the multitudes and ambiguities of trauma, loss, rebirth, kinship, and joy at the margins.

Heavy metals in soils of Mayabeque, Cuba: multifaceted and hardly discernable contributions from pedogenic and anthropogenic sources

Cuba is a country with considerable potential for economic growth, and special efforts are made to increase the agricultural output. As food production depends on the quality of soils, heavy metal concentrations were measured in 39 soils in the province of Mayabeque, Cuba, and interpreted in light of anthropogenic activities and pedogenic conditions (soil type and properties). With median concentrations of 1.8 Cd, 60.3 Cr, 48.1 Cu, 36.2 Ni, 16.7 Pb, 55.0 Zn, and 0.1 mg/kg Hg, soils of Mayabeque were mostly below Cuban quality reference values (QRV) representing benchmarks of quality standards but no official threshold values. Only Cd concentrations were in many cases above the QRV of 0.6 mg/kg and some Cu concentrations above the one of 83 mg/kg. While Cd, Cr, and Ni concentrations were rather pedogenically driven, Cu, Pb, Zn, and Hg contents were rather anthropogenically influenced. When evaluated statistically, Cd and Cr showed most times a significant influence of both sources. In contrast, Ni and Zn could not be significantly related with the origins investigated in this study. Hence, the allocation of heavy metal concentrations to pedogenic or anthropogenic contamination or pollution sources is tentative and needs further investigations. Nevertheless, the present data adds information on soil heavy metal concentrations in the Caribbean region, serves as reference before further industrial development, and sets the ground for adaptation of the QRV for Cd and possibly future national environmental standards.

10-Years assessment of 7Be and 210Pb in atmospheric bulk depositions in Cienfuegos (Cuba)

10-years records of monthly bulk atmospheric fluxes of ⁷Be and ²¹⁰Pb (wet + dry, n = 119 samples) at a coastal station in Cienfuegos (Cuba) between 2010 and 2019 were reported and assessed in function of their temporal variability and meteorological influence. Fluxes of ⁷Be and ²¹⁰Pb ranged from 120 to 15617 and from 29 to 911 mBq m^-2 day^-1, respectively. Both radionuclides exhibited a similar seasonal trend with highest values during wet months and minimum values during dry months. The removal of ⁷Be and ²¹⁰Pb from the atmosphere was mainly controlled by wet depositions, while dry deposition was estimated to be more important for ²¹⁰Pb (29% of the total bulk deposition) than for ⁷Be (12%). The ²¹⁰Pb/⁷Be ratios (average of 0.10) showed low variability during wet months with abrupt peaks in the driest months with low temperatures and the highest wind speed and pressure, which was mainly attributed to contributions from soil resuspension. The calculated total deposition velocity of aerosols derived from ⁷Be (average of 0.48 cm s^-1) and ²¹⁰Pb (average of 0.47 cm s^-1) was in agreement with values reported in the literature. Multiple linear regression models for the monthly fluxes of ⁷Be and ²¹⁰Pb based on precipitation, temperature and pressure and explaining about 60% of their variances were derived, highlighting the preponderant role of the local and regional conditions on the variability of these radionuclides. The annual fluxes of ⁷Be (209-1901 Bq m^-2 y^-1) and ²¹⁰Pb (35-123 Bq m^-2 y^-1) were in the range of variations observed in other coastal stations worldwide, showing fluctuations affected by changes in the amount of precipitation during the wet periods. ⁷Be annual variability also evidenced a significant modulation with the solar activity.

International Population Study in Spain, Cuba, and the United States of Attitudes Toward Organ Donation Among the Cuban Population

Cuban immigrants constitute an important group in both the United States and Spain, with different behaviors toward organ donation having been described among the different Latin American nationalities. We analyzed the attitude toward organ donation among the Cuban populations in Cuba, Spain, and Florida. The study population was Cuban immigrants over 15 years of age residing in Cuba, Spain, and Florida, with samples randomly stratified by age and sex. A validated questionnaire on psychosocial aspects of organ donation (PCID-DTO Rios) was used. Census was used as the sampling base in all 3 countries; however, additionally, in Spain and the United States (Florida), we sought the support of immigration support associations to determine the Cuban population without legal documentation. The questionnaire was completed anonymously and self-administered. The completion rate of the study was 74% (4123/5574) among 424 surveyed in Spain, 1224 in Florida, and 2475 in Cuba. The attitude in favor of donating their own organs upon death was 60.6% of those surveyed in Spain, 37.6% in Florida, and 68.9% in Cuba, or 58% of the global sample. Multivariate analysis showed that country of residence was an independent factor associated with attitude toward organ donation (odds ratio, 1.929). Other factors associated with attitude were sex, educational level, performance of prosocial activities, knowledge of the brain death concept, religion, the couple's opinion toward donation, fear of mutilation after donation, and attitude toward manipulation of the body after death. The attitude toward organ donation among Cubans in their country of origin and immigrants in Spain was similar, being significantly different from those who emigrate to Florida, where the attitude is much less favorable.

First Report on Microcystin-LR Occurrence in Water Reservoirs of Eastern Cuba, and Environmental Trigger Factors

The factors related to cyanotoxin occurrence and its social impact, with comprehension and risk perception being the most important issues, are not yet completely understood in the Cuban context. The objectives of this research were to determine the risk extension and microcystin-LR levels, and to identify the environmental factors that trigger the toxic cyanobacteria growth and microcystin-LR occurrence in 24 water reservoirs in eastern Cuba. Samplings were performed in the early morning hours, with in situ determination and physicochemical analysis carried out in the laboratory. Microcystin-LR were determined in water and within the cells (intracellular toxins) using UPLC–MS analysis after solid phase extraction. The reservoirs studied were found to be affected by eutrophication, with high levels of TN:TP ratio and phytoplankton cell concentrations, high water temperatures and low transparency, which cause collateral effect such as cyanobacterial bloom and microcystin-LR occurrence. In Hatillo, Chalóns, Parada, Mícara, Baraguá, Cautillo, La Yaya, Guisa and Jaibo reservoirs, concentrations of MC-LR higher than the WHO limits for drinking water (1 µg·L⁻¹), were detected.

Clinical and Psychological Factors Associated With Return to Work Among United States Diplomats Who Sustained a Work-Related Injury While on Assignment in Havana, Cuba

OBJECTIVE

To determine factors associated with return to work in US diplomats injured during a work assignment in Cuba.

METHODS

In this case series work ability was determined at each visit. Questionnaires used included the Symptom Score Questionnaire, Beck Anxiety Inventory, Beck Depression Inventory, Quality-of-Life Inventory, and Patient Health Questionnaire.

RESULTS

Of the 45 employees referred to Occupational Medicine, the mean age was 42.5 years, 60% were men, 68% were never out of work, 22% were out of work for some period, and 15% remain out of work. Vestibular, cognitive, hearing, sleep, and visual symptoms, and a higher initial symptom score were significantly associated with work inability while psychiatric symptoms were not.

CONCLUSIONS

This exposure resulted in prolonged illness with cognitive impairment and other clinical manifestations associated with work inability.

Reliability and clinical utility of the chronic pain classification in the 11th Revision of the International Classification of Diseases from a global perspective: results from India, Cuba, and New Zealand

ABSTRACT

Chronic pain affects 1 in 5 persons and contributes substantially to the global burden of disease. The 11th Revision of the International Classification of Diseases (ICD-11) includes a comprehensive classification of chronic pain. The aim of this ecological implementation field study was to evaluate the classification's interrater reliability and clinical utility in countries with different income levels. The study was conducted in 4 pain clinics in Cuba, India, and New Zealand. Twenty-one clinicians used the ICD-11 to diagnose and code n = 353 patients with chronic pain. Of these, 111 were assessed by 2 clinicians, and Fleiss' kappa was calculated to establish interrater reliability for any diagnosis assigned to ≥15 patients. The clinicians rated the clinical utility of all diagnoses. The interrater reliability could be calculated for 11 diagnoses. It was substantial for 10 diagnoses and moderate for 1 (kappa: 0.596-0.783). The mean clinical utility of the ICD-11 chronic pain diagnoses was rated as 8.45 ± 1.69/10. Clinical utility was rated higher for ICD-11 than for the commonly used classification systems (P < 0.001, η2 = 0.25) and differed between all centers (P < 0.001, η2 = 0.60). The utility of the ICD-11 diagnoses was rated higher than the commonly used diagnoses in Dunedin and Havana, and no difference was found in Kolkata and Hyderabad. The study showed the high interrater reliability of the new chronic pain diagnoses. The perceived clinical utility of the diagnoses indicates their superiority or equality compared with the classification systems currently used in pain clinics. These results suggest the global applicability of the classification in specialized pain treatment settings.

Tracking breastfeeding and weaning practices in ancient populations by combining carbon, nitrogen and oxygen stable isotopes from multiple non-adult tissues

This paper explores the potential of combining different isotope systems from different tissues to improve resolution when reconstructing breastfeeding and weaning practices (BWP) in archaeology. Additionally, we tested whether changes in diet can be detected in deciduous teeth. Rib collagen samples from 22 infants/children from the archaeological site of Bacuranao I (Mayabeque, Cuba) were processed for nitrogen (δ¹⁵N) and carbon (δ¹³C_co) stable isotopes and assessed using a Bayesian model (WARN). In addition, enamel of 48 teeth from 30 infants/children were analyzed for oxygen (δ¹⁸O_en) and carbon (δ¹³C_en) stable isotopes. Data revealed that the timing of weaning cannot be characterized precisely by analyzing either δ¹⁸O or δ¹⁵N. While a depletion in both δ¹⁵N and δ¹³C_co is only evident after one year, the WARN model suggested that the weaning process started at around 3 months and ended around 1.7 years. Most teeth were enriched in δ¹⁸O_en compared to deciduous incisors, suggesting a breastfeeding signal. However, a high variability in δ¹⁸O was found between similar teeth from the same individuals. Higher enrichment in δ¹⁸O_en, and variability, was observed in tissues formed during the first six months of life. A δ¹³C enrichment of 1.0‰ was observed among deciduous teeth and ribs. While most individuals enriched in δ¹⁵N showed enrichment in δ¹³C, the δ¹⁸O values were more variable. Our data suggests that stable isotopes of deciduous teeth, especially δ¹³C_en, can be used to detect changes in diet during the weaning process. It is also possible that the δ¹⁸O enrichment observed in M1 is influenced by the effects of cooking techniques on weaning foods. The combination of multiple isotope systems and tissues overcome some of the limitations posed by single tissue approaches.

Wound Chronicity, Impaired Immunity and Infection in Diabetic Patients

BACKGROUND

Diabetic foot ulcers are a common diabetic complication leading to alarming figures of amputation, disability, and early mortality. The diabetic glucooxidative environment impairs the healing response, promoting the onset of a 'wound chronicity phenotype'. In 50% of ulcers, these non-healing wounds act as an open door for developing infections, a process facilitated by diabetic patients' dysimmunity. Infection can elicit biofilm formation that worsens wound prognosis. How this microorganism community is able to take advantage of underlying diabetic conditions and thrive both within the wound and the diabetic host is an expanding research field.

OBJECTIVES

1) Offer an overview of the major cellular and molecular derangements of the diabetic healing process versus physiological cascades in a non-diabetic host. 2) Describe the main immunopathological aspects of diabetics' immune response and explore how these contribute to wound infection susceptibility. 3) Conceptualize infection and biofilim in diabetic foot ulcers and analyze their dynamic interactions with wound bed cells and matrices, and their systemic effects at the organism level. 4) Offer an integrative conceptual framework of wound-dysimmunity-infection-organism damage.

EVIDENCE AQUISITION

We retrieved 683 articles indexed in Medline/PubMed, SciELO, Bioline International and Google Scholar. 280 articles were selected for discussion under four major subheadings: 1) normal healing processes, 2) impaired healing processes in the diabetic population, 3) diabetic dysimmunity and 4) diabetic foot infection and its interaction with the host.

DEVELOPMENT

The diabetic healing response is heterogeneous, torpid and asynchronous, leading to wound chronicity. The accumulation of senescent cells and a protracted inflammatory profile with a pro-catabolic balance hinder the proliferative response and delay re-epithelialization. Diabetes reduces the immune system's abilities to orchestrate an appropriate antimicrobial response and offers ideal conditions for microbiota establishment and biofilm formation. Biofilm-microbial entrenchment hinders antimicrobial therapy effectiveness, amplifies the host's pre-existing immunodepression, arrests the wound's proliferative phase, increases localized catabolism, prolongs pathogenic inflammation and perpetuates wound chronicity. In such circumstances the infected wound may act as a proinflammatory and pro-oxidant organ superimposed onto the host, which eventually intensifies peripheral insulin resistance and disrupts homeostasis.

CONCLUSIONS

The number of lower-limb amputations remains high worldwide despite continued research efforts on diabetic foot ulcers. Identifying and manipulating the molecular drivers underlying diabetic wound healing failure, and dysimmunity-driven susceptibility to infection will offer more effective therapeutic tools for the diabetic population.

Immunological Resistance of Pseudosuccinea columella Snails From Cuba to Fasciola hepatica (Trematoda) Infection: What We Know and Where We Go on Comparative Molecular and Mechanistic Immunobiology, Ecology and Evolution

One of the most interesting biological models is that of snail–trematode interactions, many of which ultimately result in the transmission of several important diseases, particularly in the tropics. Herein, we review the scientific advances on a trematode–snail system in which certain populations of Pseudosuccinea columella (a common host species for trematodes) have been demonstrated naturally-resistant to Fasciola hepatica, in association with an effective encapsulation of the parasite by innate immune cells of the host, the hemocytes. Emphasis is made on the molecular and immunological features characterizing each P. columella phenotype in relation to their anti-parasitic competence, their distinctive ecological patterns and the existence of a significant cost of resistance. An integrative overview of the resistance to F. hepatica through comparative immunobiology, genetics and ecology is presented to hypothesize on the possible origins and evolution of this phenomenon and to postulate significant roles for parasite mediated-selection and environmental factors in shaping and maintaining the resistant phenotype in the field. Lastly, clues into future experimental perspectives to deeply characterize the interplay between P. columella and F. hepatica and the immunobiology of the resistance are also included. The advances revised in the present paper are only beginning to unravel mechanisms of anti-parasite innate defense responses and their evolutionary bases, and can facilitate the development of prospective approaches towards practical applications of P. columella resistance.

Health-related quality of life in Cuban patients with chronic liver disease: A real-world experience

INTRODUCTION AND OBJECTIVES

Patient-reported outcomes (PROs) are important for comprehensive assessment of chronic liver disease (CLD). Latin America and the Caribbean have a high burden of CLD, but PROs are lacking. We assessed health-related quality of life (HRQL) in Cuban patients with compensated CLD.

MATERIALS AND METHODS

A cross sectional study performed of adult patients with a diagnosis of chronic viral infection B and C (HBV, HCV), non-alcoholic fatty liver diseases (NAFLD) and autoimmune liver diseases (AILD) including autoimmune hepatitis (AIH), primary biliary cholangitis (PBC) and overlap syndrome (AIH+PBC). PROs were collected using: Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F), Work Productivity and Activity-Specific Health Problem (WPAI: SHP), and the Chronic Liver Disease Questionnaire (CLDQ)-disease-specific.

RESULTS

543 patients enrolled, n=91 (HBV), n=188 (HCV), n=221 (NAFLD), n=43 (AILD). Of those with AILD, 22 had AIH, 14 PBC, and 7 overlap AIH/PBC. Mean age was 53.5 years, 64.1% female, 69.2% white, and 58.0% employed. Patients with HCV and AILD had more severe liver disease. A significant impairment in PROs was observed in HCV group whereas the AILD patients had more activity impairment. CLDQ-HRQL scores were significantly lower for patients with NAFLD and AILD compared to HBV. Male gender and exercising ≥90min/week predicted better HRQL. The strongest independent predictors of HRQL impairment were fatigue, abdominal pain, anxiety, and depression (p<0.05).

CONCLUSIONS

HRQL for Cuban patients with compensated CLD differs according to the CLD etiology. Patients with HCV and AILD had the worst PRO scores most likely related to severe underlying liver disease and/or extrahepatic manifestations.

Interfamily Therapy, a multifamily therapy model settled in infant-juvenile mental health services of Havana (Cuba): A qualitative study from participants' perspectives

Interfamily therapy (IFT) is a specific model for multifamily therapy (MFT) of recent expansion in Latin American and European countries. In IFT a multifamily group becomes a community of learning where professionals and family members establish collaborative relationships and participate in dialogues. This study used a qualitative phenomenological approach to explore the participants' perspective of 14 members and ex-members of two IFT groups conducted in Infant-Juvenile Mental Health Centers in Havana (Cuba). In this study IFT was well accepted and effective, and it was perceived as beneficial due to its positive influence for participants, with benefits on a personal, family and social level. In addition, participants articulated a series of therapeutic elements of IFT that were essential to promote these benefits. In conclusion, IFT seems to be a useful therapeutic model in the treatment of children, adolescents and their families in a Cuban psychiatric setting.

Fungal populations in the bedroom dust of children in Havana, Cuba, and its relationship with environmental conditions

The study of the fungal community composition in house dust is useful to assess the accumulative exposure to fungi in indoor environments. The objective of this research was to characterize the fungal diversity of house dust and its association with the environmental conditions of bedrooms. For this, the dust was collected from 41 bedrooms of children between the ages of 8 and 9 with a family history of asthma, residents of Havana, Cuba. The fungal content of each sample was determined by two methods: plate culture with malt extract agar and by direct microscopy. An ecological analysis was carried out from the fungal diversity detected. To describe the factors associated with the fungi detected, bivariate logistic regression was used. Through direct microscopy, between 10 and 2311 fragments of hyphae and spores corresponding mainly to Cladosporium, Coprinus, Curvularia, Aspergillus/Penicillium, Xylariaceae, and Periconia were identified. Through the culture, 0-208 CFU were quantified, where Aspergillus, Cladosporium, and Penicillium predominated. The culturability evidenced the differences between the quantification determined by both methods. A positive relationship was found between the type of cleaning of the furniture, the presence of trees in front of the bedroom, indoor relative humidity, indoor temperature, the presence of air conditioning, and natural ventilation with specific spore types and genera. The use of two different identification methods allowed to detect a greater fungal diversity in the residences evaluated. Monitoring the exposure to these fungal allergens in childhood can help to prevent sensitization in the allergic child, the development of asthma, and other respiratory diseases.

Mollusk death assemblages in 210Pb-dated marine sediment cores reveal recent biotic changes in the Gulf of Guanahacabibes, NW Cuba

We investigated stratigraphic changes in mollusk death assemblages and geochemistry in sediment cores from four seagrass beds and one unvegetated site in the Gulf of Guanahacabibes (GG), NW Cuba. There was a transition from mangrove to seagrass beds, associated with sea level rise ∼6000 years ago. Sediment accumulation rates during the last century showed a general rise, but increased sharply after ∼1980, likely because of human activities. The GG displayed overall high mollusk γ-diversity, and our estimate of 189 species is biased toward the low end. High β-diversity was driven by inter-site differences in grain size, vegetation cover, and nutrient input. Spatial heterogeneity within the basin influenced downcore abundance and diversity metrics, highlighting the influence of local drivers. Herbivorous gastropods dominated in seagrass beds and suspension feeder bivalves were dominant on sandy bottom. In the top parts of cores, species richness declined at two sites that were subject to high, human-mediated bulk sedimentation rates and eutrophication. Conservation measures are needed to preserve this hotspot of marine diversity.

scientific collaboration: Beyond the embargo

Cuba and the U.S. have the oldest Academies of Sciences outside Europe. Both countries have a long history of scientific collaboration that dates to the 1800s. Both scientific communities also share geographical proximity and common scientific research interests mainly in Biotechnology, Meteorology, and Public Health research. Despite these facts, scientists from both nations face serious barriers to cooperation raised by the U.S. embargo established in 1961 that prohibits exchanges with Cuba. The study aims to analyze the effects of U.S. policy on scientific collaboration with Cuban scientific institutions. The results of the bibliometric analysis of Cuba-U.S. joint publications in the Web of Science, and Scopus databases between 1980 to 2020 indicate sustained growth of scientific collaboration between scientists of both nations over the past forty years. The results also show that after the 1980 Smithsonian Institution and the Cuba’s Academy of Sciences agreement significantly increased scientific collaboration between U.S. scientists with their Cuban peers. President Barack Obama’s approach to normalizing the U.S. Cuba relations in 2015 enhanced Cuban scientific production with U.S. scientists by exceeding the number of collaborative papers published during any preceding U.S. Presidential administration. By 2020, Cuba had expanded its scientific links to 80% of the countries in the world. Cuban and U.S. scientists converted from adversaries into partners, showing that science is an effective diplomatic channel. A particularly important question for the future is how robust is the collaboration system in the face of greater political restrictions?

Biomodulina T May Restore Immunity in Older Adults

Worldwide, there has been a progressive demographic shift over the past 50 years resulting in a larger proportion of older adults in the general population. Aging itself is a complex biological phenomenon characterized in part by changes in the immune system known as "immunosenescence", which makes older adults more susceptible to infectious, cardiovascular and autoimmune diseases, as well as cancers. Several strategies have been proposed in an attempt to reverse immunosenescence, including use of hormones, cytokines and thymic factors. A promising drug in the search to restore the thymic microenvironment (which plays an important role in the regulation and maintenance of the immune system) in older adults is Biomodulina T, a Cuban product registered for use in patients with recurrent respiratory infections. The administration of Biomodulina T increases the number of naïve T-lymphocyte, CD4-positive cells that have recently migrated from the thymus gland (recent thymic emigrants) and memory CD8-positive T lymphocytes, which have characteristics akin to stem cells (stem cell-like memory). Furthermore, the expression of programmed cell death 1 protein in CD4-positive T lymphocytes and CD4-positive T lymphocytes decreases, and the proliferative capacity of CD4-positive T lymphocytes increases, without changes in the frequency of regulatory T lymphocytes. These results suggest that the administration of Biomodulina T could be used to restore immunity in older adults and in other immunocompromised individuals, improve response to other immunotherapies in cancer patients, and increase the effi cacy of vaccinations in older adults. Its use has been approved in Cuba for immune system restoration.KEYWORDS Immunosenescence, aging, immunotherapy, immuno-modulation, antineoplastic protocols, Cuba.

Fear of COVID-19 Scale (FCV-19S) across countries: Measurement invariance issues

AIM

The threats of novel coronavirus disease 2019 (COVID-19) have caused fears worldwide. The Fear of COVID-19 Scale (FCV-19S) was recently developed to assess the fear of COVID-19. Although many studies found that the FCV-19S is psychometrically sound, it is unclear whether the FCV-19S is invariant across countries. The present study aimed to examine the measurement invariance of the FCV-19S across eleven countries.

DESIGN

Cross-sectional study.

METHODS

Using data collected from prior research on Bangladesh (N = 8,550), United Kingdom (N = 344), Brazil (N = 1,843), Taiwan (N = 539), Italy (N = 249), New Zealand (N = 317), Iran (N = 717), Cuba (N = 772), Pakistan (N = 937), Japan (N = 1,079) and France (N = 316), comprising a total 15,663 participants, the present study used the multigroup confirmatory factor analysis (CFA) and Rasch differential item functioning (DIF) to examine the measurement invariance of the FCV-19S across country, gender and age (children aged below 18 years, young to middle-aged adults aged between 18 and 60 years, and older people aged above 60 years).

RESULTS

The unidimensional structure of the FCV-19S was confirmed. Multigroup CFA showed that FCV-19S was partially invariant across country and fully invariant across gender and age. DIF findings were consistent with the findings from multigroup CFA. Many DIF items were displayed for country, few DIF items were displayed for age, and no DIF items were displayed for gender.

CONCLUSION

Based on the results of the present study, the FCV-19S is a good psychometric instrument to assess fear of COVID-19 during the pandemic period. Moreover, the use of FCV-19S is supported in at least ten countries with satisfactory psychometric properties.