Part 2: COVID-19 and knowledge for midwifery practice—impact and care of the baby

It is well-known that newborn infants are more susceptible to infection due to their immature host defence mechanisms. However, in relation to the COVID-19 virus, it appears that the naivete of the neonatal immune system has afforded some protection against the inflammatory response experienced by adolescents and adults. That said, COVID-19 and the associated changes in practice and policies implemented in response to the pandemic, has had an impact on the care of the baby during the perinatal and neonatal period. This article is the second in a two-part series focusing on important care issues relating to the newborn baby specifically, taken from an integrative review of current literature within the maternal and neonatal field. This paper analyses the emerging themes from selected literature to add to a developing body of knowledge; namely, physiological differences between the newborn baby and adult, neonatal management including, preterm labour and delivery, newborn resuscitation, investigations, care of the newborn, the importance of human milk and breastfeeding, and the implications of COVID-19 restrictions. Finally, an overview of the World Health Organization guidance will be outlined for a global view and summary.

Paleocene origin of the Neotropical lineage of cleptoparasitc bees Ericrocidini-Rhathymini (Hymenoptera, Apidae)

Cleptoparasitic bees abandoned the pollen collecting for their offspring and lay their eggs on other bees’ provisioned nests. Also known as cuckoo bees they belong to several lineages, especially diverse in Apinae. We focused on a lineage of Apinae cleptoparasitic bees, the clade Ericrocidini+Rhathymini, which attack nests of the oil-collecting bees. We sequenced five genes for a broad sampling in this clade plus a large outgroup and reconstruct phylogeny and divergence times. We confirmed the monophyly of the clade Ericrocidini+Rhathymini and its position inside the ericrocidine line, together with the tribes Protepeolini, Isepeolini and Coelioxoidini. Our results corroborate the current taxonomic classification. Ericrocis is the basal most lineage in Ericrocidini and the position of Acanthopus and the most diverse genus Mesoplia were inconclusive. Ericrocidini+Rhathymini diverged from Parepeolus aterrimus 74 mya in the Cretaceous. Considering the robust molecular evidence of their sister relationships, the striking differences on the first instar larvae morphology of the two groups are probably adaptations to the distinct nesting biology of their hosts. As other parasites in the ericrocidine line, both groups possess larvae adapted to kill the immature host and to feed on floral oil provisioned by the host female. The evolution of host specialization in the line Ericrocidini+Rhathymini retroced to the Eocene when they arose synchronously with their hosts, Centris and Epicharis.

Intravenous Immunoglobulin in Neonatal Sepsis

Neonatal sepsis remains the major cause of mortality and morbidity including neurodevelopmental impairment and prolonged hospital stay in newborn infants. Despite of advances in technology and optimal antibiotic treatment, incidence of neonatal sepsis and its complications remains unacceptably high especially in developing countries. Premature neonates in particular are at higher risk due to developmentally immature host defense mechanisms. Though not approved by Food and Drug Administration (FDA) U.S.A, off label use of intravenous immunoglobulin continues in many countries. Recent evidences showed no significant decrease in the mortality rate or other outcomes when intravenous immunoglobulin is administered in addition to standard therapies. Hence, use of intravenous immunoglobulin in suspected or proven neonatal sepsis is not recommended. The expense of prophylactic use of intravenous immunoglobulin administration for both term and preterm newborn population, given the minimal benefit is not justified. Future studies are required which should focus on other prophylactic or adjuvant treatment modalities in addition to the standard therapy in neonatal sepsis. DOI: http://dx.doi.org/10.3126/jnps.v33i2.7400 J Nepal Paediatr Soc. 2013; 33(2):125-128

Enhancerless Cytomegalovirus Is Capable of Establishing a Low-Level Maintenance Infection in Severely Immunodeficient Host Tissues but Fails in Exponential Growth

ABSTRACT Major immediate-early transcriptional enhancers are genetic control elements that act, through docking with host transcription factors, as a decisive regulatory unit for efficient initiation of the productive virus cycle. Animal models are required for studying the function of enhancers paradigmatically in host organs. Here, we have sought to quantitatively assess the establishment, maintenance, and level of in vivo growth of enhancerless mutants of murine cytomegalovirus in comparison with those of an enhancer-bearing counterpart in models of the immunocompromised or immunologically immature host. Evidence is presented showing that enhancerless viruses are capable of forming restricted foci of infection but fail to grow exponentially.

Non-sibling parasites (Strepsiptera) develop together in the same paper wasp

SUMMARYHost discrimination by immature host-seeking endoparasites is a complex and somewhat unexplored topic. In the case of multiple infections, conflicts among conspecifics may occur to monopolize space and resources in the same host. Two or more 1st instar larvae ofXenos vesparum(Strepsiptera, Stylopidae) may enter into aPolistes dominulus(Hymenoptera, Vespidae) larva and develop together until the adult stage of both parasite and host. We carried out a screening of mitochondrial haplotypes inX. vesparumindividuals extracted from superparasitized wasps taken in 5 naturally infected nests from different areas of Tuscany (Italy), to assess whether non-sibling parasites may infect the same colony and host. In total, we obtained 12 different haplotypes out of 122 genotyped individuals of both sexes: 17 of 34 superparasitized wasps hosted parasites that originated from females differing in their haplotypes. To date, this is the first described case of superparasitism with non-sibling host-seeking larvae infecting a single individual hymenopteran host. In addition, at least in heavily infected colonies, there is evidence of a male-biased sex-ratio and synchronous development of the parasites, regardless of their haplotypes. Finally, the distribution of haplotypes per nest is consistent with either phoretic infection or larvipositing on nests by means of superparasitized wasps.

Culture and consignment techiques used for parasites introduced against Queensland fruit fly. (Strumeta tryoni (Frogg.))

The paper describes techniques used in rearing and transporting parasites of the oriental fruit fly (Dacus dorsalis) liberated in Australia against the Queensland fruit fly (Strumeta tryoni) during 1956–1959. The principal species reared were Opius oophilus, O. vandenboschi, and O. longicaudatus at Sydney and Honolulu, and O. incisi at Honolulu only. The laboratory hosts were Strumeta tryoni alt Sydney and Dacus dorsalis at Honolulu. A culture medium consisting of banana tissue and a carrot-yeast mixture was developed in which the immature host stages developed satisfactorily and were readily available for parasitization. During 1958 and 1959, the major periods of liberation, most of the wasps were reared at Honolulu and sent by air to Australia. To prevent introduction of' unwanted insects, all wasps were immobilized with carbon dioxide for checks of identification at both Honolulu and Sydney. The carbon dioxide treatment had some slightly unfavourable effects which were outweighed by the usefulness of the technique. About 83% of the 583 000 opiine wasps shipped survived to be liberated.

Memoirs: Observation on the Insect Parasites of some Coccidæ

(1) Aphelinus mytilaspidis Le Baron, a Chalcid belonging to the sub-family Aphelininæ, is the principal parasite of the mussel scale (Lepidosaphes ulmi L.) in England. Material obtained from various parts of the country indicates that it is generally distributed. Detailed descriptions are given of the insect in all its stages. (2) The parasite passes through two generations in the year, and the adults consist almost entirely of females. Out of over 750 bred specimens only 10, or approximately 1 percent., were males. Parthenogenesis is definitely proved to occur, and is probably the usual method of reproduction. (3) The adult insects seldom resort to flight, and have extremely limited powers of migration. They are positively phototropic, but exhibit no marked response to geotropism. (4) In the first generation the adults appear in greatest frequency between the third week in June and the middle of July. The female lays a single egg on the dorsal or ventral surface of the body of the immature host, only the scaly covering of the latter being perforated. The newly hatched larva closely resembles the fully grown stage in form, and during larval life the insect is an ectoparasite of its host. The second generation of adults mostly appear between the middle of August and the first week in September. They parasitise the sexually mature hosts, and the resulting larvæ hibernate through the winter, giving rise to the first generation of adults of the following year. (5) The results of the first generation of parasitism are complete, the affected hosts invariably dying in consequence. In the second generation of parasitism the affected hosts usually deposit a small number of eggs before succumbing; its results, therefore, are partial and incomplete. The parasite exercises an inhibitory effect upon oviposition, the essential reduction in the number of eggs not being primarily due, as stated by previous observers, to their destruction by the Aphelinus larvas. (6) Assuming that every 1000 hosts lay on an average 37,200 eggs, the net results of a year's parasitism entails a reduction of about 2600 in the number of eggs laid, or 7 percent. The efficiency of the parasite, therefore, is far below that of the most effective insecticides. This is primarily due to four factors: (1) its extremely limited powers of migration; (2) its relatively low fecundity; (3) its marked susceptibility to the influence of unfavourable climatic conditions ; (4) the effects of the second annual generation of parasitism being only partial and incomplete.