The Holy Ones: Stories

The Holy Ones is a collection of five short stories and two novellas exploring relationships and solitude through a fabulist prism. In keeping with the tenants of fabulism, most of these stories take the primary world as their starting point and imbue it with one magical, mystical, or absurd quirk. While these stories are somewhat strange, they attempt to find relevance and resonance in the banality of their characters’ desires: a wizard wishes to rent the perfect apartment, a group of boys want to ask their crushes to the school dance, a Mennonite girl wants to climb a sycamore tree, and so on. The Holy Ones, like many fabulist collections, combines the mystical with the banal in an attempt to defamiliarize common emotions and experiences—like a fear of commitment, adolescent love, a search of a higher power, and so on—and perhaps, at least momentarily, return these emotions and experiences to their original state of strangeness

A success story: HIV prevention for injection drug users in Rhode Island

BACKGROUND: New HIV diagnoses related to injection drug use (IDU) have declined in the United States. Access to clean syringes and decreasing HIV transmission among injection drug users have been HIV prevention priorities of the Rhode Island (RI) HIV community. To examine trends in IDU-related new HIV diagnoses in RI, we performed a retrospective analysis of new HIV diagnoses according to HIV risk factor from 1990–2003. RESULTS: There has been an 80% absolute reduction in IDU-related new HIV diagnoses in RI coincident with IDU-specific prevention efforts. CONCLUSION: There has been a greater decline in IDU-related new HIV diagnoses in Rhode Island compared to national data reported by the Centers for Disease Control and Prevention. We hypothesize that this dramatic decline in Rhode Island is related to extensive HIV prevention efforts targeting IDUs. Further research is needed to examine the impact of specific HIV prevention interventions for injection drug users

Dimethyl fumarate in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial

Dimethyl fumarate (DMF) inhibits inflammasome-mediated inflammation and has been proposed as a treatment for patients hospitalised with COVID-19. This randomised, controlled, open-label platform trial (Randomised Evaluation of COVID-19 Therapy [RECOVERY]), is assessing multiple treatments in patients hospitalised for COVID-19 (NCT04381936, ISRCTN50189673). In this assessment of DMF performed at 27 UK hospitals, adults were randomly allocated (1:1) to either usual standard of care alone or usual standard of care plus DMF. The primary outcome was clinical status on day 5 measured on a seven-point ordinal scale. Secondary outcomes were time to sustained improvement in clinical status, time to discharge, day 5 peripheral blood oxygenation, day 5 C-reactive protein, and improvement in day 10 clinical status. Between 2 March 2021 and 18 November 2021, 713 patients were enroled in the DMF evaluation, of whom 356 were randomly allocated to receive usual care plus DMF, and 357 to usual care alone. 95% of patients received corticosteroids as part of routine care. There was no evidence of a beneficial effect of DMF on clinical status at day 5 (common odds ratio of unfavourable outcome 1.12; 95% CI 0.86-1.47; p = 0.40). There was no significant effect of DMF on any secondary outcome

The evolving SARS-CoV-2 epidemic in Africa: Insights from rapidly expanding genomic surveillance

INTRODUCTION Investment in Africa over the past year with regard to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) sequencing has led to a massive increase in the number of sequences, which, to date, exceeds 100,000 sequences generated to track the pandemic on the continent. These sequences have profoundly affected how public health officials in Africa have navigated the COVID-19 pandemic. RATIONALE We demonstrate how the first 100,000 SARS-CoV-2 sequences from Africa have helped monitor the epidemic on the continent, how genomic surveillance expanded over the course of the pandemic, and how we adapted our sequencing methods to deal with an evolving virus. Finally, we also examine how viral lineages have spread across the continent in a phylogeographic framework to gain insights into the underlying temporal and spatial transmission dynamics for several variants of concern (VOCs). RESULTS Our results indicate that the number of countries in Africa that can sequence the virus within their own borders is growing and that this is coupled with a shorter turnaround time from the time of sampling to sequence submission. Ongoing evolution necessitated the continual updating of primer sets, and, as a result, eight primer sets were designed in tandem with viral evolution and used to ensure effective sequencing of the virus. The pandemic unfolded through multiple waves of infection that were each driven by distinct genetic lineages, with B.1-like ancestral strains associated with the first pandemic wave of infections in 2020. Successive waves on the continent were fueled by different VOCs, with Alpha and Beta cocirculating in distinct spatial patterns during the second wave and Delta and Omicron affecting the whole continent during the third and fourth waves, respectively. Phylogeographic reconstruction points toward distinct differences in viral importation and exportation patterns associated with the Alpha, Beta, Delta, and Omicron variants and subvariants, when considering both Africa versus the rest of the world and viral dissemination within the continent. Our epidemiological and phylogenetic inferences therefore underscore the heterogeneous nature of the pandemic on the continent and highlight key insights and challenges, for instance, recognizing the limitations of low testing proportions. We also highlight the early warning capacity that genomic surveillance in Africa has had for the rest of the world with the detection of new lineages and variants, the most recent being the characterization of various Omicron subvariants. CONCLUSION Sustained investment for diagnostics and genomic surveillance in Africa is needed as the virus continues to evolve. This is important not only to help combat SARS-CoV-2 on the continent but also because it can be used as a platform to help address the many emerging and reemerging infectious disease threats in Africa. In particular, capacity building for local sequencing within countries or within the continent should be prioritized because this is generally associated with shorter turnaround times, providing the most benefit to local public health authorities tasked with pandemic response and mitigation and allowing for the fastest reaction to localized outbreaks. These investments are crucial for pandemic preparedness and response and will serve the health of the continent well into the 21st century

Dimethyl fumarate in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial

Dimethyl fumarate (DMF) inhibits inflammasome-mediated inflammation and has been proposed as a treatment for patients hospitalised with COVID-19. This randomised, controlled, open-label platform trial (Randomised Evaluation of COVID-19 Therapy [RECOVERY]), is assessing multiple treatments in patients hospitalised for COVID-19 (NCT04381936, ISRCTN50189673). In this assessment of DMF performed at 27 UK hospitals, adults were randomly allocated (1:1) to either usual standard of care alone or usual standard of care plus DMF. The primary outcome was clinical status on day 5 measured on a seven-point ordinal scale. Secondary outcomes were time to sustained improvement in clinical status, time to discharge, day 5 peripheral blood oxygenation, day 5 C-reactive protein, and improvement in day 10 clinical status. Between 2 March 2021 and 18 November 2021, 713 patients were enroled in the DMF evaluation, of whom 356 were randomly allocated to receive usual care plus DMF, and 357 to usual care alone. 95% of patients received corticosteroids as part of routine care. There was no evidence of a beneficial effect of DMF on clinical status at day 5 (common odds ratio of unfavourable outcome 1.12; 95% CI 0.86-1.47; p = 0.40). There was no significant effect of DMF on any secondary outcome

Habitat Use and Foraging Ecology of Bats in North Dakota

Habitat use is a key component to understanding the conservation needs of species. While an array of quantitative analyses for studying fine-scale habitat use and selection have been developed, such methods have rarely been applied to bat species, with most work focused at a broad scale or using qualitative methods. Insectivorous bat communities face major threats from habitat conversion, exploitation of natural resources, and the impending spread of white-nose syndrome. Hence, detailed knowledge of their habitat needs is critical for developing effective management plans. In North Dakota, little was known about local bat populations prior to 2009, with essentially no knowledge of habitat associations and preferences of bat species. The overall objective of this research was to survey habitats across North Dakota to document species occurrences within key ecological regions and to assess the influence of fine-scale habitat characteristics on community diversity and foraging patterns. We further aimed to assess the foraging habitat selection of little brown bats, Myotis lucifugus, a species of conservation concern. Our specific objectives were to: 1) assess species’ occurrence and distributions within North Dakota; 2) assess the influence of habitat and the availability of water resources on species diversity and community-level foraging activity; 3) identify habitats associated with areas of high foraging activity; 4) identify indicator species that characterize key habitats; 5) assess foraging habitat selection of female M. lucifugus; 6) and assess individual variation in habitat selection of M. lucifugus. From 2009 to 2012, mist netting and acoustic surveys were conducted to document species occurrence at 68 sites. From 2012 to 2015, targeted acoustic surveys were conducted at 37 sites to assess foraging activity levels in variable habitats. In 2014 and 2015, data-logging telemetry receivers were used to assess foraging habitat selection of M. lucifugus. The presence of 11 species was confirmed in the state. We found that bat community diversity and foraging activity were influenced by fine-scale habitat characteristics. M. lucifugus selected for edge habitats and nearby water sources. These results will be valuable for the conservation and management of bats and provide baseline information for future research on habitat use of bats.North Dakota Game and Fish Departmen

Distribution and Occurrence of Bat Species in North Dakota

Prior to 2009, a detailed survey of occurrence and distribution of bats in North Dakota had not been conducted. Localized surveys, occurrence reports, and museum specimens provided the only records of bats in the state. Ongoing habitat loss, exploitation of natural resources, and the impending spread of white-nose syndrome to the western United States are major threats to bat populations of the region. The objective of this study was to document presence and distributions of bat species resident in North Dakota. From 2009 to 2012, multiple mist-netting and acoustic surveys were conducted to document species presence across North Dakota. A total of 68 sites across 5 ecological regions were surveyed, with a capture total of 333 bats. The presence of 11 species was confirmed in the state. The occurrences of Corynorhinus townsendii and Myotis thysanodes represent substantial range expansions beyond previously reported species distributions, as well as the first capture of M. thysanodes in North Dakota. We also report issues with acoustic identification of M. septentrionalis and highlight the importance of using multiple sampling methods, especially for species of conservation concern. The results of this study will be valuable for informing state managers about the conservation needs of North Dakota’s bat populations, as well as providing baseline information for future research on bat populations within the state