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Treating the Virus, Triggering IRIS: ART Timing in HIV Patients with Bacterial and Fungal Opportunistic Infections
No full textObjective: To evaluate the optimal timing of antiretroviral therapy (ART) initiation in HIV-1-infected adults with bacterial or fungal opportunistic infections (OIs), and to assess its impact on immune reconstitution inflammatory syndrome (IRIS), mortality, and pathogen type.
Methods: A structured literature review was conducted using PubMed, IDSA guidelines, and supplemental Google searches. Search terms included combinations such as ART initiation TB meningitis, ART initiation IRIS TB, ART intiation IRIS cryptococcal, and ART initiation IRIS pneumocystis. Studies published in English from 2019-2024 were included, with one exception for TB meningitis due to limited recent data. Eligible studies were randomized controlled trials or systematic reviews comparing early (\u3c2 weeks) vs. delayed (\u3e2 weeks) ART initiation in ART-naive HIV-1-infected adults with bacterial (tuberculosis [TB], TB meningitis) or fungal (cryptococcal meningitis [CM], Pneumocystis pneumonia [PCP]) OIs. Outcomes included IRIS incidence and mortality.
Results: In TB, early ART showed the greatest mortality benefit in patients with CD4 \u3c50, despite increased non-fatal IRIS. For TB meningitis, delayed ART was preferred due to increased severe adverse events and no survival benefit with early ART. Early ART was advised for PCP due to high mortality and no effect on IRIS. In CM, delayed ART reduced mortality in low-income settings, while early ART appeared safe in high-income settings. Pathogen type did not independently predict IRIS.
Conclusion: Current ART timing guidelines remain appropriate. However, early ART in CM may be safe in high-income settings. IRIS warrants continued attention and improved diagnostic criteria.
Keywords: HIV; antiretroviral therapy; IRIS; opportunistic infections; tuberculosis; cryptococcal meningiti
Occurrence of Spotted Wing Drosophila (Drosophila suzukii) in Wild Berries in Forested Areas of Marquette and Keweenaw Counties, Upper Peninsula of Michigan
Get PDFSpotted-wing Drosophila (SWD, Drosophila suzukii Matsumura, Diptera: Drosophilidae) is an invasive fly that targets unripe soft-fruits causing premature ripening, dehiscence, and rotting. While the presence of SWD in agricultural systems is well-documented, much less is known about the host range of SWD in wild areas, especially in more northern latitudes where colder temperatures and short summers are thought to restrict their life-cycles and limit population growth. In 2019 and 2020, we collected wild berries from two counties in the Upper Peninsula of Michigan, with long, cold winters, to determine the prevalence, host range, and seasonal/temporal variation of SWD. We found SWD in five of seven different plant families surveyed but we restricted statistical analyses to three families in which we predominantly collected from and in which SWD larvae were most common: Caprifoliaceae, Ericaceae, and Rosacea. In general, average numbers of SWD per berry were highest for Rosaceae species and this pattern is likely attributed to the thin cell walls and poly-drupelet structure of their fruits that is known to enhance sustained infestation. SWD infestation intensity also generally increased throughout the season for all host families; a pattern most likely due to the ripening of fruits and associated increase in sugar content as the season progresses. Lastly, although we found that SWD abundances, on average, were higher in 2020 than in 2019 and in berries collected from Keweenaw versus Marquette County, these patterns could be due to sampling artefacts (e.g., unequal host sampling) rather than to climate differences between years and/or sites. To better assess future consequences that SWD infestations may have for humans, wildlife, and plant communities in non-agricultural northern temperate ecosystems, we suggest that more data is needed on how temporal and spatial climate variability effects SWD infestation patterns in these systems
He Is the Master of Wood, Water, and Hill: Is Tom Bombadil the True Key Keeper of the Old Forest?
Get PDFTom Bombadil, with his iconic singing―”Hey! Come merry doll! Derry doll and merry-o!―has captivated scholars worldwide, due to the enigmatic nature Tolkien intentionally left unexplained. This deliberate mystery has fuelled extensive debate, leading many to explore possible mythological and cultural frameworks that might decode Bombadil’s origins. Among these hypotheses, a Celtic interpretation has often been dismissed despite its potential relevance. This paper, thereby, seeks to analyse Bombadil’s function within the Old Forest and his interactions with the hobbits during their forest episode, presenting fresh insights into his role as a Celtic-inspired guide and druidic figure.
To support this analysis, primary sources such as The Fellowship of the Ring (1954), The Adventures of Tom Bombadil (1962), The Mabinogion, and Sir Gawain and the Green Knight (2014) have been pivotal. These texts offer valuable insights into Bombadil’s narrative significance and his potential ties to Celtic mythos and provide a foundation for understanding Bombadil’s unique characteristics, including his profound connection to the natural world and his role as a protector and guide for mortal beings.
While Tolkien never explicitly defined Bombadil’s nature, and evidence of direct Celtic influence is limited, this analysis argues that both Bombadil characteristics and his setting in the Old Forest suggest strong parallels with Celtic traditions. By exploring these connections, this study aims to highlight Bombadil’s narrative significance and his potential as a symbol of harmony and guidance deeply rooted in mythological and cultural archetypes
The Biogeography of a Disjunct Plant-Insect Relationship: Thimbleberry and Diastrophis kincaidii (Hymenoptera: Cynipidae) in the Great Lakes Region
Get PDFThe clonal shrub thimbleberry (Rubus parviflorus) ranges throughout western North America and is disjunct to the northern Great Lakes region. Diastrophis kincaidii (Hymenoptera: Cynipidae) is an obligate gall wasp of thimbleberry that has long been known from western North America but has only been reported from the Great Lakes region since the early 1990s. It has been suggested that Diastrophis kincaidii was only recently introduced into the Great Lakes region sometime in the 1980s. We conducted a survey to determine the distribution of D. kincaidii and its parasitoids within the thimbleberry range in the Great Lakes region. We found that D. kincaidii is restricted to the colder and more xeric habitats within the Great Lakes thimbleberry range. Additionally D. kincaidii was found to have colonized isolated micro-habitats in the region were it attained high population densities. The inquiline community inhabiting D. kincaidii in the Great Lakes Region was similar to past reports. This community included species from eastern and western North America as well as two undescribed species. We suggest that D. kincaidii and its inquiline community have long been a part of the insect fauna of the Great Lakes region and is likely a remnant of an original connected pre-glacial continental thimbleberry population
Description of the Nymph of Ophiogomphus smithi (Odonata: Gomphidae), With a Key to the Species of Ophiogomphus in the Western Great Lakes Region
Get PDFOphiogomphus smithi Tennessen & Vogt is a gomphid dragonfly with restricted distribution which includes northeast Iowa, southeast Minnesota, and central to northwestern Wisconsin. The nymph is described and illustrated based on 173 specimens (66 exuviae of reared specimens plus 107 nymphs) from throughout the species’ range. The nymph of O. smithi is very similar to nymphs of O. carolus Needham, O. colubrinus Selys, and O. rupinsulensis (Walsh). Nearly all (99%) of O. smithi sampled can be distinguished from O. colubrinus by prementum terminal width less than or equal to 2.97 mm (98% of O. colubrinus greater than 2.97 mm), and from O. carolus and O. rupinsulensis by the ratio of metatibia length to abdominal segment 10 width being greater than 1.66 (96% of O. smithi) vs. less than 1.66 (98.5% of O. carolus and O. rupinsulensis). Several characters and character combinations previously unused for Ophiogomphus nymphs were found to be of taxonomic value, including color pattern on dorsal hooks and dorsum of abdomen, shape of abdominal mid-dorsal punctae, length and shape of fronto-clypeal ridge setae, and ratio of metatibia length to width of abdomen on segments 9 and 10. An illustrated quantitative key to the 7 species of Ophiogomphus occurring in the western Great Lakes region is provided, along with a separate, more qualitative key enabling species identification in the field. Ophiogomphus smithi is regularly syntopic only with O. rupinsulensis, rarely with O. carolus and O. colubrinus and not with O. anomalus, O. howei, or O. susbehcha; nymphs inhabit small to medium-sized, sandy, cool to warm stream segments with patches of pea-sized gravel
Riddles in the Dark (of Space), or, Further Adventures Romanticizing Astronomers’ Middle-earth Identified Research
Get PDFIn this slightly expanded version of a paper delivered at Westmoot 2025 I explore scientists\u27 creative use of Tolkien-related acronyms in scientific papers, and argue that, despite opinions to the contrary, many of these activities are beneficial for both Tolkien studies and the scientific culture
Fears and Pains and Rages: The Psychology of Gandalf\u27s Anger
Get PDFWe are used to seeing emotions in Tolkien as coded morally. Lust or possessiveness is evil whereas care and forbearance are good. There are some emotions, though, that cross these moral boundaries and one of these is anger Moreover, anger in Tolkien is very coded in terms of gender, as it is nearly always male rage. After examining the cases of Saruman and Wormtongue (angry because the world will not cooperate with their plans) and Thingol (angry because he realizes he has just postponed his doom rather than staved it off), we will examine the case of Gandalf. Gandalf is represented as humble, altruistic, succoring other people not in it for himself. Yet Gandalf is frequently angry, especially at the ninnyish behavior of the very Hobbits he elsewhere champions. Gandalf actually hurts Pippin’s feelings when he calls the Hobbit ”tom-fool of a Took:” after a miraculous reunion, and his rage at Donator terrifies Pippin as much as does Denethor himself. Why do we love and admire this irascible, cranky character? One can trace aspects of Gandalf’s anger back to the thumos of the ancient Greeks and the saeva indignatio of Roman satirists and Hebrew prophets; but there is also something modern and, dare one say professorial, in Gandalf’s anger as well. Gandalf represents everything that is positive in Tolkien’s value-system; yet a spectator watching an actor play Gandalf might have the same question famously posed by a first-time viewer of King Lear: why is that man so old and so angry? Is there something about Gandalf’s articulation of masculinity which makes him angry even when every pore of him seems to want to do good for others
Correction to the Key (page 92) of Description of the Nymph of Ophiogomphus smithi (Odonata: Gomphidae), With a Key to the Species of Ophiogomphus in the Western Great Lakes Region TGLE 49(1&2): 78–97
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In our paper describing the nymph of Ophiogomphus smithi (TGLE, vol. 49, pages 78–97), we characterized Ophiogomphus howei in couplet 1 of the Primary Key (p. 92) as “Head W [width] greater than maximum abdomen W”. The statement was based on our misinterpretation of data reported online
Observations on the Biology of the Slender Seedcorn Beetle, Clivina Impressifrons (Coleoptera: Carabidae)
Get PDFThe slender seedcorn beetle, Clirina impressijirons, is known to attack germinating corn seed, but field and laboratory studies of its life history indicate it may sometimes play a beneficial role. Feeding studies show that adults and larvae are primarily carnivorous but will feed on corn seed when their primary food is absent or in short supply. Certain behavioral aspects indicate that populations of this beetle might be attracted to selected agricultural areas where adults and larvae could serve as predators of soil pests of corn. Much of the activity of these beetles is governed by temperature. with low temperatures below 16 and 10°C causing either a slowing or cessation respectively of several biological activities