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In this article, I argue for the notion of what I term ‘uncanny water’ as a conceptual tool for reading contemporary oceanic fictions. The uncanny’s affective capacity to destabilise epistemological and ontological certainties makes it a particularly potent literary tool for challenging the nature/culture binary. I argue that fictions which actively defamiliarise the ocean can be used to redress the anthropocentric privilege found in hitherto narratives of the oceanic that were predicated upon mastery and control, and that uncanny moments of displacement and uncertainty can illuminate human/oceanic interconnections and foster a sense of responsibility and compassion towards the oceans. I identify resonances between the uncanny’s continuing referentiality and the notion that feminist transcorporeality interrelates the subject into networks of materiality which extend across time and space in unknowable ways. Both transcorporeality and the uncanny work against the conceit of the individual through the dissolution of boundaries, and, crucially, both require a suspension of assumptions of the self as whole, discrete and impermeable. To demonstrate this, I read the uncanny waters of contemporary fictions from the Northern Atlantic Littoral (Atlantic Canada and the westernmost parts of the UK). The littoral position of these spaces makes them ideally placed to negotiate the borders between habitable and unhabitable spaces, and the limitations of knowledge that run alongside this. I assert that iterations of uncanny water offer a transoceanic dialogue which shifts constructions of subjectivity away from national and terrestrial boundaries to one more akin to the fluid and relational dialectics of transcorporeality.

In this article, I argue for the notion of what I term ‘uncanny water’ as a conceptual tool for reading contemporary oceanic fictions. The uncanny’s affective capacity to destabilise epistemological and ontological certainties makes it a particularly potent literary tool for challenging the nature/culture binary. I argue that fictions which actively defamiliarise the ocean can be used to redress the anthropocentric privilege found in hitherto narratives of the oceanic that were predicated upon mastery and control, and that uncanny moments of displacement and uncertainty can illuminate human/oceanic interconnections and foster a sense of responsibility and compassion towards the oceans. I identify resonances between the uncanny’s continuing referentiality and the notion that feminist transcorporeality interrelates the subject into networks of materiality which extend across time and space in unknowable ways. Both transcorporeality and the uncanny work against the conceit of the individual through the dissolution of boundaries, and, crucially, both require a suspension of assumptions of the self as whole, discrete and impermeable. To demonstrate this, I read the uncanny waters of contemporary fictions from the Northern Atlantic Littoral (Atlantic Canada and the westernmost parts of the UK). The littoral position of these spaces makes them ideally placed to negotiate the borders between habitable and unhabitable spaces, and the limitations of knowledge that run alongside this. I assert that iterations of uncanny water offer a transoceanic dialogue which shifts constructions of subjectivity away from national and terrestrial boundaries to one more akin to the fluid and relational dialectics of transcorporeality.

COVID-19 is a multisystem disease and patients who survive might have in-hospital complications. These complications are likely to have important short-term and long-term consequences for patients, health-care utilisation, health-care system preparedness, and society amidst the ongoing COVID-19 pandemic. Our aim was to characterise the extent and effect of COVID-19 complications, particularly in those who survive, using the International Severe Acute Respiratory and Emerging Infections Consortium WHO Clinical Characterisation Protocol UK. We did a prospective, multicentre cohort study in 302 UK health-care facilities. Adult patients aged 19 years or older, with confirmed or highly suspected SARS-CoV-2 infection leading to COVID-19 were included in the study. The primary outcome of this study was the incidence of in-hospital complications, defined as organ-specific diagnoses occurring alone or in addition to any hallmarks of COVID-19 illness. We used multilevel logistic regression and survival models to explore associations between these outcomes and in-hospital complications, age, and pre-existing comorbidities. Between Jan 17 and Aug 4, 2020, 80 388 patients were included in the study. Of the patients admitted to hospital for management of COVID-19, 49·7% (36 367 of 73 197) had at least one complication. The mean age of our cohort was 71·1 years (SD 18·7), with 56·0% (41 025 of 73 197) being male and 81·0% (59 289 of 73 197) having at least one comorbidity. Males and those aged older than 60 years were most likely to have a complication (aged ≥60 years: 54·5% [16 579 of 30 416] in males and 48·2% [11 707 of 24 288] in females; aged <60 years: 48·8% [5179 of 10 609] in males and 36·6% [2814 of 7689] in females). Renal (24·3%, 17 752 of 73 197), complex respiratory (18·4%, 13 486 of 73 197), and systemic (16·3%, 11 895 of 73 197) complications were the most frequent. Cardiovascular (12·3%, 8973 of 73 197), neurological (4·3%, 3115 of 73 197), and gastrointestinal or liver (10·8%, 7901 of 73 197) complications were also reported. Complications and worse functional outcomes in patients admitted to hospital with COVID-19 are high, even in young, previously healthy individuals. Acute complications are associated with reduced ability to self-care at discharge, with neurological complications being associated with the worst functional outcomes. COVID-19 complications are likely to cause a substantial strain on health and social care in the coming years. These data will help in the design and provision of services aimed at the post-hospitalisation care of patients with COVID-19. National Institute for Health Research and the UK Medical Research Council.

Most reported cases of coronavirus disease 2019 (COVID-19) in children aged <18 years appear to be asymptomatic or mild (1). Less is known about severe COVID-19 illness requiring hospitalization in children. During March 1-July 25, 2020, 576 pediatric COVID-19 cases were reported to the COVID-19-Associated Hospitalization Surveillance Network (COVID-NET), a population-based surveillance system that collects data on laboratory-confirmed COVID-19-associated hospitalizations in 14 states (2,3). Based on these data, the cumulative COVID-19-associated hospitalization rate among children aged <18 years during March 1-July 25, 2020, was 8.0 per 100,000 population, with the highest rate among children aged <2 years (24.8). During March 21-July 25, weekly hospitalization rates steadily increased among children (from 0.1 to 0.4 per 100,000, with a weekly high of 0.7 per 100,000). Overall, Hispanic or Latino (Hispanic) and non-Hispanic black (black) children had higher cumulative rates of COVID-19-associated hospitalizations (16.4 and 10.5 per 100,000, respectively) than did non-Hispanic white (white) children (2.1). Among 208 (36.1%) hospitalized children with complete medical chart reviews, 69 (33.2%) were admitted to an intensive care unit (ICU); 12 of 207 (5.8%) required invasive mechanical ventilation, and one patient died during hospitalization. Although the cumulative rate of pediatric COVID-19-associated hospitalization remains low (8.0 per 100,000 population) compared with that among adults (164.5),* weekly rates increased during the surveillance period, and one in three hospitalized children were admitted to the ICU, similar to the proportion among adults. Continued tracking of SARS-CoV-2 infections among children is important to characterize morbidity and mortality. Reinforcement of prevention efforts is essential in congregate settings that serve children, including childcare centers and schools.

IntroductionThe Emergency Department (ED) opt-out BBV testing programme was initiated in April 2022. People who test positive for HIV are managed by local Sexual Health Services (SHS) for follow-up and partner notification (PN).We reviewed PN outcomes for people diagnosed during the first six months of the London ED programme to assess effectiveness and to measure performance against national PN standards.MethodsSHS representing nine EDs across six NHS Trusts provided PN data for people diagnosed through the ED from 1st April to 30th September 2022. For each index case clinics were asked to provide: data on partners, testing outcomes for contactable partners and timeframes.Primary outcomes were calculated using the BASHH/BHIVA/NAT standards.ResultsA total of 77 index cases were reported for the first 6 months of the programme. A breakdown of partner reporting and follow-up is summarised in Figure 1.Abstrct P042 Figure 1Summary of index patients and PN outcomes[Figure omitted. See PDF]Outcome 1 - Number of contacts tested per total number of index cases= 0.38 (standard 0.6 HCP verified (HCPv); 0.8 HCPv and Index patient reported (IPR))Outcome 2 - Proportion of contactable partners tested= 67.4% (standard 65% HCPv; 85% HCPv and IPR)DiscussionED HIV testing provides an opportunity to diagnose people who are unaware of their status. Partner notification amplifies this reach, allowing healthcare professionals to engage a population who may not be aware they are at risk of HIV, and is extremely effective with high test positivity. Current reported performance of PN is below national standards; however this is likely to improve over time with further follow up. Further examination is being undertaken to determine HCPv outcomes.ReferenceBritish Association for Sexual Health and HIV: HIV partner notification for adults: definitions, outcomes and standards. 2015. https://www.bashhguidelines.org/media/1070/hiv_partner_notification_standards_2015.pdf (accessed 23rd March 2023).

Pre-pregnancy maternal obesity is associated with adverse offspring outcomes at birth and later in life. Individual studies have shown that epigenetic modifications such as DNA methylation could contribute. Within the Pregnancy and Childhood Epigenetics (PACE) Consortium, we meta-analysed the association between pre-pregnancy maternal BMI and methylation at over 450,000 sites in newborn blood DNA, across 19 cohorts (9,340 mother-newborn pairs). We attempted to infer causality by comparing effects of maternal versus paternal BMI and incorporating genetic variation. In four additional cohorts (1,817 mother-child pairs), we meta-analysed the association between maternal BMI at the start of pregnancy and blood methylation in adolescents. In newborns, maternal BMI was associated with small (<0.2% per BMI unit (1kg/m2), P<1.06*10-7) methylation variation at 9,044 sites throughout the genome. Adjustment for estimated cell proportions greatly attenuated the number of significant CpGs to 104, including 86 sites common to the unadjusted model. At 72/86 sites, the direction of association was the same in newborns and adolescents, suggesting persistence of signals. However, we found evidence for a causal intrauterine effect of maternal BMI on newborn methylation at just 8/86 sites. In conclusion, this well-powered analysis identified robust associations between maternal adiposity and variations in newborn blood DNA methylation, but these small effects may be better explained by genetic or lifestyle factors than a causal intrauterine mechanism. This highlights the need for large-scale collaborative approaches and the application of causal inference techniques in epigenetic epidemiology.