Multiorgan MRI findings after hospitalisation with COVID-19 in the UK (C-MORE): a prospective, multicentre, observational cohort study

Introduction: The multiorgan impact of moderate to severe coronavirus infections in the post-acute phase is still poorly understood. We aimed to evaluate the excess burden of multiorgan abnormalities after hospitalisation with COVID-19, evaluate their determinants, and explore associations with patient-related outcome measures. Methods: In a prospective, UK-wide, multicentre MRI follow-up study (C-MORE), adults (aged ≥18 years) discharged from hospital following COVID-19 who were included in Tier 2 of the Post-hospitalisation COVID-19 study (PHOSP-COVID) and contemporary controls with no evidence of previous COVID-19 (SARS-CoV-2 nucleocapsid antibody negative) underwent multiorgan MRI (lungs, heart, brain, liver, and kidneys) with quantitative and qualitative assessment of images and clinical adjudication when relevant. Individuals with end-stage renal failure or contraindications to MRI were excluded. Participants also underwent detailed recording of symptoms, and physiological and biochemical tests. The primary outcome was the excess burden of multiorgan abnormalities (two or more organs) relative to controls, with further adjustments for potential confounders. The C-MORE study is ongoing and is registered with ClinicalTrials.gov, NCT04510025. Findings: Of 2710 participants in Tier 2 of PHOSP-COVID, 531 were recruited across 13 UK-wide C-MORE sites. After exclusions, 259 C-MORE patients (mean age 57 years [SD 12]; 158 [61%] male and 101 [39%] female) who were discharged from hospital with PCR-confirmed or clinically diagnosed COVID-19 between March 1, 2020, and Nov 1, 2021, and 52 non-COVID-19 controls from the community (mean age 49 years [SD 14]; 30 [58%] male and 22 [42%] female) were included in the analysis. Patients were assessed at a median of 5·0 months (IQR 4·2–6·3) after hospital discharge. Compared with non-COVID-19 controls, patients were older, living with more obesity, and had more comorbidities. Multiorgan abnormalities on MRI were more frequent in patients than in controls (157 [61%] of 259 vs 14 [27%] of 52; p<0·0001) and independently associated with COVID-19 status (odds ratio [OR] 2·9 [95% CI 1·5–5·8]; padjusted=0·0023) after adjusting for relevant confounders. Compared with controls, patients were more likely to have MRI evidence of lung abnormalities (p=0·0001; parenchymal abnormalities), brain abnormalities (p<0·0001; more white matter hyperintensities and regional brain volume reduction), and kidney abnormalities (p=0·014; lower medullary T1 and loss of corticomedullary differentiation), whereas cardiac and liver MRI abnormalities were similar between patients and controls. Patients with multiorgan abnormalities were older (difference in mean age 7 years [95% CI 4–10]; mean age of 59·8 years [SD 11·7] with multiorgan abnormalities vs mean age of 52·8 years [11·9] without multiorgan abnormalities; p<0·0001), more likely to have three or more comorbidities (OR 2·47 [1·32–4·82]; padjusted=0·0059), and more likely to have a more severe acute infection (acute CRP >5mg/L, OR 3·55 [1·23–11·88]; padjusted=0·025) than those without multiorgan abnormalities. Presence of lung MRI abnormalities was associated with a two-fold higher risk of chest tightness, and multiorgan MRI abnormalities were associated with severe and very severe persistent physical and mental health impairment (PHOSP-COVID symptom clusters) after hospitalisation. Interpretation: After hospitalisation for COVID-19, people are at risk of multiorgan abnormalities in the medium term. Our findings emphasise the need for proactive multidisciplinary care pathways, with the potential for imaging to guide surveillance frequency and therapeutic stratification

Composition and Activity of Microbial Communities along the Redox Gradient of an Alkaline, Hypersaline, Lake

We compared the composition of microbial communities obtained by sequencing 16S rRNA gene amplicons with taxonomy derived from metatranscriptomes from the same samples. Samples were collected from alkaline, hypersaline Mono Lake, California, USA at five depths that captured the major redox zones of the lake during the onset of meromixis. The prokaryotic community was dominated by bacteria from the phyla Proteobacteria, Firmicutes, and Bacteroidetes, while the picoeukaryotic chlorophyte Picocystis dominated the eukaryotes. Most (80%) of the abundant (>1% relative abundance) OTUs recovered as amplicons of 16S rRNA genes have been reported in previous surveys, indicating that Mono Lake's microbial community has remained stable over 12 years that have included periods of regular, annual overturn interspersed by episodes of prolonged meromixis that result in extremely reducing conditions in bottom water. Metatranscriptomic sequences binned predominately to the Gammaproteobacteria genera Thioalkalivibrio (4–13%) and Thioalkalimicrobium (0–14%); and to the Firmicutes genera Dethiobacter (0–5%) and Clostridium (1–4%), which were also abundant in the 16S rRNA gene amplicon libraries. This study provides insight into the taxonomic affiliations of transcriptionally active communities of the lake's water column under different redox conditions

Natural Resources Research Institute Technical Report

Part II, Technical Report, NRRI/TR-87-3, December 1987The study objective was to analyze prospects for manufacturing wood products in Minnesota using birch in small scale and cottage industries. The current status of Minnesota's birch-based industry is described indicating that low valued firewood is 60 percent of consumption and the majority of the remaining consumption is in sawbolts. In secondary manufacturing most birch is used in low value-added products. Cottage industry is defined in several ways, but by any definition Minnesota has been effective in developing this segment. Some of Minnesota's cottage industry is using wood as a raw material. Three successful companies are profiled; a classic cottage industry, a small home-based cooking utensil manufacturer and a small wood products manufacturer. Each of these uses wood to a greater or lesser degree. There are good prospects for increasing the use of wood, including birch, in companies of this type. A discussion of challenges is presented and specific recommendations made. The profiled cottage industry would serve as a model for further expansion. Creation of a Minnesota wood turning industry should be explored. Establishment of a prototype manufacturing shop would help existing and new operations.Blandin Foundation, Grand Rapids, Minnesota; Natural Resources Research Institute, University of Minnesota, Duluth 3151 Miller Trunk Highway, Duluth , Minnesota 5581

Environmental Sources of Bacteria Differentially Influence Host-Associated Microbial Dynamics.

Host-associated microbial dynamics are influenced by dietary and immune factors, but how exogenous microbial exposure shapes host-microbe dynamics remains poorly characterized. To investigate this phenomenon, we characterized the skin, rectum, and respiratory tract-associated microbiota in four aquarium-housed dolphins daily over a period of 6 weeks, including administration of a probiotic during weeks 4 to 6. The environmental bacterial sources were also characterized, including the animals' human handlers, the aquarium air and water, and the dolphins' food supply. Continuous microbial exposure occurred between all sites, yet each environment maintained a characteristic microbiota, suggesting that the majority of exposure events do not result in colonization. Small changes in water physicochemistry had a significant but weak correlation with change in dolphin-associated bacterial richness but had no influence on phylogenetic diversity. Food and air microbiota were the richest and had the largest conditional influence on other microbiota in the absence of probiotics, but during probiotic administration, food alone had the largest influence on the stability of the dolphin microbiota. Our results suggest that respiratory tract and gastrointestinal epithelium interactions with air- and food-associated microbes had the biggest influence on host-microbiota dynamics, while other interactions, such as skin transmission, played only a minor role. Finally, direct oral stimulation with a foreign exogenous microbial source can have a profound effect on microbial stability. IMPORTANCE These results provide valuable insights into the ecological influence of exogenous microbial exposure, as well as laying the foundation for improving aquarium management practices. By comparing data for dolphins from aquaria that use natural versus artificial seawater, we demonstrate the potential influence of aquarium water disinfection procedures on dolphin microbial dynamics

Table_3_Transport from the wild rapidly alters the diversity and composition of skin microbial communities and antifungal taxa in spring peeper frogs.xlsx

Amphibians are routinely collected from the wild and added into managed care and public display facilities; however, there is a gap in understanding how these practices might alter the diversity and composition of skin microbial communities on these animals. The aim of this study was to evaluate and compare skin microbial communities of spring peeper frogs (Pseudacris crucifer) from acquisition in the wild through the end of their quarantine period and identify microbial taxa with antifungal properties. From an original group of seventy-six frogs, cohorts of ten were swabbed when acquired in the wild, upon transport from the wild, and swabbed throughout a 9-week quarantine period while under managed care. An immediate loss of microbial richness and diversity was evident upon transfer of the frogs from their original environment and continued throughout subsequent sampling time-points during quarantine. Importantly, antifungal taxa comprised significantly more of the overall skin community after the frogs were moved from the wild, largely due to members of the family Moraxellaceae. Overall, our findings demonstrate that amphibian skin microbiome changes immediately on removal from the wild, and that these changes persist throughout quarantine while being housed under managed care. This may play a pivotal role in the development of dermatological disease and have implications in the health and immune function of amphibians.</p

Table_1_Transport from the wild rapidly alters the diversity and composition of skin microbial communities and antifungal taxa in spring peeper frogs.docx

Amphibians are routinely collected from the wild and added into managed care and public display facilities; however, there is a gap in understanding how these practices might alter the diversity and composition of skin microbial communities on these animals. The aim of this study was to evaluate and compare skin microbial communities of spring peeper frogs (Pseudacris crucifer) from acquisition in the wild through the end of their quarantine period and identify microbial taxa with antifungal properties. From an original group of seventy-six frogs, cohorts of ten were swabbed when acquired in the wild, upon transport from the wild, and swabbed throughout a 9-week quarantine period while under managed care. An immediate loss of microbial richness and diversity was evident upon transfer of the frogs from their original environment and continued throughout subsequent sampling time-points during quarantine. Importantly, antifungal taxa comprised significantly more of the overall skin community after the frogs were moved from the wild, largely due to members of the family Moraxellaceae. Overall, our findings demonstrate that amphibian skin microbiome changes immediately on removal from the wild, and that these changes persist throughout quarantine while being housed under managed care. This may play a pivotal role in the development of dermatological disease and have implications in the health and immune function of amphibians.</p

Table_2_Transport from the wild rapidly alters the diversity and composition of skin microbial communities and antifungal taxa in spring peeper frogs.docx

Amphibians are routinely collected from the wild and added into managed care and public display facilities; however, there is a gap in understanding how these practices might alter the diversity and composition of skin microbial communities on these animals. The aim of this study was to evaluate and compare skin microbial communities of spring peeper frogs (Pseudacris crucifer) from acquisition in the wild through the end of their quarantine period and identify microbial taxa with antifungal properties. From an original group of seventy-six frogs, cohorts of ten were swabbed when acquired in the wild, upon transport from the wild, and swabbed throughout a 9-week quarantine period while under managed care. An immediate loss of microbial richness and diversity was evident upon transfer of the frogs from their original environment and continued throughout subsequent sampling time-points during quarantine. Importantly, antifungal taxa comprised significantly more of the overall skin community after the frogs were moved from the wild, largely due to members of the family Moraxellaceae. Overall, our findings demonstrate that amphibian skin microbiome changes immediately on removal from the wild, and that these changes persist throughout quarantine while being housed under managed care. This may play a pivotal role in the development of dermatological disease and have implications in the health and immune function of amphibians.</p