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

Memorializing the Freedom Riders

Ellen Spears examines the ongoing struggle to create a memorial honoring the Freedom Riders during the 1961 bus bombing in Anniston, Alabama

"Rights Still Being Righted": Scottsboro Eighty Years Later

Daily Worker, Scottsboro headline, 1932. Courtesy of Emory University's Manuscript, Archives, and Rare Book Library. In her essay on the March 25, 2011 commemoration activities marking the eightieth anniversary of the Scottsboro Boys' arrests, Ellen Spears reflects on how the Scottsboro trials have been represented and remembered. Spears considers the space of the Scottsboro Boys Museum and Cultural Center as the commemoration setting and the challenges of civil rights memorialization

Visibility and anonymity effects on attraction and group cohesiveness

This study investigated attraction and group cohesiveness under different visibility and anonymity conditions for social categories that differed in their capacity to be visually cued. Using computer-mediated communication in 36 mixed gender (visually cued category) and nationality (non-visually cued category) groups, we manipulated social category salience (via discussion topic), and anonymity versus visibility (via live video links). Under high salience, the effects of anonymity versus visibility were moderated by availability of visible category cues. Visibility increased attraction and cohesiveness for visually cued groups, whereas anonymity increased attraction and cohesiveness for non-visually cued groups. Path analysis showed that, under high salience, effects of visibility and anonymity were mediated by self-categorization processes, triggered by prototypicality of self in the case of non-visually cued groups under anonymity. In low salience conditions, visibility directly cued attraction independently from self-categorization, in line with relational attraction processes

Denileukin Diftitox (Ontak) as Maintenance Therapy for Peripheral T-Cell Lymphomas: Three Cases with Sustained Remission

Peripheral T-cell lymphomas (PTCL) are rare but markedly aggressive forms of non-Hodgkin’s lymphoma (NHL). They carry a poor prognosis, with current therapeutic approach being generally ineffective. The most employed first-line treatment is CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisone), which still results in high rates of relapses. Denileukin diftitox is a fusion protein combining the cytotoxic portion of the diphtheria toxin and the receptor-binding domain of the interleukin-2 (IL-2) molecule, thereby targeting cells expressing the IL-2 receptor, including both T-cell and B-cell lymphomas. It has been approved for the treatment of cutaneous T-cell lymphomas, and it has documented activity in PTCL both as a single agent and as part of combination therapy. This report documents three cases of PTCL where denileukin diftitox has been used as long-term maintenance therapy after complete remission was achieved. While the overall survival rate of patients with advanced stage, refractory PTCL is generally poor (with median overall survival of 5.5 months), the three patients described in this report are all experiencing an ongoing complete remission for more than four years

Motherhood on the inside: exploring the challenges facing incarcerated women at Julia Tutwiler Prison for Women

In this thesis, I argue that the criminal justice system is deeply entrenched in racist and classist perceptions that make incarcerated women especially vulnerable to policies and ideologies that regularly involve the denial of their reproductive and parental rights. With shifting public policies and sentencing reform in reaction to the "war on drugs," women, the poor, and people of color have disproportionately become caught in the net of the criminal justice system. The subtle fusion of the war on drugs with the fetal protection movement has furthermore positioned pregnant women and mothers quite precariously within the criminal justice system, and Alabama's own chemical endangerment law provides a useful case study for exploring this topic. This thesis highlights the unique challenges facing women in correctional institutions, focusing on women's reproductive rights and claims to motherhood in particular. An elaboration of the history of Alabama's Julia Tutwiler Prison for Women helps to reveal these broader issues. In this thesis, I argue that motherhood can provide a means for incarcerated women to strategize resistance and claim agency from the space of the prison, suggesting that programs such as the Montgomery-based organization Aid to Inmate Mothers help meet the specific needs of incarcerated women that are otherwise neglected by the prison system. I use data that I collected from fifteen interviews conducted with inmate mothers at Tutwiler Prison, drawing on the experiences of these women to make an argument about the nature of incarceration for women and the potential for motherhood to be an empowering identity. (Published By University of Alabama Libraries

Community Perspectives and Environmental Justice Issues in an Unincorporated Black Township

Through each era, the southeastern United States was and continues to be an epicenter for industrial companies to establish factories and plants. Though this development attracts economic gain for the companies and surrounding areas, low-income and predominantly Black communities bear the brunt of the environmental consequences while frequently remaining stagnant economically. This qualitative, community-based participatory research study grew out of a larger study designed to recruit lay community advisors from communities labeled as hard to reach in research. We focus on Holt, Alabama, an unincorporated community in the southeastern United States region. The primary goal of this research inquiry is to thematically analyze community interviews stemming from a topic of research, practice, and policy interest to community members: the effects of industrial pollution on Holt citizens’ daily lives. Content analysis of focus-group transcripts revealed four emergent themes, including: (1) how the pollution affects their water, soil, and air quality; (2) illness related to pollution; (3) community engagement and empowerment; and (4) suggestions regarding what government officials could do to address this area of need. Building upon the prior research regarding environmental justice, human flourishing, and the definition of nurturing environments, suggestions are made regarding the creation, implementation, and maintenance of project advisory councils focused on issues of environmental justice. Community advocacy and empowerment as well as community and scientific partnerships are imperative to alleviate problems associated with environmental justice