18 research outputs found
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
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Indoor Air Pollution in Rural India
https://digitalcommons.wpi.edu/gps-posters/1757/thumbnail.jp
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Designing a Climate Program for Puerto Rico Project Center
The climate crisis is a global issue catalyzed by a steady increase in atmospheric levels of greenhouse gases. This project focused on strategies to analyze and mitigate carbon emissions generated by WPI's Global Projects. To achieve this, we estimated the carbon emissions produced on IQP using the Puerto Rico Project Center as a case study, researched and compared carbon offset companies, and spoke to our stakeholders to generate the most effective guide and outreach methods. This work resulted in calculator tools that can be used to estimate IQP emissions, a roadmap of recommended steps towards carbon neutrality and sustainability, and a website to host our information and generate ongoing discussion around the climate crisis and sustainability initiatives
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HURON: Full-size Humanoid Robot (Lower Body)
In the past 20 years, there have been over 7 thousand natural disasters, totaling 1.23 million casualties and affecting 4.2 billion people. Often these disasters create hostile environments where human search-and-rescue missions are too dangerous. In these situations, humanoid robots can be used in place of human rescuers for a safer emergency response. This project aims to manufacture, design, and control the lower half of a self-balancing bipedal robot, named HURON. HURON will be able to react to forces anywhere on the body and move accordingly to regain balance and exhibit a human-like gait for walking. Using HURON for search and rescue eliminates the danger of sending search parties into high-risk environments, decreasing risk during disaster relief efforts. Therefore, this Major Qualifying Project started from scratch to develop the basis of a disaster relief humanoid robot which is comprised of three main systems: designing, sensing, and controlling. The main design constraint was that it would have human proportions without the need for a backpack. Additionally, since this robot would mimic a human, all components had to be designed such that a pair of pants could fit over the robot. In order to achieve this, research was done into the degrees of freedom (DOF) and proportions of human legs for 5’ 10” male. During the design process, a torque analysis and finite element analysis (FEA) were done and concluded that the robot had to be constructed out of a mixture between aluminum and steel components. In the end, the robot was made of over 130 manufactured components. In order to act, reason, and interact like humans, humanoids need to take input from the environment around them and react. This is done with sensors, as they take touch sensitivity inputs to understand the force transferred. To understand how balanced the humanoid robot is and how its weight is distributed, we implemented force sensors on the feet. With a combination of designing a circuit and applying the theory of foot force stability margin with the geometric and physical limitations of the robot, stability decisions were made. These decisions use the current stability state of the robot to determine how the robot must move in order to regain balance against external perturbations. Precise control of the hardware, based off inputs from the sensing circuits, is important for accurate control of the robot. Using the stability margins calculated from the force sensors in the feet as well as from the encoders in the motors, HURON can react to external forces. We yielded control of HURON using inverse kinematics based on the positions and angles of each of our joints. The outputs of our inverse kinematic equations returned specific positional poses, which were then converted to commands to the robot’s motors. Prior to testing on the physical robot, we opted for testing in two modes of simulations, Gazebo and MATLAB, to verify validity of our equations and feasibility. We then applied the techniques and equations used to the physical robot, allowing it to react to a push from behind and replicate human walking