32 research outputs found
Strangler unmasked:Parasitism of <i>Cystoderma amianthinum</i> by <i>Squamanita paradoxa</i> and S. <i>pearsonii</i>
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 โฅ18 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 5ยท0 months (IQR 4ยท2โ6ยท3) 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<0ยท0001) and independently associated with COVID-19 status (odds ratio [OR] 2ยท9 [95% CI 1ยท5โ5ยท8]; padjusted=0ยท0023) after adjusting for relevant confounders. Compared with controls, patients were more likely to have MRI evidence of lung abnormalities (p=0ยท0001; parenchymal abnormalities), brain abnormalities (p<0ยท0001; more white matter hyperintensities and regional brain volume reduction), and kidney abnormalities (p=0ยท014; 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 4โ10]; mean age of 59ยท8 years [SD 11ยท7] with multiorgan abnormalities vs mean age of 52ยท8 years [11ยท9] without multiorgan abnormalities; p<0ยท0001), more likely to have three or more comorbidities (OR 2ยท47 [1ยท32โ4ยท82]; padjusted=0ยท0059), and more likely to have a more severe acute infection (acute CRP >5mg/L, OR 3ยท55 [1ยท23โ11ยท88]; padjusted=0ยท025) 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
Prosperity and the future. : Speech on the progress and prosperity of the United States under the present Democratic administration, delivered before the Chamber of commerce of Raleigh, N. C., on May 31, 1916, by Hon. William G. McAdoo.
Presented by Mr. Simmons. Ordered printed June 3, 1916.Mode of access: Internet
Prohibition, nullification and lawlessness : address of William Gibbs McAdoo delivered at the mid-winter meeting of the Ohio State Bar Association, Toledo, Ohio, January 28, 1927.
Cover title.Mode of access: Internet
Enhancing the efficacy of behavior therapy for obesity: effects of aerobic exercise and a multicomponent maintenance program
Tested whether the efficacy of behavior therapy for obesity might be improved by the programmatic additions of an aerobic exercise regimen during treatment and a multicomponent maintenance program following treatment. 14 male and 76 female obese 22โ60 yr olds were randomly assigned to 2 treatment conditions (behavior therapy or behavior therapy plus aerobic exercise) and 2 posttreatment conditions (no further contact or a multicomponent maintenance program). The exercise regimen consisted of 80 min/week of brisk walking or stationary cycling. The maintenance program included therapist contact by telephone and mail and peer self-help group meetings. At posttreatment, Ss in the behavior therapy plus aerobic exercise condition lost significantly more weight than those who received behavior therapy only. Over an 18-mo follow-up period, maintenance program participants demonstrated significantly better weight-loss progress than Ss in the no-further-contact condition
Jacob Henry Schiff collection 1895, 1905-1918, 1935
Contains a signed letter to Louis Monash concerning immigration to the United States (1912), a signed letter of thanks to Everett P. Wheeler acknowledging a pamphlet on the Holy Land (1912), and two manuscript letters to William G. McAdoo, Sevretary of the Treasury, on various matters (1915, 1918)Also contains: Western Union telegram (1905); 1895 souvenir book from a fair in aid of the Educational Alliance & the Hebrew Technical Institute (of which he was a founding trustee); and 3 copies of memorial prayer said in his memory (1935)Gift, in part, of the Elsie O. and Philip D. Sang Foundatio