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

Exploring Potential of Seed Endophytic Bacteria for Enhancing Drought Stress Resilience in Maize (Zea mays L.)

Water scarcity is abiotic stress that is becoming more prevalent as a result of human activities, posing a threat to agriculture and food security. Recently, endophytic bacteria have been proven to reduce drought stress and increase crop productivity. Here, we explored the efficacy of seed endophytic bacteria in maize crops under water deficit conditions. For this purpose, twenty-seven endophytic bacteria have been isolated from three distinct maize cultivars seeds (Malka 2016, Sahiwal Gold and Gohar-19) and evaluated for desiccation tolerance of −0.18, −0.491, and −1.025 MPa induced by polyethylene glycol (PEG) 6000. The nine isolates were chosen on the basis of desiccation tolerance and evaluated for maize growth promotion and antioxidant activity under normal and drought conditions. Results showed that drought stress significantly decreased the growth of maize seedlings. However, isolates SM1, SM4, SM19, and SM23 significantly improved the root and shoot length, plant biomass, leaf area, proline content, sugar, and protein content under normal and drought conditions. Antioxidant enzymes were significantly decreased at p-value < 0.05 with inoculation of seed endophytic bacteria under drought conditions. However, further experiments of seed endophytic bacteria (SM1, SM4, SM19, and SM23) should be conducted to validate results

An innovative outpatient monitor service for gynecological patients in the United Kingdom: case study evaluation of clinical effectiveness, economic outcomes, patient safety, and service improvement

Background: Failure to attend appointments places a huge strain on health care systems around the world, resulting in poorer care for the patients, waste of staff time and increased waiting times. This study looked at the impact of an Outpatient-Monitor-Service (OMS) on clinical, economic, patient safety and service improvement outcomes in gynaecology patients compared with care as usual (with no access to the OMS). Methods: We conducted a retrospective match-pair controlled study at a London-based hospital. The cohort included adult women who received either (i) gynecological, (ii) hysteroscopy or (iii) vulval procedures. A cost-consequences analysis compared intervention (who received the OMS) with control (historical cases who did not receive the OMS. Main outcome measures were clinical-effectiveness, NHS-cost, patient safety, and service improvement. Results: The intervention had positive impacts spanning clinical, patient safety and service improvement areas and showed cost saving results for the healthcare in terms of reduced follow-up consultations and did-not-attend occurrences. Conclusions: The OMS offered by Message Dynamics appears to be a successful digital health technology to monitor gynecological patients' conditions and inform clinical decision making via remote channels, which is particularly relevant in coronavirus disease pandemic

Deciphering the Potential of Bioactivated Rock Phosphate and Di-Ammonium Phosphate on Agronomic Performance, Nutritional Quality and Productivity of Wheat (Triticum aestivum L.)

Wheat is one of the leading staple crops in many countries. Phosphorus (P) plays an important role for wheat growth and yield as it takes part in many metabolic pathways. Even for soluble phosphatic fertilizers, most of the Pakistani soils, being alkaline and calcareous in nature, show phosphorus use efficiency (PUE) not more than 10–25%. The major issue is the unavailability of P due to fixation and precipitation reactions with soil particles. Composting of rock-phosphate with animal and poultry manures supplied with bio-stimulated phosphate solubilizing bacteria (PSB) not only enhances the RP solubilization but also serves as a potent source of P for plants. Composted/bio-activated rock-phosphate (B-RP), prepared by group of three bacterial strains i.e., Pseudomonas sp. (E11), Bacillus sp. (MN54) and Enterobacter sp. (MN17) aided with molasses (5%) and urea (10%), was tested alone and in various combinations with di-ammonium phosphate (DAP). In this pot trial, the combined application of B-RP and DAP was found superior to the sole application of B-RP. Even the combination of B-RP and DAP sharing equal amount of recommended P showed better results as compared to the sole application of DAP, giving improved shoot biomass (25%), total P-uptake (67%), recovery efficiency of P (75%), dry matter (29%), crude protein (29%), and other yield, physiological and nutritional quality parameters of wheat. So, it could be concluded that integrated use of B-RP and DAP with equal proportion of recommended P could serve as a better management practice for not only improving quantity but also the quality of the wheat grain

Novel Homozygous Mutations in the Genes TGM1, SULT2B1, SPINK5 and FLG in Four Families Underlying Congenital Ichthyosis

Background: Ichthyoses are a large group of hereditary cornification disorders, which are both clinically and etiologically heterogeneous and affect mostly all the skin surface of the patients. Ichthyosis has its origin in an ancient Greek word “ichthys” meaning fish, this is because the ichthyosis patients have dry, thickened, and scaly skin. There is an excess accumulation of epidermal cells resulting in the appearance of continuous and widespread scales on the body. There are many varieties of ichthyosis with a broad spectrum of intensity, severity, and associated symptoms, most of them are extremely rare. Ichthyosis vulgaris is the most frequently occurring type of ichthyoses. Method: The present study consists of four Pakistani ichthyosis families (A, B, C, and D). Whole exome sequencing (WES) approach was used to identify the pathogenic sequence variants in probands. The segregation of these variants in other participants was confirmed by Sanger sequencing. Results: Total four variants including, two splice site (TGM1: c.2088 + 1G > A) and (SPINK5: c.882 + 1G > T), a missense (SULT2B1: c.419C > T; p. Ala140Val), and a nonsense (FLG: c.6109C > T; p. Arg2037Ter) variant were identified in families A, C, B, and D, respectively, as causative mutations responsible for ichthyosis in these families. Conclusion: Our study unravels the molecular etiology of the four Pakistani ichthyosis families and validates the involvement of TGM1, SULT2B1, SPINK5, and FLG, in the etiology of different forms of ichthyosis. In addition, this study also aims to give a detailed clinical report of the studied ichthyosis families

Potential enzyme inhibitor triazoles from aliphatic esters: Synthesis, enzyme inhibition and docking studies

Enzyme inhibitors are vital aspects for studying enzymes and are employed as drugs to treat certain disorders, thus implying pivotal role in drug discovery. In the current study, a series of triazole compounds 4(a-o) were synthesised to explore their inhibitory potential against α-glucosidase and urease enzymes. These derivatives with dichlorophenyl substituents were prepared by cyclization of thiosemicarbazides and their structures were confirmed through spectroanalytical techniques. The in vitro biological screening revealed that the compounds 4a, 4b, 4k, 4l, 4m, 4o having IC50 values of 121.09 ± 1.25, 137.22 ± 0.22, 110.4 ± 2.4, 114.79 ± 1.1, 146.72 ± 1.29, 94.21 ± 0.15 [µM] respectively, exhibited good potential α-glucosidase inhibition, in comparison to Acarbose: IC50 51.23 µM, while the compounds 4a, 4b, 4c, 4k, 4l, having IC50 values of 48.52 ± 0.39, 52.22 ± 1.37, 60.98 ± 0.34, 37.06 ± 0.51, 38.66 ± 1.7 [µM] respectively exhibited good potential for urease inhibition near to standard(Thiourea: IC50 24.14 [µM]). These in vitro findings were accompanied further by molecular docking simulations, which revealed significant binding interactions of the synthesized derivatives within the active sites of the enzymes