COVID-19 Pandemic and Radiology: Facts, Resources, and Suggestions for Near-term Protocols

The purpose of this editorial is to offer a synopsis about the COVID-19 pandemic and to present some recommendations as they relate to the practice of radiology, focused on Low- and Middle-Income Countries (LMIC). Health departments and professional bodies around the world are issuing guidelines for personal protection and patient handling in radiology. In High-Income Countries (HIC) these guidelines have been periodically updated as knowledge evolves about COVID-19 viral disease (1,2,3). The HIC guidelines assume the availability of portable radiography, ability to reserve one of many CT scanners only for COVID-19 patients, supply of a whole range of personal protective equipment (PPE), sanitizers and a variety of disinfecting chemicals. Nevertheless the exponential spread of COVID-19 is causing shortages of supplies in regions with supposedly “unlimited” resources. Much continues to be published on the rapidly evolving body of knowledge on this highly contagious respiratory infection, with a much higher mortality compared to the Influenza-A virus responsible for respiratory disease during “flu season” (4). Concurrently, speculative and false information is being exchanged on social media by “experts” from all walks of life offering “science” on the current pandemic. We urge our readers to use resources from established health organizations and universities, many of whom are referenced in this editorial

PACS for the Developing World

Digital imaging is now firmly ensconced in the developed world. Its widespread adoption has enabled instant access to images, remote viewing, remote consultation, and the end of lost or misplaced film. Unfortunately, the current paradigm of Picture Archiving and Communication System (PACS), with advanced technology inseparable from high complexity, high purchase costs, and high maintenance costs, is not suited for the low-income developing world. Like the simple, easy to repair, 1950’s American cars still running on the streets of Havana, the developing world requires a PACS (DW-PACS) that can perform basic functions and survive in a limited-resource environment. The purpose of this article is to more fully describe this concept and to present a blueprint for PACS tailored to the needs and resources of the developing world. This framework should assist both users looking for a vendor-supplied or open-source solutions and developers seeking to address the needs of this emerging market

Current Concepts Imaging in COVID-19 and the Challenges for Low and Middle Income Countries

With nearly 3,800,000 cases and 270,000 deaths reported worldwide, COVID-19 is a global pandemic unlike any we have seen in our lifetimes (1). As early as 1995, the WHO was warning of a global infectious disease crisis, citing 30 new infectious diseases emerging in the past 20 years, loss of antibiotic effectiveness, low rates of immunization, poverty, and inadequate investment in public health contributing to the more than 17 million people dying each year from infectious diseases, principally in Low and Middle Income countries (LMIC) (2). Unlike previous infectious diseases, at the time of this writing over 63% of the total reported cases of COVID-19 are in 6 High Income Countries (HIC): USA, Italy, Spain, France, Germany and the UK. Information concerning the imaging findings in COVID-19 has been rapidly disseminated from the centers first affected by the pandemic. This article attempts to summarize the current state of knowledge regarding the imaging findings in COVID-19, focusing on pulmonary findings, and offer recommendation for the use of imaging for diagnosis and surveillance of COVID-19, particularly in LMIC

First results from the VIRIAL survey: the stellar content of UVJUVJ-selected quiescent galaxies at 1.5<z<21.5 < z < 2 from KMOS

We investigate the stellar populations of 25 massive, galaxies ($\log[M_\ast/M_\odot] \geq 10.9$) at $1.5 < z < 2$ using data obtained with the K-band Multi-Object Spectrograph (KMOS) on the ESO VLT. Targets were selected to be quiescent based on their broadband colors and redshifts using data from the 3D-HST grism survey. The mean redshift of our sample is $\bar{z} = 1.75$, where KMOS YJ-band data probe age- and metallicity-sensitive absorption features in the rest-frame optical, including the $G$ band, Fe I, and high-order Balmer lines. Fitting simple stellar population models to a stack of our KMOS spectra, we derive a mean age of $1.03^{+0.13}_{-0.08}$ Gyr. We confirm previous results suggesting a correlation between color and age for quiescent galaxies, finding mean ages of $1.22^{+0.56}_{-0.19}$ Gyr and $0.85^{+0.08}_{-0.05}$ Gyr for the reddest and bluest galaxies in our sample. Combining our KMOS measurements with those obtained from previous studies at $0.2 < z < 2$ we find evidence for a $2-3$ Gyr spread in the formation epoch of massive galaxies. At $z < 1$ the measured stellar ages are consistent with passive evolution, while at $1 < z \lesssim2$ they appear to saturate at $\sim$1 Gyr, which likely reflects changing demographics of the (mean) progenitor population. By comparing to star-formation histories inferred for "normal" star-forming galaxies, we show that the timescales required to form massive galaxies at $z \gtrsim 1.5$ are consistent with the enhanced $\alpha$-element abundances found in massive local early-type galaxies.Comment: 6 pages, 5 figures, accepted for publication in ApJ

The Kinematics of Massive Quiescent Galaxies at 1.4 &lt; z &lt;2.1: Dark Matter Fractions, IMF Variation, and the Relation to Local Early-type Galaxies

We study the dynamical properties of massive quiescent galaxies at 1.4 DM[e]. Comparing our high-redshift sample to their likely descendants at low redshift, we find that f DM[e] has increased by a factor of more than 4 since z ≈ 1.8, from f DM[e] = 6.6% ± 1.0% to ~24%. The observed increase appears robust to changes in the methods used to estimate dynamical masses or match progenitors and descendants. We quantify possible variation of the stellar IMF through the offset parameter α, defined as the ratio of dynamical mass in stars to the stellar mass estimated using a Chabrier IMF. We demonstrate that the correlation between stellar velocity dispersion and α reported among quiescent galaxies at low redshift is already in place at z = 2, and we argue that subsequent evolution through (mostly minor) merging should act to preserve this relation while contributing significantly to galaxies' overall growth in size and stellar mass

MRI-localized biopsies reveal subtype-specific differences in molecular and cellular composition at the margins of glioblastoma

Glioblastomas (GBMs) diffusely infiltrate the brain, making complete removal by surgical resection impossible. The mixture of neoplastic and nonneoplastic cells that remain after surgery form the biological context for adjuvant therapeutic intervention and recurrence. We performed RNA-sequencing (RNA-seq) and histological analysis on radiographically guided biopsies taken from different regions of GBM and showed that the tissue contained within the contrast-enhancing (CE) core of tumors have different cellular and molecular compositions compared with tissue from the nonenhancing (NE) margins of tumors. Comparisons with the The Cancer Genome Atlas dataset showed that the samples from CE regions resembled the proneural, classical, or mesenchymal subtypes of GBM, whereas the samples from the NE regions predominantly resembled the neural subtype. Computational deconvolution of the RNA-seq data revealed that contributions from nonneoplastic brain cells significantly influence the expression pattern in the NE samples. Gene ontology analysis showed that the cell type-specific expression patterns were functionally distinct and highly enriched in genes associated with the corresponding cell phenotypes. Comparing the RNA-seq data from the GBM samples to that of nonneoplastic brain revealed that the differentially expressed genes are distributed across multiple cell types. Notably, the patterns of cell type-specific alterations varied between the different GBM subtypes: the NE regions of proneural tumors were enriched in oligodendrocyte progenitor genes, whereas the NE regions of mesenchymal GBM were enriched in astrocytic and microglial genes. These subtypespecific patterns provide new insights into molecular and cellular composition of the infiltrative margins of GBM

The Kinematics of Massive Quiescent Galaxies at 1.4 < z < 2.1: Dark Matter Fractions, IMF Variation, and the Relation to Local Early-type Galaxies

We study the dynamical properties of massive quiescent galaxies at 1.4 <z <2.1 using deep Hubble Space Telescope WFC3/F160W imaging and a combination of literature stellar velocity dispersion measurements and new near-infrared spectra obtained using the K-band Multi Object Spectrograph(KMOS) on the ESO Very Large Telescope. We use these data to show that the typical dynamical-to-stellar mass ratio has increased by∼0.2 dex from z = 2 to the present day, and we investigate this evolution in the context of possible changes in the stellar initial mass function(IMF) and/or fraction of dark matter contained within the galaxy effective radius,fDM[<re]. Comparing our high-redshift sample to their likely descendants at low redshift, we find that fDM[<re] has increased by a factor of more than 4 since z ≈ 1.8, from fDM[<re] = 6.6% +-1.0% to∼24%. The observed increase appears robust to changes in the methods used to estimate dynamical masses or match progenitors and descendants. We quantify possible variation of the stellar IMF through the offset parameter α, defined as the ratio of dynamical mass in stars to the stellar mass estimated using a Chabrier IMF. We demonstrate that the correlation between stellar velocity dispersion and α reported among quiescent galaxies at low redshift is already in place atz = 2, and we argue that subsequent evolution through (mostly minor) merging should act to preserve this relation while contributing significantly to galaxies'overall growth in size and stellar mass.J.T.M. acknowledges the support of the Australian Research Council Centre of Excellence for All Sky Astrophysics in 3 Dimensions (ASTRO 3D), through project No. CE170100013. D.J.W. and M.F. acknowledge the support of the Deutsche Forschungsgemeinschaft via Project IDs 3871/1-1 and 3871/1-2. M.F. has received funding from the European Research Council (ERC) under the European Union’s Horizon 2020 research and innovation program (grant agreement No. 757535)

KMOS3D:dynamical constraints on the mass budget in early star-forming disks

We exploit deep integral-field spectroscopic observations with KMOS/Very Large Telescope of 240 star-forming disks at 0.6 &lt;z &lt;2.6 to dynamically constrain their mass budget. Our sample consists of massive (≳109.8M⊙) galaxies with sizes Re ≳ 2kpc. By contrasting the observed velocity and dispersion profiles with dynamical models, we find that on average the stellar content contributes 32-7 +8% of the total dynamical mass, with a significant spread among galaxies (68th percentile range fstar ∼ 18%-62%). Including molecular gas as inferred from CO- and dust-based scaling relations, the estimated baryonic mass adds up to 56-12 +17% of the total for the typical galaxy in our sample, reaching ∼90% at z &gt; 2. We conclude that baryons make up most of the mass within the disk regions of high-redshift star-forming disk galaxies, with typical disks at z &gt; 2 being strongly baryon-dominated within R e. Substantial object-to-object variations in both stellar and baryonic mass fractions are observed among the galaxies in our sample, larger than what can be accounted for by the formal uncertainties in their respective measurements. In both cases, the mass fractions correlate most strongly with measures of surface density. High-Σstar galaxies feature stellar mass fractions closer to unity, and systems with high inferred gas or baryonic surface densities leave less room for additional mass components other than stars and molecular gas. Our findings can be interpreted as more extended disks probing further (and more compact disks probing less far) into the dark matter halos that host them.</p

Prototype Testing Results of Charged Particle Detectors and Critical Subsystems for the ESRA Mission to GTO

The Experiment for Space Radiation Analysis (ESRA) is the latest of a series of Demonstration and Validation (DemVal) missions built by the Los Alamos National Laboratory, with the focus on testing a new generation of plasma and energetic paritcle sensors along with critical subsystems. The primary motivation for the ESRA payloads is to minimize size, weight, power, and cost while still providing necessary mission data. These new instruments will be demonstrated by ESRA through ground-based testing and on-orbit operations to increase their technology readiness level such that they can support the evolution of technology and mission objectives. This project will leverage a commercial off-the-shelf CubeSat avionics bus and commercial satellite ground networks to reduce the cost and timeline associated with traditional DemVal missions. The system will launch as a ride share with the DoD Space Test Program to be inserted in Geosynchronous Transfer Orbit (GTO) and allow observations of the Earth\u27s radiation belts. The ESRA CubeSat consists of two science payloads and several subsystems: the Wide field-of-view Plasma Spectrometer, the Energetic Charged Particle telescope, high voltage power supply, payload processor, flight software architecture, and distributed processor module. The ESRA CubeSat will provide measurements of the plasma and energetic charged particle populations in the GTO environment for ions ranging from ~100 eV to ~1000 MeV and electrons with energy ranging from 100 keV to 20 MeV. ESRA will utilize a commercial 12U bus and demonstrate a low-cost, rapidly deployable spaceflight platform with sufficient SWAP to enable efficient measurements of the charged particle populations in the dynamic radiation belts

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London