Pregnancy inclusion in US statewide scarce resource allocation guidelines during COVID-19 pandemic

OBJECTIVE: On November 22, 2022, 2 hospitals in Oregon declared crisis standards of care (CSC) in response to the “tripledemic,” or rising rates of influenza, respiratory syncytial virus, and COVID-19. CSC guidelines direct the triage of limited resources when demands for health care exceed standard capacity, such as intensive care unit beds. Hospital CSCs are adopted from statewide CSCs, and many states developed their CSC policies during the COVID-19 pandemic,which placed a global strain on the healthcare infrastructure. A systematic review of allocation guidelines found that the Sequential Organ Failure Assessment (SOFA) score is used to determine priority for allocation of scarce resources among patients seeking the same resource. However, the SOFA score has not been validated in pregnancy when normal physiological changes, such as platelet count and bilirubin level, are expected to affects core parameters compared with non-gravid physiology. In this report, we assess whether statewide CSC guidelines active during COVID-19, included pregnancy. Among those that do, we describe the ethical triage principles used in allocation guidelines when a pregnant patient was among potential recipients

Trematode Infections inLittorina littoreaon the New Hampshire Coast

The prevalence of parasite infections in Littorina littorea (Common Periwinkle) was examined at 16 rocky intertidal sites along the New Hampshire coastline over three summers (2006 to 2008). We sampled over a relatively small spatial scale (21 km) and expected that the prevalence of infections in L. littorea would be similar between sites over this sampling area. In total, 1983 snails were collected from areas at mean low water during spring tides. Snail size (mm), gender, and type of parasitic infection were noted for all snails. Eleven percent of snails collected were infected with rediae and cercariae of the trematodes Cryptocotyle lingua or Cercaria parvicaudata; one snail had a double infection of both trematodes. The prevalence of infection at sites ranged from 1.9% to 30.1%. At all sites, female snails outnumbered male snails, and a greater proportion of females were infected than males. Large snails were more likely to be infected with trematodes at 3 sites, while a higher level of infection was found in small snails at 1 site. Snails at wave-protected sites were more likely to be infected than snails at wave-exposed sites. No relationship was found between the number of gulls at a site and the prevalence of infection. Although temporal variation in levels of prevalence in parasitic infections may explain some of our site-to-site differences, our data show large spatial variation of parasite prevalence in L. littorea over a minimum distance of 0.5 km and provide a foundation to test hypotheses concerning the susceptibility of female and immature (small) snails to infection

Study of the radiative decay ϕ→ηγ\phi \to \eta \gamma with CMD-2 detector

Using the $1.9 pb^{-1}$ of data collected with the CMD-2 detector at VEPP-2M the decay mode $\phi \to \eta \gamma$, $\eta \to \pi^+\pi^-\pi^0$ has been studied. The obtained branching ratio is B($\phi \to \eta \gamma) = (1.18 \pm 0.03 \pm 0.06)$.Comment: 13 pages, 5 figures, LaTex2e, to be published in Phys. Lett.

Mutations of the BRAF gene in human cancer

Cancers arise owing to the accumulation of mutations in critical genes that alter normal programmes of cell proliferation, differentiation and death. As the first stage of a systematic genome-wide screen for these genes, we have prioritized for analysis signalling pathways in which at least one gene is mutated in human cancer. The RAS RAF MEK ERK MAP kinase pathway mediates cellular responses to growth signals. RAS is mutated to an oncogenic form in about 15% of human cancer. The three RAF genes code for cytoplasmic serine/threonine kinases that are regulated by binding RAS. Here we report BRAF somatic missense mutations in 66% of malignant melanomas and at lower frequency in a wide range of human cancers. All mutations are within the kinase domain, with a single substitution (V599E) accounting for 80%. Mutated BRAF proteins have elevated kinase activity and are transforming in NIH3T3 cells. Furthermore, RAS function is not required for the growth of cancer cell lines with the V599E mutation. As BRAF is a serine/threonine kinase that is commonly activated by somatic point mutation in human cancer, it may provide new therapeutic opportunities in malignant melanoma

Tests of the Equivalence Principle with Neutral Kaons

We test the Principle of Equivalence for particles and antiparticles, using CPLEAR data on tagged K0 and K0bar decays into pi^+ pi^-. For the first time, we search for possible annual, monthly and diurnal modulations of the observables |eta_{+-}| and phi_{+-}, that could be correlated with variations in astrophysical potentials. Within the accuracy of CPLEAR, the measured values of |eta_{+-}| and phi_{+-} are found not to be correlated with changes of the gravitational potential. We analyze data assuming effective scalar, vector and tensor interactions, and we conclude that the Principle of Equivalence between particles and antiparticles holds to a level of 6.5, 4.3 and 1.8 x 10^{-9}, respectively, for scalar, vector and tensor potentials originating from the Sun with a range much greater than the distance Earth-Sun. We also study energy-dependent effects that might arise from vector or tensor interactions. Finally, we compile upper limits on the gravitational coupling difference between K0 and K0bar as a function of the scalar, vector and tensor interaction range.Comment: 15 pages latex 2e, five figures, one style file (cernart.csl) incorporate

Study of the Process e+e−→KL0KS0e^+e^- \to K^0_L K^0_S in the C.M.Energy Range 1.05-1.38 GeV with CMD-2

The process $e^+e^- \to K^0_L K^0_S$ has been studied with the CMD-2 detector using about 950 events detected in the center-of-mass energy range from 1.05 to 1.38 GeV. The cross section exceeds the expectation based on the contributions of the rho(770), omega(782) and phi(1020) mesons only.Comment: 12 pages, 3 figures, uses elsart.cls, submitted to Physics Letters

High-statistics measurement of the pion form factor in the rho-meson energy range with the CMD-2 detector

We present a measurement of the pion form factor based on e+e- annihilation data from the CMD-2 detector in the energy range 0.6<sqrt(s)<1.0 GeV with a systematic uncertainty of 0.8%. A data sample is five times larger than that used in our previous measurement.Comment: 18 pages, 10 figures. Added comparison with KLOE measurement, minor updates. Accepted by PL

Study of KS KL Coupled Decays and KL -Be Interactions with the CMD-2 Detector at VEPP-2M Collider

The integrated luminosity about 4000 inverse nanobarn of around phi meson mass ( 5 millions of phi mesons) has been collected with the CMD-2 detector at the VEPP-2M collider. A latest analysis of the KS KL coupled decays based on 30 % of available data is presented in this paper. The KS KL pairs from phi meson decays were reconstructed in the drift chamber when both kaons decayed into two charged particles. From a sample of 1423 coupled decays a selection of candidates to the CP violating KL into pi+ pi- decay was performed. CP violating decays were not identified because of the domination of events with a KL regenerating at the Be beam pipe into KS and a background from KL semileptonic decays. The regeneration cross section of 110 MeV/c KL mesons was found to be 53 +- 17 mb in agreement with theoretical expectations. The angular distribution of KS mesons after regeneration and the total cross section of KL for Be have been measured.Comment: 14 pages, 8 figure