Fair Allocation of Scarce Therapies for Coronavirus Disease 2019 (COVID-19)

The US Food and Drug Administration (FDA) has issued emergency use authorizations (EUAs) for monoclonal antibodies (mAbs) for nonhospitalized patients with mild or moderate coronavirus disease 2019 (COVID-19) disease and for individuals exposed to COVID-19 as postexposure prophylaxis. EUAs for oral antiviral drugs have also been issued. Due to increased demand because of the Delta variant, the federal government resumed control over the supply and asked states to ration doses. As future variants (e.g., the Omicron variant) emerge, further rationing may be required. We identify relevant ethical principles (i.e., benefiting people and preventing harm, equal concern, and mitigating health inequities) and priority groups for access to therapies based on an integrated approach to population health and medical factors (eg, urgently scarce healthcare workers, persons in disadvantaged communities hard hit by COVID-19). Using priority categories to allocate scarce therapies effectively operationalizes important ethical values. This strategy is preferable to the current approach of categorical exclusion or inclusion rules based on vaccination, immunocompromised status, or older age, or the ad hoc consideration of clinical risk factors

The GALFA-HI Compact Cloud Catalog

We present a catalog of 1964 isolated, compact neutral hydrogen clouds from the Galactic Arecibo L-Band Feed Array Survey Data Release One (GALFA-HI DR1). The clouds were identified by a custom machine-vision algorithm utilizing Difference of Gaussian kernels to search for clouds smaller than 20'. The clouds have velocities typically between |VLSR| = 20-400 km/s, linewidths of 2.5-35 km/s, and column densities ranging from 1 - 35 x 10^18 cm^-2. The distances to the clouds in this catalog may cover several orders of magnitude, so the masses may range from less than a Solar mass for clouds within the Galactic disc, to greater than 10^4 Solar Masses for HVCs at the tip of the Magellanic Stream. To search for trends, we separate the catalog into five populations based on position, velocity, and linewidth: high velocity clouds (HVCs); galaxy candidates; cold low velocity clouds (LVCs); warm, low positive-velocity clouds in the third Galactic Quadrant; and the remaining warm LVCs. The observed HVCs are found to be associated with previously-identified HVC complexes. We do not observe a large population of isolated clouds at high velocities as some models predict. We see evidence for distinct histories at low velocities in detecting populations of clouds corotating with the Galactic disc and a set of clouds that is not corotating.Comment: 34 Pages, 9 Figures, published in ApJ (2012, ApJ, 758, 44), this version has the corrected fluxes and corresponding flux histogram and masse

Mapping Hydrogen in the Galaxy, Galactic Halo, and Local Group with ALFA: The GALFA-HI Survey Starting with TOGS

Radio observations of gas in the Milky Way and Local Group are vital for understanding how galaxies function as systems. The unique sensitivity of Arecibo's 305m dish, coupled with the 7-beam Arecibo L-Band Feed Array (ALFA), provides an unparalleled tool for investigating the full range of interstellar phenomena traced by the HI 21cm line. The GALFA (Galactic ALFA) HI Survey is mapping the entire Arecibo sky over a velocity range of -700 to +700 km/s with 0.2 km/s velocity channels and an angular resolution of 3.4 arcminutes. We present highlights from the TOGS (Turn on GALFA Survey) portion of GALFA-HI, which is covering thousands of square degrees in commensal drift scan observations with the ALFALFA and AGES extragalactic ALFA surveys. This work is supported in part by the National Astronomy and Ionosphere Center, operated by Cornell University under cooperative agreement with the National Science Foundation.Comment: 3 pages, including 2 figure pages; figure image quality significantly reduced; for full resolution version, please see http://www.naic.edu/~gibson/cv/ao08_writeup.pdf ; to be published in AIP conference proceedings for ``The Evolution of Galaxies through the Neutral Hydrogen Window'', eds. R. Minchin & E. Momjia

The effect of optometric treatment on asthenopia experienced by VDT operators

Seventy three VDT operators at an Oregon electronics firm were asked to rate their visual symptomology related to VDT use. Nearly 55% of the respondents were classified as symptomatic. Smyptomatic subjects were given complete visual examinations. Twelve of these participants were asked to rate the effectiveness of both nearpoint and farpoint lens prescriptions after wearing each set of lenses in the same frame for a period of 4 weeks each. An in-plant visual screening was performed and recommendations were made regarding the accuracy of various optometric tests in/predicting symptomatic VDT operators. Both near and far lens treatment were shown to significantly reduce visual symptomology. Individual case analysis suggests that if the farpoint refraction is similar to the patient\u27s habitual lenses, then nearpoint lenses may be warranted and preferred

Measuring the 8621 \r{A} Diffuse Interstellar Band in Gaia DR3 RVS Spectra: Obtaining a Clean Catalog by Marginalizing over Stellar Types

Diffuse interstellar bands (DIBs) are broad absorption features associated with interstellar dust and can serve as chemical and kinematic tracers. Conventional measurements of DIBs in stellar spectra are complicated by residuals between observations and best-fit stellar models. To overcome this, we simultaneously model the spectrum as a combination of stellar, dust, and residual components, with full posteriors on the joint distribution of the components. This decomposition is obtained by modeling each component as a draw from a high-dimensional Gaussian distribution in the data-space (the observed spectrum) -- a method we call "Marginalized Analytic Data-space Gaussian Inference for Component Separation" (MADGICS). We use a data-driven prior for the stellar component, which avoids missing stellar features not well-modeled by synthetic spectra. This technique provides statistically rigorous uncertainties and detection thresholds, which are required to work in the low signal-to-noise regime that is commonplace for dusty lines of sight. We reprocess all public Gaia DR3 RVS spectra and present an improved 8621 \r{A} DIB catalog, free of detectable stellar line contamination. We constrain the rest-frame wavelength to $8623.14 \pm 0.087$ \r{A} (vacuum), find no significant evidence for DIBs in the Local Bubble from the $1/6^{\rm{th}}$ of RVS spectra that are public, and show unprecedented correlation with kinematic substructure in Galactic CO maps. We validate the catalog, its reported uncertainties, and biases using synthetic injection tests. We believe MADGICS provides a viable path forward for large-scale spectral line measurements in the presence of complex spectral contamination.Comment: 25 pages, 25 figures, submitted to Ap

Experiences of women with cardiac disease in pregnancy: A systematic review and metasynthesis

© Author(s) (or their employer(s)) 2018. Objective Cardiac disease in pregnancy is a leading cause of maternal death in high-income countries. Evidence-based guidelines to assist in planning and managing the healthcare of affected women is lacking. The objective of this research was to produce the first qualitative metasynthesis of the experiences of pregnant women with existing or acquired cardiac disease to inform improved healthcare services. Method We conducted a systematic search of peerreviewed publications in five databases to investigate the decision-making processes, supportive strategies and healthcare experiences of pregnant women with existing or acquired cardiac disease, or of affected women contemplating pregnancy. Identified publications were screened for duplication and eligibility against selection criteria, following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We then undertook a thematic analysis of the data relating to women's experiences extracted from each publication to inform new healthcare practices and communication. Results Eleven studies from six countries were included in our meta-synthesis. Four themes were revealed. Women with congenital and acquired heart disease identified situations where they had either taken charge of decision-making, lacked control or experienced emotional uncertainty when making decisions. Some women were risk aware and determined to take care of themselves in pregnancy while others downplayed the risks. Women with heart disease acknowledged the importance of specific social support measures during pregnancy and after child birth, and reported a spectrum of healthcare experiences. Conclusions There is a lack of integrated and tailored healthcare services and information for women with cardiac disease in pregnancy. The experiences of women synthesised in this research has the potential to inform new evidencebased guidelines to support the decision-making needs of women with cardiac disease in pregnancy. Shared decisionmaking must consider communication across the clinical team. However, coordinated care is challenging due to the different specialists involved and the limited clinical evidence concerning effective approaches to managing such complex care

The challenges of urban ageing : making cities age-friendly in Europe

Urban ageing is an emerging domain that deals with the population of older people living in cities. The ageing of society is a positive yet challenging phenomenon, as population ageing and urbanisation are the culmination of successful human development. One could argue whether the city environment is an ideal place for people to grow old and live at an old age compared to rural areas. This viewpoint article explores and describes the challenges that are encountered when making cities age-friendly in Europe. Such challenges include the creation of inclusive neighbourhoods and the implementation of technology for ageing-in-place. Examples from projects in two age-friendly cities in The Netherlands (The Hague) and Poland (Cracow) are shown to illustrate the potential of making cities more tuned to the needs of older people and identify important challenges for the next couple of years. Overall, the global ageing of urban populations calls for more age-friendly approaches to be implemented in our cities. It is a challenge to prepare for these developments in such a way that both current and future generations of older people can benefit from age-friendly strategies