Characterizing urban vulnerability to heat stress using a spatially varying coefficient model.

Identifying and characterizing urban vulnerability to heat is a key step in designing intervention strategies to combat negative consequences of extreme heat on human health. This study combines excess non-accidental mortality counts, numerical weather simulations, US Census and parcel data into an assessment of vulnerability to heat in Houston, Texas. Specifically, a hierarchical model with spatially varying coefficients is used to account for differences in vulnerability among census block groups. Socio-economic and demographic variables from census and parcel data are selected via a forward selection algorithm where at each step the remaining variables are orthogonalized with respect to the chosen variables to account for collinearity. Daily minimum temperatures and composite heat indices (e.g. discomfort index) provide a better model fit than other ambient temperature measurements (e.g. maximum temperature, relative humidity). Positive interactions between elderly populations and heat exposure were found suggesting these populations are more responsive to increases in heat.

Semiautomated segmentation for volumetric analysis of intratumoral ethiodol uptake and subsequent tumor necrosis after chemoembolization.

OBJECTIVE: Linear measurements, such as those described by the Response Evaluation Criteria in Solid Tumors (RECIST) criteria, may be limited for assessment of response after transarterial chemoembolization (TACE). The purpose of this pilot study was to show intra- and interobserver reproducibility of volumetric measurements of Ethiodol (ethiodized oil) seen within tumor 24 hours after TACE and of necrotic and viable tumor 1 month after treatment. Volumetric measurements are compared with linear measurements and survival outcomes. MATERIALS AND METHODS: Between 2006 and 2009, 37 consecutive TACE procedures were performed in 27 patients with hepatic malignancies. CT images obtained 24 hours and 1 month after TACE were retrospectively analyzed. Three observers measured volumes twice. Intraoperator reproducibility was determined using Wilcoxon's signed rank test to assess whether the difference in each volumetric measurement approaches zero. The intraclass correlation coefficient (ICC) and Bland-Altman plots were used to determine interoperator reproducibility. Survival data were retrospectively obtained from the electronic medical record. RESULTS: Good intraobserver reproducibility and interobserver reproducibility (p > 0.05, ICC > 0.9, respectively) were shown for Ethiodol, whole tumor, and necrotic tumor volumes. The volume of Ethiodol correlated with subsequent necrotic tumor volume (p = 0.009), reduction in whole tumor volume (p = 0.004), and patient survival (p = 0.029). Kaplan-Meier curves suggest that Ethiodol accumulation in more than 50% of the tumor and a 10% or greater increase in the volume of necrotic tumor correlated with survival (p = 0.028 and 0.047, respectively). CONCLUSION: Semiautomated volumetric analysis can be performed with good intra- and interobserver reproducibility. The volume of Ethiodol accumulated in the tumor after TACE correlates with subsequent necrosis. These early measurements may predict survival outcomes.

Salzmann nodular degeneration.

PURPOSE: To describe the characteristic, clinical, and epidemiological features of Salzmann nodular degeneration. METHODS: Retrospective review of cases. All patients with diagnosis of Salzmann nodular degeneration examined on the Cornea and External Disease Service in the Department of Ophthalmology and Vision Science at the University of California, Davis, were included in this review. Demographic features, clinical characteristics, treatment regimens, surgical procedures, and outcomes were recorded. Descriptive statistics, correlation statistics in bilateral cases, and simple regression models were constructed to assess the effect of potential indicators of severity. RESULTS: One hundred eighty eyes of 108 patients were included in this review. Seventy-nine patients (72.2%) were female and 29 (27.8%) were male. Seventy-two patients had bilateral disease. The mean age for all patients was 60.8 (13-92) years, and the mean follow-up time was 61.2 months (0-357 months). 76.1% of all eyes were from White. Mean logarithm of the minimum angle of resolution best-corrected visual acuity was 0.24 (Snellen equivalent 20/35, range -0.12 to 2.60, SD 0.44). Decreased visual acuity was the most common symptom in 30.6% of patients. The visual axis was affected in 30% of the cases. Meibomian gland dysfunction was the most common coexistent condition, identified in 41.7% of the cases. For bilateral cases, Spearman correlations for best-corrected visual acuity, magnitude of astigmatism, spherical equivalent, and disease extension were statistically significant (P = 0.001). The number of quadrants affected was found to be a significant predictor for astigmatism (P = 0.01). Surgery was indicated in 41 eyes of 30 patients. Decreased visual acuity was the most common indication for superficial keratectomy. Patients with more than 1 quadrant of the cornea affected or those in which the central visual axis was involved were more likely to require surgery (P = 0.015 and 0.0001, respectively). The surgical outcome was satisfactory in 90.2% of the cases; 9 eyes (21.9%) developed recurrences. CONCLUSIONS: Salzmann nodular degeneration is a disease of uncertain etiology in which inflammation of the ocular surface may play a role. It predominantly affects women in the sixth decade of life. Management with conservative therapy is generally adequate, and in cases that require surgical intervention, simple nodulectomy is usually effective.

Temporal changes in characteristics of injection-site sarcomas in cats: 392 cases (1990-2006).

OBJECTIVE: To evaluate changes in characteristics of feline injection-site sarcomas (ISSs) from 1990 through 2006. DESIGN: Retrospective case series. ANIMALS: 392 cats with a histologic diagnosis of soft tissue sarcoma, osteosarcoma, or chondrosarcoma at potential injection sites. PROCEDURES: Classification and anatomic location of tumors and signalment of affected cats were compared between ISSs diagnosed before and after publication of the Vaccine Associated Feline Sarcoma Task Force vaccination recommendations in 1996. RESULTS: From before to after publication of the vaccination recommendations, proportions of ISSs significantly decreased in the interscapular (53.4% to 39.5%) and right and left thoracic (10.2% to 3.6% and 9.1% to 1.3%, respectively) regions. On the other hand, proportions of ISSs significantly increased in the right thoracic limb (1.1% to 9.5%) and the combined regions of the right pelvic limb with right lateral aspect of the abdomen (12.5% to 25.0%) and the left pelvic limb with left lateral aspect of the abdomen (11.4% to 13.8%). Patterns of tumor classification and signalment did not change. CONCLUSIONS AND CLINICAL RELEVANCE: Despite publication of the vaccination recommendations, a high proportion of tumors still developed in the interscapular region. There was also an increase in lateral abdominal ISSs, which are more difficult to treat and are likely attributable to aberrant placement of injections intended for the pelvic limbs. Veterinarians are complying with vaccination recommendations to some extent, but they need to focus on administering vaccines as distally as possible on a limb to allow for complete surgical margins if amputation of a limb is required.

Increased rotational mobility of the testis after vasectomy: a sonographic study.

OBJECTIVE: The purpose of this study was to evaluate for increased mobility of the testis in postvasectomy patients by observing changes in the position of the testis-epididymis complex (TEC). METHODS: This was a retrospective study of 29 postvasectomy patients compared with 29 control patients without a history of vasectomy who were referred for scrotal sonography for various clinical indications over a 1 year-period. The position of the TEC was compared between the two groups. RESULTS: The post-vasectomy group had medial or posteromedial rotation in 13 of 58 testes (22%) compared with 3 of 58 (5%) in the control group. CONCLUSIONS: Our study found a statistically higher incidence of medial rotation of the testis in the vasectomy group compared with the control group. Given our findings, it seems reasonable to assume that iatrogenic changes to the structural support mechanism of the testis occur when vasectomy is performed, with a resultant increase in the mobility of the testis within the scrotum.