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In patients presenting with refractory ventricular tachycardia (VT) and aortic and mitral mechanical prosthetic valves, traditional catheter ablation is challenging. We describe a case in which a novel noninvasive computational electrocardiogram mapping algorithm localized VT sources originating from substrate near the mechanical valves, in which stereotactic ablative radiotherapy eliminated VT in 1.5-year follow-up. (Level of Difficulty: Advanced.)

Abstract Background During a course of radiation therapy, anatomical changes such as a decrease in tumour size or weight loss can trigger the need for repeating a computed tomography (CT) simulation scan in order to generate a new treatment plan. This adaptive approach requires a separate appointment for an additional CT scan which generates additional burden, cost, and radiation exposure for patients. Case Presentation Here, we present a case of a head and neck cancer patient who required palliative radiation for a large neck mass. During treatment, he had a remarkable response which required a replan due to rapid tumour downsizing. In this case, we used a novel technique to avoid repeating the planning CT simulation by using a mid‐treatment high‐quality cone beam CT (CBCT) to deform the secondary image (plan CT) of the original planning CT and generate a new adapted treatment plan. Conclusion This is the first report to our knowledge using a Halcyon CBCT to deform the original planning CT in order to generate a new radiation treatment plan, and this novel technique represents a new potential method of adaptive replanning for select patients.

Abstract Although there have been few attempts to systematically analyze information on the use of deterrents on polar bears (Ursus maritimus), understanding their effectiveness in mitigating human‐polar bear conflicts is critical to ensuring both human safety and polar bear conservation. To fill this knowledge gap, we analyzed 19 incidents involving the use of bear spray on free‐ranging polar bears from 1986 to 2019 in Canada, Russia, and the United States to evaluate the effectiveness of bear spray as a polar bear deterrent. We found that bear spray was an effective deterrent in close‐range encounters with polar bears, stopping undesirable behavior in 18 of 19 incidents. Bear spray effectively deterred both curious and aggressive polar bears, including polar bears attempting to attack people. The mean distance between user and bear at the time of spraying was 2 m (min–max = 0.2–10.0 m, mode = 1 m), though bears were usually first seen at greater distances. Bear spray was successfully deployed against polar bears in all 4 seasons. Wind affected spray performance in 1 of 19 of incidents. In 8 of 14 bear spray incidents, other deterrents were used without success before bear spray was used effectively to deter polar bears. No humans or polar bears were killed or injured in any of the incidents in which bear spray was used. We also analyzed 54 polar bear attacks and attempted attacks on humans where bear spray was not carried. The data suggest that in 93% of those incidents, the use of bear spray might have saved the lives of both the people and bears involved if it had been available and used. Our analysis improves our understanding of the effectiveness of bear spray for polar bear conflict mitigation.

Abstract Background Image guidance in radiation oncology has resulted in significant improvements in the accuracy and precision of radiation therapy (RT). Recently, the resolution and quality of cone beam computed tomography (CBCT) for image guidance has increased so that tumor masses and lymph nodes are readily detectable and measurable. During treatment of head and neck squamous cell carcinoma (HNSCC), on-board CBCT setup imaging is routinely obtained; however, this CBCT imaging data is not utilized to predict patient outcomes. Here, we analyzed whether changes in CBCT measurements obtained during a course of radiation therapy correlate with responses on routine 3-month follow-up diagnostic imaging and overall survival (OS). Materials/methods Patients with oropharyngeal primary tumors who received radiation therapy between 2015 and 2018 were included. Anatomical measurements were collected of largest nodal conglomerate (LNC) at CT simulation, end of radiation treatment (EOT CBCT), and routine 3-month post-RT imaging. At each timepoint anteroposterior (AP), mediolateral (ML) and craniocaudal (CC) measurements were obtained and used to create a 2-dimensional (2D) maximum. Results CBCT data from 64 node positive patients were analyzed. The largest nodal 2D maximum and CC measurements on EOT CBCT showed a statistically significant correlation with complete response on 3-month post-RT imaging (r = 0.313, p = 0.02 and r = 0.318, p = 0.02, respectively). Furthermore, patients who experienced a 30% or greater reduction in the CC dimension had improved OS (Binary Chi-Square HR 4.85, p = 0.028). Conclusion Decreased size of pathologic lymph nodes measured using CBCT setup imaging during a radiation course correlates with long term therapeutic response and overall survival of HNSCC patients. These results indicate that CBCT setup imaging may have utility as an early predictor of treatment response in oropharyngeal HNSCC.

The USDA/APHIS/Wildlife Services (WS) oral rabies vaccination program uses tetracycline, a broad-spectrum antibiotic and relatively reliable biomarker, to quantify vaccinebait uptake by raccoons (Procyon lotor). However, obtaining samples (e.g., bone or teeth) to assess tetracycline uptake is highly invasive, and sample preparation can be expensive. By contrast, rhodamine B, a commercially available dye, is absorbed systemically in growing tissues, including hair and whiskers, and can be observed under ultraviolet (UV) light as fluorescent orange bands. Our goal was to evaluate whether rhodamine B can be used as a biomarker to monitor bait uptake by raccoons. We began by orally administering a solution containing 100 mg, 150 mg, or 200 mg of rhodamine B to captive raccoons. We monitored whisker and hair samples for fluorescence using a hand-held UV lamp and a fluorescent microscope for 13-weeks post-treatment. All raccoons that were administered rhodamine B exhibited fluorescence in their whisker and hair samples during the course of the study. Our ability to detect fluorescing whiskers varied based on the method of detection and time interval, but not with rhodamine B dosage level. We detected rhodamine B in 81% of marked individuals using the fluorescent microscope and 58% of marked subjects using the UV lamp. We were able to detect rhodamine B when doses as low as 1 mg/kg were given. Raccoons did not exhibit a taste aversion to baits containing ≤3% rhodamine B. We believe that rhodamine B can be a useful biomarker for raccoons and has potential as an application to monitor the uptake of oral rabies vaccine.

The Centers for Disease Control (CDC) and USDA Wildlife Services (WS) have been involved in an oral rabies vaccination (ORV) program for raccoons (Procyon lotor) that has slowed the westward spread of raccoon rabies. The objective of this study was to forecast the spread of the disease if an ORV zone was not maintained. A group decision-making process was designed to address the forecasting problem and was implemented using a group of 15 experts and 4 support personnel at a meeting at the USDA National Wildlife Research Center. Ten expansion regions were constructed that described the spread of disease at 2-year intervals. This forecast may provide for more accurate cost-benefit analysis of the ORV barrier.

The United States Department of Agriculture (USDA), Animal and Plant Health Inspection Service (APHIS), Wildlife Services National Rabies Management Program has conducted cooperative oral rabies vaccination (ORV) programs since 1997. Understanding the eco-epidemiology of raccoon (Procyon lotor) variant rabies (raccoon rabies) is critical to successful management. Pine (Pinus spp.)-dominated landscapes generally support low relative raccoon densities that may inhibit rabies spread. However, confounding landscape features, such as wetlands and human development, represent potentially elevated risk corridors for rabies spread, possibly imperiling enhanced rabies surveillance and ORV planning. Raccoon habitat suitability in pine-dominated landscapes in Massachusetts, Florida, and Alabama was modeled by the maximum entropy (Maxent) procedure using raccoon presence, and landscape and environmental data. Replicated (n = 100/state) bootstrapped Maxent models based on raccoon sampling locations from 2012–2014 indicated that soil type was the most influential variable in Alabama (permutation importance PI = 38.3), which, based on its relation to landcover type and resource distribution and abundance, was unsurprising. Precipitation (PI = 46.9) and temperature (PI = 52.1) were the most important variables in Massachusetts and Florida, but these possibly spurious results require further investigation. The Alabama Maxent probability surface map was ingested into Circuitscape for conductance visualizations of potential areas of habitat connectivity. Incorporating these and future results into raccoon rabies containment and elimination strategies could result in significant cost-savings for rabies management here and elsewhere.

Development of efficient techniques for monitoring wildlife is a priority in the Arctic, where the impacts of climate change are acute and remoteness and logistical constraints hinder access. We evaluated high resolution satellite imagery as a tool to track the distribution and abundance of polar bears. We examined satellite images of a small island in Foxe Basin, Canada, occupied by a high density of bears during the summer ice-free season. Bears were distinguished from other light-colored spots by comparing images collected on different dates. A sample of ground-truthed points demonstrated that we accurately classified bears. Independent observers reviewed images and a population estimate was obtained using mark-recapture models. This estimate (N: 94; 95% Confidence Interval: 92-105) was remarkably similar to an abundance estimate derived from a line transect aerial survey conducted a few days earlier (N: 102; 95% CI: 69-152). Our findings suggest that satellite imagery is a promising tool for monitoring polar bears on land, with implications for use with other Arctic wildlife. Large scale applications may require development of automated detection processes to expedite review and analysis. Future research should assess the utility of multi-spectral imagery and examine sites with different environmental characteristics.