Characterizing Spatial Variability of Climate-Relevant Hazards and Vulnerabilities in the New England Region of the United States.

Weather and climate have substantial effects on human health. While much is known about how morbidity and mortality are affected by moderate-to-extreme heat, poor air quality, and heavy precipitation individually, less is known about the cumulative occurrence of these climatic hazards, and the extent to which they spatially overlap with community-scale vulnerabilities. Specifically, there is interest in determining whether individuals living in places with the highest exposure to multiple health hazardous climatic conditions are also more vulnerable to having negative health outcomes. Presented here is a spatial analysis of the distribution of health-relevant climatic hazards and social vulnerabilities across the New England region of the northeastern United States. We show that the frequency of excessive heat days, heavy precipitation days, and ozone (O3) and fine particulate matter (PM2.5) exceedances during the warm seasons (May-September) from 2009 to 2014 have distinct spatial distributions and are statistically significantly correlated across space with indicators of social vulnerability. We further quantify an integrated measure of the hazards and vulnerabilities to illustrate the spatial heterogeneity of overall risk, as well as to demonstrate how the choice of spatial scale influences the identification of high-risk areas. These methods are transferrable to other locations and contexts, which could be of utility not only to geographers and epidemiologists, but also to policymakers tasked with allocating public health resources to populations at greatest risk of weather- and climate-related health effects.

Arteriolar tortuosity of the white matter in aging and hypertension. A microradiographic study.

Previous studies have shown tortuous arteries and arterioles in the brains of older people, but the effects of age and other factors have not been studied. To examine the effects of hypertension, age, race and sex on white matter (WM) arteriolar tortuosity (AT), we performed high-resolution microradiography and morphometry of human brains taken at autopsy from 44 subjects of various ages (range 30-96 years; 31 hypertensives/13 normotensives). About 70% of tortuosities in the WM were found at the gray-white interfaces of the insular region and adjacent subcortical-WM of the inferior frontal and superior temporal gyri. Six morphologic types of tortuous profiles were identified. The number of tortuous profiles increased with age, but not significantly. Hypertension, sex and race had no effect on tortuosity. Our findings also suggest that 1) WM AT is found mostly at the interfaces between gray matter and WM and, therefore, 2) the physical properties of the WM somehow predispose to the development of AT; 3) AT is not associated with tortuosity in the veins; and 4) the location of complex arteriolar coils supports a recent claim that they can be mistaken for the Charcôt-Bouchard microaneurysms if injection of contrast media and low-magnification radiography of the brain slices are employed for that purpose.

Organization of the efferent projections of the medial superior olivary nucleus in the cat as revealed by HRP and autoradiographic tracing methods.

Features of the organization of the efferent axonal projections from the medial superior olivary nucleus (MSO) in the cat were studied. In order to determine the origin and distribution of projections from MSO, the retrograde horseradish peroxidase (HRP) and autoradiographic tracing methods were used. The results showed that (1) in both HRP and autoradiographic studies the projection to the inferior colliculus was largely ipsilateral, although a contralateral component was present; (2) the projection field of MSO was confined to the ventral division of the central nucleus of the inferior colliculus, and within this field the labeling was heavier in the rostral and dorsolateral parts of the ventral division; (3) the projection to the inferior colliculus was topographic with ventral parts of MSO projecting ventrally and dorsal parts of MSO projecting dorsolaterally; (4) the projection field in the central nucleus formed successive laminae oriented from ventrolateral to dorsomedial; (5) the axonal course was via the medial or internal segment of the lateral lemniscus; and (6) some fibers in this course ended additionally within the dorsal nucleus of the lateral lemniscus. This latter projection was also topographically organized. These observations supported previously described features of lamination and tonotopic order for afferents of the inferior colliculus, as well as recent suggestions that functional segregation of afferent connections exists within the laminated portion of the central nucleus of the inferior colliculus.

Somatostatin-like immunoreactivity in the midbrain of the cat.

Somatostatin (SS) immunoreactivity was localized in cat brain sections with an immunoperoxidase technique. Cell bodies in the midbrain containing SS immunoreactivity were found in the superficial and intermediate gray layers of the superior colliculus, the interpeduncular nucleus, the raphe, the inferior colliculus and nucleus of its brachium, the nucleus of the optic tract, and the lateral tegmental field. Additional positive neurons were seen in the parabigeminal nucleus and in the dorsal periaqueductal gray in kitten material. Immunoreactive fibers were observed in the periaqueductal gray and in the midbrain tegmentum, with particularly dense labeling just dorsal to the substantia nigra and in the parabrachial nuclei. This is the first report of the distribution of SS immunoreactivity in the midbrain of the cat. It is concluded that somatostatin has a distribution compatible with a role as a major neurotransmitter/neuromodulator within certain midbrain nuclei, especially the interpeduncular nucleus and the superior colliculus.

The projections of principal cells of the medial nucleus of the trapezoid body in the cat.

Previous studies suggest that the principal cells of the medial nucleus of the trapezoid body (MNTB) give rise to the projection from MNTB to the lateral superior olivary nucleus (LSO) of the same side, where they mediate rapid inhibitory effects of contralateral sound stimulation. In the present study, we explored certain morphological features of this connection as well as several other projections of the MNTB by using anterograde and retrograde axonal tracing methods. Following injections of tritiated leucine into MNTB, labeled axons reached LSO by passing ventral to, dorsal to, and through the medial superior olivary nucleus, and gave rise to labeling around the somata and proximal dendrites of LSO fusiform cells. As measured in autoradiograms of 2 micron plastic sections, these axons had a modal diameter of 5-6 micron. Terminal labeling, tentatively attributed to principal cell axons, was also seen in the ventral nucleus of the lateral lemniscus (VNLL) and the dorsomedial and ventromedial periolivary nuclei. HRP injections into the LSO and the VNLL showed that the principal cell projected to both of these nuclei and revealed a topographic arrangement of the projection to the LSO which is consistent with tonotopic maps determined electrophysiologically. Control HRP injections demonstrated that other minor projections of the MNTB arose from minor cell populations in this nucleus. The findings provide a morphological correlate of certain physiological findings and suggest a wider role for the MNTB in the ascending auditory system than previously has been supposed.

Descending projections from the superior olivary complex to the cochlear nucleus of the cat.

Subdivisions of the cochlear nuclear complex give rise to a number of discrete projections to certain cell groups of the superior olivary complex and also received substantial descending projections from the periolivary nuclei. In the present study, we sought to determine by means of retrograde transport of horseradish peroxidase (HRP), and anterograde transport of radiolabeled protein, if the periolivary nuclei give rise to discrete projections to the various subdivisions of the cochlear nuclear complex. Following medium to large injections of HRP into the cochlear nucleus, irrespective of location, labeled cells were found in all periolivary nuclei bilaterally. In every case more than 40% of the labeled cells were found in the lateral nucleus of the trapezoid body on the same side and the ventral nucleus of the trapezoid body of both sides. Other periolivary nuclei contributing more than 5% of the total number of cells in individual cases were the contralateral lateral nucleus of the trapezoid body and the ipsilateral anterolateral and dorsal periolivary nuclei. Injections of tritiated leucine into periolivary nuclei gave rise to axonal labeling to the trapezoid body and the dorsal acoustic stria, usually bilaterally, and to terminal labeling that was widely distributed within the cochlear nuclear complex. In several cases with small injections, particularly in the lateral nucleus of the trapezoid body, the projections from the periolivary nuclei to the anteroventral and dorsal cochlear nuclei connected areas described as having similar best-frequency representation. The autoradiographic data corroborated the main results from the HRP experiments and provided additional information permitting these conclusions: the projections from the periolivary nuclei to the cochlear nuclear complex are organized tonotopically, at least in part; each periolivary nucleus (and perhaps individual cells), projects widely throughout the cochlear nuclear complex; the pattern of termination of projections from different periolivary nuclei to a given region of the cochlear nuclear complex are similar, as seen in autoradiograms, and the lateral and dorsal periolivary nuclei project mainly ipsilaterally, while the medial periolivary nuclei project bilaterally with a contralateral bias. The magnitude of these projections and their widespread distribution within the cochlear nuclear complex would suggest an important role for the descending projections in the normal functioning of the cochlear nucleus.

The development of somatostatin immunoreactivity in the interpeduncular nucleus of the cat.

Somatostatin (SS) immunoreactivity was localized in a population of neurons in the interpeduncular nucleus (IPN) of the developing and adult cat. SS-immunoreactive perikarya and fibers were found in several subdivisions of the IPN, but were most heavily concentrated in the central nucleus (IPC). Some immunoreactive fibers appeared to be associated with the ventral surface of the IPN where they may come in contact with the interpeduncular cistern. Bundles of immunoreactive fibers also appeared to leave the rostral pole of the IPN bilaterally. Still other SS-positive perikarya and fibers were associated with the tegmentopeduncular tract and the medial division of the dorsal tegmental nucleus. SS was present in both perikarya and fibers of the IPN at birth. The concentration of immunoreactivity increased dramatically during the first 100 days postnatal, but by 180 days the overall intensity of immunoreactivity had decreased to adult levels. These data indicate that SS may be present in the cat IPN in a specific population of neurons that is most active during early postnatal development. The data are consistent with previous suggestions that SS plays a special role in the development of certain neuronal systems and may be particularly important in the integration of behaviors during the neonatal period.

Selective degeneration of a putative cholinergic pathway in the chinchilla cochlea following infusion with ethylcholine aziridinium ion.

Ethylcholine aziridinium ion (AF64A) diluted in artificial perilymph, or artificial perilymph alone was infused into the cochlea of chinchillas. After a survival time of 7 days, the cochleas were fixed with aldehydes, post-fixed in osmium and embedded in epoxy resin for light and electron microscopy. The ultrastructure of the cochleas infused with artificial perilymph was normal. Infusion of 1 microM AF64A resulted in massive degeneration of the axons of the lateral efferent system, a putative cholinergic pathway that originates in the brainstem and terminates on dendrites of the spiral ganglion innervating cochlear inner hair cells. The axons and terminals of a second putative cholinergic pathway, the medial efferent system which terminates on the outer hair cells, were normal. Infusion of AF64A in a concentration of 10 microM resulted in significant pathology of cochlear and supporting cells as well as the loss of efferent terminals at both inner and outer hair cell regions. The results suggest that AF64A is a selective neurotoxin when used under low-dosage conditions, and that certain pathways may be more susceptible to the effects of AF64A than others. One interpretation of these findings is that lateral efferent axons may have a higher rate of high-affinity choline uptake than terminals of the medial efferent axons.

Localization of the motor neurons to the tensor tympani muscle.

The localization of the motor neurons to the tensor tympani (TT) muscle was studied using the method of retrograde transport of horseradish peroxidase (HRP). After intramuscular injections of HRP, specifically labeled neurons were found in the ventral, parvocellular portion of the trigeminal motor nucleus. These cells had a medial relation to the rootlets of the trigeminal nerve and, rostrally, to the lateral lemniscus. The results are compared to those of other investigators and a generalization is suggested for the localization of these neurons which allows for species variation. Other incidental findings are also discussed.

Forensic nursing implications and the forensic autopsy.

1. Forensic challenges are faced by every nurse, and the bulk of these challenges are presented by living patients. 2. Because the nurse frequently is the first health care worker encountering living patients, successful arrest and prosecution of perpetrators of crime and violence may depend on the nurse's recognition of the problem and documentation. 3. Ignorance of problem detection and ignorance of what data and evidence to collect have resulted in the inability to prosecute, and perpetrators of abuse and violence are permitted to continue--and even escalate--their acts.

Locating the kidneys on CT to guide nephrotomography.

Tomography of the kidneys is a routine procedure performed during intravenous urography. Precisely locating the kidneys, however, can be difficult. This article describes a study performed to determine a simple and accurate measurement for kidney location as a guide to obtaining initial nephrotomographic sections. The authors measured the distance from the midplane of the kidney to the posterior skin line on abdominal CT images in 26 patients. This distance averaged one-third the thickness of the abdominal region. The best depth for the nephrotomographic cut was found to be one-third the thickness of the abdomen plus the thickness of any table pad.

Environmental and policy approaches to cardiovascular disease prevention through physical activity: issues and opportunities.

The majority of Americans remain inactive despite evidence of significant health benefits from even moderately intense activity. Previous intervention efforts have generally focused on changing individual behavior. This article discusses the use of policy, legislative and regulatory, and environmental interventions in promoting physical activity to prevent cardiovascular disease (CVD) and other chronic diseases. The authors present evidence on the need, formulation, description, and effectiveness of policy and environmental intervention approaches. Types of approaches addressed to promote physical activity include federal, state, and local legislation and regulation, policy development and implementation, and environmental support. They also describe opportunities for state and local health departments to initiate and participate in environmental and policy approaches.