Abstract:Communities with well-developed animal response plans, along with trained and equipped animal response teams, are typically better able to protect resident livestock and companion animals during a disaster, with fewer animals lost, higher human evacuation compliance rates, and a greater percentage of pets staying with their families. The NCARE Study is a cross-sectional descriptive survey designed to assess, among US states and counties, the level of preparedness for managing animals in an emergency. Overall, 65% of participating states (31/48) reported having a State Animal Response Team (SART), while 48% (16/33) of counties with >1 million population (large counties) and 23% (131/565) of a random sample of counties with <1 million population (small counties) reported having a County Animal Response Team (CART). Only 50% of small counties reported having plans for collocated or cohabitational emergency shelters, compared to 73% of states and 80% of large counties. In stratified analyses, the proportion of counties with a CART ranged from 2% in FEMA Region X to 69% in Region II. Our results demonstrate that many regions of the US have taken some important initial steps towards establishing the capabilities necessary for managing animals in a disaster, while other regions have areas for improvement.

Purpose: To report a single-institution experience with intracranial arteriovenous malformations (AVMs) treated utilizing a linear accelerator-based patient rotator (PR) or BrainLAB (BL) radiosurgery system (BrainLAB AG, Heimstetten, Germany). Methods and Materials: Since 1989, 84 evaluable patients were treated. PR patients (n = 45) were planned/localized on the basis of biplane angiography and treated between 1989 and 2000. BL patients (n = 39) were planned/localized on the basis of CT/MRI and treated since 2000. Kaplan-Meier analyses of survival, nidus obliteration (NO), and any radiographic improvement were undertaken with Cox regression of dose and volume effects. Results: No significant complication, survival, previous embolization incidence, AVM location or size differences existed between BL/PR patients. The groups differed significantly in prescribed dose (PR: 16.2 Gy, BL: 17.3 Gy, p = 0.004) and isodose (PR: 62%, BL: 79%, p < 0.0001). Estimated 2-year NO rate was 87% for BL patients, 12% for PR patients (p < 0.0001). Ultimate PR NO rate was 67% at 6 years. Dose (p = 0.037) and isodose (p = 0.014) significantly affected PR NO outcome; volume was of borderline significance (p = 0.069). No factors significantly affected BL outcome. Analyses of small (≤4.0 cm³), high-dose (≧17.0 Gy) PR patients (PR1 group) vs. BL patients still demonstrated greater NO (p = 0.04) and radiographic improvement (p = 0.0004) rates for the BL group. PR1 patients had a 76% 3-year NO rate. Conclusions: BL-based radiosurgery achieved a high NO rate, the PR method did not. Differences in outcomes between PR/BL groups may be due to localization methods or an inherent advantage with the BL system.