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PURPOSE: Immunosuppressed (IS) patients are at increased risk for developing Merkel cell carcinoma (MCC) with worsened outcomes compared to immunocompetent (IC) patients. We sought to determine the effects of immune status on the efficacy of adjuvant RT regarding OS for patients with stage I, II or III (localized) MCC of the head and neck. METHODS/PATIENTS: The National Cancer Database was queried for patients with resected, localized MCC of the head and neck with known immune status. Kaplan-Meier methods were used to describe OS. Log-rank tests, multivariable Cox regression models and interaction effect testing were used to compare OS by subgroup categorized by patient and treatment factors including immune status and adjuvant RT receipt. RESULTS: A total of 892 (89.6%) IC and 104 (10.4%) IS patients with MCC of the head and neck were included. Adjuvant RT was associated with improved 3-year OS rate for both IS patients (49.4% vs. 35.5%, p = 0.0467) and stage I/II IC patients (72.4% vs. 62.9%, p = 0.0092). Adjuvant RT was associated with decreased hazard of death (HR 0.77, 95% CI 0.62-0.95). Interaction effect testing did not demonstrate a difference in the efficacy of adjuvant RT on OS between IC and IS status (p = 0.157). CONCLUSIONS: In this NCDB analysis, adjuvant RT was associated with decreased hazard of death for patients with localized MCC of the head and neck regardless of immune status and should be considered for both IS and IC patients.

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Stressor-response research on stony corals in the laboratory relies on detecting relatively small changes in the size of coral fragments throughout the course of an experiment. Coral colonies are complex, three-dimensional (3D) communities of organisms, so small changes in size are best detected by changes in 3D surface area. Traditional methods to estimate 3D coral surface area commonly require destruction of the sample, thereby eliminating repeat measurements and the ability to calculate growth rate. However, non-destructive two-dimensional (2D) photogrammetry can be used if defensible relationships with 3D surface area can be established. In this study, 165 coral skeletons representing four stony coral species (Pocillopora damicornis, Madracis mirabilis, Orbicella faveolata, Porites porites) were photographed in 2D (top and side views) and then imaged with 3D laser scanning. Significant linear relationships were found between the 3D surface areas (laser) and the sum of various combinations of top and side view surface areas captured by 2D digital photography. The relationships were very strong for simple colony shapes and more variable as coral fragments increased in size and complexity. This study demonstrates an efficient method for obtaining estimates of 3D coral surface area from non-destructive 2D photogrammetry, allowing measurement of growth rate throughout experimental exposure periods.

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Coral reef condition on the south shore of St. Thomas, U.S. Virgin Islands, was assessed at various distances from Charlotte Amalie, the most densely populated city on the island. Human influence in the area includes industrial activity, wastewater discharge, cruise ship docks, and impervious surfaces throughout the watershed. Anthropogenic activity was characterized using a landscape development intensity (LDI) index, sedimentation threat (ST) estimates, and water quality (WQ) impairments in the near-coastal zone. Total three-dimensional coral cover, reef rugosity, and coral diversity had significant negative coefficients for LDI index, as did densities of dominant species Orbicella annularis, Orbicella franksi, Montastraea cavernosa, Orbicella faveolata, and Porites porites. However, overall stony coral colony density was not significantly correlated with stressors. Positive relationships between reef rugosity and ST, between coral diversity and ST, and between coral diversity and WQ were unexpected because these stressors are generally thought to negatively influence coral growth and health. Sponge density was greater with higher disturbance indicators (ST and WQ), consistent with reports of greater resistance by sponges to degraded water quality compared to stony corals. The highest FoRAM (Foraminifera in Reef Assessment and Monitoring) indices indicating good water quality were found offshore from the main island and outside the harbor. Negative associations between stony coral metrics and LDI index have been reported elsewhere in the Caribbean and highlight LDI index potential as a spatial tool to characterize land-based anthropogenic stressor gradients relevant to coral reefs. Fewer relationships were found with an integrated stressor index but with similar trends in response direction.

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Coral reef biota including stony corals, sponges, gorgonians, fish, benthic macroinvertebrates and foraminifera were surveyed in coastal waters near La Parguera, in southwestern Puerto Rico. The goal was to evaluate sensitivity of coral reef biological indicators to human disturbance. Proxies for human disturbance were measured as distance to town (DTT) and rankings of a low-level sediment contamination gradient analyzed from a previous study. Contaminant rank and DTT showed that percent mud, stony coral taxa richness, reef rugosity, and numbers of invertebrates and sponges were higher at sites closer to human disturbance, but a foraminiferal assemblage index was significantly lower at sites with higher proxies for human disturbance. Fish indicators showed no significant relationships with human activity, but associations between fish community measures and certain measures of stony corals, gorgonians and sponges were found. Contrasting responses between foraminifera and reef organisms may be due to greater exposure and sensitivity of foraminifera to sediment contaminants.

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AIMS: To identify the prevalence of erectile dysfunction (ED) in men with diabetes, and to compare the perceptions of ED and the treatment-seeking behaviour of these men with men with ED without diabetes. METHODS: Phase I of this multinational study involved 27,839 men who were questioned about a number of men's health issues including ED, diabetes and cardiovascular conditions (i.e. hypertension, high cholesterol and angina). Epidemiological associations between these conditions were explored. Phase II involved 2912 men with self-reported ED, aged 20-75 years. Participants completed questionnaires concerning their ED, efforts to seek treatment for their ED, and potential influences that might affect treatment-seeking behaviour. Comparison of these responses was made between men with ED and diabetes and men with ED without diabetes. RESULTS: There was a clear association between self-reported ED and diabetes, hypertension, angina and high cholesterol. Men with diabetes were more likely to consider their ED to be severe and permanent and to speak to a physician or a nurse about their ED, compared with men without diabetes. Sildenafil use was similar in both groups, but men with diabetes were more likely to have discontinued use, mainly because of the lack of treatment efficacy. CONCLUSION: Men with diabetes were more likely to consider their ED to be severe and permanent, compared with men without diabetes. Furthermore, men with diabetes were more likely to discontinue sildenafil therapy, primarily because of poor efficacy. These findings suggest a need for alternative treatments for ED, especially in men with diabetes.

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The horn fly Haematobia irritans L. (Diptera: Muscidae) has recently spread to Argentina and Uruguay and is believed to cause damage to cattle hides. Four groups of ten Holstein steers each were maintained for 58 weeks under different infestation levels with H. irritans to determine if it was the cause of this problem. Hides (chrome tanned) from steers maintained under minimum infestation level had 4.7 +/- 3.8% of the area damaged. Maintaining the steers under low H. irritans level for the last 44 days of the trial using insecticidal ear-tags, resulted in 29.5 +/- 15.8% of hide area being damaged. Steers that were treated with 5% cypermethrin pour-on, when the H. irritans population was close to 50 flies, showed that 31.3 +/- 16.6% of hide area was injured, and 46.6 +/- 12.8% of damaged hide area was found in hides from non-treated steers. Significant differences were found between mean hide damage from steers maintained continuously under low H. irritans infestation levels and all other groups. Hyperaemia was significantly lower in the skin of steers under low H. irritans infestation level than in the skins of non-treated steers and steers maintained under low-level infestations for the final 44 days. Eosinophil and mononuclear cell infiltration was significantly lower when the population of H. irritans was less than six per steer than when the population was more than 100 flies per steer. Low numbers of Stomoxys calcitrans were found in all groups, but most hide damage was presumed due to H. irritans.

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