Incidence and Survival for Merkel Cell Carcinoma in Queensland, Australia, 1993-2010

Importance: Merkel cell carcinoma (MCC) is an uncommon but highly invasive form of skin cancer. The mechanisms that cause MCC are yet to be fully determined. Objectives To compare the incidence and survival rates of MCC in Queensland, Australia, known to be a high-risk area, with MCC incidence and survival elsewhere in the world. We also analyzed incidence trends and differences in survival by key demographic and clinical characteristics. Design, Setting, and Participants: Retrospective cohort study of population-based administrative data for MCC collected by the Queensland Cancer Registry and supplemented with detailed histopathologic data. Deidentified records were obtained of all Queensland residents diagnosed as having MCC during the period from 1993 to 2010. A subsample of histopathologic records were reviewed by a senior dermatopathologist to determine the potential for misclassification. A total of 879 eligible cases of MCC were included in the study. Main Outcomes and Measures: Incidence rates were directly age standardized to the 2000 United States Standard Population. Trends were examined using Joinpoint software with results expressed in terms of the annual percentage change. The period method was used to calculate 5-year relative survival, and adjusted hazard ratios were obtained from multivariate Poisson models.Results: There were 340 cases of MCC diagnosed in Queensland between 2006 and 2010, corresponding to an incidence rate of 1.6 per 100 000 population. Men (2.5 per 100 000) had higher incidence than women (0.9 per 100 000), and rates peaked at 20.7 per 100 000 for persons 80 years or older. The overall incidence of MCC increased by an average of 2.6% per year from 1993 onwards. Relative survival was 41% after 5 years, with significantly better survival found for those younger than 70 years at diagnosis (56%-60%), those with tumors on the face or ears (51%), and those with stage I lesions (49%). Conclusions and Relevance: Incidence rates for MCC in Queensland are at least double those of any that have been previously published elsewhere in the world. It is likely that Queensland’s combination of a predominantly white population, outdoor lifestyle, and exposure to sunlight has played a role in this unwanted result. Interventions are required to increase awareness of MCC among clinicians and the public

Validation Test Cases for Multi-Physic Problems: Application to Magneto-Hydrodynamic Numerical Simulations

In the present paper, some elementary test cases in laminar flow with magnetic forcing terms are analyzed (Hartmann flow, Couette flow, Rayleigh flow); equations of the coupled problem are exposed and analytical solutions are derived in each case, highlighting the relevant non-dimensional number which drives the physics of the problem. Several analytical calculations are then proposed and discussed, in particular in the context of MHD propulsion by a nozzle.Comment: 10

Personalised electronic messages to improve sun protection in young adults

The incidence of all skin cancers, including melanoma, continues to rise. It is well known that ultraviolet (UV) radiation is the main environmental risk factor for skin cancer, and excessive exposure at a young age increases the risk of developing skin cancer. The aim of this study was to determine the acceptability and feasibility of delivering sun protection messages via electronic media such as short message services (SMS) to people 18-40 years, and explore factors associated with their acceptability. Overall, 80% of participants agreed that they would like to receive some form of sun protection advice; of these, 20% prefer to receive it via SMS and 42% via email. Willingness to receive electronic messages about the UV index was associated with being unsure about whether a suntanned person would look healthy and greater use of sun protection in the past. Careful attention to message framing and timing of message delivery and focus on short-term effects of sun exposure such as sunburn and skin ageing should increase the acceptability of such messages to young people. We conclude that sun protection messages delivered to young adults via electronic media appear feasible and acceptable

Effects of nitrogen supply on must quality and anthocyanin accumulation in berries of cv. Merlot

Nitrogen supply to Merlot vines (Vitis vinifera L.), grown under controlled conditions, affected must quality and the anthocyanin content in berry skins irrespective of vegetative growth. High N supply delayed fruit maturation; berries had a higher arginine and a lower anthocyanin content with relatively more abundant acylated anthocyanins compared to berries of vines supplied with low N. During maturation the anthocyanin content in the skin of berries decreased; this was more significant in high-N vines. It is concluded that high nitrogen supply affects the metabolic pathway of anthocyanins in different ways, e.g. it delays the quantitative and qualitative biosynthesis and enhances their degradation during the final steps of berry maturation.

Improvement of radiology requisition

AbstractPurposeInadequate or incomplete information on radiology requisitions may have a substantial impact on the radiological process. This study aimed to evaluate the impact of standardization and computerization of radiology requisitions on the quality of provided data, satisfaction of hospital staff and access time.MethodsThe impact of requisition support was assessed at each step of the improvement process for inpatients: before (Step 1), after standardization (Step 2) and after computerization of radiology requisition (Step 3). The quality of information provided was assessed by proportion of missing data on MRI and CT requisitions. Satisfaction was assessed by an anonymous auto-questionnaire filled by ordering physicians, radiologists and radiology technicians. Access time was prospectively assessed.ResultsStandardization of radiology requisition resulted in a significant drop in proportion of missing data. Computerization of radiology requisition, based on the single standardized radiology requisition, further improved the quality of information reported on radiology requisitions. The median access time was significantly improved (from 5 to 3days) for the largest provider of CT requisitions.ConclusionsStandardization and computerization have a synergistic effect on the overall quality improvement. Moreover, the computerized provider order entry enables traceability of information, makes communication between radiologists and ordering physicians easier and improves examination planning

The use of mobile phones for skin tumor screening

A lot of importance is attributed to mobile telemedicine these days, a topic that encompasses a wide and ever growing range of applications. Small, handheld devices such as camera mobile phones have come into every day use providing technically sophisticated tasks on a user-friendly level and can therefore be easily used in various fields of telemedicine. Dermatology is a perfect candidate for the use of telemedicine tools in general, as well as mobile devices in particular. The unique aspect of mobile teledermatology is that this system represents a filtering, or triage system, allowing a sensitive approach for the management of patients with emergent skin diseases. In order to investigate the feasibility of teleconsultation using a new generation of cellular phones, a clinical study to evaluate the accuracy of online diagnosis of skin tumours was conducted. Teledermoscopy represents a recent development of teledermatology that might add up additional information in the diagnosis of pigmented skin lesions. Teledermatology, mobile as well as stationary, can advance the reliability of diagnosis by expert consultations without expensive and time-consuming relocations. Consequently, the quality of patient's care can be raised and the costs of the health care system can be reduced

Consumer acceptance of patient-performed mobile teledermoscopy for the early detection of melanoma

Background Mobile teledermoscopy allows consumers to send images of skin lesions to a teledermatologist for remote diagnosis. Currently, technology acceptance of mobile teledermoscopy by people at high risk of melanoma is unknown. Objectives We aimed to determine the acceptance of mobile teledermoscopy by consumers based on perceived usefulness, ease of use, compatibility, attitude/intention, subjective norms, facilitators and trust before use. Consumer satisfaction was explored after use

Teledermatological monitoring of leg ulcers in cooperation with home care nurses

Objectives: To examine the feasibility and acceptance of teledermatology for wound management for patients with leg ulcers by home care nurses and evaluate the reduction of costs and the acceptance of teledermatology by patients and home care nurses