"Dreaming in colour’: disabled higher education students’ perspectives on improving design practices that would enable them to benefit from their use of technologies"

The focus of this paper is the design of technology products and services for disabled students in higher education. It analyses the perspectives of disabled students studying in the US, the UK, Germany, Israel and Canada, regarding their experiences of using technologies to support their learning. The students shared how the functionality of the technologies supported them to study and enabled them to achieve their academic potential. Despite these positive outcomes, the students also reported difficulties associated with: i) the design of the technologies, ii) a lack of technology know-how and iii) a lack of social capital. When identifying potential solutions to these difficulties the disabled students imagined both preferable and possible futures where faculty, higher education institutions, researchers and technology companies are challenged to push the boundaries of their current design practices

Long-term outcomes of clinical complete responders after neoadjuvant treatment for rectal cancer in the International Watch & Wait Database (IWWD): an international multicentre registry study

Background: The strategy of watch and wait (W&W) in patients with rectal cancer who achieve a complete clinical response (cCR) after neoadjuvant therapy is new and offers an opportunity for patients to avoid major resection surgery. However, evidence is based on small-to-moderate sized series from specialist centres. The International Watch & Wait Database (IWWD) aims to describe the outcome of the W&W strategy in a large-scale registry of pooled individual patient data. We report the results of a descriptive analysis after inclusion of more than 1000 patients in the registry. Methods: Participating centres entered data in the registry through an online, highly secured, and encrypted research data server. Data included baseline characteristics, neoadjuvant therapy, imaging protocols, incidence of local regrowth and distant metastasis, and survival status. All patients with rectal cancer in whom the standard of care (total mesorectal excision surgery) was omitted after neoadjuvant therapy were eligible to be included in the IWWD. For the present analysis, we only selected patients with no signs of residual tumour at reassessment (a cCR). We analysed the proportion of patients with local regrowth, proportion of patients with distant metastases, 5-year overall survival, and 5-year disease-specific survival. Findings: Between April 14, 2015, and June 30, 2017, we identified 1009 patients who received neoadjuvant treatment and were managed by W&W in the database from 47 participating institutes (15 countries). We included 880 (87%) patients with a cCR. Median follow-up time was 3·3 years (95% CI 3·1–3·6). The 2-year cumulative incidence of local regrowth was 25·2% (95% CI 22·2–28·5%), 88% of all local regrowth was diagnosed in the first 2 years, and 97% of local regrowth was located in the bowel wall. Distant metastasis were diagnosed in 71 (8%) of 880 patients. 5-year overall survival was 85% (95% CI 80·9–87·7%), and 5-year disease-specific survival was 94% (91–96%). Interpretation: This dataset has the largest series of patients with rectal cancer treated with a W&W approach, consisting of approximately 50% data from previous cohort series and 50% unpublished data. Local regrowth occurs mostly in the first 2 years and in the bowel wall, emphasising the importance of endoscopic surveillance to ensure the option of deferred curative surgery. Local unsalvageable disease after W&W was rare. Funding: European Registration of Cancer Care financed by European Society of Surgical Oncology, Champalimaud Foundation Lisbon, Bas Mulder Award granted by the Alpe d'Huzes Foundation and Dutch Cancer Society, and European Research Council Advanced Grant

Valor energético de subprodutos da agroindústria brasileira

It was evaluated the carbohydrate and protein fractions of cashew, passion fruit, melon, Bixa orellana, pineapple and acerola by-products; it was estimated and valided the energy value of the feeds from the NRC (2001). The carbohydrate and protein fractions and TDN values changed substantially between by-products. It was concluded that the analysis of the carbohydrate and protein fractions of by-products must be laboratory routine. The observed and predict TDN values of the feeds by NRC (2001) equations were similar, being appropriate for estimating the energy value of the feeds.Foram objetivos do presente estudo avaliar as frações de carboidratos e proteínas dos resíduos da agroindústria do caju, maracujá, melão, urucum, abacaxi e acerola; estimar e validar o valor energético dos alimentos obtido a partir das equações do NRC (2001). As frações de carboidratos e de proteínas, bem como os valores de NDT observados variaram consideravelmente entre os subprodutos. Concluiu-se que a análise das frações que constituem os carboidratos e os compostos nitrogenados dos subprodutos deve ser rotina laboratorial. Os valores de NDT dos alimentos observados e preditos pelas equações do NRC (2001) foram similares, sendo adequadas para estimar o valor energético dos alimentos

Stapleless laparoscopic assisted radical cystectomy with ileal neobladder in a male and with ileal loop in a female: initial report from Brazil

INTRODUCTION: Here, we report our initial experience with laparoscopic assisted radical cystectomy without the use of surgical staples. CASES REPORT: A 70 year old male and a 55 year old female were diagnosed to have T2G3 transitional cell carcinoma of the bladder with negative metastatic work-out. both patients were scheduled and agreed to a laparoscopic assisted radical cystectomy. In both cases, urinary diversion (orthotopic ileal Studer neobladder in the male and ileal conduit in the female) was performed extracorporeally following radical cystectomy. In both cases control of the bladder vascular pediclewas accomplished with a combination of metallic and hem-o-lock clips. The total surgical time was 6.5 hours in both cases. Estimated intra-operative blood loss was 500 cc and 350 cc respectively, however both patients required postoperative blood transfusions. No intraoperative complications occurred. In both cases, pathology revealed negative surgical margins. CONCLUSIONS: Extracorporeal creation of urinary diversion decrease the overall operative time. Laparoscopic pelvic lymphadenectomy can be performed following the extended template. The use of surgical clips instead of vascular Endo-GIA titanium staples to control the bladder vascular pedicles is feasible and safe in selected patients, thus reducing intraoperative surgical costs. Considerable experience with laparoscopic radical prostatectomy is necessary before one attempts laparoscopic radical cystectomy

Fluxo de biomassa e estrutura do dossel em capim-braquiária manejado, sob lâminas de irrigação e idades de crescimento.

Resumo: Objetivou-se avaliar o fluxo de biomassa e a estrutura do dossel do capim-braquiária manejado sob cinco lâminas de irrigação (3,84; 4,39; 6,19; 8,62 e 10,46 mm dia-1) e quatro idades de crescimento, num delineamento inteiramente casualizado em arranjo de parcelas subdivididas, sendo as lâminas de irrigação, estudadas nas parcelas, e as idades de crescimento (10, 17, 24 e 31 dias), nas subparcelas, com quatro repetições. Constatou-se interação entre lâminas de irrigação x idades de crescimento para a altura do dossel. Verificou-se resposta quadrática com ponto de mínimo para a relação folha/colmo e eficiência de uso da água em função do avanço nas idades de crescimento. Constatou-se resposta linear crescente para a taxa de alongamento foliar e taxa de alongamento dos colmos com o incremento nas lâminas de irrigação. Constatou-se resposta crescente para a biomassa de forragem verde, biomassa de lâmina foliar verde, relação material vivo/material morto, densidade populacional de perfilhos e índice de área foliar com o avanço nas idades de crescimento. As idades de crescimento mais avançadas proporcionam incremento na biomassa de forragem e a irrigação favorece o fluxo de biomassa do capim-braquiária. [Biomass flow and canopy structure in brachiaria grass managed under irrigation depth and growth ages].201