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Background: Rectal cancer survivors experience unique, prolonged posttherapy symptoms. Previous data indicate that providers are not skilled at identifying the most pertinent rectal cancer survivorship issues. Consequently, survivorship care is incomplete with the majority of rectal cancer survivors reporting at least one unmet posttherapy need. Methods: This photo-elicitation study combines participant-submitted photographs and minimally structured qualitative interviews to explore one's lived experiences. Twenty rectal cancer survivors from a single tertiary canter provided photographs representative of their life after rectal cancer therapy. The iterative steps informed by inductive thematic analysis were used to analyze the transcribed interviews. Results: Rectal cancer survivors had several recommendations to improve their survivorship care, which fell into three major themes: (1) informational needs (e.g., more details about posttherapy side effects); (2) continued multidisciplinary follow up care (e.g., dietary support); and (3) suggestions for support services (e.g., subsidized bowel altering medications and ostomy supplies). Conclusions: Rectal cancer survivors desired more detailed and individualized information, access to longitudinal multidisciplinary follow-up care, and resources to ease the burdens of daily life. These needs may be met through the restructuring of rectal cancer survivorship care to include disease surveillance, symptom management, and support services. As screening and therapy continues to improve, providers must continue to screen and to provide services that address the physical and psychosocial needs of rectal cancer survivors. [ABSTRACT FROM AUTHOR]

Purpose: The interplay between critical illness and mental disorders is poorly understood. The purpose of this study is to measure both the treated prevalence of mental disorders and psychotropic medication use before and after hospitalization and the impact of intensive care unit (ICU) admission on these outcomes. Methods: Using a population-based administrative database in Manitoba, Canada, 49,439 ICU patients admitted between 2000 and 2012 were compared to two matched comparison groups (hospitalized; n = 146,968 and general population; n = 141,937). Treated prevalence of mental disorders and psychotropic medication prescriptions were measured in the 5-year periods before and after the hospitalization. Multivariable models compared adjusted prevalence ratios (APRs) between populations. Results: The 5-year treated mental disorder prevalence in the ICU population increased from 41.5% pre-hospitalization to 55.6% post-hospitalization. Compared to non-ICU hospitalized patients, the adjusted treated mental disorder prevalence in ICU patients was lower prior to hospitalization (1-year APR 0.94, 95% CI 0.92–0.97, p < 0.0001; 5-year APR 0.99, 95% CI 0.98–1.00, p = 0.1), but higher following discharge (1-year APR 1.08, 95% CI 1.05–1.11, p < 0.0001, 5-year APR 1.03, 95% CI 1.01–1.05, p < 0.0001). A high proportion of ICU patients received antidepressant, anxiolytic and sedative-hypnotic prescriptions before and after their hospitalization. In multivariable analyses, ICU exposure was associated with an increase in mood, anxiety and psychotic disorders, and sedative-hypnotics use (p < 0.0001 for all Time × Group interactions). Conclusions: During the 5 years after admission to ICU, there is a significant increase in treated prevalence of mental disorders and psychotropic medication use compared to the 5 years prior to ICU and compared to general population and hospital cohorts. Prevention and intervention programs that identify and treat mental disorders among survivors of critical illness warrant further study. [ABSTRACT FROM AUTHOR]

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The zoonotic enterohemorrhagic Escherichia coli (EHEC) O157: H7 bacterium causes diarrhea, hemorrhagic colitis, and hemolytic uremic syndrome (HUS) in humans. Cattle are primary reservoirs and EHEC O157: H7; the bacteria predominately inhabit the colon and recto-anal junctions (RAJ). The early innate immune reactions in the infected gut are critical in the pathogenesis of EHEC O157: H7. In this study, calves orally inoculated with EHEC O157: H7 showed infiltration of neutrophils in the lamina propria of ileum and RAJ at 7 and 14 days post-infection. Infected calves had altered mucin layer and mast cell populations across small and large intestines. There were differential transcription expressions of key bovine β defensins, tracheal antimicrobial peptide (TAP) in the ileum, and lingual antimicrobial peptide (LAP) in RAJ. The main Gram-negative bacterial/LPS signaling Toll-Like receptor 4 (TLR4) was downregulated in RAJ. Intestinal infection with EHEC O157: H7 impacted the gut bacterial communities and influenced the relative abundance of Negativibacillus and Erysipelotrichaceae in mucosa-associated bacteria in the rectum. Thus, innate immunity in the gut of calves showed unique characteristics during infection with EHEC O157: H7, which occurred in the absence of major clinical manifestations but denoted an active immunological niche. [ABSTRACT FROM AUTHOR]

Hybridisation is a technique that exploits and unites the best features of individual algorithms. The literature includes several hybridisation methodologies, among which there are general procedures, termed architectures, that provide generic functionalities and features for solving optimisation problems. Successful hybridisation methodologies have applied concepts of the multi-agent paradigm, such as cooperation and agent intelligence. However, there is still a lack concerning architectures for the hybridisation of multi-objective metaheuristics that fully explore these concepts. This study proposes a new architecture, named MO-MAHM, based on concepts from Particle Swarm Optimisation, to hybridise multi-objective metaheuristics. We apply the MO-MAHM to the Bi-objective Spanning Tree Problem. Four algorithms were hybridised within the MO-MAHM: three evolutionary algorithms and a local search method. We report the results of experiments with 180 instances, analyse the behaviour of the MO-MAHM, and compare to the results produced by algorithms proposed for the Bi-objective Spanning Tree Problem. [ABSTRACT FROM AUTHOR]

The multi-objective spanning tree (MoST) is an extension of the minimum spanning tree problem (MST) that, as well as its single-objective counterpart, arises in several practical applications. However, unlike the MST, for which there are polynomial-time algorithms that solve it, the MoST is NP-hard. Several researchers proposed techniques to solve the MoST, each of those methods with specific potentialities and limitations. In this study, we examine those methods and divide them into two categories regarding their outcomes: Pareto optimal sets and Pareto optimal fronts. To compare the techniques from the two groups, we investigated their behavior on 2, 3 and 4-objective instances from different classes. We report the results of a computational experiment on 8100 complete and grid graphs in which we analyze specific features of each algorithm as well as the computational effort required to solve the instances. [ABSTRACT FROM AUTHOR]

We conducted an inventory to estimate methane (CH) and nitrous oxide (NO) emissions from beef cattle feedlot manure in Brazil for the year of 2010. The aim was to determine (CH) and (NO) emissions from beef cattle feedlot manure in Brazil using the IPCC United Nations Intergovernmental Panel on Climate Change approach and present a framework that structures priority research for decreasing uncertainties and assessing mitigation scenarios. The analysis consisted of the use of specific farm-scale activity data applied to the 2006 (IPCC) guideline equations for animal manure management updated with specific parameters for Brazil conditions. Uncertainties were assessed by error-propagation technique. The results indicated that 376.6 GgCOeq were emitted from the manure management of beef cattle feedlots in Brazil in 2010. Nitrous oxide accounted for 61 % of total emissions, out of which 69 % came from direct emissions. Uncertainties were high, comprising −30 to +80 %. Solid storage-heap and field application were the largest sources of greenhouse gas (GHG) emissions (81 % of total emissions) and held most of the variance in uncertainties. Although, due to limitations in the IPCC methodology for integrating GHG emissions at farm-scale, we could not account for emissions occurring from different lengths of time in each manure management compartment prior to field application. As a consequence, this GHG inventory lacks consistence. The use of more robust methodologies such as process-based models are recommended for improvements, however they are currently unavailable because there is a lack of key data for Brazil conditions for validating those models. Our literature revision shows that the most effective research for raising those data would track emissions from manure: generated from male Nellore ( Bos Indicus) cattle fed for 90 days with a high-energy diet, removed only at the end of feeding period and held in heaps over 60 days before being applied to maize ( Zea mays L.) cropping fields under clay soil. The proposed research and methodology approaches described in this work is required to establish a manure management emission assessment that will become more responsive to the changing practices on Brazilian beef cattle feedlots and, consequently, permitting implication of mitigation scenarios to be ascertained. [ABSTRACT FROM AUTHOR]

The aim of this study was to evaluate the relationship between blood collection and processing techniques and the quality of canine packed red blood cell (pRBC) units. This prospective study analysed 235 canine blood donations, followed by processing and evaluation of pRBC units. The need for sedation, number of venepunctures, whole blood volume, time to processing and time to analysis were registered, and five different centrifugation protocols were performed. The final pRBC volume, haematocrit, total haemoglobin concentration, haemolysis and bacterial contamination of pRBC units were evaluated. Obtained results were within the reference range of human blood banks' guidelines. One unit presented a positive bacteriologic analysis. No significant differences in haemolysis were detected when factors related to sedation, blood collection, time to processing or centrifugation protocols were studied. Significantly higher haematocrit values were detected in units centrifuged in a faster and longer programme (3,500× g, 15 min). There was a direct increase of haemolysis with longer time spent between centrifugation and analysis. This study demonstrates that haemolysis is significantly higher when analyses post centrifugations take 48-72 h to be performed than in short periods. [ABSTRACT FROM AUTHOR]

Although laparoscopy continues to be the gold standard in the diagnosis of deep endometriosis, non-invasive imaging methods are important for an adequate staging of the disease, as they may determine the site, size, and severity of the lesions and thus contribute to planning the surgical treatment better. An observational study was carried out between April 2008 and June 2009 during which time nine consecutive patients underwent preoperative PET scan examination for clinical suspicion of deep endometriosis. PET scans provide a functional assessment of cellular activity; but in our study, it did not exhibit consistent results. [ABSTRACT FROM AUTHOR]

One of the main challenges for clinical research in dengue is the low validity of clinical diagnosis. To analyze clinical and laboratory data as predicitve factors of dengue diagnosis at Evandro Chagas Clinical Research Institute, Oswaldo Cruz Foundation, during the 2001–2002 dengue outbreak in Rio de Janeiro. Cross sectional study comparing clinical laboratory data collected from the National Information System for Compulsory Notification Diseases (SINAN) in two serologically confirmed groups: dengue D (N = 453) and non-dengue ND (N = 80). Fever, exanthema, itching, mean platelet count < 150,000, WBC count < 4,000 and absence of vomiting and of abdominal pain help to distinguish D from ND groups. When considered individually, these signs and symptoms enhance diagnostic sensitivity and, when used in combination, improve specificity. A combination of symptoms not necessarily considered indicative of dengue diagnosis could improve surveillance and medical decision-making in simple clinical settings. [ABSTRACT FROM AUTHOR]