Language is the principal medium for ideas, while dialogue is the most natural and effective way for humans to interact with and access information from machines. Natural language generation (NLG) is a critical component of spoken dialogue and it has a significant impact on usability and perceived quality. Many commonly used NLG systems employ rules and heuristics, which tend to generate inflexible and stylised responses without the natural variation of human language. However, the frequent repetition of identical output forms can quickly make dialogue become tedious for most real-world users. Additionally, these rules and heuristics are not scalable and hence not trivially extensible to other domains or languages. A statistical approach to language generation can learn language decisions directly from data without relying on hand-coded rules or heuristics, which brings scalability and flexibility to NLG. Statistical models also provide an opportunity to learn in-domain human colloquialisms and cross-domain model adaptations. A robust and quasi-supervised NLG model is proposed in this thesis. The model leverages a Recurrent Neural Network (RNN)-based surface realiser and a gating mechanism applied to input semantics. The model is motivated by the Long-Short Term Memory (LSTM) network. The RNN-based surface realiser and gating mechanism use a neural network to learn end-to-end language generation decisions from input dialogue act and sentence pairs; it also integrates sentence planning and surface realisation into a single optimisation problem. The single optimisation not only bypasses the costly intermediate linguistic annotations but also generates more natural and human-like responses. Furthermore, a domain adaptation study shows that the proposed model can be readily adapted and extended to new dialogue domains via a proposed recipe. Continuing the success of end-to-end learning, the second part of the thesis speculates on building an end-to-end dialogue system by framing it as a conditional generation problem. The proposed model encapsulates a belief tracker with a minimal state representation and a generator that takes the dialogue context to produce responses. These features suggest comprehension and fast learning. The proposed model is capable of understanding requests and accomplishing tasks after training on only a few hundred human-human dialogues. A complementary Wizard-of-Oz data collection method is also introduced to facilitate the collection of human-human conversations from online workers. The results demonstrate that the proposed model can talk to human judges naturally, without any difficulty, for a sample application domain. In addition, the results also suggest that the introduction of a stochastic latent variable can help the system model intrinsic variation in communicative intention much better.

The salient issues of integrated biosensors on a complementary metal-oxide semiconductor (CMOS) platform are the limited transducer design and the need for post-processing. To overcome these issues, a heterogeneously integrated system, which employs both CMOS and large-area processing, was proposed and developed. The system presented, could become a rapid, low-cost and disposable sensing platform for point-of-care applications. The heterogeneously integrated system, comprising a CMOS front-end circuit and disposable electrodes, was applied to measure the impedance of suspended DNA at different concentrations. The measurement showed a double sensitivity compared to the one carried out on the CMOS platform only. The noise analysis of CMOS transimpedance amplifiers was performed, and the impact of technology scaling on low-noise transimpedance amplifiers was studied using the Enz-Krummenacher-Vittoz (EKV) model. It was found that the noise performance improves slowly with device scaling down to 90 nm. Further device scaling may increase the gate leakage current noise due to the very thin gate oxide. Disposable electrodes fabricated using large-area processing are low cost and flexible in terms of design. In particular, inkjet-printed silver electrodes on glossy paper and gold electrodes on the glass substrate were characterised. Both electrodes with the same dimension agreed well in determining solution resistance. In addition, the paper-based electrodes presented an improved sensitivity of impedance measurement at low frequencies. The amorphous oxide thin-film transistor (TFT) is promising for implementing active circuits on disposable substrates. In particular, the low-frequency noise of amorphous indium-gallium-zinc-oxide (a-IGZO) TFTs was characterised, and a TFT-based regulated cascade transimpedance amplifier was designed and simulated with the extracted device parameters. The a-IGZO TFT showed a comparable noise performance to the PMOS device in deep submicron processes. The simulated circuit featured a transimpedance gain up to 120 dB, a bandwidth of 29.4 kHz, input-referred noise PSD of 2.91 pA/√Hz, and a power consumption of 18.55 μW, indicating that TFT-based front-end circuits are promising for implementing low-cost, low-noise and low-power biosensors.

A integração da inteligência de mercado e a estruturação eficaz das fases iniciais (também conhecidas como front-end) do processo de desenvolvimento de novos produtos são dois dos mais importantes e difíceis desafios que inovadores enfrentam. Esta tese concentra-se na ligação entre estes dois aspectos, oferecendo um modelo conceitual para a sistematização e integração da inteligência de mercado nas atividades do front-end. O modelo, intitulado MISIPro (Market Intelligence Sistematization e Integration Process – Processo de sistematização e integração da inteligência de mercado), considera dois tipos diferentes de atividades que ocorrem no front-end: a) atividades de processamento de informações de mercado; e b) atividades de desenvolvimento de produtos. Essas atividades são então definidas, estruturadas e integradas. O modelo foi desenvolvido com base numa revisão da literatura sobre desenvolvimento de produtos, orientação de mercado e gestão do conhecimento e em 5 estudos de caso em empresas no Brasil e nos Estados Unidos. Como contribuição teórica, esta tese apresenta uma integração de conceitos importantes provenientes de diferentes perspectivas e áreas de conhecimento e uma nova abordagem e estrutura para a concepção do conceito. Para os profissionais, o modelo oferece uma ferramenta útil para a estruturação das atividades do front-end e integração das informações de mercado no processo de desenvolvimento de produtos. / Integrating market intelligence and effective structuring of the planning stages (also known as front-end) of new product development (NPD) process are two of the most important and difficult challenges facing innovators. This dissertation focuses on the link between these two elements, offering a conceptual model for the systematization and integration of market intelligence into the frontend activities. The model, entitled MISIPro (Market Intelligence Systematization and Integration Process), considers two different types of activities that take place in the front-end: a) market information processing activities; and b) product development activities. These activities are herein defined, structure and mutually integrated. The model was developed based on a review of the literature about product development, market orientation and knowledge management, and 5 case studies in Brazilian and U.S. companies. From a theoretical perspective, this dissertation offers an integration of the important concepts from different perspectives and areas of knowledge and a new approach and structure for the concept design. For practitioners, the model offers a useful tool for structuring the front-end activities and integrating market intelligence into the NPD process.

Made available in DSpace on 2014-12-17T14:13:58Z (GMT). No. of bitstreams: 1 DaniloLFM.pdf: 299799 bytes, checksum: 873a8a95a8ec000d4923f4b906406ecb (MD5) Previous issue date: 2007-03-09 / Objective- Convinced that periodontium, many times, can show alterations in human health, the aim of these studies was to investigate the periodontal situation in patients with endocrine-metabolic disorders such as, Berardinelli-Seip Syndrome, hyperthyroidism, hypothyroidism and acromegaly. Methods- Eight patients with Berardinelli-Seip Syndrome, 16 acromegalics, 30 hypothyroids, 30 hyperthyroids, and a control group with 35 patients were evaluated. Clinical attachment loss, probing depth, gingival bleeding index, gingival overgrowth and Index of Decayed, Missing and Filled Teeth were measured in each patient. All ethical aspects were rigidly observed, being the study conducted after its approval by the University of Fortaleza Research Ethics Committee. Results- The presence of periodontitis was marked in hyperthyroids and in patients with Berardinelli-Seip Syndrome. Hypothyroids showed not much presence of periodontitis, while all acromegalics presented absence of periodontitis. Conclusions- The protective effect of periodontitis in acromegalic patients is a new finding, whose mechanisms are not yet clear, but may be related to the anabolic effects of growth hormone. The presence of periodontitis in Berardinelli-Seip Syndrome may occur due the early onset of diabetes. In hyperthyroids, the high prevalence of periodontitis could be linked to thyroid hormones effects on bone, explaining also the minor prevalence in hypothyroids / Objetivo- Com a convic??o de que o periodonto, muitas vezes, pode ser um sinalizador de desequil?brios da sa?de humana, os presentes estudos tiveram como objetivo investigar a situa??o periodontal de pacientes com dist?rbios end?crino-metab?licos, destacando-se a S?ndrome de Berardinelli-Seip, hipertireoidismo, hipotireoidismo e acromegalia. M?todos- Foram avaliados 8 pacientes com S?ndrome de Berardinelli-Seip, 30 hipertire?ideos, 30 hipotire?ideos e 16 acromeg?licos, al?m de 35 pacientes que fizeram parte do grupo controle. Perda de inser??o cl?nica, profundidade de sondagem, ?ndice de sangramento gengival, aumento gengival e ?ndice de dentes cariados, perdidos e obturados foram os par?metros investigados em cada paciente. Todos os aspectos ?ticos foram rigidamente observados, sendo o estudo conduzido ap?s a aprova??o pelo Comit? de ?tica em Pesquisa da Universidade de Fortaleza. Resultados- A presen?a de periodontite foi marcante nos pacientes hipertire?ideos e naqueles com S?ndrome de Berardinelli-Seip. Os pacientes hipotire?ideos mostrarm pouca presen?a de periodontite, enquanto todos os acromeg?licos apresentaram aus?ncia de periodontite. Conclus?o- O efeito protetor dos acromeg?licos em rela??o ? periodontite ? um novo achado cujos mecanismos ainda n?o est?o claros, mas podem estar relacionados com os efeitos anab?licos do horm?nio de crescimento. A presen?a de periodontite na S?ndrome de Berardinelli-Seip pode ocorrer devido ? precoce presen?a de diabetes. Nos hipertire?ideos, a alta preval?ncia de periodontite pode estar ligada aos efeitos dos horm?nios tireoideanos no osso, explicando a menor preval?ncia nos hipotire?ideos

A integração da inteligência de mercado e a estruturação eficaz das fases iniciais (também conhecidas como front-end) do processo de desenvolvimento de novos produtos são dois dos mais importantes e difíceis desafios que inovadores enfrentam. Esta tese concentra-se na ligação entre estes dois aspectos, oferecendo um modelo conceitual para a sistematização e integração da inteligência de mercado nas atividades do front-end. O modelo, intitulado MISIPro (Market Intelligence Sistematization e Integration Process – Processo de sistematização e integração da inteligência de mercado), considera dois tipos diferentes de atividades que ocorrem no front-end: a) atividades de processamento de informações de mercado; e b) atividades de desenvolvimento de produtos. Essas atividades são então definidas, estruturadas e integradas. O modelo foi desenvolvido com base numa revisão da literatura sobre desenvolvimento de produtos, orientação de mercado e gestão do conhecimento e em 5 estudos de caso em empresas no Brasil e nos Estados Unidos. Como contribuição teórica, esta tese apresenta uma integração de conceitos importantes provenientes de diferentes perspectivas e áreas de conhecimento e uma nova abordagem e estrutura para a concepção do conceito. Para os profissionais, o modelo oferece uma ferramenta útil para a estruturação das atividades do front-end e integração das informações de mercado no processo de desenvolvimento de produtos. / Integrating market intelligence and effective structuring of the planning stages (also known as front-end) of new product development (NPD) process are two of the most important and difficult challenges facing innovators. This dissertation focuses on the link between these two elements, offering a conceptual model for the systematization and integration of market intelligence into the frontend activities. The model, entitled MISIPro (Market Intelligence Systematization and Integration Process), considers two different types of activities that take place in the front-end: a) market information processing activities; and b) product development activities. These activities are herein defined, structure and mutually integrated. The model was developed based on a review of the literature about product development, market orientation and knowledge management, and 5 case studies in Brazilian and U.S. companies. From a theoretical perspective, this dissertation offers an integration of the important concepts from different perspectives and areas of knowledge and a new approach and structure for the concept design. For practitioners, the model offers a useful tool for structuring the front-end activities and integrating market intelligence into the NPD process.

Neste trabalho, iremos analisar o livro A cidade e as serras, de Eça de Queirós, mediante os discursos referentes às estéticas de fin-de-siècle, que se estabelecem na França entre os anos de 1880 e 1900. Tentaremos observar, como o autor aproveita-se dos discursos para construir a personagem de Jacinto e como os manipula ironicamente a fim de estabelecer sua visão crítica sobre o período. Além disso, pretendemos mostrar como Eça de Queirós observa a mudança de perspectiva que acontece no campo cultural francês, ou ainda, no mundo no fim do século XIX, isto é, de um ponto de vista positivista, passando pelo decadente e pessimist, para o idealista. Acreditamos que através da manipulação irônica desse quadro histórico e do horizonte discursivo e estético que constitui o imaginário do homem do fim do século, Eça de Queirós irá estabelecer uma versão mais refinada do realismo praticada em seus livros da última fase / In this paper, we will examine the book The city and the mountains, Eça de Queirós, through the discourses concerning aesthetic of fin-de-siècle, which are established in France between the years 1880 and 1900. We will try to observe, as the author takes advantage of speeches to build character Jacinto and how ironically manipulates to establish his critical view of the period. Furthermore, we intend to show how Eça de Queirós notice the change in perspective that happens in the French cultural fields, besides in the world in the late nineteenth century, that is, a positivist point of view, through the decadent and pessimist, for idealistic. We believe that by manipulating this ironic historical context and the discursive and aesthetic which is the imaginary of man in the end of the century, Eça de Queirós horizon will establish a more refined version of realism practiced in his books of the last phase

Background: End-stage renal disease (ESRD) is a chronic medical condition where 90% or more of the kidneys are nonfunctional (Doig & Huether, 2014). The current treatment for ESRD is Hemodialysis [HD] (National Institute of Diabetes and Digestive and Kidney Disease [NIDDK], 2013). Individuals who have ESRD who undergo HD suffer from tremendous symptom and treatment burden that affects various facets of life (Axelsson, Klang, Hagelin, Jacobson, & Gleissman, 2014; Axelsson et al., 2012; Tamura & Cohen, 2010). Unfortunately, the symptom and treatment burden associated with ESRD are underrecognized and undertreated (Feely et al., 2016; Gelfman & Meyer, 2012; Murtagh, Addington-Hall, & Higginson, 2007; Russon & Mooney, 2010; Tamura & Meier, 2013). Purpose: The purpose of this quality improvement project is to explore if ESRD patients in Davita Desert Dialysis are knowledgeable about palliative care and if providing education might change their behavior. The primary aim is to create awareness in patients about PC services in an effort to improve their quality of care through education. Design: A quantitative pre- and post survey approach using qualtrics software was utilized to assess the baseline and post-education knowledge of patients who met the inclusion criteria. Setting: DaVita Desert Dialysis, Sun City, AZ. Intervention: The educational intervention is the viewing of a three-minute voice over presentation about palliative care. Limitations: The sample size was small and exposes this study to marked bias and non-generalizability due to the limited number of recruited individuals. Results: One hundred percent of the individuals in the posttest had better awareness about and knowledge about PC. Conclusion: PC can improve the quality of life of patients that suffer from the undertreated and underrecognized symptom and treatment burden (Tamura & Meier, 2013). Further data and studies will be needed to establish PC in the field of nephrology as it relates to the ESRD population undergoing HD. However, the quality improvement focus of increasing PC awareness among ESRD patients undergoing HD has shown great promise as all participants had increased awareness, knowledge availability, and readiness for PC services.

Det blir allt vanligare med människor som vårdas palliativt i hemmet. I och med det blir det vanligare att närstående är en del av vårdprocessen. Närstående ställs då inför en helt ny roll gentemot den anhörige. De upplever svårigheter med att bibehålla ett normalt familjeliv då hemmet mer och mer börjar likna ett sjukhus, samtidigt som de vet att de inte skulle klara sig utan hjälpmedlen. Upplevelsen för närstående att ha en döende familjemedlem är påfrestande. Den närstående är inte längre bara en familjemedlem eller vän utan någon som den sjuke är beroende av. För att kunna axla denna roll behöver den närstående stöttning från sjuksköterskan, vänner och familj.   För att sjuksköterskan ska kunna ge det stöd närstående behöver är det viktigt att få en uppfattning om den närståendes upplevelse av den palliativa vården i hemmet. För att ta reda på detta valdes en litteraturstudie till examensarbetet. 12 kvalitativa artiklar analyserades till resultatet vilket mynnade ut i tre teman, att ta ansvar i vårdandet, att ha behov av stöd och att möta döden.  Resultatet visar att de närstående känner ett ansvar i vårdandet. Vissa uttrycker att de inte har något val, de sätter sig själva åt sidan för att kunna uppfylla löftet att vårda den sjuke. Andra känner att det är en självklarhet. De tycker att det är en naturlig del av livet och en möjlighet att få vara nära sin älskade på slutet. Det är viktigt med stöd från sjukvårdspersonal, vänner och familj för de närstående. Brist på stöd gör att närstående känner sig övergivna. Det är lätt att den närstående blir isolerad och bunden till hemmet under vårdtiden och för att klara av det krävs det stöd från utomstående. Närstående tycker att det var svårt att prata om döden, speciellt med den sjuke. De upplever att det är lättare att diskutera döden och sjukdomen med sjuksköterskan för att inte oroa den sjuke i onödan. De känner sig ständigt konfronterande med döden men de uppskattar att de kan vara närvarande och där för den sjuke på slutet. / Background: In recent years, it has become increasingly common for patients to choose to end their life at home. Relatives often wants to fulfill the wishes of the sick person, but are often poorly prepared to act as caregivers and experience lack of continuity, insufficient information and poor treatment. The experience of relatives having a dying family member is stressful. Aim: The aim of this study was to describe the experiences of relatives in palliative homecare.  Method: A literature based study with 12 qualitative articles were performed using the Friberg method of analysis. Results: The result showed that some relatives felt that taking care of their family member where a matter of course and others felt that they had no choice. It was important for the relatives to have support from healthcare professionals, family and friends. Lack of support made them feel abandoned. It was difficult to talk about death with the dying family member and relatives expressed that it was easier to talk to the nurse about it.  Conclusion: Death was constantly present, despite that death was hard to talk about with the sick person. It was also hard for the relative to be responsible for someone else and they felt that they were isolated in their own home. The relatives felt therefore the need to be supported by the nurse. They needed to be able to talk to the nurse and feel safe to fulfill the feeling of support.

Abstract Failure to maintain an appropriate balance between cell death and proliferation is partly due to derangements in the regulation of apoptosis. In this work, apoptosis and the expression of apoptosis regulating proteins were studied by 3' - end labeling of fragmented apoptotic DNA (TUNEL) and immunohistochemistry in a set of 147 tissue samples consisting of 44 biopsies of normal and dysplastic bronchial epithelium, and 103 non-small cell lung carcinomas. The quantity of apoptotic cells and bodies, apoptotic index (AI%), is defined as a percentage of apoptotic cells in the entire tumor cell population. Changes in the apoptotic activity were already seen in the metaplasia-dysplasia-carcinoma sequence of the lung, where the AI% increased gradually until moderate epithelial dysplasia but started to decrease after that. Thus, the AI% for invasive NSCLC (1.20 for squamous cell carcinoma and 1.24 for adenocarcinoma) was slightly lower than in premalignant bronchial epithelium (mean 1.50), but clearly higher than in normal tissue (0.20 for normal bronchial epithelium and 0.24 for lung interstitial cells). 53% of SQCCs and 50% of ACs showed p53 positive nuclei indicative of mutated p53 protein. The immunostaining of bcl-2, bax and mcl-1 revealed diffuse, cytoplasmic staining and was present in most tissues studied. No statistically significant associations between the extent of apoptosis and the expression of p53, bcl-2, bax, or mcl-1 could be found, although . The immunostaining for caspases 3, 6 and 8 was restricted to the tumor areas, reflecting increased apoptotic activity in them. The AI% was significantly higher in NSCLCs in which the single-cell staining pattern for caspase-8 was dominant (P = 0.017), whereas the expression of caspases 3 and 6 had no association with apoptosis. The number of apoptotic cells was significantly higher in NSCLC tumors with a high number of CD3+ and CD8+ T-lymphocytes (P = 0.01) and B-cells (P = 0.05). By multivariate analysis, enhanced apoptosis in NSCLC showed a 1.9-fold risk (95% CI 1.04–3.60; P = 0.04) and p53 positivity a 2.3-fold risk (95% CI 1.30–4.10; P = 0.005) for a shortened survival. Both factors appeared as independent prognostic variables. Apoptosis is clearly enhanced in premalignant and malignant lung tissue in comparison with normal tissue. Furthermore, the expression of the apoptosis-regulating genes is different in tumor tissue from that in normal tissue, and some of the changes in their expression can be seen even in the premalignant lesions of the bronchial epithelium. The expression of caspases seen only in tumor tissue implies the activation of the apoptotic mechanisms and, thus, the lowered treshold of tumor cells to undergo apoptosis. Even in the advanced stages of the disease, the immune defense is effective and the cytotoxic action of activated CD8+ T-cells clearly involves apoptosis. Based on these results it is concluded that alterations in the apoptotic activity and changes in the expression of apoptosis-regulating genes are associated with malignant transformation and growth in lung tissue.

Advanced glycation end products (AGEs) are molecules formed through the nonenzymaticglycation of proteins and are central to the development of cardiovascularcomplications of diabetes including heart failure. AGEs influence cellular function throughthe cross-linking of cellular proteins as well as through actions on cell surface receptors,the most common of which is (RAGE). However, it is still unclear whether AGEs contributeto myocardial abnormalities observed in diabetes through direct myocardial actionsmediated through the RAGE receptor and if so, their underlying mechanisms of action. Wehave therefore investigated the effects of AGEs on calcium handling in isolated adultmouse cardiomyocytes and cultured neonatal rat cardiomyocytes (NRCM) andcharacterised their underlying mechanisms of action in NRCM.Standard molecular techniques were used. Western blot showed expression of RAGEreceptor in mouse whole heart tissue and in both NRCM and adult mouse cardiomyocytes. Incubation of NRCM for 24 hours with AGEs showed a dose dependant reduction ofcalcium transient amplitude with a maximum of 50% at 1 g/l (P<0.01) accompanied with32% reduction in SR calcium content with no detectable changes in calcium handlingproteins expression. We demonstrated a 24% increase (P<0.01) in the production ofreactive oxygen species (ROS) in AGE treated cardiomyocytes induced by enhancedNADPH oxidase activity (P<0.05) with subsequent activation and translocation of NF-kB, atranscriptional factor from the cytoplasm to the nucleus. Activation of NF-kB induced a56% increase in iNOS gene protein expression (P<0.01), a downstream target of NF-kBwhich was accompanied by a significant increase in NO production (P<0.05). Wedemonstrated nitrosylation of several key cellular proteins involved in excitationcontractioncoupling including the Ryanodine receptor and SERCA2a as detected byimmunofluorescence. In conclusion, our work provides insights into novel pathophysiological mechanisms thatunderlie the development of heart failure in diabetes. We demonstrate the presence andfunctionality of AGE receptors in myocardium and show that AGEs inhibit excitationcontractioncoupling through increased ROS production leading to activation andtranslocation of NF-kB from the cytoplasm to the nucleus resulting in increase in NOproduction. Concomitant increases in intracellular levels of ROS and NO favours theproduction of peroxynitrite with subsequent nitrosylation of key cellular proteins involved inthe process of excitation-contraction coupling such as the Ryanodine receptor andSERCA2a. This study provides novel insights into the role of AGEs in inducing myocardialdamage in diabetes mediated through RAGE receptor and independent from the vascular effects.