A beterraba açucareira na alimentaçao de suínos.

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Uso de dejetos de suínos na agricultura.

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NKT cells inhibit antigen-specific effector CD8 T cell induction to skin viral proteins

Type 1 diabetes (T1D) results from autoimmune destruction of insulin-producing pancreatic β cells. Therapies need to incorporate strategies to overcome the genetic defects that impair induction or maintenance of peripheral T-cell tolerance and contribute to disease development. We tested whether the enforced expression of an islet autoantigen in antigen-presenting cells (APC) counteracted peripheral T-cell tolerance defects in autoimmune-prone NOD mice. We observed that insulin-specific CD8(+) T cells transferred to mice in which proinsulin was transgenically expressed in APCs underwent several rounds of division and the majority were deleted. Residual insulin-specific CD8(+) T cells were rendered unresponsive and this was associated with TCR downregulation, loss of tetramer binding and expression of a range of co-inhibitory molecules. Notably, accumulation and effector differentiation of insulin-specific CD8(+) T cells in pancreatic lymph nodes was prominent in non-transgenic recipients but blocked by transgenic proinsulin expression. This shift from T-cell priming to T-cell tolerance exemplifies the tolerogenic capacity of autoantigen expression by APC and the capacity to overcome genetic tolerance defects

Tratamentos farmacológicos para transtornos de ansiedade, transtorno obsessivo-compulsivo e transtorno de estresse pós-traumático : uma meta-regressão e metanálise em rede mulinível

Anxiety, obsessive-compulsive, and stress-related disorders frequently co-occur, and patients often exhibit symptoms from multiple domains. However, meta-analyses typically limit the statistical analysis to specific symptom domains. Consequently, the efficacy of selective serotonin reuptake inhibitors (SSRIs) and serotonin and norepinephrine reuptake inhibitors (SNRIs) on multiple mental health domains has not yet been studied through meta-analyses in this field. While SSRIs and SNRIs are the first-line pharmacological treatments, many patients are non-compliant due to their fear of potential adverse events, which is the second leading cause of nonadherence. Therefore, comparing the rates of adverse events and tolerability profiles of each medication may help improve adherence. Despite this, no large-scale quantitative review has evaluated the comparative tolerability and rates of most adverse events associated with all SSRIs and SNRIs. The articles that comprise this thesis aim to compare the efficacy in multiple symptom domains and tolerability profiles of SSRIs and SNRIs in the treatment of children and adults diagnosed with anxiety, obsessive-compulsive, or stress-related disorders. To achieve this, data are gathered from a systematic review of published and unpublished randomized controlled trials that assessed the efficacy of SSRIs or SNRIs in individuals diagnosed with any anxiety, obsessive-compulsive, or stress-related disorder. Searches were conducted in MEDLINE, PsycINFO, Embase, Cochrane, publicly accessible clinical trial registries, and pharmaceutical companies' databases. No restrictions were imposed regarding comorbidities with any other mental disorder, as well as specific assessment instruments, participants' age and sex, date of publication, or study language. Article #1 estimates the acceptability and efficacy of SSRIs and SNRIs in internalizing symptoms of children and adults, also exploring the multilevel structure of efficacy in all symptom domains related to the diagnoses of anxiety, obsessive-compulsive, or stress-related disorders. Article #2 expands on the findings from article #1 by investigating the tolerability of SSRIs and SNRIs, estimating the incidence rates of 17 specific adverse events, and determining treatment rankings for those events. In both articles, data were pooled through three-level network meta-analyses and multiple meta-regression analyses, accounting for clinical and methodological differences. Results of the efficacy analysis, which included 469 outcome measures from 135 studies, support the efficacy of these medications in the overall measure of internalizing symptoms, across all symptom domains, and in patients from all diagnostic categories. Head-to-head comparisons revealed only minor differences between medications in terms of efficacy and acceptability. Tolerability analyses, including 799 outcome measures of adverse events from 80 studies, indicate that participants in medication groups experienced higher rates of adverse events compared to placebo groups. Significant differences in tolerability of medications were identified and distinct tolerability profiles were estimated for each SSRI or SNRI. This three-level network meta-analysis contributes to the ongoing discussion about the true benefits of antidepressants, providing robust evidence due to the significantly larger quantity of data, higher statistical power compared to previous studies, and the assessment of the multilevel structure of transdiagnostic efficacy. Furthermore, the tolerability findings presented here may guide clinical decision-making when clinicians consider one medication over another, potentially enhancing treatment acceptability and compliance.Transtornos de ansiedade, transtorno obsessivo-compulsivo e transtornos relacionados ao estresse frequentemente coocorrem, e os pacientes frequentemente apresentam sintomas de vários domínios; no entanto, metanálises geralmente limitam-se a análises de domínios de sintomas específicos. Consequentemente, a eficácia dos inibidores seletivos da recaptação de serotonina (ISRSs) e dos inibidores da recaptação de serotonina e noradrenalina (IRSNs) em múltiplos domínios de saúde mental ainda não foi avaliada por metanálises relacionadas a esses diagnósticos. Embora os ISRSs e IRSNs sejam os tratamentos farmacológicos de primeira escolha, muitos pacientes não aderem ao tratamento devido ao medo de potenciais eventos adversos, segunda causa mais comum para não adesão; portanto, estimar incidências de eventos adversos e perfis de tolerabilidade de cada medicamento pode ajudar a melhorar a adesão. Apesar disso, nenhuma metanálise avaliou a tolerabilidade comparativa e incidências da maioria dos eventos adversos associados a diversos ISRSs e IRSNs. Os artigos que compõem esta tese têm como objetivo comparar a eficácia nos múltiplos domínios de sintomas e os perfis de tolerabilidade dos ISRSs e IRSNs no tratamento de crianças e adultos diagnosticados com transtornos de ansiedade, obsessivo-compulsivo ou relacionados ao estresse. Para isso, os dados foram coletados por meio de uma revisão sistemática de ensaios clínicos randomizados desenvolvidos para estimar a eficácia de ISRSs ou IRSNs em indivíduos diagnosticados com os transtornos em estudo. As buscas foram realizadas no MEDLINE, PsycINFO, Embase, Cochrane, registros de ensaios clínicos e bancos de dados de empresas farmacêuticas. Não houve restrições com relação a comorbidades ou escalas específicas. O Artigo #1 avalia a aceitabilidade e eficácia de ISRSs e IRSNs nos sintomas internalizantes, explorando a estrutura multinível da eficácia em todos os domínios de sintomas. O Artigo #2 expande os achados do Artigo #1 investigando a tolerabilidade de ISRSs e IRSNs, estimando as taxas de incidência de 17 eventos adversos e ranqueando as medicações para esses eventos. Em ambos artigos, os dados foram analisados por meio de metanálises de rede multinível e modelos múltiplos de meta-regressão, considerando características clínicas e metodológicas. Resultados das análises de eficácia, as quais incluíram 469 desfechos de 135 estudos, demonstram eficácia no desfecho global de sintomas internalizantes, em todos os domínios de sintomas e em pacientes com todas categorias diagnósticas. Comparações pareadas revelaram apenas pequenas diferenças entre medicamentos quanto a eficácia e aceitabilidade. As análises de tolerabilidade, envolvendo 799 desfechos de eventos adversos de 80 estudos, indicam que participantes tratados com medicamentos apresentaram maiores taxas de incidência de eventos adversos quando comparados com grupos em uso de placebo. Foram identificadas diferenças significativas na tolerabilidade dos medicamentos e foram estimados perfis de tolerabilidade distintos para cada fármaco. Esta metanálise de rede multinível contribui para discussões sobre os verdadeiros benefícios dos antidepressivos, fornecendo evidências robustas devido à quantidade significativamente maior de desfechos, maior poder estatístico e avaliação da estrutura multinível de eficácia transdiagnóstica. Além disso, resultados de tolerabilidade podem orientar a tomada de decisão quando médicos consideram um medicamento em relação a outro, potencialmente melhorando a aceitabilidade e a adesão ao tratamento

Compra consultiva ou autosserviço: análise na experiência de consumo dos clientes do varejo agropecuário

Esta monografia tem como objetivo analisar, por meio da pesquisa com os clientes do varejo agropecuário da cidade de Roca Sales - RS, a percepção dos consumidores acerca da experiência de compra consultiva e o autosserviço, além de analisar a forma de atendimento perante uma nova modalidade de atendimento que é o autosserviço. Também buscou-se identificar os motivos que os consumidores optam por tal modalidade e analisar fatores negativos e positivos sobre a experiência com estes modelos de atendimentos. No âmbito do plano teórico, foi apresentado uma revisão na literatura, com conceitos e estratégias que influenciam na experiência do consumidor. O método apresenta uma abordagem descritiva, o tipo de pesquisa é quantitativo, e o público-alvo são os consumidores do comércio varejista da cidade de Roca Sales – RS. A amostragem é não probabilística por conveniência e a coleta de dados foi feita por meio de questionário. Com a análise dos dados foi constatado que o modelo de atendimento à venda consultiva é a melhor na experiência de compra dos consumidores, pelo fato da presença do vendedor ser importante para a orientação dos produtos, porém a agilidade causada pelo autoatendimento também é bem-vista pelos consumidores. Propõe-se que os resultados obtidos sejam usados para que as lojas do comércio varejista entendam o comportamento do consumidor e a experiência de compra nas duas modalidades de venda, consultiva e de autosserviço. Com isso os gestores podem entender melhor o consumidor e assim direcionar as decisões, entendendo melhor os modos de atendimento com a percepção do consumidor.This undergraduate thesis aims to analyze, through a survey with clients of agricultural retail stores from the city of Roca Sales – RS, the perception of the costumers about the assisted buying experience and self-service, as well as the service before a new method that is self-service. It was also sought to identify the motives because the customers prefer a method over the other and to analyze the negative and positive factors about the experience of these service models. On the theory plane, a literature review was presented with concepts and strategies that affect the customer experience. The method presents a descriptive approach, the type of research is qualitative, and the target group is the costumers from the retail stores from the city of Roca Sales – RS. The sampling isn’t probabilistic by convenience and the data collection was done through a survey. With the data analysis, it was observed that the service method of assisted buying is the better experience for the customers because the presence of the seller is important for product acquiring guidance, but the agility of self-service is also well regarded. It is proposed that the obtained results be used so the retail stores’ management can comprehend the customers’ behavior and buying experience in the two methods, assisted and self-service. With this, the managers can better understand the customers and so direct their decisions, better comprehending the service methods with the customers’ perceptions

An Integrated Model of Contex, Short-Term, and Long-Term Memory

I present the context-unified encoding (CUE) model, a large-scale spiking neural network model of human memory. It combines and integrates activity-based short-term memory with weight-based long-term memory. The implementation with spiking neurons ensures biological plausibility and allows for predictions on the neural level. At the same time, the model produces behavioural outputs that have been matched to human data from serial and free recall experiments. In particular, well-known results such as primacy, recency, transposition error gradients, and forward recall bias have been reproduced with good quantitative matches. Additionally, the model accounts for the effects of the acetylcholine antagonist scopolamine, and the Hebb repetition effect. The CUE model combines and extends the ordinal serial encoding (OSE) model, a spiking neuron model of short-term memory, and the temporal context model (TCM), a mathematical model of free recall. To the former, a neural mechanism for tracking the list position is added. The latter is converted into a spiking neural network under considerations of the main features and simplification of equations where appropriate. Previous models of the recall process in the TCM are replaced by a new independent accumulator recall process that is more suited to the integration into a large-scale network. To implement the modification of the required association matrices, a novel learning rule, the association matrix learning rule (AML), is derived that allows for one-shot learning without catastrophic forgetting. Its biological plausibility is discussed and it is shown that it accounts for changes in neural firing observed in human recordings from an association learning experiment. Furthermore, I discuss a recent proposal of an optimal fuzzy temporal memory as replacement for the TCM context signal and show it to be likely to require more neurons than there are in the human brain. To construct the CUE model, I have used the Neural Engineering Framework (NEF) and Semantic Pointer Architecture (SPA). This thesis makes novel contributions to both. I propose to distribute NEF intercepts according to the distribution of cosine similarities of random uniformly distributed unit vectors. This leads to a uniform distribution of active neurons and reduces the error introduced by spiking noise considerably in high-dimensional neuronal representations. It improves the asymptotic scaling of the noise error with dimensions d from O(d) to O(d^(3/4))$. These results are applied to achieve improved Semantic Pointer representations in neural networks are on par with or better than previous methods of optimizing neural representations for the Semantic Pointer Architecture. Furthermore, the vector-derived transformation binding (VTB) is investigated as an alternative to circular convolution in the SPA, with promising results

Oral hygiene in nursing home residents in an IPC perspective – a qualitative study among care workers in Copenhagen Municipality.

Baggrund Manglende mundhygiejne kombineret med forskellige risikofaktorer kan associeres med pneumoni og risiko for indlæggelse. Danmark har en relativ høj incidens for pneumoni som forebyggelig indlæggelse blandt ældre. På trods af systematisk forebyggende tandpleje til københavnske plejehjemsbeboere, ses problemer med plak og tandkødsblødninger hos 18-23 %. Mundhygiejne vurderes samtidig til at være et dagligt plejebehov hos 75 %. Social- og sundhedsmedarbejdere (SOSU-medarbejdere) har det daglige plejeansvar for beboerne inklusiv mundhygiejne. Det undersøges derfor, hvordan disse forholder sig til mundhygiejne som infektionshygiejnisk indsats. Forskningsspørgsmål Hvilken viden og opfattelse har SOSU-medarbejdere om mundhygiejne som infektionshygiejnisk indsats blandt beboere på plejehjem? Hvilke forhold eller faktorer ser SOSU-medarbejderne som fremmende eller begrænsende i forhold til at understøtte eller udføre mundhygiejne? Metode Kvalitativ undersøgelse med semi-strukturerede individuelle interviews af seks erfarne SOSU-medarbejdere med plejeansvar for plejehjemsbeboere i København. Resultater Daglig mundhygiejne ses som en vigtig infektionsforebyggende indsats og som en hverdagspraksis, der giver velvære. Personligt kendskab, relation og samarbejde med beboeren er væsentlige forudsætninger, der fremmer mulighed for mundhygiejne, hvorimod vægring og manglende samarbejde hæmmer. Uhensigtsmæssige arbejdsstillinger og dårlig belysning angives som barrierer, ligesom del-proteser opleves som svære at gennemskue og håndtere. Tandplejen er den vigtigste samarbejdspartner i forhold til viden, sparring og feedback. Mundhygiejne ses desuden i et etisk perspektiv, hvor SOSU-medarbejderen er forpligtet til at varetage den plejeafhængige beboers helbred og samtidig forpligtet til at værne om beboerens autonomi ved ikke at overskride dennes grænser. Konklusion SOSU-medarbejderne forstår mundhygiejne som en vigtig infektionshygiejnisk opgave. Tryg relation, accept og samarbejde er de vigtigste forudsætninger for opgaven, mens hensynet til beboerens autonomi kan betyde nødtørftig og lejlighedsvis udførelse af mundhygiejne, særligt hos kognitivt svækkede beboere. Hyppigste barrierer for mundhygiejne er manglende samarbejde eller vægring fra beboeren samt fysiske forhold som dårlig belysning og ubekvemme arbejdsstillinger, hvilket bør medtænkes ved indsatser, der skal forbedre beboernes mundhygiejne