Função cognitiva e capacidade funcional são preditoras de qualidade de vida em pacientes idosos com insuficiência cardíaca

Pós-graduação em Fisiopatologia em Clínica Médica - FMB

Maternal Depression, Behavioral Profile and School Performance in School-Age Children

The aim of this study was to compare behavioral profile and school performance of school-age children living with a mother who presents clinical history of recurrent depression, diagnosed according to CID-10 criteria in order to verify the influences of such adversity. Thirty-eight mother-child dyads were evaluated using tests, interviews and questionnaires. Approximately two-thirds of the children presented behavioral and school performance difficulties with predominance of emotional and relationship problems, and impairment in the three areas of school performance which were assessed (writing, arithmetic and reading). Such difficulties may be associated with the negative impact of maternal depression. One-third of the children did not present difficulties, which suggests the use of protective mechanisms. The study highlights the importance of considering differences in children's profiles for the planning of mental health practices.

Investigating Avian Influenza Infection Hotspots in Old-World Shorebirds

Heterogeneity in the transmission rates of pathogens across hosts or environments may produce disease hotspots, which are defined as specific sites, times or species associations in which the infection rate is consistently elevated. Hotspots for avian influenza virus (AIV) in wild birds are largely unstudied and poorly understood. A striking feature is the existence of a unique but consistent AIV hotspot in shorebirds (Charadriiformes) associated with a single species at a specific location and time (ruddy turnstone Arenaria interpres at Delaware Bay, USA, in May). This unique case, though a valuable reference, limits our capacity to explore and understand the general properties of AIV hotspots in shorebirds. Unfortunately, relatively few shorebirds have been sampled outside Delaware Bay and they belong to only a few shorebird families; there also has been a lack of consistent oropharyngeal sampling as a complement to cloacal sampling. In this study we looked for AIV hotspots associated with other shorebird species and/or with some of the larger congregation sites of shorebirds in the old world. We assembled and analysed a regionally extensive dataset of AIV prevalence from 69 shorebird species sampled in 25 countries across Africa and Western Eurasia. Despite this diverse and extensive coverage we did not detect any new shorebird AIV hotspots. Neither large shorebird congregation sites nor the ruddy turnstone were consistently associated with AIV hotspots. We did, however, find a low but widespread circulation of AIV in shorebirds that contrast with the absence of AIV previously reported in shorebirds in Europe. A very high AIV antibody prevalence coupled to a low infection rate was found in both first-year and adult birds of two migratory sandpiper species, suggesting the potential existence of an AIV hotspot along their migratory flyway that is yet to be discovered.

Cognition in context: Evidence on affordances and verbal language

This thesis investigated affordances and verbal language to demonstrate the flexibility of embodied simulation processes. Starting from the assumption that both object/action understanding and language comprehension are tied to the context in which they take place, six studies clarified the factors that modulate simulation. The studies in chapter 4 and 5 investigated affordance activation in complex scenes, revealing the strong influence of the visual context, which included either objects and actions, on compatibility effects. The study in chapter 6 compared the simulation triggered by visual objects and objects names, showing differences depending on the kind of materials processed. The study in chapter 7 tested the predictions of the WAT theory, confirming that the different contexts in which words are acquired lead to the difference typically observed in the literature between concrete and abstract words. The study in chapter 8 on the grounding of abstract concepts tested the mapping of temporal contents on the spatial frame of reference of the mental timeline, showing that metaphoric congruency effects are not automatic, but flexibly mediated by the context determined by the goals of different tasks. The study in chapter 9 investigated the role of iconicity in verbal language, showing sound-to-shape correspondences when every-day object figures, result that validated the reality of sound-symbolism in ecological contexts. On the whole, this evidence favors embodied views of cognition, and supports the hypothesis of a high flexibility of simulation processes. The reported conceptual effects confirm that the context plays a crucial role in affordances emergence, metaphoric mappings activation and language grounding. In conclusion, this thesis highlights that in an embodied perspective cognition is necessarily situated and anchored to a specific context, as it is sustained by the existence of a specific body immersed in a specific environment.

Context-dependent interpretation of the conjunction 'und' in different age-groups

In contrast to formal semantics, the conjunction and is nonsymmetrical in pragmatics. The events in Marc went to bed and fell asleep seem to have occurred chronologically although no explicit time reference is given. As the temporal interpretation appears to be weaker in Mia ate chocolate and drank milk, it seems that the kind and nature of events presented in a context influences the interpretation of the conjunction. This work focuses on contextual influences on the interpretation of the German conjunction und (‘and’). A variety of theoretic approaches are concerned with whether and contributes to the establishment of discourse coherence via pragmatic processes or whether the conjunction has complex semantic meaning. These approaches are discussed with respect to how they explain the temporal and additive interpretation of the conjunction and the role of context in the interpre-tation process. It turned out that most theoretic approaches do not consider the importance of different kinds of context in the interpretation process.rnIn experimental pragmatics there are currently only very few studies that investigate the inter-pretation of the conjunction. As there are no studies that investigate contextual influences on the interpretation of und systematically or investigate preschoolers interpretation of the con-junction, research questions such as How do (preschool) children interpret ‘und’? and Does the kind of events conjoined influence children’s and adults’ interpretation? are yet to be answered. Therefore, this dissertation systematically investigates how different types of context influence children’s interpretation of und. Three auditory comprehension studies were conducted in German. Of special interest was whether and how the order of events introduced in a context contributes to the temporal read-ing of the conjunction und. Results indicate that the interpretation of und is – at least in Ger-man – context-dependent: The conjunction is interpreted temporally more often when events that typical occur in a certain order are connected (typical contexts) compared to events with-out typical event order (neutral contexts). This suggests that the type of events conjoined in-fluences the interpretation process. Moreover, older children and adults interpret the conjunc-tion temporally more often than the younger cohorts if the conjoined events typically occur in a certain order. In neutral contexts, additive interpretations increase with age. 5-year-olds reject reversed order statements more often in typical contexts compared to neutral contexts. However, they have more difficulties with reversed order statements in typical contexts where they perform at chance level. This suggests that not only the type of event but also other age-dependent factors such as knowledge about scripts influence children’s performance. The type of event conjoined influences children’s and adults’ interpretation of the conjunction. There-fore, the influence of different event types and script knowledge on the interpretation process does not only have to be considered in future experimental studies on language acquisition and pragmatics but also in experimental pragmatics in general. In linguistic theories, context has to be given a central role and a commonly agreed definition of context that considers the consequences arising from different event types has to be agreed upon.

Ranibizumab (Lucentis) in neovascular age-related macular degeneration: evidence from clinical trials

BACKGROUND: Neovascular age-related macular degeneration (AMD) has a poor prognosis if left untreated, frequently resulting in legal blindness. Ranibizumab is approved for treating neovascular AMD. However, further guidance is needed to assist ophthalmologists in clinical practice to optimise treatment outcomes. METHODS: An international retina expert panel assessed evidence available from prospective, multicentre studies evaluating different ranibizumab treatment schedules (ANCHOR, MARINA, PIER, SAILOR, SUSTAIN and EXCITE) and a literature search to generate evidence-based and consensus recommendations for treatment indication and assessment, retreatment and monitoring. RESULTS: Ranibizumab is indicated for choroidal neovascular lesions with active disease, the clinical parameters of which are outlined. Treatment initiation with three consecutive monthly injections, followed by continued monthly injections, has provided the best visual-acuity outcomes in pivotal clinical trials. If continued monthly injections are not feasible after initiation, a flexible strategy appears viable, with monthly monitoring of lesion activity recommended. Initiation regimens of fewer than three injections have not been assessed. Continuous careful monitoring with flexible retreatment may help avoid vision loss recurring. Standardised biomarkers need to be determined. CONCLUSION: Evidence-based guidelines will help to optimise treatment outcomes with ranibizumab in neovascular AMD.

Human TOP1 residues implicated in species specificity of HIV-1 infection are required for interaction with BTBD2, and RNAi of BTBD2 in old world monkey and human cells increases permissiveness to HIV-1 infection

Host determinants of HIV-1 viral tropism include factors from producer cells that affect the efficiency of productive infection and factors in target cells that block infection after viral entry. TRIM5 restricts HIV-1 infection at an early post-entry step through a mechanism associated with rapid disassembly of the retroviral capsid. Topoisomerase I (TOP1) appears to play a role in HIV-1 viral tropism by incorporating into or otherwise modulating virions affecting the efficiency of a post-entry step, as the expression of human TOP1 in African Green Monkey (AGM) virion-producing cells increased the infectivity of progeny virions by five-fold. This infectivity enhancement required human TOP1 residues 236 and 237 as their replacement with the AGM counterpart residues abolished the infectivity enhancement. Our previous studies showed that TOP1 interacts with BTBD1 and BTBD2, two proteins which co-localize with the TRIM5 splice variant TRIM5 in cytoplasmic bodies. Because BTBD1 and BTBD2 interact with one HIV-1 viral tropism factor, TOP1, and co-localize with a splice variant of another, we investigated the potential involvement of BTBD1 and BTBD2 in HIV-1 restriction.

Social cognition in attention-deficit hyperactivity disorder (ADHD)

Attention-deficit hyperactivity disorder (ADHD) is associated with a range of cognitive deficits and social cognition impairments, which might be interpreted in the context of fronto-striatal dysfunction. So far only few studies have addressed the issue of social cognition deficits in ADHD.

Interobserver variability for retreatment indications after Ranibizumab loading doses in neovascular age-related macular degeneration

To assess the interobserver variability (IOV) in indicating retreatment for neovascular Age-related macular degeneration 4 weeks after three Ranibizumab loading doses using spectral domain OCT (SD-OCT) as the primary objective diagnostic tool.

Risk factors of mortality in different age groups after thoracic endovascular aortic repair

The aim of this study was to determine risk factors for mortality in different age groups after thoracic endovascular aortic repair (TEVAR).