Determinants of cognitive performance among community dwelling older adults in an impoverished sub-district of Sao Paulo in Brazil

Determinants of cognitive performance in old age have received limited attention in Latin America. We investigated the association of socio-demographic and health-related variables with cognitive performance in a sample of older adults with limited educational experience living in a poor subdistrict of the city of Sao Paulo. This was a cross-sectional population-based study which included a sample of 384 seniors 65 years and older. Cognition was assessed by the Mini-Mental State Examination (MMSE) and the Brief Cognitive Screening Battery (BCSB) (episodic memory test with 10 pictures, verbal fluency (VF), Clock Drawing Test (CDT)). Results indicated that age, sex, schooling, depressive symptoms, and systolic blood pressure (SBP) level had a significant impact on the cognitive performance of the sample. Therefore, pharmacological and psychosocial interventions with a focus on improving mood and controlling hypertension may have beneficial effects on cognition among seniors with similar socio-demographic characteristics. (C) 2011 Elsevier Ireland Ltd. All rights reserved.

Spectrum of cognitive impairment in neurocysticercosis Differences according to disease phase

Objectives: Cognitive decline related to neurocysticercosis (NC) remains poorly characterized and underdiagnosed. In a cross-sectional study with a prospective phase, we evaluated cognitive decline in patients with strictly calcified form (C-NC), the epidemiologically largest subgroup of NC, and investigated whether there is a spectrum of cognitive abnormalities in the disease. Methods: Forty treatment-naive patients with C-NC aged 37.6 +/- 11.3 years and fulfilling criteria for definitive C-NC were submitted to a comprehensive cognitive and functional evaluation and were compared with 40 patients with active NC (A-NC) and 40 healthy controls (HC) matched for age and education. Patients with dementia were reassessed after 24 months. Results: Patients with C-NC presented 9.4 +/- 3.1 altered test scores out of the 30 from the cognitive battery when compared to HC. No patient with C-NC had dementia and 10 patients (25%) presented cognitive impairment-no dementia (CIND). The A-NC group had 5 patients (12.5%) with dementia and 11 patients (27.5%) with CIND. On follow-up, 3 out of 5 patients with A-NC with dementia previously still presented cystic lesions with scolex on MRI and still had dementia. One patient died and the remaining patient no longer fulfilled criteria for either dementia or CIND, presenting exclusively calcified lesions on neuroimaging. Conclusions: Independently of its phase, NC leads to a spectrum of cognitive abnormalities, ranging from impairment in a single domain, to CIND and, occasionally, to dementia. These findings are more conspicuous during active vesicular phase and less prominent in calcified stages. Neurology (R) 2012; 78: 861-866

The role of Nox2-derived ROS in the development of cognitive impairment after sepsis

BACKGROUND: Sepsis- associated encephalopathy (SAE) is an early and common feature of severe infections. Oxidative stress is one of the mechanisms associated with the pathophysiology of SAE. The goal of this study was to investigate the involvement of NADPH oxidase in neuroinflammation and in the long-term cognitive impairment of sepsis survivors. METHODS: Sepsis was induced in WT and gp91phox knockout mice (gp91phox-/-) by cecal ligation and puncture (CLP) to induce fecal peritonitis. We measured oxidative stress, Nox2 and Nox4 gene expression and neuroinflammation in the hippocampus at six hours, twenty-four hours and five days post-sepsis. Mice were also treated with apocynin, a NADPH oxidase inhibitor. Behavioral outcomes were evaluated 15 days after sepsis with the inhibitory avoidance test and the Morris water maze in control and apocynin-treated WT mice. RESULTS: Acute oxidative damage to the hippocampus was identified by increased 4-HNE expression in parallel with an increase in Nox2 gene expression after sepsis. Pharmacological inhibition of Nox2 with apocynin completely inhibited hippocampal oxidative stress in septic animals. Pharmacologic inhibition or the absence of Nox2 in gp91phox-/- mice prevented glial cell activation, one of the central mechanisms associated with SAE. Finally, treatment with apocynin and inhibition of hippocampal oxidative stress in the acute phase of sepsis prevented the development of long-term cognitive impairment. CONCLUSIONS: Our results demonstrate that Nox2 is the main source of reactive oxygen species (ROS) involved in the oxidative damage to the hippocampus in SAE and that Nox2-derived ROS are determining factors for cognitive impairments after sepsis. These findings highlight the importance of Nox2-derived ROS as a central mechanism in the development of neuroinflammation associated with SAE.

Genetic and environmental factors associated with the risk of cognitive decline and dementia

AD is the most common age related neurodegenerative disease in the industrialized world. Clinically AD is defined as a progressing decline of cognitive functions. Neuropathologically, AD is characterized by the aggregation of b-amyloid (Ab) peptide in the form of extracellular senile plaques, and hyperphosphorlylated tau protein in the form of intracellular neurofibrillary tangles. These neuropathological hallmarks are often accompanied by abundant microvascular damage and pronounced inflammation of the affected brain regions. In this thesis we investigated several aspects of AD focusing on the genetic aspect. We confirmed that Alpha 1 antichymotrypsin (ACT), an acute phase protein, was associated to AD subjects, being plasma levels higher in AD cases than controls. In addition, in a GWA study we demonstrated that two different gene, Clusterin and CR1 were strongly associated to AD. A single gene association not explain such a complex disease like AD. The goal should be to created a network of genetic, phenotypic and clinical data associated to AD. We used a new algorithm, the ANNs, aimed to map variables and search for connectivity among variables. We found specific variables associated to AD like cholesterol levels, the presence of variation in HMGCR enzyme and the age. Other factors such as the BMI, the amount of HDL and blood folate levels were also associated with AD. Pathogen infections, above all viral infections, have been previously associated to AD. The hypothesis suggests that virus and in particular herpes virus could enter the brain when an individual becomes older, perhaps because of a decline in the immune system. Our new hypothesis is that the presence of SNPs in our GWA gene study results in a genetic signature that might affect individual brain susceptibility to infection by herpes virus family during aging.

Quantum field theory of (p,0)-forms on kaehler manifolds

In questa tesi abbiamo studiato la quantizzazione di una teoria di gauge di forme differenziali su spazi complessi dotati di una metrica di Kaehler. La particolarità di queste teorie risiede nel fatto che esse presentano invarianze di gauge riducibili, in altre parole non indipendenti tra loro. L'invarianza sotto trasformazioni di gauge rappresenta uno dei pilastri della moderna comprensione del mondo fisico. La caratteristica principale di tali teorie è che non tutte le variabili sono effettivamente presenti nella dinamica e alcune risultano essere ausiliarie. Il motivo per cui si preferisce adottare questo punto di vista è spesso il fatto che tali teorie risultano essere manifestamente covarianti sotto importanti gruppi di simmetria come il gruppo di Lorentz. Uno dei metodi più usati nella quantizzazione delle teorie di campo con simmetrie di gauge, richiede l'introduzione di campi non fisici detti ghosts e di una simmetria globale e fermionica che sostituisce l'iniziale invarianza locale di gauge, la simmetria BRST. Nella presente tesi abbiamo scelto di utilizzare uno dei più moderni formalismi per il trattamento delle teorie di gauge: il formalismo BRST Lagrangiano di Batalin-Vilkovisky. Questo metodo prevede l'introduzione di ghosts per ogni grado di riducibilità delle trasformazioni di gauge e di opportuni “antifields" associati a ogni campo precedentemente introdotto. Questo formalismo ci ha permesso di arrivare direttamente a una completa formulazione in termini di path integral della teoria quantistica delle (p,0)-forme. In particolare esso permette di dedurre correttamente la struttura dei ghost della teoria e la simmetria BRST associata. Per ottenere questa struttura è richiesta necessariamente una procedura di gauge fixing per eliminare completamente l'invarianza sotto trasformazioni di gauge. Tale procedura prevede l'eliminazione degli antifields in favore dei campi originali e dei ghosts e permette di implementare, direttamente nel path integral condizioni di gauge fixing covarianti necessari per definire correttamente i propagatori della teoria. Nell'ultima parte abbiamo presentato un’espansione dell’azione efficace (euclidea) che permette di studiare le divergenze della teoria. In particolare abbiamo calcolato i primi coefficienti di tale espansione (coefficienti di Seeley-DeWitt) tramite la tecnica dell'heat kernel. Questo calcolo ha tenuto conto dell'eventuale accoppiamento a una metrica di background cosi come di un possibile ulteriore accoppiamento alla traccia della connessione associata alla metrica.

Integration of cognitive and affective processes in perception and decision-making

The relationship between emotion and cognition is a topic that raises great interest in research. Recently, a view of these two processes as interactive and mutually influencing each other has become predominant. This dissertation investigates the reciprocal influences of emotion and cognition, both at behavioral and neural level, in two specific fields, such as attention and decision-making. Experimental evidence on how emotional responses may affect perceptual and attentional processes has been reported. In addition, the impact of three factors, such as personality traits, motivational needs and social context, in modulating the influence that emotion exerts on perception and attention has been investigated. Moreover, the influence of cognition on emotional responses in decision-making has been demonstrated. The current experimental evidence showed that cognitive brain regions such as the dorsolateral prefrontal cortex are causally implicated in regulation of emotional responses and that this has an effect at both pre and post decisional stages. There are two main conclusions of this dissertation: firstly, emotion exerts a strong influence on perceptual and attentional processes but, at the same time, this influence may also be modulated by other factors internal and external to the individuals. Secondly, cognitive processes may modulate emotional prepotent responses, by serving a regulative function critical to driving and shaping human behavior in line with current goals.

Longitudinal evolution of cognitive functions in patients with multiple system atrophy: a prospective study

Introduction and Background: Multiple system atrophy (MSA) is a sporadic, adult-onset, progressive neurodegenerative disease characterized clinically by parkinsonism, cerebellar ataxia, and autonomic failure. We investigated cognitive functions longitudinally in a group of probable MSA patients, matching data with sleep parameters. Patients and Methods: 10 patients (7m/3f) underwent a detailed interview, a general and neurological examination, laboratory exams, MRI scans, a cardiovascular reflexes study, a battery of neuropsychological tests, and video-polysomnographic recording (VPSG). Patients were revaluated (T1) a mean of 16±5 (range: 12-28) months after the initial evaluation (T0). At T1, the neuropsychological assessment and VPSG were repeated. Results: The mean patient age was 57.8±6.4 years (range: 47-64) with a mean age at disease onset of 53.2±7.1 years (range: 43-61) and symptoms duration at T0 of 60±48 months (range: 12-144). At T0, 7 patients showed no cognitive deficits while 3 patients showed isolated cognitive deficits. At T1, 1 patient worsened developing multiple cognitive deficits from a normal condition. At T0 and T1, sleep efficiency was reduced, REM latency increased, NREM sleep stages 1-2 slightly increased. Comparisons between T1 and T0 showed a significant worsening in two tests of attention and no significant differences of VPSG parameters. No correlation was found between neuropsychological results and VPSG findings or RBD duration. Discussion and Conclusions: The majority of our patients do not show any cognitive deficits at T0 and T1, while isolated cognitive deficits are present in the remaining patients. Attention is the cognitive function which significantly worsened. Our data confirm the previous findings concerning the prevalence, type and the evolution of cognitive deficits in MSA. Regarding the developing of a condition of dementia, our data did not show a clear-cut diagnosis of dementia. We confirm a mild alteration of sleep structure. RBD duration does not correlate with neuropsychological findings.

Max Abraham's and Tullio Levi-Civita's approach to Einstein Theory of Relativity

This work deals with the theory of Relativity and its diffusion in Italy in the first decades of the XX century. Not many scientists belonging to Italian universities were active in understanding Relativity, but two of them, Max Abraham and Tullio Levi-Civita left a deep mark. Max Abraham engaged a substantial debate against Einstein between 1912 and 1914 about electromagnetic and gravitation aspects of the theories. Levi-Civita played a fundamental role in giving Einstein the correct mathematical instruments for the General Relativity formulation since 1915. This work, which doesn't have the aim of a mere historical chronicle of the events, wants to highlight two particular perspectives: on one hand, the importance of Abraham-Einstein debate in order to clarify the basis of Special Relativity, to observe the rigorous logical structure resulting from a fragmentary reasoning sequence and to understand Einstein's thinking; on the other hand, the originality of Levi-Civita's approach, quite different from the Einstein's one, characterized by the introduction of a method typical of General Relativity even to Special Relativity and the attempt to hide the two Einstein Special Relativity postulates.

Essays on the Axiomatic Theory of Matching

This dissertation mimics the Turkish college admission procedure. It started with the purpose to reduce the inefficiencies in Turkish market. For this purpose, we propose a mechanism under a new market structure; as we prefer to call, semi-centralization. In chapter 1, we give a brief summary of Matching Theory. We present the first examples in Matching history with the most general papers and mechanisms. In chapter 2, we propose our mechanism. In real life application, that is in Turkish university placements, the mechanism reduces the inefficiencies of the current system. The success of the mechanism depends on the preference profile. It is easy to show that under complete information the mechanism implements the full set of stable matchings for a given profile. In chapter 3, we refine our basic mechanism. The modification on the mechanism has a crucial effect on the results. The new mechanism is, as we call, a middle mechanism. In one of the subdomain, this mechanism coincides with the original basic mechanism. But, in the other partition, it gives the same results with Gale and Shapley's algorithm. In chapter 4, we apply our basic mechanism to well known Roommate Problem. Since the roommate problem is in one-sided game patern, firstly we propose an auxiliary function to convert the game semi centralized two-sided game, because our basic mechanism is designed for this framework. We show that this process is succesful in finding a stable matching in the existence of stability. We also show that our mechanism easily and simply tells us if a profile lacks of stability by using purified orderings. Finally, we show a method to find all the stable matching in the existence of multi stability. The method is simply to run the mechanism for all of the top agents in the social preference.

Proof theory of quantified modal logics

We introduce labelled sequent calculi for indexed modal logics. We prove that the structural rules of weakening and contraction are height-preserving admissible, that all rules are invertible, and that cut is admissible. Then we prove that each calculus introduced is sound and complete with respect to the appropriate class of transition frames.

Spectral theory of differential operators on finite metric graphs and on bounded domains

Die vorliegende Arbeit widmet sich der Spektraltheorie von Differentialoperatoren auf metrischen Graphen und von indefiniten Differentialoperatoren auf beschränkten Gebieten. Sie besteht aus zwei Teilen. Im Ersten werden endliche, nicht notwendigerweise kompakte, metrische Graphen und die Hilberträume von quadratintegrierbaren Funktionen auf diesen betrachtet. Alle quasi-m-akkretiven Laplaceoperatoren auf solchen Graphen werden charakterisiert, und Abschätzungen an die negativen Eigenwerte selbstadjungierter Laplaceoperatoren werden hergeleitet. Weiterhin wird die Wohlgestelltheit eines gemischten Diffusions- und Transportproblems auf kompakten Graphen durch die Anwendung von Halbgruppenmethoden untersucht. Eine Verallgemeinerung des indefiniten Operators $-tfrac{d}{dx}sgn(x)tfrac{d}{dx}$ von Intervallen auf metrische Graphen wird eingeführt. Die Spektral- und Streutheorie der selbstadjungierten Realisierungen wird detailliert besprochen. Im zweiten Teil der Arbeit werden Operatoren untersucht, die mit indefiniten Formen der Art $langlegrad v, A(cdot)grad urangle$ mit $u,vin H_0^1(Omega)subset L^2(Omega)$ und $OmegasubsetR^d$ beschränkt, assoziiert sind. Das Eigenwertverhalten entspricht in Dimension $d=1$ einer verallgemeinerten Weylschen Asymptotik und für $dgeq 2$ werden Abschätzungen an die Eigenwerte bewiesen. Die Frage, wann indefinite Formmethoden für Dimensionen $dgeq 2$ anwendbar sind, bleibt offen und wird diskutiert.

Lateralization of cognitive functions after stroke in childhood

A child's brain shows a remarkable ability to recover from adverse events such as stroke. Language functions recover particularly well, while visuo-spatial skills are more affected by brain damage, regardless of its localization. This study investigated the lateralization of language and visual search after childhood stroke.