Assessing cognitive function in older adults using a videoconference approach

Background: The use of communication technologies is an emerging trend in healthcare and research. Despite efficient, reliable and accurate neuropsychological batteries to evaluate cognitive performance in-person, more diverse and less expensive and time consuming solutions are needed. Here we conducted a pilot study to determine the applicability of a videoconference (VC, Skype (R)) approach to assess cognitive function in older adults, using The Telephone Interview for Cognitive Status-Modified - Portuguese version (TICSM-PT). Methods: After inclusion and exclusion criteria, 69 individuals (mean age = 74.90 +/- 9.46 years), selected from registries of local health centers and assisted-living facilities, were assessed on cognitive performance using videoconference, telephone and in-person approaches. Findings: The videoconference administration method yielded comparable results to the traditional application. Correlation analyses showed high associations between the testing modalities: TICSM-PT VC and TICSM-PT telephone (r=0.885), TICSM-PT VC and MMSE face-to-face (r=0.801). Using the previously validated threshold for cognitive impairment on the TICSM-PT telephone, TICSM-PT VC administration presented a sensitivity of 87.8% and a specificity of 84.6%. Interpretation: Findings indicate for the range of settings where videoconference approaches can be used, and for their applicability and acceptability, providing an alternative to current cognitive assessment methods. Continued validation studies and adaptation of neuropsychological instruments is warranted.This work was funded by the European Commission (FP7): "SwitchBox" (Contract HEALTH-F2-2010-259772), and co-financed by the Portuguese North Regional Operational Program (ON.2 - O Novo Norte), under the National Strategic Reference Framework (QREN), through the European Regional Development Fund (FEDER), and by the Fundacao Calouste Gulbenkian (Portugal) (Contract grant number: P-139977; project "Better mental health during ageing based on temporal prediction of individual brain ageing trajectories (TEMPO)"). TCC and LA are recipients of a doctoral fellowship from the Portuguese Foundation for Science and Technology (FCT, Portugal; SFRH/BD/90078/2012 and SFRH/BD/101398/2014, respectively, the latter from the POCH program and co-financed by the Fundo Social Europeu and MCTES); PSM is supported by the FCT fellowship grant (PDE/BDE/113601/2015 from the PhD-iHES program); and, NCS of a Research Assistantship by FCT through the "FCT Investigator Programme (2008 Ciencia)".info:eu-repo/semantics/publishedVersio

Longitudinal measurement invariance of memory performance and executive functioning in healthy aging

In this work, we examined the longitudinal measurement invariance of a battery composed of distinct cognitive parameters. A sample of 86 individuals (53.5% females; mean age = 65.73), representative of the Portuguese older population, with respect to sex, age and level of education was assessed twice over an average of two years. By means of a confirmatory factor analysis approach, we tested whether a two-factor solution [corresponding to measures of memory performance (MEM) and executive functioning (EXEC)] was reliable over time. Nested models of longitudinal invariance demonstrated the existence of partial strong invariance over time. In other words, this indicates that there is an equivalence of the factorial structure and factor loadings for all items; this was also observed for the item intercepts for all the items, except for one of the items from the EXEC dimension. Stability coefficients revealed high associations between the dimensions over time and that, whereas there was a significant decline of the MEM across time, this was not observed for the EXEC dimension. These findings reveal that changes in MEM and EXEC scores can be attributed to true changes on these constructs, enabling the use of this battery as a reliable method to study cognitive aging.PSM (ref: PDE/BDE/113601/2015 - PhD-iHES program), TCC (ref: SFRH/BD/90078/2012), LA (SFRH/BD/101398/2014) and CPN (ref: PD/BD/106050/2015 - PhDOC program) were supported by FCT fellowship grants. The work has been developed under the scope of the projects NORTE-01-0145-FEDER-000013 supported by the Northern Portugal Regional Operational Programme (NORTE 2020), under the Portugal 2020 (P2020) Partnership Agreement, through the European Regional Development Fund (FEDER) and POCI-01-0145-FEDER-016428 supported by the Operational Programme Competitiveness and Internationalization (COMPETE 2020) and the Regional Operational Program of Lisbon and National Funding through Portuguese Foundation for Science and Technology (FCT, Portugal); and, by the Portuguese North Regional Operational Programme (ON.2 - O Novo Norte), under the National Strategic Reference Framework (QREN), through FEDER, the Fundação Calouste Gulbenkian (Portugal) (contract grant number: P-139977; project "TEMPO - Better mental health during ageing based on temporal prediction of individual brain ageing trajectories") and SwitchBox-FP7-HEALTH-2010-grant 259772-2info:eu-repo/semantics/publishedVersio

Asymmetrical subcortical plasticity entails cognitive progression in older individuals

Structural brain asymmetries have been associated with cognition. However, it is not known to what extent neuropsychological parameters and structural laterality covary with aging. Seventy-five subjects drawn from a larger normal aging cohort were evaluated in terms of MRI and neuropsychological parameters at two moments (M1 and M2), 18 months apart. In this time frame, asymmetry as measured by structural laterality index (ΔLI) was stable regarding both direction and magnitude in all areas. However, a significantly higher dispersion for this variation was observed in subcortical over cortical areas. Subjects with extreme increase in rightward lateralization of the caudate revealed increased M1 to M2 Stroop interference scores, but also a worsening of general cognition (MMSE). In contrast, subjects showing extreme increase in leftward lateralization of the thalamus presented higher increase in Stroop interference scores. In conclusion, while a decline in cognitive function was observed in the entire sample, regional brain asymmetries were relatively stable. Neuropsychological trajectories were associated with laterality changes in subcortical regions.This work was supported by the project NORTE‐01‐0145‐FEDER‐000013 through the Northern Portugal Regional Operational Programme (NORTE 2020), under the Portugal 2020 Partnership Agreement, through the European Regional Development Fund (FEDER), and funded by the European Commission (FP7) “SwitchBox ‐ Maintaining health in old age through homeostasis” (Contract HEALTH‐F2‐2010‐259772), and co‐financed by the Portuguese North Regional Operational Program (ON.2 – O Novo Norte), under the National Strategic Reference Framework (QREN), through FEDER, and by the Fundação Calouste Gulbenkian (Portugal) (Contract grant number: P‐139977; project “TEMPO ‐ Better mental health during ageing based on temporal prediction of individual brain ageing trajectories”) and by “PANINI ‐ Physical Activity and Nutrition INfluences In ageing” (European Commission (Horizon 2020), Contract GA 675003). Individual authors were supported under: "SwitchBox" to PM and NCS; Fundação para a Ciência e a Tecnologia (FCT) grants SFRH/BD/52291/2013 to ME and PD/BD/106050/2015 to CPN via Inter‐University Doctoral Programme in Ageing and Chronic Disease (PhDOC), PDE/BDE/113601/2015 to PSM and PDE/BDE/113604/2015 to RM via PhD Program in Health Sciences (Applied) (Phd‐iHES), SFRH/BD/90078/2012 to TCC, SFRH/BD/101398/2014 to LA and SFRH/BPD/80118/2011 do HLAinfo:eu-repo/semantics/publishedVersio

Nationwide access to endovascular treatment for acute ischemic stroke in portugal

Publisher Copyright: Copyright Ordem dos M dicos 2021.Introduction: Since the publication of endovascular treatment trials and European Stroke Guidelines, Portugal has re-organized stroke healthcare. The nine centers performing endovascular treatment are not equally distributed within the country, which may lead to differential access to endovascular treatment. Our main aim was to perform a descriptive analysis of the main treatment metrics regarding endovascular treatment in mainland Portugal and its administrative districts. Material and Methods: A retrospective national multicentric cohort study was conducted, including all ischemic stroke patients treated with endovascular treatment in mainland Portugal over two years (July 2015 to June 2017). All endovascular treatment centers contributed to an anonymized database. Demographic, stroke-related and procedure-related variables were collected. Crude endovascular treatment rates were calculated per 100 000 inhabitants for mainland Portugal, and each district and endovascular treatment standardized ratios (indirect age-sex standardization) were also calculated. Patient time metrics were computed as the median time between stroke onset, first-door, and puncture. Results: A total of 1625 endovascular treatment procedures were registered. The endovascular treatment rate was 8.27/100 000 inhabitants/year. We found regional heterogeneity in endovascular treatment rates (1.58 to 16.53/100 000/year), with higher rates in districts closer to endovascular treatment centers. When analyzed by district, the median time from stroke onset to puncture ranged from 212 to 432 minutes, reflecting regional heterogeneity. Discussion: Overall endovascular treatment rates and procedural times in Portugal are comparable to other international registries. We found geographic heterogeneity, with lower endovascular treatment rates and longer onset-to-puncture time in southern and inner regions. Conclusion: The overall national rate of EVT in the first two years after the organization of EVT-capable centers is one of the highest among European countries, however, significant regional disparities were documented. Moreover, stroke-onset-to-first-door times and in-hospital procedural times in the EVT centers were comparable to those reported in the randomized controlled trials performed in high-volume tertiary hospitalspublishersversionpublishe

Colocando o foco na qualidade de sono: medidas subjetivas de sono, actigrafia e correlatos cerebrais no envelhecimento

Tese de Doutoramento em Ciências da SaúdeSleep is a multidimensional phenomenon with a relevant role in the maintenance of organism homeostasis, overall well-being and optimal cognitive function. Throughout the lifespan, changes in sleep dimensions occur, namely on its timing, duration, architecture and quality. In what concerns to sleep quality, studies are highly heterogeneous; not only the tools used are extremely variable, but also the way this concept is defined. Thus, the present thesis aims at providing a thorough analysis on the meaning of sleep quality, contributing to the clarification of its definition. It also aims to determine the sleep patterns, routines and quality of Portuguese community-dwellers across the adult lifespan and determine the main predictors of self-reported sleep. It is also an aim to explore the association between a composite measure of sleep quality and brain correlates. For these purposes, a systematic review of the literature on sleep quality meaning was performed and three original studies developed considering a cross-sectional and/or a longitudinal approach. Portuguese community-dwellers within the adult lifespan (18 and more years) were recruited and self-reported sleep quality and psychological variables were assessed in the first two studies and in the third, neuroimaging information was also collected. Results show that sleep quality is a multidimensional concept that should integrate information from different settings (e.g. clinical measures such as the Pittsburgh Sleep Quality Index, and parameters that reflect the interpretation of lay individuals of it). Lay people interpretation of sleep quality seems to be stable across the adult lifespan and no differences between men and women are observed regarding the parameters reported. Poor subjective sleep quality is associated with decreases in functional and structural connectivity of specific brain networks, with an overlapping node in the middle left temporal region. Overall, the present work contributes for the clarification of sleep quality concept, enabling a better comparison between study results. Despite the contributions of this doctoral work to the body of literature, there are still avenues to be explored so that individuals can benefit from personalized sleep care, and physicians can better act on the subjective informations reported by their patients, feasibly taking advantages of the new technologies to better monitor sleep in ecological settings.O sono é um fenómeno multidimensional, com um papel relevante na manutenção da homeostasia do organismo, no seu bem-estar geral e no bom funcionamento da sua função cognitiva. Ao longo da vida ocorrem alterações nas suas diferentes dimensões, nomeadamente nos seus horários, duração, arquitetura e qualidade. No que respeita à qualidade de sono, os estudos são altamente heterogéneos; não só os instrumentos utilizados são muito variáveis, mas também a forma como o conceito é definido. Assim, a presente tese tem como objetivos realizar uma análise aprofundada do conceito “qualidade de sono” e contribuir para a clarificação da sua definição; determinar os padrões, rotinas e a qualidade de sono de uma amostra de indivíduos potugueses adultos, bem como os principais preditores das variáveis de sono reportadas; e determinar a associação entre uma medida compósita de qualidade de sono e correlatos cerebrais. Para este propósito, realizaram-se uma revisão sistemática da literatura sobre a definição de qualidade de sono e três estudos empíricos com uma abordagem transversal e/ou longitudinal, onde se recrutaram indivíduos de 18 e mais anos, e se avaliaram a qualidade de sono e algumas variáveis psicológicas nos dois primeiros estudos, e se realizou ainda uma ressonância magnética cerebral no terceiro. Os resultados indicam que a qualidade de sono é um conceito multidimensional, que deve integrar informação de de diferentes contextos (ex. medidas clínicas como a do Índice de Qualidade de Sono de Pittsburgh, mas também parâmetros que decorrem da interpretação do conceito pelo indivíduo). A interpretação deste conceito pelos indivíduos da comunidade parece ser estável ao longo da vida adulta, não se observando diferenças entre homens e mulheres nos parâmetros reportados. Uma má qualidade de sono correlaciona-se com uma diminuição da conectividade funcional e estrutural em redes cerebrais que se sobrepõem na região temporal média esquerda. O presente trabalho contribui para a clarificação da definição de qualidade de sono, promovendo comparações mais adequadas entre resultados de estudos. No entanto, apesar das contribuições, existem ainda caminhos a serem explorados, para que os indivíduos possam beneficiar de cuidados de sono personalizados e para que os seus médicos possam agir melhor sobre as informações subjetivas relatadas, aproveitando as vantagens das novas tecnologias para melhor monitorizar a qualidade de sono em ambientes ecológicos.The work presented in this thesis was performed in the Life and Health Sciences Research Institute (ICVS), Minho University and the Clinical Academic Center (2CA), Hospital of Braga. Financial support was provided by grants from the Foundation for Science and Technology (FCT) through the PhD grant SFRH/BD/101398/2014, by FEDER funds through the Operational Programme Competitiveness Factors - COMPETE and National Funds through FCT - Foundation for Science and Technology under the project POCI-01-0145-FEDER-007038; and by the projects NORTE-01-0145-FEDER-000013 and NORTE-01-0145- FEDER-000023, supported by Norte Portugal Regional Operational Programme (NORTE 2020), under the PORTUGAL 2020 Partnership Agreement, through the European Regional Development Fund (ERDF). Financial Support was also obtained from “SwitchBox” (Contract HEALTH-F2-2010-259772), co-financed by the Portuguese North Regional Operational Program (ON.2 – O Novo Norte), under the National Strategic Reference Framework (QREN), through the European Regional Development Fund (FEDER), and by the Fundação Calouste Gulbenkian (Portugal) (Contract grant number: P-139977; project “Better mental health during ageing based on temporal prediction of individual brain ageing trajectories (TEMPO)”)

Neurociencias y psicoterapia : retorno a lo básico

Cognitive neuroscience research has been recently advanced as central [o r a scientific foundation of psychotherapeutic treatment In fact, understanding how the maintenance, survival or neurological change is mediated psychological pro cesses, is fundamental for advancing our know ledge about the mechanisms of psychotherapy treatment. This study is an attempt to bring psychotherapy closer to neurocognitive research in order to foster understanding on the neurobiological effects 'if therapeutic equivalent tasks in reverting the effects (if chronic stress. More specifically, this study aims: (1) To compare spatial working memory and behavioural flexibility performances in groups (if adult rats submitted to chronic unpredictable stress and age-matched controls: and (2) To test the modulatory effects of a cognitive treatment-equivalent task intended to counteract the effects of chronic unpredictable stress. The results confirm that stress impairs reference memory as well as spatial working memory and reversal learning tasks. More important, this study also demonstrates that the detrimental effects of stress on spatial working memory can be attenuated by a cognitive treatment equivalent task introduced in the late phase of the stress exposure, (Ill effect that seems to be group (i.e., stressed animals) and task specific (i.e, spatial working memory).La investigación en neurociencias cognitivas ha avanzado recientemente hasta alcanzar un lugar primordial en la búsqueda de un fundamento científico para el tratamiento psicoterapéutico. De hecho, la comprensión de cómo el mantenimiento. La supervivencia o el cambio neurológico están mediatizados por procesos psicológicos es fundamental para avanzar nuestro conocimiento sobre los mecanismos de la psicoterapia. Este estudio es un intento de aproximar la psicoterapia a la investigación neurocognitiva y tiene como objetivo fomentar la comprensión de los procesos neurobiológicos de reversión de los efectos del estrés crónico mediante tareas análogas a las terapéuticas. En concreto, sus objetivos son: (1) comparar la memoria de trabajo espacia l y la flexibilidad conductual en la ejecución de tareas en un grupo de rata s adultas sometidas a estrés crónico impredecible y un grupo control de ratas de la misma edad; y (2) compro bar los efectos moduladores de una tarea análoga al tratamiento cognitivo que pretende contrarresta r los efectos del estrés crónico impredecible. Los resultados confirma n que el estrés daña la memoria de referencia as í como la memoria de trabajo espacial y las tareas de inversión de aprendiz aje. Más aún, este estudio demuestra también que los efectos perjudiciales del estrés sobre la memoria de trabajo espacial pueden ser atenuados por una tarea análoga a un tratamiento cognitivo introducida en la última fase de la exposición al estrés, efecto que parece especifico del grupo (animales estresados) y de la tarea (memoria de trabajo espacial)

Characterisation of microbial attack on archaeological bone

As part of an EU funded project to investigate the factors influencing bone preservation in the archaeological record, more than 250 bones from 41 archaeological sites in five countries spanning four climatic regions were studied for diagenetic alteration. Sites were selected to cover a range of environmental conditions and archaeological contexts. Microscopic and physical (mercury intrusion porosimetry) analyses of these bones revealed that the majority (68%) had suffered microbial attack. Furthermore, significant differences were found between animal and human bone in both the state of preservation and the type of microbial attack present. These differences in preservation might result from differences in early taphonomy of the bones. © 2003 Elsevier Science Ltd. All rights reserved

Brazilian Flora 2020: Leveraging the power of a collaborative scientific network

International audienceThe shortage of reliable primary taxonomic data limits the description of biological taxa and the understanding of biodiversity patterns and processes, complicating biogeographical, ecological, and evolutionary studies. This deficit creates a significant taxonomic impediment to biodiversity research and conservation planning. The taxonomic impediment and the biodiversity crisis are widely recognized, highlighting the urgent need for reliable taxonomic data. Over the past decade, numerous countries worldwide have devoted considerable effort to Target 1 of the Global Strategy for Plant Conservation (GSPC), which called for the preparation of a working list of all known plant species by 2010 and an online world Flora by 2020. Brazil is a megadiverse country, home to more of the world's known plant species than any other country. Despite that, Flora Brasiliensis, concluded in 1906, was the last comprehensive treatment of the Brazilian flora. The lack of accurate estimates of the number of species of algae, fungi, and plants occurring in Brazil contributes to the prevailing taxonomic impediment and delays progress towards the GSPC targets. Over the past 12 years, a legion of taxonomists motivated to meet Target 1 of the GSPC, worked together to gather and integrate knowledge on the algal, plant, and fungal diversity of Brazil. Overall, a team of about 980 taxonomists joined efforts in a highly collaborative project that used cybertaxonomy to prepare an updated Flora of Brazil, showing the power of scientific collaboration to reach ambitious goals. This paper presents an overview of the Brazilian Flora 2020 and provides taxonomic and spatial updates on the algae, fungi, and plants found in one of the world's most biodiverse countries. We further identify collection gaps and summarize future goals that extend beyond 2020. Our results show that Brazil is home to 46,975 native species of algae, fungi, and plants, of which 19,669 are endemic to the country. The data compiled to date suggests that the Atlantic Rainforest might be the most diverse Brazilian domain for all plant groups except gymnosperms, which are most diverse in the Amazon. However, scientific knowledge of Brazilian diversity is still unequally distributed, with the Atlantic Rainforest and the Cerrado being the most intensively sampled and studied biomes in the country. In times of “scientific reductionism”, with botanical and mycological sciences suffering pervasive depreciation in recent decades, the first online Flora of Brazil 2020 significantly enhanced the quality and quantity of taxonomic data available for algae, fungi, and plants from Brazil. This project also made all the information freely available online, providing a firm foundation for future research and for the management, conservation, and sustainable use of the Brazilian funga and flora