Center for Health Technology and Services Research

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Cognitive subtyping of university students with dyslexia in a semi-transparent orthography: what can weaknesses and strengths tell us about compensation?

Publication . Faisca, Luis; Reis, Alexandra; Araújo, Susana

Developmental dyslexia is characterized by a profile of reading- and writing-related difficulties which stands out as a core deficit in phonological processing. Although these difficulties seem to persist into adulthood, it is still an open question to what extent they are immune, or not, to the extensive training resulting from extended schooling. The main objective of this study was to explore the heterogeneity of the cognitive profile of European Portuguese highly literate adults with dyslexia. Thirty-one university students diagnosed with dyslexia during childhood and their matched skilled adult control readers were assessed through a battery of reading and cognitive tests. A cluster analysis of data obtained from participants with dyslexia identified two profile groups. While Cluster 1 grouped participants with clear phonological deficits and concomitant reading difficulties, Cluster 2 showed better performance on most of the core skills associated with reading and also better general cognitive abilities, suggesting that these dyslexic readers have partially resolved their phonological constraints along the development, probably due to the systematic exposure to reading and writing. As Cluster 2 matched typical readers in general cognitive abilities, it might also be the case that cognitive strengths associated with general intelligence worked as protective factors, helping students to strategically compensate for their reading difficulties. Overall, these results suggest that both mechanisms-partial remediation of the core phonological deficit and adoption of compensatory strategies supported by general cognitive skills-might contribute together to improving the reading performance of highly literate adults with dyslexia.

2023Journal article

Open Access

Reading comprehension predictors in European Portuguese adults

Publication . Gonçalves, Fábio; Reis, Alexandra; Inácio, Filomena; Morais, Inês Salomé; Faisca, Luis

Research on the predictors of reading comprehension has been largely focused on school-aged children and mainly in opaque orthographies, hindering the generalization of the results to adult populations and more transparent orthographies. In the present study, we aim to test two versions of the Simple View of Reading (SVR): the original model and an extended version, including reading fluency and vocabulary. Additional mediation models were analyzed to verify if other reading comprehension predictors (rapid automatized naming, phonological decoding, phonological awareness, morphological awareness, and working memory) have direct effects or if they are mediated through word reading and reading fluency. A sample of 67 typical adult Portuguese readers participated in this study. The SVR model accounted for 27% of the variance in reading comprehension, with oral language comprehension displaying a larger contribution than word reading. In the extended SVR model, reading fluency and vocabulary provided an additional and significant contribution of 7% to the explained variance. Moreover, vocabulary influenced reading comprehension directly and indirectly, via oral language comprehension. In the final mediation model, the total mediation hypothesis was rejected, and only morphological awareness showed a direct effect on reading comprehension. These results provide preliminary evidence that the SVR (with the possible addition of vocabulary) might be a reliable model to explain reading comprehension in adult typical readers in a semitransparent orthography. Furthermore, oral language comprehension and vocabulary were the best predictors in the study, suggesting that remediation programs addressing reading comprehension in adults should promote these abilities.

2021-12Journal article

Open Access

Does emotional valence modulate word recognition? A behavioral study manipulating frequency and arousal

Publication . Paulino, Catarina; Guerreiro, Milene; Faisca, Luis; Reis, Alexandra

Effects of emotional valence have been observed in lexical decision tasks, suggesting that valence information modulates early word recognition. However, is still unclear the processing advantage of the different valence categories, and how these advantages might be modulated by word frequency and arousal. To clarify this question, a lexical decision task was designed using emotional words as stimuli. Emotional words were divided into three categories: 60 positive, 60 negative, and 60 neutral words. Word frequency was manipulated into low and high conditions and arousal was controlled among experimental conditions (word valence and frequency). In the first experiment, 54 participants performed the task with a maximum stimuli exposure time of 2000 ms. In a follow-up experiment, 42 participants performed the same task with two shorter fixed time exposures (150 ms and 300 ms). The results were similar between experiments: positive words were recognized faster and negative words were recognized slower than neutral ones. Furthermore, this valence effect was modulated by word frequency, affecting only words that take longer to be recognized (low-frequency words). However, the valence by frequency interaction was attenuated for high-arousal words when the pressure to respond was high (short exposure time - 150 ms). Overall, the results confirm that the emotional status of a word can affect word processing at early stages when automatic processes are taking place.

2022-03Journal article

Open Access

Allelic expression imbalance of PIK3CA mutations is frequent in breast cancer and prognostically significant

Publication . Correia, Lizelle; Magno, Ramiro; Xavier, JM; Almeida, Bernardo; Duarte, Isabel; Esteves, Filipa; Ghezzo, Marinella; Eldridge, Matthew; Sun, Chong; Bosma, Astrid; Mittempergher, Lorenza; Marreiros, Ana; Bernards, Rene; Caldas, Carlos; Chin, Suet-Feung; Maia, Ana-Teresa

PIK3CA mutations are the most common in breast cancer, particularly in the estrogen receptor-positive cohort, but the benefit of PI3K inhibitors has had limited success compared with approaches targeting other less common mutations. We found a frequent allelic expression imbalance between the missense mutant and wild-type PIK3CA alleles in breast tumors from the METABRIC (70.2%) and the TCGA (60.1%) projects. When considering the mechanisms controlling allelic expression, 27.7% and 11.8% of tumors showed imbalance due to regulatory variants in cis, in the two studies respectively. Furthermore, preferential expression of the mutant allele due to cis-regulatory variation is associated with poor prognosis in the METABRIC tumors (P = 0.031). Interestingly, ER-, PR-, and HER2+ tumors showed significant preferential expression of the mutated allele in both datasets. Our work provides compelling evidence to support the clinical utility of PIK3CA allelic expression in breast cancer in identifying patients of poorer prognosis, and those with low expression of the mutated allele, who will unlikely benefit from PI3K inhibitors. Furthermore, our work proposes a model of differential regulation of a critical cancer-promoting gene in breast cancer.

2022Journal article

Open Access

The Gupta perioperative risk for myocardial infarct or cardiac arrest (MICA) calculator as an intraoperative neurologic deficit predictor in carotid endarterectomy

Publication . Pereira-Macedo, Juliana; Fernandes, Beatriz; Duarte-Gamas, Luís; Pereira-Neves, António; Mourão, Joana; Khairy, Ahmed; Andrade, José Paulo; Marreiros, Ana; Rocha-Neves, João

Background: Patients undergoing carotid endarterectomy (CEA) may experiment intraoperative neurologic deficits (IND) during carotid cross-clamping. This work aimed to assess the impact of the Gupta Perioperative Myocardial Infarct or Cardiac Arrest (MICA) risk calculator in the IND. Methods: From January 2012 to April 2021, patients undergoing CEA with regional anaesthesia for carotid stenosis with IND and consecutively control operated patients without IND were selected. A regressive predictive model was created, and a receiver operating characteristic (ROC) curve was applied for comparison. A multivariable dependence analysis was conducted using a classification and regression tree (CRT) algorithm. Results: A total of 97 out of 194 included patients developed IND. Obesity showed aOR = 4.01 (95% CI: 1.66–9.67) and MICA score aOR = 1.21 (1.03–1.43). Higher contralateral stenosis showed aOR = 1.29 (1.08–1.53). The AUROC curve was 0.656. The CRT algorithm differentiated obese patients with a MICA score ≥ 8. Regarding non-obese patients, the model identified the presence of contralateral stenosis ≥ 55% with a MICA ≥ 10. Conclusion: MICA score might play an additional role in stratifying patients for IND in CEA. Obesity was determined as the best discrimination factor, followed by a score ≥ 8. A higher ipsilateral stenosis degree is suggested to have a part in avoiding procedure-related IND. Larger studies might validate the benefit of MICA score regarding the risk of IND.

2022-10-28Journal article

Open Access