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Submitted by Micaela Sílvia Simão Fondo (micovane@outlook.com) on 2021-03-29T19:47:07Z No. of bitstreams: 1 FINAL2222.pdf: 2988482 bytes, checksum: 596cf9837909c1ca2e1dc5316536abd5 (MD5) Approved for entry into archive by Satie Tagara (satie@marilia.unesp.br) on 2021-03-29T22:53:46Z (GMT) No. of bitstreams: 1 covane_mssf_me_mar.pdf: 2988482 bytes, checksum: 596cf9837909c1ca2e1dc5316536abd5 (MD5) Made available in DSpace on 2021-03-29T22:53:46Z (GMT). No. of bitstreams: 1 covane_mssf_me_mar.pdf: 2988482 bytes, checksum: 596cf9837909c1ca2e1dc5316536abd5 (MD5) Previous issue date: 2021-02-10 Não recebi financiamento A pesquisa relatada nesta dissertação teve como objeto o ensino da literatura infantil e de leitura para a formação da criança no Ensino Básico em Moçambique. O objetivo principal foi o de compreender o papel da literatura infantil para a formação do leitor literário. Para isso foi necessário analisar os programas de ensino e os livros didáticos de língua portuguesa da 1ª e 2ª classes. Para a geração de dados, foram analisados os enunciados desses materiais e suas contradições à luz dos pressupostos bakhtinianos, segundo os quais a linguagem é uma arena de vozes sociais constitutivas dos sujeitos. A compreensão dos dados foi organizada sob dois núcleos temáticos: “Concepção da literatura infantil e leitura: dois focos de análise para a formação de leitores”; e “Compreendendo a leitura nos programas de ensino e nos livros didáticos: outras implicações na formação leitora dos alunos." A análise dos dados permitiu verificar a ausência de literatura infantil na escola. Embora existam discursos a respeito dela nos programas do ensino, os alunos não têm acesso aos textos originais, porque são inventados pelo próprio departamento oficial, o INDE/MINEDH, sem referência a autorias. Por isso os alunos não dialogam como o autor dos textos para construir sentidos. Considerando essas constatações, é de importância fundamental na realidade educacional de Moçambique, que se alterem as concepções de leitura e de literatura infantil, para que textos literários sejam incluídos em sala de aula, com diversificação temática, estilística e composicional para possibilitar o diálogo com o Outro, fundamental para a formação como leitoras das crianças moçambicanas. The research reported in this dissertation aimed at teaching children's literature and reading for the education of children in basic education in Mozambique. The main objective was to understand the role of children's literature in the formation of the literary reader. For that, it was necessary to analyze the teaching programs and didactic books of Portuguese language of the 1st and 2nd classes. For the generation of data, the statements of these materials and their contradictions were analyzed in the light of Bakhtinian assumptions, according to which language is an arena of social voices constituting the subjects. The understanding of the data was organized under two thematic groups: “Conception of children's literature and reading: two focuses of analysis for the formation of readers”; “Understanding reading in teaching programs and textbooks: other implications for students' reading training." The data analysis allowed to verify the absence of children's literature at school. Although there are speeches about it in teaching programs, students do not have access to the original texts, because they are invented by the official department, the INDE / MINEDH, without reference to authorship, which is why students do not dialogue as the author of the texts to build meanings. Considering these findings, it is of fundamental importance in the educational reality of Mozambique, that the conceptions of reading and children's literature be changed, so that literary texts are included in the classroom, with thematic, stylistic and compositional diversification to enable dialogue with the Other, which is essential for training as readers of Mozambican children.

© The Royal College of Ophthalmologists 2019, Background: To test whether a single or a composite set of macular vascular density parameters, evaluated with optical coherence tomography angiography (OCTA), are able to predict nonproliferative diabetic retinopathy (NPDR) staging according to the gold-standard ETDRS-grading scheme. Methods: Prospectively defined, cross-sectional study in which macular structural and vascular parameters of diabetic eyes with nonproliferative DR (up to ETDRS Level 53) were evaluated with OCTA (Avanti RTVue-XR 100, Optovue Inc, Fremont, CA). Seven-field photographs of the fundus were taken for DR staging according to the ETDRS-grading scheme. The vessel density in the superficial and deep capillary plexus (SCP and DCP, respectively), as well as in the choriocapillaris (CC), were calculated using automated software. Univariate and multivariate ordered logistic regression models were used in the analysis. P < 0.05 was considered statistically significant. Results: We included 101 eyes from 56 subjects (mean (SD) age 62.64 (11.74) years; 57.4% were male). On univariate analysis, several OCTA parameters were found to be associated with higher ETDRS level (parafoveal SCP density: OR = 0.87 (95% CI 0.76-0.99), p = 0.039; parafoveal DCP density: OR = 0.79 (95% CI 0.72-0.87), p < 0.001; CC density: OR = 0.89 (95% CI 0.80-0.99)), p = 0.036). In the final model, while also adjusting for relevant clinical features, only parafoveal vessel density in the DCP remained as a significant predictor of NPDR ETDRS level (OR = 0.54 (95% CI 0.32-0.92), p = 0.024). Conclusion: Our results suggest that parafoveal vessel density in the DCP is the parameter most robustly associated with ETDRS level. OCTA analysis may provide objective imaging biomarkers to monitor NPDR clinical progression.

Copyright © 2019, Wolters Kluwer Health. Ophthalmic Communications Society, Inc., Purpose: To study radial peripapillary capillary (RPC) density in the early stages of diabetic retinopathy (DR), using optical coherence tomography angiography. Methods: A cross-sectional evaluation of RPCs was performed using optical coherence tomography angiography (Avanti RTVue-XR 100, Optovue Inc, Fremont, CA). Annular RPC density was the primary outcome. Global density and retinal nerve fiber layer thickness were secondary outcomes. Diabetic eyes were divided into three groups: no DR, mild nonproliferative DR (mild NPDR), and moderate NPDR. Multilevel mixed-effects univariate and multivariate linear regression models were used. Results: We included 155 eyes (n = 42 control; n = 27 no DR; n = 28 mild NPDR; and n = 58 moderate NPDR) from 86 subjects (mean [SD] age 63.39 [10.70] years; 46.45% male). When compared with controls, a significant decrease in annular RPC density was found in all groups of diabetic eyes on multivariate analysis (no DR: β = -2.95, P < 0.001; mild NPDR: β = -1.76, P = 0.017; and moderate NPDR: β = -2.82, P < 0.001). We also detected a significant decrease in retinal nerve fiber layer thickness in diabetic eyes (even in the no DR group). Furthermore, in diabetic eyes, annular RPC density and retinal nerve fiber layer thickness correlated significantly (R = 0.4874, P < 0.001). Conclusion: Peripapillary neurovascular changes occur early in the course of DR. Their significance in the progression of DR warrants further research.

Purpose: To evaluate the age- and gender-specific prevalence of early and late age-related macular degeneration (AMD) in a Portuguese population-based sample. Methods: All patients aged ≥55 years of a Portuguese primary health-care unit were recruited for a cross-sectional population-based study. Responders underwent complete ophthalmological examination and digital fundus imaging. Early and late AMD was defined according to the International Age-Related Macular Epidemiological Study Group Classification, and the adopted staging for AMD was the same as that used in the Rotterdam study. The age- and gender-adjusted prevalence of early and late forms of AMD was calculated. Results: Of the 4,370 eligible subjects, 3,000 underwent study procedures (68.6% response rate) and 2,975 were included in the analysis; they had a mean age of 68.9 ± 8.6 years. The overall prevalence of early and late AMD was 15.53% (95% CI 14.25-16.88) and 0.67% (95% CI 0.41-1.04), respectively. Neovascular AMD (NV-AMD) and geographic atrophy (GA) accounted for 0.44% (95% CI 0.23-0.75) and 0.27% (95% CI 0.12-0.53) of individuals, respectively. The highest prevalence of advanced AMD was among those aged ≥75 years (1.13% for NV-AMD; 0.63% for GA). Conclusions: To our knowledge, this is the first AMD epidemiological study in a Portuguese population. The early forms of the disease had a similar prevalence to that of other large-scale population-based cohorts, but late AMD was less frequent than previously reported.

Purpose: The aim of this study is to present the largest normative database using multifocal electroretinography (mfERG) in the context of a multicenter clinical trial. Methods: This investigational study included 156 eyes from 78 Caucasian subjects aged 45-70 years without known ophthalmic disease or diabetes mellitus; the subjects were recruited from 11 clinical sites in the setting of the EUROCONDOR project. Standardized mfERG acquisition (103 hexagons per eye) was established based on the International Society of Clinical Electrophysiology in Vision. At least one technician per site received both specialized training and certification. The main variables that could have influenced the results were considered in the analyses. Results: The normative database was based on 111 eyes. The overall mean P1-implicit time (IT) was 33.94 ± 1.70 ms, and the mean P1 amplitude was 30.58 ± 5.20 nV/deg2. Age and gender were independently related to predictors of P1-IT but not of P1 amplitude. The responses that were averaged for the 6 rings showed a longer P1-IT time in the fovea, decreasing progressively to the parafovea and perifovea. By contrast, P1 amplitude values sharply decreased with retinal eccentricity. Conclusions: This normative database can be used as a comparative index of expected normal values in the clinical setting and for examining the effect of studies testing neuroprotective agents.

Purpose To automatically identify eyes with increased risk of developing idiopathic macular hole (IMH). This is proposed based on the fact that fellow eyes from patients with unilateral IMH have a risk increased by up to 29% of developing IMH. Our hypothesis is that there are changes in the topography of the macula that can allow the identification of these eyes prior to the development of IMH. Methods High-resolution OCT scans from eyes at risk and control patients are acquired using the Cirrus HD-OCT (Carl Zeiss Meditec, Dubin, CA, USA), Topcon 3D OCT (Topcon Medical Systems, Inc., Oakland, NJ, USA), and Spectralis HRA+OCT (Heidelberg Engineering GmbH, Heidelberg, Germany). From the volumetric scans, topographic maps are built from the segmentation of the inner limiting membrane and the retinal pigment epithelium. Parameters are extracted by fitting the maps to a set of bidimensional functions and from radial profiles of the region of interest. These are used to train a support vector machine (SVM), an automatic classification system. Optimizations to the system are ran in order to achieve the highest accuracy possible. Results Forty-nine eyes with increased risk of IMH development (age: 67.4+-5.5 yrs) and 44 control eyes (age: 58.5 +- 10.2) were imaged. The accuracy of the optimized SVM was 82.8%, sensitivity 85.7%, specificity 79.5%, assessed by 10-fold cross-validation. Conclusion The achieved results support our working hypothesis - that structural changes are present well before being visible at a regular consultation.

Macular holes are ruptures in the central part of the retina that if left untreated may lead to serious vision loss. Although there is a lot yet to know about this pathology, it is established that if one suffers from unilateral idiopathic macular hole (IMH), then there is an increased risk of developing the same condition in the fellow eye. The goal of this work is to use optical coherence tomography (OCT) scans and, resorting to automatic pattern recognition algorithms, develop a classifier that distinguishes eyes at risk of developing IMH from healthy controls. From the collected data we were able to estimate a set of parameters that allow for the classification of eyes into the group of eyes at risk or healthy controls with an accuracy of 95.1%, sensitivity of 96.9% and specificity of 93.1%.

The automatic segmentation of the retinal vascular network from ocular fundus images has been performed by several research groups. Although different approaches have been proposed for traditional imaging modalities, only a few have addressed this problem for optical coherence tomography (OCT). Furthermore, these approaches were focused on the optic nerve head region. Compared to color fundus photography and fluorescein angiography, two-dimensional ocular fundus reference images computed from three-dimensional OCT data present additional problems related to system lateral resolution, image contrast, and noise. Specifically, the combination of system lateral resolution and vessel diameter in the macular region renders the process particularly complex, which might partly explain the focus on the optic disc region. In this report, we describe a set of features computed from standard OCT data of the human macula that are used by a supervised-learning process (support vector machines) to automatically segment the vascular network. For a set of macular OCT scans of healthy subjects and diabetic patients, the proposed method achieves 98% accuracy, 99% specificity, and 83% sensitivity. This method was also tested on OCT data of the optic nerve head region achieving similar results.