bluuebunny/crossref_metadata_2025 huggingface dataset:
Interactive Internet‐based cases for undergraduate otolaryngology education
Authors: Kandasamy Thileeban , Fung Kevin
Published: February 2009

Objectives

To determine the feasibility and effectiveness of virtual‐patient computer‐assisted instruction (CAI) in pre‐clerkship undergraduate otolaryngology education.

Study Design

Prospective, randomized, controlled trial.

Subjects and Methods

Second‐year medical students at the University of Western Ontario, Canada, were randomized into two groups: group A was given a CAI module and group B was presented with two Internet review articles, both covered specific learning objectives for pediatric stridor. Students completed randomized pre‐ and post‐tests and a questionnaire one week later.

Results

Fifty‐five students completed the study with 28 in group A and 27 in group B. Mean pretest scores were 59.1% in group A and 59.8% in group B (95% CI = −7.9% to 10.4%). Mean post‐test scores were significantly elevated in group A (84.6%, P < 0.001) and group B (74.3%, P = 0.008). Group A had a significantly higher (P = 0.02) mean post‐test score than group B (mean difference of 10.2%). Students spent significantly more time (P < 0.001) reading text articles (25.5 minutes) than completing the CAI (9.06 minutes). Forty‐one (66%) students completed the survey. Thirty‐six (88%) respondents indicated that they preferred CAI to online articles.

Conclusion

CAI is a feasible, effective, and efficient means of enhancing self‐directed learning as supplementation to the pre‐clerkship undergraduate otolaryngology curriculum.
Questionnaires to evaluate anxiety and depressive levels in tinnitus patients
Authors: Crocetti Andrea , Forti Stella , Ambrosetti Umberto , Bo Luca Del
Published: February 2009

Objective

The aim of this study was to evaluate the correlation between the most common instruments used to quantify tinnitus and the level of anxiety and depression experienced by patients in order to provide a guideline for otolaryngologists.

Study Design

Cross‐sectional survey.

Subjects and Methods

A total of 108 tinnitus patients were submitted to a series of instruments, including Visual Analogue Scales (VAS), Tinnitus Handicap Inventory (THI), State Trait Anxiety Inventory Form Y (STAI‐T), and Beck Depression Inventory (BDI). These instruments were chosen based on their psychometric properties, time of administration, and validity in many countries.

Results

Of the patients studied, 24 percent had severe tinnitus, 35 percent had anxiety disorders, and 13 percent had a depressive pathosis. Significant correlations between STAI‐T and THI scores (P < 0.001), and between BDI and THI scores were shown (P < 0.001). The same results were found with VAS.

Conclusion

If a patient reports a THI greater than 38, the otolaryngologist should supplement diagnostic studies with a psychological consultation.
Post‐tonsillectomy bleeding: How much is too much?
Authors: Blakley Brian W.
Published: February 2009

Complication rates become important in discussions for informed surgical consent and for quality assurance purposes. In an attempt to quantify literature‐based rates for post‐tonsillectomy bleeding, a MEDLINE search was carried out. Of 4,610 papers 63 reported post‐tonsillectomy bleeding rates. The weighted mean, standard deviation and 95% confidence intervals were calculated for those papers. The mean (4.5%) plus 2 standard deviations (9.4%) suggests a maximum “expected” sustained bleeding rate of 13.9%. In the literature, which should reflect optimum results, there were 3 reports of bleed rates in the 18‐20% range. These data may be useful for quality assurance committees and individual clinicians.
Does olfactory function improve after endoscopic sinus surgery?
Authors: Litvack Jamie R. , Mace Jess , Smith Timothy L.
Published: February 2009

Objective

To examine the impact of endoscopic sinus surgery (ESS) on olfactory impairment in patients with chronic rhinosinusitis (CRS) over intermediate and long‐term follow‐up. We hypothesized that patients with mild olfactory dysfunction (hyposmia) would benefit from ESS, whereas patients with severe olfactory dysfunction (anosmia) would not.

Study Design

Prospective, multi‐institutional cohort study.

Subjects and Methods

A total of 111 patients presenting for ESS for treatment of CRS were examined preoperatively, and at 6 and 12 months postoperatively. Demographic, comorbidity, and Smell Identification Test (SIT) data were collected at each time point. Univariate and multivariate analyses were performed.

Results

The prevalence of gender‐adjusted olfactory dysfunction prior to surgery was 67.5 percent. Surprisingly, hyposmic patients did not significantly improve after surgery. In contrast, patients with anosmia significantly improved after ESS (baseline, 6‐month SIT scores: 9.7 ± 2.0, 21.3 ± 11.2; P = 0.001). Improvement was sustained at 12‐month follow‐up (21.7 ± 10.7; P = 0.001). Multivariate linear regression analysis showed that baseline olfactory category and nasal polyposis were significantly associated with improvement in postoperative olfactory function (P = 0.035, P = 0.002).

Conclusion

Contrary to our hypotheses, patients with severe olfactory dysfunction significantly improved after ESS and sustained improvement over time, whereas patients with mild olfactory dysfunction did not.
The role of tonsillectomy in reducing recurrent pharyngitis: A systematic review
Authors: Blakley Brian W. , Magit Anthony E.
Published: February 2009

Objective

To determine the evidence for efficacy of tonsillectomy in reducing the incidence of recurrent pharyngitis.

Data Sources

Literature databases consisting of PUBMED, SCOPUS, CINHAL AND OVID EMBASE including all languages.

Review Methods

Literature search of database by 2 authors with structured criteria using an online database. Selected studies evaluated with meta‐analysis.

Results

In four randomized, controlled trials tonsillectomy was favored over medical therapy in reducing pharyngitis. The difference was statistically significant in only one study. Overall meta‐analysis results were significant, indicating that tonsillectomy results in a reduction of about 43% in the incidence of pharyngitis. The number needed to treat with tonsillectomy to prevent one sore throat per month for the first year after surgery was 11 (95% CI; 7‐23).

Conclusion

Tonsillectomy reduces the incidence of recurrent pharyngitis to a modest degree.
Effectiveness of Pillar palatal implants for snoring management
Authors: Gillespie M. Boyd , Smith Jacob E. , Clarke Joseph , Nguyen Shaun A.
Published: February 2009

Objective

Determine patient factors associated with the success and complications of using the Pillar palatal implants for snoring management.

Study Design

Retrospective series of 79 consecutive adult patients receiving Pillar implants for snoring management between January 2005 and December 2007. Multiple regression analysis was used to determine factors associated with initial and final bed partner satisfaction with the snoring result, and factors associated with Pillar‐related complications.

Results

A total of 64 of 79 (81%) bed partners reported snoring improvement in patients after initial Pillar implantation; however, only 31 (39%) were satisfied with the level of reduction. Following secondary procedures, the number of satisfied bed partners improved to 52 (66%). Factors associated with final bed partner satisfaction included lower initial apnea‐hypopnea index (AHI) (P = 0.029), Friedman tongue position I or II (P = 0.008), and shorter follow‐up time (P = 0.001). Sixteen patients (20%) experienced procedure‐related complications. Factors associated with Pillar complications included female gender (P = 0.001) and placement under general anesthesia (P = 0.009).

Conclusions

Initial AHI values and tongue position scores are important determinants of final snoring success. Pillar implants placed in women and under general anesthesia may have a higher risk of poor placement and extrusion.
Understanding the size of the energy efficiency resource: Ten policy recommendations to accelerate more productive investments
Authors: Laitner John A “Skip”
Published: February 2009

There is a huge potential for cost-effective investments in energy efficiency throughout all sectors of the U.S. economy: on the order of 46 billion barrels of oil equivalent between now and 2030. This is about 2.5 times bigger than what some have suggested might be available from off-shore drilling. That magnitude of further gains in energy efficiency could generate a significant downward pressure on oil prices, and increase both the resilience and robustness of the American and the international economies—if we choose to encourage those more productive investments. Policy solutions will play a pivotal role in strengthening the continued development, dissemination, and widespread adoption of energy-efficient industrial and transportation technologies and systems. With a focus on transportation systems, this article recommends 10 near-term policy actions that might be undertaken to immediately provide that signal, and more critically, to change the direction of energy usage through increased energy efficiency.
PRODUCT FRACTAL SETS DETERMINED BY STABLE PROCESSES
Authors: HOU YAN-YAN , ZHAO MIN-ZHI
Published: February 2009

Let Xi be transient βi-stable processes on ℝdi, i=1,2. Assume further that X1 and X2 are independent. We shall find the exact Hausdorff measure function for the product sets R1(1)×R2(1), where $R_1(1)\break \times R_2(1)=\{(X_1(t_1), X_2(t_2))\mid 0\leq t_1, t_2\leq 1\}$. The result of Hu generalizes [Some fractal sets determined by stable processes, Probab. Theory Related Fields100 (1994), 205–225].
THE DIRICHLET PROBLEM FOR BAIRE-TWO FUNCTIONS ON SIMPLICES
Authors: SPURNÝ JIŘÍ
Published: February 2009

We show that solvability of the abstract Dirichlet problem for Baire-two functions on a simplexXcannot be characterized by topological properties of the set of extreme points ofX.
Hearing results of 1145 stapedotomies evaluated with Amsterdam hearing evaluation plots
Authors: Kisilevsky V E , Dutt S N , Bailie N A , Halik J J
Published: February 2009

Aims:

To evaluate the hearing results of a large series of primary stapedotomies, according to American Academy of Otolaryngology, Head and Neck Surgery guidelines and Amsterdam hearing evaluation plots.

Study design:

Retrospective chart review.

Methods:

The charts for 1369 consecutive stapedotomy cases were reviewed; 1145 cases of primary stapedotomy were included. Raw data from the audiometric database were evaluated using Amsterdam hearing evaluation plots. The effect on outcomes of using different audiological parameters was analysed.

Results:

A significant improvement was demonstrated in mean post-operative air conduction and speech reception thresholds, with no change in bone conduction. Air–bone gap closure of 10 dB or more was achieved in 82 per cent of cases. A ‘dead ear’ occurred in one patient (0.1 per cent).

Conclusion:

This study reports the largest series of primary stapedotomies evaluated with Amsterdam hearing evaluation plots. This method enables visual identification of successful and unfavourable results, providing more accurate and detailed presentation of surgical outcomes.
Intra-operative application of optical coherence tomography with an operating microscope
Authors: Just T , Lankenau E , Hüttmann G , Pau H W
Published: February 2009

Objective:

To introduce the use of optical coherence tomography with an operating microscope for intra-operative evaluation of the human larynx.

Methods:

A specially equipped operating microscope with integrated spectral domain optical coherence tomography apparatus was used during microlaryngoscopy.

Results:

Technical improvements in optical coherence tomography equipment (e.g. pilot beam, variable focal distance, improved image quality and integration into an operating microscope) have enabled greater sensitivity and imaging speed and a non-contact approach. Spectral domain optical coherence tomography now enables a better correlation between optical coherence tomography images and histological findings. With this new technology, the precision of biopsy can be improved during microlaryngoscopy.

Conclusions:

Use of this new optical coherence tomography technology, integrated into an operating microscope, enables the surgeon to define the biopsy site location and resection plane precisely, while the optical zoom of the operating microscope can be used over the complete range.
Session 3: Joint Nutrition Society and Irish Nutrition and Dietetic Institute Symposium on ‘Nutrition and autoimmune disease’
Authors: Feighery Conleth F. , McManus Ross
Published: February 2009

Over the past 20 years major advances have been made in the diagnosis and understanding of pathogenic mechanisms relating to coeliac disease. Recently-identified genetic markers support the immunological–inflammatory nature of the disease. It is hoped that these newly-identified genes will assist further dissection of the inflammatory pathways in coeliac disease and give insight into why certain individuals develop intolerance to dietary gluten.
The application of psychological theory to nutrition behaviour change
Authors: Barker M. , Swift J. A.
Published: February 2009

Changing individuals' health behaviour seems to be the key to solving many of the world's health problems. Although there is a multitude of potential influences, many interventions to improve health seek to change intrinsic psychological determinants of health behaviour. To date, most attention has been paid to cognitions, such as attitudes and beliefs, and a number of social cognition models (SCM) are in current use. SCM all describe cognitions as determinants of behaviour, thereby implying that changes in cognitions will lead to changes in behaviour. Although SCM are widely used to predict a range of health behaviours, they are associated with a number of important limitations, including poor levels of predictive power, particularly in relation to eating behaviour, and limited guidance about the operationalisation of theoretical constructs. These limitations may explain why very few interventions to change behaviour are explicitly theory-based, despite the widely-held view that having a clear theoretical underpinning will improve effectiveness. Ultimately, advances in understanding and changing health behaviour will come about only if psychological theory and practice are integrated. The recently-published taxonomy of behaviour-change techniques used in interventions is a good example of integrated research, but more work of this type is essential and will require respectful collaboration between researchers and practitioners working from a range of different disciplines such as health psychology, public health nutrition and health promotion.
Weak mixing implies weak mixing of higher orders along tempered functions
Authors: BERGELSON VITALY , HÅLAND KNUTSON INGER J.
Published: February 2009

We extend the weakly mixing PET (polynomial ergodic theorem) obtained in Bergelson [Weakly mixing PET.Ergod. Th. & Dynam. Sys.7(1987), 337–349] to much wider families of functions. Besides throwing new light on the question of ‘how much higher-degree mixing is hidden in weak mixing’, the obtained results also show the way to possible new extensions of the polynomial Szemerédi theorem obtained in Bergelson and Leibman [Polynomial extensions of van der Waerden’s and Szemerédi’s theorems.J. Amer. Math. Soc.9(1996), 725–753].
Trajectory tracking of mobile robots in dynamic environments—a linear algebra approach
Authors: Rosales Andrés , Scaglia Gustavo , Mut Vicente , di Sciascio Fernando
Published: February 2009

A new approach for navigation of mobile robots in dynamic environments by using Linear Algebra Theory, Numerical Methods, and a modification of the Force Field Method is presented in this paper. The controller design is based on the dynamic model of a unicycle-like nonholonomic mobile robot. Previous studies very often ignore the dynamics of mobile robots and suffer from algorithmic singularities. Simulation and experimentation results confirm the feasibility and the effectiveness of the proposed controller and the advantages of the dynamic model use. By using this new strategy, the robot is able to adapt its behavior at the available knowing level and it can navigate in a safe way, minimizing the tracking error.
Dietary saturated and unsaturated fats as determinants of blood pressure and vascular function
Authors: Hall Wendy L.
Published: February 2009

The amount and type of dietary fat have long been associated with the risk of CVD. Arterial stiffness and endothelial dysfunction are important risk factors in the aetiology of CHD. A range of methods exists to assess vascular function that may be used in nutritional science, including clinic and ambulatory blood pressure monitoring, pulse wave analysis, pulse wave velocity, flow-mediated dilatation and venous occlusion plethysmography. The present review focuses on the quantity and type of dietary fat and effects on blood pressure, arterial compliance and endothelial function. Concerning fat quantity, the amount of dietary fat consumed habitually appears to have little influence on vascular function independent of fatty acid composition, although single high-fat meals postprandially impair endothelial function compared with low-fat meals. The mechanism is related to increased circulating lipoproteins and NEFA which may induce pro-inflammatory pathways and increase oxidative stress. Regarding the type of fat, cross-sectional data suggest that saturated fat adversely affects vascular function whereas polyunsaturated fat (mainly linoleic acid (18 : 2n-6) and n-3 PUFA) are beneficial. EPA (20 : 5n-3) and DHA (22 : 6n-3) can reduce blood pressure, improve arterial compliance in type 2 diabetics and dyslipidaemics, and augment endothelium-dependent vasodilation. The mechanisms for this vascular protection, and the nature of the separate physiological effects induced by EPA and DHA, are priorities for future research. Since good-quality observational or interventional data on dietary fatty acid composition and vascular function are scarce, no further recommendations can be suggested in addition to current guidelines at the present time.
When nutrition interacts with osteoblast function: molecular mechanisms of polyphenols
Authors: Trzeciakiewicz Anna , Habauzit Véronique , Horcajada Marie-Noëlle
Published: February 2009

Recent research has provided insights into dietary components that may optimise bone health and stimulate bone formation. Fruit and vegetable intake, as well as grains and other plant-derived food, have been linked to decreased risk of major chronic diseases including osteoporosis. This effect has been partially attributed to the polyphenols found in these foods. Thus, it has been suggested that these compounds may provide desirable bone health benefits through an action on bone cell metabolism. The present review will focus on how some polyphenols can modulate osteoblast function and reports which cellular signalling pathways are potentially implicated. However, to date, despite numerous investigations, few studies have provided clear evidence that phenolic compounds can act on osteoblasts. Polyphenols cited in the present review seem to be able to modulate the expression of transcription factors such as runt-related transcription factor-2 (Runx2) and Osterix, NF-κB and activator protein-1 (AP-1). It appears that polyphenols may act on cellular signalling such as mitogen-activated protein kinase (MAPK), bone morphogenetic protein (BMP), oestrogen receptor and osteoprotegerin/receptor activator of NF-κB ligand (OPG/RANKL) and thus may affect osteoblast functions. However, it is also important to take in account the possible interaction of these compounds on osteoclast metabolism to better understand the positive correlation reported between the consumption of fruit and vegetables and bone mass.
Effects of bilingualism on verbal learning and memory in Hispanic adults
Authors: Harris Josette G. , Cullum C. Munro , Puente Antonio E.
Published: February 2009

The effect of bilingualism on qualitative aspects of verbal learning and memory was investigated. Equivalent list learning tests in English and Spanish were carefully constructed, and compared across two bilingual Hispanic groups of Mexican origin that differed in their level of English proficiency (“balanced” and “nonbalanced” bilinguals) and a group of monolingual English-speaking non-Hispanic subjects. Groups were matched for age, education, and gender composition. Nonbalanced bilinguals assessed in English utilized semantic clustering to the same extent as monolinguals, but learned fewer words overall, and demonstrated lower retention scores compared to monolinguals. Comparisons of groups assessed in their dominant languages, however, revealed no significant differences on any of the learning and memory indices examined. In addition to comparisons with standard clinical memory indices, assessment issues concerning bilingual individuals are addressed.(JINS, 1995,I, 10–16.)
Ecological implications of limb apraxia: Evidence from mealtime behavior
Authors: Foundas Anne L. , Macauley Beth L. , Raymer Anastasia M. , Maher Lynn M. , Heilman Kenneth M. , Rothi Leslie J. Gonzalez
Published: February 2009

Humans learn skilled acts in order to effectively interact with their environment. A loss of the ability to perform skilled acts is termed apraxia. Apraxia has been thought to be of theoretical interest, but the ecological implications of apraxia are controversial and have not been fully studied. We examined ten patients with unilateral left hemisphere cerebral infarctions (eight of whom were apraxic) and compared their mealtime eating behavior to a group of neurologically normal, age-matched controls. The stroke patients were less efficient in completing the meal. They made more action errors and were less organized in the sequencing of mealtime activities. Because the patients made more errors while using tools than when performing nontool actions, their deficit could not be accounted for by an elemental motor deficit. A positive relationship was found between mealtime action errors and the severity of apraxia. These findings suggest that limb apraxia may adversely influence activities of daily living. (JINS, 1995,I, 62–66.)
The nature of learning and memory impairments in schizophrenia
Authors: Paulsen Jane S. , Heaton Robert K. , Sadek Joseph R. , Perry William , Delis Dean C. , Braff David , Kuck Julie , Zisook Sidney , Jeste Dilip V.
Published: February 2009

The California Verbal Learning Test was used to characterize the learning and memory impairment in schizophrenia (SC) and to evaluate potential clinical and demographic factors associated with this impairment. SC patients (n= 175) performed worse than normal comparison (NC) subjects (n= 229) on all learning, recall, and recognition memory measures. The most important clinical correlates of these impairments were earlier age of onset, more negative symptoms, and greater anticholinergic medication dosage. SC patients showed a prominent retrieval deficit as indicated by disproportionate improvement when tested in a recognition, rather than a free recall, format. A residual impairment seen with recognition testing suggests a mild encoding deficit as well. In contrast, the relative absence of a storage deficit is suggested by the lack of rapid forgetting. Using a discriminant function analysis that differentiates cortical dementia [i.e., Alzheimer's disease (AD)], subcortical dementia [i.e., Huntington's disease (HD)], and normals, it was found that 5070 of the SC patients were classified as having a subcortical memory profile and 35% were classified as having a normal profile, whereas only 15% were classified as having a cortical memory profile. Although these findings reflect the clinical heterogeneity often found in SC, results suggest that most SC patients demonstrate a pattern of learning and memory impairments that resembles the pattern seen in patients with primary subcortical (specifically striatal) pathology. (JINS, 1995,I, 88–99.)
Detection of dementia of the Alzheimer type in a population-based sample: Neuropsychological test performance
Authors: Cahn Deborah A. , Salmon David P. , Butters Nelson , Wiederholt Wigbert C. , Corey-Bloom Jody , Edelstein Sharon L. , Barrett-Connor Elizabeth
Published: February 2009

The ability to detect dementia of the Alzheimer type (DAT) in a community-dwelling sample of elderly individuals on the basis of neuropsychological test performance was examined. Three hundred sixty community-dwelling individuals were identified by neurological examination as having probable or possible Alzheimer’s disease, being at risk for Alzheimer’s disease, or having no cognitive impairment. A logistic model comprised of tests of verbal and nonverbal memory, mental flexibility, and confrontation naming correctly classified 82% of DAT subjects and 98% of normal elderly subjects. The logistic model classified 77% of subjects who were diagnosed as at risk for Alzheimer's disease as being cognitively normal. A cross-validation with a clinically based sample of subjects correctly classified 89% of DAT patients and 100% of normal control subjects. The results suggest that psychometric discrimination of dementia may be less accurate in community-dwelling populations than in clinically based samples. (JINS, 1995, I, 252–260.)
Semantic network abnormality predicts rate of cognitive decline in patients with probable Alzheimer's disease
Authors: Chan Agnes S. , Salmon David P. , Butters Nelson , Johnson Shannon A.
Published: February 2009

The present study examined the relationship between rate of cognitive decline in patients with Alzheimer's disease (AD) and the integrity of the network of associations that comprise their semantic knowledge. The integrity of the semantic network of 12 AD patients was determined by comparing their networks to a standard normal control network derived with Pathfinder analysis, a multidimensional graphic analysis technique. A simple linear regression analysis, comparing the degree of semantic network deterioration with rate of cognitive decline as measured by the difference between the Dementia Rating Scale (DRS) scores obtained at the time of the testing of semantic knowledge (Year 1) and one year later (Year 2), was highly significant (r2= .84;p< .001). These results suggest that a sensitive measure of the structural deterioration of semantic knowledge may be useful for predicting the rate of progression of cognitive changes in patients with AD. (JINS, 1995,I, 297–303.)
Implicit memory in amnesic patients: When is auditory priming spared?
Authors: Schacter Daniel L. , Church Barbara
Published: February 2009

Amnesic patients often exhibit spared priming effects on implicit memory tests despite poor explicit memory. In previous research, we found normal auditory priming in amnesic patients on a task in which the magnitude of priming in control subjects was independent of whether speaker's voice was same or different at study and test, and found impaired voice-specific priming on a task in which priming in control subjects is higher when speaker's voice is the same at study and test than when it is different. The present experiments provide further evidence of spared auditory priming in amnesia, demonstrate that normal priming effects are not an artifact of low levels of baseline performance, and provide suggestive evidence that amnesic patients can exhibit voice-specific priming when experimental conditions do not require them to interactively bind together word and voice information. (JINS, 1995,I, 434–442.)
Severe anoxia with and without concomitant brain atrophy and neuropsychological impairments
Authors: Hopkins Ramona O. , Gale Shawn D. , Johnson Sterling C. , Anderson Carol V. , Bigler Erin D. , Blatter Duane D. , Weaver Lindell K.
Published: February 2009

Significant anoxia may cause a variety of neuropathologic changes as well as cognitive deficits. We have recently seen 3 patients who have suffered severe anoxic episodes all with initial Glasgow Coma Scores (GCS) of 3 with sustained coma for 10–14 d. All 3 patients had extended hospitalizations and rehabilitation therapy. A neuropsychological test battery was administered and volumetric analyses of MRI scans were carried out in each case at least 6 mo postinjury. Two of the patients display distinct residual cognitive and neuropathologic changes while 1 patient made a remarkable recovery without evidence of significant morphological abnormality. These three cases demonstrate, that even with similar admission GCS, the outcome is variable and the degree of neuropsychological impairment appears to match the degree of morphologic abnormalities demonstrated by quantitative MR image analysis. An important finding of this study is that even though subjects with an anoxic insult exhibit severe cognitive and memory impairments along with concomitant morphologic changes, their attention/concentration abilities appear to be preserved. MR morphometry provides an excellent means by which neural structural changes can be quantified and compared to neuropsychological and behavioral outcomes. (JINS, 1995, I, 501–509.)
Executive function in children with Tourette Syndrome and/or Attention Deficit Hyperactivity Disorder
Authors: Harris Emily L. , Schuerholz Linda J. , Singer Harvey S. , Reader Mark J. , Brown Janice E. , Cox Christiane , Mohr Jennifer , Chase Gary A. , Denckla Martha B.
Published: February 2009

Tourette Syndrome (TS) in children is associated with various neurobehavioral disorders including attention deficit hyperactivity disorder (ADHD). Children with TS and ADHD show some difficulties with neuropsychological tasks, but we do not know if children with TS alone have neuropsychological deficits. To assess specific cognitive differences among children with TS and/or ADHD, we administered a battery of neuropsychological tests, including 10 tasks related to executive function (EF), to 10 children with TS-only, 48 with ADHD-only, and 32 with TS+ADHD. Children in all groups could not efficiently produce output on a timed continuous performance task [Test of Variables of Attention (TOVA) mean reaction time and reaction time variability]. Children with TS-only appeared to have fewer EF impairments and significantly higher perceptual organization scores than children with TS+ADHD or ADHD-only. These findings suggest that deficiencies in choice reaction time and consistency of timed responses are common to all three groups, but children with TS-only have relatively less EF impairment than children with TS+ADHD or ADHD-only. (JINS, 1995, 1, 511–516.)
Performance on the Tower of London test after severe head injury
Authors: Cockburn Janet
Published: February 2009

Efficient solution of the Tower of London (T of L) test (Shallice, 1982) has been hypothesized to depend on frontal lobe mediation. Performance on the test by 20 patients with severe, diffuse, traumatic head injury was compared with that of control subjects, matched on age and years of education, and, within the patient group, according to broad location of damage (frontal or nonfrontal). Scores were also compared with those obtained on two commonly used tests of frontal lobe function, Verbal Fluency, and the Wisconsin Card Sorting test (WCST). Results indicated that whereas the Verbal Fluency test and WCST discriminated well between patients and control subjects, the T of L test did not, nor did it discriminate well between patients with and without documented frontal lobe damage. However, there were large individual differences in planning and solution times across all subjects. Interpretation of results was complicated by interaction of other variables such as premorbid IQ and duration of posttraumatic amnesia. It is suggested that closer attention to the relation between planning and total times separately for correct and incorrect solutions might be informative. A need for systematic study of the relationship between test performance and everyday behavior is also identified. (JINS, 1995, 7, 537–544.)
Right hemisphere mediation of verbal learning and memory in acquired right hemisphere speech dominant patients
Authors: Sass Kimberlee J. , Silberfein Cari M. , Platis Ioannis , Westerveld Michael , Buchanan Cathleen P. , Delaney Richard C. , Kim Jung H. , Spencer Dennis D.
Published: February 2009

Forty-eight patients with temporal lobe epilepsy completed measures of narrative recall and list learning prior to surgery. The intracarotid amytal procedure (IAP) established that 13 patients were right hemisphere dominant for speech and 35 (18 left foci, 17 right foci) were left hemisphere dominant. Hippocampal volumetric neuron densities were measured after surgery. The left hippocampal neuron densities in subfields CA3 and the hilar area were significantly correlated with list learning ability and percent retention for narrative recall only for left hemisphere speech dominant patients with left seizure foci. No significant correlations between measures of neuron volume and memory were found for the left hemisphere speech dominant patients with right seizure foci or the right hemisphere speech dominant patients with left seizure foci. This suggests that the right hemisphere of right speech dominant patients mediates verbal memory as well as speech. This conclusion is supported by patterns of correlations among measures of verbal memory that differed for patients undergoing resection of the dominant hemisphere versus those undergoing resection of the nondominant hemisphere. However, it is premature to conclude that the cerebral organization of cognitive functions of right hemisphere speech dominant patients is equivalent albeit reversed from that of left hemisphere speech dominant patients. Right hemisphere speech dominant patients with left temporal foci differed from left hemisphere speech dominant patients with right temporal foci with respect to the patterns of correlations between measures of verbal memory and intelligence as well as the level of intellectual ability that they demonstrated. (JINS, 1995, 1, 554–560.)
Delayed recognition memory span in HIV-1 infection
Authors: Martin Eileen M. , Pitrak David L. , Pursell Kenneth J. , Mullane Kathleen M. , Novak Richard M.
Published: February 2009

We administered a spatial version of the Delayed Recognition Span Test (DRST), a working memory task performed abnormally by patients with basal ganglia disease, to a group of 96 HIV-seropositive and 83 seronegative subjects with a high prevalence of substance abuse. For comparison purposes, we also administered the Symbol-Digit Modalities Test (SDMT) and the Trail Making Test (TMT), measures which detect HIV-related mental slowing efficiently in gay men but are nonspecifically impaired in subjects with a history of substance abuse. As predicted, scores on the TMT and the SDMT did not discriminate the groups, but HIV-seropositive subjects had significantly shorter spatial spans (p < .007) and DRST total scores (p < .005). These effects could not be attributed to differences in age, education, estimated intelligence, or psychological distress, because the groups were well matched on these variables. The DRST is a promising measure of HIV-related cognitive dysfunction in substance abusers, who are often nonspecifically impaired on psychomotor tasks. These preliminary data also indicate that working memory function should be studied further in HIV-seropositive subjects. (JINS, 1995, 1, 575–580.)
Relationship between psychiatric disease and neuropsychological impairment in HIV seropositive individuals
Authors: Bix Barbara C. , Glosser Guila , Holmes William , Ballas Christopher , Meritz Mary , Hutelmyer Carol , Turner John
Published: February 2009

Neuropsychological impairment and DSM-III-R Axis I psychiatric diagnoses were evaluated in a heterogenous group of HIV seropositive individuals and seronegative individuals with similar risk factors for HIV infection. Neuropsychological and psychiatric disorders were common in the HIV seropositive group, but there were no relationships between these two aspects of neuropsychiatric dysfunction in seropositive patients. Results indicate that psychiatric disorders in HIV seropositive individuals tend to predate infection and decrease over time following knowledge of seroconversion, suggesting that they are primarily a function of psychosocial factors. Neuropsychological disorders are specific to HIV seropositive patients and tend to increase over time following seroconversion, suggesting that they are due to neurological effects of HIV-infection. (JINS, 1995, 1, 581–588.)
Developmental disturbance of access to biographical information and people's names: A single-case study
Authors: van der Linden Martial , Brédart Serge , Schweich Myriam
Published: February 2009

The paper describes the case of a person (GB) without any clinical evidence of cerebral disease who showed a specific impairment in the retrieval of biographical information, including names, about famous people. This deficit appeared while GB scored normally in different long-term memory tasks, and in object naming tasks. Moreover, he showed no impairment in the structural encoding and the recognition of faces. His specific impairment is interpreted both in terms of Bruce and Young's (1986) functional model of person recognition and in terms of the more recent Burton et al. (1990) interactive activation version of the Bruce and Young model. (JINS, 1995, 7, 589–595.)
Normative data stratified by age and education for the Neuropsychological Screening Battery for Hispanics (NeSBHIS): Initial report
Authors: Pontón Marcel O. , Satz Paul , Herrera Lawrence , Ortiz Freddy , Urrutia Carla P. , Young Rene , D'Elia Louis F. , Furst Charles J. , Namerow Norman
Published: February 2009

Neuropsychological assessment of monolingual Spanish-speaking people in the United States is both a common practice and an ethical dilemma. Lack of appropriate tests, the absence of norms, use of interpreters, and the multiplicity of in-house translations of commonly used measures add to the problem of accurate assessment. This paper helps address the lack of appropriate measures for the neuropsychological assessment of Latinos in the United States by providing a standardization of the Neuropsychological Screening Battery for Hispanics (NeSBHIS). Normative data on a sample of 300 Hispanic subjects stratified by gender, age, and education are provided. Current results reveal that not one measure of cognitive functioning is free from education effects. Both nonverbal measures and psychomotor speed measures were highly related to education. Age effects were noted on measures of psychomotor speed, visuospatial reasoning, and visuoconstructive skills. Gender effects were found on measures of psychomotor speed and language, with males achieving higher scores than females. The limitations of the current findings are considered. Further research for the validation of the NeSBHIS with clinical populations, as well as further normative data collection at the national and international levels, is needed. (JINS, 1996, 2, 96–104.)
Problem solving by patients with multiple sclerosis Comparison of performance on the Wisconsin and California Card Sorting Tests
Authors: Beatty William W. , Monson Nancy
Published: February 2009

Problem solving by patients with clinically definite multiple sclerosis (MS) was examined using the Wisconsin and California Card Sorting Tests (WCST and CCST). On the WCST, the MS patients achieved fewer categories and made more perseverative responses and errors than controls, confirming results of several previous studies. On the CCST, the MS patients generated and identified fewer concepts, but they performed normally when sorting was cued by the experimenter and they made no more persevcrations than controls. Although findings from the WCST indicate that the problem solving deficits by MS patients closely resemble those exhibited by patients with various conditions that produce frontal lobe dysfunction, results from the CCST indicate that the problem solving difficulties exhibited by patients with MS arc distinct and probably represent a primary deficit in concept formation. (JINS, 1996, 2, 134–140.)
The neuropsychology of mental retardation
Authors: Pulsifer Margaret B.
Published: February 2009

This critical review examines mental retardation (MR) from a neuropsychological perspective. Competing definitions of MR are discussed and the prevalence is estimated. Descriptions are given of idiopathic MR and the five major identifiable prenatal causes of MR: fetal alcohol syndrome, Down's syndrome, fragile X syndrome, Prader-Willi syndrome, and Angelman syndrome. Similarities and differences among syndromes are examined. Cognitive deficits common to all disorders were in attention, short-term memory, and sequential information processing, whereas language and visuospatial abilities were varied. Neuroanatomical abnormalities common to all disorders were in the hippocampus and cerebellum; individual disorders typically showed a unique pattern of other neurological abnormalities. Both knowledge of individual MR-related disorders and comparative research between disorders are important for researchers and clinicians. Further research is called for in both areas. (JINS, 1996,2, 159–176.)
Subjective complaints of cognitive symptoms are related to psychometric findings of memory deficits in patients with HIV-1 infection
Authors: Poutiainen Erja , Elovaara Irina
Published: February 2009

Eighty-five subjects at various stages of human immunodeficiency virus (HIV-1) infection and 39 seronegative controls underwent neurological and neuropsychological evaluation to assess the relationship between cognitive test results and subjective complaints (cognitive, affective, motor, and other). The effect of psychiatric disorders on the association between cognitive performance and complaints of the patients was also examined. Patients with symptomatic infection had higher frequency of complaints than subjects at asymptomatic stage. Detailed neuropsychological examination confirmed a strong association between poor verbal memory and cognitive complaints. Poor performance on cognitive speed and flexibility was associated with motor complaints and motor abnormalities. These associations were not explained by psychiatric disorders or elevated depression questionnaire scores. Our observations indicate that, especially in symptomatic HIV-1 infection, cognitive changes reported by patients often reflect “objective” cognitive decline, and may be the earliest signs of HIV-1 associated cognitive disorder. No direct relationship was observed between “subjective” complaints and neuropsychological performance of asymptomatic subjects. Understanding the significance of reported cognitive changes have important therapeutic implications. (JINS, 1996, 2, 219–225.)
Freehand drawing impairments in probable Alzheimer's disease
Authors: Grossman Murray , Mickanin Jenifer , Onishi Kris , Robinson Keith M. , D'Esposito Mark
Published: February 2009

We evaluated freehand picture production of familiar objects in patients with probable Alzheimer's disease. The overall recognizability of their drawings was significantly compromised. Error analyses revealed the production of category violations and the frequent inclusion of incorrect features in a picture that were borrowed from semantically related objects, suggesting difficulty distinguishing between items with overlapping feature sets in semantic memory. Analyses of individual patient drawing profiles also revealed that some patients are disproportionately compromised in expressing a particular perceptual feature, implicating difficulty at the level of perceptual processing. Regression analyses demonstrated the contribution of limited visual attentional resources. We conclude that impaired freehand drawing in probable Alzheimer's disease is multifactorial in nature. (JINS, 1996, 2, 226–235.)
Representations in learning new faces: Evidence from prosopagnosia
Authors: Polster Michael R. , Rapcsak Steven Z.
Published: February 2009

We report the performance of a prosopagnosic patient on face learning tasks under different encoding instructions (i.e., levels of processing manipulations). R.J. performs at chance when given no encoding instructions or when given “shallow” encoding instructions to focus on facial features. By contrast, he performs relatively well with “deep” encoding instructions to rate faces in terms of personality traits or when provided with semantic and name information during the study phase. We propose that the improvement associated with deep encoding instructions may be related to the establishment of distinct visually derived and identity-specific semantic codes. The benefit associated with deep encoding in R.J., however, was found to be restricted to the specific view of the face presented at study and did not generalize to other views of the same face. These observations suggest that deep encoding instructions may enhance memory for concrete or pictorial representations of faces in patients with prosopagnosia, but that these patients cannot compensate for the inability to construct abstract structural codes that normally allow faces to be recognized from different orientations. We postulate further that R.J.'s poor performance on face learning tasks may be attributable to excessive reliance on a feature-based left hemisphere face processing system that operates primarily on view-specific representations. (JINS, 1996, 2, 240–248.)
An investigation of semantic space in patients with schizophrenia
Authors: Aloia Mark S. , Gourovitch Monica L. , Weinberger Daniel R. , Goldberg Terry E.
Published: February 2009

There has been increasing interest in the semantic cognitive system in schizophrenia. Recent findings suggest a possible breakdown of semantic information processing in this disorder. The current study attempts to further examine semantic organization in schizophrenia. Twenty-eight chronic, early-onset schizophrenic patients and 32 controls were matched for prcmorbid intelligence and compared in their ability to spontaneously cluster exemplars from a specific category during a fluency task. Using multidimensional scaling and clustering techniques, 11 exemplars occurring most frequently in both groups were chosen for examination of their relative “proximity” during word generation. Patients with schizophrenia showed a less stable two-dimensional organization of exemplars and were less likely to group exemplars into subordinate clusters than were normals. These results suggest that semantic networks arc disorganized in these patients. These findings may have some implications for the debate over the origin of “thought disorder” in schizophrenia. (JINS, 1996, 2, 267–273.)
Direct and indirect effects of demographic, medical, and psychological variables on neuropsychological performance in normal geriatric persons: A structural equation model
Authors: Uchiyama Craig Lyons , Mitrushina Maura , Satz Paul , Schall Matthew
Published: February 2009

The direct and indirect effects of demographic, medical, and psychological variables on neuropsychological performance in elderly individuals were examined using a LISREL structural equation model. One-hundred fifty-six geriatric subjects were individually administered a comprehensive neuropsychological battery, an extensive medical history and demographics questionnaire, and the Neuropsychology Behavior and Affect Profile (a psychological assessment instrument). The model assessed the effects of five independent latent variables (medical history, psychological functioning, global mental status, education, and gender-related functioning) on two dependent latent variables (nonverbal and verbal neuropsychological functioning). The best fitting model revealed that three latent variables (medical history, global mental status, and gender-related functioning) had direct effects on neuropsychological functioning and that all five independent variables exhibited indirect effects. These findings suggest that the influence of demographic variables on neuropsychological functioning for geriatric persons is complex and that certain variables should not be interpreted independently of each other due to their significant moderating influences. (JINS, 1996, 2, 299–305.)