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Identification of non-credible memory and other cognitive symptoms has received widespread attention within the past two decades. However, minimal information is available regarding patterns of non-credible language symptoms. We present the case of a 36-year-old female civil litigant who displayed delayed onset, severe, relatively focal speech and language symptoms, including difficulties with articulation, dysfluent speech, expressive language impairments with minor receptive difficulties, and lack of prosody, subsequent to a minor head trauma. On neuropsychological evaluation 3 years post injury, the patient presented with the same speech/language characteristics, but additionally exhibited a vague “foreign accent.” Cognitive scores generally were normal with the exception of poor performance on many language tasks and processing/motor speed. The patient showed passing performance on most measures of response bias, but she failed effort indicators requiring rapid letter discrimination (b Test), rapid verbal repetition (timed forward digit span), and sensory function (finger agnosia errors) while passing effort indicators falling within the domains of memory, math/number skills, visuo-constructional ability, and attention. Thus, the type of failed effort indicators predicted the categories of standard cognitive tests on which she underperformed. Personality testing revealed patterns generally consistent with hysterical personality orientation. Given her long-standing history of multiple unexplained medical symptoms, the patient was diagnosed with a somatization disorder, as well as a current conversion disorder involving language symptoms. However, given her compensation-seeking status, the possibility of additional conscious feigning of symptoms could not be ruled out. The need for validation of additional measures to detect feigned language impairment is recommended. [ABSTRACT FROM AUTHOR]

Recently published practice standards recommend that multiple effort indicators be interspersed throughout neuropsychological evaluations to assess for response bias, which is most efficiently accomplished through use of effort indicators from standard cognitive tests already included in test batteries. The present study examined the utility of a timed recognition trial added to standard administration of the WAIS-III Digit Symbol subtest in a large sample of “real world” noncredible patients (n=82) as compared with credible neuropsychology clinic patients (n=89). Scores from the recognition trial were more sensitive in identifying poor effort than were standard Digit Symbol scores, and use of an equation incorporating Digit Symbol Age–Corrected Scaled Scores plus accuracy and time scores from the recognition trial was associated with nearly 80% sensitivity at 88.7% specificity. Thus, inclusion of a brief recognition trial to Digit Symbol administration has the potential to provide accurate assessment of response bias. [ABSTRACT FROM PUBLISHER]

Several studies have examined the usefulness of the Warrington Recognition Memory Test–Words as a measure to detect suspect effort, although samples have generally been small and/or comprised of simulators rather than “real world” credible and noncredible patients. The current study examined the Warrington Recognition Memory Test–Words total score and response time of “real world” noncredible patients (as determined by motive to feign, failure on ≥2 independent measures of response bias, low cognitive scores inconsistent with normal ADLs; n = 190) versus credible patients (as determined by no motive to feign, failure of ≤1 measure of response bias; n = 124) derived from an archival database of individuals from the Harbor-UCLA Medical Center, Department of Psychiatry, Outpatient Neuropsychology Service, and the private practice of the second author. Noncredible patients obtained significantly lower total scores and longer times to complete the task. A total correct cutoff of ≤42 was found to have excellent specificity (91.9%) and sensitivity (88.9%), whereas a time cutoff of ≥207″ was associated with 65.5% sensitivity at 90.7% specificity, and when the time cut-score was used in combination with the total score cutoff, an additional 5% of the noncredible participants were captured, raising overall sensitivity to 93.7% (at 87.1% specificity). Thus, the Warrington Recognition Memory Test–Words, although not originally created for the purposes of measuring suspect effort, appears to be an excellent measure for detecting response bias on neuropsychological testing. [ABSTRACT FROM PUBLISHER]

A subset of patients who present for neuropsychological testing report dysfunction in daily life activities secondary to cognitive deficits, but are found on formal testing to have no objective abnormalities, raising the possibility of “neurocognitive hypochondriasis.” Such a case is presented, and the factors that appear to give rise to this presentation are explored. Cases of hypochondriacal overconcern regarding cognitive function are likely not rare, particularly given research showing there is little correlation between objective report of cognitive dysfunction and actual test scores in such conditions as mild traumatic brain injury, chronic fatigue syndrome, fibromyalgia, toxic mold exposure, and post-polio syndrome. [ABSTRACT FROM AUTHOR]

While it is recommended that judgments regarding the credibility of test performance be based on the results of more than one effort indicator, and recent efforts have been made to improve interpretation of multiple effort test failure, the field currently lacks adequate guidelines for using multiple measures of effort in concert with one another. A total of 103 patients were referred for outpatient neuropsychological evaluation, which included multiple measures of negative response bias embedded in standard test batteries. Using any pairwise failure combination to predict diagnostic classification was superior (sensitivity = 83.8%, specificity = 93.9%, overall hit rate = 90.3%) to using any one test by itself and to using any three-test failure combination. Further, the results were comparable to the results of logistical regression analyses using the embedded indicators as continuous predictors. Given its parsimony and clinical utility, the pairwise failure model is therefore a recommended criterion for identifying non-credible performance; however, there are of course other important contextual factors and influences to consider, which are also discussed. [ABSTRACT FROM AUTHOR]

Abstract: The relationship between ethnicity and cognitive test performance was examined in a sample of 161 patients referred for evaluation at a public hospital-affiliated neuropsychology clinic; 83 patients were Caucasian (non-Hispanic), 31 were African-American, 30 were Hispanic, and 17 were Asian. Significant group differences were present on some measures of language (Boston Naming Test), attention (Digit Span ACSS), constructional ability (Rey-Osterrieth [RO] copy), nonverbal processing speed (Trails A), and executive skills (Wisconsin Card Sorting Test [WCST]). Comparison of those who spoke English as a first language (or who learned English concurrently with a second language) versus those who spoke English as a second language (ESL) revealed significantly higher performance in the non-ESL group for Digit Span, Boston Naming Test, and FAS, and a higher score in the ESL group for RO copy. Boston Naming Test scores were significantly related to years educated in the United States; Boston Naming Test and Digit Span scores were significantly correlated with age at which conversational English was first learned and number of years in the United States; and finally, FAS scores were also significantly related to number of years in the United States. These findings are consistent with data from published literature on ethnic differences and the effects of acculturation on cognitive test performance in nonpatients, and also indicate that these observations are not attenuated by the presence of psychiatric or neurologic illness. The results further caution that normative data derived on Caucasian samples may not be appropriate for use with other ethnic groups. [Copyright &y& Elsevier]

To examine the adequacy of the WMS-III in the identification of memory deficits in older individuals, we administered the Word Lists subtest, along with a comparison measure, the Rey Auditory Verbal Learning Test (RAVLT), to four patients referred for assessment of dementia. Although the number of words recalled by the patients on the delayed trials of the Word Lists subtest and RAVLT were nearly identical, norms for the Word Lists subtest indicated that memory performance was within normal limits (i.e., low average or higher), while the RAVLT norms accurately characterized performance as impaired. We suspect that normative data for the WMS-III were compromised by inadvertent inclusion of older subjects with dementia or mild cognitive impairment. The findings from our cases call into question the use of the WMS-III Word Lists for older patients. [ABSTRACT FROM AUTHOR]

Studies the relationship between criminal arrest and gender, substance use disorder and use of community mental health services among patients with bipolar I disorder in Los Angeles County, California. Comparison of the use of community mental health services that inmates received before their arrest with the services that patients in the comparison group received before their involuntary hospitalization; Average length of stay; Characteristics of patients who had been arrested.

Abstract: Sixty-one noncredible patients (as documented by psychometric and behavioral criteria) scored significantly below 25 controls and 88 credible clinic patients with no motive to feign on most RAVLT scores, including added indices of implicit and “automatic” memory. A combination of true recognition (i.e., recognition minus false positives) + implicit memory score (i.e., the number of word stems completed with RAVLT items) + “automatic” memory score (i.e., the number of correct temporal order judgments) ≤22 was associated with 75.7% sensitivity with specificity at 91.5%. However, sensitivity was nearly as high when scores available from the standard RAVLT administration alone (i.e., no word stem or temporal order trials) were combined. Specifically, a cut-off of ≤12 for true recognition (recognition minus false positives) + primacy recognition (i.e., number of words recognized from the first third of the test) was associated with 73.8% sensitivity at 90% specificity. These results indicate that combined indices of recognition memory from the RAVLT are effective in identifying noncredible memory performance in “real world” samples and are modestly superior to the 67.2% sensitivity obtained with the standard recognition score. [Copyright &y& Elsevier]

A heterogeneous sample of chronic pain patients was first classified into one of three previously identified subgroups (i.e., dysfunctional, interpersonally distressed, adaptive) using the Multidimensional Pain Inventory (R. D. Kerns, D. C. Turk, & T. E. Rudy, 1985). Multiple differences at the domain and facet levels of the Revised NEO PI-R Personality Inventory (P. T. Costa, Jr. & R. R. McCrae, 1992) were found among the three subgroups of patients. In particular, the interpersonally distressed patients showed a greater degree of Neuroticism and were more introverted. Further analyses revealed that this group had tendencies toward feeling more vulnerable, being less trustful, and experiencing less positive emotions than the other groups. The dysfunctional group of patients was notable in terms of their low activity level and lower Openness (to new experience). Adaptive copers reported being emotionally stable, having a moderate degree of Extraversion, and being open to a wider variety of experiences. These differences may act as mediating influences in differing patient responsiveness to pain management programs. [ABSTRACT FROM AUTHOR]

Visuospatial ability is frequently compromised among elderly depressed patients, but it is unclear whether the impairment is a consequence of a visuospatial memory deficit or of an executive dysfunction that impacts visuospatial ability. The Boston Qualitative Scoring System is a method of scoring the Rey–Osterrieth Complex Figure (ROCF) that assesses the process used to draw the figure, the executive aspect of the task, as well as the accuracy and location of the completed elements. The hypotheses that executive scores as measured by the BQSS would separate diagnostic groups and that executive function would mediate the relationship between depression and nonverbal recall were tested using a between groups design with elderly depressed volunteers (N=31) and healthy controls (N=31). Participants were screened for other Axis I disorders with the Structured Clinical Interview for DSM-IV Diagnosis, diagnosed for major depression per DSM-IV criteria, and administered the ROCF. The copy and recall drawings were scored using BQSS criteria, and scores were grouped into executive and drawing scores from both copy and recall phases. Executive scores during the copy phase and drawing scores from the recall phase separated the diagnostic groups [F(1,59)=4.14, P=.05] and [F(1,59)=6.88, P=.01], respectively. Follow-up ANCOVAS showed that copy Planning, the score that quantified the process by which the figure was drawn, separated the diagnostic groups. Planning also mediated the association between depression and the percent of the figure recalled after the short delay (Z=1.84, P<.05). The significance of the depression-to-recall pathway was eliminated when Planning was controlled for, but Planning remained related to percent recalled [B=-6.90, P<.007]. A dimension of executive dysfunction, represented here by Planning, may be one underlying source of the observed decline in nonverbal recall among elderly depressed patients. This result is consistent with the theory that dysfunction of the prefrontal cortex is a critical feature of late-life depression. [Copyright &y& Elsevier]

We present 6 patients who displayed noncredible effort on neuropsychological testing (verified by failures on specialized measures designed to discreetly assess effort status and multiple behavioral inconsistencies) and complained of complete illiteracy secondary to impoverished educational history, learning disability, or acquired brain injury. The Stroop Test, a measure of a specific aspect of executive function requiring inhibition of an automatized oral reading response in favor of a less habitual, competing color-naming response, was administered to these patients. All six subjects claimed that they were unable to perform the Word-Reading trial as a consequence of total reading disability, but on the Color-Word Interference trial, they all committed "errors" by reading the written words. Five of the six subjects also performed substantially slower on the Interference condition relative to the Color-Naming trial, indicating that they were in fact inhibiting a reading response. However, in cases involving complaints of complete reading illiteracy, the observation of these individuals performing an act that they claimed to be unable to do was the most powerful and pathognomonic indicator of deliberate feigning or exaggeration of impairment in these cases. [ABSTRACT FROM AUTHOR]

The Rey Dot Counting Test was administered to 100 patients with suspect effort drawn from two separate settings (personal injury/disability, n=86; prison hospital, n=14) and to 251 subjects in nine clinical groups (head injury, learning disability, right and left cerebrovascular accident, schizophrenia, older normals, depressed elderly, and mild and moderate dementia). Sensitivity of cut-offs for individual test scores (mean grouped dot counting time, ratio of mean grouped to ungrouped dot counting time, and number of errors) differed markedly across the two suspect effort groups (e.g., 28–100%), indicating that noncredible patients drawn from different settings employ somewhat differing approaches in their fabrication of cognitive symptoms. Use of a cut-off of ≥17 applied to a combination score (mean ungrouped dot counting time+meangrouped dot counting time+number of errors) resulted in 100% sensitivity in the forensic suspect effort group and 75% sensitivity in the civil litigation/disability suspect effort group, while maintaining specificity of ≥90% for the clinical groups combined (excluding moderate dementia). [Copyright &y& Elsevier]

Background: Tamoxifen is used to treat breast cancer and may reduce the risk of breast cancer. However, there are conflicting reports as to whether tamoxifen use is associated with changes in brain metabolism and function or cognitive impairment. Consequently, we assessed the effects of tamoxifen and estrogen on the brain chemistry of elderly women.Methods: We used proton magnetic resonance spectroscopy to measure the concentrations of N-acetyl-containing compounds, myo-inositol (MI), total creatine (creatine plus phosphocreatine), and choline-containing compounds in the frontal white matter, basal ganglia, and hippocampus of 76 elderly women of whom 16 had received tamoxifen therapy, 27 had received estrogen as hormone replacement therapy (HRT), and 33 had received neither (control group). A two-way analysis of variance (ANOVA) was performed to determine the statistical significance of differences in cerebral metabolite concentrations among subject groups and brain regions. All statistical tests were two-sided.Results: Women in the tamoxifen and HRT groups had lower concentrations of MI in all areas than women in the control group (P =.02; overall group effect on ANOVA). Compared with the control group, the tamoxifen group (P =.004) and the HRT group (P =.06) had lower concentrations of MI in their basal ganglia. The MI concentration in the basal ganglia was inversely correlated with the duration of tamoxifen treatment (rho = -.72; P =.005).Conclusions: The reduced concentrations of MI in the brains of women treated with tamoxifen and HRT, compared with those of control women, suggest that tamoxifen has an effect similar to that of estrogen. These results, if confirmed, may alleviate concerns about the safety of using tamoxifen to reduce breast cancer risk in elderly women. [ABSTRACT FROM AUTHOR]

To our knowledge, no investigations have been undertaken to determine whether depression impacts performance on two commonly used tests to detect malingering of cognitive symptoms, the Rey 15-item Memorization Test and the Rey Dot Counting Test. This is a critical issue because of the high rate of depressive symptoms in patients with neurological conditions. It was hypothesized that depressed individuals, especially those with more severe depression, might be at risk for failing the tests, because these patients exhibit mild deficits in mental speed, visual perceptual/spatial skills, and visual memory, abilities required for successful completion of the malingering tests. However, examination of test performance in 64 older participants with major depression generally revealed very low false positive rates for most test scores, and severity of depression was unrelated to test scores. These results add to accumulating data supporting the validity of these cognitive malingering tests by documenting few false positive identifications. [ABSTRACT FROM AUTHOR]

Background: The emergence of new skills in the setting of dementia suggests that loss of function in one brain area can release new functions elsewhere.Aims: To characterise 12 patients with frontotemporal dementia (FTD) who acquired, or sustained, new musical or visual abilities despite progression of their dementia.Method: Twelve patients with FTD who acquired or maintained musical or artistic ability were compared with 46 patients with FTD in whom new or sustained ability was absent.Results: The group with musical or visual ability performed better on visual, but worse on verbal tasks than did the other patients with FTD. Nine had asymmetrical left anterior dysfunction. Nine showed the temporal lobe variant of FTD.Conclusion: Loss of function in the left anterior temporal lobe may lead to facilitation of artistic or musical skills. Patients with the left-sided temporal lobe variant of FTD offer an unexpected window into the neurological mediation of visual and musical talents. [ABSTRACT FROM AUTHOR]

Objective Research shows that traumatic brain injury (TBI) patients perform worse than healthy comparisons (HC) on the Symbol Digit Modalities Test (SDMT). We evaluated cut-off scores for a newly developed recognition trial of the SDMT as a performance validity assessment in monolingual and bilingual TBI survivors and HC adults. Method The sample consisted of 43 acute TBI (ATBI; 24 monolinguals; 19 bilinguals), 32 chronic TBI (CTBI; 13 monolinguals; 19 bilinguals), and 57 HC (24 monolinguals; 33 bilinguals) participants. All participants received standardized administration of the SDMT. None of the participants displayed motivation for feigning cognitive deficits. Results The HC group outperformed both TBI groups on the demographically adjusted SDMT scores, p = 0.000, ηp2 = 0.24. An interaction emerged in SDMT scores where monolingual ATBI outperformed bilingual ATBI and bilingual CTBI outperformed monolingual CTBI, p = 0.017, ηp2 = 0.06. No differences were found in the SDMT recognition trial. Both Bichlmeier and Boone's suggested cut-off scores had different failure rates in ATBI (Bichlmeier: 77%; Boone: 37%), CTBI (Bichlmeier: 69%; Boone: 19%), and HC (Bichlmeier: 56%; Boone: 26%). For the monolingual group (Bichlmeier: 66%; Boone: 36%) and the bilingual group (Bichlmeier: 66%; Boone: 21%). Finally, chi-squared analysis revealed monolingual TBI had greater failure rates than the bilingual ATBI. Conclusion Bichlmeier's proposed cut-off score resulted in greater failure rates in TBI survivors compared to Boone's suggested cut-off score. Furthermore, monolingual ATBI were influenced more by Bichlmeier's cut-off score than the bilingual ATBI group, although the reason for this finding is unclear and requires additional study with a larger sample size. [ABSTRACT FROM AUTHOR]

Objective The Dot Counting Test (DCT) is a performance validity test. McCaul et al. (2018) recently revised the DCT cut-off score from ≥17 to 13.80; we evaluated the new cut-off in non-Latinx Caucasian and Caucasian Latinx traumatic brain injury (TBI) survivors and healthy comparison (HC) participants. Method The sample consisted of 37 acute TBI (ATBI; 11 Caucasian Latinx; 26 non-Latinx Caucasian), 27 chronic TBI (CTBI; 10 Caucasian Latinx; 17 non-Latinx Caucasian), and 55 HC (29 Caucasian Latinx; 26 non-Latinx Caucasian) participants. Results An ANCOVA, controlling for age, revealed no DCT E-scores differences between groups. Both the conventional and the new cut-off scores had different failure rates in ATBI (conventional cut-off: 0%; PNC: 16%), CTBI (conventional cut-off: 7%; PNC: 15%), and HC (conventional cut-off: 10%; PNC: 11%) participants. For the Caucasian Latinx group (conventional cut-off: 6%; PNC: 12%) and the non-Latinx Caucasian group (conventional cut-off: 6%; PNC: 14%), demonstrated different failure rates across cut-off scores. Group differences were found with the McCaul et al. (2018) cut-off and the conventional cut-off. Also, chi-squared analysis revealed non-Latinx Caucasian participants with ATBI had greater failure rates than Caucasian Latinx participants with ATBI. Conclusion The new DCT cut-off score resulted in greater failure rates in TBI survivors. Also, this effect appears to be most pronounced in non-Latinx Caucasian persons with ATBI. Future work should investigate possible reasons for these differences so that more stringent DCT can be utilized in a way that provides less biased results for brain injury survivors across racial and ethnic groups. [ABSTRACT FROM AUTHOR]

Introduction We examined the impact of perceived workload and depressive symptoms on Rey-15 plus recognition (RMT) in ethnic minority participants with traumatic brain injury (TBI). Methods The sample consisted of 63 healthy comparison [HC: 38 with ethnic minority status (EM) & 25 non-ethnic minority Caucasian (NEM)] participants and 40 persons with TBI (18 EM; 22 NEM). The Hospital Anxiety and Depression Scale to measure depressive symptoms (HADS-D) and the NASA-Task Load Index (NASA TLX) to measure perceived workload. Results ANCOVAs revealed that NEM outperformed EM on the RMT, p = 0.000, ηp2 = 0.37. TBI survivors reported higher levels of HADS-D compared to HC participants, p = 0.018, ηp2 = 0.06. Additionally, the EM group reported higher levels of frustration on the RMT compared to NEMs, p = 0.033, ηp2 = 0.05. Interactions emerged for physical demand where NEM participant's with TBI had higher ratings than EM participants with TBI. For HCs, the EM participants provided higher physical demand ratings than their NEM counterparts, p = 0.029, ηp2 = 0.05. Additionally, a significant relationship between HADS-D and RMT was observed in the healthy NEM participants (r = −0.558, p = 0.004) and NEM participants with TBI (r = −0.288, p = 0.080). Finally, significant relationships between HADS-D and mental demand, physical demand, temporal demand, frustration, and overall subjective workload were observed in healthy EM participants, r = 0.342–0.431, p < 0.05. Conclusion Consistent with previous research, TBI survivors reported higher levels of depressive symptoms, which were associated with RMT performances. Overall, our data suggest the relationship between perceived workload, depression, and performance is complex and that investigators should interpret performance validity scores in person with TBI, depression, and/or EM status with great care. [ABSTRACT FROM AUTHOR]

Resin-based composite materials have been widely used in restorative dental materials due to their aesthetic, mechanical, and physical properties. However, they still encounter clinical shortcomings mainly due to recurrent decay that develops at the composite-tooth interface. The low-viscosity adhesive that bonds the composite to the tooth is intended to seal this interface, but the adhesive seal is inherently defective and readily damaged by acids, enzymes, and oral fluids. Bacteria infiltrate the resulting gaps at the composite-tooth interface and bacterial by-products demineralize the tooth and erode the adhesive. These activities lead to wider and deeper gaps that provide an ideal environment for bacteria to proliferate. This complex degradation process mediated by several biological and environmental factors damages the tooth, destroys the adhesive seal, and ultimately, leads to failure of the composite restoration. This paper describes a co-tethered dual peptide-polymer system to address composite-tooth interface vulnerability. The adhesive system incorporates an antimicrobial peptide to inhibit bacterial attack and a hydroxyapatite-binding peptide to promote remineralization of damaged tooth structure. A designer spacer sequence was incorporated into each peptide sequence to not only provide a conjugation site for methacrylate (MA) monomer but also to retain active peptide conformations and enhance the display of the peptides in the material. The resulting MA-antimicrobial peptides and MA-remineralization peptides were copolymerized into dental adhesives formulations. The results on the adhesive system composed of co-tethered peptides demonstrated both strong metabolic inhibition of S. mutans and localized calcium phosphate remineralization. Overall, the result offers a reconfigurable and tunable peptide-polymer hybrid system as next-generation adhesives to address composite-tooth interface vulnerability. [ABSTRACT FROM AUTHOR]

The Wisconsin Card Sorting Test, Stroop Test, Verbal Fluency (FAS), and Auditory Consonant Trigrams are commonly used measures of prefrontal lobe dysfunction. However, insufficient data are available regarding the specific functions assessed by these tests and the relationship of the tests to each other. These four tests, as well as measures of IQ, memory, attention, and processing speed, were administered to 250 subjects (138 patients and 112 controls). Factor analysis yielded three factors, and a higher order frontal lobe factor, using a dimensional factor analytic methodology. Present findings revealed modest correlations among the prefrontal tests, suggesting that the tests tap somewhat different abilities and are not redundant. Adequate assessment of prefrontal lobe abilities appears to require use of more than one test. [ABSTRACT FROM PUBLISHER]

The relationship between apparent faking of cognitive impairment (as detected by such ‘malingering’ tests as 15-item. Memorization and Dot Counting) and faking of psychiatric symptoms has not been investigated formally. In addition, no empirical literature is available on the relationship between personality traits and faking of cognitive symptoms. Of 154 subjects who claimed ‘stress’ psychiatric injury, 12% appeared to be faking cognitive impairment; 4.5% failed the 15-item Memorization Test, and 10% failed the Dot Counting task. Faking of cognitive symptoms occurred in only 23% of subjects who were faking/exaggerating psychological symptoms on the MCMI. Malingering test failure was associated with significant elevations of attempts to fake/exaggerate on the MCMI, rather than a reflection of ‘true’ personality traits. [ABSTRACT FROM AUTHOR]

We obtained Wisconsin Card Sorting Test (WCST) scores on 91 (35 male and 56 female) healthy, well-educated individuals aged 45 to 83. Women scored better than men on six WCST scores (categories, errors, perseverative responses, % perseverative errors, % conceptual level responses, and trials to first category), while subjects with more than 16 years of education outscored those limited to high school education on four measures (perseverative responses, errors, % perseverative errors, % conceptual level responses). Individuals older than 70 years of age scored less well than younger subjects on only two indices (errors, We conceptual level responses). Full Scale IQ was not related to WCST scores. Our findings suggest that WCST scores should be interpreted within the context of patient gender, education, and age. [ABSTRACT FROM AUTHOR]

Analyzes the white matter hyperintensity among elderly depressed patients. Comparison of white matter hyperintensity; Scores in test on patients' cognitive domains; Association of white matter hyperintensity with level of executive functioning.

Abstract The present study examined the persistent functional consequences associated with exposure to single and multiple doses of (+/-) 3,4-methylenedioxymethamphetamine (MDMA) as reflected by the neuroendocrine responses to d,l-fenfluramine (FEN). Adult male rats were administered a single dose of MDMA (20 mg/kg, SC) and challenged 2 weeks later with saline or FEN (2, 4, 6 and 8 mg/kg, SC). The corticotropin (ACTH) response to FEN (6 and 8 mg/kg) was blunted and the prolactin response to FEN (4 and 6 mg/kg) was enhanced in MDMA pre-treated rats. The ACTH and prolactin responses to FEN (6 mg/kg, SC) were then evaluated 4, 8 and 12 months after exposure to single and multiple doses MDMA (20 mg/kg, SC and 20 mg/kg, SC, bid, x 4 days, respectively). The ACTH response to FEN was significantly reduced at 4 and 8 months in both MDMA treatment groups, and at 12 months in the multiple dose group only. In contrast, the prolactin response to FEN was enhanced in both groups of MDMA treated rats at 4 months, but only in the multiple dose group at 8 months. By 12 months, the prolactin response to FEN had normalized. Following multiple doses of MDMA, 5-HT concentrations were reduced significantly in the frontal cortex at 4 and 12 months. The results indicate that exposure to single or multiple doses of MDMA can produce functional alterations which can persist for months, whereas the biochemical sequelae were less robust and shorter lived. [ABSTRACT FROM AUTHOR]

In a prospective study of late-life onset psychosis, five of the first 27 patients studied had extensive white-matter lesions demonstrated by MRI and/or CT. None of 60 age-matched psychiatrically healthy controls demonstrated such lesions. All five patients had a mild dementia and a frontal behavioural syndrome. In addition, every patient performed poorly on neuropsychological tests of frontal function. Dysfunction of the frontal cortex associated with white-matter lesions appears to contribute to the clinical picture of some cases of late-life psychosis. [ABSTRACT FROM AUTHOR]

Base rates of deficient neuropsychological test performance were evaluated among 132 neurologically healthy older normal adults using a variety of measures commonly employed in the “flexible-battery”approach to neuropsychological assessment. Subjects were divided into three age groups (50 to 59, 60 to 69, and 70 to 79 years). Despite the healthy status of our sample, most tests yielded at least some proportion of subjects earning scores in the borderline and impaired ranges (1.3 and 2.0 standard deviations below the age-group mean, respectively). Across the battery of measures, 73% of subjects earned a borderline score on at least one measure, and 20% of subjects earned at least two scores in the impaired range on separate tests. The proportion of subjects consistently earning borderline or impaired scores across multiple measures within specific cognitive domains was generally lower. Results illustrate the problems in interpreting isolated low scores, and the need to consider false-positive base rates in drawing inferences from poor test performance. [ABSTRACT FROM PUBLISHER]

Resin-based composite has overtaken dental amalgam as the most popular material for the repair of lost or damaged tooth structure. In spite of the popularity, the average composite lifetime is about half that of amalgam restorations. The leading cause of composite-restoration failure is decay at the margin where the adhesive is applied. The adhesive is intended to seal the composite/tooth interface, but the adhesive seal to dentin is fragile and readily degraded by acids, enzymes and other oral fluids. The inherent weakness of this material system is attributable to several factors including the lack of antimicrobial properties, remineralization capabilities and durable mechanical performance ― elements that are central to the integrity of the adhesive/dentin (a/d) interfacial seal. Our approach to this problem offers a transition from a hybrid to a biohybrid structure. Discrete peptides are tethered to polymers to provide multi-bio-functional adhesive formulations that simultaneously achieve antimicrobial and remineralization properties. The bio-additive materials design combines several functional properties with the goal of providing an adhesive that will serve as a durable barrier to recurrent decay at the composite/tooth interface. This article provides an overview of our multi-faceted approach which uses peptides tethered to polymers and new polymer chemistries to achieve the next generation adhesive system ― an adhesive that provides antimicrobial properties, repair of defective dentin and enhanced mechanical performance. [ABSTRACT FROM AUTHOR]

Evaluates the Boston Qualitative Scoring System (BQSS) for the Rey-Osterrieth Complex Figure. Shortcomings of the Rey-Osterrieth figure; Concept of the BQSS; Advantages and disadvantages.

Due process of law involves matters of fundamental fairness to litigants in civil and criminal proceedings. Due process rights include the opportunity to develop, obtain, inspect, present, and challenge evidence in legal proceedings. Psychologists' opinions often depend upon information that is sensitive and should not be publicly disclosed in a manner that would undercut the utility of psychological tests. There have been strident discussion and policy statements opposing nonpsychologists' access to sensitive test information by providing them with copies of test materials or by video recording examinations that include psychological tests. Notably absent from these statements has been any discussion of the legal system's demand for due process and its corresponding requirement for access to facts and data, including opinion testimony of experts. We argue that the Ethical Principles of Psychologists and Code of Conduct and the Specialty Guidelines for Forensic Psychology are congruent with due process requirements for reasonable judicial scrutiny and adequate discovery by all parties, and we believe that a judge's protective order is an acceptable remedy for the disclosure of sensitive test information in a litigated matter. Public Significance Statement: Our article argues that when psychology operates within the legal system, it is important for psychologists to recognize that the manner in which they attempt to resolve the ethical problems of their own profession can impact the constitutional rights of civil litigants and criminal defendants. [ABSTRACT FROM AUTHOR]

Objective: Neuropsychological evaluations are used to examine a person's current cognitive functioning. Performance validity tests (PVT) are included in neuropsychological test batteries to ensure that examinees are performing to the best of their abilities and identify non-credible performance. There are two types of PVTs: freestanding and embedded. A freestanding PVT is a cognitive test created to evaluate performance validity and do not measure any type of cognition directly. Meanwhile, an embedded PVT is a task design to evaluate some sort of cognition (e.g., memory) by using traditional neuropsychological tests (e.g., Trail Making Test) and performance validity. Research suggests that undergraduate college students are not always performing to the best of their abilities when completing a comprehensive neuropsychological battery. In fact, in one study where an undergraduate college sample was given three PVTs, it was reported that 56% of the participants failed at least one PVT in their first session and 31% in their second session. Research has also shown that speaking multiple languages can influence cognition. The purpose of this study was to identify in three credible language groups of college students what PVTs does bilingualism influence higher failure rates. It was predicted that bilingual college students would significantly demonstrate higher PVTs failure rates compared to monolingual college students. Participants and Methods: The sample consisted of 70 English first language monolinguals (EFLM), 33 English first language bilinguals (EFLB), and 68 English second language bilinguals (ESLB) that were psychologically and neurologically healthy. All participants completed a comprehensive neuropsychological battery in English. The Rey-Osterrith complex figure copy test, Comalli Stroop part A, B, and C, Trail Making Test part A and B, Symbol Digit Modalities Test written and oral parts, Controlled Oral Word Association Test (COWAT) letter fluency, and Finger Tapping Test were the tasks used as embedded PVTs to evaluate failure rates in our sample. Moreover, all participants were credible (i.e., they did not fail two or more PVTs). PVT cutoff scores were selected for each embedded PVT from previous literature. Chi-square analysis were used to evaluate failure rates between language groups on each PVT. Results: We found no significant failure rate differences between language groups on any of the PVTs. However, while no significant group differences were found, on the COWAT letter fluency results revealed higher failure rates between the three language groups (i.e., 13% EFLM, 24% EFLB, and 22% ESLB) compared to other PVTs. Conclusions: Our data suggested no significant failure rate differences between language groups. It has been suggested in previous studies that linguistic factors impact PVT performance and test interpretation. On the COWAT letter fluency task, it is possible that language is driving higher failure rates between bilingual speakers, even though we found no significant failure rates or performance differences between the three language groups. Future studies should examine language groups and other cultural variables (e.g., time perspective) to determine what may be driving high failure rates on the COWAT letter fluency task in credible participants. [ABSTRACT FROM AUTHOR]

The See Change survey was designed to make z > 1 cosmological measurements by efficiently discovering high-redshift Type Ia supernovae (SNe Ia) and improving cluster mass measurements through weak lensing. This survey observed twelve galaxy clusters with the Hubble Space Telescope (HST) spanning the redshift range z = 1.13–1.75, discovering 57 likely transients and 27 likely SNe Ia at z ∼ 0.8–2.3. As in similar previous surveys, this proved to be a highly efficient use of HST for supernova observations; the See Change survey additionally tested the feasibility of maintaining, or further increasing, the efficiency at yet higher redshifts, where we have less detailed information on the expected cluster masses and star formation rates. We find that the resulting number of SNe Ia per orbit is a factor of ∼8 higher than for a field search, and 45% of our orbits contained an active SN Ia within 22 rest-frame days of peak, with one of the clusters by itself yielding 6 of the SNe Ia. We present the survey design, pipeline, and supernova discoveries. Novel features include fully blinded supernova searches, the first random forest candidate classifier for undersampled IR data (with a 50% detection threshold within 0.05 mag of human searchers), real-time forward-modeling photometry of candidates, and semi-automated photometric classifications and follow-up forecasts. We also describe the spectroscopic follow-up, instrumental in measuring host galaxy redshifts. The cosmology analysis of our sample will be presented in a companion paper. [ABSTRACT FROM AUTHOR]

With the advent of highly sensitive technologies such as tandem mass spectrometry and next-generation sequencing, recombinant antibodies are now routinely analyzed for the presence of low-level sequence variants including amino acid misincorporations. During mAb cell culture process development, we found that proline was replaced with the non-canonical amino acid, hydroxyproline, in the protein sequence. We investigated the relationship between proline content in the cell culture media and proline sequence variants and found that the proline concentration was inversely correlated with the amount of sequence variants detected in the protein sequence. Hydroxyproline incorporation has been previously reported in recombinant proteins produced in mammalian expression systems as a post-translational modification. Given the dependency on proline levels, the mechanism was then investigated. To address the possibility of co-translational misincorporation of hydroxyproline, we used tandem mass spectrometry to measure incorporation of stable-isotope labelled hydroxyproline added to the feed of a production bioreactor. We discovered co-translational misincorporation of labelled hydroxyproline in the recombinant antibody. These findings are significant, since they underscore the need to track non-canonical amino acid incorporation as a co-translational event in CHO cells. Understanding the mechanism of hydroxyproline incorporation is crucial in developing an appropriate control strategy during biologics production. [ABSTRACT FROM AUTHOR]

Abstract Bacterial infection is a serious medical problem leading to implant failure. The current antibiotic based therapies rise concerns due to bacterial resistance. The family of antimicrobial peptides (AMP) is one of the promising candidates as local therapy agents due to their broad-spectrum activity. Despite AMPs receive increasing attention to treat infection, their effective delivery to the implantation site has been limited. Here, we developed an engineered dual functional peptide which delivers AMP as a biomolecular therapeutic agent onto calcium phosphate (Ca-P) deposited nanotubular titanium surfaces. Dual functionality of the peptide was achieved by combining a hydroxyapatite binding peptide-1 (HABP1) with an AMP using a flexible linker. HABP functionality of the peptide provided a self-coating property onto the nano-topographies that are designed to improve osteointegration capability, while AMP offered an antimicrobial protection onto the implant surface. We successfully deposited calcium phosphate minerals on nanotubular titanium oxide surface using pulse electrochemical deposition (PECD) and characterized the minerals by XRD, FT-IR, FE-SEM. Antimicrobial activity of the engineered peptide was tested against S. mutans (gram- positive) and E. coli (gram-negative) both in solution and on the Ca-P coated nanotubular titanium surface. In solution activity of AMP and dual functional peptide have the same Minimum Inhibitory Concentration (MIC) (32 mg/mL). The peptide also resulted in the reduction of the number of bacteria both for E.coli and S. mutans compare to control groups on the surface. Antimicrobial features of dual functional peptides are strongly correlated with their structures suggesting tunability in design through linkers regions. The dual-function peptide offers single-step solution for implant surface functionalization that could be applicable to any implant surface having different topographies. Graphical abstract Unlabelled Image Highlights • Fabrication of nano-textured titanium surfaces coated with bioactive ceramics • Application of a chimeric peptide based self-assembly methodology on ceramic implants for local therapy • Easy to use self-assembled antimicrobial solution both prior and during the orthopedic surgery • The approach could be coupled with existing therapies to fight bacterial infection. [ABSTRACT FROM AUTHOR]