"I Like and Prefer to Work Alone": Social Anxiety, Academic Self-Efficacy, and Students' Perceptions of Active Learning.

Although active learning improves student outcomes in science, technology, engineering, and mathematics (STEM) programs, it may provoke anxiety in some students. We examined whether two psychological variables, social anxiety (psychological distress relating to the fear of negative evaluation by others) and academic self-efficacy (confidence in one's ability to overcome academic challenges), interact with student perceptions of evidence-based instructional practices (EBIPs) and associate with their final grades in a STEM-related course. Human anatomy and physiology students in community college courses rated various EBIPs for their perceived educational value and their capacity to elicit anxiety (N = 227). In general, practices causing students the most anxiety (e.g., cold calling) were reported by students as having the least educational value. When controlling for students' self-reported grade point averages, socially anxious students rated several EBIPs as more anxiety inducing, whereas high-efficacy students reported less anxiety surrounding other EBIPs. Furthermore, mediation analysis revealed that individual differences in academic self-efficacy at the beginning of the term explained some of the negative association between students' social anxiety levels and final grades in the course. Our results, obtained in a community college context, support a growing body of evidence that social anxiety and academic self-efficacy are linked with how students perceive and perform in an active-learning environment.

New Species of Lissodendoryx Topsent, 1892 (Demospongiae, Poecilosclerida, Coelosphaeridae) and Myxilla Schmidt, 1862 (Demospongiae, Poecilosclerida, Myxillidae) from the Northeast Pacific.

Collections of sponges by the late Dr. William C. Austin and the authors (N. McDaniel, R. Harbo and B. Ott) provided material for descriptions of new species from two genera of Poecilosclerida for shallow waters of Southern British Columbia, Canada and Northern Washington, USA: Lissodendoryx and Myxilla. There have been no new species of these two genera described for the Northeast Pacific since Laubenfels' work in central California (Laubenfels 1930, 1932) and Lambe's reports in 1893 to 1895 for Geological Survey of Canada sponge collections from British Columbia, Canada to the Bering Sea. We describe three new species of Lissodendoryx (Lissodendoryx) (Demospongiae, Poecilosclerida, Coelosphaeridae) and one new species of Myxilla (Myxilla) (Demospongiae, Poecilosclerida, Myxillidae): L. (L.) barkleyensis n. sp., L. (L.) littoralis n. sp., L. (L.) toxaraphida n. sp. and M. (M.) austini n. sp. Lissodendoryx (L.) barkleyensis n. sp. is cave-dwelling, has acanthostyles 112-260 µm, tornotes 107-177 µm, arcuate isochelas 8-28 µm and two sizes of sigmas 18-29, 26-55 µm. Lissodendoryx (L.) littoralis n. sp. fistulate habitus is adapted to muddy substrates similar to some Polymastia species also found commonly in the Northeast Pacific. It has subtylostyles 185-336 µm, tylotes 112-229 µm, arcuate isochelas 11-23 µm, and sigmas 30-75 µm. Lissodendoryx (L.) toxaraphida n. sp. is the only described Lissodendoryx species with raphides shaped like toxas. It has acanthostyles 140-286 µm, tornotes 143-195µm, arcuate isochelas 18-34 µm and toxiform raphides 65-156 µm. Myxilla (M.) austini n. sp. has a fistulate habitus and both tornote and tylote megascleres. It appears to be tolerant of low oxygen environments. Myxilla (M.) austini n. sp. has smooth to sparsely spined styles 193-353 µm, tylotes 153-221 µm, tornotes 174-260 µm, two sizes of anchorate isochelas 13-27, 42-81 µm, and two sizes of sigmas 13-47, 33-78 µm. All specimens were collected from shallow water (intertidal to 25 m).

EXPOSURE OF A SERVICE TECHNICIAN REPAIRING A BIPLANE X-RAY SYSTEM.

While repairing a biplane cardiovascular X-ray system in a hospital, a service technician accidentally activated the system's floor pedal. He continued his work under unnoticed exposure for about 5 min until the system alarm was automatically activated. About 2 h after the exposure, the technician developed an erythema on parts of his left face and neck. The next day, he reported his incident to the competent authorities and was hospitalised in a unit specialised in treating heavily irradiated patients. Frequent blood analysis did not show any signs for a significant exposure to radiation. The Federal Office of Public Health then conducted extensive dose estimations. It could be shown that the dismounted collimator was always in front of the lateral X-ray tube, shielding the technician from the direct beam. The dose estimations came to the following conservative results: an effective dose of 5 mSv, a skin dose of 200 mSv, an eye lens dose of 100 mSv and an extremity dose (arm) of 700 mSv. The cause of the erythema remains unclear since the estimated doses are thought to be too low to induce any visible effect on the skin.

A Survey of Knowledge and Views Concerning Genetic and Amyloid PET Status Disclosure.

INTRODUCTION: This survey characterizes viewpoints of cognitively intact at-risk participants in an Alzheimer prevention registry if given the opportunity to learn their genetic and amyloid PET status. METHODS: 207 participants were offered a 25-item survey. They were asked if they wished to know their ApoE and amyloid PET status, and if so, reasons for wanting to know, or not, and the effects of such information on life plans. RESULTS: 164 (79.2%) of registrants completed the survey. Among those who were unaware of their ApoE or amyloid PET results, 80% desired to know this information. The most common reasons for wanting disclosure were to participate in research, to arrange personal affairs, to prepare family for illness, and to move life plans closer into the future. When asked if disclosure would help with making plans to end one's life when starting to lose their memory, 12.7% vs. 11.5% responded yes for ApoE and amyloid PET disclosures, respectively. Disclosure of these test results, if required for participation in a clinical trial, would make 15% of people less likely to participate. Likelihood of participation in prevention research and the desire to know test results were not related to scores on brief tests of knowledge about the tests. DISCUSSION: These results suggest that stakeholders in AD prevention research generally wish to know biological test information about their risk for developing AD to assist in making life plans.

[Implementation of regularly performed resuscitation training at a hyperbaric treatment center]. / Implementierung eines regelmäßigen Reanimationstrainings an einem Druckkammerzentrum.

BACKGROUND: Medical emergency situations and even cardiac arrest can occur during treatment of patients in therapeutic hyperbaric chambers just as in other clinical departments; therefore, high quality structured management should be implemented for dealing with emergencies in this special working area. To ensure this the emergency medical treatment should not only be performed according to the current state of medical knowledge but needs to take the special features of the hyperbaric environment including safety aspects into account. METHOD: This article presents a description of the implementation and effects of routine emergency and resuscitation training at a center for hyperbaric medicine. RESULTS: By simulation of emergencies in a hyperbaric chamber it rapidly became clear that the treatment of medical emergencies and cardiac arrest under hyperbaric conditions has some special features and due to safety aspects cannot always be performed according to current medical guidelines. At the time of this simulation in a real life working environment, previously unknown structural and logistic problems became obvious whereby the solutions contributed to a significant improvement of structural and process quality and could potentially also improve the outcome quality. Furthermore, a positive and lasting learning effect in the fields of quality of resuscitation measures, organization of the workplace, communication skills, logistics and safety aspects was detectable by analyzing participant performance over a period of 4 years. On the part of the participating staff a positive feedback and high acceptance of emergency simulator training was confirmed. CONCLUSION: Through annual compulsory emergency training of the complete staff of the hyperbaric unit at the actual workplace, a structural and confident approach to dealing with emergencies and resuscitation situations was observed. By the use of on-site simulator training even in specialized hospital units, deficits and tentativeness regarding logistics, course of action, organization and communication in emergency situations can be minimized to provide optimum patient care in a real life emergency situation by focusing on the medical measures.

Measurement of the neutron electric to magnetic form factor ratio at Q2=1.58 GeV2 using the reaction 3He[over →](e[over →],e'n)pp.

A measurement of beam helicity asymmetries in the reaction 3He[over →](e[over →],e'n)pp is performed at the Mainz Microtron in quasielastic kinematics to determine the electric to magnetic form factor ratio of the neutron GEn/GMn at a four-momentum transfer Q2=1.58 GeV2. Longitudinally polarized electrons are scattered on a highly polarized 3He gas target. The scattered electrons are detected with a high-resolution magnetic spectrometer, and the ejected neutrons are detected with a dedicated neutron detector composed of scintillator bars. To reduce systematic errors, data are taken for four different target polarization orientations allowing the determination of GEn/GMn from a double ratio. We find µnGEn/GMn=0.250±0.058(stat)±0.017(syst).

[Sheared catheter in regional anaesthesia : causes and follow-up of an axiallary plexus catheter]. / Durchtrennter Katheter in der Regionalanästhesie : Uraschen und Vorgehen bei einem axillären Plexuskatheter.

In the past years intoxication with local anesthetics, damage to nerves, vessels and other accompanying structures as well as infectiological events have been discussed more and more as complications accompanying peripheral nerve blocks (PNB). The following case report highlights a complication which seems to rarely occur and deals with a sheared continuous PNB, where a fragment of the catheter remained in the patient. The possible causes for the damage are discussed and recommendations on the clinical management of such a case are made.

[Perivascular brachial plexus block. Ultrasound versus nerve stimulator]. / Perivaskuläre axilläre Plexusanästhesie. Ultraschall versus Nervenstimulator.

BACKGROUND: Optimizing the needle position using ultrasound (US) instead of electrical nerve stimulation (NSt) is increasingly common for perivascular brachial plexus block. These two methods were compared in a prospective, randomized, single-blinded controlled trial regarding effectiveness and time of onset of peripheral nerve blockade. METHODS: After puncture (penetration of neurovascular sheath and complete insertion of needle) 56 patients were randomly assigned to either the US group (finding the needle tip in transpectoral section, short axis, correction of needle position if local anesthetic spread was insufficient) or the NSt group (target impulse reaction in median, ulnar or radial nerve of 0.3 mA/0.1 ms, if necessary correction of position before injection of local anesthetic) to verify the needle position. All patients received 500 mg 1% mepivacaine. Sensory and motor blocks were tested by single nerve measurements (SNM) 5, 10 and 20 min after finishing the injection, where 0 represents minimal and 2 maximal success of the block. RESULTS: Single nerve measurements were analyzed using repeated measures ANOVA. The mean results of cumulative SNMs were significantly higher in the US group at all measurement times. Sensitivity US/NSt: 5 min: 3.36±2.32/2.63±1.87; 10 min: 5.45±2.41/4.21±2.45; 20 min: 7.30±2.02/6.43±2.43, p=0.015, motor function US/NSt: 5 min: 3.91±1.81/3.02±1.67; 10 min: 5.27±1.66/4.05±1.70; 20 min: 6.64±1.37/5.50±1.90, p<0.001. At the beginning of surgery complete nerve blockade was achieved in 89% in the US group and 68% in the NSt group (p=0.006), 3 (US) versus 7 (NSt) patients needed supplementation and 3 (US) versus 11 (NSt) patients needed general anesthesia (p=0.022). To achieve the nerve block took approximately 1 min more in the US group (p=0.003). CONCLUSION: The use of ultrasound in perivascular brachial plexus blocks leads to significantly higher success rates and shorter times of onset.

A longitudinal study of drivers with Alzheimer disease.

OBJECTIVE: The goal of this study was to define the natural progression of driving impairment in persons who initially have very mild to mild dementia. METHODS: We studied 128 older drivers, including 84 with early Alzheimer disease (AD) and 44 age-matched control subjects without cognitive impairment. Subjects underwent repeated assessments of their cognitive, neurologic, visual, and physical function over 3 years. Self-reports of driving accidents and traffic violations were supplemented by reports from family informants and state records. Within 2 weeks of the office evaluation, subjects were examined by a professional driving instructor on a standardized road test. RESULTS: At baseline, subjects with AD had experienced more accidents and performed more poorly on the road test, compared to controls. Over time, both groups declined in driving performance on the road test, with subjects with AD declining more than controls. Survival analysis indicated that while the majority of subjects with AD passed the examination at baseline, greater severity of dementia, increased age, and lower education were associated with higher rates of failure and marginal performance. CONCLUSIONS: This study confirms previous reports of potentially hazardous driving in persons with early Alzheimer disease, but also indicates that some individuals with very mild dementia can continue to drive safely for extended periods of time. Regular follow-up assessments, however, are warranted in those individuals.

Visual and cognitive predictors of driving safety in Parkinson's disease patients.

This study assessed the clinical utility of contrast sensitivity (CS) relative to attention, executive function, and visuospatial abilities for predicting driving safety in participants with Parkinson's disease (PD). Twenty-five, non-demented PD patients completed measures of contrast sensitivity, visuospatial skills, executive functions, and attention. All PD participants also underwent a formal on-road driving evaluation. Of the 25 participants, 11 received a marginal or unsafe rating on the road test. Poorer driving performance was associated with worse performance on measures of CS, visuospatial constructions, set shifting, and attention. While impaired driving was associated with a range of cognitive and visual abilities, only a composite measure of executive functioning and visuospatial abilities, and not CS or attentional skills, predicted driving performance. These findings suggest that neuropsychological tests, which are multifactorial in nature and require visual perception and visual spatial judgments are the most useful screening measures for hazardous driving in PD patients.

Excessive daytime sleepiness and on-road driving performance in patients with Parkinson's disease.

The impact of excessive daytime sleepiness (EDS) on road test performance was examined in patients with Parkinson's disease (PD). Twenty-one patients with PD completed the Epworth Sleepiness Scale (ESS) and an on-road driving test. Five participants had EDS according to their self-report on the ESS. Neither EDS nor PD medications were associated with on-road driving performance. These findings suggest that in this pilot study EDS did not impair PD patients' driving skills on a formal driving evaluation.

Impact of endoscopist withdrawal speed on polyp yield: implications for optimal colonoscopy withdrawal time.

BACKGROUND: In 2002, a U.S. Multi-Society Task Force on Colorectal Cancer recommended that the withdrawal phase for colonoscopy should average at least 6-10 min. This was based on 10 consecutive colonoscopies by two endoscopists with different adenoma miss rates. AIMS: To characterize the relationship between endoscopist withdrawal time and polyp detection at colonoscopy, and to determine the withdrawal time that corresponds to the median polyp detection rate. DESIGN: Procedural data from out-patient colonoscopies performed at the Mayo Clinic, Rochester during 2003 were reviewed. Endoscopists were characterized by their mean withdrawal time for a negative procedure and individual polyp detection rate. RESULTS: A total of 10 955 colonoscopies performed by 43 endoscopists were analysed. Median withdrawal time was 6.3 min (range: 4.2-11.9); polyp detection rate was 44.0% (all polyps), 29.8% (< or = 5 mm), 5.9% (6-9 mm), 6.7% (10-19 mm), 2.1% (> or = 20 mm). Longer withdrawal time was associated with higher polyp detection rate (r = 0.76; P < 0.0001); this relationship weakened for larger polyps (r = 0.19 for polyps 6-9 mm, r = 0.28 for polyps 10-19 mm, r = 0.02 for polyps > or = 20 mm). Overall median polyp detection rate corresponded to a withdrawal time of 6.7 min. CONCLUSION: Our findings support a colonoscopy withdrawal time of at least 7 min, which correlates with higher colon polyp detection rates.

Prospective assessment of the impact of feedback on colonoscopy performance.

BACKGROUND: Colonoscopy is an operator-dependent procedure. The medical literature describes disparity in colonoscopy performance with respect to polyp detection, caecal intubation rates and procedural times. AIM: To assess prospectively the impact of feedback among a large cohort of colonoscopists on three performance parameters: caecal intubation rate, insertion time and withdrawal time. METHOD: In a prospective clinical study, procedural data from all out-patient colonoscopies performed by attending gastroenterologists at our institution were recorded routinely in a computerized database. Enhanced serial feedback was provided on a quarterly basis for three procedure parameters: intubation to caecum, insertion time and withdrawal time. Feedback (absolute value, % rank and group distribution) was sent by email every 3 months beginning with January 2005 feedback for all of 2004, and subsequently quarterly in April 2005 (for January-March 2005), July 2005 (for April-June 2005) and October 2005 (for July-September 2005). RESULTS: Feedback was provided to 58 endoscopists with a median experience level of 8 years. There was a relative decline of 19% in incomplete procedures, with median caecal non-intubation rates decreasing from 4.7% to 3.8% following the introduction of feedback while median insertion times declined from 10.6 to 9.5 mins, P = 0.02. Median withdrawal times did not change significantly, 9.1-8.9 mins, P = 0.6. CONCLUSIONS: Feedback by email appears to improve colonoscopy performance, enhancing completion rates and shortening insertion times without compromising withdrawal times.

Comparative in vitro study of tissue welding using a 808 nm diode laser and a Ho:YAG laser.

In vitro porcine arteries and veins have been welded end-to-end using either a 808 nm diode laser combined with an indocyanine green enhanced albumin solder, or with a continuous-wave (cw) Ho:YAG laser without biological solder. The vascular stumps were approached to each other over a coronary dilatation catheter in order to obtain a precise alignment and good coaptation. Standard histology revealed for both welding techniques lateral tissue damage between 2 and 3 mm caused by laser-induced heat. Good solder attachment to the tissue was observed by the use of a scanning electron microscope. The vessels soldered with the 808 nm diode laser using albumin solder showed considerably higher tensile strength (1 N compared to 0.3 N) than vessels welded exclusively by Ho:YAG laser radiation. In contrast, leaking pressure (350 +/- 200 mmHg) and bursting pressure (457 +/- 200 mmHg) were found to be independent of the welding technique used. This study demonstrates that fast (total welding time about 2-5 min), stable and tight microvascular anastomosis can be achieved with the use of a dye-enhanced albumin laser soldering technique and an ancillary coronary dilatation catheter.

Internal limiting membrane ablation in pig eyes with the Er:YAG laser under perfluorodecalin.

PURPOSE: The aim of our study was to evaluate the in vivo feasibility of non-contact Er:YAG laser ablation of the internal limiting membrane (ILM), which is recommended for the treatment of macular holes. METHOD: Vitrectomy was performed in 16 eyes of 15 pigs. After perfluorodecalin filling, it was attempted to remove the ILM using a free-running fiber-guided Er:YAG laser (lambda=2.94 microm, pulse length 250 micros, repetition rate 1.7 Hz, radiant exposure 0.6-2.05 J/cm2). The eyes were enucleated either immediately (11 eyes, group 1) or 2 weeks after laser therapy (5 eyes, group 2). Furthermore, in one additional pig eye the retina was carefully treated with microforceps after vitrectomy to assess the damage produced by conventional techniques of ILM peeling. All eyes were examined histologically. RESULTS: Group 1: Nine eyes could be examined (problems with fixation in two eyes). In four of nine eyes, the ILM was either removed or detached, in one eye there was a superficial retinal hemorrhage, and in four eyes the ILM was still intact. In the latter cases, there was no intraoperative whitening or bleeding and no posterior vitreous detachment was present histologically. Group 2: Four eyes (problems with fixation in one eye) could be examined. The ILM was either removed or detached in three eyes. In one eye there was a superficial retinal hemorrhage. In one eye the ILM was not removed and there had neither been intraoperative whitening or hemorrhage nor histologically visible posterior vitreous detachment. In both groups, the nerve fiber layer in treated areas was thicker than in adjacent untreated retina. In one eye the retina was gently manipulated with microforceps in an attempt to perform ILM peeling. This led to damage to all layers of the retina. CONCLUSIONS: Removal of the ILM by Er:YAG laser is possible in vivo. However, the variability of the laser effects calls for further improvement such as a reliable indicator of ablation depth. In any case, any damage to the retina was lesser than that produced by microforceps.

Single photon emission computed tomography, magnetic resonance imaging hyperintensity, and cognitive impairments in patients with vascular dementia.

BACKGROUND: The relationship between subcortical hyperintensity (SH) on magnetic resonance imaging (MRI), cortical perfusion on single photon emission computed tomography (SPECT), and cognitive function is not well understood. The authors examined these relationships in individuals with vascular dementia (VaD), paying particular attention to frontal lobe function to determine whether the presence of SH on MRI was associated with frontal hypoperfusion on SPECT, which in turn would be associated with impairments of executive-attention function. METHODS: Patients with vascular dementia (n = 26) were assessed on neurocognitive tests and brain MRI and SPECT. SH volume was quantified from the axial T2-weighted fluid attenuated inversion recovery MRI. Total counts of activation across voxels for 12 cortical regions of interest were determined from SPECT. Perfusion ratios of both total cortical and frontal activation relative to cerebellum activation were derived, and regression analyses were performed to determine the relationships between cognitive, MRI, and SPECT indices. RESULTS: SH volume on MRI was significantly associated with frontal lobe perfusion, but not with global cortical perfusion as measured by SPECT. Frontal lobe perfusion did not consistently correlate with performance on measures of executive-attention function, although both total and frontal perfusion ratios were significantly associated with other cognitive functions. CONCLUSIONS: These results suggest that a functional "disconnection" between the frontal lobes and subcortical structures does not fully account for the magnitude of global cognitive impairment in VaD. Cortical perfusion as measured by SPECT appears to be associated with cognitive performance, but not specifically executive-attention dysfunction. Additional studies are needed to further examine the relationship between subcortical and cortical function in VaD.

Laser solder welding of articular cartilage: tensile strength and chondrocyte viability.

BACKGROUND AND OBJECTIVE: The surgical treatment of full-thickness cartilage defects in the knee joint remains a therapeutic challenge. Recently, new techniques for articular cartilage transplantation, such as mosaicplasty, have become available for cartilage repair. The long-term success of these techniques, however, depends not only on the chondrocyte viability but also on a lateral integration of the implant. The goal of this study was to evaluate the feasibility of cartilage welding by using albumin solder that was dye-enhanced to allow coagulation with 808-nm laser diode irradiation. STUDY DESIGN/MATERIALS AND METHODS: Conventional histology of light microscopy was compared with a viability staining to precisely determine the extent of thermal damage after laser welding. Indocyanine green (ICG) enhanced albumin solder (25% albumin, 0.5% HA, 0.1% ICG) was used for articular cartilage welding. For coagulation, the solder was irradiated through the cartilage implant by 808-nm laser light and the tensile strength of the weld was measured. RESULTS: Viability staining revealed a thermal damage of typically 500 m in depth at an irradiance of approximately 10 W/cm(2) for 8 seconds, whereas conventional histologies showed only half of the extent found by the viability test. Heat-bath investigations revealed a threshold temperature of minimum 54 degrees C for thermal damage of chondrocytes. Efficient cartilage bonding was obtained by using bovine albumin solder as adhesive. Maximum tensile strength of more than 10 N/cm(2) was achieved. CONCLUSIONS: Viability tests revealed that the thermal damage is much greater (up to twice) than expected after light microscopic characterization. This study shows the feasibility to strongly laser weld cartilage on cartilage by use of a dye-enhanced albumin solder. Possibilities to reduce the range of damage are suggested.

Executive function and magnetic resonance imaging subcortical hyperintensities in vascular dementia.

OBJECTIVE: To determine the relation between subcortical hyperintensities (SHs) visible on magnetic resonance imaging and executive function among patients with vascular dementia. BACKGROUND: The relation between SHs and executive dysfunction is not well understood, because studies have varied widely in methodology and have produced conflicting results. METHOD: We examined the relation between SHs (expressed as a percentage of total brain volume, not including ventricular volume) and six tests of executive function in a well-defined group of 24 individuals with vascular dementia. Executive tests were divided in two groups: Attention/Speed and Abstraction/Problem Solving. Bivariate correlations were computed between individual neuropsychological variables and SHs. RESULTS: Results showed significant bivariate correlations between SHs and three of the four tests in the Attention/Speed domain. Subcortical hyperintensities shared virtually no association with performance on tests in the Abstraction/Problem-Solving domain. CONCLUSIONS: The finding that SHs are significantly associated with psychomotor slowing and attentional dysfunction is consistent with what is known about the behavioral manifestations of subcortical disease. More detailed investigations of the regional distribution of SHs as well as measures of atrophy, hypoperfusion, and hypometabolism may be necessary to accurately characterize the complex relation between vascular disease and different aspects of executive dysfunction.

Performance on the Hooper Visual Organizational Test in patients diagnosed with subcortical vascular dementia: relation to naming performance.

OBJECTIVE: To examine the performance of individuals with vascular dementia (VaD) on the Hooper Visual Organization Test (HVOT) and to determine the influence of naming on HVOT performance in this population. BACKGROUND: The HVOT is commonly administered to assess visuospatial perception among neurologic patients, but the test requires verbal identification of stimuli as well as spatial ability. Previous studies have examined the influence of naming on the HVOT, but the issue has not been systematically addressed in individuals with subcortical VaD. METHOD: Individuals with a diagnosis of VaD were administered the HVOT, three additional measures of visuospatial function (Block Design and Picture Completion subtests of the Wechsler Adult Intelligence Scale-Revised, Rey-Osterrieth Complex Figure Test copy trial), and the Boston Naming Test (BNT). RESULTS: On average, the VaD patients performed poorly compared with normative data on each of the cognitive measures, with the most pronounced deficit evident on the BNT. Regression analyses revealed that more than 60% of the variance in performance on the HVOT was accounted for by performance on the Block Design subtest of the Wechsler Adult Intelligence Scale-Revised; performance on the BNT did not contribute significantly. CONCLUSIONS: The results suggest that VaD patients perform below expectations on the HVOT and that the measure is robust to naming deficits in this population.

Performance on the Mattis Dementia Rating Scale in patients with vascular dementia: relationships to neuroimaging findings.

Impairment on screening measures such as the Mattis Dementia Rating Scale (MDRS) provides evidence of dementia in patients with cerebrovascular disease. However, the relationships between neuroimaging findings and performance on the MDRS in vascular dementia (VD) have not been determined. In the present study, we examined the relationships between subcortical hyperintensity (SH) volume and whole brain volume (WBV) on the subscales and total score of the MDRS. Results revealed that SH accounted for a significant amount of variance on the Initiation/Perseveration and Construction subscales, whereas WBV accounted for a significant amount of variance on the Memory subscale. The total score on the MDRS was found to be significantly related to WBV but not SH. These results suggest that subcortical damage and brain volume account for different aspects of cognitive decline in VD and that overall cognitive impairment may reflect cortical and subcortical involvement.