Influence of human allogenic bone marrow and cord blood-derived mesenchymal stem cell secreting trophic factors on ATP (adenosine-5'-triphosphate)/ADP (adenosine-5'-diphosphate) ratio and insulin secretory function of isolated human islets from cadaveric donor

Successful islet transplantation (ITx) is not only dependent on the number of islets, but also their quality, including viability, metabolic activity, and function. Islet quality decreases during cultivation after the isolation procedure. To overcome this obstacle, we established the practice of islet and mesenchymal stem cells (MSCs) coculture. This coculture condition improved the ATP (adenosine-5'-triphosphate)/ADP (adenosine-5'-diphosphate) ratio and insulin secretory function in vitro. It is believed that the enhancement of islet quality in islet-MSCs cocultures may be caused by the secretion of active agents by MSCs. Herein we have shown that interleukin-6 (IL-6), vascular endothelial growth factor-A (VEGF-A), hepatocyte growth factor (HGF), and transforming growth factor-beta (TGF-beta) were significantly increased as measured by enzyme-linked immunosorbent assay (ELISA) in MSCs-cultured medium, factors that have been shown to improve the survival, function, and angiogenesis/revascularization of islets. These results indicated that the quality of human islets was enhanced by trophic molecules secreted by MSCs, which influence the intracellular islet ATP content and insulin secretory function.

Development of a Decision Support Model for Screening Attention-deficit Hyperactivity Disorder with Actigraph-based Measurements of Classroom Activity

OBJECTIVE

Questionnaire-based ADHD screening tests may not always be objective or accurate, owing to both subjectivity and prejudice. Despite attempts to develop objective measures to characterize ADHD, no widely applicable index currently exists. The principal aim of this study was to develop a decision support model for ADHD screening by monitoring children's school activities using a 3-axial actigraph.

METHODS

Actigraphs were placed on the non-dominant wrists of 153 children for 3 hours, while they were at school. Children who scored high on the questionnaires were clinically examined by child psychiatrists, who then confirmed ADHD. Mean, variance, and ratios of low-level (0.5-1.0G) and high-level (1.6-3.2G) activity were extracted as activity features from 142 children (10 ADHD, 132 non-ADHD). Two decision-tree models were constructed using the C5.0 algorithm: [A] from whole hours (class + playtime) and [B] during classes. Accuracy, sensitivity, and specificity were evaluated. PPV, NPV, likelihood ratio, and AUC were also calculated for evaluation.

RESULTS

[Model A] One child without ADHD was misclassified, resulting in an accuracy score of 99.30%. Sensitivity and NPV were 1.0000. Specificity and PPV were 0.992 and 0.803-0.909, respectively. [Model B] Two children without ADHD were misclassified, resulting in an accuracy score of 98.59%. Specificity and PPV were scored at 0.985 and 0.671-0.832, respectively.

CONCLUSION

The selected features were consistent with the findings of previous studies. Objective screening of latent patients with ADHD can be accomplished with a simple watch-like sensor, which is worn for just a few hours while the child attends school. The model proposed herein can be applied to a great many children without heavy cost in time and manpower cost, and would generate valuable results from a public health perspective.

Increase of modified retrograde to antegrade flow ratio on doppler ultrasounds of the hepatic vein indicating tricuspid regurgitation during follow-up of liver transplantation: correlation with echocardiographic results

The purpose of this study was to explore the best parameter of hepatic vein (HV) Doppler ultrasounds (DUS) that correlated with echocardiographic findings of and particularly the optimal cutoff value for tricuspid regurgitation (TR) following liver transplantation (LT). Thirty-six patients underwent echocardiography and DUS after LT from January 2006 to July 2007. Echocardiographic records were searched for TR grade and peak velocity of TR flow. The HV DUS parameters included peak velocity of retrograde flow (R), peak velocity of antegrade flow (A), the difference between R and A (R-A), the ratio of R to A (R/A ratio), and a modified R/A ratio, namely, the product of the R/A ratio and the R/A duration ratio. Correlation tests and receiver-operator characteristic analyses explored their interrelations and to obtained cutoff values to diagnose moderate and severe TR. TR grade best correlated with the modified R/A ratio (rho = 0.585), followed by the R/A ratio (rho = 0.503) and R (rho = 0.455). The modified R/A ratio was the most accurate parameter for the diagnosis of moderate and severe TR (Az = 0.825 and 0.895, respectively); its cutoff value was > or =0.11 for moderate TR (sensitivity and specificity both 77.78%) and 0.13 for severe TR (sensitivity, 100%; specificity, 81.2%). The modified R/A ratio best correlated with echocardiographic results of TR, although the strength of correlation was only moderate. Additionally, the modified R/A ratio was an accurate DUS parameter to diagnose moderate and severe TR among patients following LT.

The implication of nigrostriatal dopaminergic degeneration in the pathogenesis of REM sleep behavior disorder

BACKGROUND AND PURPOSE

The pathogenesis of rapid eye movement (REM) sleep behavior disorder (RBD) is not clear despite its frequent association with Parkinson's disease (PD). We investigated whether the nigrostriatal dopaminergic system is involved in the development of idiopathic RBD.

METHODS

Fourteen patients with RBD, 14 patients with PD and 12 normal controls were included in the study. The diagnosis of RBD was confirmed on polysomnography. All the participants performed single-photon emission computed tomography imaging 3 h after injection of [(123)I]FP-CIT. During REM sleep of the RBD patients, each 30-s epoch was rated as 'tonic' when there was at least 50% of tonically maintained chin electromyography (EMG) activity in the epoch. Phasic EMG activities were calculated as the percentage of 3-s mini-epoch containing phasic EMG events (leg and chin, separately).

RESULTS

The RBD patients showed a trend of lower binding in the striatum than the normal controls (P = 0.07), and the significance was revealed in the putamen (P = 0.02). However, in 11 individual cases of the 14 RBD patients, the dopamine transporter (DAT) densities in the putamen still remained within the normal range. In the RBD patients, there was no correlation between EMG activities and DAT densities.

CONCLUSIONS

Nigrostriatal dopaminergic degeneration could be a part of the pathogenesis of RBD, but not essential for the development of RBD. The lack of correlation between RBD severity and DAT densities suggests that another pathogenic process not related to nigrostriatal dopaminergic transmission may be implicated in RBD.

Measurement of compensatory hyperplasia of the contralateral kidney: usefulness for differential diagnosis of fetal unilateral empty renal fossa

OBJECTIVE

To assess the usefulness of sonographic evaluation of compensatory hyperplasia of the contralateral kidney for the differential diagnosis of fetal unilateral empty renal fossa (ERF).

METHODS

We retrospectively measured the ratio of the anteroposterior (AP) and transverse (TR) diameters of the contralateral kidney in 24 fetuses with unilateral ERF including 12 cases of unilateral renal agenesis, six cases of a unilateral pelvic kidney and six cases of a unilateral ectopic multicystic dysplastic kidney (MCDK). For the normal reference value, we calculated the AP : TR diameter ratios of both kidneys in 20 normal fetuses in the second and third trimesters. We calculated the accuracy of the AP : TR ratio to detect contralateral compensatory hyperplasia.

RESULTS

The median (range) AP : TR diameter ratios of the normal kidneys were 0.84 (0.72-0.89) in the second trimester and 0.81 (0.65-0.89) in the third trimester. All cases of unilateral renal agenesis and ectopic MCDK showed the presence of compensatory hyperplasia, while no case of renal ectopy was seen with compensatory hyperplasia. The median (range) ratios for unilateral renal agenesis and ectopic MCDK were 1.0 (0.95-1.02) and 1.1 (1-1.25) in the second and third trimesters, respectively. The median ratios for a unilateral pelvic kidney were 0.8 (0.74-0.85) and 0.77 (0.74-0.84) in the second and third trimesters, respectively. Using 0.9 as the discriminating value, the sensitivity, specificity, and accuracy of the AP : TR diameter ratio for the prenatal diagnosis of compensatory renal hyperplasia was 100%.

CONCLUSION

Sonographic evaluation of compensatory hyperplasia of the contralateral kidney may be useful for the differential diagnosis of a fetal unilateral ERF. Prospective studies are warranted.

Increased serum B cell-activating factor level in children with atopic dermatitis

BACKGROUND

B cell-activating factor (BAFF) is a tumour necrosis factor superfamily member best known for its role in the survival and maturation of B cells. BAFF activity is seen in naïve and effector/memory T cells.

AIM

To investigate the level and role of BAFF in serum of patients with atopic dermatitis (AD).

METHODS

Levels of serum BAFF, a proliferation-inducing ligand (APRIL) and total serum IgE level, and total eosinophil count were measured in 245 children.

RESULTS

Patients were characterized as having atopic eczema (AE) (n = 90) or non-AE (n = 77); the remainder were healthy control subjects (n = 78). Serum BAFF level in children with AE (1625.04 +/- 708.32 pg/mL) was significantly higher than in non-AE children (1194.69 +/- 448.44 pg/mL, P < 0.0001) or healthy controls (1062.89 +/- 444.74 pg/mL, P < 0.0001). Serum APRIL level was not different between the three groups. Serum BAFF level significantly correlated with total serum IgE level (gamma = 0.42, P < 0.0001) and total eosinophil count. It was also positively correlated with serum BAFF and egg-specific IgE level (gamma = 0.252, P = 0.045) in AE.

CONCLUSIONS

Serum BAFF level is high in AE and might be a useful marker for AE.

A new HLA-B*5124 variant, B*512402 allele, identified by sequence-based typing

A novel human leukocyte antigen-B allele, officially named B*512402, was identified in a Korean bone marrow donor. The B*512402 allele shows two nucleotide substitutions compared with B*512401 in exon 3 at codons 135 (GCG --> GCC) and 138 (ACC --> ACG) without any amino acid substitution.

Haemodynamic events and localised parenchymal changes following transcatheter arterial chemoembolisation for hepatic malignancy: interpretation of imaging findings

Following transcatheter arterial chemoembolisation (TACE), the appearances on CT or MR images are largely related to the chemical and ischaemic insults to the portal tract. Understanding the mechanism of TACE-induced changes is essential for radiologists in order to determine the therapeutic effect as well as to distinguish these changes from recurrent tumours. This pictorial review illustrates the haemodynamic and substantial parenchymal changes related to TACE for hepatic malignancy.

Double contrast-enhanced MRI of viral hepatitis-induced cirrhosis: correlation of gross morphological signs with hepatic fibrosis

The purpose of this study was to evaluate the diagnostic ability of the expanded gallbladder fossa and right posterior hepatic notch signs for hepatic fibrosis determined by double contrast-enhanced MRI. For patients with chronic viral hepatitis B (n = 96) or hepatitis C (n = 13) who underwent gadopentate dimeglumine-enhanced dynamic MRI followed by ferucarbotran-enhanced gradient-echo imaging, the degree of parenchymal fibrosis was categorised into three groups based on the extent of reticulation and nodularity: (1) pre-cirrhotic or minimal fibrosis; (2) mild to moderate fibrosis; (3) advanced cirrhosis. Each group was evaluated for the presence of a sharp notch in the posterior-medial surface of the right lobe of the liver and expanded gallbladder fossa. The expanded gallbladder fossa sign gradually increased with an increasing degree of fibrosis (Group 1, 50%; Group 2, 61%; Group 3, 78%), and there was no significant difference (p>0.5) between hepatitis B (67%) and C (73%). In the case of the right posterior hepatic notch sign, only 6% of Group 1 and Group 2 patients were positive; 27% of hepatitis B patients and 90% of hepatitis C patients in Group 3 exhibited the sign (p<0.05). Owing to its low prevalence, even in advanced cirrhosis, the right posterior hepatic notch sign is of little value in the diagnosis of cirrhosis due to chronic hepatitis B virus infection, whereas an expanded gallbladder fossa could be used as a non-specific indicator of early fibrosis before the gross appearance of advanced hepatic fibrosis.

Effect of citral, eugenol, nerolidol and alpha-terpineol on the ultrastructural changes of Trichophyton mentagrophytes

The antifungal effects of citral, eugenol, nerolidol and alpha-terpineol on Trichophyton mentagrophytes were investigated. Citral over 0.1 mg/ml strongly inhibited the hyphal growth of T. mentagrophytes, and the antifungal activity of alpha-terpineol was less effective. The morphological changes of the fungus exposed to the terpenes were observed by electron microscopy. The hyphae were distorted and collapsed at 0.2, 0.4 and 1 mg/ml of eugenol, nerolidol and alpha-terpineol respectively, and cell membrane and organelles were irreversibly damaged at 0.2 mg/ml citral. These suggested that four terpenes possess antifungal activity against T. mentagrophytes, and the activity might lead to irreversible cellular disruption.

Coexistence of static magnetism and superconductivity in SmFeAsO(1-x)F(x) as revealed by muon spin rotation

The recent observation of superconductivity with critical temperatures (Tc) up to 55 K in the pnictide RFeAsO(1-x)F(x), where R is a lanthanide, marks the first discovery of a non-copper-oxide-based layered high-Tc superconductor. It has raised the suspicion that these new materials share a similar pairing mechanism to the cuprate superconductors, as both families exhibit superconductivity following charge doping of a magnetic parent material. In this context, it is important to follow the evolution of the microscopic magnetic properties of the pnictides with doping and hence to determine whether magnetic correlations coexist with superconductivity. Here, we present a muon spin rotation study on SmFeAsO(1-x)F(x), with x=0-0.30 that shows that, as in the cuprates, static magnetism persists well into the superconducting regime. This analogy is quite surprising as the parent compounds of the two families have rather different magnetic ground states: itinerant spin density wave for the pnictides contrasted with the Mott-Hubbard insulator in the cuprates. Our findings therefore suggest that the proximity to magnetic order and associated soft magnetic fluctuations, rather than strong electronic correlations in the vicinity of a Mott-Hubbard transition, may be the key ingredients of high-Tc superconductors.

Direct measurement of the electronic spin diffusion length in a fully functional organic spin valve by low-energy muon spin rotation

Electronic devices that use the spin degree of freedom hold unique prospects for future technology. The performance of these 'spintronic' devices relies heavily on the efficient transfer of spin polarization across different layers and interfaces. This complex transfer process depends on individual material properties and also, most importantly, on the structural and electronic properties of the interfaces between the different materials and defects that are common to real devices. Knowledge of these factors is especially important for the relatively new field of organic spintronics, where there is a severe lack of suitable experimental techniques that can yield depth-resolved information about the spin polarization of charge carriers within buried layers of real devices. Here, we present a new depth-resolved technique for measuring the spin polarization of current-injected electrons in an organic spin valve and find the temperature dependence of the measured spin diffusion length is correlated with the device magnetoresistance.

Dimensionality-controlled insulator-metal transition and correlated metallic state in 5d transition metal oxides Sr n+1Ir nO3n+1 (n=1, 2, and infinity)

We investigated the electronic structures of the 5d Ruddlesden-Popper series Sr n+1Ir nO3n+1 (n=1, 2, and infinity) using optical spectroscopy and first-principles calculations. As 5d orbitals are spatially more extended than 3d or 4d orbitals, it has been widely accepted that correlation effects are minimal in 5d compounds. However, we observed a Mott insulator-metal transition with a change of bandwidth as we increased n. In addition, the artificially synthesized perovskite SrIrO3 showed a very large mass enhancement of about 6, indicating that it was in a correlated metallic state.

Bound excitons in Sr2CuO3

We investigated temperature dependent optical spectra of the one-dimensional chain compound Sr2CuO3. The charge transfer transition polarized along the chain direction shows a strongly asymmetric line shape as expected in one-dimensional extended Hubbard model. At low temperature, the charge transfer peak shows a large blueshift and reveals additional sharp peaks at the gap. Even though many spectroscopic studies suggest that this material cannot have a bound exciton based on the one-dimensional extended Hubbard model, we attribute the additional sharp peaks to excitons, which come to exist due to the long-range Coulomb interaction.

Case report. Sclerosing liver haemangioma with pericapillary smooth muscle proliferation: atypical CT and MR findings with pathological correlation

We report a case of sclerosing liver haemangioma with pericapillary smooth muscle proliferation in a 63-year-old man who presented with abdominal pain. Because the tumour showed atypical features on CT and MRI, a correct diagnosis could not be made until surgery. In this report, the atypical radiological findings are illustrated and correlated with pathological findings.

Electrical control of exchange bias mediated by graphene

The role of graphene in mediating the exchange interaction is theoretically investigated when placed between two ferromagnetic dielectric materials. The calculation based on a tight-binding model illustrates that the magnetic interactions at the interfaces affect not only the graphene band structure but also the thermodynamic potential of the system, leading to an effective exchange bias between magnetic layers. The analysis indicates a strong dependence of the exchange bias on the properties of the mediating layer, revealing an efficient mechanism of electrical control even at room temperature.

Coexistence of magnetic fluctuations and superconductivity in the pnictide high temperature superconductor SmFeAsO1-xFx measured by muon spin rotation

Muon spin rotation experiments were performed on the pnictide high temperature superconductor SmFeAsO1-xFx with x=0.18 and 0.3. We observed an unusual enhancement of slow spin fluctuations in the vicinity of the superconducting transition which suggests that the spin fluctuations contribute to the formation of an unconventional superconducting state. An estimate of the in-plane penetration depth lambda ab(0)=190(5) nm was obtained, which confirms that the pnictide superconductors obey an Uemura-style relationship between Tc and lambda ab(0);(-2).

Superconducting energy gap and c-axis plasma frequency of (Nd,Sm)FeAsO0.82F0.18 superconductors from infrared ellipsometry

We present far-infrared ellipsometric measurements of polycrystalline samples of the pnictide superconductor RFeAsO0.82F0.18 (R=Nd and Sm). We find evidence that the electronic properties are strongly anisotropic such that the optical spectra are dominated by the weakly conducting c-axis response similar to the cuprate high-temperature superconductors. We deduce an upper limit of the c-axis superconducting plasma frequency of omega pl,c(SC)< or =260 cm(-1) corresponding to a lower limit of the c-axis magnetic penetration depth of lambda c > or =6 microm and lambda c/lambda ab > or =30 as compared to lambda ab=185 nm from muon spin rotation [A. Drew, arXiv:0805.1042 [Phys. Rev. Lett. (to be published)]]. We also observe a gaplike suppression of the conductivity in the superconducting state with a shoulderlike feature at omegaSC* approximately 300 cm(-1) and spectral shape which is consistent with an unconventional order parameter with 2Delta approximately omegaSC* approximately 37 meV.

Solid pseudopapillary carcinoma of the pancreas: differentiation from benign solid pseudopapillary tumour using CT and MRI

AIM

To describe the computed tomography (CT) and magnetic resonance imaging (MRI) findings that differentiate solid pseudopapillary carcinomas (SPC) from benign solid pseudopapillary tumours (SPT) of the pancreas.

MATERIALS AND METHODS

Preoperative CT or MRI images for 26 patients (eight patients with SPC and 18 patients with SPT) were retrospectively reviewed. In addition to the general morphological features, the presence of pancreatic duct dilation, vascular invasion, and extrapancreatic metastases were comparatively assessed.

RESULTS

There were no significant differences between pancreatic SPC and benign SPT with respect to tumour size, location, capsule thickness, internal composition, and pattern of calcification, nor was there any correlation with the age and gender of the patients. Pancreatic duct dilation was present in four of the eight (50%) SPC patients, and was absent in all benign SPT patients (p=0.005). Vascular encasement by the tumour (n=2) and hepatic metastases (n=2) were also exclusively demonstrated in SPC patients. Multivariate logistic regression analysis showed that pancreatic duct dilation (p=0.001), vessel encasement (p=0.027), and metastasis (p=0.027) were the variables that can be used to differentiate SPC from benign SPT.

CONCLUSION

SPC of the pancreas may help to differentiate from benign SPT using the imaging features of aggressive behaviour of pancreatic duct dilation and vessel encasement with or without extrapancreatic metastases.

The Severe Cognitive Impairment Rating Scale--an instrument for the assessment of cognition in moderate to severe dementia patients

BACKGROUND/AIMS

This study aimed to develop a brief, reliable and valid test for cognitive function of severely demented patients.

METHODS

We constructed the Severe Cognitive Impairment Rating Scale, which consisted of 11 items covering memory, language, visuospatial function, frontal function and orientation, and investigated its reliability and validity on 267 subjects [normal: 65, very mild Alzheimer's disease (AD): 42, mild AD: 58, moderate AD: 36, severe AD: 44, profound AD: 22].

RESULTS

The internal consistency obtained by Cronbach's coefficient alpha was 0.93. The interrater reliability and test-retest reliability in the moderately to severely impaired subjects with an MMSE score of <or=14 was 0.99 (p < 0.001) and 0.90 (p < 0.001), respectively. It showed significant correlation with Severe MMSE (r = 0.96, p < 0.01), MMSE (r = 0.86, p < 0.01) and Clinical Dementia Rating (r = -0.83, p < 0.01). It was robust to both the floor effect in the severe/profound stage of AD and the ceiling effect in the mild/moderate stage of AD. Exploratory factor analysis yielded 2 factors (automatic informational processing and controlled informational processing) accounting for 73.5% of the total variance.

CONCLUSIONS

The Severe Cognitive Impairment Rating Scale is a valid and reliable test for evaluating the cognitive function of advanced AD patients.

Charge dynamics of doped holes in high Tc cuprate superconductors: a clue from optical conductivity

The charge dynamics in weakly hole doped high temperature superconductors is studied in terms of the accurate numerical solution to a model of a single hole interacting with a quantum lattice in an antiferromagnetic background, and accurate far-infrared ellipsometry measurements. The experimentally observed two electronic bands in the infrared spectrum can be identified in terms of the interplay between the electron correlation and electron-phonon interaction resolving the long standing mystery of the midinfrared band.

Intrinsic mobility limit for anisotropic electron transport in Alq3

Muon spin relaxation has been used to probe the charge carrier motion in the molecular conductor Alq3 (tris[8-hydroxy-quinoline] aluminum). At 290 K, the magnetic field dependence of the muon spin relaxation corresponds to that expected for highly anisotropic intermolecular electron hopping. Intermolecular mobility in the fast hopping direction has been found to be 0.23+/-0.03 cm2 V-1 s(-1) in the absence of an electric- field gradient, increasing to 0.32+/-0.06 cm2 V-1 s(-1) in an electric field gradient of 1 MV m(-1). These intrinsic mobility values provide an estimate of the upper limit for mobility achievable in bulk material.

Multicystic cavernous haemangioma of the liver: ultrasonography, CT, MR appearances and pathological correlation

Among the hepatic haemangiomas with atypical features when studied radiologically, the multicystic type is extremely rare. We report a case of multicystic hepatic haemangioma in a 62-year-old woman, which was found incidentally during ultrasound screening. Because the tumour showed atypical features on ultrasonography, CT and MRI, the correct diagnosis was not made until the surgery. In this report, the atypical radiological findings are illustrated and correlated with pathological findings.

Optical study of the free-carrier response of LaTiO3/SrTiO3 superlattices

We used infrared spectroscopic ellipsometry to investigate the electronic properties of LaTiO_{3}/SrTiO_{3} superlattices (SLs). Our results indicated that, independent of the SL periodicity and individual layer thickness, the SLs exhibited a Drude metallic response with sheet carrier density per interface approximately 3x10;{14} cm;{-2}. This is probably due to the leakage of d electrons at interfaces from the Mott insulator LaTiO3 to the band insulator SrTiO3. We observed a carrier relaxation time approximately 35 fs and mobility approximately 35 cm;{2} V-1 s;{-1} at 10 K, and an unusual temperature dependence of carrier density that was attributed to the dielectric screening of quantum paraelectric SrTiO3.

A normative study of the Revised Hasegawa Dementia Scale: comparison of demographic influences between the Revised Hasegawa Dementia Scale and the Mini-Mental Status Examination

BACKGROUND/AIMS

We investigated the demographic influence on the performance of the Revised Hasegawa Dementia Scale (HDS-R) and provided normative data of the HDS-R in the elderly.

METHODS

The HDS-R was administered to 803 community-dwelling cognitively normal elderly subjects aged 55 years or over. Cognitive disorders and psychiatric disorders were strictly excluded using the CERAD-K assessment packet and the Mini-International Neuropsychiatric Interview. The demographic influence on the performance of the HDS-R was examined using multiple linear regression analyses, and compared with that on the performance of the Mini-Mental Status Examination (MMSE) using the Chow test and t statistics. Overlapping strata were used in developing age-, education- and gender-specific normative data of the HDS-R.

RESULTS

Age, education, and gender influenced significantly the performance of the HDS-R, and explained 22.5% of the total score variance. Older age, lower education, and male gender were associated with lower performance of the HDS-R. However, the demographic influence on the HDS-R was much weaker than that on the MMSE (t = 5.578, d.f. = 800, p < 0.001). The normative data of the HDS-R stratified by age (60-69, 70-79, > or =80), education (0-6, 7-12, > or =13), and gender were presented.

CONCLUSIONS

The HDS-R was more robust to demographic influences than the MMSE, and normative data may contribute to improving further its diagnostic accuracy for dementia.