VATA-ADL: The Visual Analogue Test for Anosognosia for Activities of Daily Living.

OBJECTIVE: To study awareness of problems with one's own Activities of Daily Living (ADL) following stroke by means of a novel instrument-the Visual-Analogue Test for Anosognosia for Activities of Daily Living (VATA-ADL). METHODS: The new test overcomes some of the methodological problems of traditional structured interviews and self-rating questionnaires. In particular, to account for possible verbal communication difficulties, each question is illustrated by a drawing and a 4-point visual-analogue Likert scale. The patient's self-rating is compared with that given by informants (personal or professional caregiver) to acquire a measure of metacognition of one's own problems in performing everyday tasks. RESULTS: The VATA-ADL was validated in 61 dyads of older people and their informants. A group of 80 post-acute stroke patients and their informants then completed the test. Informant ratings correlated highly with traditional ADL scales, the questionnaire items showed high internal consistency (α = .95) and loaded onto one factor. By comparison to informants' assessments, the patients showed a generally poor appreciation of their functional disabilities. Thirty-nine patients overestimated their abilities (anosognosia) whereas nine showed underestimation of their abilities. CONCLUSIONS: Anosognosia (overestimation of abilities) for ADL is frequent, even in post-acute stages post-stroke. Some other patients underestimated their abilities, indicating that poor metacognition of one's own abilities in brain damaged patients is bi-directional. Both types of misestimation may have clinical consequences worth considering for the wellbeing of patients and their carers.

A new brachylophosaurin (Dinosauria: Hadrosauridae) from the Upper Cretaceous Menefee Formation of New Mexico.

Brachylophosaurini is a clade of hadrosaurid dinosaurs from the Campanian of western North America. Although well-known from northern localities in Montana and Alberta, including abundant material of Brachylophosaurus canadensis and Maiasaura peeblesorum and the holotypes of Acristavus gagslarsoni and Probrachylophosaurus bergei, material from southern localities in Utah and Colorado is restricted to a partial skull referred to A. gagslarsoni and several indeterminate specimens. Here we describe Ornatops incantatus gen. et sp. nov., a new brachylophosaurin known from a partial skeleton from the Allison Member of the Menefee Formation in New Mexico. Ornatops is the first brachylophosaurin reported from New Mexico and the southernmost occurrence of the clade. Ornatops shares with Probrachylophosaurus and Brachylophosaurus a caudally expanded nasofrontal suture on the frontals, but also exhibits an autapomorphic nasofrontal suture morphology, with a horizontal rostral region and elevated caudal region with two prominent parasagittal bumps, which is different from other brachylophosaurin specimens, including juvenile and adult Brachylophosaurus. A phylogenetic analysis places Ornatops in a trichotomy with Probrachylophosaurus and Brachylophosaurus, with Maiasaura and Acristavus as successive outgroups.

Transitional evolutionary forms in chasmosaurine ceratopsid dinosaurs: evidence from the Campanian of New Mexico.

Three new chasmosaurines from the Kirtland Formation (~75.0-73.4 Ma), New Mexico, form morphological and stratigraphic intermediates between Pentaceratops (~74.7-75 Ma, Fruitland Formation, New Mexico) and Anchiceratops (~72-71 Ma, Horseshoe Canyon Formation, Alberta). The new specimens exhibit gradual enclosure of the parietal embayment that characterizes Pentaceratops, providing support for the phylogenetic hypothesis that Pentaceratops and Anchiceratops are closely related. This stepwise change of morphologic characters observed in chasmosaurine taxa that do not overlap stratigraphically is supportive of evolution by anagenesis. Recently published hypotheses that place Pentaceratops and Anchiceratops into separate clades are not supported. This phylogenetic relationship demonstrates unrestricted movement of large-bodied taxa between hitherto purported northern and southern provinces in the late Campanian, weakening support for the hypothesis of extreme faunal provincialism in the Late Cretaceous Western Interior.

Wise up: Clarifying the role of metacognition in the Dunning-Kruger effect.

The Dunning-Kruger effect (DKE) is the finding that, across a wide range of tasks, poor performers greatly overestimate their ability, whereas top performers make more accurate self-assessments. The original account of the DKE involves the idea that metacognitive insight requires the same skills as task performance, so that unskilled people perform poorly and lack insight. However, global measures of self-assessment are prone to statistical and other biases that could explain the same pattern. We used psychophysical methods to examine metacognitive insight in simple movement and spatial memory tasks: pointing at a dot or recalling its position after a delay. We measured task skill in an initial block, and self-assessment in a second block, in which participants judged after every trial whether they had hit the target or not. Metacognitive calibration and sensitivity were related to task skill, but a path analysis showed that their net contribution to the DKE was weak. The major driver of the DKE was the level of task performance. In a second study, we again measured task skill in an initial block, but titrated task difficulty in the second block so that all participants performed at equivalent levels of success. Metacognitive measures were again related to task skill, but the DKE pattern was eliminated. We present a simple model of these findings, showing that metacognitive differences can contribute to the DKE but are neither necessary nor sufficient for it. This analysis clarifies and quantifies how metacognitive insight and other factors interact to determine this famous effect. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Over- and underestimation of motor ability after a stroke: Implications for anosognosia.

We administered a discrepancy-based measure of anosognosia for hemiplegia (AHP) to a group of 42 right-brain-damaged (RBD) and left-brain-damaged (LBD) stroke patients with varying levels of functional motor ability. In addition to the expected (anosognosic) pattern of overestimation of motor function in some RBD patients, we found an equal and opposite underestimation in some others, both RBD and LBD. We also found that around a quarter of self-estimation error could be predicted directly from actual ability, such that patients with poorer motor function tended to overestimate, and vice versa. This pattern suggests that some misestimation is attributable simply to statistical regression. However, even after adjusting for this regression effect, levels of overestimation were significantly greater in RBD patients, while LBD patients were more likely to underestimate their motor ability.

A New Brachylophosaurin Hadrosaur (Dinosauria: Ornithischia) with an Intermediate Nasal Crest from the Campanian Judith River Formation of Northcentral Montana.

BACKGROUND: Brachylophosaurini is a clade of hadrosaurine dinosaurs currently known from the Campanian (Late Cretaceous) of North America. Its members include: Acristavus gagslarsoni, which lacks a nasal crest; Brachylophosaurus canadensis, which possesses a flat paddle-shaped nasal crest projecting posteriorly over the dorsal skull roof; and Maiasaura peeblesorum, which possesses a dorsally-projecting nasofrontal crest. Acristavus, from the lower Two Medicine Formation of Montana (~81-80 Ma), is hypothesized to be the ancestral member of the clade. Brachylophosaurus specimens are from the middle Oldman Formation of Alberta and equivalent beds in the Judith River Formation of Montana; the upper Oldman Formation is dated 77.8 Ma. METHODOLOGY/PRINCIPAL FINDINGS: A new brachylophosaurin hadrosaur, Probrachylophosaurus bergei (gen. et sp. nov.) is described and phylogenetically analyzed based on the skull and postcranium of a large individual from the Judith River Formation of northcentral Montana (79.8-79.5 Ma); the horizon is equivalent to the lower Oldman Formation of Alberta. Cranial morphology of Probrachylophosaurus, most notably the nasal crest, is intermediate between Acristavus and Brachylophosaurus. In Brachylophosaurus, the nasal crest lengthens and flattens ontogenetically, covering the supratemporal fenestrae in large adults. The smaller nasal crest of Probrachylophosaurus is strongly triangular in cross section and only minimally overhangs the supratemporal fenestrae, similar to an ontogenetically earlier stage of Brachylophosaurus. Sutural fusion and tibial osteohistology reveal that the holotype of Probrachylophosaurus was relatively more mature than a similarly large Brachylophosaurus specimen; thus, Probrachylophosaurus is not simply an immature Brachylophosaurus. CONCLUSIONS/SIGNIFICANCE: The small triangular posteriorly oriented nasal crest of Probrachylophosaurus is proposed to represent a transitional nasal morphology between that of a non-crested ancestor such as Acristavus and the large flat posteriorly oriented nasal crest of adult Brachylophosaurus. Because Probrachylophosaurus is stratigraphically and morphologically intermediate between these taxa, Probrachylophosaurus is hypothesized to be an intermediate member of the Acristavus-Brachylophosaurus evolutionary lineage.

Health professionals are unaware of anosognosia.

"Implicit awareness" may be inferred from compliance with medical treatment, even when the patient explicitly denies the need for treatment. Such compliance may cause medics and other health professionals to underestimate the frequency of anosognosia and its effects on the lives of patients and carers. We report survey data showing that health professionals do indeed consider anosognosia following stroke to be relatively uncommon and unimportant, in contrast with evidence on its true frequency and impact. Mograbi and Morris' emphasis on the distinction between implicit and explicit awareness may promote increased recognition of anosognosia amongst health professionals.

Neurologic findings in infants with deformational plagiocephaly.

This study evaluates the neurologic profiles of infants with deformational plagiocephaly. Forty-nine infants with deformational plagiocephaly between the ages of 4 and 13 months (mean age, 8.1 months) are evaluated, along with 50 age-matched control subjects (mean age, 8.1 months). A modified version of the Hammersmith infant neurologic assessment was performed on each infant. A caregiver completed a questionnaire regarding the infant's prematurity, development, and health to date. Results are analyzed using t test. There is a statistically significant difference in overall neurologic assessment scores of infants with deformational plagiocephaly vs their healthy peers (P = .002). This difference is predominately in tone, whereby infants with deformational plagiocephaly have significantly more abnormal tone than nonplagiocephalic infants (P = .003). This abnormality is not one of decreased tone but one of variable tone, deflecting abnormally high and low tone. Infants with deformational plagiocephaly are more likely to have altered tone but not exclusively decreased tone.