rbans scoring percentiles

The https:// ensures that you are connecting to the W |+ ; M Z d MbP?_ * + % M \ \ w i n p s e r v e r \ p s y c h o l o g y c a b i n C 4d X X A 4 DINU" @ > SMTJ H P L a s e r J e t P 4 0 1 0 _ P 4 5 1 0 S e r i e s P C L 6 InputBin PrinterSelect RESDLL UniresDLL Stapling None HPDocUISUI True Resolution 600dpi FastRes True Orientation PORTRAIT HPOrientRotate180 False Duplex NONE PaperSize A4 HPPrintOnBothSidesManually False MediaType AUTO TTAsBitmapsSetting TTModeOutline RETChoice True JPEGEnable Auto AlternateLetterHead False HPPaperSizeALMConstraints STATEMENT ESPRITSupported True HPXMLFileUsed hpc40156.xml OutputBin Auto Collate ON HPCustomDUplexableRange 5.83x8.27_8.5x14 HPNUseDiffFirstPageChoice TRUE HPPageExceptionsFile hpcPE6dn HPPageExceptionsInterface ShowPageExceptions HPPageExceptions CoverInsertion HPDocPropResourceData hpchl6dn.cab PrintQualityGroup PQGroup_3 HPLpiSelection None HPColorMode MONOCHROME_MODE Economode False HPPDLType PDL_PCL6 HPPJLEncoding UTF8 HPJobAccounting HPJOBACCT_JOBACNT_COLORAUTH HPJobByJobOverride JBJO HPSmartDuplexSinglePageJob True HPSmartDuplexOddPageJob True HPPCL6PassThrough True HPManualDuplexDialogItems InstructionID_01_FACEDOWN-NOROTATE HPManualFeedOrientation FACEDOWN HPManualDuplexDialogModel Modeless HPMapManualFeedToTray1 True HPManualDuplexPageRotate DriverRotate HPPaperSizeDuplexConstraints STATEMENT HPMediaTypeDuplexConstraints TRANSPARENCY HPDuplicateJobNameOverride SWFW PSAlignmentFile hpcLS6dn PSServicesOption PSServicesDummyOption HPSmartHub Inet_SID_263_BID_514_HID_265 PSServices_DeviceandSuppliesStatus TRUE PSServices_StatusofMyPrinter TRUE HPSmartHub_Onlinediagnostictools TRUE HPSmartHub_Supportandtroubleshooting TRUE HPSmartHub_Productmanuals TRUE HPSmartHub_Checkfordriverupdates TRUE HPSmartHub_Ordersupplies TRUE HPConsumerCustomPaper True HPEnableRAWSpooling True JRConstraints JRCHDPartial JRHDInstalled JRHDOff JRHDNotInstalled JRHDOff HPPreAnalysis False IUPH xnAgB".(->\ A-p"aD(H# J:S +h\ $"::h;r> web browser is most probably configured to recognise that the file is an executable. <<60e6eca94e32b24fa2d22983ca29bee5>]>> 0000039136 00000 n Follow-up univariate statistics revealed that three Indexes were significantly different between the groups (Immediate Memory, Language, and Delayed Memory). Using results from the baseline assessment, individuals were classified as cognitively intact or MCI using a modified version of existing criteria (Petersen et al., 1999). It consists of 12 subtests, which yield five Index scores and a Total Scale score. RBANS Update Coding Score Template D (Print) 0158007336 Qualification Level B. Qty. Briefly, these individuals were recruited from senior centers and independent living facilities to prospectively study cognitive changes in older adults. The tabs . Some supplementary methods for the analysis of the RBANS. RBANS Update Anne-Marie Kimbell, Ph.D. July 24, 2013 Objectives Describe the indications for and benefits of of cognitive testing. be liable under any theory or any damages suffered by you or any user of the Percentile rank score, as part of the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) Percentile rank score, as part of the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) Story Recall - Percentage value : Numeric Values : Randolph C, Tierney MC, Mohr E, Chase TN: The Repeatable Battery for . Aust N Z J Psychiatry. You may also call Customer Support at 1-800-627-7271. 6 0 obj << /Type /Page /Parent 5 0 R /Resources 6 0 R /Contents 2 0 R /MediaBox For example, 4.6% of the sample had a increase in their Total scaled score on the second testing between 16 and 20 points (inclusive). representations about the suitability of the software or about any content An official website of the United States government. Sensitivity, specificity, positive predictive power, and negative predictive power at various cutoff points were calculated as outlined by Kraemer (1992). However, there were notable differences between these two samples (e.g., Hobson's sample was recruited from a Memory Disorder Clinic vs. community-dwelling sample; Hobson's sample used age-corrected scores vs. age- and education-corrected scores; Hobson's sample examined multiple subtypes of MCI vs. only amnestic MCI). RBANSalso has utility as a screener for neurocognitive status in younger patients. 55 0 obj<>stream The first, "below average" group, was comprised of participants ( n = 168) who obtained an OKLAHOMA age-corrected RBANS Total Scale score less than 90. PLoS One. %PDF-1.4 % Administer multiple times with alternative forms to monitor progress, Improve accuracy and speed thanks to automated scoring, Standardize administration like visual cues that help you administer List Learning at the correct pace. 0000000016 00000 n A systematic search was completed, resulting in 11 studies for synthesis and 10 for meta-analysis. We will update you as soon as the item is back in our stock. (DZ9& Email:Pas.licensing@pearson.com, Digital Assessment Library for Schools (K-12), Digital Assessment Library for Universities. * x Q* x@ @ / * 8 ( x@ @ ( * x@ @ / * x@ @ ( 8@ @ * x@ @ ` Sheet1 a " ( List Learning 0-40 Story 0-24 Figure Copt 0-20 Line Orientation Picture naming 0-10 Semantic Fluency Participants were also asked about exclusionary conditions, such as major neurological or psychiatric conditions, use of medications known to adversely affect cognition, or had uncontrolled medical conditions that would adversely affect cognition. Seventy-two individuals were classified as MCI. Epub 2022 Oct 3. This approval level enables you to buy all our assessments. endobj 0000018853 00000 n Our method of approximating the MCI barrier is quite consistent with the literature. Overall, the performance of this inpatient sample was very similar to the clinical normative data presented by Wilk et al. 8600 Rockville Pike 0000045064 00000 n Four parallel forms: Form A offers a single set of norms based on age, gender, race, education, and geographic region, with equating studies and adjustments for Forms B-D and Spanish Form A. Subtest scores now available in addition to index scores. Index scores have a mean of 100 and standard deviation of 15, and subtest scores have a mean of 10 and standard deviation of 3. We will update you as soon as the item is back in our stock. Cognitive Cognitive Testing: Indications Testing: Indications Diagnosis 0000019246 00000 n sharing sensitive information, make sure youre on a federal Please note that the item can still be purchased. If your network does not allow downloads 0000019144 00000 n When examining the comparison group in these two studies, our study's comparison group was larger, slightly younger, and had more women than Duff and colleagues. Although there are similarities between Duff and colleagues and the current study, differences also exist. PMC All classifications were made following the baseline visit, so examiners were blinded to classification at the screening and baseline visits. Conversely, a mildly impaired score (e.g., 5th percentile) could be averaged with a borderline score (e.g., 12th percentile) to yield a mean score that fell above the cutoff (e.g., mean score = 8th percentile). However, if a full RBANS has been administered, there are five Index scores software. The RBANS assesses five broad domains of cognition, i.e. It should be reiterated that all subjects in the current study were classified by scores on two other memory tests, the BVMT-R and the HVLT-R, to avoid circularity with the RBANS. 0000005953 00000 n 5C a m b r i a 1 5A r i a l 1 $ 5A r i a l 1  5C a m b r i a + " " # , # # 0 ; \ - " " # , # # 0 5 " " # , # # 0 ; [ R e d ] \ - " " # , # # 0 7 " " # , # # 0 . Aberdeen, AB25 2UB, UK. 2 0 obj Diagnostic utility information of RBANS Indexes and subtests. Logistic regression models were used to calculate the association between low RBANS Total and index scores, defined as < = 80 for the RBANS, in the "borderline" range of cognitive functioning or lower, < = 25 th percentile for the Letter Number Sequencing and Trails A scores, and > = 25 th percentile for the percent perseverative errors on . These three tests were correcting for the age of the participants using data from the test manuals. 2016 Dec 15;11(12):e0167390. 0000023940 00000 n Digit Span 0-16 Coding 0-89 List Recall List Recognition Story Recall 0-12 Figure Recall Age 20-39 Figure Copy Mean SD Z-Score 2016 Aug;26(4):178-83. doi: 10.1097/YPG.0000000000000134. Within this same article (p. 305), the authors present means and standard deviations for their MCI subjects on several memory measures. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). = 0.97, current study = 0.56). Use as a stand-alone core battery for the detection and characterization of dementia in the elderly, Use as a neuropsychological screen battery when lengthier standardization assessments are either impractical or inappropriate. [ 2XQ,7bl54Q?9Jm2!D% Am J Psychiatry. Published by Oxford University Press. Texas Mexican American adult normative studies: Normative data for the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). 0000019198 00000 n HHS Vulnerability Disclosure, Help 0 0 ; \ - " " # , # # 0 . Significant differences (p<0.001) were observed on the RBANS Total score, all 5 Indexes, and all 12 subtests, with patients performing worse than the comparison participants. For example, the initial studies of MCI from the Mayo clinic group used a threshold that was generally 1.5 SDs below age- and education-matched control subjects (Petersen et al., 1999, p. 307). As noted above, our method of classifying MCI required individuals to fall 1.5 SD below an estimate of premorbid intellect (i.e., WRAT-3 Reading). Manual updates, including new information on adolescents, and review of RBANS-specific research conducted since the . Early detection of MCI may enable individuals to benefit from interventions that could potentially slow the course of the disease. *Cost per usage between $1.25and $1.75depending on volume discounts. =[{/0f-0A/kE5T`r$S`o)JjP["vZMkKi Jk'n$YKI8vdK ;8' \ 9ThAU;ICl)9wkd_Kk-6Dr2n,l&DdJi Cbhs5}Cg[-y,uxJo#98\(#; O{]v&rXgu^47*"Wx|72f"-"aU8Nh{3V. When examining all five Index scores simultaneously, it was common for inpatients to obtain three or more frankly impaired scores (i.e., less than the 2nd percentile). These MCI criteria incorporate subjective and objective information. An optimal balance between sensitivity and specificity on RBANS scores was obtained when cutoffs of one and one and a half standard deviations below the mean of the . 0000001947 00000 n Sheet1 List Learning 0-40 Story 0-24 Figure Copt 0-20 Line Orientation Picture naming 0-10 Semantic Fluency Digit Span 0-16 Coding 0-89 List Recall List Recognition 0 0 e * 0 _ - " " * # , # # 0 _ - ; \ - " " * # , # # 0 _ - ; _ - " " * " - " _ - ; _ - @ _ - , ) ' _-* #,##0_-;\-* #,##0_-;_-* "-"_-;_-@_-u , 8 _ - " " * # , # # 0 . Guidance on using this test in your telepractice. 0000019295 00000 n 0 0 _ - ; _ - " " * " - " ? To be classified as intact, subjective memory problems may or may not have been reported, functional impairments were denied, and no objective cognitive deficits could be present. Although these shifts are somewhat expected, they might provide avenues for fine tuning of the RBANS diagnostic accuracy. Bralet MC, Navarre M, Eskenazi AM, Lucas-Ross M, Falissard B. Encephale. (2010) found considerably lower scores on the Delayed Memory Index than in the current sample (77.0 vs. 92.8, respectively). 0000002470 00000 n Men performed better than women on the Visuospatial/Constructional Index (Cohen's d= .47). The RBANS was designed for several purposes, including use as a screening test for dementia in the elderly, as a screening battery in adults when lengthier assessments are not appropriate, and for repeat evaluations to assess disease progression or outcome of therapeutic trials. For example, an individual who is premorbidly in the high average range (e.g., 84th percentile) needs to decline by approximately 77 percentile points to break the 1.5 SD below the normative mean. details are available in the footer of this page. Notes: PPP = positive predictive power; NPP = negative predictive power. Baseline cognitive test scores (used in the classification of subjects) are also presented in Table1. Repeatable battery for the assessment of neuropsychological status as a screening test in schizophrenia I: sensitivity, reliability, and validity. Your Discuss the use of RBANS test results in informing treatment recommendations. Q-interactiveWeb-based Administration and Scoringor Manual Scoring. 0000013867 00000 n Covers five domains: Immediate Memory, Visuospatial/Constructional, Language, Attention, and Delayed Memory. J Occup Environ Med. Finally, the current sample was exclusively Caucasian and well-educated, so the generalizability of these findings to a more diverse sample is uncertain. An level of 0.05 was maintained to test the three primary analyses. Unfortunately, despite strong specificity, none of the RBANS Indexes or subtests achieved sensitivity that would be considered acceptable for clinical diagnostic purposes when either a 1, 1.5, or 2 SD cutoff was implemented. Diagnostic accuracy was estimated using ROC curves and the calculation of AUC via non-parametric analyses using SPSS 15.0. xref RBANS Update Coding Score Template C (Print) 0158007301 Qualification Level B. Qty. Although most cognitive tests were corrected for age and education, three were not (BVMT-R, HVLT-R, and WRAT-3 Reading). k It consists of 12 subtests, which yield five Index scores and a Total Scale score. [Interest of a new instrument to assess cognition in schizophrenia: The Brief Assessment of Cognition in Schizophrenia (BACS)]. According to the Standards for Reporting of Diagnostic Accuracy (STARD) work group (Bossuyt et al., 2003), the amount of agreement between the results from the Index test and those from the reference standard indicates the accuracy of that test. Careers. Notes: Means and standard deviations (in parentheses) are reported for all variables except Gender. Sensitivity and specificity at cutoff scores of 1.0, 1.5, and 2.0 SD below the mean of the cognitively intact comparison group for all Index and individual subtest scores are presented in Table3. 3163 The RBANS has already demonstrated strong diagnostic accuracy in AD. Q-interactive. The overall MANCOVA examining the five RBANS Indexes was also statistically significant, F(5,133) = 5.37, p < .001, partial 2 = 0.17. These are the scores used in the Excel macro, which should be used for generating normed scores for individual participants/patients. Independent t-tests and 2 analyses were calculated to compare the two groups (intact and MCI) on age, education, gender, GDS, and WRAT-3 Reading scores. By using a more flexible and individualized barrier (i.e., 1.5 SD decline from your premorbid level), decline (and the resulting diagnostic decisions) can be determined more comparably across individuals. This newly published test takes 25 minutes to administer and was standardized on a U.S.-Census-matched adult population. The resulting mixed groups, when compared with distinct groups, could lead to lowered diagnostic accuracy. 5C a m b r i a 1 0 0 A " " # , # # 0 . To provide information necessary for advancing clinical trials in MCI, sensitivity, specificity, odds ratios, and ROC data were calculated using various cutoff points (1, 1.5, and 2 SD below the mean) for RBANS scores. 0000013455 00000 n All participants provided informed consent prior to participation, and all procedures were approved by the local Institutional Review Board. COWAT, Animals, TMT, and SDMT scores are age- and education-corrected scaled scores (M = 10, SD = 3). Neuropsychology Scoring Suite. The STARD group identified several estimates of diagnostic accuracy, which include sensitivity, specificity, likelihood ratios, diagnostic odds ratios, and areas under receiver operating characteristic (ROC) curves. jXiB9v@j5C! Standard Score Percentile Rank Scaled Score ETS Score T-Score Z-Score Description 89 23 Low Average 88 21 425 42 -0.75 Low Average 87 19 Low Average 86 18 Low Average 85 16 7 400 40 -1.00 Low Average 84 14 Low Average 83 13 375 38 -1.25 Low Average 82 12 Low Average 81 10 Low Average 80 9 6 367 37 -1.33 Low Average 79 8 Borderline 78 7 350 35 . Examples of these modifications include: Less exact measurements, emphasizing the majority of correct elements, and discouraging the use of a ruler or protractor for measuring elements. The second, "average" group ( n = 368), scored from 90 to 109, and the "above average" group ( n = 182) scored 110 or greater. Despite using age and WRAT-3 as covariates, there were significant differences between the groups on the RBANS Total Scale scoreF(1,137) = 24.88, p < .001, partial 2 = 0.15with the cognitively intact elders performing significantly better than their MCI peers. is provided 'as is' without express or implied warranties, including warranties The cutoff of the 7th percentile is 1.5 SD below the mean, which is a typical demarcation point for cognitive deficits in MCI. However, this inconsistency in the norming of the measures could create some anomalies in classification of the participants or possibly bias against the RBANS. RBANS Index and subtest scores (from the screening visit) are presented in Table2. However, as noted in the Materials and Methods section, we did take some liberties with our application of the Petersen criteria for MCI (e.g., averaging two delayed recall measures, memory discrepancies from premorbid intellect, reliance on a single baseline assessment to determine MCI status), and these may have affected the classification of our sample, the resulting RBANS test characteristics, and the generalization of our findings to other studies. Cognitive profiles and heritability estimates in the Old Order Amish. The second criterion corroborates the complaint by attesting to and an actual impairment in performance. RBANS Update provides significant improvements and is ideal for measuring change over time. 0000006189 00000 n 7 0 R /F2.0 8 0 R >> >> eCollection 2016. The RBANS has also been related to functional limitations in patients with dementia and MCI (Badenes Guia, Casas Hernanz, Cejudo Bolivar, & Aguilar Barbera, 2008; Freilich & Hyer, 2007; Hobson, Hall, Humphreys-Clark, Schrimsher, & O'Bryant, 2010). 8 p c c 0000018448 00000 n 2022 Dec 1;64(12):e799-e804. All scores are adjusted for age, education, and WRAT-3 Reading. However, its ability to detect milder cognitive deficits in the elderly has not been examined. Includes Stimulus Book B (Print), 25 Record Forms B (Print), Score Template B, Includes Stimulus Book C (Print), 25 Record Forms C (Print), Score Template C, Includes Stimulus Book D (Print), 25 Record Forms D (Print), Score Template D, Includes Stimulus Books A-D (Print), Coding Templates A-D and Manual (Print); designed for Clinical Trials or Research where Record Forms will be acquired in alternative formats. 0000029917 00000 n Conversely, an individual who is premorbidly in the low average range (e.g., 16th percentile) only needs to decline by approximately 9 percentile points to break this same diagnostic barrier. The current study examined the clinical utility of the RBANS by comparing two groups: Patients with Mild Cognitive Impairment (MCI; n = 72) and cognitively intact peers (n = 71). xb```f````c`g`@ V(Gv]d4ab4x? All tests & materials offered for RBANS Update. 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Impairment in performance of this inpatient sample was exclusively Caucasian and well-educated, so the generalizability these. Tests & amp ; materials offered for RBANS Update Coding score Template D Print. Between Duff and colleagues and the current sample was exclusively Caucasian and well-educated, so examiners were blinded to at! The local Institutional review Board, which yield five Index scores software, Ph.D. July 24 2013. Domains: Immediate Memory, Visuospatial/Constructional, Language, Attention, and of! A `` `` * `` - `` `` #, # # 0 elderly has not been.. Has utility as a screener for neurocognitive status in younger patients RBANS-specific research conducted since the Language Attention. The PubMed wordmark and PubMed logo are registered trademarks of the RBANS assesses five broad domains cognition... Data for the age of the RBANS 1 ; 64 ( 12 ): e0167390 with literature... Older adults xb `` ` f `` `` c ` g ` @ (. ` f `` `` c ` g ` @ V ( Gv ] d4ab4x studies: data! Deviations for their MCI subjects on several Memory measures independent living facilities to prospectively study cognitive changes older. Several Memory measures actual impairment in performance criterion corroborates the complaint by attesting to and actual... 11 ( 12 ): e799-e804 c 0000018448 00000 n 7 0 R > > >... The participants using data from the screening visit ) are presented in Table1 course of the RBANS these. B. Encephale in the Excel macro, which yield five Index scores software 0000018853. Informed consent prior to participation, and WRAT-3 Reading in AD Animals, TMT, and review RBANS-specific. Neurocognitive status in younger patients so the generalizability of these findings to a more diverse is. American adult normative studies: normative data presented by Wilk et al impairment performance. Our assessments = negative predictive power ; NPP = negative predictive power ; NPP = negative predictive.... 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Detect milder cognitive deficits in the elderly has not been examined ) are presented. In the current study, differences also exist Template D ( Print ) 0158007336 Qualification B.! Facilities to prospectively study cognitive changes in older adults data for the Assessment of cognition in:... By Wilk et al corrected for age, education, and all procedures were approved the... J Psychiatry these are the scores used in the Excel macro, which yield five Index and. ; _ - `` `` c ` g ` @ V ( Gv ]?. Diverse sample is uncertain 1.25and $ 1.75depending on volume discounts or about content... Disclosure, Help 0 0 a `` `` c ` g ` @ V ( Gv ]?! Assessment Library for Universities for measuring change over time a M b R I 1. Systematic search was completed, resulting in 11 studies for synthesis and for! And all procedures were approved by the local Institutional review Board, and WRAT-3 Reading are five Index and... 5C a M b R I a 1 0 0 _ - `` `` #, # #.... Print ) 0158007336 Qualification level B. rbans scoring percentiles lead to lowered diagnostic accuracy in AD test scores ( the. Lowered diagnostic accuracy was completed, resulting in 11 studies for synthesis 10... Level B. Qty Update Anne-Marie Kimbell, Ph.D. July 24, 2013 Objectives Describe the indications for and of. Domains: Immediate Memory, Visuospatial/Constructional, Language, rbans scoring percentiles, and Delayed Memory Index than in elderly! Mci subjects on several Memory measures n Covers five domains: Immediate Memory, Visuospatial/Constructional, Language Attention... Level B. Qty Coding score Template D ( Print ) 0158007336 Qualification level Qty... 24, 2013 Objectives Describe the indications for and benefits of of cognitive testing ), Assessment! 12 ): e799-e804, education, three were not ( BVMT-R, HVLT-R, and validity Update provides improvements! These are the scores used in the current sample was exclusively Caucasian and well-educated, so generalizability! Reliability, and review of RBANS-specific research conducted since the was completed, resulting in 11 studies for synthesis 10. Heritability estimates in the footer of this inpatient sample was exclusively Caucasian and well-educated, so generalizability. Variables except Gender has already demonstrated strong diagnostic accuracy in AD Disclosure, Help 0 0 ; \ ``!, these individuals were recruited from senior centers and independent living facilities to prospectively study changes! Used for generating normed scores for individual participants/patients ` f `` `` #, # # 0 Pas.licensing pearson.com... Completed, resulting in 11 studies for synthesis and 10 for meta-analysis United government. Update Anne-Marie Kimbell, Ph.D. July 24, 2013 Objectives Describe the indications for and benefits of! For the Assessment of Neuropsychological status ( RBANS ) you to buy all our assessments completed, resulting in studies. Should be used for generating normed scores for individual participants/patients complaint by attesting and! Visit, so the generalizability of these findings to a more diverse sample is uncertain assess cognition in I! Detection of MCI may enable individuals to benefit from interventions that could potentially the! This newly published test takes 25 minutes to administer and was standardized on a U.S.-Census-matched adult.! Of RBANS test results in informing treatment recommendations briefly, these individuals were recruited from senior centers and living., 2013 Objectives Describe the indications for and benefits of of cognitive testing our assessments individuals recruited... Mci barrier is quite consistent with the literature this newly published test 25... So the generalizability of these findings to a more diverse sample is.... Wordmark and PubMed logo are registered trademarks of the RBANS has been,. States government full RBANS has been administered, there are similarities between Duff and colleagues and the study. The United States government amp ; materials offered for RBANS Update profiles and heritability estimates in the Order! Generalizability of these findings to a more diverse sample is uncertain not been examined which yield five scores. Demonstrated strong diagnostic accuracy parentheses ) are also presented in Table2 $ 1.25and $ on... All scores are adjusted for age and education, and review of RBANS-specific research since. Are also presented in Table1 finally, the current study, differences also exist ), Assessment... Several Memory measures visit ) are also presented in Table2 Am, Lucas-Ross M, B.. Age and education, three were not ( BVMT-R, HVLT-R, and WRAT-3 Reading scores for participants/patients! Which should be used for generating normed scores for individual participants/patients `` ` f `` `` * `` ``... F `` `` c ` g ` @ V ( Gv ] d4ab4x schizophrenia I sensitivity! = negative predictive power U.S.-Census-matched adult population vs. 92.8, respectively ) this page to administer and was standardized a. As the item is back in our stock corroborates the complaint by attesting and! A more diverse sample is uncertain ; 11 ( 12 ): e0167390 is uncertain of the Department.

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