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Obstetric complications (OCs) are associated with cognitive and brain abnormalities observed in patients with schizophrenia. Gyrification, a measure of cortical integrity sensitive to events occurring during the prenatal and perinatal periods, is also altered in first-episode psychosis (FEP). We examined the relationship between OCs and gyrification in FEP, as well as whether gyrification mediates the relationship between OCs and cognition.
Methods
We examined differences in the Local Gyrification Index (LGI) for the frontal, parietal, temporal, occipital, and cingulate cortices between 139 FEP patients and 125 healthy controls (HCs). Regression analyses explored whether OCs and diagnosis interact to explain LGI variation. Parametric mediation analyses were conducted to assess the effect of LGI on the relationship between OCs and cognition for FEP and HC.
Results
Significant LGI differences were observed between FEP patients and HC in the left parietal and bilateral cingulate and occipital cortices. There was a significant interaction between OCs and diagnosis on the left cingulate cortex (LCC) that was specific to males (p = 0.04) and was driven by gestational rather than intrauterine OCs.
In HCs, OCs had a direct effect on working memory (WM) (p = 0.048) in the mediation analysis, whereas in FEP, we observed no significant effect of OCs on either verbal or WM.
Conclusions
OCs interact with diagnosis to predict LCC gyrification, such that males with FEP exposed to OCs exhibit the lowest LGI. OCs influence WM, and LCC gyrification may mediate this relation only in HC, suggesting a differential neurodevelopmental process in psychosis.
At coastal archaeological sites, measuring erosion rates and assessing artifact loss are vital to understanding the timescale(s) and spatial magnitude of past and future site loss. We describe a straightforward low-tech methodology for documenting shoreline erosion developed by professionals and volunteers over seven years at Calusa Island Midden (8LL45), one of the few remaining sites with an Archaic component in the Pine Island Sound region of coastal Southwest Florida. We outline the evolution of the methodology since its launch in 2016 and describe issues encountered and solutions implemented. We also describe the use of the data to guide archaeological research and document the impacts of major storms at the site. The response to Hurricane Ian in 2022 is one example of how simply collected data can inform site management. This methodology can be implemented easily at other coastal sites at low cost and in collaboration with communities, volunteers, and heritage site managers.
The transformative impact of artificial intelligence (AI) across various sectors, with recent advancements, such as the release of the generative AI model GPT-4, raises critical legal and policy concerns. These concerns include important societal and potentially existential impacts: Threats to democracy, workforce displacement, copyright challenges, environmental effects, new and more lethal cybersecurity threat vectors, and the potential for AI advanced to become uncontrollable or be used for malicious purposes if it falls into the wrong hands. Human rights concerns are also implicated, including the potential for biased and discriminatory decision-making, unreasonable privacy impacts, inaccurate and unfair outcomes, and lack of transparency and due process. The unveiling of GPT-4 emphasizes the need for legislation to address these issues. The European Union (EU) has taken a global lead by enacting the Artificial Intelligence Act (AIA) to regulate AI development, placement, and use, and by proposing the AI Liability Directive (AILD), which aims to facilitate civil claims for damages arising from AI products and services. The AIA takes a comprehensive, risk-based approach to regulating AI across sectors. Significant differences had to be negotiated among the EU co-legislators to reach a consensus on the final text of the AIA, such as defining AI systems, regulating foundation models, determining bans on specific AI systems, and establishing redress rights for consumers and fundamental rights violations. The chapter explores the global context, the EU legislative approach, the key issues that had to be resolved, and the interaction of the AIA with other EU laws, particularly with the General Data Protection Regulation (GDPR).
The elections of Donald Trump and Jair Bolsonaro, as well as the strengthening of the radical right globally, brought back debates of the similarities and differences between populism and fascism. This volume argues that fascism and populism are similar in so far that they constructed the people as one; understood leadership as embodiment; and performed politics of the extraordinary. They are different because there is a consensus that fascism occurred at a particular historical moment, and what came after was postfascism. There is not such an agreement to restrict populism to a historical moment. These isms also differ in the use of violence to deal with enemies, and on how they constructed their legitimacy using elections or abolishing democracy. Whereas fascism destroyed democracy and replaced elections with plebiscitary acclamation, populists promise to give power back to the people. Yet when in power the logic of populism leads to democratic erosion.
One of the most relevant risk factors for suicide is the presence of previous attempts. The symptomatic profile of people who reattempt suicide deserves attention. Network analysis is a promising tool to study this field.
Objective
To analyze the symptomatic network of patients who have attempted suicide recently and compare networks of people with several attempts and people with just one at baseline.
Methods
1043 adult participants from the Spanish cohort “SURVIVE” were part of this study. Participants were classified into two groups: single attempt group (n = 390) and reattempt group (n = 653). Different network analyses were carried out to study the relationships between suicidal ideation, behavior, psychiatric symptoms, diagnoses, childhood trauma, and impulsivity. A general network and one for each subgroup were estimated.
Results
People with several suicide attempts at baseline scored significantly higher across all clinical scales. The symptomatic networks were equivalent in both groups of patients (p > .05). Although there were no overall differences between the networks, some nodes were more relevant according to group belonging.
Conclusions
People with a history of previous attempts have greater psychiatric symptom severity but the relationships between risk factors show the same structure when compared with the single attempt group. All risk factors deserve attention regardless of the number of attempts, but assessments can be adjusted to better monitor the occurrence of reattempts.
The Nasrid emirate of southern Iberia emanated power through architecture; this project aims to better understand how this was made possible, via an interdisciplinary exploration of the Alhambra monument and other Al-Andalus constructions. Initial results of archaeological campaigns, structure chronologies and communication plans undertaken in 2021 and 2022 are presented.
For classroom teaching and learning, classifying students’ skills into more than two categories (e.g., no, basic, and advanced masteries) is more instructionally relevant. Such classifications require polytomous attributes, for which most existing cognitive diagnosis models (CDMs) are inapplicable. This paper proposes the saturated polytomous cognitive diagnosis model (sp-CDM), a general model that subsumes existing CDMs for polytomous attributes as special cases. The generalization is shown by mathematically illustrating the relationships between the proposed and existing CDMs. Moreover, algorithms to estimate the proposed model is proposed. A simulation study is conducted to evaluate the parameter recovery of the sp-CDM using the proposed estimation algorithms, as well as to illustrate the consequences of improperly fitting constrained or unnecessarily complex polytomous-attribute CDMs. A real-data example involving polytomous attributes is presented to demonstrate the practical utility of the proposed model.
The present paper proposes a hierarchical, multi-unidimensional two-parameter logistic item response theory (2PL-MUIRT) model extended for a large number of groups. The proposed model was motivated by a large-scale integrative data analysis (IDA) study which combined data (N = 24,336) from 24 independent alcohol intervention studies. IDA projects face unique challenges that are different from those encountered in individual studies, such as the need to establish a common scoring metric across studies and to handle missingness in the pooled data. To address these challenges, we developed a Markov chain Monte Carlo (MCMC) algorithm for a hierarchical 2PL-MUIRT model for multiple groups in which not only were the item parameters and latent traits estimated, but the means and covariance structures for multiple dimensions were also estimated across different groups. Compared to a few existing MCMC algorithms for multidimensional IRT models that constrain the item parameters to facilitate estimation of the covariance matrix, we adapted an MCMC algorithm so that we could directly estimate the correlation matrix for the anchor group without any constraints on the item parameters. The feasibility of the MCMC algorithm and the validity of the basic calibration procedure were examined using a simulation study. Results showed that model parameters could be adequately recovered, and estimated latent trait scores closely approximated true latent trait scores. The algorithm was then applied to analyze real data (69 items across 20 studies for 22,608 participants). The posterior predictive model check showed that the model fit all items well, and the correlations between the MCMC scores and original scores were overall quite high. An additional simulation study demonstrated robustness of the MCMC procedures in the context of the high proportion of missingness in data. The Bayesian hierarchical IRT model using the MCMC algorithms developed in the current study has the potential to be widely implemented for IDA studies or multi-site studies, and can be further refined to meet more complicated needs in applied research.
A number of empirically based Q-matrix validation methods are available in the literature, all of which were developed for cognitive diagnosis models (CDMs) involving dichotomous attributes. However, in many applications, it is more instructionally relevant to classify students into more than two categories (e.g., no mastery, basic mastery, and advanced mastery). To extend the practical utility of CDMs, methods for validating the Q-matrix for CDMs that measure polytomous attributes are needed. This study focuses on validating the Q-matrix of the generalized deterministic input, noisy, “and” gate model for polytomous attributes (pG-DINA). The pGDI, an extension of the G-DINA model discrimination index, is proposed for polytomous attributes. The pGDI serves as the basis of a validation method that can be used not only to identify potential misspecified q-entries, but also to suggest more appropriate attribute-level specifications. The theoretical properties of the pGDI are underpinned by several mathematical proofs, whereas its practical viability is examined using simulation studies covering various conditions. The results show that the method can accurately identify misspecified q-entries and suggest the correct attribute-level specifications, particularly when high-quality items are involved. The pGDI is applied to a proportional reasoning test that measures several polytomous attributes.
The G-DINA (generalized deterministic inputs, noisy “and” gate) model is a generalization of the DINA model with more relaxed assumptions. In its saturated form, the G-DINA model is equivalent to other general models for cognitive diagnosis based on alternative link functions. When appropriate constraints are applied, several commonly used cognitive diagnosis models (CDMs) can be shown to be special cases of the general models. In addition to model formulation, the G-DINA model as a general CDM framework includes a component for item-by-item model estimation based on design and weight matrices, and a component for item-by-item model comparison based on the Wald test. The paper illustrates the estimation and application of the G-DINA model as a framework using real and simulated data. It concludes by discussing several potential implications of and relevant issues concerning the proposed framework.
Higher-order latent traits are proposed for specifying the joint distribution of binary attributes in models for cognitive diagnosis. This approach results in a parsimonious model for the joint distribution of a high-dimensional attribute vector that is natural in many situations when specific cognitive information is sought but a less informative item response model would be a reasonable alternative. This approach stems from viewing the attributes as the specific knowledge required for examination performance, and modeling these attributes as arising from a broadly-defined latent trait resembling the ϑ of item response models. In this way a relatively simple model for the joint distribution of the attributes results, which is based on a plausible model for the relationship between general aptitude and specific knowledge. Markov chain Monte Carlo algorithms for parameter estimation are given for selected response distributions, and simulation results are presented to examine the performance of the algorithm as well as the sensitivity of classification to model misspecification. An analysis of fraction subtraction data is provided as an example.
A number of parametric and nonparametric methods for estimating cognitive diagnosis models (CDMs) have been developed and applied in a wide range of contexts. However, in the literature, a wide chasm exists between these two families of methods, and their relationship to each other is not well understood. In this paper, we propose a unified estimation framework to bridge the divide between parametric and nonparametric methods in cognitive diagnosis to better understand their relationship. We also develop iterative joint estimation algorithms and establish consistency properties within the proposed framework. Lastly, we present comprehensive simulation results to compare different methods and provide practical recommendations on the appropriate use of the proposed framework in various CDM contexts.
This rejoinder responds to the commentary by Liu (Psychometrika, 2015) entitled “On the consistency of Q-matrix estimation: A commentary” on the paper “A general method of empirical Q-matrix validation” by de la Torre and Chiu (Psychometrika, 2015). It discusses and addresses three concerns raised in the commentary, namely the estimation accuracy when a provisional Q-matrix is used, the consistency of the Q-matrix estimator, and the computational efficiency of the proposed method.
In contrast to unidimensional item response models that postulate a single underlying proficiency, cognitive diagnosis models (CDMs) posit multiple, discrete skills or attributes, thus allowing CDMs to provide a finer-grained assessment of examinees’ test performance. A common component of CDMs for specifying the attributes required for each item is the Q-matrix. Although construction of Q-matrix is typically performed by domain experts, it nonetheless, to a large extent, remains a subjective process, and misspecifications in the Q-matrix, if left unchecked, can have important practical implications. To address this concern, this paper proposes a discrimination index that can be used with a wide class of CDM subsumed by the generalized deterministic input, noisy “and” gate model to empirically validate the Q-matrix specifications by identifying and replacing misspecified entries in the Q-matrix. The rationale for using the index as the basis for a proposed validation method is provided in the form of mathematical proofs to several relevant lemmas and a theorem. The feasibility of the proposed method was examined using simulated data generated under various conditions. The proposed method is illustrated using fraction subtraction data.
This paper studies three models for cognitive diagnosis, each illustrated with an application to fraction subtraction data. The objective of each of these models is to classify examinees according to their mastery of skills assumed to be required for fraction subtraction. We consider the DINA model, the NIDA model, and a new model that extends the DINA model to allow for multiple strategies of problem solving. For each of these models the joint distribution of the indicators of skill mastery is modeled using a single continuous higher-order latent trait, to explain the dependence in the mastery of distinct skills. This approach stems from viewing the skills as the specific states of knowledge required for exam performance, and viewing these skills as arising from a broadly defined latent trait resembling the θ of item response models. We discuss several techniques for comparing models and assessing goodness of fit. We then implement these methods using the fraction subtraction data with the aim of selecting the best of the three models for this application. We employ Markov chain Monte Carlo algorithms to fit the models, and we present simulation results to examine the performance of these algorithms.
Suicidal behavior constitutes a multi-cause phenomenon that may also be present in people without a mental disorder. This study aims to analyze suicidal behavior outcomes in a sample of attempters, from a symptom-based approach.
Methods
The sample comprised 673 patients (72% female; M = 40.9 years) who attended a hospital emergency department due to a suicide attempt. A wide range of clinical factors (e.g., psychopathology symptoms, psychiatric diagnoses, impulsivity, acquired capability), was administered within 15 days after the index attempt. Nine psychopathology domains were explored to identify the profile of symptoms, using latent profile analysis. The relationship between the profile membership and suicide outcome (i.e., intensity of suicidal ideation, number of suicide behaviors, and medical injury derived from index attempt) was also studied, using linear and logistic regression.
Results
Three psychopathology profiles were identified: high-symptom profile (45.02% of participants), moderate-symptom profile (42.50%), and low-symptom profile (12.48%). High-symptom profile members were more likely to show higher risk of non-suicidal self-injury, acquired capability for suicide, and more severe suicide behavior and ideation. On the other hand, a more severe physical injury was associated with low-symptom profile membership in comparison to membership from the other profiles (OR < 0.45, p < .05).
Conclusions
A symptom-based approach may be useful to monitor patients and determine the risk of attempt repetition in the future and potential medical injury, and to optimize prevention and intervention strategies.
People with severe mental illness (SMI) have worse physical health than the general population. There is evidence that support from volunteers can help the mental health of people with SMI, but little evidence regarding the support they can give for physical health.
Aims
To evaluate the feasibility of an intervention where volunteer ‘Health Champions’ support people with SMI in managing their physical health.
Method
A feasibility hybrid randomised controlled trial conducted in mental health teams with people with SMI. Volunteers delivered the Health Champions intervention. We collected data on the feasibility of delivering the intervention, and clinical and cost-effectiveness. Participants were randomised by a statistician independent of the research team, to either having a Health Champion or treatment as usual. Blinding was not done.
Results
We recruited 48 participants: 27 to the intervention group and 21 to the control group. Data were analysed for 34 participants. No changes were found in clinical effectiveness for either group. Implementation outcomes measures showed high acceptability, feasibility and appropriateness, but with low response rates. No adverse events were identified in either group. Interviews with participants found they identified changes they had made to their physical health. The cost of implementing the intervention was £312 per participant.
Conclusions
The Health Champion intervention was feasible to implement, but the implementation of the study measures was problematic. Participants found the intervention acceptable, feasible and appropriate, and it led them to make changes in their physical health. A larger trial is recommended, with tailored implementation outcome measures.