Analyzing and Comparing Univariate, Multivariate, and Bifactor Generalizability Theory Designs for Hierarchically Structured Personality Traits.

We demonstrate how to use structural equation models to represent generalizability theory-based univariate, multivariate, and bifactor model designs. Analyses encompassed multi-occasion data obtained from the recently expanded form of the Big Five Inventory (BFI-2) that measures the broad personality domain constructs Agreeableness, Conscientiousness, Extraversion, Negative Emotionality, and Open-Mindedness along with three nested subdomain facets within each global domain. Results overall highlighted the importance of taking both item and occasion effects into account but underscored additional benefits of the multivariate and bifactor designs in providing more appropriate indices of generalizability for composite scores and effective ways to gauge subscale added value. Bifactor models further extended partitioning of universe score variance to separate general and group factor effects at both composite and subscale levels, expanded score consistency indices to distinguish or combine such effects, and allowed for further evaluation of score dimensionality and subscale viability. We provide guidelines, formulas, and code in R for analyzing all illustrated designs within the article and extended online Supplemental Material.

Applying multivariate generalizability theory to psychological assessments.

Multivariate generalizability theory (GT) represents a comprehensive framework for quantifying score consistency, separating multiple sources contributing to measurement error, correcting correlation coefficients for such error, assessing subscale viability, and determining the best ways to change measurement procedures at different levels of score aggregation. Despite such desirable attributes, multivariate GT has rarely been applied when measuring psychological constructs and far less often than univariate techniques that are subsumed within that framework. Our purpose in this tutorial is to describe multivariate GT in a simple way and illustrate how it expands and complements univariate procedures. We begin with a review of univariate GT designs and illustrate how such designs serve as subcomponents of corresponding multivariate designs. Our empirical examples focus primarily on subscale and composite scores for objectively scored measures, but guidelines are provided for applying the same techniques to subjectively scored performance and clinical assessments. We also compare multivariate GT indices of score consistency and measurement error to those obtained using alternative GT-based procedures and across different software packages for analyzing multivariate GT designs. Our online supplemental materials include instruction, code, and output for common multivariate GT designs analyzed using mGENOVA and the gtheory, glmmTMB, lavaan, and related packages in R. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Expanding bifactor models of psychological traits to account for multiple sources of measurement error.

Over the last decade, applications of bifactor modeling within clinical settings have increased markedly but typically rely on data collected on single occasions. A shortcoming of such research is that reliability coefficients are likely inflated because key sources of measurement error are inadequately modeled and/or confounded with construct variance. We address these problems using three variations of multi-occasion bifactor models with Bayesian-derived parameter estimates to separate systematic variance into general and group factor effects and measurement error into three subcomponents (transient, specific-factor, and random-response). Collectively, these models produce indices of reliability and validity aligned with both standard confirmatory factor models and generalizability designs that extend interpretations of results to the broader domains from which items and occasions are sampled. We demonstrate how these techniques can provide new insights into psychometric properties of scores using Negative Emotionality domain and facet scales from the newly updated Big Five Inventory (BFI-2; Soto & John, 2017). Overall, the two-occasion congeneric bifactor model provided the best fit to the data and most informative indices for revising measures, examining dimensionality of composite and subscale scores, and evaluating the viability of those scores. We include code in R for analyzing all models in our extended online Supplemental Material. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Surgical outcomes of early congenital cholesteatoma: minimally invasive transcanal approach.

OBJECTIVES/HYPOTHESIS: To introduce a simple and alternative surgical technique, minimally invasive transcanal myringotomy (MITM), for early stage congenital cholesteatoma in children and to evaluate the feasibility and results of MITM for management of early stage congenital cholesteatoma with respect to its effectiveness and safety. STUDY DESIGN: Retrospective review. METHODS: Between August 2008 and September 2012, a total of 36 patients with congenital cholesteatoma met the inclusion criteria and were analyzed. Patient medical records, including demographic characteristics, intraoperative findings, and follow-up records, were reviewed. RESULTS: Subjects consisted of 23 males (64%) and 13 females (36%), and the age at operation ranged from 12 months to 6 years (mean age = 3 years and 6 months). The number of congenital cholesteatoma was as follows: 26 patients at stage I and 10 patients at stage II. The follow-up duration was between 12 and 56 months, with an average of 30 months. There were no postoperative complications such as tympanic membrane perforation, dizziness, or secondary middle ear infection. Among 36 patients who had undergone the MITM approach for the treatment of congenital cholesteatoma, five (13.8%) showed recurrence and underwent a second-look operation. CONCLUSIONS: On the basis of our data, the MITM approach is a useful surgical technique for early stage congenital cholesteatoma in children. It has many advantages, in that there is no external wound and it is a simple surgical technique that involves easy postoperative care, a short operation time and hospitalization period, avoidance of serious complications, and easy repeatability for recurrence.

Voxel-wise analysis of diffusion tensor imaging for clinical outcome of cochlear implantation: retrospective study.

OBJECTIVES: To evaluate retrospectively, the possible difference in diffusion tensor imaging (DTI) metric of fractional anisotropy (FA) between good and poor surgical outcome cochlear implantation (CI) patients using investigator-independent voxel-wise analysis. METHODS: Eighteen patients (11 males, 7 females; mean age, 5.9 years) with profound sensorineural hearing loss underwent DTI scans using a 3.0 Tesla magnetic resonance scanner. Among the 18 patients, 10 patients with categories of auditory performance (CAP) score over 6 were classified into the good outcome group and 8 patients with CAP score below 6 were classified into the poor outcome group. The diffusion tensor scalar measure was calculated from the eigenvalues of the tensor on a voxel-by-voxel basis from each subject and two-sample t-test evaluation between good and poor outcome subjects were performed for each voxel of FA values, across the entire brain, with a voxel-wise intensity threshold of P<0.0005 (uncorrected) and a contiguous cluster size of 64 voxels. Individual values of FA were measured by using the region-of-interest based analysis for correlation analysis with CAP scores, open sentence and open word scores. RESULTS: Two-sample t-test evaluation using SPM voxel-wise analysis found significantly higher FA values at the several brain areas including Broca's area, genu of the corpus callosum, and auditory tract in good outcome subjects compared to poor outcome subjects. Correlation analyses between FA and CAP scores, open sentence and open word scores revealed strong correlations at medial geniculate nucleus, Broca's area, genu of the corpus callosum and auditory tract. CONCLUSION: Investigator-independent voxel-based analysis of DTI image demonstrated that good outcome subjects showed better neural integrity at brain areas associated with language and auditory functions, suggesting that the conservation of microstructural integrity of these brain areas is important. Preoperative functional imaging may be helpful for CI.

Construction of a DNA chip for screening of genetic hearing loss.

OBJECTIVES: Hearing loss is the most common sensory disorder in humans and genetic causes are estimated to cause more than 50% of all incidents of congenital hearing loss. To develop an efficient method for a genetic diagnosis of hearing loss, we have developed and validated a genetic hearing loss DNA chip that allows the simultaneous analysis of 7 different mutations in the GJB2, SLC26A4, and the mtDNA 12S rRNA genes in Koreans. METHODS: A genotyping microarray, based on the allele-specific primer extension (ASPE) method, was used and preliminary validation was examined from the five patients and five controls that were already known their genotypes by DNA sequencing analysis. RESULTS: The cutoff Genotyping index (GI) of genotyping for each mutation was set up and validated to discriminate among the genotypes. The result of the DNA chip assay was identical to those of previous results. CONCLUSION: We successfully designed the genetic hearing loss DNA chip for the first time in Korea and it would be useful for a clinical genetic diagnosis of hearing loss. Further consideration will be needed in order to examine the accuracy of this DNA chip with much larger patient sample numbers.

Endoscopic repairment of septal perforation with using a unilateral nasal mucosal flap.

OBJECTIVES: Nasal septal perforation is an anatomic defect of the cartilaginous and bone tissues of the nasal septum. Many approaches and techniques to repair nasal septal perforations have been reported on. The purpose of this paper is to report on our surgical technique and the results of the treatment for nasal septal perforations. METHODS: From May 2001 to March 2008, 14 patients (12 males and 2 females; mean age: 41.3 yr) were enrolled. The mean perforation size was 15 mm, and all the perforations were located at the cartilaginous portion. Our surgical technique is based on an endoscope-assisted endonasal approach, with dissection of unilateral advanced mucosal flaps with using a temporalis fascia graft. The follow-up periods ranged from 3 to 23 months (mean follow-up period: 8 months). RESULTS: Using our surgical technique on 14 patients, 12 cases (85.7%) of septal perforation were closed without complication. The remaining two patients (14.3%) had incomplete closures (about 2-3 mm) without any significant symptoms related to the remaining perforation. CONCLUSION: Our technique is a viable procedure with a high success rate for achieving closure of nasal septal perforations. It has the advantages of shortening the operative time, no external incision and avoiding any other perforation during the operation. Therefore, we consider it to be a good alternative for repairing nasal septal perforations.

The snake venom disintegrin salmosin induces apoptosis by disassembly of focal adhesions in bovine capillary endothelial cells.

Salmosin, a disintegrin purified from a Korean snake (Agkistrodon halys brevicaudus) venom, interacts with integrin alpha(v)beta(3) and inhibits the proliferation of bovine capillary endothelial (BCE) cells induced by basic fibroblast growth factor (bFGF). We investigated salmosin's mechanism of inhibition of BCE cell proliferation by examining changes in the cytoskeleton and activation of integrin-mediated signaling molecules. Salmosin disassembled cortical actins at focal adhesions and induced cells to be rounded and detached, but it did not alter microtubule structures in the early stage of cells being rounded. Immunolocalization of paxillin also demonstrated that focal adhesions were disassembled by salmosin. In salmosin-treated BCE cells, focal adhesion kinase (FAK) was dephosphorylated and expression of paxillin and p130(CAS) was decreased, but PI3 kinase, ILK, and beta-catenin were not expressed in decreased amounts or modified, suggesting that salmosin inactivated FAK-dependent integrin signaling pathways. While BCE cells proliferated normally on plates coated with salmosin, cells treated with salmosin eventually underwent apoptosis. These observations strongly suggest that salmosin disorganizes focal contacts to detach cells by competing with the extracellular matrix (ECM) for direct binding to integrin alpha(v)beta(3) on the cell surface, eventually leading to apoptosis.