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To compare the rate of development of buttock claudication in patients undergoing aortoiliac aneurysm repair with and without exclusion of antegrade hypogastric arterial flow. In the absence of convincing data, questions remain regarding the best management of hypogastric arterial (HA) flow to prevent the theoretical risk of buttock claudication.The Veterans' Affairs Open Versus Endovascular Repair (OVER) Cooperative Study prospectively collected information on buttock claudication. Trial participants were specifically prompted both pre- and postoperatively to report the development of claudication symptoms at several anatomic levels. Of note, trial investigators were specifically trained to occlude the trunk HA preserving the anterior and posterior divisions. Bayesian survival models were created to evaluate time to development of left, right or bilateral buttock claudication according to the presence/absence of antegrade hypogastric perfusion.881 patients from the OVER trial with information regarding status of hypogastric flow were included in the analysis. 788 patients maintained bilateral antegrade hypogastric arterial perfusion, 63 had right hypogastric coverage/occlusion, 27 had left hypogastric coverage/occlusion while 3 patients had bilateral hypogastric coverage/occlusion. Just under 5% (n=41) of all patients developed buttock claudication. After adjustment for smoking, COPD, medications, study arm, preoperative activity level, BMI, age and diabetes, intervention-related changes to hypogastric perfusion had no effect on time to development of buttock claudication. A Maximum A Posteriori Kullback- Leibler misfit chi-square was 14.45 with 24 degrees of freedom resulting in a goodness of fit p-value of p=0.94, indicative of a good fit.OVER is the largest aneurysm treatment study to prospectively collect data related to the development of claudication as well as hypogastric preservation status. Despite this, we were unable to find evidence to support the assertion that preservation of antegrade hypogastric flow decreases the rate of development of buttock claudication symptoms. The low rate of development of buttock claudication overall and in the subgroups is striking.

The present study explores how Black and White youth respond to measures of subjective well-being within the context of critical race theory (CRT). Three levels of measurement invariance (i.e., configural, metric and scalar) were examined for indicators of subjective well-being. We hypothesized that there would be limited measurement invariance across groups based on the premise established by CRT that youth of color experience and perceive life differently than their White peers, which was supported. The findings of this study demonstrate that the measures work as expected within groups, but there is a considerable lack of invariance across groups. This study also provides some evidence that racial/ethnic differences cannot be taken for granted when assessing SWB in youth.

Multiple scoring systems (including rank and score functions; MSS) have been widely used in multiple regression, intelligent biometric systems, multiple artificial neural nets, combining pattern classifiers, ensemble methods, machine learning and artificial intelligence (AI), data and information fusion, preference ranking, and deep learning. Combining MSS has achieved numerous successful results in a variety of domain applications. However, the reasons why this happens remains an active area of investigation. Combinatorial fusion analysis (CFA) combines MSS using the rank-score characteristic (RSC) function and cognitive diversity (CD). The RSC function was proposed to characterise the predictive behaviour of a scoring system. It was subsequently used to define the notion of “cognitive diversity”, which measures the dissimilarity in the representation of information between two scoring systems. In this article, we first examine characterizations of and diversity between scoring systems. Then, we review combinatorial fusion analysis with a variety of domain applications, including biometric systems in cognitive neuroscience, and joint decision making with visual cognitive systems. Finally, we demonstrate that multi-layer combinatorial fusion (MCF) on the Kemeny rank space is a viable machine learning and AI framework for preference ranking and reinforcement learning. This work provides a scientific foundation and technological insights for the use of Combinatorial Fusion in ensemble methods, data and information fusion, preference ranking, and deep reinforcement learning with applications to a variety of domains in data science and informatics for secure and sustainable societies.

Background and ObjectivesCerebrovascular disease (CBVD) is frequently comorbid with autopsy-confirmed Alzheimer disease (AD), but its contribution to the clinical presentation of AD remains unclear. We leveraged the National Alzheimer's Coordinating Center (NACC) uniform and neuropathology datasets to compare the cognitive and functional trajectories of AD+/CBVD+ and AD+/CBVD− brain donors.MethodsThe sample included NACC brain donors with autopsy-confirmed AD (Braak stage ≥3,Consortium to Establish a Registry for Alzheimer's Diseasescore ≥2) and complete Uniform Data Set (UDS) evaluations between 2005 and 2019, with the most recent UDS evaluation within 2 years of autopsy. CBVD was defined as moderate to severe arteriosclerosis or atherosclerosis. We used propensity score weighting to isolate the effects of comorbid AD and CBVD. This method improved the balance of covariates between the AD+/CBVD+ and AD+/CBVD− groups. Longitudinal mixed-effects models were assessed with robust bayesian estimation. UDS neuropsychological test and the Clinical Dementia Rating Scale Sum of Boxes (CDR-SB) scores were primary outcomes.ResultsOf 2,423 brain donors, 1,476 were classified as AD+/CBVD+. Compared with AD+/CVBD− donors, the AD+/CBVD+ group had accelerated decline (i.e., group × time effects) on measures of processing speed (β = −0.93, 95% CI −1.35, −0.51, Bayes factor [BF] 130.75), working memory (β = 0.05, 95% CI 0.02, 0.07, BF 3.59), verbal fluency (β = 0.10, 95% CI 0.04, 0.15, BF 1.28), naming (β = 0.09, 95% CI 0.03, 0.16, BF = 0.69), and CDR-SB (β = −0.08, 95% CI −0.12, −0.05, BF 18.11). Effects ranged from weak (BFs DiscussionIn brain donors with autopsy-confirmed AD, comorbid CBVD was associated with an accelerated functional and cognitive decline, particularly on neuropsychological tests of attention, psychomotor speed, and working memory. CBVD magnified effects of AD neuropathology on semantic-related neuropsychological tasks. Findings support a prominent additive and more subtle synergistic effect for comorbid CBVD neuropathology in AD.

Introduction: Misophonia is marked by abnormal negative reactions to specific and idiosyncratic sounds. Despite unclear etiology and diagnostic conceptualization, neuropsychology may be abl...

Introduction: Published reports suggest negative effect of exclusion of antegrade hypogastric artery flow on erectile function after endovascular aneurysm repair (EVR). This has stimulated new branched device development and off-label and open surgical hybrid procedures, trying to maintain antegrade pelvic perfusion in EVR patients. However, proof is lacking that such efforts have positive influence on clinical outcomes with respect to erectile function. Hypothesis: We hypothesized that, when analyzed 60 months postoperatively, there would be no difference in patient-reported erectile function outcomes when compared between patients with and without maintenance of bilateral antegrade pelvic perfusion following EVR. Methods: OVER trial patients were all male and had erectile function assessed at multiple time points by administration of the IIEF-5 questionnaire. Bayesian hierarchical regression models were created with the outcome variable (erectile function) treated as a latent variable. Primary effects of differences in erectile function between groups with and without preservation of bilateral antegrade hypogastric flow were compared. In addition to visual inspection of the posterior predictive distribution, model convergence was assessed by maximum Gelman-Rubin statistic Results: 252 men from the EVR arm of the OVER trial were included in the analysis. Of these, 202 underwent a repair which maintained bilateral antegrade pelvic flow while 50 did not preserve both hypogastrics. After adjustment for baseline score, age, beta blocker use, ejection fraction, preoperative ABIs and time, loss of bilateral antegrade hypogastric perfusion was not associated with a significant difference in IIEF score compared to maintenance of antegrade perfusion (score change: -0.065; 95% CI: -0.239, 0.109). Conclusions: This is the largest aneurysm treatment trial to prospectively collect data on erectile function. There is no evidence that decreased erectile function is mitigated by preservation of antegrade hypogastric flow. Additional radiation exposure and resource utilization for this purpose may be unnecessary.

The newly launched Research Domain Criteria (RDoC) emphasize specific mechanisms over diagnostic categories of psychopathology. In our view, RDoC provides a useful heuristic for mental health disorders, but does not capture the complexity of psychological data when proposed mechanisms are viewed as static entities. However, temporal and complex system dynamics may advance RDoC's utility. By investigating temporal patterns within trajectories and the interaction of complex networks, we propose that dynamic modeling provides comprehensive methods with which to investigate the etiopathology and maintenance of mental health disorders. We examine applications of dynamical systems to periphery physiology, an RDoC construct that has been widely used in psychological science. A review of the literature suggests methodological problems with aggregate and reductive models. We present a dynamical systems modeling of anxiety which suggests avenues for future biomarker research. This model appears congruent with RDoC and recent learning theory.