Antithesis of Human Rater: Psychometric Responding to Shifts Competency Test Assessment Using Automation (AES System)

This research is part of proof tests to a combination of statistical processing methods, collecting assessment rubrics in vocational education by comparing two systems, automated essay scoring and human rater. It aims to analyze the final assessment score of essays in Akademi Komunitas Negeri (AKN) Pacitan (Pacitan’s State Community College) and Akademi Komunitas Negeri (AKN) Blitar (Blitar’s State Community College) in East Java, Indonesia. The provisional assumption is that the results show an antithesis to the assessment of human feedback with an automated system due to the conversion of scores between the rubric and the algorithm design. As the hypothesis, algorithm-based score conversion affects automated essay scoring and human rater methods, which led to antithesis feedback. The validity and reliability of the measurement maintain the scoring consistency between the two methods and the accuracy of the answers. The novelty of this article is comparing between AES system and Human Rater using statistical methods. The research shows that there is a similar result using the psychometrics approach, which indicates different metaphor expressions and language systems. Thus, the objective of this study is to provide assistance in the advancement of an information technology system that utilizes a scoring mechanism merging computer and human evaluations, employing a psychological approach known as psychometric leads

White Matter Microstructural Correlates of Cognitive and Motor Functioning Revealed via Multimodal Multivariate Analysis

Recent advances in cognitive neuroscience emphasise the importance of healthy white matter (WM) in optimal behavioural functioning. It is now widely accepted that brain connectivity via WM contributes to the emergence of behaviour. However, the association between the microstructure of these fibre and behaviour is poorly understood. This is due to indirect and overlapping methods of assessing microstructure, and the oversimplification approaches in assessing behaviour. Here, we used the Mahalanobis Distance (D2) to integrate 10 metrics of WM derived from multimodal neuroimaging that have strong ties to microstructure. The D2 was chosen because it measures the voxelwise distance between every subject and the average, while also accounting for the overlap between the metrics. To examine WM-behaviour associations, we used multivariate regression to examine the voxelwise correlates of 2 cognitive and 2 motor tasks, which allowed us to compare within and across domains in white matter. We observed that behaviour is organised in cognitive, motor, and integrative variables that are widespread in their associations with WM, from frontal to parietal regions. Our results highlight the complex nature of microstructure and behaviour, and show the need for multivariate modelling when examining brain-behaviour associations

Stroke of the Visual Cortex

Stroke is the leading cause of homonymous visual field defect (VFD), resulting from irreversible damage of the post-chiasmatic visual pathway. From 6 to 13% of ischaemic strokes affect the supply area of the posterior cerebral artery, including the visual cortex in the occipital lobe. Besides ischaemic injury, the visual cortex can be damaged by intracerebral haemorrhage (ICH), 10% of which reside in the occipital lobe. Since occipital stroke almost always disturbs vision but can leave motor and language functions untouched, it may remain unrecognised in the acute phase, withholding the patients from receiving recanalisation treatments. Moreover, only up to 25% of stroke-related VFD recover spontaneously, whereas the rest continue to hinder patients’ independence in daily living and quality of life. Despite rigorous efforts, no evidence-based rehabilitation method to restore vision after stroke has been established. The aim of this thesis was to study the recognition, clinical characteristics, rehabilitation, neural mechanisms, and outcome of occipital stroke patients with VFD. The retrospective part of the thesis consists of two cohorts. The first cohort comprised 245 occipital ischaemic stroke patients admitted to the neurological emergency department of Helsinki University Hospital due to visual symptoms in 2010‒2015. We investigated their prehospital recognition and diagnostic delays and analysed the obstacles in their access to acute stroke treatment. The second retrospective cohort was the Helsinki ICH Study registry of 1013 consecutive non-traumatic ICH patients treated at Helsinki University Hospital in 2005‒2010, among whom we searched for isolated occipital ICH patients and analysed their clinical characteristics, aetiology, outcome, and incidence of post-stroke epilepsy in comparison to ICHs of other location. The prospective part of the thesis was based on the multicentre, randomised, sham-controlled exploratory REVIS (Restoration of Vision after Stroke) trial that studied rehabilitation of persistent VFD after chronic occipital stroke with different methods of non-invasive electrical brain stimulation. Altogether 56 patients were included in three 10-day experiments in three centres. The centres examined: 1) repetitive transorbital alternating current stimulation (rtACS) vs transcranial direct current stimulation preceding rtACS (tDCS/rtACS) vs sham in Germany, 2) rtACS vs sham in Finland, and 3) tDCS vs sham in Italy. In a functional magnetic resonance imaging spin-off study, resting-state functional connectivity of occipital stroke patients receiving rtACS or sham was compared to healthy control subjects at baseline and to each other after intervention. We found out that the prehospital delay of occipital stroke patients ranged between 20 minutes and 5 weeks and only 20% were admitted within the 4.5-hour time window of intravenous thrombolysis. Consequently, only 6.5% received thrombolysis, which is the mainstay of acute stroke treatment. One fourth of the patients arrived through at least two points of care and as many were assessed by an ophthalmologist before entering the neurological care, even though acute stroke patients should be transported directly to the neurological emergency department. The diagnostic delay was primarily caused by the patients’ late contact to health care but was also attributed to poor recognition and misdiagnosis by health-care professionals. The incidence of isolated occipital ICH was 1.9% of all non-traumatic ICHs and 5.3% of lobar ICHs. The patients with occipital ICH were younger and had more often vascular malformations as an aetiology of the bleeding than the non-occipital lobar ICH patients. They presented with milder symptoms and longer delay, and over 60% of the patients suffered solely from visual focal symptom. The haematoma volume in the occipital lobe was smaller and grew less compared to the non-occipital lobar haemorrhages. All in all, the occipital location of ICH was independently associated with favourable outcome at discharge among the patients with lobar ICH. The majority of the occipital ICH patients were able to return to independent activities of daily living, including driving a car and working, within a follow-up of a year. However, post-stroke epilepsy was as frequent as after non-occipital lobar ICH. In the prospective REVIS trial, rtACS was mostly ineffective in vision rehabilitation according to behavioural vision tests. Neither did it affect resting-state functional connectivity in comparison to sham. Transcranial DCS alone increased the monocular visual field measured with standard automated perimetry. The combined tDCS/rtACS propelled some improvements in the secondary visual outcome measures but did not differ from the sham stimulation. All the stimulation modalities were tolerated well. The functional connectivity of the chronic occipital stroke patients with VFD did not differ from the healthy control subjects when the whole brain network was considered in the analyses. However, a few occipital regions close to the infarct expressed lower local connectivity to the highly connected regions of the network according to the network graph metrics, whereas a lateral occipital region in the damaged hemisphere had higher network connectivity. These findings support the view that chronic ischaemic damage of the visual cortex affects functional connectivity within the visual network but leaves global connectivity unchanged. In conclusion, occipital stroke patients are insufficiently recognised, and thus the awareness of visual stroke symptoms should be raised especially among the public but also among health-care professionals to provide the patients with timely acute treatment and to prevent permanent disability. Occipital ICH patients have relatively favourable outcomes, but a structural cause of bleeding should be searched. Non-invasive electrical brain stimulation with the examined modalities does not cause robust improvement in vision or functional connectivity of the brain networks after a 10-day treatment, but further experiments with tDCS-based methods, potentially in combination with vision training, may be worth pursuing.Ihmisen näköaivokuori sijaitsee pääosin takaraivolohkossa ja sen vaurio johtaa tyypillisesti molempien silmien toispuoleiseen näkökenttäpuutokseen. Yleisin syy vaurioon on aivoverenkiertohäiriö: joko aivovaltimon tukoksesta johtuva infarkti tai verisuonen repeämästä aiheutuva aivoverenvuoto. Näkökenttäpuutos alentaa toiminta-, työ- ja ajokykyä ja heikentää elämänlaatua. Alle neljäsosa näkökenttäpuutoksista paranee täysin, eikä niiden kuntouttamiseksi ole kliiniseen käyttöön vakiintunutta menetelmää. Väitöskirjatyössä tutkittiin näköaivokuoren aivoverenkiertohäiriöiden tunnistamista, kliinistä kuvaa, kuntoutusta ja ennustetta. Tutkimuksessa selvisi, että ainoastaan 20,8 % HUS:in neurologian päivystyksessä vuosina 2010–2015 hoidetuista, näköoirein ilmenneen takaraivolohkon infarktin saaneista potilaista tuli hoitoon liuotushoidon mahdollistavassa aikaikkunassa ja vain 6,5 % sai liuotuksen. Viiveen yleisin syy oli potilaiden hidas hakeutuminen hoitoon, mutta kolmasosassa tapauksista myöskään terveydenhuoltohenkilökunta ei aluksi tunnistanut oireiden johtuvan aivoverenkiertohäiriöstä. Takaraivolohkoon rajautuvia aivoverenvuotoja esiintyi 1,9 %:lla HUS:issa 2005–2010 hoidetusta 1013 aivoverenvuotopotilaasta. Potilaat olivat nuorempia ja lieväoireisempia kuin muut vuotopotilaat, ja heidän vuotonsa johtuivat useammin verisuoniepämuodostumista. Vuodon sijainti takaraivolohkossa ennusti parempaa toimintakykyä sairaalasta kotiutuessa, ja suurin osa potilaista toipui vuoden sisällä päivittäistoiminnoissa itsenäisiksi. Epilepsian ilmaantuvuus ei eronnut pitkäaikaisseurannassa muista aivoverenvuotopotilaista. Satunnaistetussa, lumekontrolloidussa REVIS-monikeskustutkimuksessa selvitettiin kajoamattomien, heikkoa sähkövirtaa hyödyntävien stimulaatiomenetelmien tehoa takaraivolohkon aivoinfarktin aiheuttaman kroonisen näkökenttäpuutoksen kuntoutuksessa. Hoitokokeessa tasavirtastimulaatio (tDCS) pienensi vaurion vastapuoleisen silmän näkökenttäpuutosta verrattuna lumehoitoon, kun taas vaihtovirtastimulaatio (rtACS) oli tehotonta. Myöskään näiden yhdistelmällä (tDCS/rtACS) tulokset eivät eronneet lumeesta. Lisäksi toiminnallisella magneettikuvauksella tutkittiin 16 takaraivolohkon aivoinfarktipotilaan lepohermoverkostojen toiminnallista kytkeytyvyyttä verrattuna terveisiin koehenkilöihin. Tutkimus paljasti paikallisia muutoksia kytkeytyvyydessä potilaiden näköinformaation käsittelyyn osallistuvilla aivoalueilla, mutta laajemmin verkostojen toiminta ei eronnut verrokeista. Vaihtovirtastimulaatio ei muuttanut toiminnallista kytkeytyvyyttä

Variabilität funktionell definierter gesichtssensitiver Hirnregionen und Einfluss von DIRAS2 auf die neuronalen Korrelate emotionaler Wahrnehmung – Zwei fMRT-Untersuchungen an Erwachsenen mit und ohne Aufmerksamkeitsdefizit-Hyperaktivitätsstörung

Diese Dissertationsschrift berichtet über zwei wissenschaftliche Studien, welche einen Beitrag zur fMRT-Forschung auf zwei Ebenen leisten sollen – die erste in der Grundlagenforschung an Gesunden mit einer genaueren Untersuchung zum „Face Localizer“ (wörtlich „Gesichts-Orter“), einem Paradigma zur Eingrenzung gesichtssensitiver Hirnregionen, welches gewöhnlich „nur“ als Hilfsexperiment dient; die zweite in der Grundlagenforschung zur Emotionswahrnehmung und den Auswirkungen eines Risiko-Einzelnukleotidpolymorphismus (SNP, „single nucleotide polymorphism“) an erwachsenen Patienten mit Aufmerksamkeitsdefizit-/Hyperaktivitätsstörung (ADHS) unter Verwendung unter anderem des in der ersten Studie genauer untersuchten „Face Localizers“. Hierbei wurde insbesondere (1) die intraindividuelle Variabilität und zeitliche Stabilität der verschiedenen gesichtssensitiven Regionen bis zur Eignung für "fMRI-fingerprinting" und (2) Auswirkungen von Diagnose und Genotyp auf die Fähigkeit, Emotionen aus Sprachmelodie und Mimik zu erkennen, sowie auf die Gehirnaktivität hierbei, untersucht. Es zeigten sich die rechte fusiforme und die rechte okzipitale Gesichtsregionen für fingerprinting geeignet, während der posteriore superiore temporale Sulcus zeitlich instabile Aktivierung aufwies. Es zeigten sich weiterhin erwachsene ADHS-Patienten in Erkennung von Emotionen beeinträchtigt, unabhängig vom Genotyp, und umgekehrt veränderte Aktivierung in Thalamus und temporaler Stimmregion bei Risikoallelträgern von rs1412005 in DIRAS2, besonders bei von ADHS Betroffenen