Meaningful Groups Research Articles

Beneficial effects of Silexan on sleep are mediated by its anxiolytic effect

Disturbed sleep is among the most prevalent hyperarousal symptoms in anxiety disorders. Most drugs recommended for anxiety and insomnia have a sedating effect which is related to their beneficial effect on disturbed sleep. Silexan is a proprietary essential oil from Lavandula angustifolia. This drug has significant anxiolytic and sleep improving properties. Interestingly, these effects are not associated with sedation. Here we asked whether the positive effects on sleep are due to primary pharmacodynamic or secondary, disease related effects. We used the data from a double-blind, randomized study in which 212 patients were analyzed for efficacy after ten weeks' treatment with 80 mg/day Silexan or placebo. Anxiety and disturbed sleep were assessed using the Hamilton Anxiety Scale (HAMA) and the Pittsburgh Sleep Quality Index (PSQI), respectively. Regression-based mediation analysis was employed to estimate direct treatment effects and indirect effects mediated by anxiety control separately for each study group. Sobel's test was used to investigate the extent to which the mediator (HAMA change) contributes to the total effect of the independent variable (treatment) on the dependent variable (PSQI change). Compared to placebo, Silexan significantly reduced the total scores of the HAMA (p < 0.001) and of the PSQI (p = 0.002) after ten weeks, with clinically meaningful treatment group differences that were observed already after two and six weeks for HAMA and PSQI, respectively. Silexan had a statistically meaningful indirect effect on sleep (mediated by the effect on anxiety; p < 0.001) but no appreciable direct effect (p = 0.958). The ratio between the indirect and the total effect was determined to be 0.984, i. e., 98.4% of the total effect of Silexan on disturbed sleep were explained by the effect of Silexan on the symptoms of anxiety whereas 1.6% were attributable to a direct effect. The results indicate that Silexan exerts a secondary sleep improving effect almost exclusively through its anxiolytic action rather than by sedation. Findings are consistent with the drug's assumed mechanism of action.

Essential Updates in Grading, Morphotyping, Reporting, and Staging of Prostate Carcinoma for General Surgical Pathologists.

Within this decade, several important updates in prostate cancer have been presented through expert international consensus conferences and influential publications of tumor classification and staging. To present key updates in prostate carcinoma. The study comprised a review of literature and our experience from routine and consultation practices. Grade groups, a compression of the Gleason system into clinically meaningful groups relevant in this era of active surveillance and multidisciplinary care management for prostate cancer, have been introduced. Refinements in the Gleason patterns notably result in the contemporarily defined Gleason score 6 cancers having a virtually indolent behavior. Grading of tertiary and minor higher-grade patterns in radical prostatectomy has been clarified. A new classification for prostatic neuroendocrine tumors has been promulgated, and intraductal, microcystic, and pleomorphic giant cell carcinomas have been officially recognized. Reporting the percentage of Gleason pattern 4 in Gleason score 7 cancers has been recommended, and data on the enhanced risk for worse prognosis of cribriform pattern are emerging. In reporting biopsies for active surveillance criteria-based protocols, we outline approaches in special situations, including variances in sampling or submission. The 8th American Joint Commission on Cancer TNM staging for prostate cancer has eliminated pT2 subcategorization and stresses the importance of nonanatomic factors in stage groupings and outcome prediction. As the clinical and pathology practices for prostate cancer continue to evolve, it is of utmost importance that surgical pathologists become fully aware of the new changes and challenges that impact their evaluation of prostatic specimens.

Molecular biology in pancreatic ductal adenocarcinoma: implications for future diagnostics and therapy

Novel technology has enabled researchers to better characterize pancreatic cancers at the molecular level. We wanted to explore some of the emerging discoveries, such as molecular subclassification, use of liquid biopsy and use of organoids in cancer assessment. A literature review with a search specific to the topic, with recent reviews in major journals and a focus on the last 5 years (until December 2018), was done. Pancreatic ductal adenocarcinoma (PDAC) may now be classified into clinical subgroups based on the predominant genomic profiles, but consensus on one classification system is lacking. Several subtypes have been suggested, including categories such as basal-like, stroma-activated, desmoplastic, pure classical and immune classical types. Further refinement may translate into clinically meaningful groups for therapeutic or prognostic purposes. Liquid biopsies (by means of circulating cancer cells, cell-free DNA, exosomes or other constituents of cancer cells in blood) may aid in earlier diagnosis, define prognostic groups and even predict therapy response and resistance. Organoids are increasingly used for the opportunity to investigate druggable and effective targets ex vivo and should facilitate personalized and precise, targeted therapy in the near future. While immunotherapy has not yet proved to be effective, a better understanding of molecular subgroups and specific immune profiles may help identify candidates for this approach in a more selective approach. Novel molecular techniques have the potential to accelerate the road to improved outcomes in patients with pancreatic cancer.

Somatic mutation detection and classification through probabilistic integration of clonal population information

Somatic mutations are a primary contributor to malignancy in human cells. Accurate detection of mutations is needed to define the clonal composition of tumours whereby clones may have distinct phenotypic properties. Although analysis of mutations over multiple tumour samples from the same patient has the potential to enhance identification of clones, few analytic methods exploit the correlation structure across samples. We posited that incorporating clonal information into joint analysis over multiple samples would improve mutation detection, particularly those with low prevalence. In this paper, we develop a new procedure called MuClone, for detection of mutations across multiple tumour samples of a patient from whole genome or exome sequencing data. In addition to mutation detection, MuClone classifies mutations into biologically meaningful groups and allows us to study clonal dynamics. We show that, on lung and ovarian cancer datasets, MuClone improves somatic mutation detection sensitivity over competing approaches without compromising specificity.

Social cure and social curse: Social identity resources and adjustment to acquired brain injury

AbstractThere is increasing evidence that identification with social groups can protect and enhance health, establishing a kind of ‘social cure’. However, for those affected by chronic or disabling conditions such as acquired brain injury (ABI), their identity may also represent a burden, a form of ‘social curse’. The present study explored the identity benefits and burdens available to 15 participants living with ABI using semi‐structured interviews. The qualitative data was then analysed systematically using thematic analysis. The findings highlight social identity changes as central to the experience of brain injury. Participants reported changes in their social networks and social group memberships after injury. Identity loss and reduced social support were described as disabling. Engagement in meaningful group activity with others affected by ABI and access to affected peers enabled new group‐based resources such as social support. In this way, group activity can be seen as a form of identity enactment that can drive social cure effects. Similarly, adaptation to life after injury was demonstrably linked to social identity processes pointing to the importance of a social cure approach to rehabilitation.

IoT\u2009+\u2009AR: pervasive and augmented environments for \u201cDigi-log\u201d shopping experience

The current bare Internet of Things (IoT) infrastructure has recently been extended to include smarter and more effective user interactions. Individual or meaningful sets and groups of IoT objects can be imbued with data and/or content in a distributed manner and efficiently utilized by the client. This distribution makes it possible to scale and customize interaction techniques such as augmented reality (AR). This paper proposes an architecture for combining the AR interface with IoT for an improved shopping experience. The proposed architecture is distributed and therefore scalable such that any IoT product can be accessed on the spot locally without any server restriction and provide intuitive AR-based visualization and interaction for a flexible product trial in the showroom. We identify three key architectural components required to support such a seamless and scalable AR service and experience for IoT-ready products: (1) object-centric data management and visualization, (2) mechanism for accessing, controlling, and interacting with the object, and (3) content exchange interoperability. We illustrate the possible scenarios of shopping in the future with the interactive and smart digital information combined with the analog, that is, the real world. A proof-of-concept implementation is presented as applied to such a “digital–analog” style of shopping. In addition, its usability is experimentally assessed as compared to using the conventional control interface. Our experimental study shows that the subjects clearly experience higher usability and greater satisfaction with AR-interactive shopping, thereby demonstrating the potential of the proposed approach.

Analysis of group time interaction: Focusing on age group three classroom

본 연구는 만 세 유아교사 명의 이야기 나누기에 대한 사례연구를 통하여 교사의 이야기나누기 인식과 그에 따른 교사 유아 상호작용 양상을 교사개시 질문 단계 유아응답 단계 교사 피드백 단계로 나누어 구체적으로 조사하는데 목적으로 두었다 연구 참여자는 서울 경기 지역 개 어린이집의 만 세 담임교사 명과 해당학급의 유아이다 연구는 주간 진행되었으며 자료수집은 수업 동영상과 면담자료 연구일지 등을 중심으로 이루어졌다 연구자료 분석은 와의 수업분석 준거를 바탕으로 교실 내 상호작용을 전사하여 질적 분석을 실행하고 상호작 용의 유형을 요약하기 위하여 보완적인 목적의 양적자료를 포함하였다 연구결과 참여 교사들의 이야기 나누기에 대한 인식은 이야기 들려주기 와 경험 구조화하기 두가지 유형으로 분류되었다 교사개시 질문단계에서 교사들의 발문 정도는 폐쇄형 질문하기 설명하기 가 나타났으며 개별 교사의 이야기 나누기 인식유형에 따라 차이가 있었다 이야기나누기에 참여한 유아의 반응을 분석한 결과 유아들은 대답 하기 단답형 단계적 확산 질문하기 소극적 반응 주의분산반응 의 반응유형을 나타내었다 연구 참여 교사들은 참여 유아들의 대답하기 반응과 주의분산 반응이 교사의 이야기 나누기 인식과 관련이 있음을 설명하였다 교사피드백 단계에서 피드백 중 수용하기 재질문하기 가 나타났으며 교사의 피드 백하기 를 구체적으로 살펴본 결과 사고를 확장하기 위한 칭찬이 아닌 제한적인 질문 방법을 활용하는 수준으로 나타났다 연구자는 본 사례연구를 통하여 누리과정에서 이루어지는 이야기나누기 수업의 양상을 살펴보는 기회를 가졌고 이야기 나누기를 통한 유아의 사고 확장을 위한 교사의 역량개발이 지속적으로 이루어질 필요가 있다는 점을 제시한다The purpose of this study was to investigate teacher’s perception of group time and their interaction between teacher and children during group time. The research participants included 6 daycare center teachers and 92 three year old children from Kyunggi Province and Seoul area. The researchers collected data from classroom teaching video recording, interview recording, and research journal, for 7 weeks. This study used qualitative research method, but also included quantitative data in order to summarize the diversity of interaction between teacher and children. The study result indicates that the participant teachers’ perception of group time included ‘story telling’ and ‘constructing experience.’ In the ‘Initiate’ stage, the participant teachers’ questions included ‘closed question’& ‘explanation’ and each teacher differed by the type of group time perception. In this study, the participant teachers used praise in a limited way, which failed to encourage children’s expanded thinking. In the “Response” stage, the participant children’s response included ‘answering’, ‘questioning’, ‘passive response’, and ‘distraction.’ The participant teachers explained that their attitude on group time influenced children’s response in specific ways. The “Feedback” stage included interaction of ‘feedback-accepting, requestion’ & direction by teacher. Based on this case study, the researchers suggest that educators need to redevelop the concept of a meaningful group time, and encourage children’s ability by developing teacher’s group time skills.

Social and psychological heterogeneity among binary transgender, non-binary transgender and cisgender individuals

ABSTRACTResearchers have identified important psychosocial distinctions between three emergent gender categories: cisgender, binary transgender and non-binary transgender. The present study further examines such heterogeneous experiences and explores the methodological implications for research of the transgender community. Participants were 153 cisgender, 201 binary transgender and 164 non-binary transgender American adults who completed questionnaires on the topics of life satisfaction, gender determinism and perceived social support. Results demonstrate that non-binary transgender participants report lower gender determinism than both cisgender and binary transgender participants. Furthermore, correlations between significant other support and life satisfaction were higher in cisgender participants than either binary or non-binary transgender participants, whereas the correlation between friend support and life satisfaction was higher in both cisgender and binary transgender participants than in non-binary transgender participants. These results threaten the methodological coherence of studying a unitary ‘transgender community’, and suggest that some meaningful group differences can be attributed to one of two dimensions of gender variance: cisgender versus transgender identity, or binary versus non-binary gender identity. Future survey research should further explore the methodology of assessing non-binary identity and transgender identity using separate items.

A Biological Signature for Breast Ductal Carcinoma In Situ to Predict Radiotherapy Benefit and Assess Recurrence Risk.

Ductal carcinoma in situ (DCIS) patients and their physicians currently face challenging treatment decisions with limited information about the individual's subsequent breast cancer risk or treatment benefit. The DCISionRT biological signature developed in this study provides recurrence risk and predicts radiotherapy (RT) benefit for DCIS patients following breast-conserving surgery (BCS). A biological signature that calculates an individualized Decision Score (DS) was developed and cross-validated in 526 DCIS patients treated with BCS ± RT. The relationship was assessed between DS and 10-year risk of invasive breast cancer (IBC) or any ipsilateral breast event (IBE), including IBC or DCIS. RT benefit was evaluated by risk group and as a function of DS. The DS was significantly associated with IBC and IBE risk, HR (per 5 units) of 4.2 and 3.1, respectively. For patients treated without RT, DS identified a Low Group with 10-year IBC risk of 4% (7% IBE) and an Elevated Risk Group with IBC risk of 15% (23% IBE). In analysis of DS and RT by group, the Elevated Risk Group received significant RT benefit, HR of 0.3 for IBC and IBE. In a clinicopathologically low-risk subset, DS reclassified 42% of patients into the Elevated Risk Group. In an interaction analysis of DS and RT, patients with elevated DS had significant RT benefit over baseline. The DS was prognostic for risk and predicted RT benefit for DCIS patients. DS identified a clinically meaningful low-risk group and a group with elevated 10-year risks that received substantial RT benefit over baseline.

A Comparison of Prognostic Indices in Diffuse Large B-Cell Lymphoma within the UK NCRI R-CHOP 14 Versus 21 Phase III Trial

A Comparison of Prognostic Indices in Diffuse Large B-Cell Lymphoma within the UK NCRI R-CHOP 14 Versus 21 Phase III Trial

DNA Methylation Subgroups in Juvenile Myelomonocytic Leukemia: An International Collaborative Analysis and Development of a Common Diagnostic Platform

Juvenile myelomonocytic leukemia (JMML) is a rare myeloproliferative neoplasm of early childhood characterized by Ras pathway mutations and aberrant DNA methylation. Despite allogeneic hematopoietic stem cell transplantation (HSCT) approx. 30% of patients (pts) succumb to resistant leukemia. Slowly regressing disease in the absence of HSCT is, however, noted in some pts. Mutational patterns and known clinical risk factors are insufficient to fully explain this heterogeneity. Three independent recent studies demonstrated the potential of DNA methylation profiling to identify clinically meaningful risk groups (Lipka et al., Nat Commun 2017; Stieglitz et al., Nat Commun 2017; Murakami et al., Blood 2018).The aim of this work was to establish an international consensus for the classification of JMML based on DNA methylation, to systematically describe the biological and clinical features of the subgroups identified and to develop a molecular classifier that enables the prospective assignment of DNA methylation categories.In a collaborative effort, we re-analyzed three well-annotated Illumina 450k methylation array data sets. In total, data from 292 pts with JMML or Noonan syndrome-associated myeloproliferative disorder (NS/MPD; EWOG-MDS, Europe: 147 pts, Nagoya, Japan: 106 pts, UCSF, USA: 39 pts) were available. Methylation data from 285 pts passed our quality control and were included in the present analysis. Of these, 256 (89.8%) pts had been diagnosed with JMML and 29 (10.2%) with NS/MPD. Mean age at diagnosis was 1.9 yrs. Levels of fetal hemoglobin (HbF) were available in 228/285 pts and elevated for age in 61%. Driver mutations affecting the Ras pathway were identified in 92% of JMML pts (PTPN11: 36%, NF1: 11%, NRAS: 15%, KRAS: 15%, CBL: 14%), and monosomy 7 in 14%. Initial exploratory analysis revealed batch effects that could, at least in part, be explained by the different ethnical backgrounds of the pts but also included a technical component. Therefore, we stringently filtered probes containing SNPs and performed batch correction using an empirical Bayes framework (Combat). CpG dinucleotides (CpGs) showing variable methylation across normal hematopoietic cell types were excluded from the analysis to avoid confounding with differential cell type composition between the samples.Unsupervised consensus clustering using the 5000 most variable CpGs identified three stable methylation clusters in this inter-group patient cohort. According to their DNA methylation levels, the clusters were designated “high methylation” (HM), “intermediate methylation” (IM) and “low methylation” (LM). Overall, 29.5%, 23.5%, and 47.0% of the cohort of JMML and NS/MPD pts were assigned to the HM, IM, and LM clusters, respectively. The methylation clusters showed a highly significant association with specific Ras-pathway mutations and with known clinical risk factors. All NS/MPD pts clustered with the LM subgroup and showed the lowest methylation levels. The HM cluster was enriched for somatic PTPN11 mutations, elevated HbF and older age, while the LM cluster was enriched for NRAS and CBL mutations, normal HbF and age <2yrs. KRAS mutations as well as monosomy 7 were significantly enriched in the IM cluster. Comparison of clusterassignments made in the present study to those from the original publications found only 3.9% (11/285) discordant cases.This encouraged us to establish a low-dimensional DNA methylation classifier for JMML that could be applied in a prospective setting. Therefore, we split the intergroup cohort randomly into a training (N=202) and a validation cohort (N=83) and trained an extreme gradient boosting machine (xgboost). When using as few as 10 CpGs, the resulting model predicted methylation clusters with 94% accuracy in the validation cohort.This inter-group meta-analysis is the single largest dataset of JMML patients to date and demonstrates the robustness of the JMML methylation signature across continents of origin and its power to identify biologically and clinically distinct JMML subgroups. Our ongoing efforts include developing a sequencing-based assay to predict DNA methylation clusters and to validate this assay using an independent cohort of 60 pts from the three participating research groups. This assay would allow for inclusion of DNA methylation as a biomarker into prospective clinical trials to assist in molecularly driven risk-stratification of JMML. DisclosuresNiemeyer:Celgene: Consultancy, Membership on an entity's Board of Directors or advisory committees.

Analysing technical choices: improving the archaeological classification of Late Republican Black Gloss pottery in north-eastern Hispania consumption centres

In order to improve archaeological classifications of Late Republican Black Gloss pottery, an assemblage from two consumption sites in north-eastern Hispania has been physicochemically characterized to identify its provenance and to gain an idea of its manufacture process. The study has been organized according to a multiphase sampling (Buxeda i Garrigos and Madrid i Fernandez 2016, 20). In the first phase, chemical characterization by means of wavelength-dispersive X-ray fluorescence (WDXRF) and mineralogical characterization by means of X-ray diffraction (XRD) were performed. In the next phase, a subsample was microstructurally characterized by means of scanning electron microscopy (SEM), thanks to which the sintering/vitrification stage of the matrix and the gloss was determined. The combination of both disciplines, archaeology and archaeometry, enables us to identify four meaningful ceramic groups: Campanian A, Cales 1, 2 and 3. The study also allowed us to infer that all of them must be related to the Campanian region and assignable to three different chronological periods. The Campanian region thus seems to have been the primary source that supplied the settlements considered. The study also allows us to appreciate that the classification criteria used by the archaeologists working at those sites reflect the technical choices made by the potters and that, in many cases, they can only be detected and therefore interpreted by means of archaeometry.

A functional description of adult picky eating using latent profile analysis

ObjectiveResearch has indicated that adult picky eating (PE) is associated with elevated psychosocial impairment and limited dietary variety and fruit and vegetable intake; however, research operationalizing PE behaviors is limited. Previous research identified a PE profile in children, marked by high food avoidance (satiety responsiveness, fussiness, and slow eating) and low food approach (food enjoyment and responsiveness) appetitive traits. The present study aimed to replicate a similar latent eating behavior profile in an adult sample.MethodsA sample of 1339 US adults recruited through Amazon’s MTurk completed an online survey that included a modified self-report version of the Child Eating Behavior Questionnaire (CEBQ-A). Latent profile analysis was employed to identify eating profiles using the CEBQ-A subscales, ANCOVAs were employed to examine profile differences on various self-report measures, and eating profiles were compared across BMI classifications.ResultsAnalyses converged on a four-profile solution, and a picky eater profile that closely resembled the past child profile emerged. Participants in the picky eater profile (18.1%) scored higher on measures of adult PE and social eating anxiety compared to all other profiles, scored higher on eating-related impairment and depression than moderate eating profiles, and were more likely to be of normal weight.DiscussionA distinct adult PE profile was observed, indicating childhood PE and appetitive behaviors may carry over into adulthood. Research identifying meaningful groups of picky eaters will help to shed light on the conditions under which picky eating is a risk factor for significant psychosocial impairment or distress, or weight-related problems.

Strategies for Pathway Analysis Using GWAS and WGS Data.

Single-allele study designs, commonly used in genome-wide association studies (GWAS) as well as the more recently developed whole genome sequencing (WGS) studies, are a standard approach for investigating the relationship of common variation within the human genome to a given phenotype of interest. However, single-allele association results published for many GWAS studies represent only the tip of the iceberg for the information that can be extracted from these datasets. The primary analysis strategy for GWAS entails association analysis in which only the single nucleotide polymorphisms (SNPs) with the strongest p-values are declared statistically significant due to issues arising from multiple testing and type I errors. Factors such as locus heterogeneity, epistasis, and multiple genes conferring small effects contribute to the complexity of the genetic models underlying phenotype expression. Thus, many biologically meaningful associations having lower effect sizes at individual genes are overlooked, making it difficult to separate true associations from a sea of false-positive associations. Organizing these individual SNPs into biologically meaningful groups to look at the overall effects of minor perturbations to genes and pathways is desirable. This pathway-based approach provides researchers with insight into the functional foundations of the phenotype being studied and allows testing of various genetic scenarios. © 2018 by John Wiley & Sons, Inc.

Errors in Translation: A Comparative Study of Noun Phrase in English and Malay Abstracts

Abstract as a summary of a dissertation harbours important information where it serves to attract readers to consider reading the entire passage or to abandon it. This study seeks to investigate the backward translation of abstracts made by 10 randomly selected postgraduate students. This research serves as a guideline for students in composing their abstracts as it aims to compare the differences in noun phrase structure written in Malay as translated from English. It also analyses the types of errors when English noun phrases are translated to Malay. Preliminary findings from this pilot study found that translation errors committed were mainly inaccurate word order, inaccurate translation, added translation, dropped translation and also structure change. For this study, an exploratory mode of semantic analysis is applied by looking at noun phrases, the meaningful group of words that form a major part of any sentence, with the noun as the head of the group. Syntax is inevitably interwoven in the analysis as the structure and grammatical aspects of the translations are also analysed. They are examined by comparing English texts to its corresponding translation in the Malay language. Particularly relevant in this study is the need to emphasize on the semantics and syntax skills of the students before a good transaltion work can be produced. Language practitioners can also tap on translation activities to improve the learners’ language competency.

Adapter et intégrer la méthodologie de recherche dans la formation des enseignants d’anglais langue seconde : les entretiens ethnographiques

This teaching note provides a brief introductory lesson plan for using ethnographic interviews in TESOL teacher education. In pairs, these educators prepare for and interview each other about a cultural aspect, tradition, experience, event (etc.) that the interviewer knows little or nothing about. This lesson plan is designed for a single seventy-five minute class period, but can easily be expanded into a larger project. By the end of the lesson, TESOL educators should better understand the concept of culture and cultural differences, as well as have a tangible example to understand how people form meaningful cultural groupings in all aspects of their lives.

Committee machine that votes for similarity between materials.

A method has been developed to measure the similarity between materials, focusing on specific physical properties. The information obtained can be utilized to understand the underlying mechanisms and support the prediction of the physical properties of materials. The method consists of three steps: variable evaluation based on nonlinear regression, regression-based clustering, and similarity measurement with a committee machine constructed from the clustering results. Three data sets of well characterized crystalline materials represented by critical atomic predicting variables are used as test beds. Herein, the focus is on the formation energy, lattice parameter and Curie temperature of the examined materials. Based on the information obtained on the similarities between the materials, a hierarchical clustering technique is applied to learn the cluster structures of the materials that facilitate interpretation of the mechanism, and an improvement in the regression models is introduced to predict the physical properties of the materials. The experiments show that rational and meaningful group structures can be obtained and that the prediction accuracy of the materials' physical properties can be significantly increased, confirming the rationality of the proposed similarity measure.

Ego-centered relative neighborhood deprivation and reported dietary habits among youth

Dietary habits are important precursors of childhood obesity. Youths' dietary habits may be constrained by the experience of deprivation due to social (e.g., family purchasing power) and physical (e.g., availability of fast food outlets in low-income neighborhoods) factors limiting dietary choices. This study considers whether a Yitzhaki-based index of ego-centered relative neighborhood deprivation explains dietary outcomes (i.e., reported healthful and unhealthful food consumption), adjusting for absolute deprivation. The Yitzhaki index takes into account the total incomes to which a youth is deprived in relation to a meaningful reference group, and the youth's position in the cumulative income distribution of this meaningful reference group. The study also considers whether the impact of deprivation on dietary outcomes is moderated by the experience of symptoms of depression. There was some indication that reported healthful food consumption was highest for youth who experienced low absolute deprivation (p ≤ 0.01) and low symptoms of depression (p ≤ 0.01), but high relative deprivation (p ≤ 0.001). These youth therefore appear to benefit from being both "better-off", and living among "better-off" individuals. The results for reported unhealthful food consumption were less robust. The results may therefore suggest that youth who are not detrimentally impacted by their relative deprivation, and who have the financial means to access healthful foods, have improved dietary outcomes. The findings suggest that while absolute deprivation plays a key role in explaining healthful food consumption, additional insights can be gleaned from considering youths' relative deprivation and indicators of their well-being.

Latent Class Analysis of Specialized Palliative Care Needs in Adult Intensive Care Units From a Single Academic Medical Center

ContextIn the intensive care unit (ICU), 14% of patients meet criteria for specialized palliative care, but whether subgroups of patients differ in their palliative care needs is unknown. ObjectivesThe objective of this study was to use latent class analysis to separate ICU patients into different classes of palliative care needs and determine if such classes differ in their palliative care resource requirements. MethodsWe conducted a retrospective cohort study of ICU patients who received specialized palliative care, August 2013 to August 2015. Reason(s) for consultation were extracted from the initial note and entered into a latent class analysis model to generate mutually exclusive patient classes. Differences in “high use” of palliative care (defined as having five or more palliative care visits) between classes were assessed using logistic regression, adjusting for age, race, Charlson Comorbidity Index, and length of stay. ResultsIn a sample of 689 patients, a four-class model provided the most meaningful groupings: 1) Pain and Symptom Management (n = 218, 31.6%), 2) Goals of Care and Advance Directives (GCAD) (n = 131, 19.0%), 3) All Needs (n = 112, 16.3%), and 4) Supportive Care (n = 228, 33.1%). In comparison to GCAD patients, all other classes were more likely to require “high use” of palliative care (adjusted odds ratio [aOR] 2.61 [1.41–4.83] for “All Needs,” aOR 2.01 [1.16–3.50] for “Pain and Symptom Management,” aOR 1.94 [1.12–3.34] for “Supportive Care”). ConclusionBased on the initial reason for consultation, we identified four classes of palliative care needs among critically ill patients, and GCAD patients were least likely to be high utilizers. These findings may help inform allocation of palliative care resources for this population.

Algoritmo semisupervisado de agrupamiento que combina SUBCLU y el agrupamiento basado en restricciones, para la detección de grupos en conjuntos de alta dimensionalidad

Los datos de alta dimensionalidad plantean un desafío para los algoritmos de agrupamiento tradicionales, ya que las medidas de similitud convencionales utilizadas por estos no son significativas cuando se aplican sobre el espacio completo de datos, por lo que afectan la calidad de los grupos. Ante esto, los algoritmos de agrupamiento de subespacios han sido propuestos como alternativa para encontrar todos los grupos en todos los espacios del conjunto de datos. Al detectar grupos en espacios de menor dimensionalidad, cada grupo detectado puede pertenecer a diferentes subespacios del conjunto de datos original. Consecuentemente, atributos que el usuario considere de interés pueden ser excluidos en algunos o todos los grupos, perdiendo información importante y reduciendo el valor del resultado para los analistas. En este proyecto, se propone un nuevo método que combina el algoritmo SUBCLU y el algoritmo de agrupamiento por restricciones, el cual permite al usuario identificar variables como atributos de interés con base en conocimiento previo del dominio, esto con el objeto de dirigir la detección de grupos hacia espacios que incluyan estos atributos y, por ende, generar grupos más significativos.