scholarly journals Bilateral asymmetric tonic seizure in insulo-opercular epilepsy: an anatomo-electro-clinical study

2020 ◽  
Vol 2 (1) ◽  
Author(s):  
Xiangshu Hu ◽  
Kaihui Li ◽  
Xiao Wang ◽  
Ping Yang ◽  
Qinghua Tan ◽  
...  
Keyword(s):  
Cluster Analysis ◽  
Clonic Seizure ◽  
Tonic Seizure ◽  
Seizure Semiology ◽  
Intracerebral Eeg ◽  
Autonomic Changes ◽  
Sensorimotor Area ◽  
High Prevalence ◽  
Classical Pattern ◽  
Kendall Correlation

Abstract Background Insulo-opercular seizures are highly heterogeneous in seizure semiology and electrical features. Bilateral asymmetric limb posturing, as a classical pattern of supplementary sensorimotor area (SMA) seizure, also occurs in insulo-opercular epilepsy. This study was aimed to study the anatomo-electro-clinical correlations in bilateral asymmetric tonic seizures (BATS), in order to advance the understanding of insulo-opercular epilepsy. Methods Eight patients with insulo-opercular epilepsy as confirmed by stereoelectroencephalography (SEEG) and manifesting BATS as the major ictal motor sign, in Guangdong Sanjiu Brain Hospital Epilepsy Center from 2014 to 2018, were employed in this study. The BATS of the patients were evaluated, and the semiologic features and concomitant intracerebral EEG changes were quantified. Then the variables were examined with Cluster Analysis, and the semiologic features were correlated with anatomic localization using the Kendall correlation test. Results Of the 8 patients, the most frequent initial motor sign was bilateral asymmetric tonic posturing (62.5%). Facial tonic-clonic sign also had a high prevalence in the evolution of seizures (87.5%). The results of Cluster Analysis showed that the semiologic features were subdivided into two main groups, one group comprising exclusively BATS and the other including signs of focal tonic seizure, aura, focal limb tonic-clonic seizure (TCS), facial TCS, hypermotor behavior, eye movement, autonomic changes and generalized TCS. The BATS was strongly associated with the posterior long gyrus (PLG) of insula (t = 0.732) and parietal operculum (t = 1.000); the hypermotor behaviors were associated with the anterior long gyrus (ALG) (t = 0.770); and the autonomic changes were associated with the anterior limiting sulcus (ALS) (t = 0.734) and middle short gyrus (MSG) (t = 0.700). Conclusions The seizure semiology of insulo-opercular epilepsy is characterized, in temporal order, by BATS, with or without simultaneous hypermotor behaviors, and frequently ends up with facial tonic-clonic signs, which is different from that of the SMA seizure. The early spread network involving the posterior insular lobe and parietal operculum may contribute to this pattern of manifestation.

scholarly journals Could clustering of comorbidities be useful for better defining the internal medicine patients’ complexity?

2018 ◽  
Vol 12 (2) ◽  
pp. 137 ◽  
Author(s):  
Flavio Tangianu ◽  
Paola Gnerre ◽  
Fabrizio Colombo ◽  
Roberto Frediani ◽  
Giuliano Pinna ◽  
...  
Keyword(s):  
Internal Medicine ◽  
Decision Making ◽  
Cluster Analysis ◽  
Adverse Events ◽  
Decision Making Process ◽  
High Similarity ◽  
High Prevalence ◽  
Clinical Problems ◽  
Index Disease ◽  
Improve Health

Internal medicine patients are mostly elderly with multiple comorbidities, usually chronic. The high prevalence of comorbidity and multimorbidity has a significant impact on both positive responses to treatment and the occurrence of adverse events. Clustering is the process of nosography grouping into meaningful associations with some index disease, so that the objects within a cluster have high similarity in comparison with one another. In the decision-making process it is imperative that, in addition to understanding the immediate clinical problems, we are able to explicit all the contextual factors that have to be taken into account for the best outcome of care. Cluster analysis could be leveraged in developing better interventions targeted to improve health outcomes in subgroups of patients.

scholarly journals Revisiting comorbidities in gout: a cluster analysis

2013 ◽  
Vol 74 (1) ◽  
pp. 142-147 ◽  
Author(s):  
Pascal Richette ◽  
Pierre Clerson ◽  
Laure Périssin ◽  
René-Marc Flipo ◽  
Thomas Bardin
Keyword(s):  
Cluster Analysis ◽  
Renal Failure ◽  
Large Cohort ◽  
High Rate ◽  
Cross Sectional ◽  
High Prevalence ◽  
History Of ◽  
Obesity Hypertension ◽  
Almost All

ObjectivesThe reciprocal links between comorbidities and gout are complex. We used cluster analysis to attempt to identify different phenotypes on the basis of comorbidities in a large cohort of patients with gout.MethodsThis was a cross-sectional multicentre study of 2763 gout patients conducted from November 2010 to May 2011. Cluster analysis was conducted separately for variables and for observations in patients, measuring proximity between variables and identifying homogeneous subgroups of patients. Variables used in both analyses were hypertension, obesity, diabetes, dyslipidaemia, heart failure, coronary heart disease, renal failure, liver disorders and cancer.ResultsComorbidities were common in this large cohort of patients with gout. Abdominal obesity, hypertension, metabolic syndrome and dyslipidaemia increased with gout duration, even after adjustment for age and sex. Five clusters (C1–C5) were found. Cluster C1 (n=332, 12%) consisted of patients with isolated gout and few comorbidities. In C2 (n=483, 17%), all patients were obese, with a high prevalence of hypertension. C3 (n=664, 24%) had the greatest proportion of patients with type 2 diabetes (75%). In C4 (n=782, 28%), almost all patients presented with dyslipidaemia (98%). Finally, C5 (n=502, 18%) consisted of almost all patients with a history of cardiovascular disease and renal failure, with a high rate of patients receiving diuretics.ConclusionsCluster analysis of comorbidities in gout allowed us to identify five different clinical phenotypes, which may reflect different pathophysiological processes in gout.

scholarly journals Validation of distinct pathogenic patterns in a cohort of membranoproliferative glomerulonephritis patients by cluster analysis

2019 ◽  
Vol 13 (2) ◽  
pp. 225-234
Author(s):  
Nóra Garam ◽  
Zoltán Prohászka ◽  
Ágnes Szilágyi ◽  
Christof Aigner ◽  
Alice Schmidt ◽  
...  
Keyword(s):  
Cluster Analysis ◽  
Membranoproliferative Glomerulonephritis ◽  
Late Onset ◽  
Age At Onset ◽  
Disease Onset ◽  
Membrane Attack Complex ◽  
Hierarchical Cluster ◽  
Nephritic Syndrome ◽  
Significant Difference ◽  
High Prevalence

Abstract Background A novel data-driven cluster analysis identified distinct pathogenic patterns in C3-glomerulopathies and immune complex-mediated membranoproliferative glomerulonephritis. Our aim was to replicate these observations in an independent cohort and elucidate disease pathophysiology with detailed analysis of functional complement markers. Methods A total of 92 patients with clinical, histological, complement and genetic data were involved in the study, and hierarchical cluster analysis was done by Ward method, where four clusters were generated. Results High levels of sC5b-9 (soluble membrane attack complex), low serum C3 levels and young age at onset (13 years) were characteristic for Cluster 1 with a high prevalence of likely pathogenic variations (LPVs) and C3 nephritic factor, whereas for Cluster 2—which is not reliable because of the small number of cases—strong immunoglobulin G staining, low C3 levels and high prevalence of nephritic syndrome at disease onset were observed. Low plasma sC5b-9 levels, decreased C3 levels and high prevalence of LPV and sclerotic glomeruli were present in Cluster 3, and patients with late onset of the disease (median: 39.5 years) and near-normal C3 levels in Cluster 4. A significant difference was observed in the incidence of end-stage renal disease during follow-up between the different clusters. Patients in Clusters 3–4 had worse renal survival than patients in Clusters 1–2. Conclusions Our results confirm the main findings of the original cluster analysis and indicate that the observed, distinct pathogenic patterns are replicated in our cohort. Further investigations are necessary to analyse the distinct biological and pathogenic processes in these patient groups.

scholarly journals Cluster Analysis to Characterize the Patterns of Complementary and Alternative Medicines Usage in Asthma Controls

2020 ◽  
Vol 13 (1) ◽  
pp. 227-231
Author(s):  
Pooja M.R. ◽  
Pushpalatha M.P.
Keyword(s):  
Cluster Analysis ◽  
Asthma Control ◽  
Complementary And Alternative Medicines ◽  
Alternative Medicines ◽  
Medicines Use ◽  
High Prevalence ◽  
Controller Medications ◽  
Complementary And Alternative

Background: Clinicians and physicians need to be aware of the high prevalence of complementary and alternative medicines use in patients with asthma, as it is found to be associated with lack of asthma control, though the degree to which associations exist is still not clear. Methods: We have performed a cluster analysis to characterize patterns defining different asthma control levels and the extent to which the medicines have an impact in these categories. Results and Conclusion: We have explored the association of Complementary and Alternative medicines utilization with asthma control and the effect of asthma controller medications, with the conclusion that the usage of complementary and alternative medicines does not have a significant impact on partially and uncontrolled asthmatics.

M1346 High Prevalence of Lower Gastrointestinal (GI) Symptoms in Functional Dyspepsia: A Factor and Cluster Analysis in the General Population

2010 ◽  
Vol 138 (5) ◽  
pp. S-385
Author(s):  
Hidekazu Suzuki ◽  
Juntaro Matsuzaki ◽  
Keiko Asakura ◽  
Yasushi Fukushima ◽  
Yoshimasa Saito ◽  
...  
Keyword(s):  
Cluster Analysis ◽  
General Population ◽  
Functional Dyspepsia ◽  
Gi Symptoms ◽  
High Prevalence ◽  
Factor And Cluster Analysis ◽  
And Cluster Analysis

scholarly journals Determining Potential Target Groups for Oral Cancer Screening by Investigating Risk Behaviors Among Occupations

2018 ◽  
Vol 4 (Supplement 2) ◽  
pp. 49s-49s
Author(s):  
Y.-T. Huang ◽  
Y.-W. Wang ◽  
R.-C. Chen ◽  
C.-Y. Wu ◽  
Y.-H. Yang
Keyword(s):  
Cluster Analysis ◽  
Cancer Screening ◽  
Oral Cancer ◽  
Cigarette Smoking ◽  
Screening Program ◽  
Smoking Habits ◽  
Betel Quid ◽  
High Prevalence ◽  
Betel Quid Chewing ◽  
Oral Cancer Screening

Background: Oral cancer is a major public health burden in Taiwan. Studies have suggested that habits of betel quid chewing, tobacco smoking and alcohol drinking as well as their interaction effects are important risk factors for oral cancer and oral potentially malignant disorders (OPMD). A population-based oral cancer screening program has been implemented by Health Promotion Administration, Ministry of Health and Welfare, Taiwan. People with betel quid chewing and/or cigarette smoking habits are recommended for biennially screening. Previous studies found that majority of betel quid chewers were in labor intensive occupations. Given the fact that high risk groups of oral cancer are often reluctant to attend screening, targeted approach should be applied to improve the effectiveness of screening program. Aim: The aims of this study are to identify occupations with high prevalence of betel-quid chewing and also to investigate changing trends using the National Health Interview Survey (NHIS) database. Methods: The NHIS database of 2009 and 2013 were used to conduct this study. We identified current users of betel quid and/or cigarette from adults with aged 20-64 years old and working on jobs. Occupations were classified using the International Standard Classification of Occupations (ISCO-88). Statistical analyses included indirect standardized rate ratios and cluster analysis of chewing/smoking habits. Results: From the total survey participants (2009: 19,201, 2013: 17,249), we extracted 11,507 and 10,760 persons for the study. In the year of 2013, using the 2-digit code of ISCO-88, drivers and mobile-plant operators (code 83 in ISCO-88) had the highest prevalence of betel quid chewing habit (30.9%), followed by extraction and building trades workers (code 71 in ISCO-88, 29.6%). These two groups also had the 2 highest smoking prevalence (61.2% and 62.2%). The betel quid chewing prevalence decreased from 2009 to 2013 slightly (32.3%-30.9%). However, the prevalence of smoking increased (60.0%-62.2%). Among the betel quid chewers of the two focused occupations, the corresponding rates of receiving oral cancer screening were rather low (35.47% and 21.52%). The indirect standardized ratios using the total sample as the reference showed 6 occupations (2 digit of ISCO-88) with significantly higher ratios (larger than 2). Cluster analysis demonstrated that the group with high prevalence of betel quid chewing also had high prevalence of cigarette smoking habit. Conclusion: The betel quid chewing prevalence has been decreased in all occupations. While at the same time, prevalence of cigarette smoking did not largely decrease. We analyzed the NHIS databases and found that workers in some occupations tend to have higher prevalence in both betel quid chewing and smoking. The oral cancer screening and cancer awareness need be targeted on certain occupations.

scholarly journals OP0047 IDENTIFICATION OF CLINICAL PHENOTYPES IN PATIENTS WITH AXIAL SPONDYLOARTHRITIS, PERIPHERAL SPONDYLOARTHRITIS AND PSORIATIC ARTHRITIS ACCORDING TO PERIPHERAL MUSCULOSKELETAL MANIFESTATIONS: A CLUSTER ANALYSIS IN THE INTERNATIONAL ASAS-PERSPA STUDY

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 24.2-25
Author(s):  
C. López-Medina ◽  
S. Chevret ◽  
A. Moltó ◽  
J. Sieper ◽  
M. T. Duruöz ◽  
...  
Keyword(s):  
Cluster Analysis ◽  
Prior Information ◽  
Hla B27 ◽  
Peripheral Arthritis ◽  
Specific Location ◽  
High Prevalence ◽  
Musculoskeletal Manifestations ◽  
Low Prevalence ◽  
Cluster 2 ◽  
Axial Involvement

Background:Patients with a diagnosis of Spondyloarthritis (SpA) and Psoriatic Arthritis (PsA) may have predominant axial or peripheral symptoms, and the frequency and distribution of these symptoms may determine the clinical diagnosis by the rheumatologist (“clinical clusters”). Clustering analysis represents an unsupervised exploratory analysis which tries to identify homogeneous groups of cases (“statistical clusters”) without prior information about the membership for any of the cases.Objectives:To identify “statistical clusters” of peripheral involvement according to the specific location of these symptoms in the whole spectrum of SpA and PsA (without prior information about the diagnosis of the patients), and to evaluate whether these “statistical clusters” are in agreement with the “clinical clusters”.Methods:Cross-sectional and multicentre study with 24 participating countries. Consecutive patients considered by their treating rheumatologist as suffering from either PsA, axial SpA (axSpA) or peripheral SpA (pSpA) were enrolled. Four different cluster analyses were conducted: the first one using information about the specific location from all the peripheral musculoskeletal manifestations (i.e., peripheral arthritis, enthesitis and dactylitis), and thereafter a cluster analysis for each peripheral manifestation individually. Multiple correspondence analyses and k-means clustering methods were used. Distribution of peripheral manifestations and clinical characteristics were compared across the different clusters.Results:4465 patients were included in the analysis. Two clusters were found with regard to the location of all the peripheral manifestations (Fig. 1). Cluster 1 showed a low prevalence of peripheral manifestations in comparison with cluster 2; however, when peripheral involvement appeared in cluster 1, this was mostly represented by arthritis of hip, knee and ankle, as well as enthesitis of the heel. Patients from cluster 1 showed a higher prevalence of males (63% vs 44%), HLA-B27 positivity (69% vs 38%) and axial involvement (80% vs 52%), as well as more frequent diagnosis of axSpA (66% vs 21%) and more frequently fulfilling the ASAS axSpA criteria (69% vs. 41%). Patients from cluster 2 showed a higher prevalence of psoriasis (63% vs 25%), a more frequent diagnosis of PsA (61% vs 19%), and they fulfilled more frequently the peripheral ASAS (26% vs 11%) and the CASPAR criteria (57% vs 19%).Figure 1.Distribution of the peripheral involvement across clustersThree clusters were found with regard to the location of the peripheral arthritis. Clusters 2 and 3 showed a high prevalence of peripheral joint disease, although this was located more predominantly in the lower limbs in cluster 2, and in the upper limbs in cluster 3. Cluster 1 showed a higher prevalence of males, HLA-B27 positivity, axial involvement, a lower presence of psoriasis, a more frequent diagnosis of axSpA and fulfilling the ASAS axSpA criteria in comparison with clusters 2 and 3, respectively. Clusters 2 and 3 showed a higher prevalence of enthesitis and dactylitis in comparison with cluster 1, a more frequent diagnosis of PsA and fulfillment of the CASPAR criteria.Information about the location of enthesitis exhibited three groups: cluster 1 showed a very low prevalence of enthesitis, while cluster 2 and 3 showed a high prevalence of enthesitis, with a predominant involvement of axial enthesis in cluster 2 and peripheral enthesitis in cluster 3.Finally, the analysis of dactylitis also exhibited three clusters that showed a very low prevalence of dactylitis, predominantly toes and predominantly fingers involvement, respectively.Conclusion:These results suggest the presence of heterogeneous patterns of peripheral involvement in SpA and PsA patients without clearly defined groups, confirming the clear overlap of these peripheral manifestations across the different underlying diagnoses.Acknowledgements:This study was conducted under the umbrella of ASAS with unrestricted grant of Abbvie, Pfizer, Lilly, Novartis, UCB, Janssen and Merck.Disclosure of Interests:None declared

Cluster analysis for large data sets: applications to individual aerosol particles from the mid-pacific

1992 ◽  
Vol 50 (2) ◽  
pp. 1488-1489
Author(s):  
Thomas W. Shattuck ◽  
James R. Anderson ◽  
Neil W. Tindale ◽  
Peter R. Buseck
Keyword(s):  
Cluster Analysis ◽  
Chemical Reactivity ◽  
Large Data ◽  
Large Data Sets ◽  
Particle Analysis ◽  
Data Sets ◽  
Halogen Chemistry ◽  
Complete Study ◽  
Components Analysis ◽  
Automated Scanning

Individual particle analysis involves the study of tens of thousands of particles using automated scanning electron microscopy and elemental analysis by energy-dispersive, x-ray emission spectroscopy (EDS). EDS produces large data sets that must be analyzed using multi-variate statistical techniques. A complete study uses cluster analysis, discriminant analysis, and factor or principal components analysis (PCA). The three techniques are used in the study of particles sampled during the FeLine cruise to the mid-Pacific ocean in the summer of 1990. The mid-Pacific aerosol provides information on long range particle transport, iron deposition, sea salt ageing, and halogen chemistry.Aerosol particle data sets suffer from a number of difficulties for pattern recognition using cluster analysis. There is a great disparity in the number of observations per cluster and the range of the variables in each cluster. The variables are not normally distributed, they are subject to considerable experimental error, and many values are zero, because of finite detection limits. Many of the clusters show considerable overlap, because of natural variability, agglomeration, and chemical reactivity.

Measuring “Language Access Profiles” in Deaf and Hard-of-Hearing Children With the DHH Language Exposure Assessment Tool

2020 ◽  
pp. 1-25
Author(s):  
Matthew L. Hall ◽  
Stephanie De Anda
Keyword(s):  
Cluster Analysis ◽  
Exposure Assessment ◽  
Hard Of Hearing ◽  
Assessment Tool ◽  
Communication Mode ◽  
Developmental Potential ◽  
Language Access ◽  
Retest Reliability ◽  
Language Exposure ◽  
Test Retest Reliability

Purpose The purposes of this study were (a) to introduce “language access profiles” as a viable alternative construct to “communication mode” for describing experience with language input during early childhood for deaf and hard-of-hearing (DHH) children; (b) to describe the development of a new tool for measuring DHH children's language access profiles during infancy and toddlerhood; and (c) to evaluate the novelty, reliability, and validity of this tool. Method We adapted an existing retrospective parent report measure of early language experience (the Language Exposure Assessment Tool) to make it suitable for use with DHH populations. We administered the adapted instrument (DHH Language Exposure Assessment Tool [D-LEAT]) to the caregivers of 105 DHH children aged 12 years and younger. To measure convergent validity, we also administered another novel instrument: the Language Access Profile Tool. To measure test–retest reliability, half of the participants were interviewed again after 1 month. We identified groups of children with similar language access profiles by using hierarchical cluster analysis. Results The D-LEAT revealed DHH children's diverse experiences with access to language during infancy and toddlerhood. Cluster analysis groupings were markedly different from those derived from more traditional grouping rules (e.g., communication modes). Test–retest reliability was good, especially for the same-interviewer condition. Content, convergent, and face validity were strong. Conclusions To optimize DHH children's developmental potential, stakeholders who work at the individual and population levels would benefit from replacing communication mode with language access profiles. The D-LEAT is the first tool that aims to measure this novel construct. Despite limitations that future work aims to address, the present results demonstrate that the D-LEAT represents progress over the status quo.

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