scholarly journals Comparing Multimorbidity Patterns Among Discharged Middle-Aged and Older Inpatients Between Hong Kong and Zurich: A Hierarchical Agglomerative Clustering Analysis of Routine Hospital Records

2021 ◽  
Vol 8 ◽  
Author(s):  
Francisco T. T. Lai ◽  
Patrick E. Beeler ◽  
Benjamin H. K. Yip ◽  
Marcus Cheetham ◽  
Patsy Y. K. Chau ◽  
...  
Keyword(s):  
Hong Kong ◽  
Clustering Analysis ◽  
Chronic Conditions ◽  
Healthcare Services ◽  
Agglomerative Clustering ◽  
High Prevalence ◽  
Older Inpatients ◽  
Hierarchical Agglomerative Clustering ◽  
Different Populations ◽  
Multimorbid Patients

Background: Multimorbidity, defined as the co-occurrence of ≥2 chronic conditions, is clinically diverse. Such complexity hinders the development of integrated/collaborative care for multimorbid patients. In addition, the universality of multimorbidity patterns is unclear given scarce research comparing multimorbidity profiles across populations. This study aims to derive and compare multimorbidity profiles in Hong Kong (HK, PRC) and Zurich (ZH, Switzerland).Methods: Stratified by sites, hierarchical agglomerative clustering analysis (dissimilarity measured by Jaccard index) was conducted with the objective of grouping inpatients into clinically meaningful clusters based on age, sex, and 30 chronic conditions among 20,000 randomly selected discharged multimorbid inpatients (10,000 from each site) aged ≥ 45 years. The elbow point method based on average within-cluster dissimilarity, complemented with a qualitative clinical examination of disease prevalence, was used to determine the number of clusters.Results: Nine clusters were derived for each site. Both similarities and dissimilarities of multimorbidity patterns were observed. There was one stroke-oriented cluster (3.9% in HK; 6.5% in ZH) and one chronic kidney disease-oriented cluster (13.1% in HK; 11.5% ZH) in each site. Examples of site-specific multimorbidity patterns, on the other hand, included a myocardial infarction-oriented cluster in ZH (2.3%) and several clusters in HK with high prevalence of heart failure (>65%) and chronic pain (>20%).Conclusion: This is the first study using hierarchical agglomerative clustering analysis to profile multimorbid inpatients from two different populations to identify universalities and differences of multimorbidity patterns. Our findings may inform the coordination of integrated/collaborative healthcare services.

scholarly journals Innovative Strategies to Facilitate Patient-Centered Research in Multiple Chronic Conditions

2021 ◽  
Vol 10 (10) ◽  
pp. 2112
Author(s):  
Tullika Garg ◽  
Courtney A. Polenick ◽  
Nancy Schoenborn ◽  
Jane Jih ◽  
Alexandra Hajduk ◽  
...  
Keyword(s):  
Chronic Conditions ◽  
Clinical Care ◽  
Intervention Development ◽  
Healthcare Services ◽  
Multiple Chronic Conditions ◽  
Patient Centered ◽  
Older Americans ◽  
Innovative Strategies ◽  
Department Of Health ◽  
Innovative Methods

Multiple chronic conditions (MCC) are one of today’s most pressing healthcare concerns, affecting 25% of all Americans and 75% of older Americans. Clinical care for individuals with MCC is often complex, condition-centric, and poorly coordinated across multiple specialties and healthcare services. There is an urgent need for innovative patient-centered research and intervention development to address the unique needs of the growing population of individuals with MCC. In this commentary, we describe innovative methods and strategies to conduct patient-centered MCC research guided by the goals and objectives in the Department of Health and Human Services MCC Strategic Framework. We describe methods to (1) increase the external validity of trials for individuals with MCC; (2) study MCC epidemiology; (3) engage clinicians, communities, and patients into MCC research; and (4) address health equity to eliminate disparities.

scholarly journals Clustering Techniques for Secondary Substations Siting

Energies ◽  
2021 ◽  
Vol 14 (4) ◽  
pp. 1028
Author(s):  
Silvia Corigliano ◽  
Federico Rosato ◽  
Carla Ortiz Dominguez ◽  
Marco Merlo
Keyword(s):  
Rural Areas ◽  
Urban Areas ◽  
Universal Access ◽  
Distribution Networks ◽  
Industrialized Countries ◽  
Agglomerative Clustering ◽  
Clustering Techniques ◽  
Hierarchical Agglomerative Clustering ◽  
Efficient Planning ◽  
Target Set

The scientific community is active in developing new models and methods to help reach the ambitious target set by UN SDGs7: universal access to electricity by 2030. Efficient planning of distribution networks is a complex and multivariate task, which is usually split into multiple subproblems to reduce the number of variables. The present work addresses the problem of optimal secondary substation siting, by means of different clustering techniques. In contrast with the majority of approaches found in the literature, which are devoted to the planning of MV grids in already electrified urban areas, this work focuses on greenfield planning in rural areas. K-means algorithm, hierarchical agglomerative clustering, and a method based on optimal weighted tree partitioning are adapted to the problem and run on two real case studies, with different population densities. The algorithms are compared in terms of different indicators useful to assess the feasibility of the solutions found. The algorithms have proven to be effective in addressing some of the crucial aspects of substations siting and to constitute relevant improvements to the classic K-means approach found in the literature. However, it is found that it is very challenging to conjugate an acceptable geographical span of the area served by a single substation with a substation power high enough to justify the installation when the load density is very low. In other words, well known standards adopted in industrialized countries do not fit with developing countries’ requirements.

scholarly journals Identifying organ dysfunction trajectory-based subphenotypes in critically ill patients with COVID-19

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Chang Su ◽  
Zhenxing Xu ◽  
Katherine Hoffman ◽  
Parag Goyal ◽  
Monika M. Safford ◽  
...  
Keyword(s):  
New York ◽  
Respiratory Failure ◽  
Sofa Score ◽  
Severity Of Illness ◽  
Agglomerative Clustering ◽  
Baseline Severity ◽  
Organ Systems ◽  
Hierarchical Agglomerative Clustering ◽  
Dynamic Time ◽  
Post Intubation

AbstractCOVID-19-associated respiratory failure offers the unprecedented opportunity to evaluate the differential host response to a uniform pathogenic insult. Understanding whether there are distinct subphenotypes of severe COVID-19 may offer insight into its pathophysiology. Sequential Organ Failure Assessment (SOFA) score is an objective and comprehensive measurement that measures dysfunction severity of six organ systems, i.e., cardiovascular, central nervous system, coagulation, liver, renal, and respiration. Our aim was to identify and characterize distinct subphenotypes of COVID-19 critical illness defined by the post-intubation trajectory of SOFA score. Intubated COVID-19 patients at two hospitals in New York city were leveraged as development and validation cohorts. Patients were grouped into mild, intermediate, and severe strata by their baseline post-intubation SOFA. Hierarchical agglomerative clustering was performed within each stratum to detect subphenotypes based on similarities amongst SOFA score trajectories evaluated by Dynamic Time Warping. Distinct worsening and recovering subphenotypes were identified within each stratum, which had distinct 7-day post-intubation SOFA progression trends. Patients in the worsening suphenotypes had a higher mortality than those in the recovering subphenotypes within each stratum (mild stratum, 29.7% vs. 10.3%, p = 0.033; intermediate stratum, 29.3% vs. 8.0%, p = 0.002; severe stratum, 53.7% vs. 22.2%, p < 0.001). Pathophysiologic biomarkers associated with progression were distinct at each stratum, including findings suggestive of inflammation in low baseline severity of illness versus hemophagocytic lymphohistiocytosis in higher baseline severity of illness. The findings suggest that there are clear worsening and recovering subphenotypes of COVID-19 respiratory failure after intubation, which are more predictive of outcomes than baseline severity of illness. Distinct progression biomarkers at differential baseline severity of illness suggests a heterogeneous pathobiology in the progression of COVID-19 respiratory failure.

scholarly journals Patterns of Periodontal Destruction among Smokeless Tobacco Users in a Central Indian Population

Healthcare ◽  
2021 ◽  
Vol 9 (6) ◽  
pp. 744
Author(s):  
Pradeep S. Anand ◽  
Supriya Mishra ◽  
Deepti Nagle ◽  
Namitha P. Kamath ◽  
Kavitha P. Kamath ◽  
...  
Keyword(s):  
Smokeless Tobacco ◽  
Tobacco Consumption ◽  
Periodontal Health ◽  
Clinical Attachment Loss ◽  
Periodontal Tissues ◽  
Probing Depth ◽  
High Prevalence ◽  
Periodontal Destruction ◽  
Different Populations ◽  
Oral Hygiene Habits

Background: Findings of studies testing the association between smokeless tobacco (SLT) use and periodontal health have shown varying results in different populations. Considering the high prevalence of SLT use in India, the present study was conducted to understand the pattern of periodontal destruction within different areas of the dentition among SLT users. Methods: Age, gender, oral hygiene habits, the frequency and duration of SLT consumption, the type of SLT product used, and the site of retention of the SLT product in the oral cavity were recorded among 90 SLT users. Probing depth (PD), recession (REC), and clinical attachment loss (CAL) at SLT-associated and non SLT-associated teeth of the mandibular arch were compared based on the site of retention of the SLT product, the type of product used, and the duration of the habit. Results: REC and CAL were significantly higher at the SLT-associated zones compared to non SLT-associated zones and at both interproximal and mid-buccal sites of SLT-associated teeth. Among individuals who had the habit for more than 5 years and also among those who had the habit for 5–10 years, PD, REC, and CAL were significantly higher at SLT-associated teeth than at non SLT-associated teeth. Significantly greater periodontal destruction was observed at SLT-associated teeth among khaini users and gutkha users. Conclusions: Smokeless tobacco consumption resulted in greater destruction of periodontal tissues. The severity of periodontal destruction at SLT-associated sites differed depending on the type of smokeless tobacco used, the site of retention of the SLT, and the duration of the habit.

Hong Kong Chinese People's View of Creativity

1998 ◽  
Vol 13 (2) ◽  
pp. 159-174 ◽  
Author(s):  
Elisabeth Rudowicz ◽  
Anna Hui
Keyword(s):  
Hong Kong ◽  
Tertiary Education ◽  
Demographic Data ◽  
Occupational Status ◽  
Hong Kong Chinese ◽  
Second Stage ◽  
Third Stage ◽  
Different Populations ◽  
Subway Stations ◽  
Power And Energy

This study was aimed at attaining some sense of implicit concepts of creativity among Hong Kong Chinese across different populations of participants and finding out how these implicit concepts compare to explicit concepts grounded in Western culture and tradition. Three stages of investigation are reported. In the first stage, 370 persons at railway and subway stations were asked to give their views on creativity and nominate Hong Kong person(s) outstanding for creativity, They were also asked to provide some demographic data and rate themselves on the creativity scale. In the second stage, 34 persons nominated in the first stage as outstanding for creativity were given the same task as the general public. In the third stage, local academics working in the area of creativity were asked to assign the categories of answers generated in the first and second stages of the study into one of the creativity strands: process, product, person or press. It was found that some core parts of the implicit concepts of creativity were overlapped highly across sex, age, education and occupational status variables. In other parts of the concept, how-ever, differences were found between males and females, teachers and laypersons, persons with tertiary education and other groups. Points of agreement between the implicit concepts of Hong Kong Chinese and explicit ones in the Western literature of creativity were these which linked creativity with something new, unique, leading to change and based on the independent thinking initiated by internal power and energy. However, originality, self expression as well as aesthetic and artistic elements were almost invisible in the Hong Kong implicit concepts of creativity.

High prevalence of primary Enfuvirtide (ENF) resistance-associated mutations in HIV-1-infected patients in Hong Kong

2010 ◽  
Vol 47 (3) ◽  
pp. 273-275 ◽  
Author(s):  
P.H.M. Leung ◽  
J.H.K. Chen ◽  
K.H. Wong ◽  
K.C. Chan ◽  
H.Y. Lam ◽  
...  
Keyword(s):  
Hong Kong ◽  
High Prevalence ◽  
Hiv 1

Hierarchical Agglomerative Clustering

2013 ◽  
pp. 886-887 ◽  
Author(s):  
Marie Lisandra Zepeda-Mendoza ◽  
Osbaldo Resendis-Antonio
Keyword(s):  
Agglomerative Clustering ◽  
Hierarchical Agglomerative Clustering

scholarly journals Chromatographic, Chemometric and Antioxidant Assessment of the Equivalence of Granules and Herbal Materials of Angelicae Sinensis Radix

Medicines ◽  
2020 ◽  
Vol 7 (6) ◽  
pp. 35
Author(s):  
Valentina Razmovski-Naumovski ◽  
Xian Zhou ◽  
Ho Yee Wong ◽  
Antony Kam ◽  
Jarryd Pearson ◽  
...  
Keyword(s):  
Ferulic Acid ◽  
Caffeic Acid ◽  
Radical Scavenging ◽  
Principal Component ◽  
Ultra Performance Liquid Chromatography ◽  
Array Detector ◽  
Agglomerative Clustering ◽  
Antioxidant Power ◽  
Hierarchical Agglomerative Clustering ◽  
Angelicae Sinensis

Background: Granules are a popular way of administrating herbal decoctions. However, there are no standardised quality control methods for granules, with few studies comparing the granules to traditional herbal decoctions. This study developed a multi-analytical platform to compare the quality of granule products to herb/decoction pieces of Angelicae Sinensis Radix (Danggui). Methods: A validated ultra-performance liquid chromatography coupled with photodiode array detector (UPLC-PDA) method quantitatively compared the aqueous extracts. Hierarchical agglomerative clustering analysis (HCA) and principal component analysis (PCA) clustered the samples according to three chemical compounds: ferulic acid, caffeic acid and Z-ligustilide. Ferric ion-reducing antioxidant power (FRAP) and 2,2-Diphenyl-1-picrylhydrazyl radical scavenging capacity (DPPH) assessed the antioxidant activity of the samples. Results: HCA and PCA allocated the samples into two main groups: granule products and herb/decoction pieces. Greater differentiation between the samples was obtained with three chemical markers compared to using one marker. The herb/decoction pieces group showed comparatively higher extraction yields and significantly higher DPPH and FRAP (p < 0.05), which was positively correlated to caffeic acid and ferulic acid, respectively. Conclusions: The results confirm the need for the quality assessment of granule products using more than one chemical marker for widespread practitioner and consumer use.

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