Assessing Differential Effects of Somatic Amplification to Positive Affect in Midlife and Late Adulthood—A Regression Mixture Approach

This study aims to provide an empirical demonstration of a novel method, regression mixture model, by examining differential effects of somatic amplification to positive affect and identifying the predictors that contribute to the differential effects. Data derived from the second wave of Midlife in the United States. The analytic sample consisted of 1,766 adults aged from 33 to 84 years. Regression mixture models were fitted using Mplus 7.4, and a two-step model-building approach was adopted. Three latent groups were identified consisting of a maladaptive (32.1%), a vulnerable (62.5%), and a resilient (5.4%) group. Six covariates (i.e., age, education level, positive relations with others, purpose in life, depressive symptoms, and physical health) significantly predicted the latent class membership in the regression mixture model. The study demonstrated the regression mixture model to be a flexible and efficient statistical tool in assessing individual differences in response to adversity and identifying resilience factors, which contributes to aging research.

Risk of adverse events in gastrointestinal endoscopy: Zero-inflated Poisson regression mixture model for count data and multinomial logit model for the type of event

Background and aims We analyze the possible predictive variables for Adverse Events (AEs) during sedation for gastrointestinal (GI) endoscopy. Methods We consider 23,788 GI endoscopies under sedation on adults between 2012 and 2019. A Zero-Inflated Poisson Regression Mixture (ZIPRM) model for count data with concomitant variables is applied, accounting for unobserved heterogeneity and evaluating the risks of multi-drug sedation. A multinomial logit model is also estimated to evaluate cardiovascular, respiratory, hemorrhagic, other AEs and stopping the procedure risk factors. Results In 7.55% of cases, one or more AEs occurred, most frequently cardiovascular (3.26%) or respiratory (2.77%). Our ZIPRM model identifies one population for non-zero counts. The AE-group reveals that age >75 years yields 46% more AEs than age <66 years; Body Mass Index (BMI) ≥27 27% more AEs than BMI <21; emergency 11% more AEs than routine. Any one-point increment in the American Society of Anesthesiologists (ASA) score and the Mallampati score determines respectively a 42% and a 16% increment in AEs; every hour prolonging endoscopy increases AEs by 41%. Regarding sedation with propofol alone (the sedative of choice), adding opioids to propofol increases AEs by 43% and adding benzodiazepines by 51%. Cardiovascular AEs are increased by age, ASA score, smoke, in-hospital, procedure duration, midazolam/fentanyl associated with propofol. Respiratory AEs are increased by BMI, ASA and Mallampati scores, emergency, in-hospital, procedure duration, midazolam/fentanyl associated with propofol. Hemorrhagic AEs are increased by age, in-hospital, procedure duration, midazolam/fentanyl associated with propofol. The risk of suspension of the endoscopic procedure before accomplishment is increased by female gender, ASA and Mallampati scores, and in-hospital, and it is reduced by emergency and procedure duration. Conclusions Age, BMI, ASA score, Mallampati score, in-hospital, procedure duration, other sedatives with propofol increase the risk for AEs during sedation for GI endoscopy.

Targeted design for adaptive clinical trials via semiparametric model

Precision medicine approach that assigns treatment according to an individual’s personal (including molecular) profile is revolutionizing health care. Existing statistical methods for clinical trial design typically assume a known model to estimate characteristics of treatment outcomes, which may yield biased results if the true model deviates far from the assumed one. This article aims to achieve model robustness in a phase II multi-stage adaptive clinical trial design. We propose and study a semiparametric regression mixture model in which the mixing proportions are specified according to the subjects’ profiles, and each sub-group distribution is only assumed to be unimodal for robustness. The regression parameters and the error density functions are estimated by semiparametric maximum likelihood and isotonic regression estimators. The asymptotic properties of the estimates are studied. Simulation studies are conducted to evaluate the performance of the method after a real data analysis.

Is Autonomy Always Beneficial for Work Engagement? A Six-year Four-Wave Follow-Up Study

Work engagement is expected to result from job resources such as autonomy. However, previous results have yielded that the autonomy–work engagement relationship is not always particularly strong. Whereas previous longitudinal studies have examined this relationship as an average at a specific point in time, this study examined whether this relationship is different within individuals from one time to another over the years. Furthermore, experiences of work engagement are expected to affect how employees benefit from autonomy, but no studies have so far investigated whether the initial level of work engagement affects the autonomy–work engagement relationship. This study aimed to first identify the different kinds of longitudinal relationship patterns between autonomy and work engagement, and then to investigate whether the identified relationship patterns differ in terms of the initial mean level of work engagement. The four-wave study was conducted among Finnish managers (n = 329) over a period of six years. Multilevel regression mixture analysis identified five relationship patterns. Four of the patterns showed a positive predictive relationship between autonomy and work engagement. However, the relationship was statistically significant in only one of these patterns. Furthermore, when the initial mean level of work engagement was high, autonomy related more strongly to work engagement. However, an atypical pattern was identified that showed a negative association between autonomy and work engagement. In this pattern, the mean level of work engagement was low. Consequently, autonomy may not always enhance work engagement; sometimes this relationship may even be negative.

Use of Multiensemble Track Clustering to Inform Medium-Range Tropical Cyclone Forecasts

Tropical cyclone ensemble track forecasts from 153 initialization times during 2017–18 are clustered using regression mixture models. Clustering is performed on a four-ensemble dataset [ECMWF + GEFS + UKMET + CMC (EGUC)], and a three-ensemble dataset that excludes the CMC (EGU). For both datasets, five-cluster partitions are selected to analyze, and the relationship between cluster properties (size, ensemble composition) and 96–144-h cluster-mean error is evaluated. For both datasets, small clusters produce very large errors, with the least populous cluster producing the largest error in more than 50% of forecasts. The mean of the most populous EGUC cluster outperforms the most accurate (EGU) ensemble mean in only 43% of forecasts; however, when the most populous EGUC cluster from each forecast contains ≥30% of the ensemble population, its average cluster-mean error is significantly reduced compared to when the most populous cluster is smaller. Forecasts with a highly populous EGUC cluster also appear to have smaller EGUC-, EGU-, and ECMWF-mean errors. Cluster-mean errors also vary substantially by the ensembles composing the cluster. The most accurate clusters are EGUC clusters that contain threshold memberships of ECMWF, GEFS, and UKMET, but not CMC. The elevated accuracy of EGUC CMC-excluding clusters indicates the potential utility of including the CMC in clustering, despite its large ensemble-mean errors. Pruning ensembles by removing members that belong to small clusters reduces 96–144-h forecast errors for both EGUC and EGU clustering. For five-cluster partitions, a pruning threshold of 10% affects 49% and 35% of EGUC and EGU ensembles, respectively, improving 69%–74% of the forecasts affected by pruning.