cluster analysis

聚类分析
  • 文章类型: Journal Article
    这项研究使用基于各种距离函数的复杂网络方法研究了人β-分泌酶1(BACE-1)抑制剂的聚类模式,包括欧几里得,Tanimoto,Hamming,和Levenshtein距离。分子描述符载体,如分子质量,默克分子力场(MMFF)能量,克里彭分配系数(ClogP),Crippen磨牙屈光度(MR),偏心率,Kappa指数,综合可达性评分,拓扑极表面积(TPSA),和2D/3D自相关熵用于捕获这些抑制剂的不同性质。欧氏距离网络展示了最可靠的聚类结果,具有强大的协议度量和最小的信息损失,表明其在捕获基本结构和物理化学性质方面的稳健性。Tanimoto和Hamming距离网络产生有价值的聚类结果,尽管表现适中,而Levenshtein距离网络显示出明显的差异。对不同网络的特征向量中心性的分析确定了充当枢纽的关键抑制因素,这可能是生化途径的关键。社区检测结果突出了不同的聚类模式,明确定义的社区提供对BACE-1抑制剂的功能和结构分组的见解。该研究还进行了非参数检验,揭示了分子描述符的显著差异,验证聚类方法。尽管有其局限性,包括对特定描述符和计算复杂性的依赖,本研究为理解分子间相互作用和指导治疗干预提供了一个全面的框架.未来的研究可以整合额外的描述符,先进的机器学习技术,和动态网络分析,以提高聚类的准确性和适用性。
    This study investigates the clustering patterns of human β-secretase 1 (BACE-1) inhibitors using complex network methodologies based on various distance functions, including Euclidean, Tanimoto, Hamming, and Levenshtein distances. Molecular descriptor vectors such as molecular mass, Merck Molecular Force Field (MMFF) energy, Crippen partition coefficient (ClogP), Crippen molar refractivity (MR), eccentricity, Kappa indices, Synthetic Accessibility Score, Topological Polar Surface Area (TPSA), and 2D/3D autocorrelation entropies are employed to capture the diverse properties of these inhibitors. The Euclidean distance network demonstrates the most reliable clustering results, with strong agreement metrics and minimal information loss, indicating its robustness in capturing essential structural and physicochemical properties. Tanimoto and Hamming distance networks yield valuable clustering outcomes, albeit with moderate performance, while the Levenshtein distance network shows significant discrepancies. The analysis of eigenvector centrality across different networks identifies key inhibitors acting as hubs, which are likely critical in biochemical pathways. Community detection results highlight distinct clustering patterns, with well-defined communities providing insights into the functional and structural groupings of BACE-1 inhibitors. The study also conducts non-parametric tests, revealing significant differences in molecular descriptors, validating the clustering methodology. Despite its limitations, including reliance on specific descriptors and computational complexity, this study offers a comprehensive framework for understanding molecular interactions and guiding therapeutic interventions. Future research could integrate additional descriptors, advanced machine learning techniques, and dynamic network analysis to enhance clustering accuracy and applicability.
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  • 文章类型: Journal Article
    背景:儿童超重和肥胖是全球关注的问题,在过去的几十年中,西班牙的儿童超重和肥胖有所增加。生活方式行为的组合(即,饮食,睡眠,和沉默症)与体重状态高度相关。因此,这项研究旨在确定马德里市儿童的生活方式,并分析与超重患病率的关系,肥胖,和腹部肥胖,考虑社会经济因素。
    方法:对来自ENPIMAD研究的4545名儿童进行了横断面分析,并获得了饮食数据,睡眠,人体测量学,和社会经济变量。K-means聚类分析用于识别生活方式簇,和逻辑回归被用来检验社会经济指标和集群成员之间的关联,以及群集和体重状态之间的关系。
    结果:研究结果表明三种生活方式(健康,混合,和不健康),男孩和年龄较大的孩子在不健康群体中的比例更高。粮食不安全和社会经济地位低与男孩和女孩群体不健康有关。不健康人群中的儿童更有可能患有肥胖和腹部肥胖。然而,在控制粮食不安全后,这些协会在女孩中消失了。
    结论:这些结果提供了与儿童肥胖相关的行为和社会经济因素组合的见解,这可能有助于设计未来的干预措施。
    BACKGROUND: Childhood overweight and obesity is a global concern and has increased in Spain over the last decades. Combinations of lifestyle behaviors (i.e., diet, sleep, and sedentarism) are highly related to weight status. Therefore, this study aimed to identify lifestyle patterns among children from Madrid City, and analyze associations with the prevalence of overweight, obesity, and abdominal obesity, considering socio-economic factors.
    METHODS: A cross-sectional analysis was conducted on 4545 children from the ENPIMAD study with data on diet, sleep, anthropometric, and socio-economic variables. K-means cluster analysis was used to identify lifestyle clusters, and logistic regressions were used to examine the associations between socio-economic indicators and cluster membership, and between clusters and weight status.
    RESULTS: Findings show three lifestyle clusters (healthy, mixed, and unhealthy), with boys and older children more represented in the unhealthy cluster. Food insecurity and low socio-economic status were associated with unhealthier clusters in boys and girls. Children in unhealthier clusters were more likely to have obesity and abdominal obesity. However, these associations disappeared in girls after controlling for food insecurity.
    CONCLUSIONS: These results provide insight into the combination of behaviors and socio-economic factors associated with childhood obesity that may aid in the design of future interventions.
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  • 文章类型: Journal Article
    包括这个星球上最大的人口群体,Z世代提出了由气候变化和食品驱动的面向未来的消费领域。本研究旨在调查Z世代对植物性食物和饮食的看法,并探索态度成分之间的关系,参与膳食准备,个人和生活方式因素,以及采用植物性饮食的感知障碍,都愿意采用绿色饮食。使用希腊大学生的横截面数据,印度,和英国,使用各种工具来确定影响年轻人对动物蛋白替代品的消费行为的因素。PCA指出了学生对植物性食物的观点的基本维度,而分层和k均值聚类提供了聚类结构。估计了一个有序的概率模型来描述Z世代采用植物性饮食的意愿,并区分大多数不愿意的饮食,有点愿意,大多是心甘情愿的年轻人。我们的发现确定了两个消费者群体,即植物性食品和饮食的支持者和反对者,在植物性饮食的健康益处方面存在统计学上的显着差异,对动物蛋白质的依恋,感知到对动物性食品的排斥,对植物性食品属性的不满,以及确保充足蛋白质摄入的需求。有序的probit模型估计表明,影响年轻人采用植物性饮食的意愿的因素存在“同质性”,有了态度成分,膳食准备指标,感知到吃“绿色”的障碍,和个人因素,例如自我评估的健康饮食和体育锻炼知识,这三个国家的学生都愿意转向植物性饮食。在转向更多的绿色饮食行为方面绘制潜在的障碍和推动者,我们的研究结果可以增加信息,以更好地了解影响食物选择和青少年过渡到更可持续的生活方式的因素。
    Comprising the largest population cohort on this planet, Gen Z presents a future-oriented consumer segment driven by climate change and food. This study sought to investigate Gen Z\'s perceptions toward plant-based foods and diets and explore the relationship that attitude components, meal preparation involvement, personal and lifestyle factors, and perceived barriers in adopting a plant-based diet have with willingness to adopt green-eating practices. Using cross-sectional data from university students in Greece, India, and the UK, various tools were employed to determine the factors influencing youths\' consumer behavior toward animal-protein substitutes. PCA indicated the underlying dimensions of students\' viewpoints on plant-based foods, whereas hierarchical and k-means clustering provided the cluster structure. An ordered probit model was estimated to delineate Gen Z\'s willingness to adopt plant-based diets and distinguish among mostly unwilling, somewhat willing, and mostly willing youths. Our findings identified two consumer segments, namely proponents and opponents of plant-based foods and diets, with statistically significant differences in the perceived health benefits of plant-based diets, attachment to animal-based proteins, perceived exclusion of animal-based foods, dissatisfaction with plant-based foods\' attributes, and demand for ensuring adequate protein intake. The ordered probit model estimates showed that there is a \"homogeneity\" in the factors influencing youths\' intention to adopt plant-based diets, with attitude components, meal preparation indicators, perceived barriers to eating \"green\", and personal factors, such as self-assessed knowledge of healthy eating and physical activity, being strongly associated with students\' willingness to switch to plant-based diets in all three countries. Mapping potential obstacles and enablers in terms of shifting to more green-eating behaviors, our findings could add information to better understand the factors affecting food choice and youths\' transition to a more sustainable lifestyle.
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  • 文章类型: Journal Article
    背景:最近的难治性精神分裂症(TRS)的操作标准识别为阳性和阴性症状。TRS患者阴性症状可能存在异质性,但缺乏经验数据。我们的目标是使用聚类分析根据阴性症状来表征TRS患者,并检查集群之间的社会功能差异。
    方法:我们进行了阴性症状临床评估访谈(CAINS),简短阴性症状量表(BNSS),阳性和阴性综合征量表(PANSS)以及社会和职业功能评估(SOFAS对126名TRS门诊患者。所有患者还完成了快乐时间体验量表(TEPS),情感表现力量表(EES),和社会功能量表(SFS)。对CAINS进行了两阶段层次聚类分析,TEPS和EES作为聚类变量。我们使用ANOVA验证了聚类,以比较BNSS中的组差异,PANSS,SOFAS和SFS。
    结果:集群索引支持3集群解决方案。群集1(n=46)和3(n=16)表现出比群集2(n=64)更高的CAINS得分,并且是阴性症状TRS亚型。群集1报告的TEPS低于群集3;但群集3报告的EES低于群集1。验证后,聚类1和3表现出比聚类2更高的BNSS评分,但只有聚类1表现出比聚类2更低的SOFAS和更高的PANSS一般症状。群集1和群集3的自我报告功能均高于群集2。
    结论:我们提供了TRS阴性症状异质性的证据。阴性症状可以表征TRS患者并预测功能结果。
    BACKGROUND: Recent operational criteria for treatment-resistant schizophrenia (TRS) recognized positive and negative symptoms. TRS patients may have heterogeneity in negative symptoms, but empirical data were lacking. We aimed to characterize TRS patients based on negative symptoms using cluster analysis, and to examine between-cluster differences in social functioning.
    METHODS: We administered the Clinical Assessment Interview of Negative symptoms (CAINS), Brief Negative Symptom Scale (BNSS), the Positive and Negative Syndrome Scale (PANSS) and the Social and Occupational Functional Assessment (SOFAS to 126 TRS outpatients. All patients also completed the Temporal Experience of Pleasure Scale (TEPS), the Emotion Expressivity Scale (EES), and the Social Functional Scale (SFS). A two-stage hierarchical cluster analysis was performed with the CAINS, TEPS and EES as clustering variables. We validated the clusters using ANOVAs to compare group differences in the BNSS, PANSS, SOFAS and SFS.
    RESULTS: Clustering indices supported a 3-cluster solution. Clusters 1 (n = 46) and 3 (n = 16) exhibited higher CAINS scores than Cluster 2 (n = 64), and were negative-symptom TRS subtypes. Cluster 1 reported lower TEPS than Cluster 3; but Cluster 3 reported lower EES than Cluster 1. Upon validation, Clusters 1 and 3 exhibited higher BNSS scores than Cluster 2, but only Cluster 1 exhibited lower SOFAS and higher PANSS general symptoms than Cluster 2. Both Clusters 1 and 3 had higher self-report functioning than Cluster 2.
    CONCLUSIONS: We provided evidence for heterogeneity of negative symptoms in TRS. Negative symptoms can characterize TRS patients and predict functional outcome.
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  • 文章类型: Journal Article
    生物数据的日益复杂刺激了创新计算技术的发展,以提取有意义的信息并发现大量数据集中的隐藏模式。生物网络,如基因调控网络和蛋白质-蛋白质相互作用网络,对生物特征的连接和功能持有关键见解。集成和分析高维数据,特别是在基因表达研究中,在破译这些网络的挑战中,这是突出的。聚类方法在解决这些挑战中起着至关重要的作用,考虑到固有的几何结构,谱聚类成为一种有效的无监督技术。然而,频谱聚类的用户定义的聚类编号可能导致不一致,有时甚至是正交的聚类机制。我们提出了多层捆绑(MLB)方法来解决这个限制,结合多个突出的聚类制度,提供一个全面的数据视图。我们将结果群集称为“bundle”。这种方法改进了聚类结果,解开等级制度,并标识在网络组件之间进行通信的网桥元素。通过分层聚类结果,MLB提供生物特征簇的全局到局部视图,从而能够洞察复杂的生物系统。此外,该方法通过将束协同聚类矩阵与亲和矩阵相结合来增强束网络预测。MLB的多功能性超越了生物网络,使其适用于需要理解复杂关系和模式的各种领域。
    The growing complexity of biological data has spurred the development of innovative computational techniques to extract meaningful information and uncover hidden patterns within vast datasets. Biological networks, such as gene regulatory networks and protein-protein interaction networks, hold critical insights into biological features\' connections and functions. Integrating and analyzing high-dimensional data, particularly in gene expression studies, stands prominent among the challenges in deciphering these networks. Clustering methods play a crucial role in addressing these challenges, with spectral clustering emerging as a potent unsupervised technique considering intrinsic geometric structures. However, spectral clustering\'s user-defined cluster number can lead to inconsistent and sometimes orthogonal clustering regimes. We propose the Multi-layer Bundling (MLB) method to address this limitation, combining multiple prominent clustering regimes to offer a comprehensive data view. We call the outcome clusters \"bundles\". This approach refines clustering outcomes, unravels hierarchical organization, and identifies bridge elements mediating communication between network components. By layering clustering results, MLB provides a global-to-local view of biological feature clusters enabling insights into intricate biological systems. Furthermore, the method enhances bundle network predictions by integrating the bundle co-cluster matrix with the affinity matrix. The versatility of MLB extends beyond biological networks, making it applicable to various domains where understanding complex relationships and patterns is needed.
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  • 文章类型: English Abstract
    背景:对感染上升和下降的可能决定因素的研究可能具有重要意义,就像在COVID-19大流行期间所经历的那样。了解决定因素是同时发生还是通过不同区域之间的连续性发展的方法之一是研究区域之间的诊断复制指数RDt。
    目的:介绍RDt变异性的分析以及最近引入的功能聚类方法的后续应用,作为识别流行曲线中具有相似趋势的聚类的存在的非常有用的程序。
    方法:在考虑的时期内,在四个不同的时间间隔内详细分析了区域RDt的趋势。
    方法:举例说明此方法,2021年底至2022年初期间的变异性研究可能会引起人们的兴趣。
    方法:区域RDt指数的变异性是通过相对于各个区域的种群加权的相关系数来评估的。聚类过程应用于绝对RDt值的时间序列。
    结果:出现了RDt变异性增加的时期对应于感染数量的初始增长或减少,而功能聚类确定了流行曲线具有相似趋势的宏观区域。导致传染病增加的原因似乎与某些地区并非特定的因素有关,在某些情况下,邻近地区之间的传染动力有所贡献。
    结论:区域诊断复制指数趋势的变异性,只需延迟几天计算,是早期发现流行曲线趋势重大变化的进一步指标。流行病指数曲线的聚类可用于确定决定因素是同时起作用还是通过相邻区域之间的邻接起作用。
    BACKGROUND: the study of the possible determinants of the rise and fall of infections can be of great relevance, as was experienced during the COVID-19 pandemic. One of the methods to understand whether determinants are simultaneous or develop through contiguity between different areas is the study of the diagnostic replication index RDt among regions.
    OBJECTIVE: to introduce the analysis of RDt variability and the subsequent application of a recently introduced functional clustering method as highly useful procedures for recognizing the presence of clusters with similar trends in epidemic curves.
    METHODS: within the considered period, trends in regional RDt are analyzed in detail over four different time intervals.
    METHODS: to exemplify this methodology, the study of variability in the period from the end of 2021 to the beginning of 2022 may be of interest.
    METHODS: the variability in the regional RDt indices is assessed by means of the correlation coefficient weighted with respect to the populations of the individual regions. The clustering procedure is applied to the time series of absolute RDt values.
    RESULTS: it emerges that the periods of increasing variability in the RDt correspond to the initial growth or decrease in the number of infections, while functional clustering identifies macro-areas in which the epidemic curves have had similar trends. What caused contagions to increase seems to relate to a factor that is not specific to certain areas, with the contribution in some cases of a contagion dynamic between adjacent areas.
    CONCLUSIONS: the variability in the trend of regional diagnostic replication indices, which are calculated with only a few days delay, is a further indicator for the early detection of major changes in the trend of epidemic curves. The clustering of epidemic index curves may be useful to determine whether determinants act simultaneously or by contiguity between adjacent areas.
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  • 文章类型: Journal Article
    这项研究描述了在斯洛伐克首次检测到文氏伊克斯。从斯洛伐克东部捕获的Dunnocks(Prunellamodialaris)中收集了两名沉迷的I.ventalloi雌性。雌性的鉴定基于形态和分子16SrRNA基因特征。系统发育分析显示,将雌性分为不同的基因组。此外,比较形态学分析强调了两个雌性之间的差异,特别是在耳廓的曲率中,coxaI的形状,和内部刺激。这些发现表明,文氏I.ventalloi的各种表型与其基因组相关的潜力。尽管如此,I.斯洛伐克境内的ventalloi种群建立需要通过标记或拖动采样进行进一步调查。
    This study describes the first detection of Ixodes ventalloi in Slovakia. Two engorged females of I. ventalloi were collected from Dunnocks (Prunella modularis) captured in eastern Slovakia. The identification of females was based on morphological and molecular 16S rRNA gene features. Phylogenetic analysis revealed a classification of the females into distinct genogroups. Moreover, comparative morphological analysis highlighted variations between the two females, particularly in the curvature of the auriculae, the shape of coxa I, and the internal spur. These findings suggest the potential for varied phenotypes of I. ventalloi correlated with their genogroups. Nonetheless, I. ventalloi population establishment within Slovakia necessitates further investigation through flagging or drag sampling.
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  • 文章类型: Journal Article
    背景:队列研究越来越多地收集生物样品进行分子谱分析,并观察到分子异质性。高通量RNA测序提供了能够反映疾病机制的大型数据集。聚类方法已经产生了许多工具来帮助剖析复杂的异构数据集,但是选择合适的方法和参数来执行转录组数据的探索性聚类分析需要深入理解机器学习和广泛的计算实验。在没有事先现场知识的情况下帮助做出此类决策的工具是不存在的。为了解决这个问题,我们开发了Omada,一套工具,旨在自动化这些过程,并通过基于机器学习的自动化功能使转录组数据的健壮无监督聚类更易于访问。
    结果:使用以不同表达信号强度为特征的7个数据集测试了每种工具的效率,以捕获广谱的RNA表达数据集。我们的工具包的决策反映了数据集中的稳定分区的实际数量,其中子组是可辨别的。在生物学区别不太明确的数据集中,我们的工具要么形成了具有不同表达谱和可靠临床关联的稳定亚组,要么揭示了有问题数据的迹象,例如偏倚测量.
    结论:结论:Omada成功地自动化了转录组数据的健壮无监督聚类,即使对于那些没有广泛的机器学习专业知识的人来说,也能使高级分析变得容易和可靠。Omada的实施可在http://biocorductor.org/packages/omada/上获得。
    BACKGROUND: Cohort studies increasingly collect biosamples for molecular profiling and are observing molecular heterogeneity. High-throughput RNA sequencing is providing large datasets capable of reflecting disease mechanisms. Clustering approaches have produced a number of tools to help dissect complex heterogeneous datasets, but selecting the appropriate method and parameters to perform exploratory clustering analysis of transcriptomic data requires deep understanding of machine learning and extensive computational experimentation. Tools that assist with such decisions without prior field knowledge are nonexistent. To address this, we have developed Omada, a suite of tools aiming to automate these processes and make robust unsupervised clustering of transcriptomic data more accessible through automated machine learning-based functions.
    RESULTS: The efficiency of each tool was tested with 7 datasets characterized by different expression signal strengths to capture a wide spectrum of RNA expression datasets. Our toolkit\'s decisions reflected the real number of stable partitions in datasets where the subgroups are discernible. Within datasets with less clear biological distinctions, our tools either formed stable subgroups with different expression profiles and robust clinical associations or revealed signs of problematic data such as biased measurements.
    CONCLUSIONS: In conclusion, Omada successfully automates the robust unsupervised clustering of transcriptomic data, making advanced analysis accessible and reliable even for those without extensive machine learning expertise. Implementation of Omada is available at http://bioconductor.org/packages/omada/.
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  • 文章类型: Journal Article
    目的:为了确定自我报告的疲劳,焦虑,抑郁症,认知困难,与健康相关的生活质量,SLE患者的疾病活动评分和神经心理电池(NB)根据症状强度以及在1年随访时是否有变化而分为不同组.
    方法:这是一项对连续同意的患者的回顾性分析,在一个单一的中心。患者完成了全面的NB,贝克焦虑量表,贝克抑郁量表,疲劳严重程度量表,简短的健康调查身体成分汇总和心理成分汇总得分和感知缺陷问卷。通过系统性红斑狼疮疾病活动指数2000评估疾病活动。Ward的方法用于聚类,主成分分析用于可视化聚类的数量。用kappa统计量评估1年时的稳定性。
    结果:在142例患者中,发现了三个簇:簇1症状强度较轻,第2组症状强度中等,第3组症状强度严重.在1年的随访中,49%的患者保持在他们的基线群。轻度集群具有最高的稳定性(77%的患者留在同一集群中),其次是严重集群(51%),中度集群的稳定性最低(3%)。少数患者从轻度集群转移到重度集群(19%)。在严重集群中,更多的人转移到中度集群(40%),更少的人转移到轻度集群(9%)。
    结论:在SLE患者中记录了与认知功能相关的三种不同的症状强度。在一年的过程中,轻度和重度集群中的患者移动的趋势较低,但不是中度集群。这可能表明干预有机会使中度集群患者移至轻度集群而不是移至重度集群。需要进一步的研究来评估影响运动到中等集群的因素。
    OBJECTIVE: To determine if self-reported fatigue, anxiety, depression, cognitive difficulties, health-related quality of life, disease activity scores and neuropsychological battery (NB) cluster into distinct groups in patients with SLE based on symptom intensity and if they change at 1-year follow-up.
    METHODS: This is a retrospective analysis of consecutive consenting patients, followed at a single centre. Patients completed a comprehensive NB, the Beck Anxiety Inventory, Beck Depression Inventory, Fatigue Severity Scale, Short-Form Health Survey Physical Component Summary and Mental Component Summary scores and the Perceived Deficits Questionnaire. Disease activity was assessed by Systemic Lupus Erythematosus Disease Activity Index 2000. Ward\'s method was used for clustering and principal component analysis was used to visualise the number of clusters. Stability at 1 year was assessed with kappa statistic.
    RESULTS: Among 142 patients, three clusters were found: cluster 1 had mild symptom intensity, cluster 2 had moderate symptom intensity and cluster 3 had severe symptom intensity. At 1-year follow-up, 49% of patients remained in their baseline cluster. The mild cluster had the highest stability (77% of patients stayed in the same cluster), followed by the severe cluster (51%), and moderate cluster had the lowest stability (3%). A minority of patients from mild cluster moved to severe cluster (19%). In severe cluster, a larger number moved to moderate cluster (40%) and fewer to mild cluster (9%).
    CONCLUSIONS: Three distinct clusters of symptom intensity were documented in patients with SLE in association with cognitive function. There was a lower tendency for patients in the mild and severe clusters to move but not moderate cluster over the course of a year. This may demonstrate an opportunity for intervention to have moderate cluster patients move to mild cluster instead of moving to severe cluster. Further studies are necessary to assess factors that affect movement into moderate cluster.
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  • 文章类型: Journal Article
    目的:根据累积的长期状况(LTC)作为轨迹,将老年人分类为簇,表征集群并量化它们与全因死亡率的关联。
    方法:我们进行了一项纵向研究,使用英国纵向老龄化研究超过9年(n=15091,年龄在50岁及以上)。基于群体的轨迹建模用于基于随时间累积的LTC将人分类成群。派生聚类用于量化轨迹成员之间的关联,社会人口统计学特征和全因死亡率,通过回归模型。
    结果:确定了五个不同的累积LTC轨迹簇,并将其表征为:\'无LTC\'(18.57%),“单一LTC”(31.21%),“不断发展的多发病率”(25.82%),“中度多浊度”(17.12%)和“高多浊度”(7.27%)。年龄的增长始终与更多的LTC相关。少数民族(校正后的OR=2.04;95%CI1.40至3.00)与“高多重性”群相关。随着时间的推移,高等教育和有偿就业与LTC数量增加的可能性较低相关。所有群集的全因死亡率均高于“无LTC”群集。
    结论:随着时间的推移,多种疾病的发展遵循不同的轨迹。这些是由不可修改的(年龄,种族)和可改变的因素(教育和就业)。通过聚类对风险进行分层将使从业者能够识别出随着时间的推移LTC恶化的可能性较高的老年人,以制定有效的干预措施来预防死亡。
    OBJECTIVE: To classify older adults into clusters based on accumulating long-term conditions (LTC) as trajectories, characterise clusters and quantify their associations with all-cause mortality.
    METHODS: We conducted a longitudinal study using the English Longitudinal Study of Ageing over 9 years (n=15 091 aged 50 years and older). Group-based trajectory modelling was used to classify people into clusters based on accumulating LTC over time. Derived clusters were used to quantify the associations between trajectory memberships, sociodemographic characteristics and all-cause mortality by conducting regression models.
    RESULTS: Five distinct clusters of accumulating LTC trajectories were identified and characterised as: \'no LTC\' (18.57%), \'single LTC\' (31.21%), \'evolving multimorbidity\' (25.82%), \'moderate multimorbidity\' (17.12%) and \'high multimorbidity\' (7.27%). Increasing age was consistently associated with a larger number of LTCs. Ethnic minorities (adjusted OR=2.04; 95% CI 1.40 to 3.00) were associated with the \'high multimorbidity\' cluster. Higher education and paid employment were associated with a lower likelihood of progression over time towards an increased number of LTCs. All the clusters had higher all-cause mortality than the \'no LTC\' cluster.
    CONCLUSIONS: The development of multimorbidity in the number of conditions over time follows distinct trajectories. These are determined by non-modifiable (age, ethnicity) and modifiable factors (education and employment). Stratifying risk through clustering will enable practitioners to identify older adults with a higher likelihood of worsening LTC over time to tailor effective interventions to prevent mortality.
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