Bayesian consensus clustering for multivariate longitudinal data

In clinical and epidemiological studies, there is a growing interest in studying the heterogeneity among patients based on longitudinal characteristics to identify subtypes of the study population. Compared to clustering a single longitudinal marker, simultaneously clustering multiple longitudinal markers allow additional information to be incorporated into the clustering process, which reveals co-existing longitudinal patterns and generates deeper biological insight. In the current study, we propose a Bayesian consensus clustering (BCC) model for multivariate longitudinal data. Instead of arriving at a single overall clustering, the proposed model allows each marker to follow marker-specific local clustering and these local clusterings are aggregated to find a global (consensus) clustering. To estimate the posterior distribution of model parameters, a Gibbs sampling algorithm is proposed. We apply our proposed model to the primary biliary cirrhosis study to identify patient subtypes that may be associated with their prognosis. We also perform simulation studies to compare the clustering performance between the proposed model and existing models under several scenarios. The results demonstrate that the proposed BCC model serves as a useful tool for clustering multivariate longitudinal data.     

From the "what" to the "how": Teaching integrative medicine-related skills to medical students during COVID-19

ObjectiveTo examine the impact of an integrative medicine (IM) course on self-perceived IM-related communication and research skills.MethodsA 3-day mandatory "hybrid" (online and in-person) IM course was held within COVID-19 restrictions for 161 pre-clerkship medical students, with workshops facilitated by mentor healthcare professionals (IM and non-IM) and student-directed tasks. Self-perceived levels of 6 IM-related skills were scored (from 1 to 5) for history-taking; communicating with patients with "alternative" health-beliefs; referral to IM consultations; assessing risks/benefits; and working with non-medical IM practitioners.Results137 students (85.1%) completed pre-/post-course questionnaires, with overall scores improving from pre-course (1.98 ± 0.92) to post-course (3.31 ± 0.63; p < 0.0001), for the entire group and student subgroups (with vs. without prior IM experience). Multivariate analysis found no association between age, gender, primary language or prior experience with IM and improvement in skill scores.ConclusionsThe IM course increased self-perceived skill levels, reflecting the course curriculum and workshops. Further research needs to explore the application of these skills during clinical training.Practice implicationsTeaching medical students about IM in a course comprising communication and research skills was shown to be feasible and effective. The application of IM-related skills needs to be evaluated during the clinical clerkship.     

Parts‐based representations of perceived face movements in the superior temporal sulcus

Facial motion is a primary source of social information about other humans. Prior fMRI studies have identified regions of the superior temporal sulcus (STS) that respond specifically to perceived face movements (termed fSTS), but little is known about the nature of motion representations in these regions. Here we use fMRI and multivoxel pattern analysis to characterize the representational content of the fSTS. Participants viewed a set of specific eye and mouth movements, as well as combined eye and mouth movements. Our results demonstrate that fSTS response patterns contain information about face movements, including subtle distinctions between types of eye and mouth movements. These representations generalize across the actor performing the movement, and across small differences in visual position. Critically, patterns of response to combined movements could be well predicted by linear combinations of responses to individual eye and mouth movements, pointing to a parts‐based representation of complex face movements. These results indicate that the fSTS plays an intermediate role in the process of inferring social content from visually perceived face movements, containing a representation that is sufficiently abstract to generalize across low‐level visual details, but still tied to the kinematics of face part movements.     

8—2岁市区学龄儿童感觉统合失调与不良行为及家庭因素调查分析

目的：调查本市区小学儿童感觉统合失调现状与不良行为及家庭因素的关系。方法：用感觉统合诊断量表和自制儿童生长发育调查表对1775名学龄儿童进行心理行为问题调查。结果：感觉统合轻度失调23．4％，重度失调13．5％，男童失调发和率（42．86％）明显高于女童（31．36％）P＜0．0），前庭功能失衡发生率最高（21．30％）；统合失调组儿童不良行为发生率高达64．38％明显高于统合正常组（31．11％）P＜0．01，失调组不良行为各因子的发生率亦明显高于统合正常组P＜0．01；学习能力不足儿童与父母文化程度和不同职业有关P＜0．01。结论：儿童感觉纺合失调现状易成为成人心理障碍的潜在因素，应引起重视。     

整体护理改善护患关系的体会

整体护理的实施,重塑了护士的职业价值观,增加了护患之间的接触。护士能够在自己的专业范围内积极主动地解决病人的问题,挖掘了护理人员的自身潜力,加深了护患交流,使护患关系明显改善。     

40例痔患者的辨证施护体会

目的：总结了痔患者的辨证施护体会，为临床护理工作提供参考。方法：回顾分析了自2001年以来收治的40例痔患者的临床资料。护理诊断及相应措施。结果：本组40例患者，痊愈者28例，好转者10例，病情稳定出院者2例。结论：树立以病人为中心的整体观。实施相应的辨证护理，贯彻以预防为主的方针，可提高痔的治愈率。     

Insults to the body civil: Mistreatment of elderly in two Plains Indian tribes

The mistreatment of elderly is subject to various social constructions. On two geographically distinct Plains Indian Reservations which we call Lone Mountain and Abundant Lands, the abuse or neglect of elderly is construed as a health problem which is a dysfunction of the community as a whole. Both physical abuse and neglect are more common on the Lone Mountain Reservation, occurring in association with other indicators of community disorganization such as unemployment and substance abuse. On the Abundant Lands Reservation physical abuse was categorically denied and what neglect existed appeared to be a function of role strain, geographic dispersal, climate and terrain. We attribute differences in the prevalence of mistreatment of elders to variations in economic opportunities for younger residents. Examining the historical and present contexts of intergenerational relationships on the reservations, we discuss the implications of this study for social exchange theory and policy applications.This research was supported by the Gerontological Society of America AppliedThis research was supported by the Gerontological Society of America AppliedThis research was supported by the Gerontological Society of America AppliedThis research was supported by the Gerontological Society of America AppliedThis research was supported by the Gerontological Society of America AppliedThis research was supported by the Gerontological Society of America Applied