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Multiple imputation is a common technique for dealing with missing values and is mostly applied in regression settings. Its application in cluster analysis problems, where the main objective is to classify individuals into homogenous groups, involves several difficulties which are not well characterized in the current literature. In this paper, we propose a framework for applying multiple imputation to cluster analysis when the original data contain missing values. The proposed framework incorporates the selection of the final number of clusters and a variable reduction procedure, which may be needed in data sets where the ratio of the number of persons to the number of variables is small. We suggest some ways to report how the uncertainty due to multiple imputation of missing data affects the cluster analysis outcomes-namely the final number of clusters, the results of a variable selection procedure (if applied), and the assignment of individuals to clusters. The proposed framework is illustrated with data from the Phenotype and Course of Chronic Obstructive Pulmonary Disease (PAC-COPD) Study (Spain, 2004-2008), which aimed to classify patients with chronic obstructive pulmonary disease into different disease subtypes.
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http://dx.doi.org/10.1093/aje/kws289 | DOI Listing |
Matern Child Health J
September 2025
University of Southern California, 1845 N Soto St, Los Angeles, CA, 90032, USA.
Objective: To test whether parent restriction, pressure to eat, and maternal concern for child weight mediated the positive association between food insecurity and child body mass index (BMI) in cross-sectional and longitudinal analysis.
Methods: Data were from mother-child pairs (n = 202 at baseline). Children were M = 10.
Front Public Health
September 2025
Department of Personnel Strategies, Institute of Management, Collegium of Management and Finance, SGH Warsaw School of Economics, Warsaw, Poland.
Introduction: Organizational resilience is of paramount importance for coping with adversity, particularly in the healthcare sector during crises. The objective of the present study was to evaluate the impact of resilience-based interventions on the well-being of healthcare employees during the pandemic. In this study, resilience-based interventions are defined as organizational actions that strengthen a healthcare institution's capacity to cope with crises-such as ensuring adequate personal protective equipment and staff testing, clear risk-communication, alternative care pathways (e.
View Article and Find Full Text PDFMenopause
September 2025
Department of Anesthesiology and Perioperative Medicine, Medical College of Georgia at Augusta University, Augusta, GA.
Objective: To evaluate depression in postmenopausal women and to explore the relationship between age at menopause, hormone therapy, and depression, while also identifying potential mediators that may explain these associations.
Methods: This cross-sectional study analyzed data from National Health and Nutrition Examination Survey (NHANES) (2005-2020) for women older than 60 years who completed the Patient Health Questionnaire 9 (PHQ-9) depression questionnaire (n=7,027). Exposures included age at menopause and self-reported hormone therapy; the outcome was depression severity (PHQ-9 ≥10).
Clin Transplant
September 2025
Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK.
Background: Liver transplantation is the definitive treatment for end-stage liver disease and some cancers. The use of livers from donors following pre-donation cardiac arrest (PDCA), especially with prolonged downtime duration, has been limited outside of the US due to fears over inferior outcomes from ischemic injury. However, PDCA may induce ischemic preconditioning, paradoxically improving post-transplant outcomes.
View Article and Find Full Text PDFActa Anaesthesiol Scand
October 2025
Centre for Anaesthesiological Research, Department of Anaesthesiology, Zealand University Hospital, Køge, Denmark.
Background: Multiple organ dysfunction syndrome (MODS) in critical illness involves dysregulated immune and inflammatory responses, endotheliopathy, and coagulation activation. We investigated how three types of endotheliopathy biomarkers relate to pro- and anti-inflammatory responses and clinical outcomes in intensive care unit (ICU) patients.
Methods: In this secondary, explorative analysis of a prospective single-centre cohort (n = 459), we assessed associations between endotheliopathy biomarkers (syndecan-1, soluble thrombomodulin (sTM), platelet endothelial cell adhesion molecule-1 (PECAM-1)) and inflammatory biomarkers (pro-inflammatory: IFN-ϒ, IL-1β, IL-2, IL-6, IL-8, IL-12p70, TNF-α; anti-inflammatory: IL-4, IL-10, IL-13) at ICU admission using linear regression.