Collectives of diagnostic biomarkers identify high-risk subpopulations of hematuria patients: exploiting heterogeneity in large-scale biomarker data

Background: Ineffective risk stratification can delay diagnosis of serious disease in patients with hematuria. We applied a systems biology approach to analyze clinical, demographic and biomarker measurements (n = 29) collected from 157 hematuric patients: 80 urothelial cancer (UC) and 77 controls with confounding pathologies.

Methods: On the basis of biomarkers, we conducted agglomerative hierarchical clustering to identify patient and biomarker clusters. We then explored the relationship between the patient clusters and clinical characteristics using Chi-square analyses. We determined classification errors and areas under the receiver operating curve of Random Forest Classifiers (RFC) for patient subpopulations using the biomarker clusters to reduce the dimensionality of the data.

Results: Agglomerative clustering identified five patient clusters and seven biomarker clusters. Final diagnoses categories were non-randomly distributed across the five patient clusters. In addition, two of the patient clusters were enriched with patients with ‘low cancer-risk’ characteristics. The biomarkers which contributed to the diagnostic classifiers for these two patient clusters were similar. In contrast, three of the patient clusters were significantly enriched with patients harboring ‘high cancer-risk” characteristics including proteinuria, aggressive pathological stage and grade, and malignant cytology. Patients in these three clusters included controls, that is, patients with other serious disease and patients with cancers other than UC. Biomarkers which contributed to the diagnostic classifiers for the largest ‘high cancer- risk’ cluster were different than those contributing to the classifiers for the ‘low cancer-risk’ clusters. Biomarkers which contributed to subpopulations that were split according to smoking status, gender and medication were different.

Conclusions: The systems biology approach applied in this study allowed the hematuric patients to cluster naturally on the basis of the heterogeneity within their biomarker data, into five distinct risk subpopulations. Our findings highlight an approach with the promise to unlock the potential of biomarkers. This will be especially valuable in the field of diagnostic bladder cancer where biomarkers are urgently required. Clinicians could interpret risk classification scores in the context of clinical parameters at the time of triage. This could reduce cystoscopies and enable priority diagnosis of aggressive diseases, leading to improved patient outcomes at reduced costs. © 2013 Emmert-Streib et al; licensee BioMed Central Ltd.

Chronic smartphone gaming consumption and positive coping practice

Purpose - Chronic consumption practice has been greatly accelerated by mobile, interactive and smartphone gaming technology devices. This study explores how chronic consumption of smartphone gaming produces positive coping practice. Design/methodology/approach - Underpinned by cognitive framing theory, empirical insights from eleven focus groups (n=62) reveal how smartphone gaming enhances positive coping amongst gamers and non-gamers. Findings - The findings reveal how the chronic consumption of games allows technology to act with privileged agency that resolves tensions between individuals and collectives. Consumption narratives of smartphone games, even when play is limited, lead to the identification of three cognitive frames through which positive coping processes operate: (a) the market generated frame, (b) the social being frame, and (c) the citizen frame. Research limitations/implications – This paper adds to previous research by providing an understanding of positive coping practice in the smartphone chronic gaming consumption. Originality/value - In smartphone chronic gaming consumption, cognitive frames enable positive coping by fostering appraisal capacities in which individuals confront, hegemony, culture and alterity-morality concerns. 

The Emerging Church Movement: A Sociological Assessment

With so many voices, groups, and organizations participating in the Emerging Church Movement (ECM), few are willing to “define” it, though authors have offered various definitions. Emerging Christians themselves do not offer systematic or coherent definitions, which contributes to frustration in isolating it as a coherent group – especially for sociologists who strive to define and categorize. In presenting our understanding of this movement, we categorize Emerging Christianity as an orientation rather than an identity, and focus on the diverse practices within what we describe as “pluralist congregations” (often called “gatherings,” “collectives” or “communities” by Emerging Christians themselves). This leads us to define the ECM as a creative, entrepreneurial religious movement that strives to achieve social legitimacy and spiritual vitality by actively disassociating from its roots in conservative, evangelical Christianity. Our findings are extensively developed in The Deconstructed Church: Understanding Emerging Christianity (Marti and Ganiel 2014).