Schizophrenia is a complex disorder with many comorbid conditions. In this study, we used polygenic risk scores (PRSs) from schizophrenia and comorbid traits to explore consistent cluster structure in schizophrenia patients. With 10 comorbid traits, we found a stable 4-cluster structure in two datasets (MGS and SSCCS). When the same traits and parameters were applied for the patients in a clinical trial of antipsychotics, the CATIE study, a 5-cluster structure was observed. One of the 4 clusters found in the MGS and SSCCS was further split into two clusters in CATIE, while the other 3 clusters remained unchanged. For the 5 CATIE clusters, we evaluated their association with the changes of clinical symptoms, neurocognitive functions, and laboratory tests between the enrollment baseline and the end of Phase I trial. Class I was found responsive to treatment, with significant reduction for the total, positive, and negative symptoms (p=0.0001, 0.0099, and 0.0028, respectively), and improvement for cognitive functions (VIGILANCE, p=0.0099; PROCESSING SPEED, p=0.0006; WORKING MEMORY, p=0.0023; and REASONING, p=0.0015). Class II had modest reduction of positive symptoms (p=0.0492) and better PROCESSING SPEED (p=0.0071). Class IV had a specific reduction of negative symptoms (p=0.0111) and modest cognitive improvement for all tested domains. Interestingly, Class IV was also associated with decreased lymphocyte counts and increased neutrophil counts, an indication of ongoing inflammation or immune dysfunction. In contrast, Classes III and V showed no symptom reduction but a higher level of phosphorus. Overall, our results suggest that PRSs from schizophrenia and comorbid traits can be utilized to classify patients into subtypes with distinctive clinical features. This genetic susceptibility based subtyping may be useful to facilitate more effective treatment and outcome prediction.
In view of the rescue delay due to traffic congestion in the urban road network, this paper implemented real-time traffic control with congestion index constraints in emergency vehicle dispatching and proposed a two-stage optimization model and algorithm. In the first stage, salp swarm algorithm (SSA) was combined with Dijkstra algorithm, and a novel hybrid algorithm with new updating rules was designed to get the multiple alternative paths. In the second stage, an improved salp swarm algorithm (ISSA) with a population grouping strategy was proposed to obtain the best evacuation schemes and the optimal rescue paths of emergency vehicles. Results of the illustrative examples show that, after evacuation, the average travel time of all alternative paths is reduced by 24.22%, while traffic congestion indexes of the adjacent road sections almost unchanged. The computation time of the hybrid algorithm for obtaining the set number of alternative paths is 56.62% and 50.47% shorter than that of bat algorithm (BA) and SSA. For the solution of the evacuation model, the computation time of the ISSA is 33.51%, 30.15%, and 30.60% shorter than that of particle swarm optimization (PSO), BA, and SSA, and the optimal solution of the ISSA is 25.92%, 10.06%, and 0.97% better than that of PSO, BA, and SSA. That is, we shorten the emergency response time and control the adverse impact of traffic evacuation on background traffic. The improved algorithm has excellent performance. This study provides a new idea and method for emergency rescue of traffic accidents.
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