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Bay Area Health Care Psychiatric Home Care Model.

This article describes the Bay Area Health Care Psychiatric Home Care Model. The symbol of a home is used to define the components of the model. The foundation of the house is a moral/spiritual one. The walls of the home are made up of assessment skills and relationship building. The second floor of the psychiatric home care model, supported by the walls of assessment and relationship, are the issues surrounding medications. The two sides of the roof of the psychiatric home care model are made up of teaching/psychotherapeutic interventions and case management. This model is comprehensive, and directed to caring, stabilizing, and maximizing potential.

Community Health Nursing↗

Numerical simulation of a natural gradient tracer experiment for the natural attenuation study: flow and physical transport.

Results are presented for numerical simulations of ground water flow and physical transport associated with a natural gradient tracer experiment conducted within a heterogeneous alluvial aquifer of the Natural Attenuation Study (NATS) site near Columbus, Mississippi. A principal goal of NATS is to evaluate biogeochemical models that predict the rate and extent of natural biodegradation under field conditions. This paper describes the initial phase in the model evaluation process, i.e., calibration of flow and physical transport models that simulate conservative bromide tracer plume evolution during NATS. An initial large-scale flow model (LSM) is developed encompassing the experimental site and surrounding region. This model is subsequently scaled down in telescopic fashion to an intermediate-scale ground water flow model (ISM) covering the tracer-monitoring network, followed by a small-scale transport model (SSM) focused on the small region of hydrocarbon plume migration observed during NATS. The LSM uses inferred depositional features of the site in conjunction with hydraulic conductivity (K) data from aquifer tests and borehole flowmeter tests to establish large-scale K and flow field trends in and around the experimental site. The subsequent ISM incorporates specified flux boundary conditions and large-scale K trends obtained from the calibrated LSM, while preserving small-scale K structure based on some 4000 flowmeter data for solute transport modeling. The configuration of the ISM-predicted potentiometric surface approximates that of the observed surface within a root mean squared error of 0.15 m. The SSM is based on the dual-domain mass-transfer approach. Despite the well-recognized difficulties in modeling solute transport in extremely heterogeneous media as found at the NATS site, the dual-domain model adequately reproduced the observed bromide concentration distributions. Differences in observed and predicted bromide concentration distributions are attributed to aquifer heterogeneity at the decimeter (dm) and smaller scales. The calibrated transport parameters for the SSM (i.e., 1:7 for the ratio of mobile-to-total porosity; 2.5 x 10(-3) day-1 for the mass-transfer coefficient; 1 m for longitudinal dispersivity; and 0.1 m for transverse dispersivity) are consistent with separate numerical simulations of two earlier tracer experiments at the site. The multiscale modeling approach adopted in this study permits the incorporation of both large-scale geologic features important for flow simulation and small-scale heterogeneities critical for transport simulation. In addition, the dual-domain transport model provides a foundation for multispecies reactive transport modeling studies of natural attenuation of hydrocarbons during NATS.

Chemical Phenomena↗

Continuing education in athletic training: an alternative approach based on adult learning theory.

OBJECTIVE: To offer an alternative perspective on current continuing education practices and to propose a model for facilitating continuing education in the athletic training workplace. BACKGROUND: Professional knowledge can quickly become outdated, and the personal/professional contexts of allied medical fields such as athletic training are becoming increasingly more complex, making continuing education paramount. Adult learning theory suggests that individuals are self- directed, autonomous learners in nature and that experience is a rich source for learning, subsequently making the workplace a fruitful environment in which to engage in continuing education. Unfortunately, mandating continuing education may violate the voluntary nature of adult learning, making the practice questionable. Therefore, alternative aspects of continuing education may be helpful. DESCRIPTION: This article consists of a brief synthesis of related literature that offers an alternative perspective of continuing education and proposes a model for facilitating continuing education in the workplace. The model's foundation includes preparing an environment conducive to learning and then focuses on identifying learning needs, setting goals, implementing specific strategies to facilitate self-directed learning, and assessing leaming. Additionally, the model suggests that ongoing reflection is a key factor in enhancing the identification of learning needs, goals, and strategies. ADVANTAGES: The model may best be used by clinical coordinators, directors, and supervisors to better facilitate employee learning and subsequently improve patient care delivery.

Journal Article↗

Medication management model as experiential education tool for students of pharmacy.

A visiting nurse association (VNA) and a college of Pharmacy sought cost-effective models by which consultant pharmacy services could be offered at a rural branch office to improve medication management for high-risk patients. Through a collaborative relationship with the Albany College of Pharmacy, the Eddy VNA used the structure and support of the Partners In Care Foundation (The Model) Medication Management Model to simultaneously provide patient services and train Doctor of Pharmacy candidates. The Model brings the pharmacist into the homecare team to provide pharmaceutical care and can provide the framework by which pharmacist preceptors and interns can effectively provide services to high-risk patients identified through the agency's CQI process. Results from program implementation with 100 Medicaid waiver patients indicate positive staff response and an overall 43% acceptance rate with prescribers and suggest that this is a cost-effective medication management service with implications for adaptation by other HHAs.

Education, Pharmacy↗

The management of battle-fatigued soldiers: an occupational therapy model.

Battle fatigue is a soldier's response to the overwhelming environmental and psychological stressors associated with combat. Management efforts that emphasize replenishment of physiologic needs, structured occupation, and support of the affected soldier's occupational roles have yielded high return-to-duty rates. Although such effective battle-fatigue management principles, or "principles of battlefield psychiatry," are well described, they have not been explained in terms of theoretical foundation. The model of human occupation, an occupational therapy treatment model, is presented as a theoretical framework to explain the success of current battle-fatigue management principles and to guide continued refinement of the process of restoring battle-fatigued soldiers to duty.

Humans↗

SPINFAST: using structure alignment profiles to enhance the accuracy and assess the reliability of protein side-chain modeling.

We present a novel, knowledge-based method for the side-chain addition step in protein structure modeling. The foundation of the method is a conditional probability equation, which specifies the probability that a side-chain will occupy a specific rotamer state, given a set of evidence about the rotamer states adopted by the side-chains at aligned positions in structurally homologous crystal structures. We demonstrate that our method increases the accuracy of homology model side-chain addition when compared with the widely employed practice of preserving the side-chain conformation from the homology template to the target at conserved residue positions. Furthermore, we demonstrate that our method accurately estimates the probability that the correct rotamer state has been selected. This interesting result implies that our method can be used to understand the reliability of each and every side-chain in a protein homology model.

Amino Acid Sequence↗

Primary health care for Korean immigrants: sustaining a culturally sensitive model.

This report describes a 4-year long bilingual interdisciplinary primary health care project that was designed to make culturally sensitive services available to underserved Korean immigrants in Chicago. It also describes some of the particular needs of this population and the strategies that the project staff adopted to identify and address the population's mental health needs. The project reflected the successful collaborative efforts of four participating principals: the Korean community, the University of Illinois at Chicago College of Nursing, the Chicago Department of Public Health, and the W. K. Kellogg Foundation. The model of service demonstrated in the project paired a bilingual advanced practice nurse, a certified family nurse practitioner, with a bilingual community advocate to conduct a program emphasizing community outreach and health promotion and prevention. A bilingual physician provided consultation for the nurse and attended to patients in need of medical care. Patients were referred to bilingual community social service agencies for assistance with a variety of other problems. A central goal of the project was for the services developed during its course to be assimilated into the regular programming of the Chicago Department of Public Health, a goal that was achieved. Finally, some of the challenges of introducing role change into an organization are discussed.

Chicago↗

Bistable Mutation-Selection Equilibria and Violations of Fisher's Theorem in Tetraploids: Insights from Nonlinear Dynamics.

Polyploidy and whole genome duplication (WGD) are widespread biological phenomena with substantial cellular, meiotic, and genetic effects. Despite their prevalence and significance across the tree of life, population genetics theory for polyploids is not well developed. The lack of theoretical models limits our understanding of polyploid evolution and restricts our ability to harness polyploidy for crop improvement amidst increasing environmental stress. To address this gap, we developed and analyzed deterministic models of mutation-selection balance for tetraploids under polysomic (autotetraploid) and disomic (allotetraploid) inheritance patterns and arbitrary dominance relationships. We also introduced a new mathematical framework based on ordinary differential equations and nonlinear dynamics for analyzing the models. We find that autotetraploids approach Hardy-Weinberg Equilibrium 33% faster than allotetraploids, but the different tetraploid inheritance models show little differences in mutation load and allele frequency at mutation-selection balance. Our model also reveals two bistable points of mutation-selection balance for dominant alleles with biased mutation rates over a wide range of selection coefficients in the tetraploid models compared to bistability in only a narrow range for diploids. Finally, using discrete time simulations, we explore the temporal dynamics of allele frequency and fitness change and compare these dynamics to the predictions of Fisher's Fundamental Theorem of Natural Selection. While Fisher's predictions generally hold, we show that the bistable dynamics for dominant mutations fundamentally alter the associated temporal dynamics. Overall, this work develops foundational theoretical models that will facilitate the development of population genetic models and methodologies to study evolution in empirical tetraploid populations.

Fisher’s Fundamental Theorem↗

Needs assessment of community-based services for children and youth with emotional or behavioral disorders and their families: Part 1. A conceptual model.

Communities throughout the nation are attempting to develop comprehensive systems of community-based, interagency care for children and youth with emotional or behavioral disorders and their families. Needs assessment has been identified as a key component of these initiatives. A needs assessment provides system planners with the data needed to make informed decisions with regard to improving the current system of care. In this first of a two-article series, an overview is presented of a model needs assessment designed for implementation by an interagency coalition interested in developing a comprehensive system of community-based services for children and youth with emotional or behavioral disorders and their families. Major components of the model include foundations for needs assessment, data collection, and data utilization.

Adolescent↗

[Mathematical model of epidermal growth factor receptor-mediated lipid phosphatidylinositol(4,5)-bisphosphate hydrolyzation by phospholipase C-gamma1 activity].

OBJECTIVE: To investigate the dynamic characteristics of lipid phosphatidylinositol (4,5)-bisphosphate (PIP(2)) in plasma membrane hydrolyzed by phospholipase C-gamma1 in epidermal growth factor receptor(EGFR)-mediated signal pathway. METHODS: A mathematical model based on the law of mass action was established with differential equations to simulate metabolizable pathway of PIP(2). RESULTS: Differential equations of the key product concentration during hydrolysis of PIP(2) were formulated, and the effects of the parameters on these hydrolyzed products analyzed. CONCLUSION: This mathematical model provides foundation for further investigation of the dynamic changes of biological characteristics and the relations between the key product concentrations in PIP2 hydrolysis.

ErbB Receptors↗

Artificial intelligence agents and agentic artificial intelligence applied to precision medicine.

Precision medicine seeks to individualise care by integrating multimodal biomedical data, yet most deployed clinical artificial intelligence (AI) remains assistive, providing predictions without managing workflows or adapting autonomously. Agentic AI, built on large language models (LLMs), has emerged as a paradigm characterised by autonomy, goal-directed reasoning, memory, planning and tool use. This review synthesises evidence on agentic AI and LLMs applied to precision medicine, encompassing drug discovery, genomics, oncology, rare disease diagnostics and clinical pharmacology. This review also examines architectural components, recent validation milestones and emerging challenges, including hallucination, sociodemographic bias and evolving regulatory frameworks across the FDA, the EU AI Act and the WHO.

agentic AI↗

Perceptual disturbances predicted in zero-g through three-dimensional modeling.

Perceptual disturbances in zero-g and 1-g differ. For example, the vestibular coriolis (or "cross-coupled") effect is weaker in zero-g. In 1-g, blindfolded subjects rotating on-axis experience perceptual disturbances upon head tilt, but the effects diminish in zero-g. Head tilts during centrifugation in zero-g and 1-g are investigated here by means of three-dimensional modeling, using a model that was previously used to explain the zero-g reduction of the on-axis vestibular coriolis effect. The model's foundation comprises the laws of physics, including linear-angular interactions in three dimensions. Addressed is the question: In zero-g, will the vestibular coriolis effect be as weak during centrifugation as during on-axis rotation? Centrifugation in 1-g was simulated first, with the subject supine, head toward center. The most noticeable result concerned direction of head yaw. For clockwise centrifuge rotation, greater perceptual effects arose in simulations during yaw counterclockwise (as viewed from the top of the head) than for yaw clockwise. Centrifugation in zero-g was then simulated with the same "supine" orientation. The result: In zero-g the simulated vestibular coriolis effect was greater during centrifugation than during on-axis rotation. In addition, clockwise-counterclockwise differences did not appear in zero-g, in contrast to the differences that appear in 1-g.

Centrifugation↗

Identification of C. elegans sensory ray genes using whole-genome expression profiling.

The three cells that comprise each C. elegans sensory ray (two sensory neurons and a structural cell) descend from a single neuroblast precursor cell. The atonal ortholog lin-32 and the E/daughterless ortholog hlh-2 act to confer neural competence during ray development, but additional regulatory factors that control specific aspects of cell fate are largely unknown. Here, we use full-genome DNA microarrays to compare gene expression profiles in adult males of two mutant strains to identify new components of the regulatory network that controls ray development and function. This approach identified a large set of candidate ray genes. Using reporter genes, we confirmed ray expression for 13 of these, including a beta-tubulin, a TWK-family channel, a putative chemoreceptor and four novel genes (the cwp genes) with a potential role in sensory signaling through the C. elegans polycystins lov-1 and pkd-2. Additionally, we have found several ray-expressed transcription factors, including the Zn-finger factor egl-46 and the bHLH gene hlh-10. The expression of many of these genes requires lin-32 function, though this requirement may not reflect direct activation by lin-32. Our strategy provides a complementary foundation for modeling the genetic network that controls the development of a simple sensory organ.

Animals↗

Chemical library subset selection algorithms: a unified derivation using spatial statistics.

If similar compounds have similar activity, rational subset selection becomes superior to random selection in screening for pharmacological lead discovery programs. Traditional approaches to this experimental design problem fall into two classes: (i) a linear or quadratic response function is assumed (ii) some space filling criterion is optimized. The assumptions underlying the first approach are clear but not always defendable; the second approach yields more intuitive designs but lacks a clear theoretical foundation. We model activity in a bioassay as realization of a stochastic process and use the best linear unbiased estimator to construct spatial sampling designs that optimize the integrated mean square prediction error, the maximum mean square prediction error, or the entropy. We argue that our approach constitutes a unifying framework encompassing most proposed techniques as limiting cases and sheds light on their underlying assumptions. In particular, vector quantization is obtained, in dimensions up to eight, in the limiting case of very smooth response surfaces for the integrated mean square error criterion. Closest packing is obtained for very rough surfaces under the integrated mean square error and entropy criteria. We suggest to use either the integrated mean square prediction error or the entropy as optimization criteria rather than approximations thereof and propose a scheme for direct iterative minimization of the integrated mean square prediction error. Finally, we discuss how the quality of chemical descriptors manifests itself and clarify the assumptions underlying the selection of diverse or representative subsets.

Journal Article↗

Early temperament and attachment as predictors of the Five Factor Model of personality.

To increase our understanding of developmental aspects of the Five Factor Model (FFM) of personality, prospective relations from infant temperament and attachment security to the 'Big Five' dimensions of personality in middle childhood were studied in a sample of 85 Swedish middle class children. Combined maternal and paternal temperament ratings at infant age 20 months and Strange Situation attachment to mother at 15 months were used as predictors of mother and teacher ratings of personality at child age 8 - 9 years. Also the A1 - B2 versus B3 - C2 classification grouping was used as a measure of infant negative emotionality. The results showed extraversion/surgency to be the dimension most clearly related to infancy data; it was predicted by both temperament and attachment security. Attachment security also predicted neuroticism and openness. The emotionality shown in the Strange Situation was not related to the 'Big Five'. The results were discussed in terms of approach and anxiety systems and internal working models as foundations for the FFM personality traits.

Child↗

Stochastic gene expression in a single cell.

Clonal populations of cells exhibit substantial phenotypic variation. Such heterogeneity can be essential for many biological processes and is conjectured to arise from stochasticity, or noise, in gene expression. We constructed strains of Escherichia coli that enable detection of noise and discrimination between the two mechanisms by which it is generated. Both stochasticity inherent in the biochemical process of gene expression (intrinsic noise) and fluctuations in other cellular components (extrinsic noise) contribute substantially to overall variation. Transcription rate, regulatory dynamics, and genetic factors control the amplitude of noise. These results establish a quantitative foundation for modeling noise in genetic networks and reveal how low intracellular copy numbers of molecules can fundamentally limit the precision of gene regulation.

Bacterial Proteins↗

Identification of mRNAs associated with alphaCP2-containing RNP complexes.

Posttranscriptional controls in higher eukaryotes are central to cell differentiation and developmental programs. These controls reflect sequence-specific interactions of mRNAs with one or more RNA binding proteins. The alpha-globin poly(C) binding proteins (alphaCPs) comprise a highly abundant subset of K homology (KH) domain RNA binding proteins and have a characteristic preference for binding single-stranded C-rich motifs. alphaCPs have been implicated in translation control and stabilization of multiple cellular and viral mRNAs. To explore the full contribution of alphaCPs to cell function, we have identified a set of mRNAs that associate in vivo with the major alphaCP2 isoforms. One hundred sixty mRNA species were consistently identified in three independent analyses of alphaCP2-RNP complexes immunopurified from a human hematopoietic cell line (K562). These mRNAs could be grouped into subsets encoding cytoskeletal components, transcription factors, proto-oncogenes, and cell signaling factors. Two mRNAs were linked to ceroid lipofuscinosis, indicating a potential role for alphaCP2 in this infantile neurodegenerative disease. Surprisingly, alphaCP2 mRNA itself was represented in alphaCP2-RNP complexes, suggesting autoregulatory control of alphaCP2 expression. In vitro analyses of representative target mRNAs confirmed direct binding of alphaCP2 within their 3' untranslated regions. These data expand the list of mRNAs that associate with alphaCP2 in vivo and establish a foundation for modeling its role in coordinating pathways of posttranscriptional gene regulation.

3' Untranslated Regions↗