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PubMedDate not supplied

Anticoagulation clinics: the Italian experience.

BACKGROUND AND OBJECTIVE: The clinical quality of oral anticoagulant therapy (OAT) depends on how successful physicians and patients are in achieving and maintaining levels of anticoagulation capable of preventing thromboembolic events without increasing the risk of hemorrhagic complications. Concerning the patient, education and compliance are the major problems. As for the physician, on the other hand, the management of patients receiving OAT is a complex task that requires frequent laboratory testing, dosage regulation, prompt diagnosis and treatment of thromboembolic and hemorrhagic events. It requires educated and skilled personnel and a well-organized framework of services. Anticoagulation clinics, which provide patient education, close monitoring of prothrombin time and continuous clinical surveillance, may help in improving the overall quality of OAT. INFORMATION SOURCES: The authors have been working in this field contributing, original papers. In addition, the material examined in this article includes articles published in the journals covered by the Science Citation Index and Medline. STATE OF ART AND PERSPECTIVES: The concept of a coordinated network of medical services specifically devoted to the control of OAT was developed in the Netherlands following the model created by the late Professor Jordan, who in 1949 founded the first thrombosis center at the University of Utrecht. Many other anticoagulant clinics were organized on, a voluntary basis in the following decades in the Netherlands. The Dutch Federation of Thrombosis Centers was founded in 1971 and each affiliated Center is formally recognized and supported by the central Government. Today, there is a nation-wide system of regionally centralized anticoagulant control for outpatients and home patients that counts approximately 70 anticoagulant clinics (thrombosis centers), covering more than 90% of the country. Similar global approaches to the management of patients receiving OAT were proposed in other countries. In the 1950's, a group of internists and surgeons at the University of Michigan, USA, developed a unit specifically devoted to the diagnosis and treatment of thromboembolic disease, and proposed common strategies, teaching and research programs. In 1959, Sevitt and Gallagher were the first to propose a formal recognition of an anticoagulant unit in Great Britain. Finally, the Italian Federation of Centers for the Surveillance of Anticoagulant (FCSA) therapies was founded in 1989. Nowadays, Italian anticoagulation clinics operating in the framework of the FCSA are still voluntary organizations which provide a specific medical service by continuously reorganizing the personnel, structures and resources available to meet increasing demands. Since OAT has a profound social impact, its control should not be left to the good will of dedicated people, but should instead represent a specific task of the public health system. The achievement of a formal recognition of federated centers is essential for their growth, but the unavoidable increase of the expenses needed to support anticoagulation clinics is difficult to bear in a public care system which is currently facing a substantial reduction of financial resources. In a fixed health care budget, a redistribution of existing resources is the only possible solution, but to achieve this goal, public authorities have to be convinced that the management of OAT in specific anticoagulation clinics is cost-effective. A more accurate estimate of costs is needed and should be performed by the FCSA. Finally, the FCSA should strengthen its contacts with patient organizations and other scientific associations in order to develop common action strategies for improving the quality of OAT.

Ambulatory Care Facilities↗
PubMed2004

The carbohydrate sequence markup language (CabosML): an XML description of carbohydrate structures.

UNLABELLED: Bioinformatics resources for glycomics are very poor as compared with those for genomics and proteomics. The complexity of carbohydrate sequences makes it difficult to define a common language to represent them, and the development of bioinformatics tools for glycomics has not progressed. In this study, we developed a carbohydrate sequence markup language (CabosML), an XML description of carbohydrate structures. AVAILABILITY: The language definition (XML Schema) and an experimental database of carbohydrate structures using an XML database management system are available at http://www.phoenix.hydra.mki.co.jp/CabosDemo.html CONTACT: kikuchi@hydra.mki.co.jp.

Carbohydrate Sequence↗
PubMed2026

An integrated human immunoglobulin germline resource linking allele diversity to expressed repertoire structure.

Human immunoglobulin (IG) loci are highly polymorphic, yet existing germline resources remain noisy and incomplete, limiting our ability to link inherited variation to antibody repertoires. Here, we integrate high-fidelity long-read genomic sequencing with matched adaptive immune receptor repertoire sequencing (AIRR-seq) to construct HUSA, a population-scale, evidence-resolved germline resource. Using a conservative allele inference framework, HUSA expands current references more than three-fold, identifying over 1300 alleles while preserving allele-level evidence provenance across genomic and repertoire data. By linking genotype and expressed repertoires within individuals, we show that coding-region similarity predicts the structure of adjacent recombination signal sequences and leader regions, revealing that IG alleles are organized as linked cis-regulatory units associated with differences in recombination context and allele usage. These results define key germline constraints shaping repertoire formation and establish a robust, genotype-aware foundation for the analysis of immune receptor repertoires.

Journal Article↗
PubMed2003

Cognitive impairment and resource use of nursing home residents: a structural equation model.

BACKGROUND: Only a few studies have examined relationships between cognitive impairment and resource use of nursing home residents, and these studies have yielded mixed results. METHODS: To develop and test structural equation models for relationships between cognitive impairment, covariates, and resource use of nursing home residents on Alzheimer special care units (SCUs) and conventional units. RESEARCH DESIGN: Analysis of data obtained in 1999 from an Indiana nursing facility time study that measured resident-specific direct care minutes per day, and assessment data from the Minimum Data Set (version 2.0). PARTICIPANTS: Participants were 1290 residents without specialized nursing requirements or licensed therapies: 447 drawn from 22 SCUs in 16 facilities, 485 from 16 conventional units in the same facilities, and 358 from units in 13 facilities without SCUs. MEASURES: Direct care resource use (weighed minutes/d), Cognitive Performance Scale, activities of daily living (ADLs), clinically complex conditions, daily behavioral problems, physical restraints, psychotropic medication, and Alzheimer or dementia diagnosis. RESULTS: Cognitive impairment had a substantial indirect effect on resource use in facilities with and without SCUs. This effect was mediated largely through ADL dependency and SCU placement. Severity of cognitive impairment was strongly related to ADL dependency, and ADL, in turn, was a strongly related to resource use. Also, residents on SCUs used significantly more direct care resources than residents on conventional units. CONCLUSIONS: This study demonstrates relationships between cognitive impairment, covariates, and resource use for nursing home residents on SCUs and conventional units. It also raises issues about reimbursement for care of dementia residents.

Activities of Daily Living↗
PubMedDate not supplied

[On the regulation of the ecological community structure by a variation of the concentration ratios of resources in environment].

The possibility to regulate the structure of a community using a variational model of the ecological community was studied. The dependences of relative numbers of microorganisms on the initial ratios of resources of nutrients in environment were obtained. The potential possibility of controlling the community structure was shown. Model calculations and experimental data obtained on a community of Chlorococcales indicated that, as the ratios of resources vary, a change of the dominating species takes place.

Biodiversity↗
PubMed2003

Tools for comparative protein structure modeling and analysis.

The following resources for comparative protein structure modeling and analysis are described (http://salilab.org): MODELLER, a program for comparative modeling by satisfaction of spatial restraints; MODWEB, a web server for automated comparative modeling that relies on PSI-BLAST, IMPALA and MODELLER; MODLOOP, a web server for automated loop modeling that relies on MODELLER; MOULDER, a CPU intensive protocol of MODWEB for building comparative models based on distant known structures; MODBASE, a comprehensive database of annotated comparative models for all sequences detectably related to a known structure; MODVIEW, a Netscape plugin for Linux that integrates viewing of multiple sequences and structures; and SNPWEB, a web server for structure-based prediction of the functional impact of a single amino acid substitution.

Internet↗
PubMed1996

Orthodontic care provided by general practitioners and specialists in three Swedish counties with different orthodontic specialist resources.

Three counties in Sweden (A, G, and W) with free orthodontic care and different orthodontic resources and geographic structures were studied in 1987. Samples of totally 942 young adults (mean age 18.8 years, SD 0.44) were examined concerning malocclusions and all orthodontic treatment provided by general practitioners or by orthodontic specialists. The care in a rural area (county G) with abundant specialist resources was based on specialist treatments easy assessable to the patients and supplemented by treatments, mainly without appliances and provided by general practitioners. There was a generous attitude of consultation with specialists and of providing treatment. The sparsity of specialist resources had in an urban area (county A) resulted in a greater restriction on providing treatments. The treatments were performed in a higher age and were, to a greater extent, not completed by the age of 19, and a smaller percentage of individuals were treated than in the other two counties. The care in a large rural area (county W) with long distances to the only specialist clinic was based on treatments provided by general practitioners. In spite of the few specialist resources there was a generous attitude of providing treatments. Interceptive methods were used to a great extent, and later completed with appliance therapy. According to a treatment priority index 44% of the untreated individuals in the three counties had malocclusions and an objective treatment need, and there were no significant differences between the counties. Regardless of differences in specialist resources and structure of the free public orthodontic care, a substantial and equal proportion of the untreated individuals in the counties had malocclusions with treatment need, but they had no treatment desire.

Adolescent↗
PubMed1991

Coordinating community and public-institutional mental health services: some unintended consequences.

Where a target group such as the mentally ill tend to use multiple and varied services over a long period of time, service coordination is often seen as the key to continuity of care. This article argues that coordination also has its perverse effects. To demonstrate, two types of community organizations (COs) working in mental health in the Canadian province of Québec are examined: alternative COs, which have their roots in community action and maintain few formal links with each other or with institutional resources; and transitional structures, COs which are developed with the cooperation of psychiatric professionals, are closely linked to hospitals and are often part of a tightly coordinated system of community services. With respect to access, continuity, programs, internal structure and flexibility, each type of community resource has particular strengths and weaknesses. In the first part of the article, these are described and compared. In the second part of the article, we examine the possible effects of Québec's new mental health policy on COs working in mental health. The policy seeks to create comprehensive systems coordinating all services at the regional level-including alternative organizations, transitional structures and public institutions. The imperatives of the complex planning process risk diluting or even eradicating the differences between the two types of mental health COs described earlier. The process may thus rob certain service users of the particular advantages they found in alternative COs. For those mentally ill who, by choice or by chance, remain marginal to the coordinated system, there may ultimately be no resources available at all.

Community Mental Health Services↗
PubMed2002

Success and failure in a Michigan telepsychiatry programme.

Telemedicine programmes are often complex undertakings that result in combinations of success and failure. Michigan State University and LifeWays received a grant for a four-phase telepsychiatry research project in 2000. We employed multiple data-collection techniques, including patient and provider surveys, in-depth interviews, observation, patient chart analyses, and organizational archival data analyses. Of the four phases in the project, two proved to be successful, one failed in its initial goal but succeeded with a redefined goal, and one failed completely. Issues that affected success or failure included human resource conflicts, organizational structure, inter-organizational relationships and allocated resources.

Attitude of Health Personnel↗
PubMed2002

The influence of work, household structure, and social, personal and material resources on gender differences in health: an analysis of the 1994 Canadian National Population Health Survey.

Data from the 1994 Canadian National Population Health Survey (NPHS) do not confirm the widespread assumption that women experience considerably more ill health than men. The patterns vary by condition and age and at many ages, the health of women and men is more similar than is often assumed. However, we should not minimize the gender differences that do exist and in this paper we focus on three health problems which are more common among women: distress, migraine and arthritis/rheumatism. We consider to what extent work, household structure and social, personal and material resources explain these gender differences in health. Analysis of the distributions of paid work conditions, household circumstances and resources reveal mostly minor differences by gender and differences in exposure to these circumstances contribute little to understanding gender differences in health. There is also little evidence that greater vulnerability is a generalized health response of women to paid and household circumstances. We find limited evidence that social, personal and material resources are involved in pathways linking work and home circumstances to health in ways that differ between the sexes. In conclusion, we consider some reasons for the lack of support for our explanatory model: the measures available in the NPHS data set which contains little information on the household itself; the difficulty of separating 'gender' from the social and material conditions of men's and women's lives; and changes in women's and men's roles which may have led to a narrowing of differences in health.

Adolescent↗
PubMed1999

Leader behavior impact on staff nurse empowerment, job tension, and work effectiveness.

OBJECTIVE: The authors tested a model linking specific leader-empowering behaviors to staff nurse perceptions of workplace empowerment, occupational stress, and work effectiveness in a recently-merged Canadian acute care hospital. SUMMARY BACKGROUND DATA: An integration of Kanter's organizational empowerment theory and Conger and Kunungo's model of the leader empowerment process constituted the theoretical framework for the study. Few published studies were found in which specific leader behaviors were linked empirically to staff nurses' workplace empowerment. METHODS: Staff nurses (n = 537) were surveyed shortly after a merger of two large tertiary hospitals. Structural equation modeling techniques were used to test the proposed model. RESULTS: Leader-empowering behaviors significantly influenced employees perceptions of formal and informal power and access to empowerment structures (information support, resources, and opportunity). Higher perceived access to empowerment structures predicted lower levels of job tension and increased work effectiveness. The amount of explained variance in the final model was 42%. CONCLUSIONS: Support for the model tested in this study highlights the importance of nurse managers' leadership behaviors within current turbulent healthcare organizations.

Adult↗
PubMed2025

Largest-Scale Genomic Resource Reconstructing the Genetic Origin, Population Structure, and Biological Adaptations of the Hui People.

Historical and archaeological records indicate that the Maritime and Land Silk Roads played a pivotal role in facilitating Trans-Eurasian migrations and cultural exchanges. However, the extent to which population movements or the spread of ideas shape Chinese Hui populations remains debated. We present the largest genomic resource to date, including 2,280 Hui individuals sequenced or genotyped from 30 diverse regions, to examine the genetic origins, population structure, and biological adaptations of this underrepresented group in global human genome research. We identified a detailed population structure characterized by five distinct genetic lineages of the Hui, influenced by geography and varying gene flow. The admixture history and demographic events suggest that the northwestern and northern Hui lineages emerged from demic diffusion during the Tang and Yuan Dynasties via the Land Silk Road. In contrast, the southern and island Hui lineages reflect cultural diffusion along the Maritime Silk Road, while the mixed southern-northern lineage likely developed through a combination of demic and cultural diffusion. Our findings support a hybrid model for Hui formation, indicating that both demographic processes and sociocultural transmissions contributed to their population history. We identified east-west highly differentiated variants and pre- and post-admixture adaptations in Hui genomes, demonstrating that admixture-driven adaptive or neutral variants impacted susceptibility to cardiovascular diseases and immune- and diet-related traits. These adaptive signatures include post-admixture signals of SLC24A5 and ECHDC1 in the Hui, as well as pre-admixture signals of the HLA region, BCL2A1, and KCNH8 in the East Asian source. Overall, our study suggests that Han-related genetic components helped the Hui population rapidly adapt to new local environments. Additionally, the frequency spectrum of clinically essential variants differed significantly between Hui and Han individuals, emphasizing the importance of including underrepresented populations in genomic research to promote health equity.

Humans↗
PubMed2006

Protein Circular Dichroism Data Bank (PCDDB): data bank and website design.

The Protein Circular Dichroism Data Bank (PCDDB) is a new deposition data bank for validated circular dichroism spectra of biomacromolecules. Its aim is to be a resource for the structural biology and bioinformatics communities, providing open access and archiving facilities for circular dichroism and synchrotron radiation circular dichroism spectra. It is named in parallel with the Protein Data Bank (PDB), a long-existing valuable reference data bank for protein crystal and NMR structures. In this article, we discuss the design of the data bank structure and the deposition website located at http://pcddb.cryst.bbk.ac.uk. Our aim is to produce a flexible and comprehensive archive, which enables user-friendly spectral deposition and searching. In the case of a protein whose crystal structure and sequence are known, the PCDDB entry will be linked to the appropriate PDB and sequence data bank files, respectively. It is anticipated that the PCDDB will provide a readily accessible biophysical catalogue of information on folded proteins that may be of value in structural genomics programs, for quality control and archiving in industrial and academic labs, as a resource for programs developing spectroscopic structural analysis methods, and in bioinformatics studies.

Circular Dichroism↗
PubMed2005

Recent advances in gene expression data clustering: a case study with comparative results.

Several advanced techniques have been proposed for data clustering and many of them have been applied to gene expression data, with partial success. The high dimensionality and the multitude of admissible perspectives for data analysis of gene expression require additional computational resources, such as hierarchical structures and dynamic allocation of resources. We present an immune-inspired hierarchical clustering device, called hierarchical artificial immune network (HaiNet), especially devoted to the analysis of gene expression data. This technique was applied to a newly generated data set, involving maize plants exposed to different aluminum concentrations. The performance of the algorithm was compared with that of a self-organizing map, which is commonly adopted to deal with gene expression data sets. More consistent and informative results were obtained with HaiNet.

Algorithms↗
PubMed2005

For love and money? The impact of family structure on family income.

What do the half-century decline in U.S. marriage and the attendant rise in single parenthood mean for the economic well-being of children, especially children living in single-parent families? Adam Thomas and Isabel Sawhill show how differing living arrangements can be expected to affect families' economic well-being. Married-parent and cohabiting households, for example, can benefit from economies of scale and from having two adult earners. The availability of child support for single-parent families and the marriage penalties in the tax and transfer system reduce but rarely completely offset the economic benefits of marriage. Consistent with these expectations, national data on family income show that across all races and for a variety of income measures, children in lone-parent families (single-parent households with no cohabiter) have less family income and are more likely to be poor than children in married-parent families. Cohabiting families are generally better off economically than lone-parent families, but considerably worse off than married-parent families. Thomas and Sawhill acknowledge the possibility that the link between famlily structure and family resources may not be causal. But new research that simulates niarriages between existing single mothers and unattached men with similar characteristics suggests that family structure does affect family resources and that child poverty rates would drop substantially if these mothers were to marry. It does not necessarily follow, however, that policymakers ought to, or even can, do anything about family structure. Marriage is not an economic cure-all for the complex problem of child poverty. It would be a mistake for policymakers to focus on promoting marriage to the exclusion of encouraging and rewarding work or addressing problems such as early out-of-wedlock childbearing. Still, Thomas and Sawhill conclude that a continuation of recent declines in single parenthood, linked most recently to declines in teen and out-of-wedlock births, offers great promise for improving the economic welfare of U.S. children.

Adult↗
PubMed2006

Leveraging enzyme structure-function relationships for functional inference and experimental design: the structure-function linkage database.

The study of mechanistically diverse enzyme superfamilies-collections of enzymes that perform different overall reactions but share both a common fold and a distinct mechanistic step performed by key conserved residues-helps elucidate the structure-function relationships of enzymes. We have developed a resource, the structure-function linkage database (SFLD), to analyze these structure-function relationships. Unique to the SFLD is its hierarchical classification scheme based on linking the specific partial reactions (or other chemical capabilities) that are conserved at the superfamily, subgroup, and family levels with the conserved structural elements that mediate them. We present the results of analyses using the SFLD in correcting misannotations, guiding protein engineering experiments, and elucidating the function of recently solved enzyme structures from the structural genomics initiative. The SFLD is freely accessible at http://sfld.rbvi.ucsf.edu.

Animals↗
PubMed1991

Life stressors, personal and social resources, and depression: a 4-year structural model.

By extending earlier stress-resistance research with a 1-year time lag, findings with 254 adults show that adaptive personality characteristics and positive family support operate prospectively over 4 years in predicting reduced depression, even when prior depression is controlled. By strengthening knowledge about the determinants and mediational role of coping, the results demonstrate in a 2-group LISREL analysis that the pattern of predictive relations differs under high and low stressors. Under high stressors, personal and social resources relate to future psychological health indirectly, through more adaptive coping strategies. Under low stressors, these resources relate directly to psychological health. The results support the idea that such resources play a causal role in maintaining psychological health, and they suggest the potential for a general, adaptively oriented framework applicable to adjustment under both high and low stressors.

Adaptation, Psychological↗
PubMed2002

Building an automated classification of DNA-binding protein domains.

Intensive growth in 3D structure data on DNA-protein complexes as reflected in the Protein Data Bank (PDB) demands new approaches to the annotation and characterization of these data and will lead to a new understanding of critical biological processes involving these data. These data and those from other protein structure classifications will become increasingly important for the modeling of complete proteomes. We propose a fully automated classification of DNA-binding protein domains based on existing 3D-structures from the PDB. The classification, by domain, relies on the Protein Domain Parser (PDP) and the Combinatorial Extension (CE) algorithm for structural alignment. The approach involves the analysis of 3D-interaction patterns in DNA-protein interfaces, assignment of structural domains interacting with DNA, clustering of domains based on structural similarity and DNA-interacting patterns. Comparison with existing resources on describing structural and functional classifications of DNA-binding proteins was used to validate and improve the approach proposed here. In the course of our study we defined a set of criteria and heuristics allowing us to automatically build a biologically meaningful classification and define classes of functionally related protein domains. It was shown that taking into consideration interactions between protein domains and DNA considerably improves the classification accuracy. Our approach provides a high-throughput and up-to-date annotation of DNA-binding protein families which can be found at http://spdc.sdsc.edu.

Artificial Intelligence↗