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The preferred provider organization development process: models for applying a systematic approach.

To date, the preferred provider organization (PPO) concept has received considerable attention. Current literature, however, has focused on conceptual explanations and case studies of this new alternative delivery system as opposed to the process involved in developing operational PPOs. This paper focuses on the application of analytical techniques to strengthen PPO development activities. These techniques range from network analysis for planning PPO development to system flowcharts that depict new PPO operations. Since PPOs are used as the application base for the above tools, a brief description of PPOs will be addressed prior to explaining the techniques.

Insurance, Health↗

Genetic discontinuity revealed by chloroplast microsatellites in eastern North American Abies (Pinaceae).

Development of conservation strategies for Fraser fir (Abies fraseri) in the southern Appalachian Mountains depends in part on recognition of the extent to which Fraser fir is genetically distinct from the closely related balsam (A. balsamea) and intermediate (A. balsamea var. phanerolepis) fir. These sibling species have exhibited intergrading, clinal variation in morphological, chemical, and genetic characteristics in prior research. Chloroplast microsatellite markers were polymerase chain reaction amplified from genomic DNA samples of 78 individuals representing the geographic ranges of Fraser, balsam, and intermediate fir. Gene diversity levels at two loci ranged among taxa from 0.65 to 0.84. Allele frequencies demonstrated significant differentiation among taxa, with R(ST) values of 0.36 and 0.10. Haplotype diversity and D(SH) were highest for balsam fir and lowest for intermediate fir. A haplotype network analysis based on allele size distribution for the two loci revealed two distinct clusters of haplotypes and population-specific haplotypes. Ninety-two percent of the haplotypes in one cluster were from balsam fir and intermediate fir, and 84% of the haplotypes in the other cluster were from Fraser fir and intermediate fir. The genetic differentiation of chloroplast DNA markers provides justification for the recognition of Fraser fir as a distinct Management Unit (MU) for conservation purposes, regardless of its taxonomic classification.

Journal Article↗

[Airborne molds in Nantes--effect of climatic factors].

Many cities are studying biological atmospheric and, particularly, pollen pollution, but they are having difficulties setting up a mold analysis network and only a few provide fungal spore counts. The significance of some of those spores, and Alternaria in particular, as major allergens is now well known. The number of Alternaria spores varies extensively according to weather conditions over the year.

Air Pollution↗

Wealth happens.

The economic world is full of patterns, and one of the most controversial is the distribution of wealth. You might expect the balance between rich and poor to vary widely from country to country. But back in 1897, Vilfredo Pareto discovered a pattern of wealth distribution that appears to be universal. Whenever you double the amount of wealth within a country, the number of people in each successively higher wealth bracket falls by a constant factor. The factor varies among countries, but the pattern remains essentially the same. From a mathematical standpoint, Pareto's distribution has stubbornly defied explanation. But recently, researchers were able to replicate the curve by applying the principles of network organization. They began with two simple assumptions. First, wealth accumulates either by transfers from person to person or through investment returns, positive or negative. Second, rich people invest more money than poor people. Starting with a hypothetical group of 1,000 people of equal wealth and abilities, the model always produces Pareto's wealth distribution no matter how the links in the network are organized or how the balance between interpersonal transactions and investment returns are set. The model also indicates that the degree of wealth concentration can be influenced. Increasing the number of links in the network or the total amount of money flowing through an economy tends to decrease wealth disparities; increasing investment returns or volatility tends to increase it. Replete with public policy implications, the model is only one example of how network analysis can reshape our understanding of complex economic and social systems, which may have less to do with the behavior of individual members than with impersonal and seemingly insignificant forces.

Models, Economic↗

Reappraisal of the motor role of basal ganglia: a functional magnetic resonance image study.

The importance of the basal ganglia in controlling motor function is well known. However, neuroimaging studies have failed to show either movement-rate dependence or different activation patterns caused by self-initiated (SI) and externally triggered (ET) movements in the basal ganglia-thalamo-motor loop. We herein report the functional magnetic resonance image (fMRI) mapping of sequential left-hand finger movements at five different rates under SI and ET conditions. Significant movement-rate dependence was found in the whole right basal ganglia-thalamo-motor loop only during the SI task. Network analysis also showed strong interactions within this loop during SI movement, whereas interactions were present only from the premotor cortex to the putamen via the sensorimotor cortex during the ET task. Furthermore, psychophysiological interaction analysis confirmed the different modulation between the two tasks in the putamen. fMRI provides evidence that the basal ganglia-thalamo-motor loop plays a key role in controlling the rate of sequential finger movements in SI movement but not in ET movement.

Adult↗

The effects of drainage basin geomorphometry on minimum low flow discharge: the study of small watershed in Kelang River Valley in Peninsular Malaysia.

This study investigate the relationships between geomorphometric properties and the minimum low flow discharge of undisturbed drainage basins in the Taman Bukit Cahaya Seri Alam Forest Reserve, Peninsular Malaysia. The drainage basins selected were third-order basins so as to facilitate a common base for sampling and performing an unbiased statistical analyses. Three levels of relationships were observed in the study. Significant relationships existed between the geomorphometric properties as shown by the correlation network analysis; secondly, individual geomorphometric properties were observed to influence minimum flow discharge; and finally, the multiple regression model set up showed that minimum flow discharge (Q min) was dependent of basin area (AU), stream length (LS), maximum relief (Hmax), average relief (HAV) and stream frequency (SF). These findings further enforced other studies of this nature that drainage basins were dynamic and functional entities whose operations were governed by complex interrelationships occurring within the basins. Changes to any of the geomorphometric properties would influence their role as basin regulators thus influencing a change in basin response. In the case of the basin's minimum low flow, a change in any of the properties considered in the regression model influenced the "time to peak" of flow. A shorter time period would mean higher discharge, which is generally considered the prerequisite to flooding. This research also conclude that the role of geomorphometric properties to control the water supply within the stream through out the year even though during the drought and less precipitations months. Drainage basins are sensitive entities and any deteriorations involve will generate reciprocals and response to the water supply as well as the habitat within the areas.

Climate↗

Promoting breastfeeding in Bolivia: do social networks add to the predictive value of traditional socioeconomic characteristics?

This study tested whether the prediction of health-related knowledge (correct breastfeeding practices in this case) could be improved by including information about the composition of an individual's personal network above and beyond that predicted by his/her socioeconomic or demographic characteristics. Few studies have tested the predictive value of social networks, especially for population-based studies, despite an increased use of social networks in the past few years in several fields of health research, especially in research relating to prevention of HIV/AIDS and design of HIV/AIDS programmes. Promotion of breastfeeding practices that enhance child survival is important in Bolivia because of high infant morbidity and mortality in the country. Data on a cross-sectional urban probability sample of 2,354 women and men aged 15-49 years were collected from seven urban areas in Bolivia. Model building and the log likelihood ratio criteria were used for assessing the significance of variables in a logistic model. Results showed that the network variables added significantly (p < 0.05 for knowledge of breastfeeding only with no other liquids and for knowledge of breastfeeding only with no solids p < 0.01) to the predictive power of the socioeconomic variables. These results may also hold for other health research areas, increasingly using social network analysis, such as that of HIV/AIDS.

Adolescent↗

Discovering regulated networks during HIV-1 latency and reactivation.

Human immunodeficiency virus (HIV) affects millions of people across the globe. Despite the introduction of powerful anti-viral therapies, one factor confounding viral elimination is the ability of HIV to remain latent within the host genome. Here, we perform a network analysis of the viral reactivation process using human gene expression profiles and curated databases of both human-human and human-HIV protein interactions. Based on this analysis, we report the identification of active pathways in both the latent and early phases of reactivation. These active pathways suggest host functions that are altered and important for HIV pathogenesis.

Algorithms↗

[Theory of microcirculation. 2. Problems of microcirculation from the viewpoint of the new theoretical concept].

By means of network analysis and the use of a model which stimulates continuous blood supply to the tissue the basis of Starling's hypothesis of microcirculation is challenged. Contrary to the Starling's conception, we found that the microcirculation in the tissue is a stable process, whereby the interstitial hydraulic pressure (IHP) depends on the intracapillary blood pressure, on the permeability of the capillary wall, on the colloid-osmotic pressure and on the static pressure in the vessels and form a characteristic gradient along the capillary wall. The main effect of the colloid-osmotic pressure cannot be regarded as counteracting to the blood pressure, but instead consists in reduction of the IHP. Based on a theoretical conception about elastic interactions in the tissue a new method for measurement of the capillary filtration coefficients (CFC) is developed. Applying the method on the rabbit skeletal muscle the CFC is found to be 0.130 ml/min.mm Hg.100 g. This value is substantially higher than the values obtained from similar experiments reported in the literature (0.008 ml/min.mm Hg.100 g). The lymphatic fluid is not a result of a disbalance between filtration and resorption across the capillary wall, but it is a consequence of the protein recirculation in the following manner: blood vessels--interstitial space--lymphatic vessels--blood vessels. This recirculation is essential for the vital function of the tissue cells.

Animals↗

Simulation of action potential propagation in terminal arborizations of cultured sensory ganglia.

In order to study possible integrative properties of axon terminations, impulse propagation in arbitrarily complex terminal arborizations is simulated using a general purpose network analysis program. Detailed, anatomically based models are constructed from HRP-filled arborizations of sensory ganglia impinging upon motoneurons grown in an organotypic rat spinal cord culture. On assuming an excitable membrane the action potential propagates into all the ramifications. If some branches are assumed to be inexcitable, the electrotonically propagated potential may not depolarize the synaptic endings sufficiently to release transmitter. Under such conditions only part of the morphologically found synapses are expected to release transmitter following stimulation of sensory neurons.

Action Potentials↗

[Dendroarchitectonic study of the neurons of the corpus quadrigeminum superius in man].

Two different functional zones may be described in the superior colliculus. The superficial layers receive retinal and cortical fibers, the deep layers are a multimodal center and are implied in the oculo-motor control mechanisms. The aim of the present study has been to use network analysis in order to quantify the cell types of the deep layers of the superior colliculus in Man. 50 Golgi impregnated cell have been drawn in the three plans of space. Topological analysis permits to emphasize the existence of two different cell types: collaterally-branched cells or CB cells, and dichotomously-branched cells or DR cells. Quantitative analysis of the dendritic arcs has shown the spatial orientation of the dendritic tree. The proximal dendrites of DR cells are in the horizontal plane, the terminal dendrites are in the vertico-frontal plane. This difference seems to be due to different functional afferences.

Aged↗

[Interspecies study of statistical correlations existing between the pineal gland size and weight and brain and body weight in two groups of mammals. Interspecies study of correlations between the pineal gland and brain in the rat and in man].

Network analysis procedures have been applied to study the cell patterns on the dorso medial and ventral lateral formation of the inferior colliculus of different species, i-e: Cat, Tat and Monkey. The results suggests the existence of important interspecific differences, more particularly in the primates. These differences are more obvious in the dorso medial formation. The functionnal implications of these results are discussed.

Animals↗

[Typology of the cells of the bulbopontine reticular formation].

The network analysis methods have been applied to study the neurons of the medial bulbo pontine reticular formation in the cat. The bifurcation ratio allows isolation of two different cellular patterns: collateral branched cells or CB type, and at random pendant vertices dichotomously branched cells or DA type. The morphologic features of CB cells lead to the assumption that these cells have an integrative function. The topographic distribution of the two cells types seems to vary in the different parts of the reticular formation and should argue for the fact that the reticular formation represents an aggregation of several discrete anatomical units.

Animals↗

[Comparative study of the dorso-medial nucleus of the inferior colliculus].

The comparative study by network analysis of the dorso-median nucleus of the inferior colliculus has been performed in the adult and new born cat, the adult rat and the adult monkey. For each animal, the two previously recognized types of cells have been identified. However the number of each type of cells is different. The 2 order cells have the same volume in the rat, the adult cat and the monkey. The 3 order cells are larger in the monkey and the cat than in the rat. The number and the volume of the different types of cells is similar in the ventro-lateral nucleus of the adult cat and in the dorso-medial nucleus of the new born cat.

Animals↗

[The multimedia workstation, electronic assistant to the health care professional].

The health professional multimedia workstation is the natural entry point to health and knowledge networks. It should allow an easy and transparent management of all the data necessary for patient management. Multimedia nature of processed information reflects evolution of medical techniques that involve more and more complex objects such as video sequences or digitized signals. Workstations can be considered from 3 points of view: the professional end-users, the developers and the decision makers. The long term goal for the end-user is to establish an easy access in a working environment, that gives him/her the feeling of a single comprehensive application running on a single computer when the information system relies on a set of heterogeneous and geographically distributed components. Development of a workstation requires the integration into the same environment of tools to localize, access, manipulate and communicate the required information within a health information network. Analysis of the 445 Medline-indexed publications for the January 1991 to December 1994 period, that included the word workstation either in their title or in their abstract, helps in refining objectives and challenges both for the health professionals and the decision makers.

Computer Terminals↗

On the importance of peer influence for adolescent drug use: commonly neglected considerations.

Peer influence is generally believed to be a major cause of adolescent drug behavior. This paper reviews research findings on friend selection and projection to suggest that the magnitude of friend influence may be overestimated. This paper also observes that, although adolescent drug use is assumed to begin in response to peer group influence, peer groups have rarely been measured in studies of drug behavior. Social network analysis is identified as a promising method for measuring peer groups. The implications of this review for research and programs are considered.

Adolescent↗

GINsim: a software suite for the qualitative modelling, simulation and analysis of regulatory networks.

This paper presents GINsim, a Java software suite devoted to the qualitative modelling, analysis and simulation of genetic regulatory networks. Formally, our approach leans on discrete mathematical and graph-theoretical concepts. GINsim encompasses an intuitive graph editor, enabling the definition and the parameterisation of a regulatory graph, as well as a simulation engine to compute the corresponding qualitative dynamical behaviour. Our computational approach is illustrated by a preliminary model analysis of the inter-cellular regulatory network activating Notch at the dorsal-ventral boundary in the wing imaginal disc of Drosophila. We focus on the cross-regulations between five genes (within and between two cells), which implements the dorsal-ventral border in the developing imaginal disc. Our simulations qualitatively reproduce the wild-type developmental pathway, as well as the outcome of various types of experimental perturbations, such as loss-of-function mutations or ectopically induced gene expression.

Animals↗

Analysis of gene networks for drug target discovery and validation.

Understanding responses of the cellular system for a dosing molecule is one of the most important problems in pharmacogenomics. In this chapter, we describe computational methods for identifying and validating drug target genes based on the gene networks estimated from microarray gene expression data. We use two types of microarray gene expression data: gene disruptant microarray data and time-course drug response microarray data. For this purpose, the information of gene networks plays an essential role and is unattainable from clustering methods, which are the standard for gene expression analysis. The gene network is estimated from disruptant microarray data by the Bayesian network model, and then the proposed method automatically identifies sets of genes or gene regulatory pathways affected by the drug. We use an actual example from analysis of Saccharomyces cerevisiae gene expression profile data to express a concrete strategy for the application of gene network information toward drug target discovery.

Antifungal Agents↗