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[Morning care of patients with Alzheimer's dementia: a theoretical model based on direct observation].

Five hospitalized patients in different stages of Alzheimer-type dementia were monitored by unstructured, direct observations during morning care. Orem's model of nursing as a compensation for the patient's lack of self-care capabilities was used as a frame of reference for an analysis of the behaviours of patients and nurses during morning care. A 12-step classification system was developed to be used as a guide to understand and determine abilities essential for performance of morning care for demented patients. The quantitative assessment showed that none of the patients was able to manage morning care independently, but there was a wide variation in their highest level of performance.

Alzheimer Disease↗

[Protection of workers' health against occupational psycho-social hazards--theoretical models].

Occupational Health Service are not yet equipped with tools which could permit them to include protection of workers' health against occupational psycho-social hazards into their prophylactic activities. The authors present a model of such a system, its objectives and conditions which should be satisfied in order to put the system into operation. The model discussed is somewhat an ideal solution which does not necessarily adhere to the reality but it sets tasks and identifies lines of activities to be carried out at the Department of Occupational Psychology, the Nofer Institute of Occupational Medicine, Lodz. These activities are aimed at monitoring and evaluating of health risk generated by psycho-social factors.

Environmental Monitoring↗

The dynamics of laser-induced changes in human skin autofluorescence--experimental measurements and theoretical modeling.

To study the temporal dynamics of human skin autofluorescence photobleaching, we measured the autofluorescence spectral changes of skin in vivo during continuous exposure to 442 nm (He-Cd) laser light. Integral intensities were calculated for various spectral wavelength bands and plotted as a function of time. Mathematical analysis of the time function revealed a double-exponential photobleaching process: I(t) = a exp (-t/tau 1) + b exp(-t/tau 2) + c, in which tau 1 and tau 2 differed by an order of magnitude. A hypothesis for the mechanism of the double-exponential photobleaching dynamics was proposed and evaluated using Monte Carlo modeling of light propagation in the skin and autofluorescence escape from skin. By combining the fluorophore microdistributions, Monte Carlo simulation results and the variation in fluorescence decrease parameters (a, b, c, tau 1, tau 2) with increasing exposure intensities a biophysical explanation for the double-exponential photobleaching function was elucidated. The fast decrease term corresponds to laser-induced photobleaching in the stratum corneum, while the slow decrease term represents fluorophore changes in the dermis. The measured autofluorescence photobleaching dynamics can be used to determine the fractional contributions of different skin layers to the total autofluorescence signal measured in vivo.

Fluorescence↗

Theoretical modelling of some spatial and temporal aspects of the mitochondrion/creatine kinase/myofibril system in muscle.

After discussing approaches to the modelling of mitochondrial regulation in muscle, we describe a model that takes account, in a simplified way, of some aspects of the metabolic and physical structure of the energy production/usage system. In this model, high-energy phosphates (ATP and phosphocreatine) and low energy metabolites (ADP and creatine) diffuse between the mitochondrion and the myofibrillar ATPase, and can be exchanged at any point by creatine kinase. Creatine kinase is not assumed to be at equilibrium, so explicit account can be taken of substantial changes in its activity of the sort that can now be achieved by transgenic technology in vivo. The ATPase rate is the input function. Oxidative ATP synthesis is controlled by juxtamitochondrial ADP concentration. To allow for possible functional 'coupling' between the components of creatine kinase associated with the mitochondrial adenine nucleotide translocase and the myofibrillar ATPase, we define parameters phi and psi that set the fraction of the total flux carried by ATP rather than phosphocreatine out of the mitochondrial unit and into the ATPase unit, respectively. This simplification is justified by a detailed analysis of the interplay between the mitochondrial outer membrane porin proteins, mitochondrial creatine kinase and the adenine nucleotide translocase. As both processes of possible 'coupling' are incorporated into the model as quantitative parameters, their effect on the energetics of the whole cell model can be explicitly assessed. The main findings are as follows: (1) At high creatine kinase activity, the hyperbolic relationship of oxidative ATP synthesis rate to spatially averaged ADP concentration at steady state implies also a near-linear relationship to creatine concentration, and a sigmoid relation to free energy of ATP hydrolysis. At high creatine kinase activity, the degree of functional coupling at either the mitochondrial or ATPase end has little effect on these relationships. However, lowering the creatine kinase activity raises the mean steady state ADP and creatine concentrations, and this is exaggerated when phi or psi is near unity (i.e. little coupling). (2) At high creatine kinase activity, the fraction of flow at steady state carried in the middle of the model by ATP is small, unaffected by the degree of functional coupling, but increases with ADP concentration and rate of ATP turnover. Lowering the creatine kinase activity raises this fraction, and this is exaggerated when psi or psi is near unity. (3) Both creatine and ADP concentrations show small gradients decreasing towards the mitochondrion (in the direction of their net flux), while ATP and phosphocreatine concentration show small gradients decreasing towards the myosin ATPase. Unless phi = psi = 0 (i.e. complete coupling), there is a gradient of net creatine kinase flux that results from the need to transform some of the 'adenine nucleotide flux' at the ends of the model into 'creatine flux' in the middle; the overall net flux is small, but only zero if phi = psi. A reduction in cytosolic creatine kinase activity decreases ADP concentration at the mitochondrial end and increases it at the ATPase end. (4) During work-jump transitions, spatial average responses exhibit exponential kinetics similar to those of models of mitochondrial control that assume equilibrium conditions for creatine kinase. (5) In response to a step increase in ATPase activity, concentration changes start at the ATPase end and propagate towards the mitochondrion, damped in time and space. This simplified model embodies many important features of muscle in vivo, and accommodates a range of current theories as special cases. We end by discussing its relationship to other approaches to mitochondrial regulation in muscle, and some possible extensions of the model.

Adenosine Diphosphate↗

[The health belief model. A theoretical approach to the prevention of AIDS].

Despite recent drug developments, the best available strategy we have today against HIV/AIDS is still preventive education. Since a voluntary behavioral change is difficult to achieve, even under the best possible conditions, preventive-education interventions should consider any strategy that facilitates the process of change. Although the final objective is to adopt a specific behavior, theoretical models that include cognitive-perceptive components can be useful in achieving that objective. It has been proven that a certain amount of information, even if not sufficient for sustaining behavior change, is an important predisposing component of initiating behavior changes. This paper examines the role of the Health Belief Model (HBM) as an educational tool for HIV/AIDS preventive interventions, and supports the use of social-cognitive theories in health education.

Acquired Immunodeficiency Syndrome↗

Noise analysis of MAP-EM algorithms for emission tomography.

The ability to theoretically model the propagation of photon noise through PET and SPECT tomographic reconstruction algorithms is crucial in evaluating the reconstructed image quality as a function of parameters of the algorithm. In a previous approach for the important case of the iterative ML-EM (maximum-likelihood-expectation-maximization) algorithm, judicious linearizations were used to model theoretically the propagation of a mean image and a covariance matrix from one iteration to the next. Our analysis extends this approach to the case of MAP (maximum a posteriori)-EM algorithms, where the EM approach incorporates prior terms. We analyse in detail two cases: a MAP-EM algorithm incorporating an independent gamma prior, and a one-step-late (OSL) version of a MAP-EM algorithm incorporating a multivariate Gaussian prior, for which familiar smoothing priors are special cases. To validate our theoretical analyses, we use a Monte Carlo methodology to compare, at each iteration, theoretical estimates of mean and covariance with sample estimates, and show that the theory works well in practical situations where the noise and bias in the reconstructed images do not assume extreme values.

Algorithms↗

Immunoreactions involving platelets. II. Theoretical analysis of the model.

Theoretical equations have been derived, using the methods of statistical mechanics, for associations between platelets, antibody, quinidine, and complement, based on a model of an immunoreaction described in the preceding paper of this series. The two cases considered (i.e. the possibilities that quinidine can attach first to antibody or platelets) lead to the same final equations. The comparison of the theoretical results with experimental results is contained in the preceding paper.

Antibodies↗

[The role of mathematical models in microhemorheology (author's transl)].

The basic fluid-mechanical and structural elements that determine the microhemorheological behavior of blood are presented and discussed. Microhemorheological models are classified into three groups: empirical models, theoretical models, and hybrid models. Major contributions in each area are reviewed and the state-of-the-art in microhemorheological modelling is discussed. Finally, important areas of future research are delineated.

Biomechanical Phenomena↗

Acquisition of the covalent quaternary structure of an immunoglobulin G molecule. Theoretical reoxidation models.

A theoretical format suitable for analyzing diverse complex kinetic systems where reaction pathways may exhibit cooperativity, is developed to account for the in vitro kinetics of air reoxidation of a human IgGlkappa immunoglobulin, in which the four interchain disulfide bonds have been reduced (Sears, D.W., et al. (1977), Biochemistry 16 (preceding paper in this issue)). The equations relate experimentally determined concentrations of the reactants, product, and macroscopic intermediates to the probability of occurrence of any of 12 distinct microscopic states. The concentrations of the macroscopic species--light chains (L), heavy chains (H), covalently associated intermediates HL, H2, H2L, and product H2L2--are also explicitly related to an observable function of those concentrations, the sulfhydryl titer, r. Since values of r can be calculated for any microscopic state of the system, the theory is in principle capable of a complete description of the experimental reaction course. In practice, limited experimental information precludes a unique solution of the equations at present, and it was not judged worthwhile to attempt curve fitting or approximation of probability terms with adjustable parameters of unknown physical significance. Certain special cases of the theory are, however, readily and exactly solved. These include models in which reoxidation is a random process and others in which the probabilities for inter-HL and inter-HH bond formation are different but independent of one another. The experimental results in the case of the IgGlkappa studied here clearly depart form the predicted behavior in either of these models. The initial probability for formation of a bond between a heavy and light chain is 1.5 to 2 times greater than for a bond between heavy chains. From the fact that this ratio changes as the reaction proceeds, and from the pattern of variation in concentration of intermediates during the reaction, it is concluded that the reoxidation process is not random, and that the bonds do not form independently, exhibiting instead kinetic cooperativity. The results are discussed in terms of assembly pathways in this and related systems. A novel feature of the theory is that it eliminates time as an explicit variable in the treatment of the kinetic process. This makes it especially useful for discerning whether the formation of one bond influences the reaction probability of another in a system where several similar or intrinsically identical reactions occur, and where kinetic order is difficult to establish. While the theory here is formulated in terms of the reoxidation reactions, it is, for example, equally applicable to the reduction process described (Sears, D.W., et al. (1977b), Biochemistry 16 (following paper in this issue)).

Disulfides↗

Studies on the physical state of water in living cells and model systems: IX. Theoretical significance of a straight line relationship between intracellular concentration of a partially excluded solute and its concentration in the bathing medium.

The experimentally observed steady-level distribution of Na+ (25 degrees) and of D-glucose (0 degree c) in frog muscle were chosen as examples of solute distribution patterns observed in living cells, for comparison with those predicted by two theoretical models: one derived from the membrane-pump theory and the other from the association-induction (AI) hypothesis. Neither the distribution of Na+ nor that of D-glucose follows the pattern predicted by the membrane-pump models for solutes maintained at lower level than in the external medium, in which the plot of intracellular solute concentration as ordinate against different external concentrations as abscissa bends upward with increasing external solute concentration. Instead, both Na+ and D-glucose exhibit either straight line distribution with unchanging (below unity) slopes, or that of a hyperbola superimposed on such a straight line, both in agreement with the AI hypothesis.

Animals↗

Theoretical analysis of right gastroepiploic artery grafting to right coronary artery.

BACKGROUND: The right gastroepiploic artery (GEA) has been used as the second reliable arterial graft for coronary artery bypass grafting (CABG). However, concern regarding the flow competition with the recipient coronary artery has remained. METHODS: An application of in situ GEA grafting to the right coronary artery (RCA) was studied by using a theoretical model. The theoretical model of CABG was given variables; ie, the diameters and the lengths of both in situ GEA and proximal segment of the RCA, and the degree of proximal stenosis in the RCA. According to the range of these variables obtained from clinical data, the ratio of the GEA flow to the flow of the RCA distal to the anastomosis was calculated. RESULTS: Main factors to determine the flows in the two parallel paths were the inner diameters of both vessels, and the degree of the proximal stenosis. When the inner diameters of the GEA were 0.5 mm larger than that of the RCA, the GEA carried more than 50% of the total flow of the RCA distal to the anastomosis despite a moderate stenosis in the RCA. When the inner diameter of the GEA was equal to, or 0.5 mm smaller than, that of the RCA, the GEA flow was dominated by the native RCA flow unless the proximal stenosis was critical. CONCLUSIONS: If the inner diameter of the GEA is 0.5 mm larger than that of the RCA, CABG with the GEA can be applied more widely. If not, the application would basically be limited.

Coronary Artery Bypass↗

Oscillometric determination of diastolic, mean and systolic blood pressure--a numerical model.

A theoretical model of oscillometric blood pressure measurement is presented. Particular emphasis is paid to the collapse behavior of the artery, and an exponential volume-pressure curve is used. The results of this study suggest that mean blood pressure can be accurately predicted from the peak of the oscillometric curve if corrections related to the cuff pressure waveform are applied. It is also shown, however, that systolic and diastolic pressure may not in general be accurately determined from fixed amplitude ratios based on the oscillometric peak due to the sensitivity of the method to variations in blood pressure waveform, pulse pressure, and arterial compliance. No simple procedures are found to correct for these effects.

Biomechanical Phenomena↗

Nursing theory applications: a practice model.

A theoretical model derived from the open system nursing principles of Parse, Newman, and Rogers guided the development of a nursing practice application designed to promote the health and quality of life of hospitalized, chronically mentally ill patients. The harmonious accord model, which consists of the concepts of value, movement, and creative expression patterns and operationalizes these concepts in specific nursing assessment and intervention strategies, was implemented on two extended psychiatry units over a 3-year period. This article discusses practice applications of the model, describes the plan for implementation and patient/nurse responses to implementation, and suggests a line of inquiry to eventually evaluate the effectiveness of the model for increasing patient quality of life.

Activities of Daily Living↗

Resolution optimisation in micellar electrokinetic chromatography using empirical models.

Theoretical and empirical models can be used to model the migration or separation characteristics in micellar electrokinetic chromatography in order to optimise the resolution. In this paper only empirical models were used, because it is easier and more straightforward to obtain these models. Several empirical approaches for the optimisation of the resolution were compared in order to determine which response should be modelled preferably. The use of models of the effective mobility in combination with average plate numbers proved to be the most suitable approach to optimisation of the resolution, because the relative prediction errors of the models of the effective mobility were a factor of 2-4 smaller than the relative prediction errors of the models of the apparent mobility. Moreover for the least separated peak pair the resolutions based on the models of the apparent and effective mobility showed relative prediction errors that were approximately a factor of 2 smaller than the relative prediction errors of the resolutions based on the models of the resolution and separation factor. The predictions of the separation factor based on the different models generally showed lower prediction errors than the predictions of the corresponding resolutions. Although the relative prediction errors were large, particularly for closely migrating compounds, the empirical approach will probably lead to the optimum separation buffer composition.

Chromatography, Micellar Electrokinetic Capillary↗

Lyophilization of pharmaceutical injections: theoretical physical model.

A physical model for the lyophilization kinetics of parenteral formulations is presented. Mathematical relationships are derived, which involve the simultaneous change in the receding boundary of the ice-vapor interface with time as well as water vapor diffusion across the dry porous matrix and boundary layer. Heat from an external heat source is transferred across the frozen solution to the receding ice surface. The model predicts that the water lost and the receding boundary distance are linearly related to the square root of time when lyophilization is matrix controlled. The mathematical descriptions are predictive of the physicochemical and transport events and can lead to the design of quantitative experiments to relate theory to formulation design.

Chemical Phenomena↗

Polyelectrolyte study of the calcium-induced chain association of pectate.

The theoretical model devised in the previous paper (Donati, I.; Benegas, J. C.; Cesàro, A.; Paoletti, S. Biomacromolecules 2006, 7 (5), 1587-1596) for the description of ion-induced chain aggregation is here applied to the case of chain dimerization of poly(galacturonate) in the presence of calcium ions. Particular attention has been directed toward the initial stage of dimer formation [i.e., in the low regime of calcium-to-polymer ratio (Rj)]. Circular dichroism (CD) data allowed evaluation of the fraction, theta, of calcium ions bound within chain dimers according to the "egg-box"-model. The theoretical model was able to reproduce satisfactorily the total molar enthalpy variation experimentally determined; the contributions of affinity (specificity in territorial condensation) and chemical bonding of calcium counterions to the thermodynamic properties of the system (i.e., enthalpy and entropy) were calculated. The intrinsic molar enthalpy of bonding, DeltaH(bond,0), displayed a peculiar sigmoid dependence on Rj. In particular, its decrease toward more negative values was interpreted as stemming from a (cooperative) calcium-induced conformational change that accompanies pectate chain pairing upon junction formation. The calculated pKin of instability of the Ca-(GalA-)4 complex was 10.80, in very good agreement with the corresponding value reported for the Ca-EDTA complex (i.e., 10.96). Significant contributions to the complex stability were the enthalpy of ion pairing (DeltaH(ionpairing,bond) = -5.1 kcal (mol calcium)-1, in good agreement with the value reported for calcium-EDTA: approximately -5.4 kcal (mol calcium)-1), and the entropy of desolvation (DeltaS(desolv,bond) = 43.7 cal mol-1 K-1, well within the range of values reported for calcium-EDTA: 42-57 cal mol-1 K-1).

Calcium↗