Clustering In Certain Regions Research Articles

Implementation of the cluster approach in the practice of the territorial organization of health care: theoretical, institutional and practical aspects

Introduction. The reform of the health care system in Ukraine ensured the creation of a multi-level provision of medical services, which covered medical institutions of all forms of ownership, which are not only competitors on the regional and local markets, but also had the full opportunity to participate in contractual relations with the National Health Service of Ukraine (NSZU) regarding the provision of medical care packages. Despite the positive consequences of transformational changes, a number of problems arose in the regions regarding the formation of optimal communications between different levels of providing medical services, the availability of services for patients, logistics related to medical care, the effectiveness of the use of budget funds, material and human resources, the availability of special medical care in separate regions (primarily regions of military operations), territorial organization of the network. According to government decisions, to solve these problems, the process of forming hospital districts and hospital clusters has been initiated, which, as practice shows, requires ambiguous management decisions. The above actualizes the problem of scientific support (analytical assessments, monitoring, design of possible further changes) of modern processes of the territorial organization of health care and its public management at the regional and local levels.
 The purpose of the research is a systematic analysis of the processes of cluster formation in health care and, on this basis, the development of theoretical and methodological provisions and justification of directions for further improvement of the established models of territorial organization of the industry.
 Methods. Applied methods of system analysis - to evaluate the process of establishing regulatory and legal prerequisites for starting cluster initiatives in health care, comparative analysis - in order to identify theoretical approaches to the interpretation of the phenomenon of territorial clusters in domestic and foreign scientific opinion. General scientific and empirical methods of economic science are used: methods of analysis and synthesis, comparison, summary and grouping - to identify the potential, opportunities and threats in the implementation of management decisions regarding the further functioning and development of clusters in health care of the regions of Ukraine.
 The results. Using a number of arguments, the expediency of using the cluster approach in the territorial organization of health care has been proven. The process of establishing the institutional basis for the formation of clusters in health care in Ukraine is evaluated. The peculiarities of the organizational structure of the territorial hospital cluster are determined. An empirical analysis of the prerequisites for the formation of hospital clusters in certain regions of Ukraine was carried out. The expected results of the formation of a capable network and the formation of territorial hospital clusters and risks in the implementation of management decisions regarding the selected model of the territorial organization of the medical space are determined. Based on the modeling of the possible influence of institutional, industrial, infrastructural and financial factors on the functioning and development of newly formed structural entities in the health care of the region, possible options for prevention and leveling of negative effects and development of relations between local self-government bodies and medical institutions of various levels are proposed for the purpose of optimization synergistic effect of cluster formation.
 Prospects. It is advisable to focus further scientific research on the issues of monitoring the work of the network of primary and specialized medical care institutions within the framework of newly formed hospital clusters and the introduction of information systems into the practice of strategic and operational management of a capable health care network.

Matrix association region/scaffold attachment region (MAR/SAR) sequence: its vital role in mediating chromosome breakages in nasopharyngeal epithelial cells via oxidative stress-induced apoptosis

BackgroundOxidative stress is known to be involved in most of the aetiological factors of nasopharyngeal carcinoma (NPC). Cells that are under oxidative stress may undergo apoptosis. We have previously demonstrated that oxidative stress-induced apoptosis could be a potential mechanism mediating chromosome breakages in nasopharyngeal epithelial cells. Additionally, caspase-activated DNase (CAD) may be the vital player in mediating the chromosomal breakages during oxidative stress-induced apoptosis. Chromosomal breakage occurs during apoptosis and chromosome rearrangement. Chromosomal breakages tend to cluster in certain regions, such as matrix association region/scaffold attachment region (MAR/SAR). We hypothesised that oxidative stress-induced apoptosis may result in chromosome breaks preferentially at the MAR/SAR sites. The AF9 gene at 9p22 was targeted in this study because 9p22 is a deletion site commonly found in NPC.ResultsBy using MAR/SAR recognition signature (MRS), potential MAR/SAR sites were predicted in the AF9 gene. The predicted MAR/SAR sites precisely match to the experimentally determined MAR/SARs. Hydrogen peroxide (H2O2) was used to induce apoptosis in normal nasopharyngeal epithelial cells (NP69) and NPC cells (HK1). Nested inverse polymerase chain reaction was employed to identify the AF9 gene cleavages. In the SAR region, the gene cleavage frequency of H2O2-treated cells was significantly higher than that of the non-treated cells. A few chromosomal breakages were detected within the AF9 region which was previously found to be involved in the mixed lineage leukaemia (MLL)-AF9 translocation in an acute lymphoblastic leukaemia patient. As for the non-SAR region, no significant difference in the gene cleavage frequency was found between the untreated control and H2O2-treated cells. Furthermore, H2O2-induced cleavages within the SAR region were reduced by caspase-3 inhibitor, which indirectly inhibits CAD.ConclusionsThese results reaffirm our previous findings that oxidative stress-induced apoptosis could be one of the potential mechanisms underlying chromosome breakages in nasopharyngeal epithelial cells. MAR/SAR may play a vital role in defining the location of chromosomal breakages mediated by oxidative stress-induced apoptosis, where CAD is the major nuclease.

Pigs in Space: Determining the Environmental Justice Landscape of Swine Concentrated Animal Feeding Operations (CAFOs) in Iowa.

Given the primacy of Iowa in pork production for the U.S. and global markets, we sought to understand if the same relationship with traditional environmental justice (EJ) variables such as low income and minority populations observed in other concentrated animal feeding operation (CAFO) studies exists in the relationship with swine CAFO densities in Iowa. We examined the potential for spatial clustering of swine CAFOs in certain parts of the state and used spatial regression techniques to determine the relationships of high swine concentrations to these EJ variables. We found that while swine CAFOs do cluster in certain regions and watersheds of Iowa, these high densities of swine are not associated with traditional EJ populations of low income and minority race/ethnicity. Instead, the potential for environmental injustice in the negative impacts of intensive swine production require a more complex appraisal. The clustering of swine production in watersheds, the presence of antibiotics used in swine production in public waterways, the clustering of manure spills, and other findings suggest that a more literal and figurative “downstream” approach is necessary. We document the presence and location of antibiotics used in animal production in the public waterways of the state. At the same time, we suggest a more “upstream” understanding of the structural, political and economic factors that create an environmentally unjust landscape of swine production in Iowa and the Upper Midwest is also crucial. Finally, we highlight the important role of publicly accessible and high quality data in the analysis of these upstream and downstream EJ questions.

Land use perception of self-reported health: Exploratory analysis of anthropogenic land use phenotypes

This paper investigates the spatial heterogeneity of self-reported health in the Greater Toronto Area in relation to its land use. This is implemented by means of local spatial autocorrelation of response types of the Canadian Community Health Survey (CCHS) and land use. Spatial heterogeneity was tested by assessment of the stratified responses of the survey, ranging from excellent to poor. A total of 8212 collected surveys from the CCHS master file for 2010 were used. Georeferenced surveys were agglomerated at census tract level, and spatial autocorrelation followed assessing of frequency distribution. The geography of the hotpots of surveys per response type was conducted. The resulting hotspots were compared to the properties of their land use types as to understand what the influence on surrounding land use on self-reported health is. A significant spatial autocorrelation exists over the region area concerning health perception, forming clusters in certain regions. A negative influence on self-reported health was found in commercial and industrial land use, while open spaces, on the other hands show significantly positive responses. While resource and industrial land use share a negative influence of self-reported health, open spaces and parks and recreational areas may lead to a better health perception. From a landscape and planning perspective, we argue that land use plays a crucial role in the complex social factors of health self-report. Geographic Information Systems and spatial analysis may allow to better understanding the combination of health factors and land use, as to allow a better planning of infrastructure and anthropogenic land use phenotypes for increasing health self-perception and wellbeing in developed countries.

Development of Aluminum-based Hybrid Composites with Graphite Nanofibers/Alumina Short Fibers: Processing and Characterization

In this study, aluminum-based hybrid composites were developed and characterized. Initially, a hybrid preform was fabricated using graphite nanofibers (GNFs) and alumina short fibers (Al2O3sf) with the total volume fraction of fiber at 10, 15, and 20%. The hybrid preforms were then infiltrated with aluminum alloy (A356), and the microstructure and mechanical properties of the hybrid composites were evaluated. The Taguchi approach to experimental design was used to identify those process parameters that had the largest effects on hardness and porosity of the preform. The amount of binder was found to have the largest effect on hardness; volume fraction of fiber affected porosity most significantly. Scanning electron microscopy observations indicated that alumina short fibers were well dispersed within the aluminum matrix. Although GNFs formed clusters in certain regions, their distribution within the short-fiber network was relatively good. The hardness of these composites was found to be higher than that of Al/Al2O3sf mono-composites; however, their tensile strength and compressive strength were reduced considerably. This is attributed to the presence of agglomerated GNFs, which may weaken load sharing between the Al matrix and Al2O3sf.

Amyotrophic lateral sclerosis in Finland: birthplaces of patients, parents and grandparents.

Amyotrophic lateral sclerosis (ALS) appears to be more prevalent in the southeastern part of Finland and among the war evacuees displaced from this area after the World War II than elsewhere in the country. A random sample of 31 ALS patients was chosen and the birthplaces of their ancestors traced back in two generations to find out whether there would be any tendency of clustering in certain regions of the country. No such trend was found. This finding speaks against a genetically determined tendency for the disease.

Analisis Aglomerasi Dan Faktor-Faktor Yang Mempengaruhi Terkonsentrasinya Lembaga Pendidikan Tinggi di Pulau Jawa

This paper seeks to find out agglomeration of higher education institutions in Java. Using logistic regression analysis, it will examine to what extent some key variables predicting and explaining why these institutions tended to cluster in certain regions. (1) Number of labor force, (2) Number of school age, (3) GNP, (4) Technology, (5) Economic activity, (6) Infrastructure and (7) Existance of public higher education institution. The results show that spatial pattern of higher education institutions tended to be similar to those of large and medium scale enterprises. Higher education institutions agglomerated overwhelmingly around city centre while large and medium enterprises preferred to cluster around the outskirtThis paper seeks to find out agglomeration of higher education institutions in Java. Using logistic regression analysis, it will examine to what extent some key variables predicting and explaining why these institutions tended to cluster in certain regions. (1) Number of labor force, (2) Number of school age, (3) GNP, (4) Technology, (5) Economic activity, (6) Infrastructure and (7) Existance of public higher education institution. The results show that spatial pattern of higher education institutions tended to be similar to those of large and medium scale enterprises. Higher education institutions agglomerated overwhelmingly around city centre while large and medium enterprises preferred to cluster around the outskirt

Thermal entanglement of spins in mean-field clusters

We determine thermal entanglement in mean field clusters of $N$ spin one-half particles interacting via the anisotropic Heisenberg interaction, with and without external magnetic field. For the $xxx$ cluster in the absence of magnetic field we prove that only the N=2 ferromagnetic cluster shows entanglement. An external magnetic field $B$ can only entangle $xxx$ anti-ferromagnetic clusters in certain regions of the $B-T$ plane. On the other hand, the $xxz$ clusters of size $N>2$ are entangled only when the interaction is ferromagnetic. Detailed dependence of the entanglement on various parameters is investigated in each case.

Mitochondrial DNA and human thyroid diseases.

Cells of the thyroid tissue, either diseased or normal, can accumulate altered mitochondrial genomes in primary lesions and in surrounding parenchyma. Depending on the experimental approaches and the extent of the mutational process, it has been possible to demonstrate the occurrence of homoplasmic or heteroplasmic point mutations, presence of a common deletion and random large-scale mtDNA aberrations in various pathological states. Point somatic mutations documented in 5-60% of thyroid tumors do not concentrate in obvious hotspots but tend to cluster in certain regions of the mitochondrial genome and their distribution may differ between carcinomas and controls. Large-scale deletions in mtDNA are quite prevalent in healthy and diseased thyroid; however, the proportion of aberrant mtDNA molecules accounts for a very small part of total mtDNA and does not seem to correlate with pathological characteristics of thyroid tumors. Common deletion is most abundant in Hurthle cell tumors, yet it also occurs in other thyroid diseases as well as in normal tissue. The principal difference between the common deletion and other deletion-type mtDNA molecules is that the former does not depend on the relative mtDNA content in the tissue whereas in a subset of thyroid tumors, such as radiation-associated papillary carcinomas and follicular adenomas, there is a strong correlation between mtDNA levels and prevalence of large-scale deletions. Relative mtDNA levels by themselves are elevated in most thyroid tumors compared to normal tissue. Distinct differential distribution and prevalence of mutational mtDNA burden in normal tissue and thyroid lesions are suggestive of the implication of altered mtDNA in thyroid diseases, especially in cancer.

Assessment of higher order correlation effects with the help of Moller-Plesset perturbation theory up to sixth order

For 30 molecules and two atoms, MPn correlation energies up to n = 6 are computed and used to analyse higher order correlation effects and the initial convergence behaviour of the MPn series. Particularly useful is the analysis of correlation contributions EXY (n) ...(n = 4,5,6; X, Y,... = S, D, T, Q denoting single, double, triple, and quadruple excitations) in the form of correlation energy spectra. Two classes of system are distinguished, namely class A systems possessing well separated electron pairs and class B systems which are characterized by electron clustering in certain regions of atomic and molecular space. For class A systems, electron pair correlation effects as described by D, Q, DD, DQ, QQ, DDD, etc., contributions are most important, which are stepwise included at MPn with n = 2,...,6. Class A systems are reasonably described by MPn theory, which is reflected by the fact that convergence of the MPn series is monotonic (but relatively slow) for class A systems. The description of class B systems is difficult since three- and four-electron correlation effects and couplings between two-, three-, and four-electron correlation effects missing for lower order perturbation theory are significant. MPn methods, which do not cover these effects, simulate higher order with lower order correlation effects thus exaggerating the latter, which has to be corrected with increasing n. Consequently, the MPn series oscillates for class B systems at low orders. A possible divergence of the MPn series is mostly a consequence of an unbalanced basis set. For example, diffuse functions added to an unsaturated sp basis lead to an exaggeration of higher order correlation effects, which can cause enhanced oscillations and divergence of the MPn series.

055 An Apple Linkage Map with SSRs and Other Sequence Tagged Sites Suitable for Comparative Mapping

The positions of over 50 SSR loci and other sequence tagged sites (STSs) have been located on the linkage maps of five apple cultivars (Rome Beauty, White Angel, Golden Delicious, Liberty, McIntosh) and two New York accessions. In most cases, the primers used produced single amplification products, permitting identification of homologous loci in the different cultivars and the precise alignment of the linkage maps generated for each. Based on this information, we present a general linkage map for apple with STS markers on each linkage group. The map consists of 17 linkage groups (equal to the haploid chromosome number for the species) with over 500 markers. The positions of several resistant gene analogues have been located on this linkage map. None of these sequences map near genes conferring resistance to scab or powdery mildew. SSR loci exhibited a tendency to cluster in certain regions of the linkage map. This clustering slightly reduces their effectiveness as genome markers for comparative mapping or germplasm diversity. However, the SSR markers definitely displayed a high level of polymorphism, making them particularly useful for genetic studies.

Quantitative organization of the known protein x‐ray structures. I. Methods and short‐length‐scale results

We address herein the problem of delineating the relationships between the known protein structures. In order to study this problem, methods have been developed to represent arbitrarily sized fragments of biopolymer backbone, and to compare distributions of such fragments. These methods are applied to a classification of 123 structures representing the entire set of known x-ray structures. The resulting data are analyzed (on the four-C alpha length scale) to determine both the large-scale organization of the set of known structures (i.e., the relationships between large groups of structures, each comprised of proteins that are structurally related) and its local structure (i.e., the quantitative degree of similarity between any two specific structures). It is shown that the set of structures forms a continuum of structural types, ranging from all-helical to all-sheet/barrel proteins. It is further demonstrated that the density of protein structures is not uniform across this continuum, but rather that structures cluster in certain regions, separated by regions of lower population. The properties of the various regions of the structural space are determined. The existence is demonstrated of strong quantitative correlations between the contents of different types of four-C alpha fragments within protein structures, which imply significant constraints on the types of architecture that can occur in proteins. Analysis of the distribution of structures demonstrates some hitherto unsuspected similarities and suggests that, in some circumstances, neither structural similarity nor sequence homology may be necessary conditions for evolutionary relationship between proteins. It is also suggested that these unsuspected similarities may imply similar folding mechanisms for structures of apparently different global architecture. Cases are also noted in which apparently similar structures may fold by different mechanisms. The connection between structure and dynamic properties is discussed, and a possible role of dynamics in the evolution of protein structures is suggested. The sensitivity of the methods presented herein to anomalies of structure refinement is demonstrated. It is suggested that the present results provide a framework for analyzing experimental results on structural similarity obtained using vibrational circular dichroism spectra, which are sensitive to local backbone structure.

Effect of fast-neutron irradiation on tetrahedrally bonded amorphous thin films

Abstract Thin films of RF sputtered amorphous germanium, silicon and silicon carbide have been irradiated in a reactor with fast-neutron fluence of up to 3.6 × 1013 n/cm2 at a temperature not exceeding 50°C. The irradiation induced changes in electrical and structural properties have been studied. The effect of irradiation on dark conductivity is appreciable though the activation energy gap and phonon spectra do not seem to undergo much change. The results could be explained as a combined effect of two processes (i) the rearrangement of the atoms of the amorphous medium in the presence of neutron-fluence to produce a more complete amorphous network, and (ii) the production of defect clusters in certain regions of the amorphous medium, giving rise to isolated zones with high concentration of dangling bonds. Our results, however, indicate that in the amorphous thin films studied, the first process is predominant throughout the volume.

The TWERL Experiment

One of the experiments aboard the Nimbus-6 satellite was a data collection and Doppler location system used in conjunction with a fleet of instrumented superpressure balloon platforms. The acronym TWERLE stands for Tropical Wind, Energy Conversion, and Reference Level Experiment, after its principal scientific objectives. A brief system description is given together with a discussion of the launch, in the tropics and Southern Hemisphere, of the 400 balloon platforms. The platforms were designed to float at a nominal pressure of 150 mb. A number of preliminary scientific results are discussed in different subject areas. The large, or hemispheric scale, dispersion of the platforms exhibited definite nonrandomness in that clustering in certain regions of the tropics occurred while other regions were avoided. Owing to the fact that the balloons drift with the wind on a surface of constant density, the basic data are quasi-Lagrangian in nature. Some interesting aspects of such data are discussed. Notable was the fact that ~2 5% of the balloons launched from Christchurch, New Zealand (44°S), at some time in their history entered the Northern Hemisphere. The TWERLE platforms carried sensors for measuring pressure, temperature, and altitude. Such sensor data permit investigations of various kinds of wave motion that influence the balloon platforms. Among those motions investigated and discussed are gravity waves, orographic lee waves, and forced wave flow over developing convective clouds. The subjects covered here are intended to demonstrate the extraordinary flexibility and utility of an instrumented superpressure balloon system using a satellite vehicle for data collection and for location determination.