Effects of an increase in patient copayments on medical service demands of the insured in japan

Objectives:To examine quantitatively the effects of an increase in patient copayments from 10% to 20% on the demand for medical services in Japan. Methods: The subjects of the study were the employees insured by the 1,797 health insurance societies, belonging to the National Federation of Health Insurance Societies, in 1996 and 1998. Indicators of medical service demands analyzed include the inpatient, outpatient, and dental case rates, the number of serviced days per case, the medical cost per day and the medical cost per insured. Results: When the effects of an increase in patient copayments from 10% to 20% were evaluated, taking into account the average age, the average monthly salary, the total number, the gender (male-tofemale) ratio and the dependent ratio of the insured, the estimated change in the case rate was &#8722;6.96% for inpatient, &#8722;4.79% for outpatient, and &#8722;5.77% for dental care. The estimated change in the number of serviced day per case was &#8722;4.66% for inpatient, &#8722;5.67% for outpatient, and &#8722;1.82% for dental care. The estimated change in the medical cost per day was &#8722;3.15% for inpatient, &#8722;13.00% for outpatient, and &#8722;11.48% for dental care. The estimated change in the medical cost per insured was &#8722;14.08% for inpatient, &#8722;21.54% for outpatient, and &#8722;18.11% for dental care. Conclusions: The increase in patient copayments from 10% to 20% enabled insurers to substantially reduce medical costs by cost shifting from the insurer to the insured, with resultant changes in the case rate and the number of service days per case.</p

Spred-2 deficiency exacerbates acetaminophen-induced hepatotoxicity in mice

MAPKs are involved in acetaminophen (APAP)-hepatotoxicity, but the regulatory mechanism remains unknown. Here, we explored the role of Spred-2 that negatively regulates Ras/ERK pathway in APAP-hepatotoxicity. Spred-2 knockout (KO) mice demonstrated exacerbated liver injury, an event that was associated with increased numbers of CD4(+) T, CD8(+) T and NK cells in the liver compared to the control. Levels of CXCL9/CXCL10 that attract and activate these cells were increased in Spred-2 KO-liver. Kupffer cells isolated from Spred-2 KO mice after APAP challenge expressed higher levels of CXCL9/CXCL10 than those from the control. Upon stimulation with APAP or IFN gamma, naive Kupffer cells from Spred-2 KO mice expressed higher levels of CXCL9/CXCL10. NK cell-depletion attenuated APAP-hepatotoxicity with lowered hepatic IFN gamma and decreased numbers of not only NK cells but also CD4(+) T and CD8(+) T cells in the liver. These results suggest that Spred-2 negatively regulates APAP-hepatotoxicity under the control of Kupffer cells and NK cells

Revisiting PFA-mediated tissue fixation chemistry: FixEL enables trapping of small molecules in the brain to visualize their distribution changes

ホルマリン漬けから着想した小分子可視化法 --医薬品開発効率化につながる新たな戦略--. 京都大学プレスリリース. 2022-12-05.Various small molecules have been used as functional probes for tissue imaging in medical diagnosis and pharmaceutical drugs for disease treatment. The spatial distribution, target selectivity, and diffusion/excretion kinetics of small molecules in structurally complicated specimens are critical for function. However, robust methods for precisely evaluating these parameters in the brain have been limited. Herein, we report a new method termed “fixation-driven chemical cross-linking of exogenous ligands (FixEL), ” which traps and images exogenously administered molecules of interest (MOIs) in complex tissues. This method relies on protein-MOI interactions and chemical cross-linking of amine-tethered MOI with paraformaldehyde used for perfusion fixation. FixEL is used to obtain images of the distribution of the small molecules, which addresses selective/nonselective binding to proteins, time-dependent localization changes, and diffusion/retention kinetics of MOIs such as the scaffold of PET tracer derivatives or drug-like small molecules

Thermotomaculum hydrothermale gen. nov., sp. nov., a novel heterotrophic thermophile within the phylum Acidobacteria from a deep-sea hydrothermal vent chimney in the Southern Okinawa Trough

http://www.godac.jamstec.go.jp/darwin/cruise/natsushima/nt08-13/

The Japanese space gravitational wave antenna; DECIGO

DECi-hertz Interferometer Gravitational wave Observatory (DECIGO) is the future Japanese space gravitational wave antenna. DECIGO is expected to open a new window of observation for gravitational wave astronomy especially between 0.1 Hz and 10 Hz, revealing various mysteries of the universe such as dark energy, formation mechanism of supermassive black holes, and inflation of the universe. The pre-conceptual design of DECIGO consists of three drag-free spacecraft, whose relative displacements are measured by a differential Fabry– Perot Michelson interferometer. We plan to launch two missions, DECIGO pathfinder and pre- DECIGO first and finally DECIGO in 2024

Evaluation of focal damage in the retinal pigment epithelium layer in serous retinal pigment epithelium detachment

The purpose of this study was to evaluate focal damage in the retinal pigment epithelium (RPE) layer in serous retinal pigment epithelium detachment (PED) with multi-contrast optical coherence tomography (OCT), which is capable of simultaneous measurement of OCT angiography, polarization-sensitive OCT and standard OCT images. We evaluated 37 eyes with age-related macular degeneration that had serous PED. Focal RPE damage was indicated by hyper-transmission beneath the RPE-Bruch’s membrane band in standard OCT images. Distribution of RPE melanin was calculated using the dataset from multi-contrast OCT. Twenty-four points with hyper-transmission were detected in 21 of the 37 eyes. Standard OCT images failed to show disruption of the RPE-Bruch’s membrane band at 5 of the 24 hyper-transmission points. Conversely, multi-contrast OCT images clearly showed melanin defects in the RPE-Bruch’s membrane band at all points. Areas of melanin defects with disruption of the RPE-Bruch’s membrane band were significantly larger than those without disruption. The volume of intraretinal hyper-reflective foci was significantly larger in eyes with hyper-transmission than that in eyes without hyper-transmission. Multi-contrast OCT is more sensitive than standard OCT for displaying changes at the RPE-Bruch’s membrane band when there are small areas of RPE damage

DECIGO pathfinder

DECIGO pathfinder (DPF) is a milestone satellite mission for DECIGO (DECi-hertz Interferometer Gravitational wave Observatory) which is a future space gravitational wave antenna. DECIGO is expected to provide us fruitful insights into the universe, in particular about dark energy, a formation mechanism of supermassive black holes, and the inflation of the universe. Since DECIGO will be an extremely large mission which will formed by three drag-free spacecraft with 1000m separation, it is significant to gain the technical feasibility of DECIGO before its planned launch in 2024. Thus, we are planning to launch two milestone missions: DPF and pre-DECIGO. The conceptual design and current status of the first milestone mission, DPF, are reviewed in this article

ダイジョ DIOSCOREA ALATA L. ノ セイチョウ カテイ ニ オケル ケイヨウ コンケイ ノ ガンスイリツ ノ ヘンカ

関東地域で収穫可能なダイジョの1品種を用いて,地下部の塊茎のみならず塊茎デンプンのソースである地上部の茎葉における生長過程の含水率の変化を調べた。その結果,生長時期の推移に伴う茎葉含水率と塊茎の含水率の変化には顕著な差異が認められた。すなわち,茎葉の含水率は生長期間の大半を通して緩やかに減少するが,塊茎の含水率は肥大初期に急速に減少し,その後横這いから緩やかな減少傾向を示した。塊茎では,肥大初期にはその組織が主に若い柔組織細胞で構成されているため水分含量が高いが,肥大が旺盛になるにつれてデンプンの蓄積が進み,それに伴って含水率が低下したものと推測された。このことから,ダイジョの塊茎の含水率の推移は,品種の塊茎成熟度の特性を評価する有効な方法となる可能性が考えられた。Greater yam (Dioscorea alata L.) is one of the yams and still a staple food tuber crop in parts of developing and self-sustaining agriculture in tropical Asia. Yam tuber contains high moisture content, which changes during growth stages. The present research investigated changes of moisture content in tubers and tops of an early cultivar, which is able to riper in the Kanto Metropolitan area. According to the results, remarkable differences were observed in changes of moisture content of tubers and tops of growing plants. Moisture content of tops gradually decreased throughout whole growth stages, while that of tubers rapidly decreased at the early stage of growth and thereafter tended to reduce gradually. In the earlier stage of growth, tubers consisting of young parenchyma seems to maintain higher moisture content. But as the growth of tuber progresses, starch is accumulated and moisture content of the tuber is thought to be reduced. From these results, the changes of moisture content in tubers will be an useful indicator for tuber maturity

ダイジョ DIOSCOREA ALATA L. ノ セイチョウ カテイ ニ オケル ケイヨウ コンケイ ノ ガンスイリツ ノ ヘンカ

関東地域で収穫可能なダイジョの1品種を用いて,地下部の塊茎のみならず塊茎デンプンのソースである地上部の茎葉における生長過程の含水率の変化を調べた。その結果,生長時期の推移に伴う茎葉含水率と塊茎の含水率の変化には顕著な差異が認められた。すなわち,茎葉の含水率は生長期間の大半を通して緩やかに減少するが,塊茎の含水率は肥大初期に急速に減少し,その後横這いから緩やかな減少傾向を示した。塊茎では,肥大初期にはその組織が主に若い柔組織細胞で構成されているため水分含量が高いが,肥大が旺盛になるにつれてデンプンの蓄積が進み,それに伴って含水率が低下したものと推測された。このことから,ダイジョの塊茎の含水率の推移は,品種の塊茎成熟度の特性を評価する有効な方法となる可能性が考えられた。Greater yam (Dioscorea alata L.) is one of the yams and still a staple food tuber crop in parts of developing and self-sustaining agriculture in tropical Asia. Yam tuber contains high moisture content, which changes during growth stages. The present research investigated changes of moisture content in tubers and tops of an early cultivar, which is able to riper in the Kanto Metropolitan area. According to the results, remarkable differences were observed in changes of moisture content of tubers and tops of growing plants. Moisture content of tops gradually decreased throughout whole growth stages, while that of tubers rapidly decreased at the early stage of growth and thereafter tended to reduce gradually. In the earlier stage of growth, tubers consisting of young parenchyma seems to maintain higher moisture content. But as the growth of tuber progresses, starch is accumulated and moisture content of the tuber is thought to be reduced. From these results, the changes of moisture content in tubers will be an useful indicator for tuber maturity