Effectiveness of Government Policy: An Experience from a National HealthCare System

This paper examines the trade-off between the length of treatment days and the units of service provided per day for elderly patients in the context of the initiative taken by the Ministry of Health and Welfare of Japan to discourage lengthy hospital treatment and/or stay by elderly patients. By using three leading diseases among the elderly in Japan (cancer, heart related disease and mental illness) and separating care utilization into an episode by types of treatment, our results suggest that the government measures function but they do not effectively work to reduce increases in medical expenditures by the elderly under the fee-for-service basis. The evidence shows the interdependency between days and quantity of services, and the larger impact of services on days than days on services. Providers are more able to raise their revenue by additional services, than by additional treatment days, under the government's current cost containment policy toward the elderly care. For the so-called skilled type of treatment services (injection, general treatment, consultation and operation), the results on all elderly ages 65 and over without disease classification show some statistically significant positive impact on length of treatment in days and quantity of services provided per day. For the so-called material type of service (medication and examination), medical service providers are likely to prescribe more drugs as the price of drugs falls under the current strict drug price control by the Japanese government.

Isolation and characterization of Streptococcus sp. from diseased flounder (Paralichthys olivaceus) in Jeju Island

Streptococcus sp. is gram-positive coccus that causes streptococcal infections in fish due to intensification of aquaculture and caused significant economic losses in fish farm industry. A streptococcal infection occurred from cultured diseased olive flounder (Paralichthys olivaceus) in May, 2005 at a fish farm in Jeju Island, Korea. The diseased flounder exhibited bilateral exophthalmic eyes and rotten gills; water temperature was 16~18℃ when samples were collected. Of the 22 fish samples collected, 3 samples were identified as Lactococcus garvieae and 18 samples were identified as Streptococcus parauberis by culture-based, biochemical test. Serological methods such as slide agglutination, hemolysis and antimicrobial susceptibility test were also used as well as multiplex PCR-based method to simultaneously detect and confirm the pathogens involved in the infection. S. parauberis and L. garvieae have a target region of 700 and 1100 bp., respectively. One fish sample was not identified because of the difference in the different biochemical and serological tests and was negative in PCR assay. In the present study, it showed that S. parauberis was the dominant species that caused streptococcosis in the cultured diseased flounder

An End-to-End Tool for Developing CPSs from Design to Implementation

For a Cyber-Physical System (CPS), the real-time execution must be guaranteed at the design time for the safe and reliable interaction between a Cyber and a Physical System. Thus, simulation method is widely used to verify and validate the behavior of a CPS, in the development process. Commercial tools of today, however, only mimic the functional behavior of the system, not the temporal behavior. Moreover, when the simulation target system is changed, developers have to reconfigure all settings to simulate properly. To overcome this limitation, we introduce our End-to-End Development Tool that can support the functional and temporal co-validation and smooth migration for the change of the simulation target system.OAIID:RECH_ACHV_DSTSH_NO:A201617646RECH_ACHV_FG:RR00200003ADJUST_YN:EMP_ID:A077084CITE_RATE:FILENAME:V2CPS_final.pdfDEPT_NM:컴퓨터공학부EMAIL:[email protected]_YN:FILEURL:https://srnd.snu.ac.kr/eXrepEIR/fws/file/8cf7890c-46ec-4551-9c3e-2715774d7f34/linkCONFIRM:

Giant Piloleiomyoma of the Forehead

Cutaneous piloleiomyomas are benign smooth muscle tumors arising from the arrector pili muscles. Piloleiomyomas appear as firm dermal papules of skin color or with a reddish to brown surface, and are commonly located on the extremities. Histologically, these lesions are composed of interlacing bundles of smooth muscle cells in the reticular dermis. Our case presented with an unusually large nodule on the forehead that was accompanied by intermittent pain. Histological analysis was compatible with piloleiomyoma and the lesion showed haphazardly arranged bundles of smooth muscle in the dermis. We describe herein an interesting case of a giant piloleiomyoma occurring on the forehead

Transition from Pemphigus Foliaceus to Pemphigus Vulgaris: Case Report with Literature Review

The transition between the main subtypes of pemphigus, pemphigus vulgaris (PV), and pemphigus foliaceus (PF) has rarely been reported. Moreover, the development of PV in a patient with PF is much more unusual than that of PF in a patient with PV. We report a 48-year-old man who presented with cutaneous lesions showing the typical clinical and histological features of PF. Five years later, his skin lesions became extensive and he developed oral erosions. His condition did not respond well to steroids and azathioprine. Histological examination of a vesicle disclosed suprabasal acantholysis in contrast to the subcorneal acantholysis discovered upon initial histological evaluation. Indirect immunofluorescence revealed IgG antikeratinocyte cell surface antibodies at a titer of 1:640. The titer was 1:160 at initial diagnosis. Upon immunoblotting, the patient's serum reacted with 130 kiloDalton (kDa) and 160 kDa proteins, suggesting desmoglein (Dsg) 3 and 1, respectively. We herein report an unusual case of PV that developed from PF during the disease's flare-up

STATIC AND DYNAMIC CHARACTERISTICS OF AIR FOIL THRUST BEARING CONSIDERING TILTING PAD CONDITION

ABSTRACT The thrust pad of the rotor is used to sustain the axial force generated due to the pressure difference between the compressor and turbine sides of turbomachinery such as the gas turbines and turbochargers. Furthermore, this thrust pad has a role to maintain and determines the attitude of the rotor. In a real system, it also helps reinforce the stiffness and damping of the journal bearing. This study was performed for the purpose of analyzing the characteristics of the air foil thrust bearing. The model for the air foil thrust bearing used in this study is composed of two parts: one is an inclined plane, which plays a role to increase the load carrying capacity using the physical wedge effect, and the other is a flat plane. This study mainly consists of three parts. First, the static characteristics were obtained over the region of the thin air film using the finite difference method (FDM) and the bump foil characteristics using the finite element method (FEM). Second, the analysis of the dynamic characteristics was conducted by perturbation method. For more exact calculation, the rarefaction gas coefficients perturbed about the pressure and film thickness were taken into consideration. At last, the static and dynamic characteristics of the tilting condition of the thrust pad were obtained. Furthermore, the load carrying capacity and torque were calculated for both tilting and not-tilting conditions. From this study, several results were presented: 1) the stiffness and damping of the bump foil under the condition of the various bump parameters, 2) the load carrying capacity and bearing torque at the tilting state, 3) the bearing performance under various bearing parameters, 4) the effects considering the rarefaction gas coefficients