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OBJECTIVES: The widespread adoption of health information technology (IT) will help contain health care costs by decreasing inefficiencies in healthcare delivery. Theoretically, health IT could lower hospitals' malpractice insurance premiums (MIPs) and improve the quality of care by reducing the number and size of malpractice. This study examines the relationship between health IT investment and MIP using California hospital data from 2006 to 2007. METHODS: To examine the effect of hospital IT on malpractice insurance expense, a generalized estimating equation (GEE) was employed. RESULTS: It was found that health IT investment was not negatively associated with MIP. Health IT was reported to reduce medical error and improve efficiency. Thus, it may reduce malpractice claims from patients, which will reduce malpractice insurance expenses for hospitals. However, health IT adoption could lead to increases in MIPs. For example, we expect increases in MIPs of about 1.2% and 1.5%, respectively, when health IT and labor increase by 10%. CONCLUSIONS: This study examined the effect of health IT investment on MIPs controlling other hospital and market, and volume characteristics. Against our expectation, we found that health IT investment was not negatively associated with MIP. There may be some possible reasons that the real effect of health IT on MIPs was not observed; barriers including communication problems among health ITs, shorter sample period, lower IT investment, and lack of a quality of care measure as a moderating variable.
California ; Delivery of Health Care ; Electronic Health Records ; Health Care Costs ; Health Information Systems ; Humans ; Insurance* ; Investments ; Malpractice* ; Medical Errors ; Medical Informatics*

PURPOSE: There has been little research regarding the effectiveness of oseltamivir for influenza B infections. We sought to identify the different clinical manifestations between patients treated with and without oseltamivir. METHODS: We retrospectively studied the medical records of 72 inpatients or outpatients from two medical centers diagnosed with influenza B infections by either a rapid antigen test or multiplex reverse transcriptase PCR between January 2012 and July 2012. We compared gender, age, past medical history, admission period, total fever duration, fever duration after hospitalization, post-oseltamivir medication peak temperature, laboratory test, chest X-ray, antibiotic medication, and the presence of concomitant viral or bacterial infections. RESULTS: The number of subjects in our study was 72 who were diagnosed with influenza B pneumonia, acute bronchitis, acute bronchiolitis, croup, and mean age was 3.6+/-2.8 year old. The demographic characteristics and clinical manifestations of oseltamivir and the non-oseltamivir groups, including hospitalization period (4.18+/-2.10 vs 4.79+/-1.49 days, P=.17) and total fever duration (5.32+/-2.07 vs 6.41+/-3.25 days, P=.09), demonstrated no significant differences. Notably, the oseltamivir group did have significantly reduced usage of antibiotic treatment than the non-oseltamivir group (P=.04). When we limited our patient group to patients under the age of three, similar results were seen. The group prescribed oseltamivir within 48 hours of fever onset had less antibiotic usage, in addition to a shorter fever duration. CONCLUSION: Oseltamivir appeared to have no benefit in improving the clinical course. However, if it is prescribed within the first 48 hours of symptoms, it may be more effective.
Bacterial Infections ; Bronchiolitis ; Bronchitis ; Child* ; Croup ; Fever ; Hospitalization ; Hospitals, University* ; Humans ; Influenza B virus* ; Influenza, Human ; Inpatients ; Medical Records ; Oseltamivir* ; Outpatients ; Pneumonia ; Retrospective Studies ; Reverse Transcriptase Polymerase Chain Reaction ; Thorax

Purpose: This study aimed to understand and explore the work experiences of Generation Y nurses in hospital organizations. Methods: Participants were nine nurses with generation Y working in the hospital. Data were collected through individual interviews from December 2, 2022 to June 30, 2023. The transcripts were coded and analyzed using Colaizzi's phenomenological method. Results: A total of 33 formulated meanings were derived from the meaningful 50 statements of nine study participants, and then categorized them into 12 themes with a collection of five theme clusters. Conclusion This study found that Generation Y nurses experienced role confusion and physical and mental burden as they caught in the middle in other generations. Even they were wondering whether to continue working as a nurse, which seems that it is crucial to establish a recognition and compensation system to maintain Generation Y nurses in the field. In addition, Generation Y nurses have been found to endure difficult hospital work and demonstrate patience even when working alone, while also deriving strength from their colleagues. Therefore, it is necessary to establish a program for intergenerational harmony among nurses.

OBJECTIVE: The purpose of this study was to determine the frequency and distribution of cytogenetically abnormal miscarriages in couples with spontaneous abortions (SA) or recurrent miscarriages (RM). METHODS: Karyotyping of specimens from 164 abortuses with SA and 86 abortuses with RM was successfully performed according to the standard cytogenetic methods using G-banding technique. RESULTS: Among the total 164 cases of SA group, 81 (49.4%) were euploid and the rest (83, 50.6%) showed chromosomal abnormalities. In RM(> or =2) and RM(> or =3) group, 31 (36.0%)/27 (34.6%) cases were euploid and 55 (64.0%)/51(65.4%) cases were abnormal, respectively. A statistically significant difference was found in the rate of cytogenetic abnormality between SA and RM groups (P<0.05). In all groups, women with advanced maternal age (> or =35 years) had a higher rate of chromosome anomalies compared with women younger than age 35 (normal:abnormal = 32.4%:67.6% for > or =35 years and 53.8%:46.2% for <35 years in SA; 19.2%:80.8%/21.7%:78.3% for > or =35 years and 43.3%:56.7%/40.0%:60.0% for <35 years in RM(> or =2) and RM(> or =3), respectively; P<0.05). In SA group, an increase of normal karyotypes was noted with increased gestational age (<10 week, 38.0%; 10-15 week, 53.5%; 16-20 week, 65.7%). In RM group, most of cases were in <10 week and the frequency of trisomies with chromosomes 1 to 10 were increased compared with that of SA. CONCLUSION: There was a statistically significant difference in the frequency and distribution of chromosomal abnormalities between SA and RM groups. Our results will provide useful information for diagnosis and genetic counseling of patients with SA or RM.
Abortion, Habitual* ; Abortion, Spontaneous* ; Chromosome Aberrations ; Cytogenetic Analysis ; Cytogenetics* ; Diagnosis* ; Family Characteristics ; Female ; Genetic Counseling ; Gestational Age ; Humans ; Karyotype ; Karyotyping ; Maternal Age ; Pregnancy ; Trisomy

Hepatitis C virus (HCV) is a major cause of chronic hepatitis, liver cirrhosis and hepatocellular carcinoma. HCV core protein has been shown to modulate various cellular signaling pathways including the nuclear factor κB (NF-κB) pathway which is associated with inflammation, cell proliferation and apoptosis. However, there have been conflicting reports about the effect of HCV core protein on NF-κB pathway, and the mechanism by which the core protein affects NF-κB activity remains nuclear. In this study, the functional interaction of HCV core protein and IκB kinase γ (IKKγ) was investigated using the expression plasmids of core and the components of IKK complex. The data revealed that HCV core protein activates NF-κB. Also, HCV core protein up-regulated the phosphorylation and degradation of IκBα. The activating effect of HCV core protein on NF-κB was synergistically elevated by IKKγ. It was noticed that the N-terminal IKKβ binding site, C-terminal leucine zipper, and zinc finger domains of IKKγ are not necessary for its synergistic effect. HCV core protein and IKKγ appeared to activate NF-κB by up-regulating the IKKβ activity resulting in the degradation of IκBα. As expected, HCV core protein induced the expression of NF-κB-targeted pro-inflammatory genes such as iNOS, IL-1β and IL-6 in the transcription level. These results suggest that HCV core protein induces NF-κB through the interaction with IKKγ and may play a critical role in the development of inflammation and related liver diseases.
Apoptosis ; Binding Sites ; Carcinoma, Hepatocellular ; Cell Proliferation ; Hepacivirus* ; Hepatitis C* ; Hepatitis* ; Hepatitis, Chronic ; Inflammation ; Interleukin-6 ; Leucine Zippers ; Liver Cirrhosis ; Liver Diseases ; Phosphorylation ; Phosphotransferases ; Plasmids ; Zinc Fingers

No abstract available.
Hepatolenticular Degeneration*

PURPOSE: The aim of this study was to investigate the alterations of growth and bone metabolism in SDR induced by dexa administration and to evaluate the effects of GH treatment in dexamethasone(dexa) induced growth and bone metabolism in SDR. METHODS: Forty-five female Sprague-Dawley rats(weight 150-170gm) were divided in 3 groups: Group 1(n=15) received normal saline as control, Group 2(n=15) received dexa(1mg/kg/day), Group 3(n=15) received dexa and rhGH(LG Chem, 1IU/kg/day) simultaneously. Group 2 and 3 were injected rhGH daily, 6 days per week. Each group was divided in three subgroups(n=5) and sacrificed at 4, 6, 8 weeks, respectively. RESULTS: In Group 2, the length of tibia and femur and tibia epiphyseal plate thickness decreased significantly at 4, 6, 8 weeks compared to Group 1, respectively. In Group 2, serum IGF-I and PICP level also decreased at 6, 8 weeks and serum ICTP level increased at 4, 6 weeks compared to Group 1 significantly. In Group 3, the length of tibia and femur increased at 4, 6, 8 weeks compared to Group 2 but there was no statistical significance. In Group 3, tibia epiphyseal plate thickness increased significantly at 6, 8 weeks compared to Group 1. In Group 3, serum IGF-I and PICP level increased significantly at 4, 6, 8 weeks respectively compared to Group 2. But serum ICTP level showed no changes between two groups. Serum PTH level increased in Group 2 compared to Group 1, and decreased in Group 3 compared to Group 2 but no statistical significance was noted, respectively. CONCLUSION: Our data suggest that dexa inhibits longitudinal bone growth and interferes with bone metabolism, both inhibiting bone formation and stimulating bone resorption in SDR. Simultaneous GH administration may abolish alterations of growth and bone metabolism induced by dexa in SDR.
Animals ; Bone Density ; Bone Development ; Bone Resorption ; Dexamethasone* ; Female ; Femur ; Growth Hormone* ; Growth Plate ; Humans ; Insulin-Like Growth Factor I ; Metabolism* ; Osteogenesis ; Rats* ; Rats, Sprague-Dawley ; Tibia

Acute necrotizing encephalopathy (ANE) is a rare immune-mediated complication of a viral infection commonly involving the bilateral thalamus and has been reported mainly in children. Here, we describe the MRI findings of coronavirus disease 2019 (COVID-19)-associated ANE in two pediatric patients, including a 7-year-old girl with fever and mental change, and a 6-year-old girl with fever and generalized seizures. Brain MRI revealed symmetrical T2 fluid attenuated inversion recovery high-signal intensity lesions in the bilateral thalamus with central hemorrhage. In one patient, the thalamic lesions showed a trilaminar pattern on the apparent diffusion coefficient map. This report emphasizes the importance of creating awareness regarding these findings in patients with COVID-19, particularly in children with severe neurological symptoms. Furthermore, it provides a literature review of several documented cases of COVID-19 presenting with bilateral thalamic hemorrhagic necrosis, suggesting a diagnosis of ANE.

Acute necrotizing encephalopathy (ANE) is a rare immune-mediated complication of a viral infection commonly involving the bilateral thalamus and has been reported mainly in children. Here, we describe the MRI findings of coronavirus disease 2019 (COVID-19)-associated ANE in two pediatric patients, including a 7-year-old girl with fever and mental change, and a 6-year-old girl with fever and generalized seizures. Brain MRI revealed symmetrical T2 fluid attenuated inversion recovery high-signal intensity lesions in the bilateral thalamus with central hemorrhage. In one patient, the thalamic lesions showed a trilaminar pattern on the apparent diffusion coefficient map. This report emphasizes the importance of creating awareness regarding these findings in patients with COVID-19, particularly in children with severe neurological symptoms. Furthermore, it provides a literature review of several documented cases of COVID-19 presenting with bilateral thalamic hemorrhagic necrosis, suggesting a diagnosis of ANE.