This study examined the variability in the length of stay (LOS) and daily medical expenses (DME) for hypertension and pneumonia inpatient care. Using 10 years of National Health Insurance Service data (2010–2019), a multilevel analysis assessed variability at the patient and institutional levels. During the study period, the mean LOS decreased, whereas the DME increased for both hypertension and pneumonia. Institutional level variability in the LOS increased during the study period, demonstrating greater variability than that for pneumonia. For both conditions, institutional-level variability was more marked in smaller institutions (hospitals and clinics) than in larger institutions (general and tertiary hospitals).These findings indicate a need for standardized healthcare service protocols to promote consistent and efficient patient care.

This study examined the variability in the length of stay (LOS) and daily medical expenses (DME) for hypertension and pneumonia inpatient care. Using 10 years of National Health Insurance Service data (2010–2019), a multilevel analysis assessed variability at the patient and institutional levels. During the study period, the mean LOS decreased, whereas the DME increased for both hypertension and pneumonia. Institutional level variability in the LOS increased during the study period, demonstrating greater variability than that for pneumonia. For both conditions, institutional-level variability was more marked in smaller institutions (hospitals and clinics) than in larger institutions (general and tertiary hospitals).These findings indicate a need for standardized healthcare service protocols to promote consistent and efficient patient care.

This study examined the variability in the length of stay (LOS) and daily medical expenses (DME) for hypertension and pneumonia inpatient care. Using 10 years of National Health Insurance Service data (2010–2019), a multilevel analysis assessed variability at the patient and institutional levels. During the study period, the mean LOS decreased, whereas the DME increased for both hypertension and pneumonia. Institutional level variability in the LOS increased during the study period, demonstrating greater variability than that for pneumonia. For both conditions, institutional-level variability was more marked in smaller institutions (hospitals and clinics) than in larger institutions (general and tertiary hospitals).These findings indicate a need for standardized healthcare service protocols to promote consistent and efficient patient care.

This study examined the variability in the length of stay (LOS) and daily medical expenses (DME) for hypertension and pneumonia inpatient care. Using 10 years of National Health Insurance Service data (2010–2019), a multilevel analysis assessed variability at the patient and institutional levels. During the study period, the mean LOS decreased, whereas the DME increased for both hypertension and pneumonia. Institutional level variability in the LOS increased during the study period, demonstrating greater variability than that for pneumonia. For both conditions, institutional-level variability was more marked in smaller institutions (hospitals and clinics) than in larger institutions (general and tertiary hospitals).These findings indicate a need for standardized healthcare service protocols to promote consistent and efficient patient care.

Sesquiterpene lactones, a class of natural compounds abundant in the Asteraceae family, have gained attention owing to their diverse biological activities, and particularly their anti-proliferative effects on human cancer cells. In this study, we systematically investigated the structure-activity relationship of ten sesquiterpene lactones with the aim of elucidating the structural determinants for the STAT3 inhibition governing their anti-proliferative effects. Our findings revealed a significant correlation between the STAT3 inhibitory activity and the anti-proliferative effects of sesquiterpene lactones in MDA-MB-231 breast cancer cell lines. Among the compounds tested, alantolactone and isoalantolactone emerged as the most potent STAT3 inhibitors, highlighting their potential as candidates for anticancer drug development. Through protein-ligand docking studies, we revealed the structural basis of STAT3 inhibition by sesquiterpene lactones, emphasizing the critical role of hydrogen-bonding interactions with key residues, including Arg609, Ser611, Glu612, and Ser613, in the SH2 domain of STAT3. Furthermore, our conformational analysis revealed the decisive role of the torsion angle within the geometry-optimized structures of sesquiterpene lactones in their STAT3 inhibitory activity (R=0.80, p<0.01). These findings not only provide preclinical evidence for sesquiterpene lactones as promising phytomedicines against diseases associated with abnormal STAT3 activation, but also highlight the importance of stereochemical aspects in their activity.

The natural flavonoid macakurzin C (1) exhibited adiponectin biosynthesis-inducing activity during adipogenesis in human bone marrow mesenchymal stem cells and its molecular mechanism was directly associated with a pan-peroxisome proliferator-activated receptor (PPAR) modulator affecting all three PPAR subtypes α, γ, and δ. In this study, increases in adiponectin biosynthesisinducing activity by macakurzin C derivatives (2–7) were studied. The most potent adiponectin biosynthesis-inducing compound 6, macakurzin C 3,5-dimethylether, was elucidated as a dual PPARα/γ modulator. Compound 6 may exhibit the most potent activity because of the antagonistic relationship between PPARδ and PPARγ. Docking studies revealed that the O-methylation of macakurzin C to generate compound 6 significantly disrupted PPARδ binding. Compound 6 has therapeutic potential in hypoadiponectinemia-related metabolic diseases.

Objective: This study aimed to identify the utility of risk-rescue rating scale (RRRS), a psychological scale, and certain biomarkers in determining the disposition of patients visiting the emergency department (ED) after their suicide attempts. Methods: We retrospectively reviewed the medical records of patients who visited the ED after attempting suicide. The patients were classified into three groups for comparison: the discharged (DC) group, the general ward (GW) admission group, and the intensive care unit (ICU) admission group. Results: This study included 454 patients, with 344 patients in the DC group (75.8%), 63 patients in the GW admission group (13.9%), and 47 patients in the ICU admission group (10.3%). The three groups showed statistically significant differences in age, time of visit, physical status, presumptive diagnosis, the RRRS, mental status, C-reactive protein, neutrophil-lymphocyte ratio (NLR), and systemic immune inflammation index. Multivariate logistic regression analysis showed that predictors of the GW admission included the time of visit, mental status, and the RRRS. A receiver operating characteristic curve analysis of RRRS for the decision to admit to GW and ICU showed a cut-off value of 36.5 and 44.5, respectively. However, no inflammatory biomarkers were identified as factors predicting GW and ICU admissions. Conclusion The RRRS is useful in determining the disposition of patients who visited the ED after suicide attempts.

Objective: This study aimed to identify the utility of risk-rescue rating scale (RRRS), a psychological scale, and certain biomarkers in determining the disposition of patients visiting the emergency department (ED) after their suicide attempts. Methods: We retrospectively reviewed the medical records of patients who visited the ED after attempting suicide. The patients were classified into three groups for comparison: the discharged (DC) group, the general ward (GW) admission group, and the intensive care unit (ICU) admission group. Results: This study included 454 patients, with 344 patients in the DC group (75.8%), 63 patients in the GW admission group (13.9%), and 47 patients in the ICU admission group (10.3%). The three groups showed statistically significant differences in age, time of visit, physical status, presumptive diagnosis, the RRRS, mental status, C-reactive protein, neutrophil-lymphocyte ratio (NLR), and systemic immune inflammation index. Multivariate logistic regression analysis showed that predictors of the GW admission included the time of visit, mental status, and the RRRS. A receiver operating characteristic curve analysis of RRRS for the decision to admit to GW and ICU showed a cut-off value of 36.5 and 44.5, respectively. However, no inflammatory biomarkers were identified as factors predicting GW and ICU admissions. Conclusion The RRRS is useful in determining the disposition of patients who visited the ED after suicide attempts.

Adiponectin secretion-promoting compounds have therapeutic potentials in human metabolic diseases. Diallyl biphenyl-type neolignan compounds, magnolol, honokiol, and 4-O-methylhonokiol, from a Magnolia officinalis extract were screened as adiponectin-secretion promoting compounds in the adipogenic differentiation model of human bone marrow mesenchymal stem cells (hBM-MSCs). In a target identification study, magnolol, honokiol, and 4-O-methylhonokiol were elucidated as PPARα and PPARγ dual modulators. Diallyl biphenyl-type neolignans affected the transcription of lipid metabolism-associated genes in a different way compared to those of specific PPAR ligands. The diallyl biphenyl-type neolignan structure provides a novel pharmacophore of PPARα/γ dual modulators, which may have unique therapeutic potentials in diverse metabolic diseases.

Extracellular interleukin 1 alpha (IL-1α) released from keratinocytes is one of the endpoints for in vitro assessments of skin irritancy. Although cells dying via primary skin irritation undergo apoptosis as well as necrosis, IL-1α is not released in apoptotic cells. On the other hand, active secretion has been identified in interleukin-1 receptor antagonist (IL-1ra), which was discovered to be a common, upregulated, differentially-expressed gene in a microarray analysis performed with keratinocytes treated using cytotoxic doses of chemicals. This study examined whether and how IL-1ra, particularly extracellularly released IL-1ra, was involved in chemically-induced keratinocyte cytotoxicity and skin irritation. Primary cultured normal adult skin keratinocytes were treated with cytotoxic doses of chemicals (hydroquinone, retinoic acid, sodium lauryl sulfate, or urshiol) with or without recombinant IL-1ra treatment. Mouse skin was administered irritant concentrations of hydroquinone or retinoic acid. IL-1ra (mRNA and/or intracellular/extracellularly released protein) levels increased in the chemically treated cultured keratinocytes with IL-1α and IL-1β mRNAs and in the chemically exposed epidermis of the mouse skin. Recombinant IL-1ra treatment significantly reduced the chemically-induced apoptotic death and intracellular/extracellularly released IL-1α and IL-1β in keratinocytes. Collectively, extracellular IL-1ra released from keratinocytes could be a compensatory mechanism to reduce the chemically-induced keratinocyte apoptosis by antagonism to IL-1α and IL-1β, suggesting potential applications to predict skin irritation.
Adult ; Animals ; Apoptosis* ; Epidermis ; Hand ; Humans ; In Vitro Techniques ; Interleukin 1 Receptor Antagonist Protein ; Interleukin-1* ; Interleukin-1alpha ; Keratinocytes* ; Mice ; Microarray Analysis ; Necrosis ; RNA, Messenger ; Skin ; Sodium Dodecyl Sulfate ; Tretinoin