“
“Swiss hospitals were required to implement a prospective payment system for reimbursement using a diagnosis-related groups (DRGs) classification system by the beginning of 2012. Reforms to a health care system should be assessed for their impact, including their impact on ethically relevant factors. Over a number of years and in a number of countries, questions have been raised

in the literature about the ethical implications of the implementation RepSox molecular weight of DRGs. However, despite this, researchers have not attempted to identify the major ethical issues associated with DRGs systematically. To address this gap in the literature, we have developed a matrix for identifying the ethical implications of the implementation of DRGs. It was developed using a literature review, and empirical studies on DRGs, as well as a review and analysis of existing ethics frameworks. The matrix consists of the ethically relevant parameters of health care systems on which DRGs are likely to have an impact;

the ethical values underlying these parameters; and examples of specific research questions associated with DRGs to illustrate how the matrix can be applied. While the matrix has been developed in light of the Swiss health care reform, it could be used as a basis for identifying the ethical implications of DRG-based systems worldwide and for highlighting the ethical implications of other kinds of provider payment systems (PPS). (C) 2013 Elsevier Ireland

Ltd. All rights reserved.”
“Black rice vinegar (kurosu) made from a jar is a traditional vinegar Proteases inhibitor in Japan. Kurosu has been commonly used as a healthcare supplement; however, it is not clear whether kurosu has a treatment effect on the expression of drug metabolism enzymes and transporters, whose expression alterations may induce food-drug interaction. Alteration of the principal drug metabolism enzymes and expression following kurosu and moromi, the residue from black vinegar brewing, for 30-day treatment was evaluated. Water, 0.23% acetic acid, concentrated kurosu (containing 0.23% acetic acid) and moromi was administered to Wister rats. The treatment did selleck chemical not significantly affect the biochemical parameters of serum, alanine aminotransferase, alkaline phosphatase, total protein, creatinine in the serum, and body weight. The treatment also did not affect the expression levels of cytochrome P450 (Cyp) 1a2, Cyp2b1/2, Cyp3a1, glutathione S-transferase, p-glycoprotein, multidrug resistance protein 2, breast cancer resistance protein, organic anion transport polypeptide 2, and organic anion transport 2 and 3 in the liver. In conclusion, the present study suggests that kurosu from a jar does not have toxic effect and does not alter expression levels of principal drug metabolism enzymes and transporters.