Objective This study aimed to evaluate the effects of establishing a Department of General Internal Medicine (DGIM) on the length of hospitalization. We evaluated the length of hospitalization associated with diseases for which full-time specialists were not available and were instead treated by physicians of the DGIM after its establishment. Methods A retrospective cohort study was conducted with a review of the subjects' medical records. The subjects included patients ! 16 years of age who were hospitalized with pneumonia or cerebral infarction and treated by a physician with a specialty in internal medicine as the disease outside their specialty prior to DGIM establishment (October 1, 2006 to September 30, 2008 or by a physician of the DGIM after its establishment (October 1, 2009 to September 30, 2011). The primary outcome was the change in the length of hospitalization. The length of hospitalization for heart failure, which was treated by specialists (cardiologists) in both study periods, was also examined for comparison. Results We evaluated 322 and 423 cases of pneumonia treated before and after the establishment of the DGIM, as well as 223 and 229 cases of cerebral infarction and 132 and 206 cases of heart failure, respectively. The length of hospitalization before and after establishment of the DGIM was 21.6 and 16.0 days for the pneumonia patients (p<0.001) and 24.2 and 19.9 days for the cerebral infarction patients (p<0.001), respectively. On the other hand, the change in the length of hospitalization for the heart failure patients was not statistically significant (19.9 vs. 17.6 days; p=0.281). Conclusion The establishment of the DGIM reduced the length of hospitalization associated with diseases for which full-time specialists were not available by over 17%.
Nature friendly hydraulic structures made of natural stones such as ripraps have attracted attention in recent years. However, those structures are subject to failure problem under flood flow. Therefore, the authors proposed tied gravels to increase its stability against flood flow. Coefficients such as the drag and lift force are necessary in designing those structures. However, the authorized values for those coefficients are not established yet, the coefficients used for concrete structures are therefore applied in designing structures made of stones at present condition. This study aims to clarify the drag and lift coefficient for gravels and tied gravels experimentally.
Nature friendly hydraulic structures made of natural stones such as ripraps have attracted attention in recent years. However, those structures are subject to failure problem under flood flow. Therefore, the authors proposed connected stone to increase its stability against flood flow. Coefficients such as the drag and lift force are necessary in designing those structures. However, the authorized values for those coefficients are not established yet, the coefficients used for concrete structures are therefore applied in designing structures made of stones at present condition. This study aims to clarify the drag and lift coefficient for connected stones placed at the middle and upper reach of the bed protection works using connected stones.
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