¹⁸F-FDG PET/CTの定量指標を用いた血管肉腫患者の予後予測

京都大学0048新制・課程博士博士(医学)甲第22739号医博第4657号新制||医||1046(附属図書館)京都大学大学院医学研究科医学専攻(主査)教授 武藤 学, 教授 佐藤 俊哉, 教授 椛島 健治学位規則第4条第1項該当Doctor of Medical ScienceKyoto UniversityDGA

Is Environmental Tax Harmonization Desirable in Global Value Chains?

The spatial unbundling of parts production and assembly currently characterizes globalization, leading to the worldwide dispersion of pollution. We consider socially optimal (cooperative) environmental taxes in a two-country model of global value chains in which the location of both parts and assembly can differ. When unbundling costs are so high that parts and assembly must colocate in the pre-globalized world, pollution is spatially concentrated, and harmonizing environmental taxes maximizes global welfare. In contrast, with low unbundling costs triggering the dispersion of parts and thus pollution throughout the world as today, harmonization fails to maximize global welfare. Similar results hold when the two countries non-cooperatively choose their environmental taxes

喫煙と肝内脂肪の関連性

藤田医科大

Combination of high-resolution cone beam computed tomography and metal artefact reduction software: a new image fusion technique for evaluating intracranial stent apposition after aneurysm treatment.

We introduce a new imaging technique to improve visualisation of stent apposition after endovascular treatment of brain aneurysms employing high-resolution cone beam CT and three-dimensional digital subtraction angiography. After performing a stent-assisted coil embolisation of brain aneurysm, the image datasets were processed with a metal artefact reduction software followed by the automated image fusion programmes. Two patients who underwent aneurysm coiling using a Neuroform stent were evaluated. The reconstructed 3D images showed a detailed structure of the stent struts and identified malappositions of the deployed stents. Case 1 showed good apposition on the outer curvature side of the carotid siphon, while the inner curvature side showed prominent malapposition. Case 2, with multiple aneurysms, showed good apposition on both outer and inner curvature sides, although inward prolapse of the struts was observed. This new imaging technique may help evaluate stent apposition after the endovascular aneurysm treatment

Glucose-lowering efficacy of Xultophy with low doses by FreeStyle Libre as continuous glucose monitoring (CGM)

The daily profile of blood glucose can be detected by continuous glucose monitoring (CGM) using FreeStyle Libre. The case was a 51-year-old female with type 2 diabetes mellitus (T2DM) for uncontrolled glucose variability as HbA1c 10.3%. During CGM measurement, diabetic treatment was changed from multiple daily insulin injections (MDI) to Xultophy (insulin degludec and liraglutide). Xultophy starting from 10 to 18 doses has brought the improvement of glucose variability, such as decreased pre-prandial glucose from 268 mg/dL to 101 mg/dL. Consequently, detailed data of glucose variability on Xultophy using CGM would be beneficial and become some reference for further clinical diabetic research

Analysis of Pharmacist-Patient Communication using the Roter Method of Interaction Process Analysis System

Background: Effective communication between pharmacists and patients is a crucial factor in ensuring thatmedications are used properly. However, few studies have examined the contents of actual on-sitecommunications between pharmacists and patients.Objective: To identify the characteristics of and problems with routine communications betweenpharmacists and patients using the Roter Method of Interaction Process Analysis System (RIAS).Methods: Conversations between pharmacists and simulated patients (SPs) were recorded and transcribed.Using the RIAS technique, their utterances were classified into 42 categories, and these were furtherdivided into 11 clusters, such as open- and closed-ended questions, and analyzed. Furthermore, theinfluence that the different scenarios performed by the pharmacists may have had on the structure of theircommunication was investigated. All of the transcripts were double-coded by two certified coders.Results: A total of 57 pharmacists took part in the study. The mean ratio of utterances made by SPs andpharmacists were 44% and 56%, respectively. The percentage of pharmacists’ questions was more thandouble that of SPs’ for both open- and closed-ended questions. In the influence that the different scenarios,the scenarios for patients with cancer was significantly higher ratio of utterances by the pharmacists.Conclusions: Pharmacists’ communications tended to focus more on information-gathering activities thatconcentrated on closed-ended questions and frequent counseling, or directing utterances about themedication than on considering the patient’s background. On the other hand, the pharmacists didcommunicate in ways that matched each patient’s disease. This study identified the structure ofpharmacists’ on-site communications, and revealed the associated characteristics and problems