Understanding the differences in the development and use of advanced traveler information systems for vehicles (ATIS/V) in the U.S., Germany, and Japan

Thesis (S.M.)--Massachusetts Institute of Technology, Engineering Systems Division, Technology and Policy Program, 2007.Includes bibliographical references (p. 143-157).Traffic congestion is becoming a serious problem. As a solution, advanced traveler information systems (ATIS) mitigate traffic congestion by providing real-time traffic information to travelers. ATIS includes various applications such as radio traffic reporting services and websites. Among those, this thesis focuses on more advanced real-time traffic information systems, which provide sophisticated traffic information to drivers via in-vehicle devices such as car navigation systems: we call them ATISN (advanced traveler information systems for vehicles). ATISN has a high potential to mitigate traffic congestion and improve travel for individual drivers. However, in some countries, ATISN has not been accepted well by drivers. To improve this situation, three questions motivate this study: (1) why does ATISN in some parts of the world have more penetration than in others, (2) what can be done to increase the penetration of ATISN, and (3) what kinds of strategic alliances among stakeholders can help to make better ATISNs. This thesis compares three countries, the U.S., Germany, and Japan, by a qualitative analysis of the system dynamics methodology to clarify reasons which have been causing differences in the penetration.(cont.) Additionally, a new supply chain model based on McQueen's model is used. Furthermore, stakeholder analysis and case studies regarding stakeholder alliances in current ATISNs and highway service operators' strategies for alliances are conducted. In conclusion, from a macro-perspective analysis, many prominent factors in the dynamics of ATISN penetration are found, such as public investment in a public-driven ATISN, the in-vehicle device market, and two-way communication technology development. Furthermore, from analysis for alliances among stakeholders, no absolute best alliances but many possibilities to create alliances for ATISN are clarified, and the use of ATISN as a differentiation tool is suggested as one option worth considering.b y Yoshihiko Sugawara.S.M

冠動脈高度石灰化病変に対するスコアリングバルーンラクロスNon-Slip Elementを用いた冠動脈形成術－光干渉断層法による有用性の評価

Percutaneous coronary intervention (PCI) for heavily calcified lesions is challenging because these lesions are resistant to balloon dilatation and stenting. Lacrosse non-slip element (NSE) may have the potential to dilate heavily calcified lesions. We aimed to investigate predictors of successful lesion modification using Lacrosse NSE angioplasty via optical coherence tomography (OCT)-guided PCI. We investigated 32 patients with severe target lesion calcification treated with OCT-guided PCI. Successful lesion modification was defined as the complete fracture of calcification after Lacrosse NSE angioplasty. Before PCI, 172 segments with calcification were identified. After pre-dilatation using Lacrosse NSE, successful lesion modification was achieved in 117 segments (68.0%). Calcification was significantly thinner in successfully disrupted segments than in non-disrupted segments (p < 0.001). Calcification angle tended to be larger in disrupted than in non-disrupted segments (p = 0.08). Convex types were less frequently observed in disrupted than in non-disrupted segments (p < 0.001). At minimal lumen area sites, 26 segments (81.3%) were successfully modified. Similar to the overall results, the disrupted group had significantly thinner calcification than the non-disrupted group (p < 0.001). The angle of the calcified plaque was similar between the 2 groups (p = 0.39). Convex-type calcifications were less frequently observed in the disrupted group than in the non-disrupted group (p = 0.05). Receiver-operating characteristic curve analysis showed that calcification thickness < 565 μm was the best predictor of completely disrupted calcification. The thickness and shape of calcifications were predictors of successful lesion modification after Lacrosse NSE angioplasty.博士（医学）・乙第1426号・平成31年3月15日© Japanese Association of Cardiovascular Intervention and Therapeutics 2018This is a post-peer-review, pre-copyedit version of an article published in Cardiovascular intervention and therapeutics. The final authenticated version is available online at: http://dx.doi.org/10.1007/s12928-018-0553-6

高齢の非代償性心不全患者において、非心血管疾患、特に感染症は重要な死因である

BACKGROUND:Despite marked improvements in treatment strategies for heart failure (HF), the mortality rate of elderly patients with HF is still high. Detailed causes of death have not been fully understood.METHODS AND RESULTS:We studied 459 consecutive patients with acute decompensated HF (ADHF) emergently admitted to our hospital from 2007 to 2011. Patients were divided into 2 groups: <75 years old (younger group; n = 225) and ≥75 years old (elderly group; n = 234). All-cause death, cardiovascular death, and noncardiovascular death were assessed as adverse outcomes. Compared with the younger group, the elderly group was characterized by a higher proportion of women and hypertensive patients and higher left ventricular ejection fraction. During a mean follow-up of 20.7 months, a total of 174 patients (37.9%) died. All-cause death was significantly higher in the elderly group than in the younger group (46.6% vs 28.9%; P < .0001), and this difference was caused by an increase in noncardiovascular deaths (20.9% vs 9.3%; P < .001), especially deaths due to infection (10.7% vs 4.0%; P < .01). Cardiovascular deaths did not differ between the 2 groups.CONCLUSIONS:Noncardiovascular deaths, most of which were caused by infection, were frequent among elderly patients with ADHF.博士（医学）・甲第629号・平成27年3月16日Copyright © 2014 Elsevier Inc. All rights reserved

基本的検査からの甲状腺機能亢進症患者のスクリーニング

A complementary study to our former work is performed about screening of the patient with hyperthyroidism using routine test data. The same calculation is done, however, adopting 17 routine tests in addition to former 14 tests. The result adopting 4 routine tests such as ALP, AST, ALT and T-Cho which thyroid specialist often consider as important to suspect hyperthyroidism, is evaluated. The importance of S-Cr to make screening the patients with hyperthyroidism is stressed

Achieving LDL cholesterol target levels <1.81 mmol/L may provide extra cardiovascular protection in patients at high risk: Exploratory analysis of the Standard Versus Intensive Statin Therapy for Patients with Hypercholesterolaemia and Diabetic Retinopathy study

Aims To assess the benefits of intensive statin therapy on reducing cardiovascular (CV) events in patients with type 2 diabetes complicated with hyperlipidaemia and retinopathy in a primary prevention setting in Japan. In the intension-to-treat population, intensive therapy [targeting LDL cholesterol = 2.59 to = 100 to = 2.59 to <3.10 mmol/L in patients with hypercholesterolaemia and diabetic retinopathy

Continuous Cytostatic Effects of BCR-ABL Tyrosine Kinase Inhibitors (TKIs) after Washout in Human Leukemic K562 Cells

Tyrosine kinase inhibitors (TKIs) are used as the first choice for chronic myeloid leukemia (CML) pharmacotherapeutics. Some patients taking these drugs showed good therapeutic reactivity despite the disappearance of drugs from blood. We investigated whether these drugs have sustained effects even after their disappearance and whether their effects depend on their amounts of intracellular accumulation. Cell proliferation after exposure of K562 cells or Multidrug resistance-1 (MDR-1)-transfected K562 cells was determined by a cell counting kit-8 assay. The intracellular accumulation amount of the drug showing a sustained cytostatic effect was measured by ultra high performance liquid chromatography mass spectrometry. Cell viability decreased in a culture time-dependent manner after washing out nilotinib and dasatinib. The sustained cytostatic effect of dasatinib, but not that of nilotinib, correlated with the intracellular accumulation level. In contrast, imatinib showed continuous a cytostatic effect after drug washout for long-term exposure but not after drug washout for short-term exposure. These results suggest that a good response in patients with a low serum concentration of imatinib, nilotinib or dasatinib may be due to the cytostatic effect of that drug continues even after its disappearance in plasma