中山間地域で暮らす要介護高齢者の医療福祉ニーズの構造とその関連要因

高知県立大学平成27年

Collective Properties of Excitons in Presence of a Two-Dimensional Electron Gas

We have studied the collective properties of two-dimensional (2D) excitons immersed within a quantum well which contains 2D excitons and a two-dimensional electron gas (2DEG). We have also analyzed the excitations for a system of 2D dipole excitons with spatially separated electrons and holes in a pair of quantum wells (CQWs) when one of the wells contains a 2DEG. Calculations of the superfluid density and the Kosterlitz-Thouless (K-T) phase transition temperature for the 2DEG-exciton system in a quantum well have shown that the K-T transition temperature increases with increasing exciton density and that it might be possible to have fast long range transport of excitons. The superfluid density and the K-T transition temperature for dipole excitons in CQWs in the presence of a 2DEG in one of the wells increases with increasing inter-well separation.Comment: 10 pages, 1 figure. accepted by Solid State Communication

Formation of Ge-Sn nanodots on Si(100) surfaces by molecular beam epitaxy

The surface morphology of Ge0.96Sn0.04/Si(100) heterostructures grown at temperatures from 250 to 450°C by atomic force microscopy (AFM) and scanning tunnel microscopy (STM) ex situ has been studied. The statistical data for the density of Ge0.96Sn0.04 nanodots (ND) depending on their lateral size have been obtained. Maximum density of ND (6 × 1011 cm-2) with the average lateral size of 7 nm can be obtained at 250°C. Relying on the reflection of high energy electron diffraction, AFM, and STM, it is concluded that molecular beam growth of Ge1-xSnx heterostructures with the small concentrations of Sn in the range of substrate temperatures from 250 to 450°C follows the Stranski-Krastanow mechanism. Based on the technique of recording diffractometry of high energy electrons during the process of epitaxy, the wetting layer thickness of Ge0.96Sn0.04 films is found to depend on the temperature of the substrate

Consensus statement from the International Consensus Meeting on the Role of Decompressive Craniectomy in the Management of Traumatic Brain Injury

Abstract: Background: Two randomised trials assessing the effectiveness of decompressive craniectomy (DC) following traumatic brain injury (TBI) were published in recent years: DECRA in 2011 and RESCUEicp in 2016. As the results have generated debate amongst clinicians and researchers working in the field of TBI worldwide, it was felt necessary to provide general guidance on the use of DC following TBI and identify areas of ongoing uncertainty via a consensus-based approach. Methods: The International Consensus Meeting on the Role of Decompressive Craniectomy in the Management of Traumatic Brain Injury took place in Cambridge, UK, on the 28th and 29th September 2017. The meeting was jointly organised by the World Federation of Neurosurgical Societies (WFNS), AO/Global Neuro and the NIHR Global Health Research Group on Neurotrauma. Discussions and voting were organised around six pre-specified themes: (1) primary DC for mass lesions, (2) secondary DC for intracranial hypertension, (3) peri-operative care, (4) surgical technique, (5) cranial reconstruction and (6) DC in low- and middle-income countries. Results: The invited participants discussed existing published evidence and proposed consensus statements. Statements required an agreement threshold of more than 70% by blinded voting for approval. Conclusions: In this manuscript, we present the final consensus-based recommendations. We have also identified areas of uncertainty, where further research is required, including the role of primary DC, the role of hinge craniotomy and the optimal timing and material for skull reconstruction

Omecamtiv mecarbil in chronic heart failure with reduced ejection fraction, GALACTIC‐HF: baseline characteristics and comparison with contemporary clinical trials

Aims: The safety and efficacy of the novel selective cardiac myosin activator, omecamtiv mecarbil, in patients with heart failure with reduced ejection fraction (HFrEF) is tested in the Global Approach to Lowering Adverse Cardiac outcomes Through Improving Contractility in Heart Failure (GALACTIC‐HF) trial. Here we describe the baseline characteristics of participants in GALACTIC‐HF and how these compare with other contemporary trials. Methods and Results: Adults with established HFrEF, New York Heart Association functional class (NYHA) ≥ II, EF ≤35%, elevated natriuretic peptides and either current hospitalization for HF or history of hospitalization/ emergency department visit for HF within a year were randomized to either placebo or omecamtiv mecarbil (pharmacokinetic‐guided dosing: 25, 37.5 or 50 mg bid). 8256 patients [male (79%), non‐white (22%), mean age 65 years] were enrolled with a mean EF 27%, ischemic etiology in 54%, NYHA II 53% and III/IV 47%, and median NT‐proBNP 1971 pg/mL. HF therapies at baseline were among the most effectively employed in contemporary HF trials. GALACTIC‐HF randomized patients representative of recent HF registries and trials with substantial numbers of patients also having characteristics understudied in previous trials including more from North America (n = 1386), enrolled as inpatients (n = 2084), systolic blood pressure < 100 mmHg (n = 1127), estimated glomerular filtration rate < 30 mL/min/1.73 m2 (n = 528), and treated with sacubitril‐valsartan at baseline (n = 1594). Conclusions: GALACTIC‐HF enrolled a well‐treated, high‐risk population from both inpatient and outpatient settings, which will provide a definitive evaluation of the efficacy and safety of this novel therapy, as well as informing its potential future implementation