Background. A new agent, potassium-competitive acid blocker vonoprazan (VPZ) has potent acid-inhibitory effects and may offer advantages over conventional H. pylori eradication therapies. We aimed to ...compare the eradication rate between VPZ-based treatment and PPI-based one. Methods. This randomized controlled trial was designed to assign 141 patients with H. pylori-positive gastritis to VPZ group (VPZ 20 mg, amoxicillin 750 mg, and clarithromycin 200 or 400 mg twice daily for 7 days) or PPI group (rabeprazole 20 mg or lansoprazole 30 mg, amoxicillin 750 mg, and clarithromycin 200 or 400 mg twice daily for 7 days). Primary endpoints were eradication rates and adverse events. Results. Seventy of 72 patients in VPZ group and 63 of 69 patients in PPI group completed the treatment after 7 days. The eradication rate was significantly higher in VPZ group than PPI group by intention-to-treat analysis (95.8% versus 69.6%, P=0.00003, 95% confidence interval CI 88.3-99.1% versus 57.3-80.1%) and per-protocol analysis (95.7% versus 71.4%, P=0.0002, 95% CI 88.0-99.1% versus 58.7-82.1%). The incidence of adverse events was not different between the groups (26.3% in VPZ group versus 37.7% in PPI group, P=0.15). Conclusion. VPZ-based regimen is more useful than that PPI-based regimen as a first-line H. pylori eradication therapy.
Persistent hepatitis C virus (HCV) infection may induce autoimmune diseases and chronic hepatitis C is sometimes accompanied by autoimmune hepatitis (AIH). However, we are worried about the treatment ...for chronic hepatitis C-AIH overlap syndrome because interferon-based antiviral therapies may enhance autoimmunity and immunosuppressive corticosteroid administration may promote viral replication. Here, we report a patient having chronic hepatitis C-AIH overlap syndrome treated with the direct-acting antivirals (DAA), daclatasvir and asunaprevir. A 50-year-old man was referred to our hospital because of positive anti-HCV antibody and liver dysfunction at a health checkup. Blood tests showed increased immunoglobulin G (IgG) and a high titer of antinuclear antibody (ANA) in addition to elevated serum alanine aminotransferase (ALT) and HCV-RNA. Infiltration of lymphocytes and plasma cells in Glisson's capsule and severe interface hepatitis were observed in biopsied specimen, which fulfilled the criteria of AIH. We first started oral corticosteroid administration, and serum ALT levels decreased once but elevated again. We commenced daclatasvir and asunaprevir (60 and 200 mg/day, respectively) and serum HCV-RNA became negative after 6 weeks. Adverse effects were not found during the DAA treatment, and serum ALT, IgG, and ANA were significantly decreased. Corticosteroid could be tapered and stopped, but no recurrence occurred. DAA treatment appears to be effective and safe for the patients with chronic hepatitis C-AIH overlap syndrome.
Decentralization is highly considered as an alternative to make better fisheries management. This is due to that decentralization appears as a means for increasing the efficiency and equity of ...development activities and services delivery, and also for promoting local participation and democracy. The evolution of decentralization of fisheries management policy in Indonesia showed that the decentralization was gradually developed from deconcentration and delegation to devolution form. After Reform Era, devolution form of decentralization has been implemented due to the enactment of UU 22/1999 (the Local Autonomy Law), where local government has gained the amount of new authorities concerning marine-fisheries management. By such devolution, however, the community based management system, which is rooted from traditional fishing communities, is recognized. The effectiveness of the community based management system for the marine resources sustainability is caused by the bottom up planning and participative approach that led to the increasing of the local fishers’ sense of stewardship over the resources. Even though this kind of decentralization practice has been dealing with several problems, this is still a better way rather than centralization. This paper identifies some agendas are being encountered both in the central and the local level. This is related to the need of improvement of the legal framework, the capacity building of the local government, and the revitalization of the local institution.
Program canceled for a disaster Program canceled for the 2018 Hokkaido Eastern Iburi earthquake. However, This abstract is quotable and viewable on PDF.
Background/Aims
A light‐cured intermediate material is useful for fabricating a hard insert and a buffer space mouthguard (H&SMG). However, it requires improvement in its mechanical properties and ...shock‐absorbing capacity. The aim of this study was to evaluate the mechanical properties of two prototype light‐cured intermediate materials reinforced with glass fibers, and the impact absorption capacity and durability of H&SMGs made with the prototype intermediate materials.
Materials and Methods
Two prototype materials containing long and microlength glass fibers in a light‐cured intermediate material, Innerframe LC®, for H&SMG, were fabricated and tested. A three‐point bending test was performed for evaluation of the mechanical properties. In addition, a shock absorption test was conducted using a customized pendulum impact testing machine to evaluate the H&SMGs' impact absorption capacity and durability.
Results
Long and microlength glass fibers significantly improved flexural modulus and strength. H&SMGs made with these two glass fiber‐containing materials had high impact absorption capacity against both low and high impact forces, while the mouthguards made with long glass fiber materials had the best results.
Conclusion
Long and microlength glass fibers with the prototype materials improved the mechanical properties of Innerframe LC® and the impact absorption capacity and durability of H&SMGs. H&SMGs made with the long glass fiber prototype materials had the best performance.
The purpose of this study was to clarify the effects of jaw-clenching intensity on masseter muscle oxygen dynamics during clenching and recovery and masseter muscle fatigue using the spatially ...resolved method of near-infrared spectroscopy. Pulse rate, mean power frequency from electromyography in the masseter and visual analogue scale for masseter fatigue were also examined as related items. The 25% and 50% maximum voluntary contractions were determined using electromyography before the experiment and used as visual feedback on the screen. Twenty-three healthy adult male subjects volunteered for this study. Clenching decreased oxygen and oxygenated haemoglobin, and increased deoxygenated haemoglobin in the masseter muscle. The higher the intensity of clenching, the more prominent the effect. The oxygen dynamics tended to return to normal after clenching, but the change was slower with higher clenching intensity. Pulse rate increased with clenching, and the increment was more prominent with higher clenching intensity. Clenching caused a shift of mean power frequency to a lower range, an increase in subjective fatigue, an early appearance of a breakpoint appearance time and a prolongation of a 1/2 recovery time. All of these effects were more evident with increasing clenching intensity. In conclusion, clenching intensity influenced the oxygen dynamics of the masseter muscle and fatigue state during clenching and recovery. The higher the intensity, the greater the impact.
Background/Aims
Despite the use of conventional mouthguards, preventable sports‐related dental injuries continue to occur. The authors have developed a two‐layered ethylene polyvinyl acetate (EVA) ...mouthguard with a hard polyethylene terephthalate (PET) insert and a buffer space (H&SMG). However, adapting the PET onto the EVA layer requires skill. A light‐cured Splint Resin (SRLC) and a glass fiber net (NET) reinforcement appear to resolve this issue. The aim of this study was to investigate whether SRLC with NET could replace PET and find a more practical application for NET.
Materials and Methods
A pendulum impact testing machine and a dental model with strain gages were used. Six types of mouthguards were made: one with two laminated EVA blanks (LAM‐MG), a three‐layer type with a PET insert and an intermediate space (PET‐H&SMG), a H&SMG with SRLC insert (LC‐H&SMG), and three other types with differential NET‐SRLC reinforcement; NET on the outer surface of SRLC, NET on the inner surface of SRLC, and NET on both the outer and inner surfaces. Five mouthguards of each type were fabricated and tested ten times with impact distances of 15 and 30 cm. Forty more impacts were applied to all H&SMGs to confirm the durability of the hard inner layer.
Results
All H&SMGs showed significant strain reduction compared to the LAM‐MG. PET‐H&SMG and the four types of LC‐H&SMG exhibited an equally slight strain (approximately 95% shock absorbing ability) in all conditions. During the test against the smaller impact, all H&SMGs showed no cracks. When tested against the stronger impact, only the LC‐H&SMG with the reinforced inner surface, the double NET‐reinforced LC‐H&SMG, and the PET‐H&SMG remained intact.
Conclusion
The NET‐reinforced SRLC can replace PET as an intermediate mouthguard material. The NET application, at least on the internal surface, is indispensable for the LC‐H&SMG reinforcement.
We apply the gross island products (GIP) approach to assess the economic vulnerability of islands region to environmental disasters. In this study, two types of environmental disasters, sea level ...rise and natural disasters (typhoon, heavy rain and others), are identified and assessed.
By using the case of Amami Islands of Japan, the results show that the economic loss related to environmental disasters is relatively small, ranging from 0.17% to 2.27% of the GIP. The results of vulnerability analysis indicate that, in terms of GIP-based value, Kikaijima is the most vulnerable island with the composite vulnerability index (CVI) of 0.737. However, in terms of per capita-based value, Okinoerabujima has the highest vulnerability with CVI of 0.910.
We also found that these islands have relatively high income per capita, which may convey the impression of their strong economy (high resilience). However, the economies of such islands are highly exposed to the impacts of environmental disasters.
The aim of the study was to evaluate the mechanical properties and impact absorption capacity of prototype materials comprising ethylene vinyl acetate (EVA) of different hardness reinforced using ...different amounts of glass fibers (GFs), considering a buffer space.
Six prototype materials were made by adding E-GFs (5 and 10 wt%) to EVA with vinyl acetate (VA) contents of 9.4 wt% ("hard" or HA) and 27.5 wt% ("soft" or SO). Durometer hardness and tensile strength tests were performed to evaluate the mechanical properties of the materials. Moreover, an impact test was conducted using a customized pendulum impact tester to assess the impact absorption capacity (with or without a buffer space) of the specimens.
The mechanical properties of the prototypes, namely, durometer hardness, Young's modulus, and tensile strength, were significantly higher in the HA group than in the SO group, regardless of the presence or added amount of GFs. The addition of GFs, particularly in a large amount (10 wt%), significantly increased these values. In terms of the impact absorption capacity, the original hardness of the EVA material, that is, its VA content, had a more substantial effect than the presence or absence of GFs and the added amount of GFs. Interestingly, the HA specimens with the buffer space exhibited significantly higher impact absorption capacities than the SO specimens. Meanwhile, the SO specimens without the buffer space exhibited significantly higher impact absorption capacities than the HA specimens. Moreover, regardless of the sample material and impact distance, the buffer space significantly improved impact absorption. In particular, with the buffer space, the impact absorption capacity increased with the added amount of GFs.
The basic mechanical properties, including durometer hardness, Young's modulus, and tensile strength, of the EVA prototype were significantly increased by reducing the amount of VA regardless of the presence or added amount of GFs. Adding GFs, particularly in large amounts, significantly increased the values of aforementioned mechanical properties. Impact absorption was significantly affected by the hardness of the original EVA material and enhanced by the addition of the buffer space. The HA specimen had a high shock absorption capacity with the buffer space, and the SO specimen had a high shock absorption capacity without the buffer space. With the buffer space, impact absorption improved with the amount of added GFs.
PDF
