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The Underutilization of Lifestyle Modifications in Primary Care Medicine
Jean-Marc Lucas(Jean-Marc Lucas ),Karl F. Kozlowski(Karl F. Kozlowski ) 사피엔시아 2019 Exercise Medicine Vol.3 No.-
Chronic disease accounts for the majority of deaths in the United States and is often attributed to obesity. A sedentary lifestyle and poor nutrition are primary contributing factors to the development of obesity and thus chronic disease. Primary care providers are optimally positioned to prescribe exercise and nutrition (lifestyle medicine) as a treatment for chronic disease. Unfortunately, this opportunity seems to be regularly lost. Primary care providers often rely too heavily on weight loss pharmaceuticals and bariatric surgeries to treat obesity. This treatment approach however also does little to prevent and treat the accumulation of chronic diseases. The purpose of this review was to evaluate the efficacy of conventional medical weight loss treatments and determine why primary care providers may not prescribe exercise and nutrition more frequently. Our findings suggest that some primary care providers may be uncomfortable prescribing lifestyle medicine as they receive little formal education in this field. In conclusion, prescription of exercise and nutrition by primary care providers may elicit greater long-term weight loss than current medical weight management practices. Medical management is most likely effective when combined with lifestyle medicine. We propose that primary care providers be better trained in lifestyle medicine through their formal and clinical education. Rates of chronic disease accumulation may potentially decrease if providers prescribe lifestyle medical treatments more frequently.
Lucas Pereira Jorge de Medeirosa 질병관리본부 2018 Osong Public Health and Research Persptectives Vol.9 No.2
Objectives To evaluate the impact of 3 treatment regimens upon health-related quality of life and work productivity using patient-reported outcomes (PROs) in chronic hepatitis C infected patients: sofosbuvir (SOF) + daclatasvir (DCV); SOF + DCV + ribavirin (RBV); SOF + simeprevir (SMV). Methods 4 questionnaires were used to evaluate PROs before, during and after treatment: Short Form-36 (SF-36), Chronic Liver Disease Questionnaire (CLDQ) - hepatitis C virus (HCV), Work Productivity and Activity Index, Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F). Results Of the global sample of 55 patients included in this study; SOF + DCV (n = 10); SOF + DCV + RBV (n = 29); SOF + SMV (n = 16) all had a statistically significant improvement in SF-36, CLDQ and FACIT-F scores during and post-treatment. No statistically significant differences in the PRO questionnaire values were observed between the distinct treatment regimens. The SOF and SMV patient groups presented higher mean PRO variations during and post-treatment, compared to the other groups: SF-36 functional capacity (16.1); SF-36 mental health (21.4); CLDQ activity (1.8); CLDQ emotional function (1.2); FACIT-F physical well-being (8.0); Total FACIT-F (21.6). Conclusion Treatment with SOF + DCV, with or without RBV, results in an improved PRO similar to treatment with SOF + SMV in chronic hepatitis C patients.
Lucas Veronez Goulart Ferreira,Laxmi Rathour,Devika Dabke,Fabio Roberto Chavarette,Vishnu Narayan Mishra 한국전산응용수학회 2023 Journal of applied mathematics & informatics Vol.41 No.6
Rotating machines heavily rely on an intricate network of interconnected sub-components, with bearing failures accounting for a substantial proportion (40$\%$ to 90$\%$) of all such failures. To address this issue, intelligent algorithms have been developed to evaluate vibrational signals and accurately detect faults, thereby reducing the reliance on expert knowledge and lowering maintenance costs. Within the field of machine learning, Artificial Immune Systems (AIS) have exhibited notable potential, with applications ranging from malware detection in computer systems to fault detection in bearings, which is the primary focus of this study. In pursuit of this objective, we propose a novel procedure for detecting novel instances of anomalies in varying operating conditions, utilizing only the signals derived from the healthy state of the analyzed machine. Our approach incorporates AIS augmented by Dynamic Time Warping (DTW). The experimental outcomes demonstrate that the AIS-DTW method yields a considerable improvement in anomaly detection rates (up to 53.83$\%$) compared to the conventional AIS. In summary, our findings indicate that our method represents a significant advancement in enhancing the resilience of AIS-based novelty detection, thereby bolstering the reliability of rotating machines and reducing the need for expertise in bearing fault detection.
Lucas Mognon Santiago Prates,Felipe Piana Vendramell Ferreira,Alexandre Rossi,Carlos Humberto Martins 국제구조공학회 2023 Steel and Composite Structures, An International J Vol.46 No.4
The use of precast hollow-core slabs (PCHCS) in civil construction has been increasing due to the speed of execution and reduction in the weight of flooring systems. However, in the literature there are no studies that present a finite element model (FEM) to predict the load-slip relationship behavior of pushout tests, considering headed stud shear connector and PCHCS placed at the upper flange of the downstand steel profile. Thus, the present paper aims to develop a FEM, which is based on tests to fill this gap. For this task, geometrical non-linear analyses are carried out in the ABAQUS software. The FEM is calibrated by sensitivity analyses, considering different types of analysis, the friction coefficient at the steel-concrete interface, as well as the constitutive model of the headed stud shear connector. Subsequently, a parametric study is performed to assess the influence of the number of connector lines, type of filling and height of the PCHCS. The results are compared with analytical models that predict the headed stud resistance. In total, 158 finite element models are processed. It was concluded that the dynamic implicit analysis (quasi-static) showed better convergence of the equilibrium trajectory when compared to the static analysis, such as arc-length method. The friction coefficient value of 0.5 was indicated to predict the load-slip relationship behavior of all models investigated. The headed stud shear connector rupture was verified for the constitutive model capable of representing the fracture in the stress-strain relationship. Regarding the number of connector lines, there was an average increase of 108% in the resistance of the structure for models with two lines of connectors compared to the use of only one. The type of filling of the hollow core slab that presented the best results was the partial filling. Finally, the greater the height of the PCHCS, the greater the resistance of the headed stud.
The effect of repeated surface treatment of zirconia on its bond strength to resin cement
Lucas Campagnaro Maciel,Marina Amaral,Daher Antonio Queiroz,Kusai Baroudi,Laís Regiane Silva-Concílio 대한치과보철학회 2020 The Journal of Advanced Prosthodontics Vol.12 No.5
PURPOSE. The aim of this study is to evaluate the influence of repeated surface treatments on wettability and surface roughness for zirconia surface and bond strength of zirconia-based ceramics to resin cement. MATERIALS AND METHODS. Seventy blocks (10 × 10 × 3 mm) of zirconia-based ceramics were fabricated and divided into two groups according to the surface treatments: (A) 110 μm Al2O3 airborne-particle abrasion and (R) 110 μm silica modified Al2O3 airborne-particle abrasion. At stage 2, each group was subdivided into 5 groups according to the surface retreatments: (a) 110 μm Al2O3 airborne-particle abrasion, (r) 110 μm silica modified Al2O3 airborne-particle abrasion, (D) diamond bur, (Da) diamond bur + 110 μm Al2O3 airborne-particle abrasion, and (Dr) diamond bur + 110 μm silica modified Al2O3 airborne-particle abrasion. Cylinders of self-adhesive resin cement were cemented onto each treated ceramic surface and subjected to micro-shear bond strength test. Additional specimens were prepared for roughness and wettability analyses. The data were subjected to t-test and One-way ANOVA followed by Tukey’s post hoc test (α=.05). RESULTS. At stage 1, group R presented higher bond strength values than group A (P=.000). There was a statistically significant increase of bond strength at stage 2 for group A (P=.003). The diamond bur influenced the surface roughness, increasing the values (P=.023). Group R provided better wettability. Regardless of the applied surface treatment, most of failures were adhesive. CONCLUSION. The combination of application and reapplication of Rocatec Plus showed the best results of bond strength. Surface retreatment and recementation might be an indicated clinical strategy.
Lucas S. Martin,Annie Ceron,Pedro C. Oliveira,Gisella M. Zanin,Heizir F. de Castro 한국공업화학회 2018 Journal of Industrial and Engineering Chemistry Vol.62 No.-
Silica hybrid materials, functionalized via incorporation of three organic components: β-cyclodextrin (βCD), carboxymethyl-cellulose (CMC) and hydroxyethyl-cellulose (HEC) were synthesized by the sol–gel technique and results were compared to a well-defined matrix (silica–polyvinyl alcohol–SiO2–PVA) with respect to immobilizing Burkholderia cepacia lipase. The main objective was set to select organic components that can replace the PVA to obtain a hybrid composite with greater hydrophobic character, without compromising the remarkable features of SiO2–PVA. All the three selected compounds allowed obtaining matrices that presented similar textural and morphological properties and gave high activity (1451–1661 U g−1) and thermal stability (t1/2 > 70 h) upon immobilization. Regarding glycerol affinity, all matrices had lower ability than SiO2–PVA to adsorb glycerol, with the SiO2–βCD matrix showing the lowest affinity due to the cyclic structure of the βCD. Transesterification reactions of palm kernel oil with ethanol mediated by B. cepacia immobilized on SiO2–βCD performed in a packed bed reactor under continuous flow confirmed the efficiency of the SiO2–βCD matrix in increasing the operational stability of system, revealing a half-life (t1/2 = 1040 h), 2.5 times greater than that achieved in the same system using lipase immobilized on SiO2–PVA (t1/2 = 430 h).