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.

Do changes in inflammatory markers predict hepatocellular carcinoma recurrence and survival after liver transplantation?

Lucas Jose Caram,Francisco Calderon,Esteban Masino,Victoria Ardiles,Ezequiel Mauro,Leila Haddad,Juan Pekolj,Jimena Vicens,Adrian Gadano,Eduardo de Santibanes,Martin de Santibanes 한국간담췌외과학회 2022 Annals of hepato-biliary-pancreatic surgery Vol.26 No.1

Backgrounds/Aims: The role of inflammation in malignant cell proliferation has been well described. High values of platelet-to-lymphocyte ratio (PLR) and neutrophil-to-lymphocyte ratio (NLR) as markers of systemic inflammation have shown associations with unfavorable long-term outcomes. The purpose of this study was to determine values of NLR and PLR evaluated prior to and after surgery and their associations with mortality and recurrence rates of liver transplant patients with hepatocellular carcinoma (HCC). Methods: A total of 105 patients with HCC who underwent orthotopic liver transplantation (OLT) were retrospectively reviewed. NLR and PLR values were obtained from complete blood counts prior to and after surgery. Overall survival (OS) and recurrence-free survival (RFS) in relation with delta NLR and PLR were estimated. Results: Serum alpha-fetoprotein levels > 100 ng/mL (p = 0.014) and lymphovascular emboli in the specimen (p = 0.048) were identified to be significant predictors of RFS. Child-Pugh score (p = 0.016) was found to be an independent factor associated with poorer OS. An increasing delta PLR was associated with worse RFS, although it showed no significant association with OS. Conclusions: The analysis of PLR as a continuous variable may predict recurrence outcomes in patients undergoing OLT for HCC. It is more representative than isolated values.

Application of the Fuzzy Logic for the Development of Automnomous Robot with Obstacles Deviation

Lucas Alves Dias,Roger William de Oliveira Silva,Paulo César da Silva Emanuel,André Ferrus Filho,Rodrigo Teixeira Bento 제어·로봇·시스템학회 2018 International Journal of Control, Automation, and Vol.16 No.2

This paper proposed to elaborate a navigation system for an autonomous mobile robot, able to deviate from obstacles, from the study and application of Fuzzy Logic. With the algorithm in operation, it was verified that the Fuzzy logic offers a smoother transition in the movements. In order to validate the efficiency of the navigation system created, simulations were performed with the robot according to the rules inserted in the Fuzzy controller, where the input values of the sensors and the output values in the PWM of the board were analyzed. The results obtained were consistent with the responses given by the simulation in MatLab, following the same trend of behavior. With the realization of this project, it was concluded that the Fuzzy methodology presents a solution to the problems of navigation in real environments, allowing to implement a controller for an autonomous robot that can deflect obstacles avoiding their collision. One of the problems encountered is the angle of actuation of the ultrasonic sensors. This type of sensor works with an angle of actuation of 15◦, which leaves the robot with a low vision area in the use of three sensors. As a result, there may be no reading on objects entering zones without detection, leading to a collision with these obstacles. The responses were satisfactory, following the same trend behavior of the simulations of the Fuzzy controller.

Distortional Moment Capacity Prediction Analysis of Cold-Formed Rack Section Steel Beams Using the Direct Strength Method (DSM)

Lucas Rabelo Crunivnel,Gregorio Sandro Vieira,Juliano Geraldo Ribeiro Neto 한국강구조학회 2021 International Journal of Steel Structures Vol.21 No.6

Due to the wide variety of cross-sections and their good mass/strength ratio, cold-formed steel (CFS) components are gaining prominence among steel structures, although this material is more susceptible to local, distortional, and global buckling. The design procedure based on the direct strength method (DSM) presented in some codes as the Brazilian, the American Iron and Steel Institute, and the Australia/New Zealand (AS/NZ), have been well accepted for estimating simply and safely the moment capacity of beams subject to distortional buckling. However, more recent studies show that DSM design can lead to unsafe moment capacity for beams with a high slenderness factor of distortional buckling. This study analyzes the results from 64 models developed using the fi nite element analyses (FEA) with the Abaqus software to determine the distortional moment capacity of CFS rack type beams. The selection of the specimens in which the distortional buckling mode is predominant (modal participation analysis) was performed through a linear stability analysis using the GBTul software. The nonlinear elastoplastic fi nite element model was created, including initial imperfections, and a parametric study was developed to investigate the infl uence of the slenderness factor of distortional buckling on CFS rack beams' moment capacity. The FEA results were compared with DSM results to verify the accuracy of this method to predict distortional moment capacity. It is shown that, for CFS rack beams subject to uniform bending and distortional buckling with slenderness factor of distortional buckling higher than 1.0, the DSM overestimates the moment capacity.

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.

Different organic components on silica hybrid matrices modulate the lipase inhibition by the glycerol formed in continuous transesterification reactions

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).

Treatment with Sofosbuvir and Daclatasvir (with or without Ribavirin) Improves Patient Reported Outcomes in Hepatitis C

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.

Sphenoid bone changes in rapid maxillary expansion assessed with cone-beam computed tomography

Lucas S. Stepanko,Manuel O. Lagravere 대한치과교정학회 2016 대한치과교정학회지 Vol.46 No.5

Objective: Rapid maxillary expansion (RME) is used to expand the maxilla and increase arch perimeter; yet, there are few reports on its effects on the sphenoid bone. With cone-beam computed topography (CBCT), it is possible to visualize sphenoid bone changes. The purpose of this study was to investigate sphenoid bone changes observed in conjunction with RME treatments, using CBCT. Methods: Sixty patients (34 women and 26 men, aged 11–17 years) underwent RME as part of their orthodontic treatment. Patients were randomly assigned to one of three groups: a tooth-anchored group, a bone-anchored group, or a control group. Initial CBCT scans were performed preceding the RME treatment (T₁) and again directly after the completion of expansion (T₂). Statistical analysis included ANOVA, descriptive statistics, and the intraclass correlation coefficient (ICC). Results: The reliability of the landmark location was at least 0.783, and the largest ICC mean measurement error was 2.32 mm. With regard to distances, the largest change was 0.78 mm, which was not statistically significant (p > 0.05). Statistical significance was established in patient groups of the same sex and treatment type for the following distance measurements: right anterior lateral pterygoid plate to the right edge of the hypophyseal fossa (d₂), anterior distance between the medial pterygoid plates (d₄), and anterior distance between the left medial and lateral plates (d8). Conclusions: In this study, there were no clinically significant changes in the sphenoid bone due to RME treatments regardless of sex or treatment type.

Effect of fluorescent brighteners on the insecticidal activity of LdMNPV and Bacillus thuringiensis var. kurstaki on Lymantria dispar asiatica in Korea

Lucas Mezione de Carvalho,Hwal-Su Hwang,Kyeong-Yeoll Lee 한국응용곤충학회 2023 한국응용곤충학회 학술대회논문집 Vol.2023 No.04

Best Practices for Blended Learning, by Pete Sharma and Barney Barrett, Pavilion Publishing and Media Ltd, 2018, 254 pp., £28.95 (GDP), ISBN 978-1-911028-84-0

Lucas Kohnke 아시아영어교육학회 2018 The Journal of Asia TEFL Vol.15 No.2