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.

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

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.

Residual Stress Heterogeneity Induced By Powder Metallurgy Gear Manufacturing Chains

Lucas Robatto,Ronnie Rego,Victor Righetti,Gilmar Thim,Anderson Borille 한국정밀공학회 2022 International Journal of Precision Engineering and Vol.9 No.2

Powder metallurgy represents an alternative to increase sustainability in the manufacturing of automotive gears, but its potential is hindered by a certain lack of knowledge on surface integrity properties that can impair the gear performance. This study explores the effects of the microstructural differences induced by this chain on the residual stress heterogeneity state of gears. X-ray diffraction methods of macro residual stress mapping and line profile analysis were applied for measurements of gear teeth after subsequent steps of the powder metallurgy and the conventional wrought steel chains. The powder metallurgy chain induced more pronounced heterogeneities than the conventional manufacturing, characterized by non-uniform residual stress distributions along the lead and the involute profiles of gear flanks. These non-uniformities observed after carburizing were traced back to the previous steps, surface densification, sintering and compaction. The residual stress distribution patterns of these steps were compatible with the plasticity dynamics of each manufacturing process. Such surface integrity heterogeneities result in a residual stress gradient along the gears functional surface, exposing particular regions to be more susceptible to fatigue effects.

Influence of the Adhesive, the Adherend and the Overlap on the Single Lap Shear Strength

( Lucas F M Da Silva ),( J E Ramos ),( M V Figueiredo ),( T R Strohaecker ) 한국 접착 및 계면학회 2006 접착 및 계면 Vol.7 No.4

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.

SLANT HELICES IN THE THREE-DIMENSIONAL SPHERE

Lucas, Pascual,Ortega-Yagues, Jose Antonio Korean Mathematical Society 2017 대한수학회지 Vol.54 No.4

A curve ${\gamma}$ immersed in the three-dimensional sphere ${\mathbb{S}}^3$ is said to be a slant helix if there exists a Killing vector field V(s) with constant length along ${\gamma}$ and such that the angle between V and the principal normal is constant along ${\gamma}$. In this paper we characterize slant helices in ${\mathbb{S}}^3$ by means of a differential equation in the curvature ${\kappa}$ and the torsion ${\tau}$ of the curve. We define a helix surface in ${\mathbb{S}}^3$ and give a method to construct any helix surface. This method is based on the Kitagawa representation of flat surfaces in ${\mathbb{S}}^3$. Finally, we obtain a geometric approach to the problem of solving natural equations for slant helices in the three-dimensional sphere. We prove that the slant helices in ${\mathbb{S}}^3$ are exactly the geodesics of helix surfaces.

Modelling headed stud shear connectors of steel-concrete pushout tests with PCHCS and concrete topping

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.

Nutritional and productive parameters of Holstein/Zebu cows fed diets containing cactus pear

Lucas Daniel Alcantara Borges,Vicente Ribeiro Rocha Junior,Flavio Pinto Moncao,Camila Soares,Jose Reinaldo Mendes Ruas,Fredson Vieira e Silva,Joao Paulo Sampaio Rigueira,Natanael Mendes Costa,Laura Lu 아세아·태평양축산학회 2019 Animal Bioscience Vol.32 No.9

Objective: This study ascertained effects of cactus pear in association with different roughage in the diet of F1 Holstein/Zebu cows on intake, nutrient digestibility, nitrogen balance, ingestive behavior and performance. Methods: Eight cows with 72±11 days of lactation were used. The experimental design was simultaneous in two 4×4 Latin squares. Four experimental diets were used: Diet 1, sorghum silage as exclusive roughage; Diet 2, sorghum silage associated with cactus pear in a proportion of 50% of the roughage (dry matter basis); Diet 3, elephant grass (Pennisetum purpureum cv. Roxo) as exclusive roughage; Diet 4, elephant grass associated with cactus pear in a proportion of 50% of the roughage. The roughage:concentrate ratio was 75:25. Results: Dry matter intake (p = 0.01) was higher with sorghum silage. There were differences in dry matter intake (p = 0.01), crude protein (p<0.01), ether extract (p = 0.01), non-fibrous carbohydrates (p<0.01) and total digestible nutrients (p = 0.01) among the diets. Cactus pear in the diet reduced water intake by 44.52% (p<0.01). The nitrogen balance was 59.71% and 27.49% lower in animals treated with exclusive sorghum silage and sorghum silage associated with cactus pear in relation to diets with elephant grass and elephant grass associated with cactus pear, respectively (p<0.01). The diets did not influence the milk production (p = 0.70), 3.5% fat corrected milk production (p = 0.72) or feed efficiency (p = 0.61). Conclusion: The association of cactus pear with sorghum or elephant grass silage does not alter milk production, reduces the intake of dry matter and water and improves the digestibility of nutrients.