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.

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.

Globalization and International Tax Competition: Empirical Evidence Based on Effective Tax Rates

( Lucas Bretschger ),( Frank Hettich ) 세종대학교 경제통합연구소 (구 세종대학교 국제경제연구소) 2005 Journal of Economic Integration Vol.20 No.3

Previous work showing a positive impact of globalization on capital tax revenue as a percent of GDP claims to contradict theoretical results that tax competition pressures governments to reduce taxes on highly mobile assets. However, the observed relationship is not necessarily incompatible with the predictions of tax competition literature, as the internationalization of markets also affects the capital tax base. Measuring taxes by effective tax rates instead of tax revenue for a panel of 12 OECD countries in the period 1967-96, we find that globalization has a negative impact on capital taxes, which is exactly what the theory predicts.

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.

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.

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

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.

Using Mobile Vocabulary Learning Apps as Aids to Knowledge Retention: Business Vocabulary Acquisition

Lucas Kohnke,Ruofei Zhang,Di Zou 아시아테플 2019 The Journal of Asia TEFL Vol.16 No.2