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991.
S Maloney K Zolber K Burke B Connell G Shavlik 《Journal of the American Dietetic Association》1986,86(2):237-241
Data on labor time for food production can be used as an effective management tool. It is essential for foodservice managers to know how labor time is being used (1). A continuous time study was conducted to determine total labor time for the production of eight vegetarian entrées in a hospital foodservice system. Two work areas were observed: the ingredient assembly area and the cooks' production area. Times were recorded by work function to identify how labor time was distributed. Results showed (a) observed frequency for each work function, (b) time expended in seconds per portion for each work function, (c) percentage distribution of labor time by work function, (d) total time for each employee involved in entrée production, and (e) percentage of total time in which each employee was involved in the production of each entrée. Total labor time varied by type of entrée, ranging from 39.97 to 19.33 seconds per portion. Entrées with the highest labor time required the largest amount of hand labor. A one-way analysis of variance indicated significant differences in mean labor time among the eight vegetarian entrées for direct labor time (p = .0009), and total labor time (p = .0018). No significant differences were found among entrées for indirect labor or delay time. 相似文献
992.
Lisa M. Daniels Pritish K. Tosh Justin A. Fiala Cathy D. Schleck Jay N. Mandrekar Thomas J. Beckman 《Mayo Clinic proceedings. Mayo Clinic》2017,92(11):1636-1643
Objective
To study associations between extreme erythrocyte sedimentation rate (ESR) elevations (≥100 mm/h) and diseases, age, sex, race, Charlson Comorbidity Index (CCI), and C-reactive protein (CRP) level.Patients and Methods
This was a retrospective cohort study of 4807 patients with extreme ESR values examined at Mayo Clinic, Rochester, Minnesota, from January 1, 2002, through December 31, 2011. Independent variables included diseases (infection, autoimmune, malignancy, renal disease, or miscellaneous), subcategories of diseases, patient demographic characteristics (age, sex, and race), CRP level, and CCI. The Wilcoxon rank sum test was used to assess comparisons of ESR between patients with and without disease as well as relationships between extreme ESR values and demographic characteristics of patients within disease categories. Associations between ESR and CRP level were determined using the Pearson correlation coefficient.Results
The leading diagnosis associated with extreme ESR elevations (n [%]) was infection (1932 [40]), followed by autoimmune (1839 [38]) and malignancy (1736 [36]) (P<.01). Extreme elevations in ESR varied by sex, with higher ESRs in men (mean, 117±13.3 mm/h) than in women (mean, 115.9±12.5 mm/h) (P=.008). Extreme ESR elevations correlated inversely with the CCI (P=.008) and did not correlate with the CRP level. There were no correlations between extreme elevations in ESR and age or race.Conclusion
We found that almost all patients have an identifiable etiology for extreme ESR elevations and that infection is the most common disease association. Unlike previous research, we identified higher ESRs in men than in women and no associations with age, race, and comorbid illness. These findings may enhance the diagnostic evaluation of patients with extreme ESR elevations. 相似文献993.
Melanie G Cree Jennifer J Zwetsloot David N Herndon Bradley R Newcomer Ricki Y Fram Carlos Angel Justin M Green Gerald L Dohm Dayoung Sun Asle Aarsland Robert R Wolfe 《Journal of burn care & research》2008,29(4):585-594
Impaired fatty acid oxidation occurs with type 2 diabetes and is associated with accumulations of intracellular lipids, which may increase diacylglycerol (DAG), stimulate protein kinase C activity, and inactivate insulin signaling. Glucose and fat metabolism are altered in burn patients, but have never been related to intracellular lipids or insulin signaling. Thirty children sustaining >40% total body surface area burns were studied acutely with glucose and palmitate tracer infusions and a hyper-insulinemic euglycemic clamp. Muscle triglyceride, DAG, fatty acyl CoA, and insulin signaling were measured. Liver and muscle triglyceride levels were measured with magnetic resonance spectroscopy. Muscle samples from healthy children were controls for DAG concentrations. Insulin sensitivity was reduced and correlated with whole body palmitate beta-oxidation (P = .004). Muscle insulin signaling was not stimulated by hyper-insulinemia. Tissue triglyceride concentrations and activated protein kinase C-beta were elevated, whereas the concentration of DAG was similar to the controls. Free fatty acid profiles of muscle triglyceride did not match DAG. Insulin resistance following burn injury is accompanied by decreased insulin signaling and increased protein kinase C-beta activation. The best metabolic predictor of insulin resistance in burned patients was palmitate oxidation. 相似文献
994.
Turner JH Garnovskaya MN Coaxum SD Vlasova TM Yakutovich M Lefler DM Raymond JR 《The Journal of pharmacology and experimental therapeutics》2007,320(1):314-322
The type 1 sodium-proton exchanger (NHE-1) is expressed ubiquitously and regulates key cellular functions, including mitogenesis, cell volume, and intracellular pH. Despite its importance, the signaling pathways that regulate NHE-1 remain incompletely defined. In this work, we present evidence that stimulation of the 5-hydroxytryptamine 1A (5-HT1A) receptor results in the formation of a signaling complex that includes activated Janus kinase 2 (Jak2), Ca2+/calmodulin (CaM), and NHE-1, and which involves tyrosine phosphorylation of CaM. The signaling pathway also involves rapid agonist-induced association of CaM and NHE-1 as assessed by coimmunoprecipitation studies and by bioluminescence resonance energy transfer studies in living cells. We propose that NHE-1 is activated through this pathway: 5-HT1A receptor --> G(i2)alpha and/or G(i3)alpha --> Jak2 activation --> tyrosine phosphorylation of CaM --> increased binding of CaM to NHE-1 --> induction of a conformational change in NHE-1 that unmasks an obscured proton-sensing and/or proton-transporting region of NHE-1 --> activation of NHE-1. The G(i/o)-coupled 5-HT1A receptor now joins a handful of Gq-coupled receptors and hypertonic shock as upstream activators of this emerging pathway. In the course of this work, we have presented clear evidence that CaM can be activated through tyrosine phosphorylation in the absence of a significant role for elevated intracellular Ca2+. We have also shown for the first time that the association of CaM with NHE-1 in living cells is a dynamic process. 相似文献
995.
996.
Stephanie Bee Ming Tan Justin Greenslade David Martin Michael Talbot Ken Loi George Hopkins 《Surgery for obesity and related diseases》2018,14(3):271-275
Background
Worldwide, the laparoscopic sleeve gastrectomy (LSG) is becoming the dominant bariatric procedure due to its reliable weight loss and low complication rate. Portomesenteric vein thrombosis (PVT) is an uncommon complication of LSG with an incidence of .3% to 1% and can lead to serious consequences, such as bowel ischemia and death.Objectives
This paper will present the presentation, risk factors, treatment, and long-term outcomes of patients who had PVT post-LSG.Setting
Five bariatric centers in a private setting in Australia.Methods
Retrospective data were collected from 5 bariatric centers across Australia from 2007 to 2016.Results
Across 5 centers, 5951 patients underwent LSG; 18 had recognized PVT (.3%). The mean body mass index was 41.8. Of patients, 39% had a history or family history of deep vein thrombosis. The average time to diagnosis was 13 days (range, 5–25). Treatment was nonoperative with anticoagulation in 94%. One patient required operative management with bowel resection. All patients were discharged on therapeutic anticoagulation. Mean total weight loss was 27.7% (14.8%–66.3%). Mean follow-up was 10 months. There were no mortalities. Given the low number of patients, no statistically significant data could be derived.Conclusion
PVT is difficult to diagnose, with significant consequences. The presenting symptoms are nonspecific, and a high index of suspicion needs to be maintained. Cross-sectional imaging with computed tomography of the abdomen is recommended. Patients with PVT post-LSG without previous risk factors can be anticoagulated for 3 to 6 months with an international normalized ratio of 2 to 3. 相似文献997.
998.
Julander JG Furuta Y Shafer K Sidwell RW 《Antimicrobial agents and chemotherapy》2007,51(6):1962-1966
Yellow fever virus (YFV) causes 30,000 deaths worldwide, despite the availability of a vaccine. There are no approved antiviral therapies for the treatment of YFV disease in humans, and, therefore, these studies were designed to investigate the anti-YFV properties of T-1106, a substituted pyrazine, in a hamster model of YFV disease. Intraperitoneal (i.p.) treatment with 100 mg/kg of body weight/day of T-1106 starting 4 h prior to virus inoculation and continuing twice daily through 7 days post-virus inoculation (dpi) resulted in significantly improved survival, alanine aminotransferase levels in the serum, weight gain, and mean day to death. Virus titer in the liver at 4 dpi was significantly reduced in treated animals, as determined by both quantitative real-time PCR and infectious cell culture assay. No toxicity (weight loss or mortality) was observed at a dose of 100 mg/kg/day in sham-infected control animals. The observed minimal effective dose of T-1106 was 32 mg/kg/day administered either by oral or i.p. treatment. Therapeutic treatment was effective in significantly improving survival when T-1106 was administered beginning as late as 4 days after virus challenge with twice-daily treatment for 8 days at a dose of 100 mg/kg/day. With favorable safety, bioavailability, and postviral challenge treatment efficacy, T-1106 was effective in the treatment of disease in hamsters infected with YFV and should be further studied for potential use as a therapy for human YFV disease. 相似文献
999.
David Cantu Morales Justin de Beer Danielle Petruccelli Conrad Kabali Mitch Winemaker 《The Journal of arthroplasty》2018,33(4):1181-1185
Background
A cross-sectional study of total knee arthroplasty (TKA) patients was conducted to determine the association of lower-extremity arterial calcification (LEAC) with acute perioperative cardiovascular events (CVEs).Methods
Regression modeling was used to examine the association of radiographic presence of LEAC and acute myocardial infarction (MI), perioperative CVE, 30-day CVE readmit, and 30-day and 1-year mortality.Results
Of 900 TKA patients, LEAC was identified in 21.1%. Of LEAC cases, 1.6% had an acute MI vs 0.1% of non-LEAC cases (P = .031). Perioperative CVE rate was 5.8% for LEAC vs 1.5% for non-LEAC (P = .002). Having LEAC was identified as a significant risk factor for a perioperative CVE (odds ratio [OR] 2.83; 95% confidence interval [CI] 1.09-7.35). Because of limited number of acute MI events, absence of 30-day CVE readmit, 30-day mortality, and few 1-year mortality events, computing OR for these was not possible. Likewise, because of small number of events (n = 3), estimates for the odds of LEAC cases having an acute MI are less reliable, yielding extremely large random errors (OR 11.37; 95% CI 0.09-597.93) and must be interpreted with caution. The OR for 1-year mortality was 1.88 (95% CI 0.17-13.20), but again with large random errors.Conclusion
Our study shows that LEAC around the knee is associated with an increased risk of having a perioperative CVE. Crude radiographic detection of LEAC around the knee has the potential to improve risk stratification for TKA patients by informing the surgeon of the need for further preoperative cardiac workup. 相似文献1000.
Yang Y Saenz LC Varosy PD Badhwar N Tan JH Kilicaslan F Keung EC Natale A Marrouche NF Scheinman MM 《Pacing and clinical electrophysiology : PACE》2007,30(7):891-898
BACKGROUND: The purpose of this study is to determine whether initial vector force might best distinguish tachycardias arising from the right ventricular (RV) outflow tract (OT) versus aortic sinus cusps (ASCs). METHODS: Among 45 patients with OT tachycardia, we measured the time from the earliest QRS onset in any lead to local onset and to the first QRS peak/nadir in each surface leads during VT. We compared the earliest phase differences among patients with foci in RVOT (n = 32) and in ASCs (n = 13) (determined by ablation), using unpaired t-tests. We determined the optimum cut-points by analyzing the receiver-operator characteristics curves, and derived an algorithm to discriminate ASC from RVOT foci. RESULTS: Compared with an RVOT focus, origin in the ASC was associated with lower likelihood that the earliest lead of QRS activation was V2 (4/13 [12%] vs 29/32 [88%], P = 0.0001), later initial peak/nadir in III (110 +/- 19 vs 93 +/- 16 ms, P = 0.0026) and V2 (75 +/- 26 vs 42 +/- 19 ms, P < 0.0001). After determining the optimum cut-points for each, we found that the presence of any one of these findings discriminated well between RVOT and ASC foci (sensitivity 92%, specificity 88%, positive predictive value 75%, and negative predictive value 97%). The sensitivity and specificity using standard ECG criteria were inferior to the vector approach. CONCLUSIONS: The ECG phase differences during VT can distinguish the origin of OT-VT. Earliest onset or first peak/nadir in V2 and early initial peak/nadir in the inferior leads suggest a RVOT focus. 相似文献