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PubMed2005

The use of multi-parameter flow cytometry to study the impact of limiting substrate, agitation intensity, and dilution rate on cell aggregation during Bacillus licheniformis CCMI 1034 aerobic continuous culture fermentations.

The main objective of this work was to establish those factors either physical (power input) or chemical (limiting substrate or dilution rate) that enhance cell aggregation (biofilm or floc formation) and cell physiological state during aerobic continuous cultures of Bacillus licheniformis. Glucose-limited steady-state continuous cultures growing at a dilution rate between 0.64 and 0.87/h and 1,000 rpm (mean specific energy dissipation rate (epsilonT) = 6.5 W/kg), led to the formation of a thin biofilm on the vessel wall characterized by the presence of a high proportion of healthy cells in the broth (after aggregate disruption by sonication) defined as having intact polarized cytoplasmic membranes. An increased epsilonT (from 6.5 W/kg to 38 W/kg) was found to hinder cell aggregation under carbon limitation. The carbon recovery calculated from glucose indicated that additional extracellular polymer was being produced at dilution rates >0.87/h. B. licheniformis growth under nitrogen limitation led to floc formation which increased in size with dilution rate. Counter-intuitively the flocs became more substantial with an increase in epsilonT from 6.5 W/kg to 38 W/kg under nitrogen limitation. Indeed the best culture conditions for enhanced metabolically active cell aggregate formation was under nitrogen limitation at epsilonT = 6.5 W/kg (leading to floc formation), and under carbon limitation at a dilution rate of between 0.64 and 0.87/h, at epsilonT = 6.5 W/kg (leading to vessel wall biofilm formation). This information could be used to optimize culture conditions for improved cell aggregation and hence biomass separation, during thermophilic aerobic bioremediation processes.

Aerobiosis↗
PubMed2007

Economic cost of dementia patients according to the limitation of the activities of daily living in Korea.

BACKGROUND: Dementia is expected to become a significant social burden in the future. However, there are few reports that have estimated the total economic cost of dementia, particularly according to the limitation in the activities of daily living (ADL) in Korea. OBJECTIVES: This study is to analyze the health care expenditures and cost per dementia patient, and estimated the total economic cost of dementia. METHODS: Caregivers of 609 dementia patients, who were randomly selected from a nationwide claim database of the Korean National Health Insurance Corporation, were interviewed using structured questionnaire in the period of September 2005. The total cost including the direct and indirect costs during a year was calculated. The patients were stratified into three limitation groups according to their ADL score. The cost according to the three limitation groups was analyzed. The national cost of dementia patients was then estimated. RESULTS: The total cost per dementia patient in Korea was $7,462. The direct and indirect costs were $6,626 and $836 per patient, respectively. The cost increased with increasing degree of limitation in the patient's ADL. Over a 1-year period, the total cost per patient in the low limitation group was lower ($3,698) than that of the moderate ($6,064) and high ($11,428) limitation group. CONCLUSIONS: This study demonstrates that the direct and indirect costs of dementia are considerately small for patients with lower limitation in their ADL. The total economic cost of dementia per year was estimated to be in the range of 1.3 to 3.3 billion dollars on assumptions in Korea.

Activities of Daily Living↗
PubMed1991

Effect of statistical methodology on normal limits in nerve conduction studies.

Mean +/- 2 standard deviations (SD), which relies on a Gaussian distribution, has traditionally been used to derive normal limits for nerve conduction studies. Our purpose was to examine skew in nerve conduction study (NCS) parameters, and to compare normal limits derived by several alternative methods. We examined 22 NCS parameters from 75 asymptomatic, nondiabetic men (controls). The coefficient of skewness (g1) was significantly positive (P less than 0.10, two-tailed test) in 5 of 8 amplitude and 6 of 8 latency measurements. Transformation reduced g1 in 19 of 22 parameters, and was optimal when g1 was closest to zero. For each measurement, ideal normal limits were defined as mean +/- 2 SD of the optimally transformed data of the control subjects. The percentage of 66 diabetic subjects classified as abnormal by the raw data, but normal by the ideal normal limits, was the positive misclassification rate; while the percentage considered normal by the raw data, but abnormal by the ideal normal limits, was the negative misclassification rate. Mean +/- 2 SD of the raw data produced up to 11% positive misclassifications and 12% negative misclassifications. When the range of observed values was used, up to 6% positive misclassifications and 13% negative misclassifications were found, while the 2.5 or 97.5 percentile values produced up to 10% positive misclassifications and 13% negative misclassifications. We conclude that analyses using the raw data to derive normal limits result in an unacceptable rate of misclassification. Normal limits should be derived from the mean +/- 2 SD of the optimally transformed data.

Aged↗
PubMed2000

Metabolic flux analysis in Streptomyces coelicolor under various nutrient limitations.

Metabolic flux analysis was applied to Streptomyces coelicolor continuous culture data obtained under nitrogen, phosphate, sulfate, and potassium limitations. The metabolic reaction network involved more than 200 reactions describing the major pathways as well as the secondary metabolism for the production of actinorhodin and excretion of certain metabolites. Linear programming was used for the optimization of specific growth rates and energy requirements. Two types of specific growth rates, stoichiometric and theoretical, were defined, maximized, and compared in order to investigate the microbial potential. Potassium limitation led to the largest and nitrogen limitation to the smallest difference between the stoichiometric and theoretical specific growth rates. Although the value of the maximum theoretical specific growth rate was close to that of the experimental specific growth rate with potassium limitation, this difference was the largest in the case of nitrogen limitation. Energy requirements during different nutrient limitations were also investigated. The model indicated that although the highest actinorhodin production rate was with nitrogen limitation, this was accompanied with the undesired excretion of certain metabolites.

Culture Media↗
PubMed1997

An explanation for failure to predict cyclosporine area under the curve using a limited sampling strategy: a beginner's second note.

Recently, limited sampling strategies have been developed to predict the area under a blood drug concentration-time curve (AUC). Multiple stepwise linear regression is the method used to develop limited sampling strategies. Several limited sampling strategies are used to predict cyclosporine AUC. However, recent findings demonstrated that, of all the developed limited sampling strategies, none can predict cyclosporine AUC correctly. Although several explanations have been given for this, the possible mathematical reason has not yet been fully explored. In the present study, we demonstrated that: (i) a steady-state blood drug concentration can be decomposed into the linear and non-linear components using the Fourier series; (ii) the non-linear component of the steady-state blood drug concentration leads to an AUC with a non-linear component, which affects the validation of limited sampling strategies; (iii) the correlation coefficient in a limited sampling strategy can only account for the linear association of linear components between a steady-state blood drug concentration and the AUC; (iv) the average steady-state blood drug concentration is a linear component of the steady-state blood drug concentration; and (v) when developing a limited sampling strategy, the non-linear component can be effectively ignored by: (a) choosing the sampling time around the middle point between the peak and the trough steady-state blood drug concentrations; and (b) increasing the trough steady-state blood drug concentration. However, the latter is restricted by clinical considerations.

Animals↗
PubMed1980

The DNA, RNA and protein composition of the cyanobacterium Anacystis nidulans grown in light- and carbon dioxide-limited chemostats.

The DNA, RNA and protein content of the cyanobacterium Anacystis nidudlans was determined in light-limited and carbon dioxide-limited chemostat cultures over the dilution rate range, D = 0.02 h-1 to 0.19 h-1. The macromolecular contents as a percentage of the dry weight and on a per cell basis varied significantly as a function of organism growth rate and the nature of the growth conditions. For both limitations the RNA content per cell increased [20-55 fg RNA (cell)-1] with increasing dilution rate and also showed an increase as a percentage of the dry weight. The DNA content as a percentage of the dry weight showed a 2-fold decrease with incresing dilution rate over the range examined. On a per cell basis DNA reached a peak at D = 0.1 h-1 [4.5 fg DNA (cell)-1] for light-limited organisms and at D = 0.08 h-1 [8.0 fg DNA (cell)-1] for carbon dioxide-limited organisms. The qRNA increased with increasing dilution rates over the complete growth rate examined whilst qDNA reached a maximum at D = 0.09 to 0.10 h-1. The protein content as a percentage of the dry weight was greater in CO2-limited organisms than light-limited organisms but in both cultures declined as the dilution rate was increased above D = 0.10 h-1.

Carbon Dioxide↗
PubMed1985

Changes in gene expression elicited by amino acid limitation in Neurospora crassa strains having normal or mutant cross-pathway amino acid control.

The effects of amino acid limitation on gene expression have been investigated in Neurospora crassa strains carrying normal (cpc-1+) or mutant (cpc-1) alleles at a locus implicated in cross-pathway amino acid control. Electrophoresis and fluorography were used to reveal the patterns of label incorporation into polypeptides in vivo, or after in vitro translation of extracted mRNAs. In a cpc-1+ strain at least 20% of detectable in vitro translation products showed relative increases in incorporation when RNA was obtained from mycelium grown under conditions of arginine limitation, by comparison with conditions of arginine sufficiency. A cpc-1 mutation, which impairs derepression of a variety of amino acid synthetic enzymes following amino acid limitation, had little detectable effect on in vivo polypeptide synthesis during amino acid sufficient growth or following pyrimidine limitation. However the mutation substantially altered the response to arginine or histidine limitation. The majority of in vitro translation products that showed increased expression in arginine limited cpc-1+ failed to increase in cpc-1 strains, but arginine limitation of cpc-1 also resulted in increases that did not occur in cpc-1+ strains. This may reflect both direct and indirect consequences of the impairment of cross-pathway control.

Amino Acids↗
PubMed1996

Limitation of life support: frequency and practice in a London and a Cape Town intensive care unit.

OBJECTIVES: To examine the frequency of limiting (withdrawing and withholding) therapy in the intensive care unit (ICU), the grounds for limiting therapy, the people involved in the decisions, the way the decisions are implemented and the patient outcome. DESIGN: Prospective survey. Ethical approval was obtained. SETTING: ICUs in tertiary centres in London and Cape Town. PATIENTS: All patients who died or had life support limited. INTERVENTIONS: Data collection only. RESULTS: There were 65 deaths out of 945 ICU discharges in London and 45 deaths out of 354 ICU discharges in Cape Town. Therapy was limited in 81.5% and 86.7% respectively (p = 0.6) of patients who died. The mean ages of patients whose therapy was limited were 60.2 years and 51.9 years (p = 0.014) and mean APACHE II scores 18.5 and 22.6 (p = 0.19) respectively. The most common reason for limiting therapy in both centres was multiple organ failure. Both medical and nursing staff were involved in most decisions, which were only implemented once wide consensus had been reached and the families had accepted the situation. Inotropes, ventilation, blood products, and antibiotics were most commonly withdrawn. The mean time from admission to the decision to limit therapy was 11.2 days in London and 9.6 days in Cape Town. The times to outcome (death in all patients) were 13.2 h and 8.1 h respectively. CONCLUSIONS: Withdrawal of therapy occurred commonly, most often because of multiple organ failure. Wide consensus was reached before a decision was made, and the time to death was generally short.

APACHE↗
PubMed1999

Benefit limits in managed behavioral health care: do they matter?

More than half of Americans with insurance coverage for mental health services are enrolled in plans that carve out behavioral health care services with a vendor specializing in the management of these services. However, utilization management has not taken the place of benefit limitations. Do benefit limits matter? This article reports the percentage of enrollees in managed behavioral health care carve-out plans that encounter benefit limits. Estimates are provided on the impact and savings of imposing benefit limits on enrollees in unrestricted plans. Costs to eliminate benefit limits are estimated to be very small. This study finds that benefit limits do matter but only to a very small number of plan enrollees. Furthermore, the results of this study show that for inpatient limits, children are especially vulnerable. These issues have important implications for discussions about the impact of managed care in mental health and for discussions concerning parity legislation.

Adult↗
PubMed2001

Climate change and temperature-dependent biogeography: oxygen limitation of thermal tolerance in animals.

Recent years have shown a rise in mean global temperatures and a shift in the geographical distribution of ectothermic animals. For a cause and effect analysis the present paper discusses those physiological processes limiting thermal tolerance. The lower heat tolerance in metazoa compared with unicellular eukaryotes and bacteria suggests that a complex systemic rather than molecular process is limiting in metazoa. Whole-animal aerobic scope appears as the first process limited at low and high temperatures, linked to the progressively insufficient capacity of circulation and ventilation. Oxygen levels in body fluids may decrease, reflecting excessive oxygen demand at high temperatures or insufficient aerobic capacity of mitochondria at low temperatures. Aerobic scope falls at temperatures beyond the thermal optimum and vanishes at low or high critical temperatures when transition to an anaerobic mitochondrial metabolism occurs. The adjustment of mitochondrial densities on top of parallel molecular or membrane adjustments appears crucial for maintaining aerobic scope and for shifting thermal tolerance. In conclusion, the capacity of oxygen delivery matches full aerobic scope only within the thermal optimum. At temperatures outside this range, only time-limited survival is supported by residual aerobic scope, then anaerobic metabolism and finally molecular protection by heat shock proteins and antioxidative defence. In a cause and effect hierarchy, the progressive increase in oxygen limitation at extreme temperatures may even enhance oxidative and denaturation stress. As a corollary, capacity limitations at a complex level of organisation, the oxygen delivery system, define thermal tolerance limits before molecular functions become disturbed.

Acclimatization↗
PubMed2002

Can phosphorus limitation inhibit dissolved organic carbon consumption in aquatic microbial food webs? A study of three food web structures in microcosms.

Microcosms with three different food web structures and phosphorus (P) limited growth medium were used to study the interactions between P and organic carbon (C) fractions in pelagic food webs. The cultures were run with low dilution to allow the biological processes to determine the outcome. A double isotope technique was used to follow the C and P compartments. In all systems the primary production was P limited. The measured P:C ratios and the observed accumulation of degradable dissolved organic carbon (DOC) indicated that the growth of heterotrophic bacteria was also P limited. The presence of neither algal grazers nor flagellates feeding on bacteria altered the limitation pattern. A net loss of P from the bacterial fraction was observed after the bloom. Different strategies for nutrient aquisition and growth are proposed as mechanisms enabling simultaneous P limitation of algae and bacteria, and a concomitant accumulation of degradable DOC. The ability of the algae to grow with low P:C ratio keeps the regeneration of P through grazers low enough to cause sustained P limitation of both algae and bacteria. The grazers were important producers of DOC when present. This implies that the usual assumption of carbon limited bacterial growth may lead to wrong conclusions regarding the dynamics of plankton communities and the DOC pool.

Animals↗
PubMed2002

Exercise-induced oxyhaemoglobin desaturation, ventilatory limitation and lung diffusing capacity in women during and after exercise.

Arterial haemoglobin saturation during exercise in healthy young women [eight subjects mean (SEM) age 20.8 (1.8) years] was measured to confirm the theory that young women experience exercise-induced arterial hypoxaemia (EIAH) at a lower relative percentage of maximal oxygen uptake (VO(2max)) than has been documented in their male counterparts. To determine if flow limitation [the percentage of the tidal volume ( V(T)) that met or exceeded the boundary established by multiple maximal expiratory manoeuvres] and/or post-exercise lung diffusing capacity are linked to EIAH in women, and to investigate the influence of exercise intensity and duration on post-exercise carbon monoxide lung diffusing capacity ( D(L, CO)), these parameters were measured during and after three exercise tests (incremental test until exhaustion, 5 km run and 5 km run with sprint). All subjects experienced physiologically significant EIAH (a fall of more than 3% in oxygen saturation of arterial blood from levels at rest) and seven subjects experienced flow limitation during the VO(2max) protocol [mean (SD) 12.2 (8.8)% of V(T)]. Even though there was no significant relationship between aerobic capacity and the degree of flow limitation ( r=0.33, P>0.05), the flow limitation was related to absolute ventilation in the subjects studied ( r=0.82, P<0.05). There was no significant relationship between decrements in post exercise D(L, CO) and EIAH ( r=0.05, P>0.05), however there was a strong correlation between the extent of flow limitation (% of V(T)) and EIAH ( r=0.71). Significant decreases in D(L, CO) lasted for up to 16 h after each of the exercise tests ( P<0.05) and lasted for a further 8 h after the maximal test ( P<0.05). Exercise intensity was the main contributing factor to the observed decreases in post-exercise D(L, CO) with the percentage of VO(2max) attained during the various tests being significantly related to the fall in D(L, CO) for 1, 2, 3, 16 and 24 h after exercise ( P<0.05). As the appearance of flow limitation closely coincided with the appearance of EIAH, the results from the present study suggest that flow limitation is a contributing factor to EIAH in women although the exact mechanism remains unclear.

Adult↗
PubMed2003

Limit dextrinase from germinating barley has endotransglycosylase activity, which explains its activation by maltodextrins.

Limit dextrinase (EC 3.2.1.41) from germinating barley (Hordeum vulgare L) can be activated by millimolar concentrations of linear maltodextrins with a degree of polymerisation > or = 2. The activation was assay-dependent; it was detected using assays based on the solubilisation of cross-linked dyed pullulan but not in assays that directly measured cleavage events such as the formation of new reducing termini. This strongly suggested that maltodextrins did not increase the catalytic rate of limit dextrinase i.e. this is not a true activation. On the other hand, considerable activation was noted in assays that measured pullulan degradation by reduction in viscosity. Taken together, this suggested that maltodextrins altered the mode of action of limit dextrinase, causing more rapid decreases in viscosity or greater solubilisation of dye-linked pullulan fragments per cleavage event. The proposed mechanism of activation by alteration in action pattern was reminiscent of initial work in the discovery of xyloglucan endotransglycosylase. Therefore, the ability of limit dextrinase to catalyse transglycosylation reactions into pullulan was tested and confirmed by an assay based on the incorporation of a fluorescently labelled maltotriose derivative into higher-molecular-weight products. The transglycosylation reaction was dependent on limit dextrinase activity and was enhanced in more highly purified preparations of limit dextrinase. Transglycosylation was inhibited by unlabelled maltotriose. How transglycosylation accounts for the apparent activation of limit dextrinase by maltodextrins and the physiological relevance of this novel reaction are discussed.

Chromatography, Affinity↗
PubMed2005

A dynamic morphometric model of the normal lung for studying expiratory flow limitation in mechanical ventilation.

A nonlinear dynamic morphometric model of breathing mechanics during artificial ventilation is described. On the basis of the Weibel symmetrical representation of the tracheo-bronchial tree, the model accurately accounts for the geometrical and mechanical characteristics of the conductive zone and packs the respiratory zone into a viscoelastic Voigt body. The model also accounts for the main mechanisms limiting expiratory flow (wave speed limitation and viscous flow limitation), in order to reproduce satisfactorily, under dynamic conditions, the expiratory flow limitation phenomenon occurring in normal subjects when the difference between alveolar pressure and tracheal pressure (driving pressure) is high. Several expirations characterized by different levels of driving pressure are simulated and expiratory flow limitation is detected by plotting the isovolume pressure-flow curves. The model is used to study the time course of resistance and total cross-sectional area as well as the ratio of fluid velocity to wave speed (speed index), in conductive airway generations. The results highlight that the coupling between dissipative pressure losses and airway compliance leads to onset of expiratory flow limitation in normal lungs when driving pressure is increased significantly by applying a subatmospheric pressure to the outlet of the ventilator expiratory channel; wave speed limitation becomes predominant at still higher driving pressures.

Airway Resistance↗
PubMed1996

Remacemide HCl and its metabolite, FPL 12495AA, limit action potential firing frequency and block NMDA responses of mouse spinal cord neurons in cell culture.

The novel anticonvulsant, remacemide HCl [(+/-)-2-amino-N-(1-methyl-1,2-diphenylethyl)acetamide monohydrochloride; FPL12924AA], and a desglycinated metabolite [(+/-)-1-methyl-1,2-diphenylethylamine monohydrochloride; FPL 12495AA] reversibly limited sustained high-frequency repetitive firing (SRF) of sodium-dependent action potentials by mouse spinal cord neurons in monolayer dissociated cell culture. Limitation occurred with an IC50 of 7.9 X 10(-6) M for remacemide and 1.2 X 10(-6) M for FPL 12495AA (P < 0.05 vs. remacemide). Stereoisomers of the desglycinate limited SRF with IC50 values of 3.3 X 10(-6) M and 3.5 X 10(-6) M for the S(+) and R(-) compounds, respectively. The concentration of racemic desglycinate and of either stereoisomer that produced limitation in all neurons tested was 10(-4) M. Maximal rate of rise (Vmax) of action potentials decreased progressively until firing ceased during 400-ms depolarizing pulses. Efficacy of remacemide, but not of the desglycinate, increased with time (maximum at 16-36 h). The limitation was voltage dependent. In addition, reduction of Vmax and action potential failure occurred during stimulation with 400-ms pulses and trains of brief (1 ms) depolarizations at different frequencies. These findings suggest an effect on voltage-sensitive sodium current that generates the action potential upstroke. Remacemide and the desglycinate also significantly reduced the amplitude of neuronal responses to pressure application of NMDA in use-dependent manner at concentrations equal to the IC50 values for limitation of action potential firing. Resting potential and input resistance were not changed significantly by either drug. Limitation of high-frequency firing of action potentials by both remacemide HCl and FPL 12495AA may contribute to the anticonvulsant efficacy of these compounds at concentrations overlapping the range required to block glutamatergic hyperexcitability.

Acetamides↗
PubMed2006

Relationships between performance-based tests and patients' ratings of activity limitations, self-efficacy, and pain in fibromyalgia.

OBJECTIVE: To investigate the relationship between performance-based tests, ratings of activity limitations, self-efficacy, and pain in fibromyalgia. DESIGN: Descriptive. SETTING: University hospital. PARTICIPANTS: Sixty-nine women with fibromyalgia (mean age, 45+/-7.8y). INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: The patients completed 4 performance-based tests focusing on muscle power function and 3 unloaded arm movements. The patients rated their activity limitations by means of the subscales of physical function (PF) and pain on the Fibromyalgia Impact Questionnaire (FIQ), the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36), and the Arthritis Self-Efficacy Scale (ASES). Spearman correlation coefficient (rho) and multivariate regression analysis were conducted. RESULTS: The highest correlations were found between the 6-minute walk test (6MWT) (rho range, -.48 to .68) and the activity limitations and between hand grip strength (rho range, -.34 to .57) and the activity limitations. The regression analysis indicated that hand grip strength explained 25% of the variation in the SF-36 PF scale. The 6MWT plus endurance of the shoulder muscles explained 24% of the variation in the FIQ PF scale and the 6MWT plus active abduction of the shoulder explained 48% of the variation in the ASES function scale. Correlations between the performance-based tests and the activity limitations tended to be higher than those between performance and pain. CONCLUSIONS: The majority of the performance-based tests and the patients' subjective ratings of activity limitations showed significant relationships. The 6MWT and hand grip strength, reflecting activity limitations in the SF-36, FIQ, and ASES, are recommended for use in clinical research and in the clinical examination when planning treatment for patients with fibromyalgia.

Female↗
PubMedDate not supplied

Work Hours Assessment and Monitoring Initiative (WHAMI) under resident direction: a strategy for working within limitations.

PURPOSE: A review of surgical residents' duty-hours prompted a Work Hours Assessment and Monitoring Initiative (WHAMI) that preemptively limits residents from violating "duty-hours rules." METHODS: Work hours data for the Department of Surgery were reviewed over 8-months at New York Presbyterian Hospital-Columbia Campus. This ongoing review is performed by a work-hours monitoring team, which supervises residents' hours for the initial 5-days of each week. As residents approach work-hours limits for the week, they are dismissed from duty for appropriate time periods in the remaining 2 days of the week. RESULTS: The work-hours data entry compliance for 52 residents was increased from 93% to 99% after creation of the WHAMI. Before the new system, a mean of 9.5 residents per month (19%) worked an average of 7.3 +/- 6.4 hours over the 80-hour limit. Averaged monthly compliance with the 80-hour work limit was increased to 98% with introduction of the WHAMI. A review of on-call duty hours revealed a mean of 7 (14%) residents per month who worked an average of 2.4 hours beyond 24-hour call limitations including "sign-out" time imposed by the ACGME. New monitoring procedures have improved compliance to 100% with 24-hour call limitations imposed by the ACGME. Compliance with the more stringent New York State (NYS) guidelines has approached 94% with noncompliant residents extending on-call hours by an average of 1.5 hours over the 24-hour limitations, most on "off General Surgery" rotations or out-of-state rotations. Review of mandatory rest periods contributed to an increase in mean "time off" between work periods, thereby increasing compliance with ACGME guidelines and NYS regulations from 75% to 88%, and 90% to 98%, respectively. Residents reporting less than 10 hours rest reported increased "time off" from 6.2 +/- 2.0 to 7.9 +/- 1.3 hours (p < 0.001). CONCLUSIONS: Internal review of surgical resident's duty-hours at a large university hospital revealed that despite strict scheduling and the requirement of mandatory duty-hours entry, achieving the goals of meeting the duty-hours requirements and of ongoing data entry required the creation of a resident enforced, real-time Work Hours Assessment and Monitoring Initiative.

Follow-Up Studies↗
PubMed2005

Effect of limiting snack food variety on long-term sensory-specific satiety and monotony during obesity treatment.

Limiting meal variety decreases hedonic ratings of eaten foods more so than non-eaten foods, demonstrating sensory-specific satiety. Exposure to a food over time decreases the food's hedonic ratings, indicating monotony. The effect of limiting food group variety over time on long-term sensory-specific satiety and monotony is unknown. Thirty overweight adults were randomized to one of two 8-week behavioral weight loss interventions. One condition limited snack food intake to one chosen snack food (reduced variety), while the other limited snack food intake to <1 serving/day (control), with no variety limit. In the reduced variety condition, hedonic ratings of the chosen snack food showed a decrease (p < .05) over time and decreased more (p < .05) than hedonic ratings of other snack foods. Weight loss (-7.4 +/- 5.8 lb) occurred in both conditions. Limiting food group variety over 8 weeks produced long-term sensory-specific satiety and monotony. Future research should examine if limiting food group variety over an extended time affects intake and could be used as a technique in weight loss interventions.

Adult↗