13 results on '"Robin Lai"'
Search Results
2. Assessment of Risk Tolerance for Adverse Events in Emergency Department Chest Pain Patients: A Pilot Study
- Author
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Todd B. Brown, Michael Menchine, Anand S Iyer, Hugh Milteer, Brannon L Queen, Stacey S. Cofield, David L. Schriger, Robin Lai, and Mark H. Schwab
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Adult ,Male ,Chest Pain ,medicine.medical_specialty ,Myocardial Infarction ,Pilot Projects ,Disease ,Chest pain ,Affect (psychology) ,Choice Behavior ,Risk Assessment ,White People ,Young Adult ,Interquartile range ,Humans ,Medicine ,Myocardial infarction ,Adverse effect ,Aged ,Aged, 80 and over ,business.industry ,Patient Preference ,Emergency department ,Middle Aged ,medicine.disease ,Patient Discharge ,Cardiac surgery ,Black or African American ,Hospitalization ,Emergency medicine ,Emergency Medicine ,Female ,medicine.symptom ,Emergency Service, Hospital ,business - Abstract
Background: Emergency physicians commonly encounter low-probability/high-morbidity decisions, and chest pain is a prime example. Negative outcomes are improbable but feared, resulting in substantially more patients admitted for chest pain than have important disease. The literature gives little guidance on patient preferences for decision-making when the negative outcomes are unlikely but potentially severe. Objectives: The objective of this pilot study was to assess the tolerance of Emergency Department (ED) patients with chest pain for adverse events occurring within 2 weeks of the episode. Method: We recruited a convenience sample of patients with a chief complaint of chest pain from the ED of an urban tertiary-care referral center. Each subject was interviewed to determine demographic information, perceived health status, insurance status, and tolerance for adverse events related to chest pain. Adverse events were defined loosely but were suggested to be heart attack, the need for emergency cardiac surgery, or death. The risk tolerance question was framed by describing a specific numeric risk and determining at what risk the patient switched from desiring hospital admission to desiring discharge; we termed this the decision threshold. Results: Sixty-eight (68) subjects were included. Fifty-four percent of subjects were male, 60% were African-American, and 35% were white; 40% of the subjects classified themselves as being of average health. Of the 31 subjects who had prior heart trouble, 48% (n = 15) stated they had a prior heart attack and 19% (n = 6) an irregular heartbeat. The median decision threshold, or the acceptable personal risk of an adverse event for a person to forego admission to hospital, was 6.5% (interquartile range 0.5–22.9%). The mode was 0.5%, and 44% (30/68) of subjects had a decision threshold of 2% or less. There was no obvious pattern for most of these explanatory variables, though there was a suggestion that race may affect patients' risk tolerance. Conclusions: There is substantial variation in patients' reported tolerance for adverse events from ED chest pain. Further investigation of this phenomenon may lead to better decision-making.
- Published
- 2010
3. Specific bile acids inhibit hepatic fatty acid uptake in mice
- Author
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Barry M. Forman, Heather Tran, Andreas Stahl, Hyo Min Park, Robin Lai, Yuli Chen, Su Jin Song, Amy Helene Henkin, Chris Her, Jacquelyn J. Maher, Biao Nie, Min Lin, Melissa Kazantzis, and Stephanie M. Ng
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Inbred Strains ,Medical Biochemistry and Metabolomics ,Oral and gastrointestinal ,chemistry.chemical_compound ,Mice ,Random Allocation ,2.1 Biological and endogenous factors ,Aetiology ,Cells, Cultured ,chemistry.chemical_classification ,Cultured ,Bile acid ,Subcutaneous ,Liver Disease ,Deoxycholic acid ,Fatty liver ,Ursodeoxycholic Acid ,Fatty Acids ,Fatty Acid Transport Proteins ,G protein-coupled bile acid receptor ,Ursodeoxycholic acid ,Biochemistry ,Lithocholic Acid ,medicine.drug ,Deoxycholic Acid ,medicine.drug_class ,Injections, Subcutaneous ,Cells ,Chronic Liver Disease and Cirrhosis ,Clinical Sciences ,Immunology ,Mice, Inbred Strains ,Biology ,Real-Time Polymerase Chain Reaction ,Sensitivity and Specificity ,Article ,Injections ,Bile Acids and Salts ,medicine ,Animals ,Humans ,Metabolic and endocrine ,Nutrition ,Hepatology ,Triglyceride ,Gastroenterology & Hepatology ,Animal ,Fatty acid ,Metabolism ,medicine.disease ,Lipid Metabolism ,Disease Models, Animal ,chemistry ,Disease Models ,Hepatocytes ,Digestive Diseases - Abstract
UnlabelledBile acids are known to play important roles as detergents in the absorption of hydrophobic nutrients and as signaling molecules in the regulation of metabolism. We tested the novel hypothesis that naturally occurring bile acids interfere with protein-mediated hepatic long chain free fatty acid (LCFA) uptake. To this end, stable cell lines expressing fatty acid transporters as well as primary hepatocytes from mouse and human livers were incubated with primary and secondary bile acids to determine their effects on LCFA uptake rates. We identified ursodeoxycholic acid (UDCA) and deoxycholic acid (DCA) as the two most potent inhibitors of the liver-specific fatty acid transport protein 5 (FATP5). Both UDCA and DCA were able to inhibit LCFA uptake by primary hepatocytes in a FATP5-dependent manner. Subsequently, mice were treated with these secondary bile acids in vivo to assess their ability to inhibit diet-induced hepatic triglyceride accumulation. Administration of DCA in vivo via injection or as part of a high-fat diet significantly inhibited hepatic fatty acid uptake and reduced liver triglycerides by more than 50%.ConclusionThe data demonstrate a novel role for specific bile acids, and the secondary bile acid DCA in particular, in the regulation of hepatic LCFA uptake. The results illuminate a previously unappreciated means by which specific bile acids, such as UDCA and DCA, can impact hepatic triglyceride metabolism and may lead to novel approaches to combat obesity-associated fatty liver disease.
- Published
- 2012
4. Standard versus high-dose CVVHDF for ICU-related acute renal failure
- Author
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Robert A. Oster, Brenda Stofan, Keith M. Wille, Ashita Tolwani, Ruth C. Campbell, and K. Robin Lai
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Nephrology ,Male ,medicine.medical_specialty ,Renal function ,Hemodiafiltration ,law.invention ,law ,Clinical Research ,Internal medicine ,medicine ,Humans ,Survival rate ,business.industry ,Acute kidney injury ,General Medicine ,Odds ratio ,Acute Kidney Injury ,Middle Aged ,medicine.disease ,Intensive care unit ,Confidence interval ,Surgery ,Survival Rate ,Intensive Care Units ,Anesthesia ,Female ,business ,Kidney disease - Abstract
The effect of dosage of continuous venovenous hemodiafiltration (CVVHDF) on survival in patients with acute renal failure (ARF) is unknown. In this study, 200 critically ill patients with ARF were randomly assigned to receive CVVHDF with prefilter replacement fluid at an effluent rate of either 35 ml/kg per h (high dosage) or 20 ml/kg per h (standard dosage). The primary study outcome, survival to the earlier of either intensive care unit discharge or 30 d, was 49% in the high-dosage arm and 56% in the standard-dosage arm (odds ratio 0.75; 95% confidence interval 0.43 to 1.32; P = 0.32). Among hospital survivors, 69% of those in the high-dosage arm recovered renal function compared with 80% of those in the standard-dosage arm (P = 0.29); therefore, a difference in patient survival or renal recovery was not detected between patients receiving high-dosage or standard-dosage CVVHDF.
- Published
- 2008
5. Post–Cardiac Arrest Therapeutic Hypothermia: Overcoming the Barrier of Workplace Culture and Other Implementation Lessons
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Kevin Barlotta, David James, Doris Strother, Jarred J. Thomas, Katherine Robin Lai, Amy Fellman, Andres Viles, and Henry E. Wang
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Adult ,Inservice Training ,Quality management ,Leadership and Management ,MEDLINE ,Hypothermia, Induced ,Multidisciplinary approach ,Intervention (counseling) ,Outcome Assessment, Health Care ,medicine ,Humans ,Post cardiac arrest ,Academic Medical Centers ,business.industry ,Health Plan Implementation ,Workplace culture ,Continuity of Patient Care ,Hypothermia ,medicine.disease ,Organizational Innovation ,Heart Arrest ,Alabama ,Medical emergency ,Diffusion of Innovation ,medicine.symptom ,business ,Rapid response system ,Hospital Rapid Response Team - Abstract
Article-at-a-Glance Background Therapeutic hypothermia (TH) is associated with improved neurologically intact survival after out-of-hospital cardiopulmonary arrest. Because of its complex multidisciplinary nature, many hospitals in the United States have resisted implementing TH. A post–cardiac arrest (post-arrest) TH program was implemented at a major urban academic medical center. Implementing the Therapeutic Hypothermia Program After initial efforts at TH at the University of Alabama at Birmingham Hospital nearly failed, the leaders restructured the TH program. Key elements included frequent multidisciplinary meetings involving all stakeholders, development of TH protocols and techniques consistent with customary institutional practices, introduction of cooling technology, and implementation of a TH physician rapid response system. Results During its first 21 months, the program initiated TH on 93 post-arrest patients. Of the 83 patients who achieved goal hypothermia temperature, 30 (36%; 95% confidence interval [CI]: 26%–47%) survived to hospital discharge. Care teams successfully managed expected complications. Of two patients with TH-associated coagulopathy, one required TH termination. Conclusions The program illustrates key lessons for successful TH program implementation, such as the difficulty of organizing and coordinating complex interventions in complex institutions, the importance of overcoming workplace culture, the value of technology, the need for midcourse corrections, and the advantages of a physician-based rapid response system. Many of these lessons are applicable to any quality improvement intervention.
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- 2011
6. [Untitled]
- Author
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Ashita Tolwani, Katherine Robin Lai, Amar Parikh, Sarika Kadam, and David James
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Protocol (science) ,medicine.medical_specialty ,Nephrology ,business.industry ,Emergency medicine ,medicine ,business - Published
- 2007
7. Thank You to Our 2021 Reviewers.
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Schildgen, Taylor, Aitchison, Jonathan, Jolivet, Laurent, and Rusmore, Margi
- Abstract
Plain Language Summary: Peer review is the key process through which every paper submitted to Tectonics is vetted, ensuring that each publication maintains the highest standards of scientific rigor and integrity. We depend on, and are grateful to, all of the volunteer peer reviewers who have devoted their time and considerable efforts toward this essential procedure. In 2021, the 186 papers published in Tectonics benefited from 844 reviews provided by 579 reviewers. On behalf of the entire editorial board of Tectonics, we want to express here our most heartfelt gratitude to all of you. Thank you! Key Point: The editors thank the reviewers of papers submitted in 2021 [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
- View/download PDF
8. Status of six non-native marine species in the coastal environment of Hong Kong, 30 years after their first record.
- Author
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Astudillo, Juan-Carlos, Wong, Jane C. Y., Dumont, Clement P., Bonebrake, Timothy C., and Leung, Kenneth M. Y.
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MARINE species diversity ,COASTAL ecology ,BIOTIC communities ,MARINE invertebrates ,SEA squirts - Abstract
This is the first systematic assessment conducted on fouling communities to determine the current status of six non-native marine invertebrates that were first recorded in Hong Kong three decades ago. They include the solitary ascidian, Ciona intestinalis; the slipper limpet, Crepidula onyx; the bryozoan, Bugula californica; the Caribbean bivalve, Mytilopsis sallei; the Mediterranean mussel, Mytilus galloprovincialis; and the boring isopod, Sphaeroma walkeri. Field surveys were conducted at 31 locations during wet (2011) and dry (2012) seasons and included fouling communities on piers and mariculture zones from estuarine to oceanic zones. The sampling was conducted by using photo-quadrats, destructive quadrats and field observations. To detect temporal changes in the abundance and recruitment of the sedentary non-native species, three piers were monitored with permanent photo-quadrats and recruitment panels for a one year period. We examined the relationship between seawater quality data available for Hong Kong and the abundances of fouling and non-native species. Only four of the six target non-native species were recorded in this survey. The isopod Sphaeroma walkeri was common and widely distributed in fouling communities in Hong Kong, while Ciona intestinalis, Crepidula onyx, and Mytilopsis sallei were uncommon and mainly restricted to areas with intensive human activities and poor seawater quality. These findings suggest that near shore human activities and poor water quality could increase the risk of establishment of non-native species in Hong Kong's marine fouling communities. [ABSTRACT FROM AUTHOR]
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- 2014
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9. Keyword Index.
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- 1997
- Full Text
- View/download PDF
10. Food for thought.
- Author
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Coutts, Doug
- Abstract
The author discusses his views on the increasing number of celebrity chefs on television. He compares the lifestyles during his time and today and noticed that technology has greatly affected the food industry and the television broadcasting industry. He adds that everywhere, there are celebrity chefs either on wireless media or in a glossy magazine. However, he also admits that the increase in number of celebrity chefs help inspire millions to venture into the food industry.
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- 2007
11. Enterprise Sustainability : Enhancing the Military’s Ability to Perform Its Mission
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Dennis F.X. Mathaisel, Joel M. Manary, Clare L. Comm, Dennis F.X. Mathaisel, Joel M. Manary, and Clare L. Comm
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- United States. Dept. of Defense--Management
- Abstract
Military supply chains are unique because what is supplied to the end user is routinely returned to the supply chain for maintenance, repair, and overhaul (MRO). Offering a blueprint for transforming military depot workload and processes into those of high-performance commercial facilities, Enterprise Sustainability: Enhancing the Military‘s Abilit
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- 2009
12. Service-learning projects to enhance preparation of professional health educators
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Geiger, Brian F. and Werner, Karen
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Student service -- Research -- Methods ,Health education -- Methods -- Curricula -- Research ,Experiential learning -- Methods -- Research - Abstract
Abstract: Community schools, colleges, universities, and faith communities promote the concept of service while learning. Opportunities for local and national service abound. This manuscript describes a successful partnership between faculty [...]
- Published
- 2004
13. Avid Everywhere to Bring Star Performances to Life
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Interplay Entertainment Corp. ,Avid Technology Inc. ,Software industry - Abstract
ENPNewswire-July 23, 2015--Avid Everywhere to Bring Star Performances to Life (C)2015 ENPublishing - http://www.enpublishing.co.uk Release date- 22072015 - Burlington, MA -Avid (Nasdaq: AVID) today announced that the famed Iridium Club [...]
- Published
- 2015
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