Operations management is essential for gaining competitiveness in most manufacturing or service-offering organizations.Therefore,this report is going to analyze the way in which effective operations managers use proce...Operations management is essential for gaining competitiveness in most manufacturing or service-offering organizations.Therefore,this report is going to analyze the way in which effective operations managers use process strategy as a competitive weapon.Besides,based on relevant theories,a case of fast food production process will be studied.展开更多
AIM To discuss type 2 diabetes mellitus(T2DM) medication changes required during the popular 5:2 intermittent energy restriction(IER) diet. METHODS A search was conducted in MEDLINE, EMBASE, AMED, CINAHL and Cochrane ...AIM To discuss type 2 diabetes mellitus(T2DM) medication changes required during the popular 5:2 intermittent energy restriction(IER) diet. METHODS A search was conducted in MEDLINE, EMBASE, AMED, CINAHL and Cochrane library for original research articles investigating the use of very low calorie diets(VLCD) in people with T2 DM. The search terms used included "VLCD" or "very low energy diet" or "very low energy restriction" or "IER" or "intermittent fasting" or "calorie restriction" or "diabetes mellitus type 2" and "type 2 diabetes". Reference lists of selected articles were also screened for relevant publications. Only research articles written in English, which also included an explanation of medication changes were included. A recent pilot trial using the 5:2 IER method, conducted by our research group, will also be summarized.RESULTS A total of 8 studies were found that investigated the use of VLCD in T2 DM and discussed medication management. Overall these studies indicate that the use of a VLCD for people with T2 DM usually require the cessation of medication to prevent hypoglycemia. Therefore, the 5:2 IER method will also require medication changes, but as seen in our pilot trial, may not require total cessation of medication, rather a cessation on the 2 IER days only. CONCLUSION Guidelines outlined here can be used in the initial stages of a 2-d IER diet, but extensive blood glucose monitoring is still required to make the necessary individual reductions to medications in response to weight loss.展开更多
BACKGROUND Enhanced recovery after surgery strategies are increasingly implemented to improve the management of surgical patients.AIM To evaluate the effects of new perioperative fasting protocols in children≥3 mo of...BACKGROUND Enhanced recovery after surgery strategies are increasingly implemented to improve the management of surgical patients.AIM To evaluate the effects of new perioperative fasting protocols in children≥3 mo of age undergoing non-gastrointestinal surgery.METHODS This prospective pilot study included children≥3 mo of age undergoing nongastrointestinal surgery at the Children’s Hospital(Zhejiang University School of Medicine)from January 2020 to June 2020.The children were divided into either a conventional group or an ERAS group according to whether they had been enrolled before or after the implementation of the new perioperative fasting strategy.The children in the conventional group were fasted using conventional strategies,while those in the ERAS group were given individualized fasting protocols preoperatively(6-h fasting for infant formula/non-human milk/solids,4-h fasting for breast milk,and clear fluids allowed within 2 h of surgery)and postoperatively(food permitted from 1 h after surgery).Pre-operative and postoperative fasting times,pre-operative blood glucose,the incidence of postoperative thirst and hunger,the incidence of perioperative vomiting and aspiration,and the degree of satisfaction were evaluated.RESULTS The study included 303 patients(151 in the conventional group and 152 in the ERAS group).Compared with the conventional group,the ERAS group had a shorter pre-operative food fasting time[11.92(4.00,19.33)vs 13.00(6.00,20.28)h,P<0.001],shorter preoperative liquid fasting time[3.00(2.00,7.50)vs 12.00(3.00,20.28)h,P<0.001],higher preoperative blood glucose level[5.6(4.2,8.2)vs 5.1(4.0,7.4)mmol/L,P<0.001],lower incidence of thirst(74.5%vs 15.3%,P<0.001),shorter time to postoperative feeding[1.17(0.33,6.83)vs 6.00(5.40,9.20),P<0.001],and greater satisfaction[7(0,10)vs 8(5,10),P<0.001].No children experienced perioperative aspiration.The incidences of hunger,perioperative vomiting,and fever were not significantly different between the two groups.CONCLUSION Optimizing fasting and clear fluid drinking before non-gastrointestinal surgery in children≥3 mo of age is possible.It is safe and feasible to start early eating after evaluating the recovery from anesthesia and the swallowing function.展开更多
Objective: The main aim of the study is predominately utilizing clinical pharmacist in the provision of continuing diabetic education programs to emphasize and re-emphasize the importance of risk factors, prevention, ...Objective: The main aim of the study is predominately utilizing clinical pharmacist in the provision of continuing diabetic education programs to emphasize and re-emphasize the importance of risk factors, prevention, adherence to medication and behavioral changes to prevent recurrences of the disease, their progression, and ultimately minimize hospitalization. Specific goals are to improve clinical outcomes for patients with diabetes—to maintain optimal plasma glucose concentrations Fasting, Postprandial Plasma Glucose, and Glycated Hemoglobin. Study design: A prospective interventional study in the Outpatient General Medicine Department, for a period of six months from October 2018 to March 2019. Results: HbA1c levels were reduced from baseline by −1.107 ± 0.8634, Fasting Plasma Glucose levels and Postprandial blood glucose levels were reduced from baseline by −24.2218 ± 5.70352 and −30.1891 ± 1.40592 respectively. Conclusion: A trained clinical pharmacist by providing diabetes education and care can significantly reduce hyperglycemia, thereby improving the quality of life in diabetes patients and ultimately reducing health care costs associated with these morbidities.展开更多
The handover speed is always vital for the further development of Wireless Local Area Network (WLAN), which is enjoying a fast growth. Based on the handover technology specified in IEEE 802.11 WLAN, Manageable Fast Ha...The handover speed is always vital for the further development of Wireless Local Area Network (WLAN), which is enjoying a fast growth. Based on the handover technology specified in IEEE 802.11 WLAN, Manageable Fast Handover (MFHO) mechanism is proposed to speed up handover at the Access Point (AP), meet handover demands of services with different Quality of Service (QoS), and ensure service continuity. Adopting a handover policy named 'Make-before-break', this mechanism enables wireless APs to control and manage handover between two stations based on improving Inter-Access Point Protocol (IAPP). Tests have been carried out to compare functions and performance of MFHO and IAPP-based handover technology. The test results prove that MFHO provides a higher successful handover ratio and better handover performance than IAPP-based handover technology.展开更多
In this paper the ethanol homogeneous charge compression ignition (HCCI) is achieved in a modified single cylinder engine by means of a self-developed fast thermal management system (FTMS), and the ethanol SI/HCCI ope...In this paper the ethanol homogeneous charge compression ignition (HCCI) is achieved in a modified single cylinder engine by means of a self-developed fast thermal management system (FTMS), and the ethanol SI/HCCI operation regions are defined. It can be concluded that the thermal efficiency is higher and the NOx emission is lower in the HCCI operation region. In addition, the maximum NOx emission drops by 98%. The ethanol SI/HCCI combustion mode transition is conducted in different conditions near the SI/HCCI operation boundaries. It is likely to realize the transition by the utilization of FTMS. However, it is impossible to complete the transition within one operating cycle under current operation conditions. There are fluctuations in engine speed and brake mean effective pressure during the transition process. In order to reduce the fluctuations during the transition, the initial work concerning the effects of the spark ignition on the transition smoothness is carried out and the investigation indicates that the engine speed and brake mean effective pressure fluctuations cannot be eradicated only through spark ignition. Therefore, the control strategies combined with other factors should be further optimized.展开更多
文摘Operations management is essential for gaining competitiveness in most manufacturing or service-offering organizations.Therefore,this report is going to analyze the way in which effective operations managers use process strategy as a competitive weapon.Besides,based on relevant theories,a case of fast food production process will be studied.
文摘AIM To discuss type 2 diabetes mellitus(T2DM) medication changes required during the popular 5:2 intermittent energy restriction(IER) diet. METHODS A search was conducted in MEDLINE, EMBASE, AMED, CINAHL and Cochrane library for original research articles investigating the use of very low calorie diets(VLCD) in people with T2 DM. The search terms used included "VLCD" or "very low energy diet" or "very low energy restriction" or "IER" or "intermittent fasting" or "calorie restriction" or "diabetes mellitus type 2" and "type 2 diabetes". Reference lists of selected articles were also screened for relevant publications. Only research articles written in English, which also included an explanation of medication changes were included. A recent pilot trial using the 5:2 IER method, conducted by our research group, will also be summarized.RESULTS A total of 8 studies were found that investigated the use of VLCD in T2 DM and discussed medication management. Overall these studies indicate that the use of a VLCD for people with T2 DM usually require the cessation of medication to prevent hypoglycemia. Therefore, the 5:2 IER method will also require medication changes, but as seen in our pilot trial, may not require total cessation of medication, rather a cessation on the 2 IER days only. CONCLUSION Guidelines outlined here can be used in the initial stages of a 2-d IER diet, but extensive blood glucose monitoring is still required to make the necessary individual reductions to medications in response to weight loss.
基金Supported by the Health Science and Technology Plan of Zhejiang Province in 2022,No.2022KY867.
文摘BACKGROUND Enhanced recovery after surgery strategies are increasingly implemented to improve the management of surgical patients.AIM To evaluate the effects of new perioperative fasting protocols in children≥3 mo of age undergoing non-gastrointestinal surgery.METHODS This prospective pilot study included children≥3 mo of age undergoing nongastrointestinal surgery at the Children’s Hospital(Zhejiang University School of Medicine)from January 2020 to June 2020.The children were divided into either a conventional group or an ERAS group according to whether they had been enrolled before or after the implementation of the new perioperative fasting strategy.The children in the conventional group were fasted using conventional strategies,while those in the ERAS group were given individualized fasting protocols preoperatively(6-h fasting for infant formula/non-human milk/solids,4-h fasting for breast milk,and clear fluids allowed within 2 h of surgery)and postoperatively(food permitted from 1 h after surgery).Pre-operative and postoperative fasting times,pre-operative blood glucose,the incidence of postoperative thirst and hunger,the incidence of perioperative vomiting and aspiration,and the degree of satisfaction were evaluated.RESULTS The study included 303 patients(151 in the conventional group and 152 in the ERAS group).Compared with the conventional group,the ERAS group had a shorter pre-operative food fasting time[11.92(4.00,19.33)vs 13.00(6.00,20.28)h,P<0.001],shorter preoperative liquid fasting time[3.00(2.00,7.50)vs 12.00(3.00,20.28)h,P<0.001],higher preoperative blood glucose level[5.6(4.2,8.2)vs 5.1(4.0,7.4)mmol/L,P<0.001],lower incidence of thirst(74.5%vs 15.3%,P<0.001),shorter time to postoperative feeding[1.17(0.33,6.83)vs 6.00(5.40,9.20),P<0.001],and greater satisfaction[7(0,10)vs 8(5,10),P<0.001].No children experienced perioperative aspiration.The incidences of hunger,perioperative vomiting,and fever were not significantly different between the two groups.CONCLUSION Optimizing fasting and clear fluid drinking before non-gastrointestinal surgery in children≥3 mo of age is possible.It is safe and feasible to start early eating after evaluating the recovery from anesthesia and the swallowing function.
文摘Objective: The main aim of the study is predominately utilizing clinical pharmacist in the provision of continuing diabetic education programs to emphasize and re-emphasize the importance of risk factors, prevention, adherence to medication and behavioral changes to prevent recurrences of the disease, their progression, and ultimately minimize hospitalization. Specific goals are to improve clinical outcomes for patients with diabetes—to maintain optimal plasma glucose concentrations Fasting, Postprandial Plasma Glucose, and Glycated Hemoglobin. Study design: A prospective interventional study in the Outpatient General Medicine Department, for a period of six months from October 2018 to March 2019. Results: HbA1c levels were reduced from baseline by −1.107 ± 0.8634, Fasting Plasma Glucose levels and Postprandial blood glucose levels were reduced from baseline by −24.2218 ± 5.70352 and −30.1891 ± 1.40592 respectively. Conclusion: A trained clinical pharmacist by providing diabetes education and care can significantly reduce hyperglycemia, thereby improving the quality of life in diabetes patients and ultimately reducing health care costs associated with these morbidities.
文摘The handover speed is always vital for the further development of Wireless Local Area Network (WLAN), which is enjoying a fast growth. Based on the handover technology specified in IEEE 802.11 WLAN, Manageable Fast Handover (MFHO) mechanism is proposed to speed up handover at the Access Point (AP), meet handover demands of services with different Quality of Service (QoS), and ensure service continuity. Adopting a handover policy named 'Make-before-break', this mechanism enables wireless APs to control and manage handover between two stations based on improving Inter-Access Point Protocol (IAPP). Tests have been carried out to compare functions and performance of MFHO and IAPP-based handover technology. The test results prove that MFHO provides a higher successful handover ratio and better handover performance than IAPP-based handover technology.
基金the National Basic Research Program of China (Grant No. 2001CB9206)
文摘In this paper the ethanol homogeneous charge compression ignition (HCCI) is achieved in a modified single cylinder engine by means of a self-developed fast thermal management system (FTMS), and the ethanol SI/HCCI operation regions are defined. It can be concluded that the thermal efficiency is higher and the NOx emission is lower in the HCCI operation region. In addition, the maximum NOx emission drops by 98%. The ethanol SI/HCCI combustion mode transition is conducted in different conditions near the SI/HCCI operation boundaries. It is likely to realize the transition by the utilization of FTMS. However, it is impossible to complete the transition within one operating cycle under current operation conditions. There are fluctuations in engine speed and brake mean effective pressure during the transition process. In order to reduce the fluctuations during the transition, the initial work concerning the effects of the spark ignition on the transition smoothness is carried out and the investigation indicates that the engine speed and brake mean effective pressure fluctuations cannot be eradicated only through spark ignition. Therefore, the control strategies combined with other factors should be further optimized.
