Well: Weight Loss Surgery May Not Combat Diabetes Long-Term

Weight loss surgery, which in recent years has been seen as an increasingly attractive option for treating Type 2 diabetes, may not be as effective against the disease as it was initially thought to be, according to a new report. The study found that many obese Type 2 diabetics who undergo gastric bypass surgery do not experience a remission of their disease, and of those that do, about a third redevelop diabetes within five years of their operation.

The findings contrast with the growing perception that surgery is essentially a cure for Type II diabetes. Earlier this year, two widely publicized studies reported that surgery worked better than drugs, diet and exercise in causing a remission of Type 2 diabetes in overweight people whose blood sugar was out of control, leading some experts to call for greater use of surgery in treating the disease. But the studies were small and relatively short, lasting under two years.

The latest study, published in the journal Obesity Surgery, tracked thousands of diabetics who had gastric bypass surgery for more than a decade. It found that many people whose diabetes at first went away were likely to have it return. While weight regain is a common problem among those who undergo bariatric surgery, regaining lost weight did not appear to be the cause of diabetes relapse. Instead, the study found that people whose diabetes was most severe or in its later stages when they had surgery were more likely to have a relapse, regardless of whether they regained weight.

“Some people are under the impression that you have surgery and you’re cured,” said Dr. Vivian Fonseca, the president for medicine and science for the American Diabetes Association, who was not involved in the study. “There have been a lot of claims about how wonderful surgery is for diabetes, and I think this offers a more realistic picture.”

The findings suggest that weight loss surgery may be most effective for treating diabetes in those whose disease is not very advanced. “What we’re learning is that not all diabetic patients do as well as others,” said Dr. David E. Arterburn, the lead author of the study and an associate investigator at the Group Health Research Institute in Seattle. “Those who are early in diabetes seem to do the best, which makes a case for potentially earlier intervention.”

One of the strengths of the new study was that it involved thousands of patients enrolled in three large health plans in California and Minnesota, allowing detailed tracking over many years. All told, 4,434 adult diabetics were followed between 1995 and 2008. All were obese, and all underwent Roux-en-Y operations, the most popular type of gastric bypass procedure.

After surgery, about 68 percent of patients experienced a complete remission of their diabetes. But within five years, 35 percent of those patients had it return. Taken together, that means that most of the subjects in the study, about 56 percent — a figure that includes those whose disease never remitted — had no long-lasting remission of diabetes after surgery.

The researchers found that three factors were particularly good predictors of who was likely to have a relapse of diabetes. If patients, before surgery, had a relatively long duration of diabetes, had poor control of their blood sugar, or were taking insulin, then they were least likely to benefit from gastric bypass. A patient’s weight, either before or after surgery, was not correlated with their likelihood of remission or relapse.

In Type 2 diabetes, the beta cells that produce insulin in the pancreas tend to wear out as the disease progresses, which may explain why some people benefit less from surgery. “If someone is too far advanced in their diabetes, where their pancreas is frankly toward the latter stages of being able to produce insulin, then even after losing a bunch of weight their body may not be able to produce enough insulin to control their blood sugar,” Dr. Arterburn said.

Nonetheless, he said it might be the case that obese diabetics, even those whose disease is advanced, can still benefit from gastric surgery, at least as far as their quality of life and their risk factors for heart disease and other complications are concerned.

“It’s not a surefire cure for everyone,” he said. “But almost universally, patients lose weight after weight loss surgery, and that in and of itself may have so many health benefits.”

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Union walkout cripples ports of Los Angeles and Long Beach

A small union of maritime clerks managed to shut down most of the nation's busiest seaport complex Wednesday, raising concerns about harm to the fragile economy.

Although late November is a relatively slow time for cargo movement at the ports of Los Angeles and Long Beach, a prolonged closure could prove costly for retailers and manufacturers who rely on the ports to get their goods as well as truckers and other businesses that depend on the docks for work.

"You are stranding goods at ports that handle 40% of the nation's import trade," said Jock O'Connell, an international trade economist who works as an advisor to Beacon Economics.

"The danger here is that this could call into question the reliability of the San Pedro Harbor ports," O'Connell said. "The Wal-Marts and the Home Depots may be forced to think twice about relying on these ports as their primary gateway."

Showing an influence that extended far beyond its numbers, the 800-member International Longshore and Warehouse Union Local 63's Office Clerical Unit established picket lines at seven of the eight terminals at the Port of Los Angeles, which is the largest container port in the U.S.

The union, whose members handle most of the paperwork for ships entering and leaving the ports, also struck three of the six terminals at the neighboring Port of Long Beach, which ranks second only to Los Angeles in the amount of container cargo it moves.

The union's picket lines had at least the tacit approval of the larger, 50,000-member ILWU of dockworkers, clerks and other workers who handle all of the cargo on the west coasts of the U.S. and Canada and in Hawaii.

About 10,000 of those dockworkers are employed at the Los Angeles and Long Beach ports, and they refused to cross the lightly manned picket lines. That left the normally bustling harbor eerily quiet for a Wednesday afternoon.

On Tuesday, with the walkout confined to the APM Terminals at the Port of Los Angeles, an arbitrator ruled that the picket lines were invalid because the union was not bargaining in good faith. The arbitrator ordered union members to return to work Tuesday night, but they refused. Union members have been working without a contract since June 30, 2010.

At the entrance to Long Beach's Total Terminals International, six members of the clerical workers union held signs that said, "On Strike ... For hours, wages & working conditions." Workers on that picket line and six others said they were under strict orders not to talk to the news media.

Officially, the union fell back on a statement released Tuesday evening and had no further comment Wednesday.

In that statement, logistics clerk Trinie Thompson said the workers were "drawing the line against corporate greed and outsourcing that's destroying the good-paying jobs that support working families in our community." The union's primary concern is that its jobs could be transferred to nonunion labor in countries with lower wages.

But the 14 employers involved in the contract negotiations — some of the largest ocean shipping lines and terminal operators in the world — said they hadn't outsourced any jobs. The management group said it had offered "absolute job security" and generous wage and pension increases.

The employers have accused the union of engaging in the practice of "feather bedding," requiring employers to call in temporary employees and hire new permanent employees even when there is no work to perform.

On Wednesday, the management group said the union's conduct "shows an irresponsible willingness to jeopardize port operations and thousands of jobs in the Los Angeles area." If a strike drags on, "the negative effects on jobs and the economy will be felt nationwide," the employers said.

The dispute was raising concerns far beyond the harbor area.

"A work stoppage at America's two busiest ports just as the holiday shopping season begins is a recipe for disaster," said Sandy Kennedy, president of the Retail Industry Leaders Assn., a trade group. "If the strike isn't resolved quickly, the effects on retailers, their customers and the economy will be enormous."

A 10-day lockout in 2002 at all West Coast ports left ships piling up offshore, unable to unload cargo. The cost of the dispute was estimated as high as $15 billion.

California Sens. Barbara Boxer and Dianne Feinstein issued a statement urging a quick resolution of the dispute "so we can protect the economy of the Los Angeles region, the West Coast and our nation, which will be adversely affected by the closures at these ports."

Rep. Janice Hahn (D-San Pedro) said she was backing the port workers.

"I stand in solidarity with the hard-working clerical workers, most of whom are women, of the ILWU Local 63's Office Clerical Unit, who are striking today to prevent their jobs from being sent overseas," Hahn said in a statement. "These workers have been bargaining in good faith for over two years, and I urge a fair resolution that keeps these good-paying jobs" at the ports of Los Angeles and Long Beach.

ron.white@latimes.com

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Most L.A. County youths held for prostitution come from foster care

A majority of juveniles arrested on prostitution charges in Los Angeles County come from the county's foster care system, and, in some cases, pimps use underage sex workers to recruit fellow group home residents, county officials said.

Until now, foster youth caught in the sex trade have largely been the responsibility of the county Probation Department.

The Los Angeles County Board of Supervisors voted Tuesday to launch a multiagency task force to address the ongoing issue of sex trafficking involving youth in the foster care system. The move was spurred in part by this month's passage of an anti-sex-trafficking ballot measure, which county officials said will shift much of the responsibility for juvenile prostitutes from the criminal justice system to the foster care system.

Of the 174 juveniles arrested on prostitution-related charges in Los Angeles County in 2010, 59% were in the foster care system, according to Probation Department statistics. The department has launched initiatives to address the issue of sex trafficking, including running prevention workshops in juvenile halls.

But underage sex workers may no longer fall under the Probation Department's jurisdiction.

Proposition 35, which imposes tougher penalties on pimps, also includes language that decriminalizes prostitution for minors caught up in the trade — although there is debate about the effects of that change. But officials fear that greater numbers of young people involved in prostitution will become the responsibility of the county Department of Children and Family Services. Department director Philip Browning said his agency is "really unprepared at this point" to handle such an influx.

Browning and others said the department is not empowered to keep children in group homes and other placements against their will, and can't prevent them from running away. Emilio I. Mendoza, a children services' program manager, said many young sex workers fear they will be punished by their pimps if they don't leave foster homes when they have an opportunity do so.

"These kids see themselves as having no way out unless they're in a secure setting," he said.

Probation camps and juvenile halls provide that security. But advocates say the criminal justice system is not the proper setting for young victims of abuse and coercion.

"They should not be treated as the criminal. They are a victim. The pimps should be treated as the criminal and given long prison sentences," said county Supervisor Michael D. Antonovich, who proposed the task force. Antonovich said during Tuesday's meeting that the trafficking issue came to the county board's attention early this year, when they learned that young girls were serving as prostitutes around Staples Center after Lakers games.

The task force includes county children's services, probation and mental health workers as well as law enforcement officials. It will examine the scope of the foster youth prostitution problem and report back with recommendations in six months.

But Lois Lee, founder of a Los Angeles-based, 24-bed shelter for child sex workers called Children of the Night, said she is skeptical of the claim that kids in the foster system are particularly vulnerable to sex trafficking. The majority of the shelter's clients were under the legal guardianship of their parents when they arrived, according to the organization's 2011 annual report.

"They're kids that [the Department of Children and Family Services] left behind in the first place," Lee said.

abby.sewell@latimes.com

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'Dancing With the Stars: All Stars' champ crowned

LOS ANGELES (AP) — She was dissed on "The Bachelor" and came in third place during her first stint on "Dancing With the Stars," but Melissa Rycroft is now a winner.

The reality TV star and her professional dance partner, Tony Dovolani, were named the champions Tuesday on ABC's "Dancing With the Stars: All Stars."

The pair beat out fellow finalists (and former champs) actress Kelly Monaco and Olympian Shawn Johnson to claim the sparkly mirror-ball trophy.

Fellow contestants on the show's first "all-star" season hoisted the new winners into the air as confetti rained down inside the "Dancing With the Stars" ballroom.

On the eve of the final competition, Rycroft said she felt confident and excited.

"I want to feel like a champion," she said.

Tuesday's two-hour season finale featured performances by the three finalists and each of the returning cast members: actors Pamela Anderson, Sabrina Bryan, Kirstie Alley and Gilles Marini; singers Joey Fatone and Drew Lachey; race car driver Helio Castroneves; reality TV star Bristol Palin; Olympic skater Apolo Anton Ohno; and football star Emmitt Smith.

Six of those contestants — Johnson, Monaco, Lachey, Ohno, Smith and Castroneves — were previous "Dancing" winners.

Rycroft and Dovolani came into the final contest with a pair of perfect scores. Those points were combined with viewer votes and a last set of judges' scores for an "instant dance" for which they had less than an hour to prepare.

Rycroft was a contestant on "The Bachelor" in 2009 and first appeared on "Dancing With the Stars" that same year. The 29-year-old also starred in a reality series earlier this year, "Melissa & Tye," about her marriage to Tye Strickland and their move to Hollywood so she could pursue an entertainment career.

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Online:

http://beta.abc.go.com/shows/dancing-with-the-stars/index

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Amid Hurricane Sandy, a Race to Get a Liver Transplant

It was the best possible news, at the worst possible time.

The phone call from the hospital brought the message that Dolores and Vin Dreeland had long hoped for, ever since their daughter Natalia, 4, had been put on the waiting list for a liver transplant. The time had come.

They bundled her into the car for the 50-mile trip from their home in Long Valley, N.J., to NewYork-Presbyterian Morgan Stanley Children’s Hospital in Manhattan. But it soon seemed that this chance to save Natalia’s life might be just out of reach.

The date was Sunday, Oct. 28, and Hurricane Sandy, the worst storm to hit the East Coast in decades, was bearing down on New York. Airports and bridges would soon close, but the donated organ was in Nevada, five hours away. The time window in which a plane carrying the liver would be able to land in the region was rapidly closing.

In a hospital room, Natalia watched cartoons. Her parents watched the clock, and the weather. “Our anxiety was through the roof,” Mrs. Dreeland said. “It just made your stomach into knots.”

The Dreelands, who are in their 60s, became Natalia’s foster parents in 2008 when she was 7 months old, and adopted her just before she turned 2. They have another adopted daughter, Dorothy Jane, who is 17.

Natalia is a “smart little cookie” who loves school and dressing up Alice, her favorite doll, her mother said. At age 3, Natalia used the word “discombobulated” correctly, Mr. Dreeland said.

Natalia’s health problems date back several years. Her gallbladder was taken out in 2010, and about half her liver was removed in 2011. The underlying problem was a rare disease, Langerhans cell histiocytosis. It causes a tremendous overgrowth of a type of cell in the immune system and can damage organs. Drugs can sometimes keep it in check, but they did not work for Natalia.

In her case, the disease struck the bile ducts, which led to progressive liver damage. “She would have eventually gone into liver failure,” said Dr. Nadia Ovchinsky, a pediatric liver transplant specialist at NewYork-Presbyterian. “And she demonstrated some signs of early liver failure.”

The only hope was a transplant.

Dr. Tomoaki Kato, Natalia’s surgeon, knew that the liver in Nevada was a perfect match for Natalia in the two criteria that matter most: blood type and size. The deceased donor was 2 years old, and though Natalia is nearly 5, she is small for her age. Scar tissue from her previous operations would have made it very difficult to fit a larger organ into her abdomen.

Though Dr. Kato had considered transplanting part of an adult liver into Natalia, a complete organ from a child would be far better for her. But healthy organs from small children do not often become available, Dr. Kato said. This was a rare opportunity, and he was determined to seize it.

But as the day wore on, the odds for Natalia grew slimmer. The operation in Nevada to remove the liver was delayed several times.

At many hospitals, surgery to remove donor organs is done at the end of the day, after all regularly scheduled operations. The Nevada hospital had a busy surgical schedule that day, made worse by a trauma case that took priority.

At the hospital in New York, Tod Brown, an organ procurement coordinator, had alerted a charter air carrier that a flight from Nevada might be needed. That company in turn contacted West Coast carriers to pick up the donated liver and fly it to New York.

Initially, two carriers agreed, but then backed out. Several other charter companies also declined.

Mr. Brown told Dr. Kato that they might have to decline the organ. Dr. Kato, soft-spoken but relentless, said, “Find somebody who can fly.”

Dr. Kato used to work in Miami, where pilots found ways to bypass hurricanes to deliver organs. Even during Hurricane Katrina, his hospital performed transplants.

“I asked the transplant coordinators to just keep pushing,” he said.

Mr. Brown said, “Dr. Kato knew he was going to get that organ, one way or another.”

As the trajectory of the storm became clearer, one of the West Coast charter companies agreed to attempt the flight. The plan was to land at the airport in Teterboro, N.J. The backup was Newark airport, and the second backup was Albany, from where an ambulance would finish the trip.

The timing was critical: organs deteriorate outside the body, and ideally a liver should be transplanted within 12 hours of being removed.

Early Monday, as the storm whirled offshore, the plane landed at Teterboro. Soon a nurse rushed to tell the Dreelands that she had just seen an ambulance with lights and sirens screech up to the hospital. Someone had jumped out carrying a container.

At about 5 a.m., the couple kissed Natalia and saw her wheeled off to the operating room.

Three weeks later, she is back home, on the mend. The complicated regimen of drugs that transplant patients need is tough on a child, but she is getting through it, her father said.

Recently, Mr. Dreeland said, he found himself weeping uncontrollably during a church service for the family of the child who had died. “Their child gave my child life,” he said.

Though only time will tell, because the histiocytosis appeared limited to Natalia’s bile ducts and had not affected other organs, her doctors say there is a good chance that the transplant has cured her.

This article has been revised to reflect the following correction:

Correction: November 28, 2012

Because of an editing error, a picture caption with an article on Tuesday about a girl who received a liver transplant during Hurricane Sandy misspelled the surname of the girl’s family. As the article correctly noted, it is Dreeland, not Vreeland.

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Judge orders tobacco companies to say they lied about smoking risk

WASHINGTON — A federal judge ordered tobacco companies to publish corrective statements that say they lied about the dangers of smoking and that disclose smoking's health effects, including the death on average of 1,200 people a day.

U.S. District Judge Gladys Kessler previously had said she wanted the industry to pay for corrective statements in various types of advertisements. But Tuesday's ruling was the first time she had specified what the statements will say.

Each corrective ad is to be prefaced by a statement that a federal court has concluded that the defendant tobacco companies "deliberately deceived the American public about the health effects of smoking." Among the required statements are that smoking kills more people than murder, AIDS, suicide, drugs, car crashes and alcohol combined, and that "secondhand smoke kills over 3,000 Americans a year."

The corrective statements are part of a case the government brought in 1999 under the Racketeer Influenced and Corrupt Organizations Act. Kessler ruled in that case in 2006 that the nation's largest cigarette makers concealed the dangers of smoking for decades, and said she wanted the industry to pay for "corrective statements" in various types of ads, both broadcast and print. The Justice Department proposed corrective statements, which Kessler used as the basis for some of the ones she ordered Tuesday.

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Egypt president meets judges, fails to 'contain crisis'

CAIRO — President Mohamed Morsi suggested Monday that he would scale back broad powers he assumed last week but failed to appease Egypt's judiciary, which would still lack oversight of some institutions including the Islamist-led assembly drafting a new constitution.

Morsi and senior judges met for nearly five hours to discuss differences resulting from the president's declaration that his office was free from judicial review. Morsi told judges that the decree was meant to be temporary, and mainly aimed at shielding the long-troubled constitutional assembly from any judicial attempt to disband it.

Presidential spokesman Yasser Ali said after the meeting that Morsi's decree was not designed to "infringe" on the judiciary, suggesting not all of the president's actions would be immune from court review. The Supreme Judicial Council on Saturday condemned Morsi's expanded powers as an "unprecedented attack" on the courts. And Monday's talks did not seem to soften the sentiment of some council members.

"Our meeting with the president has failed to contain the crisis," Abdelrahman Bahloul, a member of the judicial council, told the newspaper Al Masry al Youm. "The statement issued by the presidency is frail and does not represent the members of the council."

The Judges Club, a separate legal organization, also was not satisfied that Morsi had scaled back enough of his authority. It called on its members to continue a partial strike in Alexandria and other cities. Ziad Akl, a political analyst, said Morsi's negotiations with the judges were a move to show the public he's not a dictator, "but, in reality, his declaration has not changed."

The talks in the presidential palace did not stop anti-Morsi demonstrations in Tahrir Square on Monday. But in a sign tensions may be easing, the Muslim Brotherhood, which Morsi helped lead until his inauguration in June, announced it was canceling a scheduled demonstration Tuesday to avoid bloodshed and possible clashes with Morsi opponents.

The consequences of the nation's restiveness played out as Morsi and the judges met Monday, with mourners turning out to bury two boys from opposite political sides who were killed in recent clashes: a 16-year-old antigovernment protester reportedly shot with a rubber bullet near Tahrir Square and a 15-year-old struck by a stone when a crowd attacked an office of the Brotherhood's Freedom and Justice Party in the Nile Delta.

"The presidency mourns two of the nation's finest young men," Morsi said in a statement.

But the images of two funerals made it clear that Morsi and the Brotherhood, although still Egypt's dominant political forces, miscalculated the depth of public anger that has bristled since last year's overthrow of longtime autocrat Hosni Mubarak and subsequent government setbacks, including judicial action disbanding the Islamist-led parliament.

Last month, Morsi, who for months has held wide executive and legislative powers, attempted to fire Prosecutor-General Abdel Meguid Mahmoud, only to retreat after a backlash from judges. His most recent decree to hold his office above judicial oversight struck many as another ill-conceived bid to consolidate his authority and advance an Islamist agenda.

Morsi contended that his intent was to prevent Mubarak-era judges from disrupting the country's political transition. Many Egyptians, including opposition figures, are suspicious of the courts, Mahmoud in particular. But Morsi's unilateral decree echoed the strongman tactics of his predecessor.

One of the president's biggest challenges is to protect the assembly drafting the constitution, which will open the way for new parliamentary elections. In June, the Supreme Constitutional Court, made up mostly of Mubarak-appointed judges, dissolved parliament. The court has since been deciding the fate of the Islamist-led assembly, which Morsi feared would also be disbanded.

Activists, liberals, women and non-Muslims have boycotted the assembly, saying that it is too focused on sharia, or Islamic law, which could limit civil rights. Protesters in Tahrir Square said they will continue their demonstrations until Morsi retracts more of his power.

Jaber Nassar, a legal expert quoted on state TV, said Morsi's meeting with the judges showed that he remains adamant on keeping broad authority. He called Morsi's announcement Monday "simply a political statement meant to curb protests against" his decree.

jeffrey.fleishman@latimes.com

Abdellatif is a special correspondent.

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Letters: Cycle of Birth and Death (1 Letter)

To the Editor:

Re “Amid Cosmic Fatigue, Scarcely a Star Is Born” (Out There, Nov. 20): Though one may bemoan the rapidly declining birthrate of stars, the inescapable fact is that everything ends. People live for about 80 years, but any one of us could die tomorrow. As for our species, a cosmic impact causing mass extinctions like that of the dinosaurs occurs every 100 million years or so, although we may extinguish ourselves long before that through war or by destroying our environment.

Our planet will be incinerated in about 5 billion years when our Sun, in its own death throes, becomes a red giant. And our Milky Way galaxy will collide and merge with Andromeda in 3 to 4 billion years. Even the universe itself will end in either fire or ice, depending on whether its expansion continues forever, causing a “big rip,” or is reversed, resulting in a “big crunch.”

Happy holidays!

Stephen A. Silver

San Francisco

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Cyber Monday shoppers look for online deals, many while at work

Retail reporter Shan Li and consumer columnist David Lazarus talk with Trae Bodge, senior editor at Retailmenot.com Insider about Cyber Monday.

Consumers hopped online for some more Internet shopping on Cyber Monday after last week's post-Thanksgiving Black Friday frenzy came to a close.

Many started early this year: Online spending on Black Friday topped $1 billion for the first time as some shoppers turned to their computers instead of braving the crowds in person.

Cyber Monday is "the Super Bowl of online shopping," said Jonathan Johnson, president of bargain site Overstock.com.

As of late afternoon, the site's traffic was up compared with last year's Cyber Monday, he said, but it was too early to predict how the entire day's sales would shake out. In the last few years, he said, Cyber Monday shoppers with high-speed Web access have started browsing Overstock at home after a day at the office.

"It used to be during the work hours that people shopped the most," Johnson said. "Now, it's a big hump in the middle of the day during work hours, then slows down during the commute home, and the biggest hump is at night."

This Cyber Monday, up to 129 million consumers were expected to hit Web merchants to take advantage of discounts, promotions and free shipping, according to the National Retail Federation.

Some of them, just returning to work after Thanksgiving, indulged right at their desks.

"People at work already take care of personal business like online banking. During the holidays they shop and buy gifts," said Andrew Lipsman, vice president of industry analysis at research firm ComScore Inc. "People can also shop without family members looking over their shoulder and kids snooping around to see what they're getting."

Nancy Lu, 28, of Los Angeles' Koreatown planned to surreptitiously browse the websites of favorite stores such as Macy's and J. Crew in the hopes of scoring some bargains for herself and her family. The personal assistant said she was hoping to get holiday shopping done early this year.

"I'm usually the person at the malls two days before Christmas trying to find something for everyone," she said. "If I find really good deals on Monday then I can relax later on."

For the last two years, Cyber Monday has been the year's biggest online spending day, Lipsman said. That's up from 12th place in 2006. Last year, Cyber Monday sales totaled $1.3 billion, and ComScore predicted they could reach $1.5 billion this year.

More consumers are using laptops, smartphones and tablet computers to do their shopping this holiday season.

On Black Friday, 57.3 million Americans visited an online retail site, up 18% from a year earlier, ComScore said. The National Retail Federation said that for the first time ever, more than half of shoppers over the long Thanksgiving weekend said they checked out stores online.

Cyber Monday, its name coined in 2005, quickly gained traction as shoppers took advantage of work computers with faster Internet connections, Lipsman said. Now, he said, at-work transactions account for about half the dollars spent at online retailers that day.

Nearly half of workers plan to do some of their shopping online while at the office this holiday season, according to a survey from CareerBuilder. More women than men said they had shopped at work in the past: 43% compared with 36%.

The retailer with the most-visited site on Black Friday was e-commerce giant Amazon.com Inc., followed by Wal-Mart Stores Inc., Best Buy Co., Target Corp. and Apple Inc., ComScore said. Amazon is the nation's largest online-only retailer.

Nearly all merchants with a Web presence are participating in the flurry of promotions and discounts surrounding Cyber Monday, said Trae Bodge, a shopping expert at deals site RetailMeNot.

She said some people admit to devoting three or more hours to shopping while at work.

That's good news for retailers, many of which will continue to roll out deals online this week.

shan.li@latimes.com

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Survey finds lots of unused vacation time

As an information technology supervisor at Pitzer College in Claremont, Dennis Crowley had so much work to do last year that he finished 2011 without using nearly five days of paid vacation.

"And to be frank, I was too busy to even realize I was losing time," he said.

Crowley's situation is not unusual. A survey by Harris Interactive Inc. found that by the end of 2012, Americans will leave an average of 9.2 days of vacation unused, up from the average of 6.2 days in 2011.

Nearly 90% of those questioned said they would take more leisure trips on their vacation if they had the time and money to do so, according to the survey of more than 2,000 U.S. adults that was commissioned by travel website Hotwire.

Hotwire has a selfish reason for pointing out the survey results: The travel website says vacationers can save lots of money by traveling between Thanksgiving and Christmas. During the holiday gap, hotel rates drop 33% in Boston, 28% in San Francisco and 26% in Seattle, compared with the peak summer travel season, according to the website.

Crowley has learned his lesson. He said he is keeping closer tabs on his vacation time this year. But instead of using his accrued vacation time to travel, he said is spending more time with his children.

Airline food getting more healthful

On the nation's airlines, the days of free lunch are long over. That also goes for breakfast, dinner and snacks. Once complimentary, most airline food now comes with a price tag.

But there is some good news about what you get to eat on commercial airlines: It is getting more healthful.

That's the assessment of Charles Platkin, a professor of nutrition at the City University of New York's Hunter College who has tested and ranked airline foods off and on since 2000. With few exceptions, Platkin said most airlines now offer at least one healthful meal alternative on their menu.

"It's actually moving in a good direction," he said. "It's been an ebb and flow, but the overall trend is positive."

Platkin gave the top ranking this year to Virgin America, noting that the airline based in California offers low-calorie options such as roasted pear and arugula salad, a "protein plate" with hummus and whole wheat pita bread, plus oatmeal for breakfast. He gave the airline 41/4 stars out of a maximum of five stars.

At the bottom of the list was Allegiant Air, with a rating of only one and a half stars. Platkin said the Las Vegas airline "made it clear that their foods were not healthy. It shows."

The airline's snacks include M&Ms, Oreo Brownies and Pringles chips.

Air Canada and Alaska Airlines came in second and third, respectively, in Platkin's ranking. The other big airlines — including United, American, Delta and US Airways — ranked in the middle of the list.

Platkin does not eat the food on every airline. "I don't have that kind of time," he said. "I have classes to teach."

Instead, he collects and reviews lists of food items, including the ingredients and calorie numbers, from the airlines.

TSA defends stopping traveler over watch

A traveler was stopped by federal security officers at the Oakland International Airport this month because of an unusual wristwatch he was wearing.

When word got out about the incident, critics of the Transportation Security Administration blasted the agency, saying it was another example of the TSA overreacting.

In hopes of stifling the uproar, the TSA released a photo of the watch last week. This is no ordinary timepiece. It includes a toggle switch, wires and what look like tiny fuses attached to the wristband.

A TSA explosives detection team determined that the watch was not an explosive device. Still, the Alameda County sheriff's deputies, who were called by the TSA to investigate, arrested the watch owner, Geoffrey McGann, a teacher and artist from Rancho Palos Verdes. He was jailed on suspicion of possession of components to make a destructive device, according to news reports.

The Alameda County district attorney's office declined last week to file charges against McGann.

McGann's attorney accused the TSA of being "hyper-vigilant."

The TSA responded in its blog last week, saying, "Terrorists take everyday items and attempt to manipulate them to make improvised explosive devices. Our officers are trained to look for anomalies such as this one."

hugo.martin@latimes.com

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