Statin intensity and postoperative mortality following open repair of intact abdominal aortic aneurysm.

BackgroundThere is a lack of evidence for the association between intensive statin therapy and outcomes following vascular surgery. The aim of this study was to evaluate the association between perioperative statin intensity and in-hospital mortality following open abdominal aortic aneurysm (AAA) repair.MethodsPatients undergoing open AAA repair between 2009 and 2015 were identified from the Premier Healthcare Database. Statin use was classified into low, moderate and high intensity, based on American College of Cardiology/American Heart Association guidelines. Supratherapeutic intensity was defined as doses higher than the recommended guidelines. Multivariable logistic regression analyses were undertaken to assess the association between statin intensity and postoperative major adverse events and in-hospital mortality.ResultsOf 6497 patients undergoing open AAA repair, 3217 (49·5 per cent) received perioperative statin. Statin users were more likely to present with three or more co-morbidities than non-users (26·5 versus 21·8 per cent; P < 0·001). Unadjusted postoperative mortality was significantly lower in statin users (2·6 versus 6·3 per cent; P < 0·001); however, there was no difference in the risk of developing major adverse events. Multivariable analysis showed that statin use was associated with lower odds of death (odds ratio 0·41, 95 per cent c.i. 0·31 to 0·54). Moderate, high and supratherapeutic statin intensities were not associated with lower odds of death or major adverse events compared with low-intensity statin therapy.ConclusionStatin use is associated with lower odds of death in hospital following open AAA repair. High-intensity statins were not associated with lower morbidity or mortality

TOWARD SUSTAINABLE BEHAVIOUR CHANGE: AN APPROACH FOR CYBER SECURITY EDUCATION TRAINING AND AWARENESS

Effective information security education, training and awareness (SETA) is essential for protecting organisational information resources. Whilst most organisations invest significantly in implementing SETA programs, the number of incidents resulting from employee noncompliance with security policy are increasing. This trend may indicate that many current SETA programs are not as effective as they should be. We argue that existing SETA programs are not optimal in changing employee behaviour to comply with security policy as they lack a theoretical base that can inform and guide the development of SETA programs. This study draws on knowledge from the medical domain on the use of theory to design an intervention to bring about sustainable behaviour change. The paper therefore adopts an intervention design process, based on the behaviour change wheel (BCW) framework, to develop a theory-informed SETA development process. The paper demonstrates the use of BCW in the analysis of the target behaviour and the selection of suitable strategies and techniques to change the target behaviour. The proposed SETA development process provides a sound basis for future empirical work including focus groups and action research

Information Security Policy: A Management Practice Perspective

Considerable research effort has been devoted to the study of Policy in the domain of Information Security Management (ISM). However, our review of ISM literature identified four key deficiencies that reduce the utility of the guidance to organisations implementing policy management practices. This paper provides a comprehensive overview of the management practices of information security policy and develops a practice-based model. The model provides comprehensive guidance to practitioners on the activities security managers must undertake for security policy development and allows practitioners to benchmark their current practice with the models suggested best practice. The model contributes to theory by mapping existing information security policy research in terms of the defined management practices

An Exploratory Study of Current Information Security Training and Awareness Practices in Organizations

Effective information security training and awareness (ISTA) is essential to protect organizational information resources. Our review of industry best-practice guidelines on ISTA exposed two key deficiencies. First, they are presented at a conceptual-level without any empirical evidence of their validity. Second, the guidelines are generic (one size fits all) without consideration of the diversity in organizational contexts where they will be applied. Given these deficiencies in ISTA guidance, this paper reports on the findings of an exploratory study into how ISTA is implemented in different organizational contexts in six organizations. The paper identifies three challenges: the lack of motivational aspects in current ISTA program, the competition for employees’ attention and the difficulty in measuring the effectiveness of ISTA program. Several recommendations and suggestions were outlined to overcome these challenges

Teaching Information Security Management Using an Incident of Intellectual Property Leakage

Case-based learning (CBL) is a powerful pedagogical method of creating dialogue between theory and practice. CBL is particularly suited to executive learning as it instigates critical discussion and draws out relevant experiences. In this paper we used a real-world case to teach Information Security Management to students in Management Information Systems. The real-world case is described in a legal indictment (T-mobile USA Inc v. Huawei Device USA Inc. and Huawei Technologies Co. LTD) alleging theft of intellectual property (trade secrets) and breaches of contract concerning confidentiality and disclosure of sensitive information. The incident concerns a mobile phone testing robot (Tappy) developed by T-mobile USA to automate testing of mobile phones prior to launch. Tmobile alleges Huawei stole the technology by copying the robot’s specifications and stealing parts and software to develop its own testing robot. The incident scenario is interesting as it relates to a business asset that has both digital and physical components that has been compromised through an unconventional cyber-physical attack facilitated by insiders. The scenario sparked an interesting debate among students about the scope and definition of security incidents, the role and structure of the security unit, the utility of compliance-based approaches to security, and the inadequate use of threat intelligence in modern security strategies

Sphingosine 1-phosphate, a potential target in neovascular retinal disease

Neovascular ocular diseases (such as age-related macular degeneration, diabetic retinopathy and retinal vein occlusion) are characterised by common pathological processes that contribute to disease progression. These include angiogenesis, oedema, inflammation, cell death and fibrosis. Currently available therapies target the effects of vascular endothelial growth factor (VEGF), the main mediator of pathological angiogenesis. Unfortunately, VEGF blockers are expensive biological therapeutics that necessitate frequent intravitreal administration and are associated with multiple adverse effects. Thus, alternative treatment options associated with fewer side effects are required for disease management. This review introduces sphingosine 1-phosphate (S1P) as a potential pharmacological target for the treatment of neovascular ocular pathologies. S1P is a sphingolipid mediator that controls cellular growth, differentiation, survival and death. S1P actions are mediated by five G protein-coupled receptors (S1P1-5 receptors) which are abundantly expressed in all retinal and subretinal structures. The action of S1P on S1P1 receptors can reduce angiogenesis, increase endothelium integrity, reduce photoreceptor apoptosis and protect the retina against neurodegeneration. Conversely, S1P2 receptor signalling can increase neovascularisation, disrupt endothelial junctions, stimulate VEGF release, and induce retinal cell apoptosis and degeneration of neural retina. The aim of this review is to thoroughly discuss the role of S1P and its different receptor subtypes in angiogenesis, inflammation, apoptosis and fibrosis in order to determine which of these S1P-mediated processes may be targeted therapeutically

Thermoregulatory and Physiological Responses of Najdi Sheep Exposed to Environmental Heat Load Prevailing in Saudi Arabia

The objective of this study was to evaluate the thermoregulatory and physiological responses of Najdi rams raised under hot summer conditions prevailing in Kingdom Saudi Arabia. The core temperature (Tcore) showed circadian rhythm characterized by biphasic achrophases, which were associated with the feeding times during both seasons. Average daily Tcore was significantly (P<0.05) higher under hot summer conditions. However, the amplitudes of the rhythmic oscillation during winter and summer seasons were 0.85 and 0.56C, respectively. Rectal (Tre) and skin temperatures (Tsk) were significantly (P<0.05) higher under hot summer conditions and exhibited similar patterns during both seasons concurrent with the pattern of temperature humidity index (THI), reaching the maximum values late in the afternoon and the minimum values early in the morning. Respiratory rate (RR) and heart rate (HR) showed the same pattern of the thermal parameters and were significantly (P<0.05) higher under hot summer conditions. Serum concentrations of total protein, globulin, glucose, sodium and chloride were significantly (P<0.05) increased while those of albumin and calcium were decreased under hot summer conditions. The results obtained from this study indicate that hot summer conditions of Saudi Arabia is thermally stressful to Najdi rams. Therefore, Najdi sheep production under such conditions would require environmental and/or nutritional modification to alleviate the impact of heat stress

Coxiella burnetii, the causative agent of Q fever in Saudi Arabia: molecular detection from camel and other domestic livestock

AbstractObjectiveTo detect Coxiella burnetii (C. burnetii) DNA in clinical specimens from camel, goats, cattle and sheep in the Kingdom of Saudi Arabia.MethodsA total of 367 clinical samples including blood, milk, faeces and urine were collected from different livestock and subjected to PCR amplification using primers which amplify transposon-like region and transposase gene.ResultsPositive amplification from both regions was obtained from camel, goats and cattle but not from sheep. A percentage of 10.8% samples yielded positive PCR amplification from both blood and milk, where 15 of 139 blood and 16 of 148 milk samples were positive. Faeces and urine showed higher percentages of positive samples reaching 40.8% and 23.8% respectively.ConclusionsThe preferred route of shedding in camel appeared to be the faeces followed by urine, while that of goats appeared to be the faeces and that of the cattle appeared to be the milk

Quality assurance of Cyberknife robotic stereotactic radiosurgery using an angularly independent silicon detector

Purpose: The aim of this work was to evaluate the use of an angularly independent silicon detector (edgeless diodes) developed for dosimetry in megavoltage radiotherapy for Cyberknife in a phantom and for patient quality assurance (QA). Method: The characterization of the edgeless diodes has been performed on Cyberknife with fixed and IRIS collimators. The edgeless diode probes were tested in terms of basic QA parameters such as measurements of tissue-phantom ratio (TPR), output factor and off-axis ratio. The measurements were performed in both water and water-equivalent phantoms. In addition, three patient-specific plans have been delivered to a lung phantom with and without motion and dose measurements have been performed to verify the ability of the diodes to work as patient-specific QA devices. The data obtained by the edgeless diodes have been compared to PTW 60016, SN edge, PinPoint ionization chamber, Gafchromic EBT3 film, and treatment planning system (TPS). Results: The TPR measurement performed by the edgeless diodes show agreement within 2.2% with data obtained with PTW 60016 diode for all the field sizes. Output factor agrees within 2.6% with that measured by SN EDGE diodes corrected for their field size dependence. The beam profiles\u27 measurements of edgeless diodes match SN EDGE diodes with a measured full width half maximum (FWHM) within 2.3% and penumbra widths within 0.148 mm. Patient-specific QA measurements demonstrate an agreement within 4.72% in comparison with TPS. Conclusion: The edgeless diodes have been proved to be an excellent candidate for machine and patient QA for Cyberknife reproducing commercial dosimetry device measurements without need of angular dependence corrections. However, further investigation is required to evaluate the effect of their dose rate dependence on complex brain cancer dose verification

Causes of elective cesarean delivery on maternal request in Aljouf, Saudi Arabia

Background: Recently observed there is a steadily higher rate of cesarean delivery worldwide mostly due to the increasing number of women requesting an elective cesarean section on maternal request without valid indication. The aim of the study was to determine the causes of elective cesarean delivery on maternal requests in Aljouf Saudi Arabia.Methods: This was a descriptive cross-sectional study and data was evaluated by completing seven questionnaires and interviews with laboratory reports who were admitted for cesarean delivery at the Obstetrics department of Maternity and Children Hospital (MCH) Aljouf, Saudi Arabia from January 2020 to December 2020. A total of 141 Saudi women of age between 18 and over 35 years were enrolled, including those who have singleton pregnancy, no complications during pregnancy, and no medical indication for cesarean delivery.Results: 141 women reported willingness to request cesarean delivery. The mean systolic 120±6.23, diastolic 75±2.45 blood pressure mm of Hg, and fasting blood sugar level 4.1±1.1 mmol/l have been found within the normal limit. The ultrasound (US) confirmed singleton pregnancy without any abnormalities.  Data reveals that common causes of elective cesarean section on maternal request to avoid the episiotomy 77.3%, fear of labor pain 69.5%, trauma to the vagina 79.4%, uncertainty about timing 61.7%, losing a baby during vaginal delivery 54.6%, experience other members 41.8%, the risk for baby 39%, prolapse or incontinence24.1%, unsatisfactory sexual intercourse 17.7% and the undesirable experience of the previous vaginal delivery 12%.Conclusions: Maternal request for cesarean delivery is considered one of the reasons for increasing the rate of cesarean delivery in Saudi Arabia. To avoid the episiotomy and fear of labor pain may strong causes for choosing cesarean delivery