14,909 research outputs found

    Multicentre observational cohort study of NSAIDs as risk factors for postoperative adverse events in gastrointestinal surgery

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    Introduction: Non-steroidal anti-inflammatory drugs (NSAIDs) are recommended as postoperative analgesia by the Enhanced Recovery After Surgery Society. Recent studies have raised concerns that NSAID administration following colorectal anastomosis may be associated with increased risk of anastomotic leak. This multicentre study aims to determine NSAIDs' safety profile following gastrointestinal resection. Methods and analysis: This prospective, multicentre cohort study will be performed over a 2-week period utilising a collaborative methodology. Consecutive adults undergoing open or laparoscopic, elective or emergency gastrointestinal resection will be included. The primary end point will be the 30-day morbidity, assessed using the Clavien-Dindo classification. This study will be disseminated through medical student networks, with an anticipated recruitment of at least 900 patients. The study will be powered to detect a 10% increase in complication rates with NSAID use. Ethics and dissemination: Following the Research Ethics Committee Chairperson's review, a formal waiver was received. This study will be registered as a clinical audit or service evaluation at each participating hospital. Dissemination will take place through previously described novel research collaborative networks

    A comparison of single-cycle versus multiple-cycle proof testing strategies

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    An evaluation of single-cycle and multiple-cycle proof testing (MCPT) strategies for SSME components is described. Data for initial sizes and shapes of actual SSME hardware defects are analyzed statistically. Closed-form estimates of the J-integral for surface flaws are derived with a modified reference stress method. The results of load- and displacement-controlled stable crack growth tests on thin IN-718 plates with deep surface flaws are summarized. A J-resistance curve for the surface-cracked configuration is developed and compared with data from thick compact tension specimens. The potential for further crack growth during large unload/reload cycles is discussed, highlighting conflicting data in the literature. A simple model for ductile crack growth during MCPT based on the J-resistance curve is used to study the potential effects of key variables. The projected changes in the crack size distribution during MCPT depend on the interactions between several key parameters, including the number of proof cycles, the nature of the resistance curve, the initial crack size distribution, the component boundary conditions (load vs. displacement control), and the magnitude of the applied load or displacement. The relative advantages of single-cycle and multiple-cycle proof testing appear to be specific, therefore, to individual component geometry, material, and loading

    A five year outbreak of methicillin-susceptible Staphylococcus aureus phage type 53,85 in a regional neonatal unit

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    We identified a 5-year outbreak of a methicillin-susceptible Staphylococcus aureus (MSSA) strain, affecting 202 babies on a neonatal unit, by routine weekly phage typing all S. aureus isolates. Multiple staged control measures including strict emphasis on hand hygiene, environmental and staff surveillance sampling, and application of topical hexachlorophane powder failed to end the outbreak. S. aureus PT 53,85 (SA5385) was found on opened packs of Stomahesive®, used as a neonatal skin protectant. Only following the implementation of aseptic handling of Stomahesive®, and the use of topical mupirocin for staff nasal carriers of SA5385, and for babies colonized or infected with S. aureus, did the isolation rate of SA5385 decline. DNA fingerprinting indicated that [gt-or-equal, slanted]95% of SA5385 isolates were clonal. In vitro death rates of SA5385 on Stomahesive® with human serum were significantly lower than on Stomahesive® alone (P = 0·04), and on cotton sheet with serum (P = 0·04), highlighting the potential of this material as a survival niche. Phage typing remains a valuable, inexpensive and simple method for monitoring nosocomial MSSA infection

    First scattered light images of debris disks around HD 53143 and HD 139664

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    We present the first scattered light images of debris disks around a K star (HD 53143) and an F star (HD 139664) using the coronagraphic mode of the Advanced Camera for Surveys (ACS) aboard the Hubble Space Telescope (HST). With ages 0.3 - 1 Gyr, these are among the oldest optically detected debris disks. HD 53143, viewed ~45 degrees from edge-on, does not show radial variation in disk structure and has width >55 AU. HD 139664 is seen close to edge-on and has belt-like morphology with a dust peak 83 AU from the star and a distinct outer boundary at 109 AU. We discuss evidence for significant diversity in the radial architecture of debris disks that appears unconnected to stellar spectral type or age. HD 139664 and possibly the solar system belong in a category of narrow belts 20-30 AU wide. HD 53143 represents a class of wide disk architecture with characteristic width >50 AU.Comment: 7 pages, 3 figure

    Systems development methods and usability in Norway: An industrial perspective

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    This is the post-print version of the Article. The official published version can be accessed from the link below - Copyright @ 2007 Springer Berlin HeidelbergThis paper investigates the relationship between traditional systems development methodologies and usability, through a survey of 78 Norwegian IT companies. Building on previous research we proposed two hypotheses; (1) that software companies will generally pay lip service to usability, but do not prioritize it in industrial projects, and (2) that systems development methods and usability are perceived as not being integrated. We find support for both hypotheses. Thus, the use of systems development methods is fairly stable, confirming earlier research. Most companies do not use a formal method, and of those who do, the majority use their own method. Generally, the use of methods is rather pragmatic: Companies that do not use formal methods report that they use elements from such methods. Further, companies that use their own method import elements from standardised methods into their own
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