980 research outputs found

    Spinal anesthesia: should everyone receive a urinary catheter?: a randomized, prospective study of patients undergoing total hip arthroplasty.

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    BACKGROUND: The objective of this randomized prospective study was to determine whether a urinary catheter is necessary for all patients undergoing total hip arthroplasty under spinal anesthesia. METHODS: Consecutive patients undergoing total hip arthroplasty under spinal anesthesia were randomized to treatment with or without insertion of an indwelling urinary catheter. All patients received spinal anesthesia with 15 to 30 mg of 0.5% bupivacaine. The catheter group was subjected to a standard postoperative protocol, with removal of the indwelling catheter within forty-eight hours postoperatively. The experimental group was monitored for urinary retention and, if necessary, had straight catheterization up to two times prior to the placement of an indwelling catheter. RESULTS: Two hundred patients were included in the study. There was no significant difference between the two groups in terms of the prevalence of urinary retention, the prevalence of urinary tract infection, or the length of stay. Nine patients in the no-catheter group and three patients in the catheter group (following removal of the catheter) required straight catheterization because of urinary retention. Three patients in the catheter group and no patient in the no-catheter group had development of urinary tract infection. CONCLUSIONS: Patients undergoing total hip arthroplasty under spinal anesthesia appear to be at low risk for urinary retention. Thus, a routine indwelling catheter is not required for such patients

    Cybersecurity Risk Assessment Framework for Externally Exposed Energy Delivery Systems

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    Securing the energy delivery system (EDS) from complex, nonlinear, and evolving cyber threats requires a complex set of changing and interwoven classes of technologies, policies, relationships, and personnel. One key area in this technological milieu is assessment methodologies to compare information, gathered by a variety of means, about networked devices with publicly known possible threat information about said devices. This information is used to generate risk-based characterizations that allow for the adjudication and proper corresponding management action chains to be assigned. \color{blue}To address the current cybersecurity needs in the operational technology (OT) domain, we developed a novel relative-risk assessment framework and a software application called MEEDS that can detect exposed OT systems. This paper presents the detailed architecture of relative-risk assessment framework methodology and its integral role in the MEEDS software. The efficacy of the presented framework is demonstrated by testing with the real-world systems and vulnerabilities pertaining to the industrial control systems (ICS) in critical infrastructures

    Extremely high He isotope ratios in MORB-source mantle from the proto-Iceland plume

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    The high <sup>3</sup>He/<sup>4</sup>He ratio of volcanic rocks thought to be derived from mantle plumes is taken as evidence for the existence of a mantle reservoir that has remained largely undegassed since the Earth's accretion. The helium isotope composition of this reservoir places constraints on the origin of volatiles within the Earth and on the evolution and structure of the Earth's mantle. Here we show that olivine phenocrysts in picritic basalts presumably derived from the proto-Iceland plume at Baffin Island, Canada, have the highest magmatic <sup>3</sup>He/<sup>4</sup>He ratios yet recorded. A strong correlation between <sup>3</sup>He/<sup>4</sup>He and <sup>87</sup>Sr/<sup>86</sup>Sr, <sup>143</sup>Nd/<sup>144</sup>Nd and trace element ratios demonstrate that the <sup>3</sup>He-rich end-member is present in basalts that are derived from large-volume melts of depleted upper-mantle rocks. This reservoir is consistent with the recharging of depleted upper-mantle rocks by small volumes of primordial volatile-rich lower-mantle material at a thermal boundary layer between convectively isolated reservoirs. The highest <sup>3</sup>He/<sup>4</sup>He basalts from Hawaii and Iceland plot on the observed mixing trend. This indicates that a <sup>3</sup>He-recharged depleted mantle (HRDM) reservoir may be the principal source of high <sup>3</sup>He/<sup>4</sup>He in mantle plumes, and may explain why the helium concentration of the 'plume' component in ocean island basalts is lower than that predicted for a two-layer, steady-state model of mantle structure

    Safety and efficacy of fluticasone propionate in the topical treatment of skin diseases

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    Fluticasone propionate - the first carbothioate corticosteroid - has been classified as a potent anti-inflammatory drug for dermatological use. It is available as 0.05% cream and 0.005% ointment formulations for the acute and maintenance treatment of patients with dermatological disorders such as atopic dermatitis, psoriasis and vitiligo. This glucocorticoid is characterized by high lipophilicity, high glucocorticoid receptor binding and activation, and a rapid metabolic turnover in skin. Although skin blanching following fluticasone propionate exceeds that of corticosteroids of medium strength, several clinical trials demonstrate a low potential for cutaneous and systemic side-effects, even in difficult-to-treat areas like the face, the eyelids and intertriginous areas. Even among paediatric patients with atopic dermatitis, fluticasone propionate proved to be safe and effective. These pharmacological and clinical properties are reflected by the high therapeutic index of this glucocorticoid

    Beam characterisation and machine development at VELA

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    An overview is presented of developments on VELA (Versatile Electron Linear Accelerator), an RF photoinjector with two user stations (beam areas BA1, and BA2) at Daresbury Laboratory. Numerous machine development, commissioning, beam characterisation and user experiments have been completed in the past year. A new beamline and a dedicated multi-purpose chamber have been commissioned in BA1 and the first experiments performed. A number of measures have been taken to improve the stability of machine by mitigating problems with a phase drift, laser beam transport drift and a coherent beam oscillation. The 6D phase space of the electron beam has been characterised through quadrupole scans, transverse tomography and with a transverse deflecting cavity
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