Resilience risk controls and the Netflix Unified Resilience Framework.

This paper argues that programmes built around existing enterprise resilience/business continuity management (ER/BCM) metrics provide a low return on investment, which ultimately can damage the perceived value of the industry. It goes on to introduce a new approach to creating and measuring ER/BCM programmes that provides a much greater level of return for a smaller investment. Finally, it describes how this new approach can be used to satisfy traditional programme requirements, and provides a shared framework for emerging uses, such as cyber resilience.

Positive and negative stimuli in relation to tennis players' reaction time.

Research has indicated that negative and positive thoughts may affect sport performance. The purpose of this analogue study was to assess whether negative and positive stimuli influenced tennis performance similar to positive and negative thought. The reaction time (RT) of 40 competitive tennis players was measured during a timed response to a tennis ball rotating in a topspin, sidespin, or backspin direction on the computer screen. Immediately prior to the ball presentation, a phrase (accessory stimulus) was presented visually or aurally. The accessory stimulus provided either positive (e.g., 'nice shot') or negative information (e.g., 'bad shot') followed by the subject's name. Analysis showed a main effect only for the type of spin. The slowest RT occurred when responding to a tennis ball rotating in a backspin direction. A significant interaction was found for the sensory modality (audition vs vision) and polarity (positive vs negative) of the accessory stimulus. RT to negative stimuli was slowest when the accessory stimulus was presented aurally. The quickest RT to positive stimuli occurred when the accessory stimulus was presented aurally. These results indicated that negative and positive stimuli, when presented aurally, affected performance as positive and negative thoughts measured in other studies. Not measured was whether negative and positive stimuli actually produce the negative and positive thoughts, respectively, that have been reported to affect performance.

The nicotinic antagonist mecamylamine preferentially inhibits cocaine vs. food self-administration in rats.

Nicotinic acetylcholine systems play important roles in addiction, and nicotinic receptor stimulation stimulates dopamine release while the nicotinic antagonist mecamylamine reduces it. Reid et al. [Neuropsychopharmacology 20 (1999) 297.] recently found in human cocaine addicts that mecamylamine reduced cue-elicited cocaine craving. The current study assessed the impact of mecamylamine on cocaine self-administration in rats. Female Sprague-Dawley rats (N=7) were implanted with intravenous (iv) catheters and trained to lever press for cocaine (0.32 mg/kg/infusion FR-1 with a 60-s timeout) in 45-min sessions. After 2 weeks of training, the rats were injected with saline or mecamylamine (1, 2, or 4 mg/kg sc) 10 min before the session. They received the same dose for 1 week with 1 week of uninjected testing between doses. Mecamylamine, compared to saline, significantly (P<.05) reduced the number of cocaine infusions per session with each of these doses. This effect did not appear to be due to a generalized reduction in behavioral activity. Another set of female Sprague-Dawley rats (N=8) were trained to lever press for food reinforcement. In these rats, the 1 and 2-mg/kg mecamylamine doses had no effect on food self-administration. Significant reductions in food self-administration were not seen unless the high dose of 4-mg/kg mecamylamine was used. Nicotinic antagonist treatment reduces cocaine self-administration in rats at doses that do not cause generalized effects on food-reinforced responding. Nicotinic antagonistic treatment may be a useful new approach to treat cocaine addiction.

Closed fractures of the tibial shaft. A meta-analysis of three methods of treatment.

We reviewed the literature to determine the clinical outcomes of the treatment of closed fractures of the tibial shaft with immobilization in a cast, open reduction with internal fixation, or fixation with an intramedullary rod. We reviewed 2372 reports of comparative trials and uncontrolled studies of series of patients published between 1966 and 1993. Nineteen reports, involving six controlled trials and twenty-seven groups of patients, met our inclusion criteria. A structured questionnaire was used to assess the quality of the literature in terms of the experimental design and the method of assessment of outcome. Outcomes from controlled trials were summarized with odds ratios and risk differences, and outcomes from case series were summarized by the medians of the reported results. The studies that were reviewed generally had few subjects and were poorly designed. The comparative trials showed treatment with a cast to be associated with a lower rate of superficial infection than open reduction and internal fixation (mean difference, -5.81 per cent; p = 0.02) and open reduction and internal fixation to be associated with a higher rate of union by twenty weeks than treatment with a cast (mean difference, -18.07 per cent; p = 0.008). There were no other significant associations. There were insufficient data for us to evaluate any aspect of functional status, level of pain, or other patient-reported outcomes of any of the methods of treatment. The results of the present review suggest that the data from the published literature are inadequate for decision-making with regard to the treatment of closed fractures of the tibia.

Librarian participation in meta-analysis projects.

Meta-analysis is an epidemiological and statistical tool used to combine the results of independent studies and synthesize their conclusions for the purpose of evaluating therapeutic effectiveness, determining procedural efficacy, or providing a basis for development of treatment protocols. Meta-analysis also may be described as "studying the studies." The process, however defined, requires access to a large quantity of medical literature and presents new opportunities for medical librarians to use their data gathering skills. At Dartmouth Hitchcock Medical Center, a librarian assists with the identification, location, and review of literature in support of meta-analysis projects done by the Technology Assessment Program. Comprehensive literature searches are performed and references with abstracts, indexing terms, and other elements of the unit record are downloaded, converted, and presented as records in a database program. References are then analyzed, decisions are made about their relevance, and article copies are acquired for further analysis.

Clinical efficacy of SPECT bone imaging for low back pain.

METHODS: We conducted a comprehensive structured review of the literature, analyzing 940 citations from 1966 through September 1993 and completed a narrative review. We also attempted quantitative synthesis of the accuracy of SPECT evaluation of low back pain. RESULTS: We found thirteen reports on accuracy. Only three provided a reasonable gold standard reference test and allowed the calculation of sensitivity and specificity. There is weak evidence that SPECT is useful in: (a) detecting pseudarthroses after failed spinal fusion, (b) evaluating young patients with back pain and (c) distinguishing benign from malignant lesions in cancer patients. SPECT has not been sufficiently studied in any other setting. We found no reports on the clinical outcome of SPECT or its cost-effectiveness. CONCLUSION: The decision to use SPECT in most patients with low back pain cannot be supported by clinical trials. Its effect on clinical management and cost-effectiveness are unknown. The medical community should mount a large-scale, prospective evaluation of SPECT in low back pain.

Effect of plasma proteins and buffer in flushing solutions on rat kidney preservation by cold storage.

The isolated rat kidney perfused at 37 C was used to evaluate the effect of adding plasma proteins to, and varying osmolality of, cold-storage flushing solutions with or without buffering. Addition of albumin improved immediate poststorage kidney function (glomerular filtration rate [GFR], fractional sodium reabsorption, and fractional protein clearance) of all flushing solutions tested after 6 hr and 24 hr of storage. At 6 hr, these improvements also correlated with less weight gain. Flushing solutions containing citrate and sulfate produced significantly better return of function after 24 hr of cold storage than Krebs' or Collins'-derived solutions. Osmolality was unimportant with solutions containing citrate. Collins' solution with reduced MgSO4 yielded better poststorage function than conventional solution. An all-citrate isotonic solution buffered with 15 mmol THAM preserved poststorage function at 48 hr better than a similarly buffered solution containing both citrate and sulfate. Loss of dry weight during storage and subsequent perfusion appeared to correlate, in these experiments, with loss of poststorage function. The isolated rat kidney provides discrimination among various flushing solutions. The technique might be useful in the assay of additional variables that might affect the quality of kidney preservation.

Studies of the spatial distribution of firearms discharge residues.

Fingerprint lifting tape has been applied to the lifting of firearms discharge residue from various surfaces. Lifting efficiencies from coarse fabric ranged from 30 to 70%. Use of the technique has been demonstrated in identifying a bullet hole and in measuring residue patterns on floor and firing hand surfaces. In hand lifts it has been shown that autoradiography alone does not uniquely distinguish the hand of someone who has fired a revolver from the hand of someone who has not. Neutron activation analysis of lifts from selected hand areas may, however, provide such a distinction.