As the sophistication of cyber-attacks increases, understanding how to defend critical infrastructure systems—energy production, water, gas, and other vital systems—becomes more important, and ...heavily mandated. Industrial Network Security, Second Edition arms you with the knowledge you need to understand the vulnerabilities of these distributed supervisory and control systems. The book examines the unique protocols and applications that are the foundation of industrial control systems, and provides clear guidelines for their protection. This how-to guide gives you thorough understanding of the unique challenges facing critical infrastructures, new guidelines and security measures for critical infrastructure protection, knowledge of new and evolving security tools, and pointers on SCADA protocols and security implementation. * All-new real-world examples of attacks against control systems, and more diagrams of systems * Expanded coverage of protocols such as 61850, Ethernet/IP, CIP, ISA-99, and the evolution to IEC62443 * Expanded coverage of Smart Grid security * New coverage of signature-based detection, exploit-based vs. vulnerability-based detection, and signature reverse engineering
This book examines the unique protocols and applications that are the foundation of industrial control systems, and provides clear guidelines for their protection. It provides a thorough ...understanding of the unique challenges facing critical infrastructures, new guidelines and security measures for critical infrastructure protection, knowledge of new and evolving security tools, and pointers on SCADA protocols and security implementation. Topics Include: all-new real-world examples of attacks against control systems, and more diagrams of systems; expanded coverage of protocols such as 61850, Ethernet/IP, CIP, ISA-99, and the evolution to IEC62443, smart grid security; signature-based detection, exploit-based vs. vulnerability-based detection, and signature reverse engineering. --
About 10% of all protein kinases are predicted to be enzymatically inactive pseudokinases, but the structural details of kinase inactivation have remained unclear. We present the first structure of a ...pseudokinase, VRK3, and that of its closest active relative, VRK2. Profound changes to the active site region underlie the loss of catalytic activity, and VRK3 cannot bind ATP because of residue substitutions in the binding pocket. However, VRK3 still shares striking structural similarity with VRK2, and appears to be locked in a pseudoactive conformation. VRK3 also conserves residue interactions that are surprising in the absence of enzymatic function; these appear to play important architectural roles required for the residual functions of VRK3. Remarkably, VRK3 has an “inverted” pattern of sequence conservation: although the active site is poorly conserved, portions of the molecular surface show very high conservation, suggesting that they form key interactions that explain the evolutionary retention of VRK3.
Many people think of the Smart Grid as a power distribution group built on advanced smart metering—but that's just one aspect of a much larger and more complex system. The "Smart Grid" requires new ...technologies throughout energy generation, transmission and distribution, and even the homes and businesses being served by the grid. This also represents new information paths between these new systems and services, all of which represents risk, requiring a more thorough approach to where and how cyber security controls are implemented. This insight provides a detailed architecture of the entire Smart Grid, with recommended cyber security measures for everything from the supply chain to the consumer. * Discover the potential of the Smart Grid * Learn in depth about its systems * See its vulnerabilities and how best to protect it
The Centers for Medicare & Medicaid Services designed a mandatory payment model to incentivize home dialysis use: the End-Stage Renal Disease Treatment Choices (ETC). Outpatient dialysis facilities ...and health care professionals providing nephrology services were randomly assigned to ETC participation at the hospital referral region level.
To assess the association between ETC and home dialysis use in the incident dialysis population in its first 18 months of implementation.
A cohort study with controlled, interrupted time series analysis of the US End-Stage Renal Disease Quality Reporting System database was conducted, using generalized estimating equations. All adults initiating home-based dialysis in the US between January 1, 2016, and June 30, 2022, without a prior kidney transplant were included in the analysis.
Prior to vs after ETC onset in January 1, 2021, and random assignment to ETC participation of facilities and health care professionals involved in patient care.
Percentage of patients started on incident home dialysis and yearly change in percentage initiating home dialysis.
A total of 817 177 adults initiated home dialysis during the study period, of whom 750 314 were included in the study cohort. The cohort included 41.4% women; 26.2% of the patients were Black, 17.4% were Hispanic, and 49.1% were White. Approximately half (49.6%) of the patients were aged at least 65 years. A total of 31.2% received care from health care professionals assigned to ETC participation, and 33.6% had Medicare fee-for-service coverage. Overall, home dialysis use increased from 10.0% in January 2016 to 17.4% in June 2022. Home dialysis use increased more in ETC markets than in non-ETC markets after January 2021 (by 1.07%; 95% CI, 0.16%-1.97%). The rate of increase in home dialysis use in the entire cohort nearly doubled after January 2021 to 1.66% per year (95% CI, 1.14%-2.19%) compared with before 2021, when the rate was 0.86% per year (95% CI, 0.75%-0.97%), but the difference in rate of increase in home dialysis use was not significant between ETC and non-ETC markets.
This study noted that, although the overall rate of dialysis use at home was greater after ETC implementation, the increase occurred more among patients in ETC markets than among those in non-ETC markets. These findings suggest that federal policy and financial incentives affected care for the entire incident dialysis population in the US.
Transilluminated powered phlebectomy (TIPP) is a promising alternative to traditional ambulatory phlebectomy procedures. This retrospective review of 339 patients represents the senior author's first ...consecutive series of 400 cases performed using TIPP for the treatment of varicose veins in a 6-year period. Patients were followed for 12 weeks postoperatively. Data analyzed included operative time, intraoperative complications, stab incision ranges, postoperative complications, and patient satisfaction. The mean operative time was 19.7 minutes, and 246 (61.5%) cases involved 10 to 20 incisions. Postoperative complications included an episode of symptomatic deep vein thrombosis in one (0.3%) patient, excessive or hypertrophic scarring in two (0.6%) patients, discoloration of the lower extremity skin due to hemosiderin staining in eight (2.3%) patients, and cellulitis in one (0.3%) patient. No recurrences were observed at a follow-up of 12 weeks. Three hundred thirty-eight (99.7%) patients reported good outcomes and were satisfied with the procedure. This review by an individual surgeon is beneficial in analyzing the outcomes and complications associated with TIPP, as a standard protocol was followed and an adequate volume was performed to advance past the learning curve associated with the technique. When concomitant saphenous vein incompetence is present, staged treatment of varicosities with TIPP after endovenous laser ablation is recommended. With proper training and experience, utilization of TIPP with a lower oscillation frequency and secondary tumescence results in good outcome and high patient satisfaction.
As the sophistication of cyber-attacks increases, understanding how to defend critical infrastructure systems—energy production, water, gas, and other vital systems—becomes more important, and ...heavily mandated. Industrial Network Security, Second Edition arms you with the knowledge you need to understand the vulnerabilities of these distributed supervisory and control systems. The book examines the unique protocols and applications that are the foundation of industrial control systems, and provides clear guidelines for their protection. This how-to guide gives you thorough understanding of the unique challenges facing critical infrastructures, new guidelines and security measures for critical infrastructure protection, knowledge of new and evolving security tools, and pointers on SCADA protocols and security implementation.All-new real-world examples of attacks against control systems, and more diagrams of systemsExpanded coverage of protocols such as 61850, Ethernet/IP, CIP, ISA-99, and the evolution to IEC62443 Expanded coverage of Smart Grid security New coverage of signature-based detection, exploit-based vs. vulnerability-based detection, and signature reverse engineering
Internal iliac artery (IIA) aneurysms present several challenges to the vascular surgeon: They are uncommon, and the often difficult repair is associated with relatively high morbidity/mortality. ...Bilateral internal iliac disease adds technical complications secondary to ischemic complications. In this case, a 76-year-old male with bilateral IIA aneurysms underwent staged endovascular coil embolization, resulting in exclusion of flow to the aneurysms and avoidance of ischemic postoperative complications. Angiography during the procedure verified complete bilateral IIA occlusion, which remained intact at 6-week and 1 year follow-up (computed tomography). This case illustrates successful repair of bilateral IIA using endovascular techniques.
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