Who Can You Trust? Assessing Vulnerability to Digital Imposter Scams.

Social Security scams have become one of the most common forms of government imposter fraud. These scams cost innocent people in the USA millions of dollars each year and undercut the ability of the Social Security Administration to contact and interact with citizens about their benefits. This raises questions as to how individuals might improve their ability to discriminate between scams and real appeals from the Social Security Administration. The present study applies the techniques of inoculation theory to a nationally representative sample of over 4,000 US adults in a series of experiments. Participants are randomly assigned to one of four training programs: from general tips about scams to a targeted experiential learning program. There is strong evidence that the inoculation process successfully and significantly increases fraud detection without decreasing trust in real communications. It provides protection against both SSA and non-SSA scams, such as Amazon imposter scams. The impact, however, is specific to the mode of communication (email versus letter or SMS) and decays over time; training programs should be targeted accordingly.

An analysis of Oxford hip and knee scores following primary hip and knee replacement performed at a specialist centre.

The Oxford hip and knee scores (OHS and OKS) are validated patient-reported outcome measures used in patients undergoing total hip replacement (THR), hip resurfacing (HR), total knee replacement (TKR) and unicompartmental knee replacement (UKR). We analysed the absolute OHS and OKS and change in scores following THR, HR, TKR, and UKR performed at one specialist centre. All patients undergoing and completing at least one Oxford score were eligible for inclusion in the study which included 27 950 OHS and 19 750 OKS in 13 682 patients. Data were analysed using non-linear quantile regression. The median absolute Oxford scores for THR, HR, TKR and UKR were pre-operative 68.8% (15.0/48), 58.3% (20.0/48), 66.7% (16.0/48), 60.4% (19.0/48) respectively: and post-operative asymptote was 14.6% (41.0/48), 5.8% (45.2/48), 31.2% (33.0/48), 29.2% (34.0/48). The median asymptotic change from the pre-operative score for THR, HR, TKR and UKR were 47.9% (23.0/48), 47.9% (23.0/48), 33.3% (16.0/48) and 32.4% (15.5/48), respectively. The median time at which no further appreciable change in score was achieved post-operatively was 0.7 years for THR, 1.1 years for HR, 0.9 years for TKR and 1.1 years for UKR. The curves produced from this analysis could be used to educate patients, and to audit the performance of a surgeon and an institution. The time to achieve a stable improvement in outcome varied between different types of joint replacement, which may have implications for the timing of post-operative review.

Medial dislocation of the medial meniscus.

We present the first reported case of symptomatic medial dislocation of the medial meniscus in a patient who had no previous history of trauma and who had an otherwise normal knee. The treatment of instability of the medial meniscus is controversial and studies have indicated that certain individuals without a firm meniscal bony insertion may be predisposed to meniscal dislocation. In our patient, the meniscal instability interfered with daily activities. Operative stabilisation by reconstruction of the meniscotibial ligaments cured the symptoms.

The mitigating influence of time preference on the relation between smoking and BMI scores.

OBJECTIVE: Prior studies have found a strong negative relation between smoking and body mass index (BMI). Smoking and unhealthy eating both imply a preference for utility in the present at the expense of future consumption. This analysis seeks to proxy this preference through a composite index of equally weighted intertemporal behaviors to isolate the impact of smoking upon BMI independent of time discounting. DESIGN: Ordinary least squares regression is used to analyze BMI score based on a number of key independent variables. SUBJECTS: A total of 2970 individuals who provided data for the United States Department of Agriculture's (USDA) Continuing Survey of Food Intakes by Individuals (CSFII) 1994-1996, as well as the Diet and Health Knowledge Survey (DHKS). RESULTS: Adding time preference to a multivariate model inflates the magnitude of the smoking effect, consistent with discounted utility theory. CONCLUSIONS: Results suggest that full effect of the non-intertemporal aspects of smoking (e.g., the substitution of cigarettes for food) on BMI scores may be underestimated in previous studies that fail to account for the mitigating influence of time preference.

Bioequivalence and pharmacokinetic profile of promethazine hydrochloride suppositories in humans.

A bioequivalence study of promethazine hydrochloride (10-[2-(dimethylamino)propyl]-phenothiazine monohydrochloride) was conducted in 20 male human subjects with the purpose of comparing, under blind condition, the human serum levels of promethazine in three different formulations. The formulations tested were a 50-mg promethazine hydrochloride polyethylene glycol suppository, a 50-mg promethazine hydrochloride cocoa butter-white wax suppository, and a 50-mg oral dose of promethazine hydrochloride syrup. Each subject received single doses of each of the three formulations on each of three different days on a crossover basis. From the measured serum levels, estimates of the bioavailability parameters (area under the serum concentration versus time curve, time-to-peak serum concentration, and peak serum concentration) were obtained by least-squares digital computer fitting. Also, a one-compartment pharmacokinetic open model with two consecutive first-order input steps is proposed. Statistical analysis of the results was performed by using a linear multiple regression approach for the analysis of variance. No significant differences between the syrup and the polyethylene glycol suppositories were obtained (p greater than 0.05) for the above three bioavailability parameters. However, the polyethylene glycol suppositories provided statistically higher peak serum concentration, shorter time-to-peak serum concentration, and larger area under the serum concentration versus time curve than the cocoa butter-white wax suppositories.

Biocompatibility and bioabsorption of microfibrillar collagen hemostat in experimental animals.

The effects of Microfibrillar Collagen Hemostat (MCH) and Gelfoam after surgical implantation into incision sites of the liver, kidney, and brain were studied in beagle dogs, rabbits, and beagle dogs, respectively. The results of these experimental animal studies suggest that MCH is comparable to Gelfoam with respect to biocompatibility, rate of bioassimilation, and a lack for adverse systemic effects. The brain, liver, and kidney tissues responded comparably to MCH and Gelfoam with a mild to moderate infiltration of macrophages and mononuclear cells. Most of the hemostatic compound had disappeared from the incision sites by Day 28 and completely disappeared by Day 84. The tissue degree response was interpreted as a factor in the process of bioassimilation of the two hemostatic materials. Both hemostatic compounds contributed to adhesion formation in the experimental models. The incidence of adhesions was somewhat lower for MCH than for Gelfoam, but both produced more adhesions than were found at the control sites. The adhesions were only to the adjacent structures and always localized to the surgical site. When MCH or Gelfoam is used under conditions similar to those in the present experimental study, where tissue approximation is impaired, and where growth of granulation tissue is stimulated by the physical presence of the hemostatic compound, there is the possibility for increased incidence of adhesion formation. However, when an intraperitoneal absorbable hemostatic compound is desired, the present studies in experimental animals suggest that MCH will be safe by exhibiting minimal tissue reaction.

Comparative toxicity of two-dexamethasone derivatives following topical ocular instillation to rabbits. II. Systemic histopathological changes.

Dexamethasone-21-tertiary butyl acetate (dexamethasone TBA) and dexamethasone alcohol at concentrations of 0.2, 0.1, 0.01, and 0.001% were topically instilled into the right eyes of groups of 10 rabbits for 21 consecutive days. Vehicle control and untreated control groups were used for comparative evaluation. The dose-dependent changes for each compound were (1) lipid and glyocogen infiltration of liver, (2) hydropic changes of liver, (3) vacuolation and multifocal hepatic necrosis of liver, (4) atrophy of Peyer's patches of intestines, (5) white pulp atrophy of the spleen and (6) atrophy of the adrenal cortex. No pathological changes were noted for other tissues including the eye. In conclusion, the results indicate that systemic histopathologic changes for both steroids were comparable and typical for steroids.

Modification of the microtiter technique for antimicrobial drug susceptibility testing by incorporation of indicators.

A pH indicator and dextrose were incorporated into growth media as a modification of microbial microtiter methods for determining the minimal inhibitory concentration of antimicrobial drugs. This modified method was tested to evaluate the ease of reading end points by changes in the indicator color. Application of the procedure to two media, three indicators, and eight species of bacteria indicated that definitive end points could be reached as a result of indicator color change caused by acid production during bacterial growth. This method is accurate and reproducible. It is a modification which eliminates a need for plating and facilitates the reading of minimal inhibitory concentration end points.

Mechanisms regulating the renal excretion of sodium during pregnancy.

Observations were made on the relation of the renin-angiotensin-aldosterone system and renal hemodynamic function to sodium balance in 43 pregnant dogs. Daily balance studies revealed that about 30-40% of ingested sodium was retained during the last half of pregnancy; during the same period, potassium balance was also positive but to a lesser extent. For groups of pregnant dogs, plasma renin activity (n = 14) and aldosterone secretion (n = 19) were significantly higher than normal; however, in some animals one or both functions were normal even though sodium retention was present. In contrast, plasma renin substrate concentration was consistently elevated during pregnancy in seven dogs. In a group of nine dogs in which both aldosterone secretion and plasma renin activity were measured, aldosterone secretion was elevated in the three dogs with the highest values for plasma renin activity; in two of the remaining six animals aldosterone secretion was elevated but plasma renin activity was normal or only slightly increased. The sequestration of sodium and water into the uterine contents was defined quantitatively in this study but evidence was lacking to support the idea that such changes led to renin release. The glomerular filtration rate (GFR) was significantly elevated throughout pregnancy but a significant decrease from the high level of mid-pregnancy occurred during the last half of pregnancy; this decrease in GFR probably contributed to the sodium retention. Administration of a large dose of deoxycorticosterone acetate (DOCA) to dogs in late pregnancy produced marked sodium retention but "escape" from the sodium-retaining steroid occurred. The data demonstrate that although increased activity of the renin-angiotensin-aldosterone system was frequently present during pregnancy, a normal rate of aldosterone secretion occurred. This finding and the observed "escape" from DOCA suggest the existence of sodium-retaining mechanisms other than the mechanism provided by a high plasma level of aldosterone.