Cyber security fear appeals:unexpectedly complicated

Cyber security researchers are starting to experiment with fear appeals, with a wide variety of designs and reported efficaciousness. This makes it hard to derive recommendations for designing and deploying these interventions. We thus reviewed the wider fear appeal literature to arrive at a set of guidelines to assist cyber security researchers. Our review revealed a degree of dissent about whether or not fear appeals are indeed helpful and advisable. Our review also revealed a wide range of fear appeal experimental designs, in both cyber and other domains, which confirms the need for some standardized guidelines to inform practice in this respect. We propose a protocol for carrying out fear appeal experiments, and we review a sample of cyber security fear appeal studies, via this lens, to provide a snapshot of the current state of play. We hope the proposed experimental protocol will prove helpful to those who wish to engage in future cyber security fear appeal research

Acute symptomatic hypoglycaemia mimicking ischaemic stroke on imaging:a systemic review

<p>Abstract</p> <p>Background</p> <p>Acute symptomatic hypoglycaemia is a differential diagnosis in patients presenting with stroke-like neurological impairment, but few textbooks describe the full brain imaging appearances. We systematically reviewed the literature to identify how often hypoglycaemia may mimic ischaemic stroke on imaging, common patterns and relationships with hypoglycaemia severity, duration, clinical outcome and add two new cases.</p> <p>Methods</p> <p>We searched EMBASE and Medline databases for papers reporting imaging in adults with symptomatic hypoglycaemia. We analysed the clinical presentation, outcome, brain imaging findings, duration and severity of hypoglycaemia, time course of lesion appearance, including two new cases.</p> <p>Results</p> <p>We found 42 papers describing computed tomography or magnetic resonance imaging in 65 patients, plus our two cases with symptomatic hypoglycaemia. Imaging abnormalities on computed tomography and magnetic resonance were uni or bilateral, cortical or sub-cortical. Thirteen (20%) mimicked cortical or lacunar stroke. Acute lesions had restricted diffusion on magnetic resonance or low attenuation on computed tomography, plus swelling; older lesions showed focal atrophy or disappeared, as with ischaemic stroke. The association between the depth or duration of hypoglycaemia, the severity or extent of neurological deficit, and the imaging abnormalities, was weak.</p> <p>Conclusion</p> <p>Imaging abnormalities in patients with hypoglycaemia are uncommon but very variable, weakly associated with neurological deficit, and about a fifth mimic acute ischaemic stroke. Blood glucose testing should be routine in all patients with acute neurological impairment and hypoglycaemia should be included in the differential diagnosis of imaging appearances in patients presenting with acute stroke.</p

<i>Cis</i> P-tau is induced in clinical and preclinical brain injury and contributes to post-injury sequelae

Induction of the cis form of phosphorylated tau (cis P-tau) has previously been shown to occur in animal models of traumatic brain injury (TBI), and blocking this form of tau using antibody was beneficial in a rodent model of severe TBI. Here the authors show that cis P-tau induction is a feature of several different forms of TBI in humans, and that administration of cis P-tau targeting antibody to rodents reduces or delays pathological features of TBI

The utility of susceptibility-weighted imaging to evaluate the extent of iron accumulation in the choroid plexus of patients with beta-thalassaemia major

AIM: To assess iron accumulation in the choroid plexus of beta-thalassaemia patients using fast spin echo (FSE) T2-weighted, gradient echo (GRE) T2*-weighted, susceptibility-weighted imaging (SWI) and compare the results

Feasibility of healthcare providers' autonomic activation recognition in real-life cardiac surgery using noninvasive sensors

Cardiac surgery is one of the most complex specialties in medicine, akin to a complex sociotechnical system. Patient outcomes are vulnerable to surgical flow disruptions (SFDs), a source of preventable harm. Healthcare providers’ (HCPs) sympathetic activation secondary to emotional states represent an underappreciated source of SFDs. This study’s objective was to demonstrate the feasibility of detecting elevated sympathetic nervous system (SNS) activity as a proxy for emotional distress associated with a medication error using heart rate variability (HRV) analysis. After obtaining informed consent, audio/video and HRV data were captured intraoperatively during cardiac surgery from multiple HCPs. Following a critical medication administration error by the anesthesiologist in-training, the attending anesthesiologists’ recorded HRV data was analyzed using pyphysio, an open-source signal analysis package, to identify events precipitating this near-miss event. We considered elevated low-frequency/high-frequency (LF/HF) HRV ratio (normal value <2) as a primary indicator of SNS activity and emotional distress. A heightened SNS response by the attending anesthesiologist, observed as an LF/HF ratio value of 3.39, was detected prior to the near-miss event. The attending anesthesiologist confirmed a state of significant SNS activity/distress induced by task-irrelevant environmental factors, which led to a temporarily ineffective mental model. Qualitative analysis of audio/video recordings revealed that SNS activation coincided with an argument over operating room management causing SFD. This preliminary study confirms the feasibility of recognizing potentially detrimental psychophysiological states during cardiac surgery in the wild using HRV analysis. To our knowledge, this is the first case demonstrating SNS activation coinciding with self-reported and observable emotional distress during live surgery using HRV. Irrespective of the HCP’s expertise, transient but intense emotional changes may disrupt attention processes leading to SFDs and preventable errors. This work supports the possibility to detect real-time SNS activation, which could enable interventions to proactively mitigate errors. Additional studies on our large database of surgical cases are underway to confirm this observation.Accepted versio