Chief executive officers (CEOs) can turn out to be the weakest link to an organization’s security and attackers know that if they successfully exploit or impersonate someone who has a high level of access like CEOs or chief finance officers (CFOs), they instantly gain great advantage. The problem comes when attacker manages to take control of email accounts of the CEOs and CFOs and sends an email to another staff in the organization, he/she is likely to take it seriously, act accordingly and quickly as possible, and may be wire cash to an account directed by the “CEO/CFO,” and/or get away with private or sensitive corporate information. Because of the nature of these attack methods, detection and protection are very difficult since the attackers take advantage of the human weakness which is the weakest link. The main aim of this study is to provide a solution to protect every surface of the organization. By developing a human firewall, working with the already existing technical solutions offers the solution to remaining problem of human weakness. This research developed a simulator to train the users with the latest trends the attackers are using making them do it right (flagging, reporting, not clicking suspicions links) and making email security part of their responsibility. This makes employee become human firewall. The results from the simulator are displayed in charts as number of employees who passed the test, number of employees who will click on the malicious links, number of employees who will download the dangerous attachments, number of employees who will reply to phishing emails, average awareness of the organization, and how individual employees performed. While organizations have made progress over the years, security is a never-ending process that requires improvement day by day. Since no one in the organization’s structure is immune including the top most in the cadre (i.e., CEO), complexity in understanding and awareness creation is more wanting than before. Integrating human firewall into existing security measures as the last line of defense in email communication against business email compromise frauds offers this solution because it has preventive as well as reactive measures both geared toward maximizing email security. A simulation of the attacks to analyze the user involvement to breaching the security followed by an evaluation simulation after integrating human firewall to the organization’s email security shows success level. The results from the test show the different success levels, that is, results from pre-assessment definitely show low success level since staff/employees have not been made aware/trained to profile or flag compared to when the employees/staff have gone through the training/awareness. Post-assessment indicates high success level because actions from employees turned into human firewall know how to take proper action, for example, flagging, not clicking malicious links. The organization should update its policies to accommodate and reinforce rules on the employees to ensure that the tool is used regularly and actions taken on user deemed a threat to the organizational email security.

Vasculitis as a pathomechanism for neuropathy can be isolated to the peripheral nervous system, a part of a systemic autoimmune condition or a component of another syndrome. This review aims to discuss the broad range of diagnoses in which vasculitic neuropathy can be encountered, highlight the progress in imaging techniques in identifying vasculitis, and the new drugs developed for other autoimmune diseases that may be applied to neurological conditions. Advances in imaging modalities, ultrasound, MRI and FDG-PET scanning for neuromuscular applications has redefined many aspects of vasculitic neuropathies. The benefit of dividing vasculitides by vessel size is becoming less absolute as diagnostic approaches advance. MRI and FDG-PET are widely used in diagnosis, defining extent of involvement of disease and monitoring. In neuralgic amyotrophy, the identification of hourglass-like constrictions on imaging has changed the treatment paradigm to include surgical interventions. These diagnostic approaches are supported by new immunomodulating and immunosuppression techniques. Vasculitic neuropathies are a broad group of conditions with a range of causes and associations. Increased use of imaging techniques impacts our traditional definitions and classifications. The growth in treatment options for other autoimmune conditions are likely to infiltrate the neurological landscape.

ABSTRACT Youth in the juvenile legal system (JLS) are at increased risk for suicidal thoughts and behaviors. Examine the acceptability, feasibility, and appropriateness of imbedding suicide screening and intervention in the JLS. The current study involved formative semi-structured interviews with key JLS stakeholders (n = 37) from two states, one in the Northeast and one in the Midwest, to determine whether suicide screening and intervention could be integrated into the role of juvenile probation officers. Stakeholders discussed perspectives on the acceptability (perceived JLS staff comfort with suicide screening and a brief intervention), feasibility (improving comfort of staff, youth, and families), and appropriateness (perceived impact on youth and families). Qualitative data suggested acceptability of suicide screening was mitigated by staff comfort and perceived support of available clinical resources. Feasibility of improving staff comfort to conduct suicide screening and a brief intervention revolved around logistical, training, and supervisory support. Barriers to the appropriateness of suicide screening and intervention with youth in the JLS suggest concerns about how youth’s distrust of the JLS and mental health stigma might impact engagement in suicide screening and intervention efforts. We conclude with implementation strategy considerations to enhance successful suicide screening and intervention by JLS staff.

To investigate the impact of combined treatment of colorectal cancer (CRC) with electroacupuncture (EA) and capeOX (combined administration of fluorouracil, oxaliplatin and capecitabine) on the tumor volume, weight, spleen coefficient, apoptosis and ferroptosis of tumor tissue, and liver and kidney functions in nude mice with CRC, so as to explore its mechanisms underlying inhibiting CRC and alleviating toxic reactions of capeOX. Female Balb/c nude mice were randomly assigned to 3 groups：model, capeOX, and EA+capeOX, with 8 nude mice in each group. The CRC model was established by subcutaneous injection of colon cancer cells at the right inguinal region. Nude mice of the capeOX group received intraperitoneal injection of oxaliplatin for 1 day and gavage of capecitabine from day 2 to day 7. EA (1 mA, 2 Hz/100 Hz) was applied to bilateral "Zusanli" (ST36) for 20 min, once daily for 7 days. During the interven-tion, the tumor volume and weight were measured every day, and at the end of intervention, the weight of the tumor tissue and spleen were measured, with tumor volume difference and spleen coefficient calculated. The proportion of apoptotic cells was measured by flow cytometry, and the contents of serum malondialdehyde (MDA), alanine aninotransferase (ALT), aspartate aminotransferase (AST), blood urea nitrogen (BUN), and creatinine (Cr) were detected using ELISA. The expression level of glutathione peroxidase 4 (GPX4, a key regulator for ferroptosis) protein of the tumor tissue was determined using Western blot. Compared to the model group, both the capeOX group and EA+capeOX group showed a decrease in the tumor volume (on day 3 and 4 in the capeOX group, and from day 2 to 7 in the EA+capeOX group) and body weight (P<0.05, on day 3 to 7 in the EA+capeOX group and on day 2 to 7 in the capeOX group), being evidently lower in the tumor volume on day 7 in the EA+capeOX than in the capeOX group (P<0.05), and evidently higher in the body weight on day 6 and 7 in the EA+capeOX group than in the capeOX group (P<0.05). In comparison with the model group, the tumor volume difference, tumor weight and spleen coefficient in both capeOX and EA+capeOX groups were significantly decreased (P<0.05), and MDA content in EA+capeOX group was significantly decreased (P<0.05), while the contents of ALT, BUN and Cr in the capeOX group, the proportion of apoptotic cells in both capeOX and EA+capeOX groups, and the GPX4 expression level in the EA+capeOX group were all significantly increased (P<0.05). The tumor volume difference, tumor weight, and contents of MDA, ALT, AST, BUN and Cr in the EA+capeOX group were markedly lower than in the capeOX group (P<0.05), while the spleen coefficient, proportion of apoptotic cells and GPX4 expression level in the EA+capeOX group were markedly higher than those in the capeOX group (P<0.05). EA of ST36 can enhance the effect of capeOX in inhibiting colorectal cancer growth in nude mice with CRC, which may be related with its functions in promoting tumor cell apoptosis, inhibiting ferroptosis, and modulating immune tolerance. In addition, EA can lower the side effects of capeOX in hematopoietic and immune, liver, and kidney functions.

Objective: To investigate the risk factors for lymph node metastasis in patients with early gastric cancer and establish a model for prediction of risk. Methods: The cohort of this retrospective observational study comprised 1096 patients who had undergone radical gastric cancer surgery combined with standard D1 lymphadenectomy and been diagnosed with early gastric cancer by postoperative pathology in Zhongshan Hospital affiliated with Fudan University from January 2016 to July 2022. The patients were allocated to groups with and without lymph node metastases. Clinicopathological characteristics were compared between the two groups and multi-factor logistic regression analysis used to identify independent risk factors for lymph node metastasis in patients with early gastric cancer. Indications for endoscopic resection in the Japanese Gastric Cancer Association (JGCA) guideline were also incorporated into construction of the model. The patient cohort was divided into training and validation sets in a 6:4 ratio. The identified independent risk factors were used to construct a predictive nomogram. Receiver operating characteristic curves were plotted separately and the difference between them in predictive efficacy was compared using the area under the curve (AUC). Results: A total of 1,096 patients with early gastric cancer were included, with 750 males and 346 females. Their average age was (61.4±10.9) years old, and the mean tumor diameter was (23.8±11.4) mm. Among them, 188 patients (17.2%) had positive lymph node metastasis, with 109 cases in N1 stage, 42 cases in N2 stage, and 37 cases in N3 stage. Additionally, 462 patients were in T1a stage, while 634 patients were in T1b stage. Univariate analysis showed that tumor diameter, location, Lauren classification, gross morphology, histological type, intravascular invasion, ulceration, differentiation type and tumor T stage were associated with lymph node metastasis after radical gastrectomy for early gastric cancer (all P<0.05). Multifactorial analysis showed that the presence of intravascular invasion (OR=14.822, 95%CI: 9.323-23.572, P<0.001), undifferentiated type (OR=3.095, 95%CI: 1.649-5.811, P<0.001), tumor T1b (OR=1.798, 95%CI: 1.053-3.079, P=0.032), and tumor diameter ≥2 cm (OR=1.229, 95%CI: 1.031-1.469, P=0.022) were independent risk factors for lymph node metastasis. The baseline data of the training set and validation set were consistent in terms of balance (all P>0.05). We used the above variables to establish a predictive nomogram for lymph node metastasis in patients with early gastric cancer. The AUC values obtained from the validation of the model in the training and validation sets were 0.880 (95%CI: 0.849-0.911) and 0.881 (95%CI: 0.841-0.921), respectively, and were significantly better than the predictive efficacy based on the JGCA guideline (AUC=0.777, 95%CI: 0.746-0.809, P<0.001). Conclusions: Patients with early gastric cancer and intravascular invasion, undifferentiated tumors, tumor T1b, and diameter ≥2 cm are at higher risk of postoperative lymph node metastasis than other patients. The predictive model developed in this study more accurately predicts lymph node metastasis in patients with early gastric cancer than previously proposed methods.

ABSTRACT The COVID-19 pandemic presented myriad global challenges, placing unprecedented pressure on health services. Currently, there is limited qualitative research exploring the ‘felt’ impact of the pandemic on older adults’ health experiences and wider social life. Here, we report on the embodied experiences of older adults (65 and above), before, during and after the COVID-19 pandemic lockdowns in the UK, to chart the physical, social, and mental-health challenges. A figurational sociological lens was adopted to examine data from semi-structured interviews with 18 older adults, face-to-face or via telephone/video call. Notes from follow-up conversations were also recorded. Combined data were analysed thematically. Salient themes cohered around: physical activity engagement; health experiences; the role of family, friends, and community; and the role of modern technology. Our results highlight how older adults reported the felt benefits of increased PA during lockdowns, but also the negative impacts of treatment delays on experiences of hospital services. Participants also recounted how new social community connections were forged during lockdowns. Saliently, we identified a need to support older adults with modern technology so as to capture its potential to modernise, expand, and personalise healthcare within UK health services.

ABSTRACT Allain [2022. ‘A Supermultiplier Model with Two Non-Capacity-Generating Semi-autonomous Demand Components.’ Structural Change and Economic Dynamics 63: 91–103] raised the question of how two or more non-capacity-generating autonomous demand components growing at different rates may coexist in the supermultiplier, avoiding that one component absorbs all the others in the long-run steady-state. To date, the theoretical shortcut adopted in the literature has been to assume that, at least as long-term averages, the different components grow at the same rate or that institutional elements kick in to tackle this issue. Differently, we propose a solution that resorts to endogenous feedback effects and stock-flow consistent relations to solve such issues. More specifically, we build a simple supermultiplier model in which growth is driven by workers’ debt accumulation as well as rentiers’ consumption out of interest. We show that, according to specific conditions, there is a steady-state solution in which growth ultimately converges towards that of the fastest growing component, but the other does not disappear due to the presence of the mentioned endogenous stock-flow relations. This provides a way out of the two-component issue, with endogenous money creation surrounding this process of growth driven by credit provided to households.