Post-attack Period Research Articles

Catch Me if You Can : "Delaying" as a Social Engineering Technique in the Post-Attack Phase

Much is known about social engineering strategies (SE) during the attack phase, but little is known about the post-attack period. To address this gap, we conducted 17 narrative interviews with victims of cyber fraud. We found that while it was seen to be important for victims to act immediately and to take countermeasures against attack, they often did not do so. In this paper, we describe this "delay" in victims' responses as entailing a period of doubt and trust in good faith. The delay in victim response is a direct consequence of various SE techniques, such as exploiting prosocial behavior with subsequent negative effects on emotional state and interpersonal relationships. Our findings contribute to shaping digital resistance by helping people identify and overcome delay techniques to combat their inaction and paralysis.

INFLAMATOMETRIC FEATURES OF BRONCHIAL ASTHMA WITH DIFFERENT ACTIVITY DEGREE OF EOSINOPHILIC AIRWAY INFLAMMATION

The aim of the study – to investigate the clinical signifi cance of eosinophilic cationic proteinconcentration in sputum and its diagnostic role in the disease management for optimizationof the personalized anti-infl ammatory therapy of patients with bronchial asthma.
 Materials and methods. There have been examined 66 school-aged children with persistentbronchial asthma who had been under anti-infl ammatory control therapy for at least thelast three months, but still needed treatment correction. Sputum has been collected in allpatients during post-attack period of disease by the method of sputum induction usingan inhalation of hypertonic solutions (3%,5%,7%) of sodium chloride. Quantitative andqualitative cytological composition of the sputum precipitate has been determined, inthe supernatant liquid fraction, obtained after sputum centrifugation, the concentrationsof eosinophilic cationic protein (ECP) and endothelial vascular growth factor (VEGF)have been studied by ELISA method. In the general cohort of examined patients, theaverage ECP concentration was 2.28±2.2 ng/ml (minimum value 0, maximum – 9.2 ng/ml). Depending on the ECP content in the sputum, children have been divided into 2clinical groups: The fi rst (I) clinical group was formed by 29 children with a content ofECP in the sputum greater than the average cohort value, and the second (II) clinicalgroup included remaining 47 patients with the level of ECP<2 ng/ml). According to themain clinical characteristics (age, gender, place of residence, duration of the disease)the clinical groups have been comparable. All patients underwent a biochemical studyof exhaled breath condensate (EBC), which involved the content determination of totalprotein, catalase activity; concentrations of nitrogen monoxide metabolites and markers
 of proteolytic activity. The results of the study were analyzed by parametric and non-parametric calculation methods, and estimation of the tests’ diagnostic value were carried
 out from the position of clinical epidemiology taking into account their sensitivity (Se)and specifi city (Sp), as well as attributive (AR) and relative (RR) risks, and the odd ratio(OR) of the event, taking into consideration their 95% confi dence intervals (95% CI).Results. The analysis of the obtained data has showed that in the comparison groups theclinical level of asthma control (18.3 ± 1.5 vs. 18.6 ± 1.3 points, P> 0.05), and sputumcell composition (in particular by the number of eosinophilic granulocytes: 9,24±2.3vs. 9,28±2.2%, P> 0.05) did not diff er much. In addition to that, VEGF concentrationin sputum, which refl ects the bronchial remodeling processes, was 1.25 times higherin representatives of the I group (145.43 ± 19.71 pg/ml) compared with patients of theII group (115.93 ± 15, 7 pg/ml; P> 0.05). In EBC, the content of nitrogen monoxidemetabolites was higher in patients of the II group: 44.4 ± 5.74 μmol/l in comparison withrepresenatives of I group (55.8 ± 9.8 μmol/l; P> 0.05). At the same time, in patients ofclinical I group in EBC higher proteolytic activity of azocol, as well as a higher catalaseactivity was noted (68.4 ± 22.6 μmol/min x mg of protein compared to 49.6 ± 10.3 μmol/min x mg of protein in the II group of comparison; P> 0, 05). In contrast, in the II group,the infl ammatory process has been associated with the lysis of low molecular weightproteins.Conclusion. In children with bronchial asthma, increased degranulation of sputumeosinophils (according to the ECP concentration) is associated with a more pronouncedairway infl ammation, as evidenced by the increased intensity of oxidative modifi cation ofproteins (OR=3,6) and proteolytic activity of high molecular weight proteins; togetherwith high catalase activity and elevated concentration of such marker of bronchialremodeling as VEGF, along with decreased content of nitrogen monoxide metabolites inthe exhaled breath condensate.

Advances in prehospital hemorrhagic shock management since Paris' terrorist attacks in 2015: A before-and-after retrospective study.

In France, in 2015, prehospital emergency doctors were faced with civilian casualties in hemorrhagic shock resulting from terrorist attacks with automatic rifle fire and explosive weapons. The present study aimed to evaluate the impact of these attacks on the advanced life support (ALS) team's practices and equipment and on physician training in the prehospital management of traumatic hemorrhagic shock. This before-and-after multicenter study evaluated professional practices based on a questionnaire sent to emergency department heads and medical practitioners in 370 ALS teams in metropolitan France. We analyzed 672 responses from 209 (56.5 percent) ALS teams in 91 of 95 emergency medical services (EMS) headquarters. Of these 91, 73 (80.2 percent) had a protocol in use for managing traumatic hemorrhagic shock after the attacks, compared with 45 (49.5 percent) who had protocols in use before the attacks (p < 0.001). Ultrasound equipment was available in 49 (53.8 percent) of the EMS headquarters after the attacks, compared to 39 (42.9 percent) before (p < 0.001). Limb tourniquets were available in 90 (98.9 percent) EMS headquarters after the attacks, versus 27 (29.7 percent) before (p < 0.001). Tranexamic acid was available in 88 (96.7 percent) EMS headquarters after the attacks, versus 71 (78 percent) before (p < 0.001). During the post-attack period, training in war medicine did not affect individual practices, neither for using the shock index or the Focused Assessment with Sonography for Trauma (FAST) nor the tourniquet. However, this training was associated with more frequent use of hemostatic dressings (p = 0.002). Following the attacks in Paris and Nice, ALS teams received additional equipment and training to prepare for future mass causality events.

Modeling and evaluation of cyber-attacks on grid-interactive efficient buildings

Grid-interactive efficient buildings (GEBs) are not only exposed to passive threats (e.g., physical faults) but also active threats such as cyber-attacks launched on the network-based control systems. The impact of cyber-attacks on GEB operation are not yet fully understood, especially as regards the performance of grid services. To quantify the consequences of cyber-attacks on GEBs, this paper proposes a modeling and simulation framework that includes different cyber-attack models and key performance indexes to quantify the performance of GEB operation under cyber-attacks. The framework is numerically demonstrated to model and evaluate cyber-attacks such as data intrusion attacks and Denial-of-Service attacks on a typical medium-sized office building that uses the BACnet/IP protocol for communication networks. Simulation results show that, while different types of attacks could compromise the building systems to different extents, attacks via the remote control of a chiller yield the most significant consequences on a building system’s operation, including both the building service and the grid service. It is also noted that a cyber-attack impacts the building systems during the attack period as well as the post-attack period, which suggests that both periods should be considered to fully evaluate the consequences of a cyber-attack.

Особливості призначення муколітичної терапії у дітей у постнападному періоді бронхіальної астми

Bronchial asthma is the most common chronic pathology in childhood. Chronic inflammatory process of the respiratory tract forms bronchial hyperreactivity which is manifested by typical clinical symptoms. Like any other chronic disorder, the course of bronchial asthma consists of periods of exacerbation and remission. A productive cough in the post-attack period determines the prescription of mucolytic drugs by doctors to liquefy viscous sputum, to remove it more quickly, especially among the paediatric population. There are different approaches to prescribing mucolytic drugs during exacerbation of symptoms of bronchial asthma in scientific publications. The purpose of the study was to evaluate the clinical effectiveness of mucolytic therapy in children with bronchial asthma to optimize the treatment of disease exacerbations. Material and methods. One hundred two medical records of patients treated for asthma exacerbation in pulmonological department of the Chernivtsi Regional Children Clinical Hospital were analyzed. Four clinical groups were formed depending on the prescription of mucolytic drugs. There were not any significant differences by sex, place of residence, however the average age of patients who were prescribed carbocisteine. It was significantly less than in children of other clinical groups. Results and discussion. It was determined that acetylcysteine and carbocysteine were prescribed to patients on the first day of the productive cough onset. Instead to children of the IV clinical group where ambroxol was prescribed on average 1.6 days before the wet cough onset. The study results showed that the average duration of hospitalization in patients receiving ambroxol was 1.5 days less than in children taking acetylcysteine or carbocysteine. The difference was significant. However, the duration of hospitalization for children of I clinical group was not significant longer in comparison with patients received drugs with mucolytic effect in the complex therapy of asthma exacerbation. Conclusion. Despite the fact that acetylcysteine and carbocysteine were significantly more often prescribed for more severe and pronounced asthma exacerbation a decrease in the relative and absolute risks of longer hospitalization was observed in patients taking carbocysteine

Impact of terrorism on stock markets across the world and stock returns

Purpose The purpose of this paper is to study the following: short-run and long-run associations between the terror-affected country’s stock market index and other global countries’ equity indices and gold; the volatility of stock market indices when one of the countries is affected by a terrorist attack; and the linkages between terrorism and the returns in the selected stock markets. Design/methodology/approach To study the impact of the Taj attack on other global indices, the authors selected top five countries’ stock market indices, namely, FTSE, DJI, NIKKEI, SSEC and DAX. The short-run and long-run associations are also compared with gold. The authors used the autoregressive distributed lag model, LM test and bounds test for analyzing the short-run and long-run impact; ARCH family models to study the volatility impact; and the MAR model to study the impact on returns. Findings The authors found that all the global indices had a short-run association with the terror-affected country’s benchmark index, i.e. BSE. Gold moved as expected, with it having a short-run impact on the terror-affected country. All the global indices except DJI have volatility of share price movement either positively or negatively. As the benchmark of the terror-affected country fell, NIKKEI, HSI, IXIC, DAX and CAC also fell; that is, it had a positive influence on the terror-affected country’s index. Post the Mumbai attacks, DJI, NIKKEI, SSEC, DAX, BSE and CAC performed well in performance measure returns compared with the pre-attack period. Whereas, FTSE and GOLD performed well in performance measure returns in the pre-attack period compared with the post-attack period. GOLD proved that it is the best avenue to invest in, as it has only a short-term association with the terror-affected country’s index. Research limitations/implications The authors studied the short-run and long-run associations with only five countries’ benchmark indices. Practical implications The authors found that all the global indices had long- and short-run associations with the terror-affected country’s benchmark index, i.e. BSE. Global indices like DJI, NIKKEI, SSEC, DAX and FTSE had a short-term association with the affected country’s index. Gold moved as expected, with it having a short-run impact on the terror-affected country. All the global indices except DJI have volatility of share price movement either positively or negatively. As the benchmark of the terror-affected country fell, NIKKEI, HSI, IXIC, DAX, TSX, BVSP and CAC also fell; i.e., it had a positive influence on the terror-affected country’s index. Post the Mumbai attacks, DJI, NIKKEI, SSEC, DAX, BSE and CAC performed well in performance measure returns compared with the pre-attack period. Whereas, FTSE and GOLD performed well in performance measure returns in the pre-attack period compared with the post-attack period. GOLD proved that it is the best avenue to invest in, as it has only a short-term association with the terror-affected country’s index. In all the relationships were mixed with respect to terror attacks, and GOLD took the lead run out of all the associations it had in the 16-year time span from 2000 to 2016. Social implications The research has got an important implication to the investors. It shows that patience is the key, as all the indices had only short-term associations with the BSE. It implies that investors’ returns will be negative in the short run, but if they continue investing, in the long run, the impact of terrorism tapers out and the returns will increase. Originality/value There is a lot of research done on the impact of the US attacks on the stock markets of other countries, but on the impact of the Taj attack in India, there is hardly any research.

The 11/13 Paris terrorist attacks and stock prices: The case of the international defense industry

This study explores the impact of the Paris terrorist attacks on the stock returns of the most important companies in the global defense industry. The investigation is carried out using the traditional event study methodology. The findings are suggestive that this terrorist attacks event supports an upward trend in cumulative abnormal returns across all companies over the post-attack period, implying a positive effect of the attacks on the defensive companies’ stock returns.

Sympathetic Skin Responses from the Neck Area in Patients with Unilateral Migraine.

In this study, in patients with unilateral migraine headache and in normal controls, it was aimed to assess the sympathetic function during attack, post attack, and interval periods and to compare these findings by recording sympathetic skin responses from the neck area, which was not studied before. A total of 37 unilateral patients with migraine (30 women, seven men) who fulfilled the criteria of International Headache Society (2004) were recruited from our outpatient clinic. The control group consisted of 21 healthy individuals (16 women, five men) who are employees or students of our Medical Faculty. Mean latency and maximum amplitude values of sympathetic skin responses obtained from neck areas of the patients during attack, post attack, and interval periods were calculated. We compared the mean latency and the maximum amplitude values of the symptomatic side with the data of the asymptomatic side and with the data of the control group. We also compared the responses of the patients with right-sided headache with the responses of the patients with left-sided headache. All statistical analyses were performed using SPSS. On the neck area, we observed sympathetic hypo-function in the attack and interval periods and a relative hyper-function in the post attack period bilaterally, regardless of the symptomatic side. These findings suggest that there is ongoing bilateral sympathetic hypo-function in the neck area and there occurs a temporary increase in the function of sympathetic sudomotor activity in the recovery period of headaches.

Refractory periods in SUNCT

Dear Sir, The article by Paliwal et al. [1] brings to mind the importance of assessing the presence/absence of refractory periods in the differential diagnosis of short-lasting unilateral neuralgiform headache with conjunctival injection and tearing (SUNCT), primarily because trigeminal neuralgia attacks are systematically followed by refractory periods, contrary to what is frequent in SUNCT. Since the first communication of SUNCT [2], it has been known that post-attack refractory periods may be only relative or completely absent. Moreover, we reported that SUNCT paroxysms could be triggered during the “descrescendo” phase of an ongoing attack [3], and that occasionally, the usual stimuli seemed totally ineffective, even when applied for a prolonged time [4]. The sensitivity, or threshold, for attack generation, may therefore, differ from time to time. Later, we documented these findings [5] in a patient in whom many SUNCT attacks could be modulated by lengthening of the trigger stimuli. Indeed, we first described the four patterns of the temporal profile of solitary SUNCT attacks: “plateau-like”, “saw-tooth like”, “repetitive”, and “plateau-like plus exacerbations” [4]. A repetitive pattern of sharp or spike-like paroxysms, without reaching the baseline in between the solitary peaks, inherently carried important pathophysiological implications, as spontaneous or triggered attacks overlapped each other, thus substantiating our observations that SUNCT attacks may lack refractory periods. Available knowledge regarding both quantitative and qualitative temporal aspects of SUNCT attacks has been extensively reported by our group [2–5]. Unfortunately, Paliwal et al. [1] did not mention our early findings and mistakenly referenced the absence of refractory periods in SUNCT to an article by Cohen et al. [6]. For the sake of accuracy it should be noted that, in regards to this subject, Cohen et al. simply replicated our findings, many years later.

Salivary alpha amylase activity in migraine patients

Objective Salivary alpha amylase levels were measured to investigate sympathetic nervous system activity in migraine patients during attack, post-attack and interval periods of headache since salivary alpha amylase levels have been suggested as a potential indirect marker of sympatho-adrenal medullary activity in recent studies. Methods 50 patients with migraine headache (13 patients in attack, 26 patients in post-attack and 11 patients in interval period) and 60 healthy volunteers were taken into the study. In all participants, the presence of anxiety was measured by using Hamilton Anxiety Rating scale. The visual analog scale scores for pain level estimation were obtained in the attack group. Results The salivary alpha amylase levels were significantly lower in attack period ( p < 0.01) and higher in post-attack period ( p < 0.01) when compared with the control group. There was not any significant difference in salivary alpha amylase levels between interval period and control group ( p > 0.05). There was a weak negative correlation between the salivary alpha amylase levels and the visual analog scale scores. Conclusions This is the first study showing the dynamic nature of sympathetic nervous system activity by evaluating the salivary alpha amylase levels—a noninvasive, reliable and an easy method—in different periods of migraine headache.

Cointegration and Dynamic Linkages of International Stock Markets: An Emerging Market Perspective

This study investigates the long-run relationships and short-run dynamic linkages between the stock exchange of Egypt and its counterparts in Group of Seven (G7) countries, prior to and following the tragic events of September 2001, utilizing Johansen’s cointegration and variance decomposition analyses. The empirical results show, inter alia, that : (i) The Egyptian stock exchange appears to share no pairwise long-run cointegration relationships with its counterparts in the G7 countries across the pre- and post-attack periods, with the UK stock exchange being the only exception in the pre-attack period. (ii) The price variation in the Egyptian stock market over the pre- and post-attack periods is predominantly accounted for by its own innovations. (iii) Lastly, the September 2001 attack and its worldwide repercussions seem to exert no conspicuous impact on the behavior of the Egyptian stock exchange, implying that the latter tends to stand aloof from global events.

Sympathetic Skin Responses From Frontal Region in Migraine Headache: A Pilot Study

Frontal sympathetic skin responses (F-SSRs) were recorded to investigate sympathetic nervous system activity in migraine headache (MH). Thirty-five patients with unilateral MH and 10 healthy volunteers were studied by evoking bilateral F-SSRs with electrical stimulation of the median nerve in attack, post-attack and interictal periods. The mean latencies were longer and the maximum amplitudes were smaller on the symptomatic side compared with the asymptomatic side (P < 0.05 for both amplitude and latency) in attack and in interictal periods. In five patients, F-SSRs were absent bilaterally, in four patients the responses were absent only on the symptomatic side during the attack period. In the post-attack period, F-SSRs on the symptomatic side had higher amplitudes and shorter latencies compared with the asymptomatic side (P < 0.01 for both amplitude and latency). There is an asymmetric sympathetic hypofunction on the symptomatic side in attack and interictal periods, whereas there is a hyperfunction in the post-attack period.

Contagion and impulse response of international stock markets around the 9–11 terrorist attacks

This study investigates both return and volatility contagion effects of the 9–11 terrorist attacks across the major markets, and examines the extent to which international stock markets can be destabilized by shocks that arise in the US. Evidence presented in this paper suggests that to the extent that higher correlations with the US market can enhance contagion effects from the US, the attacks brought about volatility contagion (rather than return contagion) from the US to UK and German markets. In contrast, the Japanese market had return contagion (rather than volatility contagion) from the US market. After the attacks, a US shock had a strongly positive effect on the US/Japan return correlation but had little or no effect in response functions of the return correlation for the US/UK and US/German markets. Impulse responses of the volatility correlation to a US shock notably increased after the attacks for the US/UK and US/German markets. An overall analysis of the post-attack period reveals that international market correlations were strengthened through volatility for the US/UK and US/German markets and through return for the US/Japanese market.

National Threat and Political Culture: Authoritarianism, Antiauthoritarianism, and the September 11 Attacks

This paper uses published letters to the editor of major U.S. newspapers to investigate the cultural effects of a major national threat: the September 11, 2001, terrorist attacks. It is based on a hand‐coded, stratified random sample of 1,100 letters to the editor published in 17 major papers in the United States (544 pre‐September 11, 556 post‐September 11). The letters are drawn from a population of 8,101 published letters. Degrees of both authoritarianism and antiauthoritarianism, as well as the general salience of questions of authoritarianism, rose significantly in the post‐attack period. The paper suggests that, instead of a simple threat‐authoritarianism causal link, authoritarianism and antiauthoritarianism are paired elements of political culture that are invoked together in the face of a national threat.

Effects of medication use on health state in postictal migraineurs.

We investigated whether headache-free patients with migraine report a lower health state compared with healthy controls, and whether health state is differently affected during the postattack period after using sumatriptan versus habitual nonvasoactive medication. Mood, health state, and personality questionnaires were administered once during an interictal period and twice within 30 hours after different migraine attacks treated with sumatriptan or habitual nonvasoactive medication. Twenty migraineurs without aura, 10 migraineurs with aura, and 30 matched and headache-free controls participated in this study. During an interictal period, patients with migraine reported more problems regarding social activities and pain compared with healthy controls. During the postictal period, mood (fatigue and emotional state) was negatively affected by an attack that was treated with habitual medication, whereas health state (physical pain, social activities, current pain) was similar to the migraine-free period. Sumatriptan treatment had beneficial effects on aspects of health state and mood during the postictal period.

Variability dynamic analysis of cardiac rhythm at migraine

А spectral analysis of cardiac rhythm variability has taken place among patients with migraine. The purpose of that analysis was to determine the role of cerebral and peripheric regulation changes in the paroxysm pathogenesis at different phases of migrain attack: before it, during it and after it. It was established, that in pre-attack period activation of ergotropic mechanisms takes place with further generalized sympathico-parasympathic activation at the moment of migraine attack. Post-attack period is characterized by activity normalization or segmentary sympathic vasomotor and vagal mechanisms, high level of ergotropic systems activity being maintained.

Improved Subjective Health in Patients in a Post Coronary Rehabilitation Programme

AbstractWe studied the impact of a first myocardial infarction or episode of unstable angina on four areas of subjective health: wellbeing, perceived functional status, body confidence and emotional symptoms. A questionnaire in which the patient was asked to compare status before and after hospital admission was given to 61 cardiac patients attending follow-up rehabilitation clinics.Worries about health and fears of straining oneself were common in the 24 patients surveyed less than 3 months from discharge. But in patients over 3 months from discharge, sense of wellbeing was significantly improved post-infarction compared with pre-infarction: 86% of patients noting a change reported an improvement. Perceived family role performance was significantly improved, while confidence in work performance and general competence remained unchanged. The prevalences of depression, anxiety and worry were unchanged from pre to post attack, patients in whom these symptoms developed being off-set by patients who lost symptoms.Previously-reported adverse sequelae of acute coronary disease may exaggerate the extent of the problem. Restriction of studies to neurotic symptoms and failure to compare pre and post attack periods may fail to elicit improvements in quality of life associated with rehabilitation and secondary prevention programmes.Running Title: Subjective health in post-coronary patients

Chernobyl: The invisible threat

The psychology of response to threat in wartime or peacetime disasters is still not widely understood. The accident at the No. 4 Unit at Chernobyl nuclear power station directly threatened over 1000 persons who were at the plant following the accident and 135 000 people within a 30 km radius. People died or were exposed to high levels of radiation because the invisible and delayed threat from radiation was ignored while fighting the fire and during the ten-day evacuation period. The purpose of this paper is to describe the Chernobyl accident and its impact on the local population and emergency service workers. There are many lessons to be learnt from the Chernobyl accident but while the Soviets and the rest of Europe are hastily revising factor safety plans it is also time for an assessment of the implications for wartime. There are strategic implications for the exposure of defence forces moving into irradiated areas and evacuation plans for civilian populations close to nuclear reactors. With Chernobyl, the Soviets have consolidated a research advantage oh the post-attack recovery period. Twenty years before the Chernobyl accident there.was a similar accident at Kyshtym on the edge of the Siberian plain. The Kyshtym accident may have assisted subsequent preparations by. the emergency services of fire, health and militia. At all important facilities there are civil defence plans for public relocation and 20 hour civil defence courses. Following Chernobyl the Soviets have benefited from research on the regeneration of agriculture and monitoring of the irradiated population. This population included young fit men who were at the accident and 135 000 civilians. The effects of the Chernobyl accident on NATO countries have already included a loss of agricultural production and anti-nuclear propaganda. Prior to the accident, part of the propaganda against nuclear reactors and nuclear weapons was developed through esoteric scientific theories of nuclear winters and the end of the world. These have captured the public's imagination in a twentieth century version of the doomsday myth. The initial public reaction in

Nursing Homes After Nuclear War: Neglected Medical Resources

To the Editor.— In assessing the medical resources in the United States after a massive nuclear attack, Abrams 1 neglects the nursing home. My analysis of the additional beds and personnel in nursing homes shows how the total number of available beds (hospital plus nursing home) in the postattack period is doubled and new options for subacute, long-term, and rehabilitative care of casualties are made available (Table). Using the same death and incapacitation rates and urban locations as Abrams and excluding beds allocated for psychiatric patients, there will be more beds in nursing homes in the postattack period than in short- and long-stay hospitals (283,841 v 273,000). 2 This estimate for available nursing home beds is conservative for the following reasons. (1) Most nursing homes have been built in the past 20 years and are probably sounder structurally than older hospitals. (2) Most nursing homes are one or two stories,

The medical consequences of thermonuclear war. II. The physician's role in the post-attack period.

MANY monographs and articles1 2 3 4 5 6 7 8 have been written to acquaint physicians with the medical problems that might follow a thermonuclear attack on this nation. Often, these articles rely on...