– A relatively new email scam is raking in millions of dollars, and it's got nothing to do with long-lost relatives in Nigeria. Instead, as Quartz explains, the "CEO Email Scam" dupes employees into wiring money by using bogus messages from the boss. The scammers do their homework: They assume the identity of a company CEO, or sometimes simply send an email so close to the correct email that the recipient never notices the difference. The requests go to someone in the company authorized to deal with money, usually demanding quick action—and confidentiality—because of a pending business deal. It's been so successful that the FBI issued an alert last week, citing complaints in every state and in 79 countries. "On the surface, business email compromise scams may seem unsophisticated relative to moneymaking schemes that involve complex malicious software," writes Brian Krebs of Krebs on Security. But the CEO scam is especially effective because of one crucial factor: "In traditional phishing scams, the attackers interact with the victim’s bank directly, but in the CEO scam the crooks trick the victim into doing that for them." When it works, a typical haul is between $25,000 and $75,000. The known haul worldwide is $2.3 billion, says the FBI. One cybersecurity expert in France warns that it won't go away any time soon. "It will spread because it's too good to be ignored," he tells the BBC.

Expand this summary.

Media playback is unsupported on your device Media caption CEO fraud is on the rise, especially in France. But why is it so successful?

 It's a boss's worst nightmare.

 You return from a trip to find that hundreds of thousands of dollars has been transferred out of company accounts - apparently at your instruction.

 But you have no idea what your accountant is talking about - you didn't give any instructions.

 This is what happened to Carole Gratzmuller, boss of a medium-sized French company called Etna Industrie.

 Her firm, which employs 50 people and has been making industrial equipment on the outskirts of Paris for nearly 75 years, was the victim of a specialised email phishing attack dubbed CEO fraud, or "fraude au president" as they call it in France.

 'Confidential transaction'

 "My accountant was called on Friday morning," she tells the BBC. "Someone said: 'You're going to get an email from the president, and she's going to give you instructions to conduct a very confidential transaction and you're going to have to respond to whatever instructions she gives you'."

 The accountant was then emailed from an address with Ms Gratzmuller's name in it, saying Etna Industrie was buying a company in Cyprus.

 The email said the accountant was going to get a phone call from a consultant working with a lawyer, who would then give her instructions as to where to transfer the money.

 "Everything happened between 9 and 10 o'clock," says Ms Gratzmuller. "The accountant probably got about 10 emails in that time and three or four different phone calls.

 Image caption Parisian industrial equipment maker Etna Industrie might have folded if the scam had succeeded

 The fraudsters pressured her into acting quickly, without thinking - a standard feature of this type of phishing fraud.

 "They didn't give her a moment to sit back and think that this was unusual," she says.

 'Vulnerable'

 Before noon the accountant had authorised wire transfers totalling €500,000 (£372,000; $542,000) to foreign bank accounts.

 Luckily for Etna Industrie, three of the wire transfers were held up by the banks, but one for €100,000 went through.

 The many faces of business email fraud

 Image copyright Thinkstock Image caption Who's really hiding behind the mask?

 Someone poses as a boss of a company instructing staff to make a wire transfer into the fraudster's account Fraudsters pose as the IT services department of a bank saying they want to make a test transfer - but it's not a test Fraudsters claim to be a supplier and ask for outstanding invoices to be paid into a new bank account Employees click on links within phishing emails containing malware which authorises many small payments to the fraudster's account

 The company got this money back after the bank in question was found to be at fault by the French courts. However, the bank is appealing against the decision.

 "It's like when your house or apartment gets broken into," says Ms Gratzmuller. "You feel vulnerable. People get into your life and they know things about you and you have no clue, and they take things from you."

 French connection

 But the case of Etna Industrie is small fry compared to the scale of "fraude au president" across France as a whole.

 French businesses have lost an estimated €465m since 2010, official figures suggest, with 15,000 firms falling victim to the scam, including big names, such as Michelin, KPMG and Nestle.

 Image copyright Getty Images Image caption Tyre maker Michelin is one of many French big-name firms who've fallen for the fraud

 The biggest fraud was for €32m, and a further €830m could have been stolen if more phishing attacks had proved successful, say French police.

 Matthieu Bares, deputy head of their financial crime division, says there are one or two attacks on French companies every day, but that "plenty of victims don't report the fraud".

 But why France in particular?

 Gilbert Chikli, a French-Israeli man, may have a lot to do with it. He defrauded more than 30 banks and companies out of €7.9m during 2005 and 2006, pretending to be, variously, company heads and secret service agents.

 Chikli fled to Israel in 2009 and in his absence was sentenced to seven years in prison last year.

 Image copyright AP Image caption President Hollande's partner Julie Gayet is making a film about fraudster Gilbert Chikli

 With no extradition agreement between Israel and France, Chikli remains living in Tel Aviv, and a film based on his life is being made - starring French president Francois Hollande's girlfriend, Julie Gayet.

 It is still predominantly French-Israeli gangs running the fraud, police say, and their ability to impersonate French bosses has seen France bearing the brunt of the onslaught in Europe.

 Global spread

 But CEO fraud is not just a French problem.

 In the US, the FBI's internet crime centre or IC3 has been tracking "business email compromise" scams, as it calls them, and reckons about 7,000 companies have been defrauded of more than $740m (£508m; €682m) over the last two years.

 The real figure is likely to be much higher though, given how reluctant many companies are to admit being defrauded in this way.

 Image copyright Getty Images Image caption Although France has been particularly prone to CEO fraud, it is also a global problem

 "We think more than $2bn has been lost to business email scams over the last two years," says Aaron Higbee, co-founder and chief technology officer of PhishMe, a US security company specialising in educating staff about phishing attacks.

 One US company, Ubiquiti Networks, a wireless network equipment manufacturer, admitted to wiring $39.1m to fraudsters after falling victim to this type of scam repeatedly last year.

 "Fraudsters are increasing the intensity of attacks," says Amichai Shulman, chief technology officer at data security company, Imperva. "So it only takes a tiny percentage to get through to be effective. There are not enough policing resources in cyberspace to monitor them all."

 Social engineering

 But why is CEO fraud proving so effective?

 Mr Higbee suggests it because this type of email can more easily bypass spam filters and antivirus security systems.

 "It doesn't need attachments carrying malware, it's just a conversation," he says. "It's very low-tech and a big departure from the large, automated malware attacks we're used to."

 Image copyright Thinkstock Image caption Is that urgent email from your boss actually from a fraudster exploiting your credulity?

 Fraudsters use publicly available corporate data gleaned from the internet to make the emails as convincing as possible, finding out who the bosses and senior financial officers are from social networks like LinkedIn, for example.

 Staff are less likely to question instructions purporting to come from on high, and it's this psychological manipulation - often accompanied by a sense of urgency - that is a major factor in the fraud's success.

 "It will spread because it's too good to be ignored," warns Jerome Robert from French cybersecurity company, Lexsi. "[Criminals] can make so much money in a very small amount of time, with minimal risk."

 Businesses should be on their guard.

 Listen to BBC World Business Report's How not to be a victim of internet scams

 Follow Technology of Business editor Matthew Wall on Twitter: @matthew_wall ||||| FBI officials are warning potential victims of a dramatic rise in the business e-mail compromise scam or “B.E.C.,” a scheme that targets businesses and has resulted in massive financial losses in Phoenix and other cities.

 The schemers go to great lengths to spoof company e-mail or use social engineering to assume the identity of the CEO, a company attorney, or trusted vendor. They research employees who manage money and use language specific to the company they are targeting, then they request a wire fraud transfer using dollar amounts that lend legitimacy.

 There are various versions of the scams. Victims range from large corporations to tech companies to small businesses to non-profit organizations. Many times, the fraud targets businesses that work with foreign suppliers or regularly perform wire transfer payments.

 Law enforcement globally has received complaints from victims in every U.S. state and in at least 79 countries.

 From October 2013 through February 2016, law enforcement received reports from 17,642 victims.

 This amounted to more than $2.3 billion in losses.

 Since January 2015, the FBI has seen a 270 percent increase in identified victims and exposed loss.

 In Arizona the average loss per scam is between $25,000 and $75,000.

 If your company has been victimized by a BEC scam:

 Contact your financial institution immediately

 Request that they contact the financial institution where the fraudulent transfer was sent

 File a complaint—regardless of dollar loss—with the IC3.

 Tips for Businesses:

 Be wary of e-mail-only wire transfer requests and requests involving urgency

 Pick up the phone and verify legitimate business partners.

 Be cautious of mimicked e-mail addresses

 Practice multi-level authentication.

 Resources: ||||| An entrepreneur has come to the rescue of unmarried couples in Delhi and Mumbai.

 Young couples looking for some privacy in conservative India are often vulnerable to physical attacks by the police and self-appointed guardians of “Indian culture.” Vigilante groups have assaulted lovers in parks, beaches, and pubs for engaging in any sort of public display of affection. As a result, consenting adults, if they are unmarried, often struggle to find hotel rooms for some private time.

 Enter StayUncle. The New Delhi-based startup has tied up with hotels where unmarried couples can rent rooms for a duration as short as 8-10 hours. The idea is to help them with affordable rooms, without feeling uncomfortable or unsafe.

 “There is no law in India that prohibits (unmarried) couples from renting a room,” Sanchit Sethi, founder of the year-old startup, told Quartz in a phone interview. “As long as you have a government identity card, you should be given a room. We don’t live in the 1950s anymore. What we are trying to do is change the mindset of hoteliers.”

 “Couples need a room. Not a judgement.”

 Sethi’s initial business plan was to offer hotel rooms for short durations to travellers. Most hotels in India take reservations on a 24-hour basis—a relatively expensive affair. Together with Blaze Arizanov, a digital marketer, the duo launched StayUncle in April 2015. New Delhi’s Hotel Shimla Heritage became StayUncle’s first tie-up.

 The company also received its first angel investment of a “couple of lakhs” from Ajay Naqvi, the country marketing manager for Airbnb, according to Sethi.

 “What was surprising was that 99% of the enquiries we were receiving were from unmarried couples looking for rooms,” said Sethi, a Birla Institute of Technology and Science (BITS)-Pilani graduate. That’s when StayUncle decided to take a relook at its business.

 “We started fresh all over again. This time, with the focus on unmarried couples,” said Sethi.

 Uncle starts scaling up

 In December 2015, Ace Residency, a budget hotel in New Delhi’s upmarket Greater Kailash neighbourhood, partnered with StayUncle. This was the first hotel to sign up with StayUncle that allowed rooms to be booked for unmarried couples.

 Since then, the company has tied up with 34 others in the capital and 10 in Mumbai. Now, even marquee properties such as the Trident and Oberoi have joined them, according to Sethi. Over the next few months, StayUncle will also start helping young people plan surprise parties or travel, with the intention of building an ecosystem around unmarried couples.

 “Out of 10 hotels we speak to, only two or three eventually sign up,” said Sethi. “This is a new industry and people often see this as going against the culture of the country and there is always the fear of moral policing.” However, in the past three months, the company has already catered to some 200 couples.

 A poster by StayUncle (StayUncle/Facebook)

 Many hoteliers are reluctant to join, fearing “unnecessary hassles” from cops. The police in India often harass young consenting adults and threaten them with charges of public indecency. Last August, 13 couples were picked up by cops from beaches and hotels in Mumbai for “indecent behaviour.”

 A hotelier in New Delhi who spoke to Quartz on conditions of anonymity confirmed that StayUncle is bringing a “certain change to the mindset” of the public. “But, hotels don’t want to announce that they are open to unmarried couples,” the hotelier explained. “Sometimes, we face resistance from staff who question why we are allowing unmarried couples. But the fact is, it is not illegal.”

 Risky business, but sustainable

 Currently, StayUncle works on a commission basis, which varies from hotel to hotel.

 “We don’t want to scale up massively by offering cheap discounts. That is not a viable and sustainable business model,” said the 26-year-old Sethi. “In the long run, it will not work. So we would rather focus on growing slowly.”

 A large number of India’s e-commerce players and budget hotel-booking companies have relied on massive discounts to scale up business. But that model has come in for heavy criticism for bleeding investor wealth.

 An eight-hour stay at hotels that are listed on StayUncle costs anywhere between Rs1,400 ($21) and Rs5,000 ($75). The average rates, however, is around Rs2,000 ($30) for an eight-hour stay.

 Now, as StayUncle expands, it has another challenge: ensuring privacy.

 In a country where hidden cameras have been found in the changing rooms of even upmarket designer stores, Sethi, and his team will have to ensure that his clients are safe.

 “If you see, we currently only tie up with hotels that have a reputation and they would not allow something that puts their business at stake,” said Sethi. “Of course, I wouldn’t say the problem can be completely eliminated, but we know that these hotels we tie up with would never ever do it.” ||||| The U.S. Federal Bureau of Investigation (FBI) this week warned about a “dramatic” increase in so-called “CEO fraud,” e-mail scams in which the attacker spoofs a message from the boss and tricks someone at the organization into wiring funds to the fraudsters. The FBI estimates these scams have cost organizations more than $2.3 billion in losses over the past three years.

 In an alert posted to its site, the FBI said that since January 2015, the agency has seen a 270 percent increase in identified victims and exposed losses from CEO scams. The alert noted that law enforcement globally has received complaints from victims in every U.S. state, and in at least 79 countries.

 CEO fraud usually begins with the thieves either phishing an executive and gaining access to that individual’s inbox, or emailing employees from a look-alike domain name that is one or two letters off from the target company’s true domain name. For example, if the target company’s domain was “example.com” the thieves might register “examp1e.com” (substituting the letter “L” for the numeral 1) or “example.co,” and send messages from that domain.

 Unlike traditional phishing scams, spoofed emails used in CEO fraud schemes rarely set off spam traps because these are targeted phishing scams that are not mass e-mailed. Also, the crooks behind them take the time to understand the target organization’s relationships, activities, interests and travel and/or purchasing plans.

 They do this by scraping employee email addresses and other information from the target’s Web site to help make the missives more convincing. In the case where executives or employees have their inboxes compromised by the thieves, the crooks will scour the victim’s email correspondence for certain words that might reveal whether the company routinely deals with wire transfers — searching for messages with key words like “invoice,” “deposit” and “president.”

 On the surface, business email compromise scams may seem unsophisticated relative to moneymaking schemes that involve complex malicious software, such as Dyre and ZeuS. But in many ways, CEO fraud is more versatile and adept at sidestepping basic security strategies used by banks and their customers to minimize risks associated with account takeovers. In traditional phishing scams, the attackers interact with the victim’s bank directly, but in the CEO scam the crooks trick the victim into doing that for them.

 The FBI estimates that organizations victimized by CEO fraud attacks lose on average between $25,000 and $75,000. But some CEO fraud incidents over the past year have cost victim companies millions — if not tens of millions — of dollars.

 Last month, the Associated Press wrote that toy maker Mattel lost $3 million in 2015 thanks to a CEO fraud phishing scam. In 2015, tech firm Ubiquiti disclosed in a quarterly financial report that it suffered a whopping $46.7 million hit because of a CEO fraud scam. In February 2015, email con artists made off with $17.2 million from The Scoular Co., an employee-owned commodities trader. More recently, I wrote about a slightly more complex CEO fraud scheme that incorporated a phony phone call from a phisher posing as an accountant at KPMG.

 The FBI urges businesses to adopt two-step or two-factor authentication for email, where available, and to establish other communication channels — such as telephone calls — to verify significant transactions. Businesses are also advised to exercise restraint when publishing information about employee activities on their Web sites or through social media, as attackers perpetrating these schemes often will try to discover information about when executives at the targeted organization will be traveling or otherwise out of the office.

 For an example of what some of these CEO fraud scams look like, check out this post from security education and awareness firm Phishme about scam artists trying to target the company’s leadership.

 I’m always amazed when I hear security professionals I know and respect make comments suggesting that phishing and spam are solved problems. The right mix of blacklisting and email validation regimes like DKIM and SPF can block the vast majority of this junk, these experts argue.

 But CEO fraud attacks succeed because they rely almost entirely on tricking employees into ignoring or sidestepping some very basic security precautions. Educating employees so that they are less likely to fall for these scams won’t block all social engineering attacks, but it should help. Remember, the attackers are constantly testing users’ security awareness. Organizations might as well be doing the same, using periodic tests to identify problematic users and to place additional security controls on those individuals.

 Tags: ceo fraud, dkim, Dyre, fbi, phishme, spf, The Scoular Co., Ubiquiti, zeus |||||


Here is a news article: Pakistan's army ordered a reduction in U.S. military personnel operating inside the country on Thursday in apparent protest at a unilateral American commando raid that killed Osama bin Laden.

 A Pakistani police officer stands guard at a gate of the compound where al-Qaida leader Osama bin Laden was caught and killed in Abbottabad, Pakistan Thursday, May 5, 2011. The residents of Abbottabad... (Associated Press)

 Pakistan's Foreign Secretary Salman Bashir addresses a news conference with spokesperson Tehmina Janjua, left. at the Foreign Office in Islamabad, Pakistan on Thursday, May 5, 2011. Pakistan warned America... (Associated Press)

 A Pakistani police officer, right, stands guards as people lean on the wall of the house where al-Qaida leader Osama bin Laden was caught and killed in Abbottabad, Pakistan, Thursday, May 5, 2011. The... (Associated Press)

 Pakistani men stand looking at the house where al-Qaida leader Osama bin Laden was caught and killed in Abbottabad, Pakistan, Thursday, May 5, 2011. The residents of Abbottabad were still confused and... (Associated Press)

 The army has been heavily criticized at home for allowing the country's sovereignty to be violated during Monday's operation in a busy garrison town not far from the capital, Islamabad. It is also facing international charges it may have been harboring the al-Qaida chief, given his location.

 The army statement, the first since the raid, appeared aimed at countering both charges.

 It said a decision had been made to reduce the number of U.S. military personnel to the "minimum essential" levels, but gave no more details and a spokesman declined to elaborate. U.S. officials were not immediately available for comment.

 The U.S. has around 275 declared U.S. military personnel in Pakistan at any one time, some of them helping train the Pakistan army.

 The Pakistani army also warned that it would review its military and intelligence cooperation with Washington if the United States carries out any more similar raids. Earlier, the government had warned of "disastrous consequences" if the U.S. staged a similar attack on its territory.

 But in an apparent nod to international criticism, the army admitted to "shortcomings in developing intelligence on the presence" of bin Laden in Pakistan.

 Still, it said its Inter-Services Intelligence agency had given initial information to the CIA about bin Laden, but claimed the "CIA did not share further development of intelligence on the case with the ISI, contrary to the existing practice between the two services."

 Ties between American and Pakistan were already strained before Monday's raid because of American allegations it was failing to crackdown on Afghan Taliban factions sheltering on its soil and Pakistan anger over U.S. drone strikes on its soil. ||||| Pakistan’s army chief warned Thursday that any repeat of the type of U.S. commando operation that killed Osama bin Laden would be viewed as a violation of Pakistani sovereignty and would imperil military and intelligence cooperation between the two countries.

 The combative statement came as a senior U.S. defense official said Pakistan would have to take “very concrete and visible steps” to persuade Congress to continue providing $3 billion in annual military and economic assistance.

 “We are still talking with the Pakistanis and trying to understand what they did know, what they didn’t know” about bin Laden’s apparently years-long residence in a garrison city north of the Pakistani capital, Defense Undersecretary Michele Flournoy said at the Aspen Institute in Washington.

 Obama administration officials said they were uncertain whether the statement by Gen. Ashfaq Kayani, which also acknowledged “shortcomings” in Pakistani intelligence on bin Laden, reflected Pakistan’s actual stance or whether it amounted to posturing for a domestic audience.

 In conversations with U.S. officials, one administration official said, Kayani had been “much more nuanced. . . . We didn’t hear this bellicosity.”

 Regardless of the statement’s intended audience, it reflected the intense anger felt at the highest levels of Pakistan’s powerful military toward the United States and suggested that the two countries remain far apart in how they view bin Laden’s killing.

 The discovery of the terrorist leader’s refuge deepened belief in Washington that elements of Pakistan’s army had provided him sanctuary. But Pakistan’s military and intelligence establishment has chafed at U.S. expressions of victory and shown acute resentment about what it deems a lack of gratitude for Pakistan’s partnership.

 The administration has asked Pakistan for details about the compound where bin Laden lived in Abbottabad and who had access to it. But officials have largely refrained from criticizing Pakistan in recent days while trying to keep a crucial, if unsteady, counterterrorism partnership from completely unraveling.

 “It is not always an easy relationship,” Secretary of State Hillary Rodham Clinton said Thursday in Rome, on the sidelines of an international conference on Libya. “But, on the other hand, it is a productive one for both of our countries, and we are going to continue to cooperate.”

 At White House meetings Wednesday, President Obama’s national security advisers discussed how long to wait before delivering a sterner message to Pakistan, what it should be and who should deliver it, the administration official said. One option under consideration is for Vice President Biden, who visited with Pakistani President Asif Ali Zardari in January, to make a phone call. Another is to wait until Clinton visits Islamabad, the Pakistani capital, later this month.

 “We realize that at this point we have a great degree of leverage, and we want to make sure we use it wisely and effectively, because it won’t last long,” said the official, who was not authorized to discuss the situation on the record.

 Doubts on both sides

 The Thursday statement was the first by Kayani since the bin Laden operation. In the statement, he and Pakistan’s other top generals said they had decided to reduce U.S. military personnel in the country to the “minimum essential.” But U.S. military officials said they had received no formal request to draw down the 120 Special Operations trainers presently working in Pakistan.

 Kayani’s statement described Pakistan’s Inter-Services Intelligence agency as second to none in combating terrorism and its CIA counterparts as untrustworthy.

 “In the case of Osama bin Laden, while the CIA developed intelligence based on initial information provided by ISI, it did not share further development of intelligence on the case with ISI, contrary to the existing practice between the two services,” the statement said, adding that Pakistani spies had captured or killed about 100 al-Qaeda operatives and leaders.

 U.S. officials have long alleged that elements of Pakistan’s intelligence establishment provide support to Islamist militants as assets for influence against archenemy India. U.S. officials have said this week that they have no evidence of state support in Pakistan for bin Laden, but they have also expressed deep doubts that he could have lived in a military town without assistance from some security officials.

 Those doubts were voiced Thursday at a hearing on Pakistan held by the Senate Foreign Relations Committee. At the hearing, virtually all members questioned what Pakistan knew and did about bin Laden. “Some critics say it is time for us to wash our hands of the whole country,” said Sen. Richard G. Lugar (Ind.), the ranking Republican on the committee. He said his view was that “distancing ourselves from Pakistan would be unwise and extremely dangerous.”

 Lugar, John F. Kerry (D-Mass.), the committee chairman, and Rep. Howard L. Berman (D-Calif.) co-sponsored a $7.5 billion, five-year package of economic assistance to Pakistan in 2009. On Thursday, Berman sent Clinton a letter questioning whether Pakistan was qualified to receive the aid, as she had certified in March.

 Earlier Thursday, in the Pakistani government’s first detailed briefing on the bin Laden killing, Foreign Secretary Salman Bashir appeared to question the legality of the U.S. operation. Pakistani media have speculated that the United States, riding high, would soon try to capture Afghan Taliban leader Mohammad Omar or the chief of the Haqqani network, another Afghan militant group.

 Issue of sovereignty

 At least on the surface, the Pakistani responses indicate that Washington might not be able to easily leverage the embarrassing revelation that bin Laden was hiding in plain sight in Pakistan to force the nation’s army to hit harder against militant sanctuaries, turn over other high-value terrorists living in Pakistan or help speed reconciliation in Afghanistan.

 But in a week in which Pakistan’s army and intelligence services have faced a rare onslaught of criticism, the Pakistani statements also appeared to reflect a concerted effort to redirect the public discourse toward anger at the United States. Violations of sovereignty, particularly by U.S. troops, are a sensitive issue in Pakistan, and the national conversation has begun to focus on that, rather than on the presence of militants in Pakistani cities.

 Pakistanis “feel deeply angered, aggrieved, and humiliated at the failure of our civil and military leadership in the face of the flagrant violation of our sovereignty by the government of the United States,” said a statement Thursday from the Pakistan Ex-Servicemen Association, an organization of about 2,000 former officers.

 The army promised an investigation into how bin Laden could have lived undetected in Pakistan. But past Pakistani government and military inquiries, including into the assassination of former prime minister Benazir Bhutto, have rarely been revealing.

 Staff writer Walter Pincus in Washington contributed to this report. |||||
A summary of this is?

– Pakistan's army today admitted to "shortcomings in developing intelligence on the presence" of Osama bin Laden, then promptly ordered a reduction in US military in the country to "minimum essential" levels. The reduction is apparently meant to protest the independent US raid on bin Laden's compound, which has been criticized in Pakistan as violating that country's sovereignty, the AP reports. Pakistan earlier warned of "disastrous consequences" if the US carries out other, similar raids in the future. Despite the admitted shortcomings, Pakistan's army says the country's Inter-Services Intelligence agency gave initial information to the CIA. In its statement, the first since the raid, the army threatened that if the US carries out more raids like Sunday's, it will review its cooperation with Washington. The Washington Post notes that Pakistan's foreign minister also appeared to question whether the US raid was legal, citing UN Security Council resolutions and suggesting the raid may have breached international law.


News article:

A timeline of the over-medication scandal and subsequent investigation at the Tomah VA Medical Center

 Where to go for help

 The Tomah VA has sent letters to 592 patients treated over the past year by a dentist who was found to be improperly sterilizing his tools. Patients can call a 24-hour hotline with questions or to schedule an appointment for blood tests.

 Testing is available through Dec. 22 at Building 400, room #1054 on the Tomah campus weekdays between 8 a.m. and 5:30 p.m. and from 8:30 a.m. to noon on Saturdays.

 Call 888-598-7793 for questions or to schedule an appointment. ||||| Nearly 600 veterans who received care at the Tomah VA may have been infected with several types of disease due to violations in infection control procedures.

 VA administrators made the announcement Tuesday afternoon at a press conference.

 The Tomah VA says it's in the process of notifying 592 veterans that they may be infected with Hepatitis B, Hepatitis C, or HIV after they received care from one particular dental provider.

 Acting Medical Center Director Victoria Brahm said the dentist was using his own equipment, then cleaning it and reusing it, which violates the VA's regulations.

 The Tomah VA says it uses sterile and disposable equipment.

 The VA says he did this for one year, from October 2015 through October 2016.

 It came to light when someone filling in for his assistant noticed what was going on and reported it.

 That dentist has been removed from patient care and is now working in an administrative role.

 The VA also referred the case to the inspector general for assessment of any criminal charges.

 "It was purposeful that he was violating VA regulations," Brahm said. "During all of the orientation, he used all of our equipment. He used it appropriately, so it was very purposeful from what we found in our investigation that he knew exactly what he was doing, and preferred to use his own equipment against procedure."

 Brahm told reporters that the Tomah VA has made improvements but still has others to make.

 "We have clear evidence that we are moving forward and the people that remain here are very vested and here for the mission of taking care of veterans," she said. "There are pockets of improvement that need to occur they still need to I'll be honest, and we are aware of where they are and we are dealing with them as quickly as we can."

 The VA is offering free screenings to those veterans and will provide free medical treatment to those who test positive for an infection.

 The news is very alarming to a lot of people, especially veterans in Western Wisconsin. Several veterans WEAU 13 News spoke with Tuesday on and off camera say me they were surprised and concerned to hear the news out of the Tomah VA. While all of them said they have received care at the medical center, none of them received dental care.

 Army vet Jan Gross says he uses many of the services offered through the Tomah VA. While his experience has been good, he has seen others become frustrated with the medical center. Gross says that the level of care provided to vets at the Tomah VA isn't where it should be. He said he is concerned the clinic isn't keeping enough seasoned staff around to provide the best care.

 "I don't think they are paying them enough to keep good support staff and keep the main stay help for the VA so we suffer. People get frustrated, I see guys sick and tired of just waiting that they just walk out and don't come back," Gross said.

 This isn't the first time the Tomah VA has come under fire for its medical practices. In recent years, the center has been under investigations on allegations doctors there over prescribe prescription painkillers to patients.

 TOMAH, Wis. (WEAU) -- Almost 600 veterans who received care at a medical center may have been infected with several types of disease because of what it describes as “lapses in established infection control procedures.”

 The Tomah VA Medical Center made the announcement that the people may be infected with Hepatitis B, Hepatitis C or HIV at a news conference on Tuesday afternoon. The facility says it all happened at its dental clinic from Oct. 2015 to Oct. 2016. The center claims the infection risk is low and is limited to patients of a single care provider, though that provider was not named in a statement from the Tomah VA. The facility investigated the situation. It says that work was finished Oct. 31. It goes on to say that the provider was immediately removed from patient care. Staff at the Tomah VA are reviewing patient records to be sure they are "thoroughly inspected and verified.”

 The VA is calling and mailing 592 veterans it says may be affected. If affected veterans test positive, the VA will provide the necessary care and treatment at no cost. The center calls the screenings precautionary, saying there is no indication that any patients have contracted an infection. Veterans can ask questions by calling (888) 598-7793. The center also has a designated follow-up testing site in Building 400, Room #1054 on the Tomah VA campus. It's open Monday-Friday from 8 a.m. until 5:30 p.m. and Saturday from 8:30 a.m. until noon. The site will be open until Dec. 22 and will be closed on holidays.

  ||||| According to a troubling report from the U.S. Department of Veterans Affairs, one health care provider’s violation of VA protocol may have infected hundreds of veterans. A dentist at the Tomah, Wisconsin VA used his own equipment, cleaning it between patients, Acting Medical Center Director Victoria Brahm said. VA rules require the use of disposable instruments, throwing them out after use.

 This practice went on for one year, from October 2015 to October 2016, and now 592 veterans are at risk of having contracted Hepatitis B, Hepatitis C, or HIV. It was only reported when someone substituting for the dentist’s regular assistant saw what was going on and notified authorities.

 Brahm said that this wasn’t a matter of the dentist not knowing proper VA procedure, but a conscious decision to break the rules. “It was purposeful that he was violating VA regulations,” she said, according to WEAU. “During all of the orientation, he used all of our equipment. He used it appropriately, so it was very purposeful from what we found in our investigation that he knew exactly what he was doing, and preferred to use his own equipment against procedure.”

 So far, there is no report that anyone was infected, but the VA is offering free screenings to the 592 people who they determined are at risk. If anyone tests positive, the VA will provide free treatment. Those who have so far gone in for screening have been told it could take two to three weeks to get results.

 The dentist is now working in an administrative role, and is no longer treating patients. The inspector general’s office is reportedly looking into whether criminal charges are appropriate.

 [Image via WEAU screengrab] |||||
What is a shorter version of the above article?

– The VA is offering free testing to nearly 600 veterans in Wisconsin who may have been infected with hepatitis or HIV by a rogue dentist, Law Newz reports. The dentist providing care at the VA in Tomah was using his own dental instruments. And while the dentist sterilized the tools between uses, VA rules say he was supposed to use disposable instruments and throw them away after each use. Acting medical center director Victoria Brahm tells WEAU that the dentist's actions were "purposeful." "He knew exactly what he was doing and preferred to use his own equipment against procedure," she says. The dentist was using his own tools between October 2015 and October 2016. An assistant subbing for the dentist's normal assistant ratted him out to authorities. On Tuesday, the VA started contacting the 592 vets who received treatment from the dentist, offering free testing for Hepatitis B, Hepatitis C, and HIV, the La Crosse Tribune reports. There have been no reports of infections stemming from dental work at the Tomah VA. “Out of an abundance of caution it’s still the proper thing to do," a VA spokesperson says regarding free testing. The dentist is no longer treating patients but is still working at the VA; he may face criminal charges. His regular dental assistant is also being investigated. The Tomah VA was recently under investigation for over prescribing painkillers in connection with the deaths of at least two vets. "I don't think they are paying them enough to keep good support staff ... so we suffer," one vet tells WEAU.


Summarize this article:

Cries of "shame" rose up as Toronto Mayor Rob Ford walked up to the podium to honor war veterans. One World War II veteran refused to shake his hand, calling him a "druggie." Unfazed, Ford declared moments later, "I'm not going anywhere," as calls to take a leave of absence swirl around the embattled mayor. The next day, he was signing bobblehead dolls of himself at City Hall to raise money for charity.

 Toronto Mayor Rob Ford holds a Rob Ford bobblehead doll at Toronto city hall on Tuesday, Nov. 12, 2013. Up to 300 people lined up at City Hall Tuesday to buy the "Robbie Bobbie" dolls for $20 each, with... (Associated Press)

 Toronto Mayor Rob Ford speaks during a press conference to advocate relief for the people in the Philippines affected by Typhoon Haiyan, Tuesday, Nov. 12, 2013 in Toronto. A defiant Toronto Mayor Rob... (Associated Press)

 Toronto Mayor Rob Ford autographs a bobblehead doll in his likeness Tuesday, Nov. 12, 2013, at city hall in Toronto. Hundreds of people lined up to be the first to own the bobblehead doll. The defiant... (Associated Press)

 Toronto Mayor Rob Ford poses with a bobblehead doll in his likeness Tuesday, Nov. 12, 2013, at city hall in Toronto. Hundreds of people lined up to be the first to own the bobblehead doll. The defiant... (Associated Press)

 Toronto Mayor Rob Ford, right, autographs a bobblehead doll in his likeness Tuesday, Nov. 12, 2013, at city hall in Toronto. Hundreds of people lined up to be the first to own the bobblehead doll. The... (Associated Press)

 Toronto Mayor Rob Ford speaks during a press conference to advocate relief for the people in the Philippines affected by Typhoon Haiyan, Tuesday, Nov. 12, 2013 in Toronto. A defiant Toronto Mayor Rob... (Associated Press)

 Toronto Mayor Rob Ford speaks during a press conference to advocate relief for the people in the Philippines affected by Typhoon Haiyan, Tuesday, Nov. 12, 2013 in Toronto. A defiant Toronto Mayor Rob... (Associated Press)

 Ford's refusal to resign over his admitted drug use has confounded Toronto's City Council. Allies and opponents alike agree that a stream of revelations of the mayor's erratic behavior _ from smoking crack cocaine in a "drunken stupor" to threatening to kill someone in a videotaped tirade _ has consumed Toronto's politics and has impacted the City Council's ability to tackle other challenges.

 But with no clear legal path to force him out, the 44-member City Council is grasping for ways to shunt the larger-than-life leader aside and govern without him until next year's municipal elections.

 It is an unprecedented effort but in some ways, it may not be a stretch. Toronto's mayor already has limited powers compared to the mayors of many large cities in the United States. He is just one voting member in the council and his power stems mostly from his ability, as the only councilor elected by citywide vote, to build consensus and set the agenda. That authority, many council members say, has evaporated in the crack scandal.

 "We really just have to build a box around the mayor so we can get work done," said councilor John Filion, who has introduced one of two motions in the council designed to isolate Ford.

 The first motion, which goes to a vote Wednesday, would call on Ford to take a leave of absence, apologize to Toronto residents for misleading them and cooperate with police. If he refuses, the council would ask the province of Ontario to pass legislation to remove the mayor from office.

 The City Council has no authority itself to oust Ford because he has not been convicted of a crime. Toronto police said last month they had obtained a long-sought video of Ford apparently smoking from a crack pipe but that it does not constitute enough evidence to charge him.

 The motion was introduced by City Councilor Denzil Minnan-Wong, who had been a supporter of the conservative Ford's policies since the mayor took office three years ago, riding a backlash from suburbanites who felt alienated by what they deemed Toronto's downtown-centric, liberal-dominated politics.

 In an opinion piece in the Globe and Mail, Minnan-Wong said he had been encouraged by Ford's election "because we shared the same policy aims: frugal government, working to eliminate waste, contracting out work where it made sense, and respect for the tax dollars of Torontonians."

 "No longer can he set an agenda for council or build a consensus among its members," wrote Minnan-Wong, who is on Ford's executive committee. "No longer is there confidence in his judgment. Rightly or wrongly, Mr. Ford has lost the moral authority to lead."

 News reports of the crack video's existence first surfaced in May, but it has not been released publicly.

 After police announced they had the video, Ford confessed that he smoked crack last year while drunk and apologized. But he insisted he is not addicted to drugs and does not need rehab. He says he is ready to make his case before the increasingly hostile City Council.

 "It's going to be rumble in the jungle tomorrow," Ford said Tuesday, as he autographed a "Robbie Bobbie" bobblehead doll at City Hall.

 Despite the growing cries for Ford to go, the motion is unlikely to pass. Many councilors are loath to ask Ontario's provincial government to intervene in Toronto's municipal affairs, fearing it would set a dangerous precedent. Provincial government officials have publicly expressed reluctance to do so.

 Another proposed motion would curtail Ford's powers, suspending his authority to appoint and dismiss the deputy mayor and his executive committee, which runs the budget process. It likely won't be debated until December because of the council's procedural rules.

 Filion, the councilor who introduced that motion, said the idea is to prevent Ford from firing executive committee members _ such as Minnan-Wong _ who speak out against him. Councilors are also considering stripping Ford's authority to set the City Council's agenda, said Councilor Adam Vaughan, who opposes getting the province involved.

 "We will shun him, curtail his power as best we can," Vaughan said. "He clearly has gone off the deep end, shot himself in outer space."

 While Ford, 44, has lost political leverage, his core supporters have not lost faith in the populist mayor who refers to them as "Ford Nation."

 "It won't be the end of Ford Nation, they just put up a billboard in support of him last week," said Nelson Wiseman, a political professor at the University of Toronto. "The movement and the anti-government sentiment it embodied that got him elected will stay alive ... His base will remain strong whether or not he's removed from office."

 After winning office in 2010, Ford took measures that pleased his suburban voter base, including abolishing an annual $60 vehicle registration tax, squeezing valuable concessions out of the union representing 6,000 city workers, and reducing costs by contracting out half of Toronto's garbage collection. Ford claims to have saved taxpayers $1 billion dollars in the process, though councilors dismiss that claim as highly inflated since he has increased the cost of transit, among other public services, along with hiking property taxes.

 City councilors say the mayor's travails are creating chaos around efforts to confront Toronto's most difficult challenges, including developing public transit service and reduce grinding commutes.

 Ford opposes a proposed, fully-funded, light-rail transit plan in favor of a more expensive subway extension into a suburb where his support runs strong.

 The subway project _ already controversial because it will force the city to raise taxes and seek federal and provincial money _ has been engulfed in chaos since the mayor took office and was further impacted after the allegations surfaced in May that Ford had been filmed smoking a crack pipe. As the mayor's influence eroded, councilors debated back and forth on the issue, voting on and then reversing its decisions several times, until making a final decision weeks ago.

 "After the news surfaced about his personal life, that further disintegrated things," Filion said, adding that it caused councilors to distance themselves from Ford. "People are just openly scornful of him whereas six months ago they may have thought he was a wonderful mayor, and so we now have this fairly large power vacuum that someone needs to step in and fill."

 At least one city councilor has been steadfast in his support of the mayor: his brother, Doug Ford.

 "They are going to get up, 44 of them, and give my brother a public beating, a public butchering," Doug Ford said ahead of Wednesday's proceedings. "I'm going to have to stand there and watch it happen so we'll see how it turns out." ||||| Hundreds of people are snatching up bobblehead dolls of Toronto Mayor Rob Ford, signed by the embattled politician himself.

 Toronto Mayor Rob Ford autographs a bobblehead doll in his likeness Tuesday, Nov. 12, 2013, at city hall in Toronto. Hundreds of people lined up to be the first to own the bobblehead doll. The defiant... (Associated Press)

 Toronto Mayor Rob Ford autographs the box of a bobblehead doll in his likeness Tuesday, Nov. 12, 2013, at city hall in Toronto. Hundreds of people lined up to be the first to own the bobblehead doll.... (Associated Press)

 A man buys a bobblehead doll in the likeness of Toronto Mayor Rob Ford at city hall Tuesday, Nov. 12, 2013, in Toronto. Hundreds of people lined up to be the first to own the bobblehead doll. The defiant... (Associated Press)

 Toronto Mayor Rob Ford poses with a bobblehead doll in his likeness Tuesday, Nov. 12, 2013, at city hall in Toronto. Hundreds of people lined up to be the first to own the bobblehead doll. The defiant... (Associated Press)

 Toronto Mayor Rob Ford, right, autographs a bobblehead doll in his likeness Tuesday, Nov. 12, 2013, at city hall in Toronto. Hundreds of people lined up to be the first to own the bobblehead doll. The... (Associated Press)

 Up to 300 people lined up at City Hall Tuesday to buy the "Robbie Bobbie" dolls for $20 each, with the proceeds going to charity. The line included both supporters and opponents of the mayor, who acknowledged last week that he smoked crack. Some came from out of town.

 Ford showed up himself to sign some of the dolls and greet supporters. He has refused to step aside despite mounting pressure from both allies and critics. |||||

– Toronto's crack-smoking mayor has made it clear he's not going anywhere despite his many scandals, but City Council has other ideas. Councilors will today consider a motion that would call on Rob Ford to apologize, take a leave of absence, and cooperate with a police investigation into his activities, CBC reports. Just one problem: Even if it passes (Ford, who made the motion the key item at today's council meeting, has promised a "rumble in the jungle" debate), Ford won't actually have to heed the request. If he refuses, the City Council can ask Ontario to pass legislation removing him, but the council itself can't remove him from office since he hasn't been convicted of a crime—and councilors are hesitant to ask Ontario to step in. With "no clear legal path to force him out," the AP reports, the council is looking for a way to isolate Ford and run the city without him, which could actually be possible, since the powers of the Toronto mayor are more limited than the powers of many mayors in big US cities. "We really just have to build a box around the mayor so we can get work done," says one councilor. A second option to be debated next month: a motion that would further limit Ford's powers, basically keeping him from being able to fire executive committee members who want him out. "We will shun him, curtail his power as best we can," says another councilor. "He clearly has gone off the deep end, shot himself in outer space." Much of the public, though, still loves Ford: Hundreds lined up to buy "Robbie Bobbie" bobblehead dolls yesterday; they're being sold for charity.


Article:
Singer Etta James, known best for her iconic recording of "At Last," is gravely ill, diagnosed with dementia and undergoing treatment for leukemia, according to court documents.

 The 72-year-old Woodcrest resident's illness came to light as part of a civil case in Riverside County Superior Court in which Artis Mills, her husband of 41 years, is seeking control of more than $1 million of James' money.

 Her son Donto James wrote in a court declaration that he does not object to money being released for her health care. But he is asking that it be overseen by a third party, "to avoid present and future family conflict and discrepancies."

 A hearing is scheduled for Friday.

 Neither Mills nor his attorney, Bettye Barnard, returned calls seeking comment. Reached by phone, Donto James declined to comment beyond his statements on the court documents.

 The singer gave power of attorney to Donto, her other son Sametto James and Donto's wife, Christy James, in February 2008, according to court documents. Mills has challenged the power of attorney in court documents.

 Mills filed for divorce in April 2008, but the petition was dismissed a few months later.

 James, who merges blues, rock 'n' roll, gospel and jazz in her music, had an impressive string of hits throughout the 1960s, including the soulful "Tell Mama," "All I Could Do Was Cry," and "I'd Rather Go Blind."

 In 1995, James penned an autobiography, "Rage to Survive," which detailed her life, including her drug addiction and rehabilitation.

 James continued releasing music and toured the world, playing high-profile events such as the Playboy Jazz Festival.

 She also battled obesity and had gastric bypass surgery in 2001.

 Beyonce Knowles portrayed James in the film "Cadillac Records" in 2008.

 James hasn't been on stage since suffering a urinary tract infection that led to sepsis in early 2010.

 Dr. Elaine James, no relation to the singer, declared in the court documents that the singer has multiple medical conditions, including dementia, an organic brain syndrome and a recent diagnosis of leukemia.

 The Beverly Hills doctor said she and other medical staff give James continuous medical care and supervision in the singer's home in the Woodcrest area, near Riverside.

 Dr. James said the singer isn't able to sign her name and requires assistance with feeding, dressing and hygiene, but does recognize her husband and children. The doctor said James has been admitted to the hospital on occasion but returns home with round-the-clock care.

 Mills said in court documents that his wife expressed that "if she ever became disabled, she did not wish to be placed in an institutional nursing facility as long as they had the money to keep her at home."

 He is asking to move just over $1 million from three of his wife's accounts to a joint account with him or to him alone with James as a beneficiary of those accounts. He is also seeking the power to close those accounts and transfer the money into his name. In the court documents, he said the money would be used for care, maintenance and support of his wife.

 Staff writer Richard K. De Atley contributed to this report.

 Reach Vanessa Franko at 951-368-9575 or vfranko@PE.com ||||| Etta James Suffering From Leukemia, Dementia

 Email This A court battle over the health and financial affairs of R&B icon Etta James has revealed that the 'At Last' singer is gravely ill with leukemia and is suffering from dementia,

 Artis Mills, her husband of 41 years, wants control of the money, but son Donto James is asking the court to assign the duty to a third party, "to avoid present and future family conflict and discrepancies."

 James has not performed on stage since early 2010 and caused a stir in 2009 when she went public with her displeasure that she wasn't chosen to sing at President Barack Obama's inauguration. Beyonce Knowles, who portrayed James in a 2008 film, sang 'At Last' instead. A court battle over the health and financial affairs of R&B icon Etta James has revealed that the 'At Last' singer is gravely ill with leukemia and is suffering from dementia, The Press-Enterprise reports. The news came to light in a civil case between the 72-year-old star's husband and her son, who disagree on who should manage more than $1 million that is being put away for James' home-health costs.Artis Mills, her husband of 41 years, wants control of the money, but son Donto James is asking the court to assign the duty to a third party, "to avoid present and future family conflict and discrepancies."James has not performed on stage since early 2010 and caused a stir in 2009 when she went public with her displeasure that she wasn't chosen to sing at President Barack Obama's inauguration. Beyonce Knowles, who portrayed James in a 2008 film, sang 'At Last' instead.

 The singer's doctor declared in court documents that James has dementia, as well as an organic brain syndrome, and is currently receiving treatment for leukemia. Dr. Elaine James, no relation, said that James can no longer sign her name or feed and dress herself, but does recognize her husband and children.She receives round-the-clock care at her home in Riverside, Calif.In the documents, Mills stated that the primary reason he wants control of the funds is to fulfill his wife's wish not to live her final days in a hospital.According to Mills, James said that "if she ever became disabled, she did not wish to be placed in an institutional nursing facility as long as they had the money to keep her at home."The next hearing on the matter is scheduled for Friday, Jan. 14.Mills filed for divorce from James in 2008 but backed out a few months later.James is a legendary soul, blues and rock singer whose 1960s-era hits include 'Tell Mama,' 'All I Can Do Was Cry' and of course her signature song, 'At Last.' |||||Summary:

– Legendary singer Etta James is suffering from dementia and leukemia, court documents show. The 72-year-old’s illnesses came to light during a civil case involving her husband, who wants control of more than $1 million of her money, and her son, who wants the money to be overseen by a third party. A doctor said James needs help to eat and dress, and can no longer sign her name. She suffered a urinary tract infection, then sepsis, early last year and hasn’t been on stage since, the Press-Enterprise reports. Click for more on her condition and the court case.


Here is a news article: LEIDEN, Netherlands, Dec. 17 (UPI) -- People who love horror movies often say they enjoy the unexpected adrenaline rush of gruesome, surprising scenes often described by critics and fans alike as "bloodcurdling," a metaphor that may have more truth to it than previously thought.

 Researchers at Leiden University Medical Center in the Netherlands tested the physiological effects of horror movies on a group of volunteers, finding fear inspired by a horror movie increased levels of clotting agents in viewers' blood.

 While they said this doesn't mean people's veins will start clogging while binging on the Freddy Krueger or the Saw movie series, it does mean the term is somewhat literal.

 "For centuries the term "bloodcurdling" has been used to describe feeling extreme fear under frightening situations," researchers wrote in the study, published in the British Medical Journal. "The term dates back to medieval times and is based on the concept that fear or horror would 'run the blood cold' or 'curdle' [congeal] blood."

 The researchers recruited 24 healthy volunteers from the hospital under age 30, showing 14 the movie Insidious and then a documentary called A Year in Champagne separated by a week, while the other 10 were shown both movies a week apart in the reverse order. The researchers took blood samples from each participant 15 minutes before and after watching each movie.

 Insidious was expectedly found more frightening by viewers than the documentary, and levels of coagulating factor VIII increased in 57 percent of participants, as opposed to just 14 percent of participants' levels going up during A Year in Champagne. During the documentary, 86 percent of the participants' levels decreased, compared to 43 percent during the horror movie.

 The researchers said they think the increase in the clotting factor is the body preparing to heal itself as a physical response to fear -- if a person is running from an animal attack but is caught, the body's preparation could help stop bleeding faster, they explained.

 "We suspected that fear might speed clotting in the blood," said Nemeth Banne, a researcher at Leiden University Medical Center, in a press release. "Damaged tissue gives off tissue factor, which triggers the coagulation really, but that's probably faster if there are more clotting factors in the blood." ||||| Scary movies really are blood-curdling, Dutch researchers have found.

 That frisson of fear releases a little bit of the blood-clotting protein called Factor VIII, they report.

 The team at Leiden University Medical Center studied 24 healthy volunteers ages 30 and younger.

 "One group (of 14) were assigned to watch the horror movie 'Insidious' followed by the documentary 'A Year in Champagne,'" Dr. Banne Nemeth and colleagues report in the lighthearted holiday issue of the British Medical Journal.

 "The other group watched the movies in reverse order."

 Blood samples were taken before and after and each volunteer rated the 90-minute-long films.

 The horror movie was, not surprisingly, scarier than the educational movie, they found. And Factor VIII levels changed, going up in 57 percent of the volunteers during the horror move and falling in 86 percent when they watched the Champagne documentary.

 "Exposure of young and healthy adults to horror movies was associated with an increase in coagulant factor VIII levels," Nemeth's team concluded.

 Other blood-clotting proteins weren't affected, no one suffered a blood clot and there is a simple cure, the researchers advised.

 "A truly relaxing and merry Christmas, without exposure to frightening situations, seems to be advisable to prevent venous thrombosis," they wrote. ||||| Banne Nemeth , medical doctor 1 2, Luuk J J Scheres , medical doctor 1 3, Willem M Lijfering , postdoctoral researcher 1, Frits R Rosendaal , professor of clinical epidemiology 1 4 1Department of Clinical Epidemiology, Leiden University Medical Centre, 2300 RC, Leiden, Netherlands 2Department of Orthopaedic Surgery, Leiden University Medical Centre, Leiden, Netherlands 3Department of Vascular Medicine, Academic Medical Centre, Amsterdam, Netherlands 4Einthoven Laboratory for Experimental Vascular Medicine, Leiden University Medical Centre, Leiden, Netherlands Correspondence to: F R Rosendaal f.r.rosendaal{at}lumc.nl Accepted 13 November 2015

 Abstract Objective To assess whether, as has been hypothesised since medieval times, acute fear can curdle blood. Design Crossover trial. Setting Main meeting room of Leiden University’s Department of Clinical Epidemiology, the Netherlands, converted to a makeshift cinema. Participants 24 healthy volunteers aged ≤30 years recruited among students, alumni, and employees of the Leiden University Medical Center: 14 were assigned to watch a frightening (horror) movie followed by a non-threatening (educational) movie and 10 to watch the movies in reverse order. The movies were viewed more than a week apart at the same time of day and both lasted approximately 90 minutes. Main outcome measures The primary outcome measures were markers, or “fear factors” of coagulation activity: blood coagulant factor VIII, D-dimer, thrombin-antithrombin complexes, and prothrombin fragments 1+2. The secondary outcome was participant reported fear experienced during each movie using a visual analogue fear scale. Results All participants completed the study. The horror movie was perceived to be more frightening than the educational movie on a visual analogue fear scale (mean difference 5.4, 95% confidence interval 4.7 to 6.1). The difference in factor VIII levels before and after watching the movies was higher for the horror movie than for the educational movie (mean difference of differences 11.1 IU/dL (111 IU/L), 95% confidence interval 1.2 to 21.0 IU/dL). The effect of either movie on levels of thrombin-antithrombin complexes, D-dimer, and prothrombin fragments 1+2 did not differ. Conclusion Frightening (in this case, horror) movies are associated with an increase of blood coagulant factor VIII without actual thrombin formation in young and healthy adults. Trial registration ClinicalTrials.gov NCT02601053.

 Introduction Nothing in life is to be feared, it is only to be understood. Now is the time to understand more, so that we may fear less. Marie Curie, 1867-19341 For centuries the term “bloodcurdling” has been used to describe feeling extreme fear under frightening situations.2 Similar terms are used in other countries, such as “das blut in den Adern erstarrt” in Germany, “à vous glacer le sang” in France, and “bloedstollend” in the Netherlands. The term dates back to medieval times and is based on the concept that fear or horror would “run the blood cold” or “curdle” (congeal) blood.3 The validity of this theory has, however, never been studied. Several studies have explored the effects of physical stress on the coagulation system.4 For example, chronic anxiety in patients with psychiatric disorders (and associated therapies which may influence blood coagulation) is associated with increased levels of coagulation markers,5 6 and increased coagulation activity has been observed in healthy volunteers after bungee jumping.7 Yet the effects of excitement and profound physical activity are not necessarily equal to those of acute fear, because, for example, actions such as bungee jumping are performed voluntarily and this was seen as deviating from an ideal study design.8 We investigated the effect of acute fear without physical exercise on markers of coagulation. We hypothesised that acute fear activates the coagulation system and that this poses an important evolutionary benefit, by preparing the body for blood loss during life threatening situations.

 Methods We recruited 24 healthy volunteers aged ≤30 years from among students, alumni, and employees of the Leiden University Medical Centre. We excluded those who were taking prescribed drugs, pregnant, using hormonal contraceptives, had a history of thrombosis, and had had surgery or been immobilised with a cast in the past two months. One group (n=14) were assigned to watch the horror movie Insidious (2010)9 (www.imdb.com/video/imdb/vi1929288729?ref_=tt_pv_vi_aiv_2) followed by the documentary A Year in Champagne (2014).10 The other group (n=10) watched the movies in reverse order (see supplementary file for authors’ descriptions of these movies). As movie nights were set on specific dates, group allocation was based on availability of the participants. Each movie lasted approximately 90 minutes and they were shown one week apart at the same time of day (fig 1⇓). Participants were seated in comfortable chairs and were not aware in advance of either the movie genre or the study hypothesis; we provided them with a leaflet explaining that the study aimed to determine the effects on coagulation of sitting still and watching movies. Fig 1 Flow of participants through study The movies were shown at the Department of Clinical Epidemiology’s main meeting room, which for the purposes of this study was transformed into a home-style cinema. The room has a non-threatening, welcoming atmosphere. Participants were asked to avoid alcohol and tobacco on movie days. To reduce the risk of confounding by superstition, no movies were shown during a full moon or on Friday the 13th. The participants provided written informed consent. Laboratory measurements Within 15 minutes before each movie, we took blood samples from each participant’s antecubital vein and used the contralateral arm for the second blood sample taken within 15 minutes after each movie. Markers of coagulation activity (or potential “fear factors”) were blood coagulant factor VIII (IU/dL), D-dimer (ng/mL), thrombin-antithrombin complexes (μg/L), and prothrombin fragments 1+2 (pmol/L). Blood samples were drawn in vacuum tubes containing 0.105M sodium citrate and centrifuged at 2500 g for 10 minutes at 18°C within one hour of venepuncture. After aliquoting, the samples were stored at −80°C. All markers were determined within one batch. We measured prothrombin fragments 1+2 and thrombin-antithrombin complexes in duplicate and the samples were measured using a sandwich-type enzyme linked immunosorbent assay (Siemens, Marburg, Germany). Coagulant factor VIII and D-dimer levels were measured using the TOP analyser (Werfen Instrumentation Laboratory, Barcelona, Spain). The laboratory technicians were not aware of which movie corresponded to which blood sample. Fear scale and questionnaire After each movie the participants completed a visual analogue fear scale, designed specifically for this study. This scale estimates the degree of fear experienced while watching a movie, ranging from 0 (no fear at all) to 10 (worst fear imaginable). Additionally, participants reported whether they had already seen the movie and rated it on a scale from 0 (worst ever) to 10 (best ever). Finally, the participants completed a general questionnaire on lifestyle and favourite movie genre. Sample size calculation We calculated the sample size required for evaluation of coagulant factor VIII activity (two sided test, α=0.05, β=0.90) and determined that 23 participants would be required to observe an increase of 15 IU/dL (150 IU/L) or more (assuming a correlation between the difference in measurements at the two time points of 0.7). Taking into account possible dropouts, we determined that overall 24 participants would be required. Statistical analyses We summarised personal and baseline data as means with standard deviations, or proportions. Using a paired t test we compared the difference between the mean change in levels of coagulation markers (before and after watching the horror movie compared with before and after watching the educational movie). For the visual analogue fear scale we reported the mean change and 95% confidence intervals. At baseline (before both movies) the groups had similar levels of coagulation factors. Therefore we considered a carry-over effect to be absent and pooled the results of both groups by movie genre.

 Results Participants and recruitment The table shows the baseline characteristics of the study sample. Participants watched the movies, which started around 7 pm (15 minutes either way) and ended at around 8.30 pm (15 minutes either way) on 29 July and 4, 5, and 11 August. According to the availability of participants, 14 were assigned to the watch the horror movie first and 10 to watch the educational movie first. Baseline characteristics of study sample. Values are numbers (percentages) unless stated otherwise View this table: Participants perceived the horror movie as being frightening, with a mean score on the visual analogue fear scale of 5.4 (SD 1.7). The corresponding values for the educational movie were 0.0 (SD 0.2): the mean difference between scores was 5.4 (95% confidence interval 4.7 to 6.1). Fear factor analyses Three participants were excluded from the primary analyses. In two, a sample was visibly haemolytic. Therefore these results were considered unreliable because in the case of haemolysis, various measurements (coagulation factors among them) are known to be inaccurate owing to degradation of red blood cells. The third participant was tense before the first blood sample was taken (before watching the educational movie); in an attempt to relax before the second blood sample was taken he ingested a family pack of chocolates. He subsequently fainted while blood was being taken after the educational movie. Fainting was not observed in association with the second, horror, movie. Since the assumption for a crossover trial (that is, similar circumstances except for the intervention) was clearly not met, we regarded the results as unusable (coagulant factor VIII levels before and after the educational movie were 132 IU/dL and 346 IU/dL, respectively, and before and after the horror movie were 109 IU/dL and 123 IU/dL, respectively). The mean baseline levels of coagulant factor VIII of the remaining 21 participants were similar before both the horror movie and the educational movie (mean difference −2.9 IU/dL, 95% confidence interval −10.1 to 4.2). However, the mean change in levels (difference between levels before and after the movie) was higher after the horror movie than after the educational movie (mean difference 11.1 IU/dL, 1.2 to 21.0, fig 2⇓). Coagulant factor VIII levels increased in 12 (57%) participants during the horror movie, but only in 3 (14%) during the educational movie. Levels decreased in 18 (86%) participants during the educational movie, but only in 9 (43%) during the horror movie. Fig 2 Absolute mean change in levels of coagulation factor VIII, D-dimer, thrombin-antithrombin complexes, and prothrombin fragments 1+2 after exposure to a horror and educational movie (ordered by change in levels during watching a horror movie). Vertical bars represent individual participants, with order of participants identical in all graphs. *Difference -96 IU/dL, †difference −27 IU/dL The mean D-dimer levels of participants were similar before watching the horror and educational movie. The mean change in levels before and after the educational movie was −35.1 ng/mL (SD 63.0) and before and after the horror movie was −31.8 (SD 109.3). Therefore no effect of acute fear on D-Dimer levels was observed (fig 2⇑): the mean difference was 3.33 ng/mL (95% confidence interval −37.1 to 43.8). There was also no effect on levels of thrombin-antithrombin complexes: mean difference of differences −0.54 µg/L (95% confidence interval −2.5 to 1.4, fig 2⇑). All but two of the measurements for prothrombin fragments 1+2 levels before and after both movies were less than 200 pmol/L. The mean change in levels (fig 2⇑) before and after the educational movie was −10.2 (median −1.0) pmol/L and before and after the horror movie was −23.7 (median −21) pmol/L.

 Discussion In this crossover study we found that watching horror, or “bloodcurdling,” movies was associated with an increase in blood coagulant factor VIII. The mean increase in factor VIII levels of 11.1 IU/dL associated with acute fear could be clinically relevant, as every 10 IU/dL increase in coagulant factor VIII levels is associated with a 17% (95% confidence interval 7% to 28%) increase in the risk of venous thrombosis.11 Levels of D-dimer, thrombin-antithrombin complexes, and prothrombin factors 1+2 did not prove to be fear factors. This indicates that although the coagulation cascade was influenced by acute fear, this did not lead to the formation of thrombin (thrombin-antithrombin complexes and prothrombin factors 1+2) and subsequent fibrin formation (D-dimer). Limitations of this study A limitation of the study could be the magnitude of fear induced by the movie genre. Although some participants scored 7 or 8 on the visual analogue fear scale, there is definite room for the enhancement of fear. However, such designs might elicit ethical controversy and would likely be confounded by physical exertion. Secondly, we did not completely reach the intended sample size. Nevertheless, we still found a clear 11.1 IU/dL (95% confidence interval 1.2 to 21.0) increase in coagulant factor VIII levels after exposure to the horror movie. Thirdly, participants were not randomised by the order in which the movies were watched. Finally, the visual analogue fear scale was not validated. Implications of this study The underlying biological mechanism of acute fear associated with an increase in coagulation activity is still to be unravelled. However, the results of this study might be explained by an adrenergic response, as epinephrine increases the concentrations of coagulant factor VIII.12 Also, desmopressin, a vasopressin analogue, has been used to increase coagulation activity in a wide range of bleeding diathesis.13 Desmopressin stimulates the release of von Willebrand factor, resulting in increased coagulant factor VIII levels.14 Although it is not immediately obvious by which means our results could confer clinical benefits, a broader implication of these study results is that after centuries the term “bloodcurdling” in literature is justified. Conclusion In young and healthy adults, watching bloodcurdling movies is associated with an increase in blood coagulant factor VIII without actual thrombin formation. What is already known on this topic As early as medieval times it was thought that fear induced curdling (congealing) of the blood

 Several studies have reported an increase in coagulation profiles in times of physical or psychological stress

 The effect of acute fear on the coagulation system is, however, still to be unravelled What this study adds Exposure of young and healthy adults to horror movies was associated with an increase in coagulant factor VIII levels

 No effect was observed on levels of D-dimer, thrombin-antithrombin complexes, or prothrombin fragment 1+2, suggesting that watching frightening movies is associated with an acute effect on coagulation without actual thrombin formation

 A truly relaxing and merry Christmas, without exposure to frightening situations, seems to be advisable to prevent venous thrombosis

 Footnotes Contributors: According to good epidemiological practice, the decision of who would be first and who would be second author was made by randomisation. All authors were involved in the study design, study conduct, data analysis, and revision of the manuscript. All authors read and approved the final manuscript and are guarantors of the paper.

 Funding: This study was sponsored by the Department of Clinical Epidemiology, Leiden University Medical Center.

 Competing interest: All authors have completed the ICMJE uniform disclosure form at www.icmje.org/coi_disclosure.pdf and declare: no support from any organisation for the submitted work; no financial relationships with any organisations that might have an interest in the submitted work in the previous three years; no other relationships or activities that could appear to have influenced the submitted work.

 Ethical approval: This study was approved by the medical ethics committee of Leiden University Medical Center.

 Transparency: The guarantors affirm that the manuscript is an honest, accurate, and transparent account of the study being reported; that no important aspects of the study have been omitted; and that any discrepancies from the study as planned (and, if relevant, registered) have been explained.

 This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 3.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/3.0/. |||||
A summary of this is?

– People have been using the term "bloodcurdling" to describe feelings of intense fear for centuries. Now, a new study has found that being scared can, indeed, cause your blood to thicken, NBC News reports. Dutch researchers found that a frightening situation—in this case, watching a horror movie—can increase levels of Factor VIII, a blood-clotting agent. "We hypothesized that acute fear activates the coagulation system and that this poses an important evolutionary benefit, by preparing the body for blood loss during life-threatening situations," write the Leiden University Medical Center researchers in the study, which was published in the December issue of the British Medical Journal. The study used 24 healthy volunteers ages 30 and under. UPI reports 14 of the subjects watched the horror movie Insidious and then, a week later, watched the documentary A Year in Champagne at the same time of day. The order of the movies was reversed for the other volunteers. Blood samples were taken before and after participants viewed the movies. Levels of Factor VIII increased in 57% of subjects during the horror movie, while they decreased in 86% of participants during the documentary. No one in the study suffered a blood clot, NBC notes. While the researchers outline some study limitations (sample size, "the magnitude of fear induced by the movie genre"), they conclude that "after centuries the term 'bloodcurdling' in literature is justified." (Speaking of fear, here's how to cure a spider phobia in 2 minutes.)