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Offering promotion coupons is one of the most popular strategies of online marketing to attract new customers and increase customer loyalty. However, this strategy opens chances for fraud risk as the coupons are being redeemed multiple times using fake accounts. This risk becomes a burden to marketing costs and leads to failure to accomplish the intended strategic value. Therefore, this research focuses on building an automatic detection system of online promotion abuse based on its risk level. The proposed system also must work on live stream and bulk data. Therefore, in live stream data, it could alert the administrator before the transaction finished or the next process started. After conducting an exploratory factor analysis of the 24 attributes collected from four tables of data transaction, there were seven attributes indicating promotion abuse. These attributes were the user IP address, shipping address, mobile number, member email, order email, payment ID, and product name. Then, supervised machine learning of similarity algorithms was used to build models and find the hidden correlation of attributes to indicate the promotion abuse. The result from comparing five similarity methods showed that based on the workflow and performance, the most suitable methods for this case were exact match and Levenshtein edit base. The automatic risk scoring feature of the proposed system used seven attributes of online transactions as their most prominent promotion abuse parameter based on its hidden correlation. From the system performance testing, the result values of precision, recall, and F-measure are 95%, 93%, and 0.94, respectively. These results indicate that the system performance is satisfactory.

BACKGROUND Self-measured blood pressure (SMBP) monitoring is increasingly used for remote hypertension management, but the real-world performance of home blood pressure (BP) devices is unknown. We examined BP measurements from patients' home devices using the American Medical Association's (AMA) SMBP Device Accuracy Test tool. METHODS Patients at a single internal medicine clinic underwent up to five seated, same-arm BP readings using a home device and an automated BP device (Omron HEM-907XL). Following the AMA's three-step protocol, we used the patient's home device for the first, second, and fourth measurements and the office device for the third and fifth (if needed) measurements. Device agreement failure was defined as an absolute difference in systolic BP >10 mm Hg between the home and office devices in either of two confirmatory steps. Performance was examined by brand (Omron vs. non-Omron). Moreover, we examined patient factors associated with agreement failure via logistic regression models adjusted for demographic characteristics. RESULTS We evaluated 152 patients (mean age 60 ± 15 years, 58% women, 31% Black) seen between October 2020 and November 2021. Device agreement failure occurred in 22.4% (95% CI: 16.4%, 29.7%) of devices tested, including 19.1% among Omron devices and 27.6% among non-Omron devices (P  = 0.23). No patient characteristics were associated with agreement failure. CONCLUSIONS Over one-fifth of home devices did not agree based on the AMA SMBP device accuracy protocol. These findings confirm the importance of office-based device comparisons to ensure the accuracy of home BP monitoring. [ABSTRACT FROM AUTHOR]

Objective: To compare viscoelastic parameters between healthy control dogs and dogs with primary immune‐mediated hemolytic anemia (pIMHA) using a new, point‐of‐care viscoelastic coagulation monitor (VCM).a Design: Retrospective study from 2017 to 2021. Setting: Three regional private referral centers. Animals: Eighteen client‐owned dogs with pIMHA and 33 healthy control dogs. pIMHA dogs were defined based on established criteria. Interventions: None. Measurements and Main Results: Medical records of dogs with pIMHA and VCM performed at diagnosis from 2017 to 2021 and apparently healthy control dogs voluntarily enrolled in the blood donor program from 2017 to 2018 were reviewed. For the healthy control dogs, consent was obtained to perform VCM in addition to traditional screening. Compared to healthy control dogs, dogs with pIMHA had mean VCM parameters consistent with hypercoagulability, demonstrated by lower mean (SD) clot formation time (108 s [30] vs 233 s [55]; P < 0.0001), higher mean alpha angle (62 degrees [6] vs 52 degrees [6]; P < 0.0001), higher mean maximum clot formation (49 VCM units [11] vs 32 VCM units [5]; P < 0.0001), higher mean amplitude at 10 minutes (40 VCM units [11] vs 19 VCM units [3]; P < 0.0001), and higher mean amplitude at 20 minutes (47 VCM units [11] vs 25 VCM units [4]; P < 0.0001). pIMHA dogs also had significantly higher median (interquartile range) lysis index at 30 minutes (100% [100–100] vs 98% [90–100]; P < 0.0001). When compared to 3 established normal canine reference intervals, dogs with pIMHA had a significantly higher proportion of VCM variables (48%–57%) consistent with hypercoagulability, and a significant percentage of pIMHA dogs (78%–89%) had VCM tracings consistent with hypercoagulability overall, irrespective of the interval utilized for interpretation. Conclusions: This study demonstrates hypercoagulability in dogs with pIMHA when compared to healthy control dogs using VCM. Prospective evaluation is warranted to further characterize these findings as well as to evaluate their clinical impact. [ABSTRACT FROM AUTHOR]

Background The Trial of Nonpharmacologic Interventions in the Elderly (TONE) demonstrated the efficacy of weight loss and sodium reduction to reduce hypertension medication use in older adults. However, the longer-term effects of drug withdrawal (DW) on blood pressure (BP), adverse events, and orthostatic symptoms were not reported. Methods TONE enrolled adults, ages 60–80 years, receiving treatment with a single antihypertensive and systolic BP (SBP)/diastolic BP <145/<85 mm Hg. Participants were randomized to weight loss, sodium reduction, both, or neither (usual care) and followed up to 36 months; ~3 months postrandomization, the antihypertensive was withdrawn and only restored if needed for uncontrolled hypertension. BP and orthostatic symptoms (lightheadedness, feeling faint, imbalance) were assessed at randomization and throughout the study. Two physicians independently adjudicated adverse events, masked to intervention, classifying symptomatic (lightheadedness, dizziness, vertigo), or clinical events (fall, fracture, syncope). Results Among the 975 participants (mean age 66 years, 48% women, 24% black), mean (±SD) BP was 128 ± 9/71 ± 7 mm Hg. Independent of assignment, DW increased SBP by 4.59 mm Hg (95% confidence interval [CI]: 3.89, 5.28) compared with baseline. There were 113 adverse events (84 symptomatic, 29 clinical), primarily during DW. Compared with usual care, combined weight loss and sodium reduction mitigated the effects of DW on BP (β = −4.33 mm Hg; 95% CI: −6.48, −2.17) and reduced orthostatic symptoms long term (odds ratio = 0.62; 95% CI: 0.41, 0.92), without affecting adverse events (hazard ratio = 1.81; 95% CI: 0.90, 3.65). In contrast, sodium reduction alone increased risk of adverse events (hazard ratio = 1.75; 95% CI: 1.04, 2.95), mainly during DW. Conclusions In older adults, antihypertensive DW may increase risk of symptomatic adverse events, highlighting the need for caution in withdrawing their antihypertensive medications. Clinical trials registration Trial Number NCT00000535. [ABSTRACT FROM AUTHOR]

BACKGROUND Clinic-based blood pressure (BP) is a closely-tracked metric of health care quality, but is prone to inaccuracy and measurement imprecision. Recent guidelines have advocated for automated office blood pressure (AOBP) devices to improve clinic-based BP assessments. METHODS Patients from a single hypertension clinic underwent a 3-day evaluation that included a 24-hour ambulatory blood pressure monitoring (ABPM), 2 manual clinic-based BP measurements (over 2 visits), and an unattended AOBP measurement (single visit). All measurements were compared to the average wake-time systolic BP (SBP) and diastolic BP (DBP) from ABPM. RESULTS Among 103 patients (mean age 57.3 ± 14.8 years, 51% women, 29% black) the average wake-time SBP was 131.3 ± 12.3 mm Hg and DBP was 78.3 ± 9.2 mm Hg. The average of 2 manual BPs was significantly higher than wake-time ABPM with mean differences of 5.5 mm Hg (P < 0.001) for SBP and 2.7 mm Hg (P = 0.002) for DBP. In contrast, the averages of the last 2 AOBP measurements did not significantly differ from ABPM with mean differences of 1.6 mm Hg (P = 0.21) for SBP and −0.5 mm Hg (P = 0.62) for DBP. The estimated prevalence of SBP ≥ 140 or DBP ≥ 90 mm Hg based on wake-time ABPM was 27.2% vs. 49.5% based on the average of 2 manual measurements (difference 22.3%; P < 0.001) and 31.1% based on the average of the last 2 AOBP measurements (difference 3.9%; P = 0.57). CONCLUSIONS A single visit, unattended AOBP more precisely estimated BP and the prevalence of stage 2 and uncontrolled hypertension than even the average of 2 manual clinic visits, supporting guideline recommendations to use AOBP for clinic-based BP measurements. [ABSTRACT FROM AUTHOR]

Objective: The objective of this study was to compare Doppler blood pressure (DBP) measurements between blood pressure cuffs (BPCs) with and without a secondary fastener (tape) in healthy nonanesthetized large-breed dogs., Animals: 28 healthy dogs., Methods: Superficial palmar venous arch DBP measurements with and without tape on the BPC were performed in lateral recumbency with Doppler ultrasound. Each method was performed 6 consecutive times, with the final 5 values averaged. Bland-Altman plots were made and limits of agreement calculated., Results: The limits of agreement were -40.8 (95% CI, -55.6 to -26.0) to 45.6 (95% CI, 30.8 to 60.4), indicating that the DBP measured with tape would be expected to be between 40.8 mm Hg below and 45.6 mm Hg above that measured without tape 95% of the time. The mean bias estimate was 2.4 mm Hg (SD, 22.0; 95% CI, -6.1 to 11.0; P = .724), indicating that DBP measurements with tape averaged 2.4 mm Hg higher than without tape., Clinical Relevance: Doppler blood pressure measurements obtained with secondary fasteners on the BPCs differed by > 10 mm Hg compared to the BPCs' standard hook-and-loop fasteners 54% (30 of 56) of the time. Blood pressure cuffs with dysfunctional hook-and-loop fasteners should be replaced due to poor clinical reliability of DBP measurements. However, it is unclear whether Doppler sphygmomanometry is more accurate with the use of traditional Velcro BPC fasteners or with tape BPC fasteners.