(NIH) - 5/30/2012 - National Institutes of Health-funded research suggests genetics can predict success of smoking cessation and need for medications
Genetics can help determine whether a person is likely to quit smoking on his or her own or need medication to improve the chances of success, according to research published in on May 30 in the American Journal of Psychiatry. Researchers say the study moves health care providers a step closer to one day providing more individualized treatment plans to help patients quit smoking.
The study was supported by multiple components of the National Institutes of Health, including the National Institute on Drug Abuse (NIDA), the National Human Genome Research Institute, the National Cancer Institute, and the Clinical and Translational Science Awards program, administered by the National Center for Advancing Translational Sciences.
“This study builds on our knowledge of genetic vulnerability to nicotine dependence, and will help us tailor smoking cessation strategies accordingly,” NIDA Director Nora D. Volkow said. “It also highlights the potential value of genetic screening in helping to identify individuals early on and reduce their risk for tobacco addiction and its related negative health consequences.”
Researchers focused on specific variations in a cluster of nicotinic receptor genes, CHRNA5-CHRNA3-CHRNB4, which prior studies have shown contribute to nicotine dependence and heavy smoking. Using data obtained from a previous study supported by the National Heart Lung and Blood Institute, researchers showed that individuals carrying the high-risk form of this gene cluster reported a 2-year delay in the median quit age compared to those with the low-risk genes. This delay was attributable to a pattern of heavier smoking among those with the high risk gene cluster. The researchers then conducted a clinical trial, which confirmed that persons with the high-risk genes were more likely to fail in their quit attempts compared to those with the low-risk genes when treated with placebo. However, medications approved for nicotine cessation (such as nicotine replacement therapies or bupropion) increased the likelihood of abstinence in the high risk groups. Those with the highest risk had a three-fold increase in their odds of being abstinent at the end of active treatment compared to placebo, indicating that these medications may be particularly beneficial for this population.
“We found that the effects of smoking cessation medications depend on a person’s genes,” first author Li-Shiun Chen said. Chen is from the Washington University School of Medicine in St. Louis. “If smokers have the risk genes, they don't quit easily on their own and will benefit greatly from the medications. If smokers don’t have the risk genes, they are likely to quit successfully without the help of medications such as nicotine replacement or bupropion.”
The study can be found at: http://ajp.psychiatryonline.org/article.aspx?articleID=1169679.
Legislation Called Violation of Patients' Rights
Manchester, NH - 5/27/2012 - Joanne Doroshow, Executive Director of the Center for Justice & Democracy, testified on April 26 before the New Hampshire Judiciary Committee on legislation that would strip patients of the legal rights is a way that is “so dismissive of constitutional rights and potentially calamitous for injured patients” that no other state in the country has considered it. Calling this “early offer” legislation, S.B. 406, an “experiment,” Doroshow said, “This experiment, as proposed, is unethical. It violates the legal rights of patients. It flouts basic notions of fairness. It would tilt the legal playing field so dramatically in favor of insurers as to essentially eviscerate patients’ rights to adequate compensation.”
According to Doroshow, under this scheme, a patient injured by medical malpractice, or their family, would be offered compensation by the medical provider that caused the injuries or death. For many patients, this offer would come before the patient has any idea what their injuries are or their cause. Yet to agree to this “early offer,” the patient would be required to immediately sign away their legal rights.
“Once they’ve signed away their rights, the injured patients’ ability to collect economic compensation, like medical costs and lost wages, would be infected by conflicts of interest at every single step, beginning with allowing the medical provider to choose its own doctor to decide a patient’s damages," Doroshow said. "Then, in order to receive any future medical expenses in the case of a catastrophic injury, this experiment would condemn a patients – or their injured child – to a lifetime of fighting medical providers just to get their bills paid.
“As to non-economic damages, under this experiment, patients completely lose all ability to be compensated for those losses. And because the medical provider has so much discretion and cost-cutting motivation to reject portions of a patient’s claim, the patient may have no option but to reject the hospital’s ‘early offer’ for compensation and go to court. However, if they do, the patient is penalized by having to prove their case under a burden that is almost impossible to meet.
“I want to be clear that this experiment is unethical. While its proponents argue that participation in this experiment is voluntary, the actual ‘consent’ process violates even the most basic precepts of what constitutes a voluntary program. Patients who ‘opt in’ to this program must sign a waiver of their rights, written in legalese and understandable only to lawyers, before the patient even knows specifically what compensation and courtroom rights they are relinquishing. Patients could be extremely harmed by this experiment. This is highly unethical, and New Hampshire legislators should reject it.”
A copy of the written testimony can be found here.
According to Doroshow, under this scheme, a patient injured by medical malpractice, or their family, would be offered compensation by the medical provider that caused the injuries or death. For many patients, this offer would come before the patient has any idea what their injuries are or their cause. Yet to agree to this “early offer,” the patient would be required to immediately sign away their legal rights.
“Once they’ve signed away their rights, the injured patients’ ability to collect economic compensation, like medical costs and lost wages, would be infected by conflicts of interest at every single step, beginning with allowing the medical provider to choose its own doctor to decide a patient’s damages," Doroshow said. "Then, in order to receive any future medical expenses in the case of a catastrophic injury, this experiment would condemn a patients – or their injured child – to a lifetime of fighting medical providers just to get their bills paid.
“As to non-economic damages, under this experiment, patients completely lose all ability to be compensated for those losses. And because the medical provider has so much discretion and cost-cutting motivation to reject portions of a patient’s claim, the patient may have no option but to reject the hospital’s ‘early offer’ for compensation and go to court. However, if they do, the patient is penalized by having to prove their case under a burden that is almost impossible to meet.
“I want to be clear that this experiment is unethical. While its proponents argue that participation in this experiment is voluntary, the actual ‘consent’ process violates even the most basic precepts of what constitutes a voluntary program. Patients who ‘opt in’ to this program must sign a waiver of their rights, written in legalese and understandable only to lawyers, before the patient even knows specifically what compensation and courtroom rights they are relinquishing. Patients could be extremely harmed by this experiment. This is highly unethical, and New Hampshire legislators should reject it.”
A copy of the written testimony can be found here.
Note: For an update of the status of this bill, visit http://legiscan.com/gaits/view/397114
Subjects
health,
insurance,
malpractice
Study: Coffee Drinkers Have Lower Risk of Death
(NIH) - 5/23/2012 - Older adults who drank coffee — caffeinated or decaffeinated — had a lower risk of death overall than others who did not drink coffee, according a study by researchers from the National Cancer Institute (NCI), part of the National Institutes of Health, and AARP.
Coffee drinkers were less likely to die from heart disease, respiratory disease, stroke, injuries and accidents, diabetes, and infections, although the association was not seen for cancer. These results from a large study of older adults were observed after adjustment for the effects of other risk factors on mortality, such as smoking and alcohol consumption. Researchers caution, however, that they can't be sure whether these associations mean that drinking coffee actually makes people live longer. The results of the study were published in the May 17, 2012 edition of the New England Journal of Medicine.
Neal Freedman, Ph.D., Division of Cancer Epidemiology and Genetics, NCI, and his colleagues examined the association between coffee drinking and risk of death in 400,000 U.S. men and women ages 50 to 71 who participated in the NIH-AARP Diet and Health Study. Information about coffee intake was collected once by questionnaire at study entry in 1995-1996. The participants were followed until the date they died or Dec. 31, 2008, whichever came first.
The researchers found that the association between coffee and reduction in risk of death increased with the amount of coffee consumed. Relative to men and women who did not drink coffee, those who consumed three or more cups of coffee per day had approximately a 10 percent lower risk of death. Coffee drinking was not associated with cancer mortality among women, but there was a slight and only marginally statistically significant association of heavier coffee intake with increased risk of cancer death among men.
"Coffee is one of the most widely consumed beverages in America, but the association between coffee consumption and risk of death has been unclear. We found coffee consumption to be associated with lower risk of death overall, and of death from a number of different causes," said Freedman. "Although we cannot infer a causal relationship between coffee drinking and lower risk of death, we believe these results do provide some reassurance that coffee drinking does not adversely affect health."
The investigators caution that coffee intake was assessed by self-report at a single time point and therefore might not reflect long-term patterns of intake. Also, information was not available on how the coffee was prepared (espresso, boiled, filtered, etc.); the researchers consider it possible that preparation methods may affect the levels of any protective components in coffee.
"The mechanism by which coffee protects against risk of death — if indeed the finding reflects a causal relationship — is not clear, because coffee contains more than 1,000 compounds that might potentially affect health," said Freedman. "The most studied compound is caffeine, although our findings were similar in those who reported the majority of their coffee intake to be caffeinated or decaffeinated."
Coffee drinkers were less likely to die from heart disease, respiratory disease, stroke, injuries and accidents, diabetes, and infections, although the association was not seen for cancer. These results from a large study of older adults were observed after adjustment for the effects of other risk factors on mortality, such as smoking and alcohol consumption. Researchers caution, however, that they can't be sure whether these associations mean that drinking coffee actually makes people live longer. The results of the study were published in the May 17, 2012 edition of the New England Journal of Medicine.
Neal Freedman, Ph.D., Division of Cancer Epidemiology and Genetics, NCI, and his colleagues examined the association between coffee drinking and risk of death in 400,000 U.S. men and women ages 50 to 71 who participated in the NIH-AARP Diet and Health Study. Information about coffee intake was collected once by questionnaire at study entry in 1995-1996. The participants were followed until the date they died or Dec. 31, 2008, whichever came first.
The researchers found that the association between coffee and reduction in risk of death increased with the amount of coffee consumed. Relative to men and women who did not drink coffee, those who consumed three or more cups of coffee per day had approximately a 10 percent lower risk of death. Coffee drinking was not associated with cancer mortality among women, but there was a slight and only marginally statistically significant association of heavier coffee intake with increased risk of cancer death among men.
"Coffee is one of the most widely consumed beverages in America, but the association between coffee consumption and risk of death has been unclear. We found coffee consumption to be associated with lower risk of death overall, and of death from a number of different causes," said Freedman. "Although we cannot infer a causal relationship between coffee drinking and lower risk of death, we believe these results do provide some reassurance that coffee drinking does not adversely affect health."
The investigators caution that coffee intake was assessed by self-report at a single time point and therefore might not reflect long-term patterns of intake. Also, information was not available on how the coffee was prepared (espresso, boiled, filtered, etc.); the researchers consider it possible that preparation methods may affect the levels of any protective components in coffee.
"The mechanism by which coffee protects against risk of death — if indeed the finding reflects a causal relationship — is not clear, because coffee contains more than 1,000 compounds that might potentially affect health," said Freedman. "The most studied compound is caffeine, although our findings were similar in those who reported the majority of their coffee intake to be caffeinated or decaffeinated."
IC3: Internet Crime Complaints Top 300,000 in 2011
FAIRMONT, WV — 5/14/2012 - The Internet Crime Complaint Center (IC3) recently released the 2011 Internet Crime Report—an overview of the latest data and trends of online criminal activity.
According to the report, 2011 marked the third year in a row that the IC3 received more than 300,000 complaints. The 314,246 complaints represent a 3.4 percent increase over 2010.
The reported dollar loss was $485.3 million.
As more Internet crimes are reported, IC3 can better assist law enforcement in the apprehension and prosecution of those responsible for perpetrating Internet crime.
In 2011, IC3 received and processed, on average, more than 26,000 complaints per month. The most common complaints received in 2011 included FBI-related scams—schemes in which a criminal poses as the FBI to defraud victims—identity theft, and advance-fee fraud. The report also lists states with the top complaints, and provides loss and complaint statistics organized by state. It describes complaints by type, demographics, and state.
“This report is a testament to the work we do every day at IC3, which is ensuring our system is used to alert authorities of suspected criminal and civil violations,” said National White Collar Crime (NW3C) Center Director Don Brackman. “Each year we work to provide information that can link individuals and groups to these crimes for better outcomes and prosecution of cases.”
Acting Assistant Director of the FBI’s Cyber Division Michael Welch said, “Internet crime is a growing problem that affects computer users around the world and causes significant financial losses. The IC3 is an efficient mechanism for the public to report suspicious e-mail activity, fraudulent websites, and Internet crimes. These reports help law enforcement make connections between cases and identify criminals.”
IC3 is a partnership between the Federal Bureau of Investigation, the NW3C, and the Bureau of Justice Assistance. Since its start in 2000, IC3 has become a mainstay for victims reporting Internet crime and a way for law enforcement to be alerted of such crimes. IC3’s service to the law enforcement community includes federal, state, tribal, local, and international agencies that are combating Internet crime.
Source: Federal Bureau of Investigation
According to the report, 2011 marked the third year in a row that the IC3 received more than 300,000 complaints. The 314,246 complaints represent a 3.4 percent increase over 2010.
The reported dollar loss was $485.3 million.
As more Internet crimes are reported, IC3 can better assist law enforcement in the apprehension and prosecution of those responsible for perpetrating Internet crime.
In 2011, IC3 received and processed, on average, more than 26,000 complaints per month. The most common complaints received in 2011 included FBI-related scams—schemes in which a criminal poses as the FBI to defraud victims—identity theft, and advance-fee fraud. The report also lists states with the top complaints, and provides loss and complaint statistics organized by state. It describes complaints by type, demographics, and state.
“This report is a testament to the work we do every day at IC3, which is ensuring our system is used to alert authorities of suspected criminal and civil violations,” said National White Collar Crime (NW3C) Center Director Don Brackman. “Each year we work to provide information that can link individuals and groups to these crimes for better outcomes and prosecution of cases.”
Acting Assistant Director of the FBI’s Cyber Division Michael Welch said, “Internet crime is a growing problem that affects computer users around the world and causes significant financial losses. The IC3 is an efficient mechanism for the public to report suspicious e-mail activity, fraudulent websites, and Internet crimes. These reports help law enforcement make connections between cases and identify criminals.”
IC3 is a partnership between the Federal Bureau of Investigation, the NW3C, and the Bureau of Justice Assistance. Since its start in 2000, IC3 has become a mainstay for victims reporting Internet crime and a way for law enforcement to be alerted of such crimes. IC3’s service to the law enforcement community includes federal, state, tribal, local, and international agencies that are combating Internet crime.
Source: Federal Bureau of Investigation
Coalition Questions Cost of Bank 'Swipe' Fees
WASHINGTON- (BUSINESS WIRE) - 5/12/2012 - In a May 11 news article, USA Today exposed some of the myths banks propagate about hidden, exorbitant “swipe” fees the banks charge retailers when customers buy with credit or debit cards, said the Merchants Payments Coalition.
The article also makes a strong case for reforming the way Visa and MasterCard and their bank members fix the fees that consumers pay when they “swipe” their cards.
American merchants pay the highest swipe fees in the industrialized world, which pushes up prices at their stores. Because MasterCard and Visa fix fees for their banks, which refuse to compete on price, the fees have become retailers’ second-highest operating cost, after labor, and a real obstacle for small merchants in particular.
Here is what the newspaper found:
First, consumers are saving from debit reform. Public reports for America’s largest retailers show that operating margins fell in the fourth quarter of 2011, when the Durbin Amendment to the Dodd-Frank financial reform law reduced debit card fees. That means those retailers were passing along any savings they might have, and then some. And some companies are giving discounts specifically for using debit cards, including, among others, Ikea, Nice N Easy Grocery Shoppes and some Exxon and Arco stations.
Second, free checking has not disappeared under the Durbin Amendment, as the banks claimed it would. In fact, more banks offered free checking after reform than before and overall prices on bank accounts dropped.
In the second half of 2011, 39 percnet of banks offered checking accounts with no monthly maintenance fee, up from 35 percent for the first part of the year, according to a survey of the 50 largest banks and 50 midsize and small banks by MoneyRates.com.
Even at the big banks that charged a fee for checking accounts, the average cost fell to $11.28 from $11.75, the survey found. The average minimum balance required to avoid a monthly fee also fell, to $391.41 from $412.53 in mid-2011.
Third, small banks have benefitted from the reforms. The rates those banks charge on debit cards has not been driven down at all by Durbin, which does not apply to them.
"So far, it has turned out to be not nearly as bad as we were concerned it might have been," says Bill Hampel, chief economist for the Credit Union National Association, the trade association for credit unions.
Debit cards are still offering rewards, though some programs have changed strategies. “Instead of cash back or miles, some banks have switched to rewards programs that give debit-card holders points that can be used to get discounts on specific purchases," said Alex Matjanec, co-founder of MyBankTracker.com.
For example, a consumer who buys a lot of coffee might receive points that can be used to get a discount at Starbucks.
Finally, savings for consumers would have been bigger, but the Federal Reserve’s mistakes in setting its rules let banks charge more for small purchases.
Retailers who previously paid as little as 4 cents on a small debit card transaction found themselves hit with a 21-cent fee.
"A customer buying a can of soda on a debit card is costing me more today than it did before the legislation," said Ari Haseotes, president of Cumberland Farms, which operates almost 600 gas and convenience stores in 11 states across the Northeast and in Florida.
Meanwhile Visa and MasterCard announced big jumps in profit for their latest quarter, and Visa said it was under a federal antitrust investigation into the way it handles debit card fees.
“Were the Fed to reform its rules,” said Doug Kantor, counsel to the Merchants Payments Coaliton, a group of retailers that fights exorbitant swipe fees, “consumers would be saving even more. “And that’s not even counting credit cards; reforming that broken market should be the next step toward fairness.”
The article also makes a strong case for reforming the way Visa and MasterCard and their bank members fix the fees that consumers pay when they “swipe” their cards.
American merchants pay the highest swipe fees in the industrialized world, which pushes up prices at their stores. Because MasterCard and Visa fix fees for their banks, which refuse to compete on price, the fees have become retailers’ second-highest operating cost, after labor, and a real obstacle for small merchants in particular.
Here is what the newspaper found:
First, consumers are saving from debit reform. Public reports for America’s largest retailers show that operating margins fell in the fourth quarter of 2011, when the Durbin Amendment to the Dodd-Frank financial reform law reduced debit card fees. That means those retailers were passing along any savings they might have, and then some. And some companies are giving discounts specifically for using debit cards, including, among others, Ikea, Nice N Easy Grocery Shoppes and some Exxon and Arco stations.
Second, free checking has not disappeared under the Durbin Amendment, as the banks claimed it would. In fact, more banks offered free checking after reform than before and overall prices on bank accounts dropped.
In the second half of 2011, 39 percnet of banks offered checking accounts with no monthly maintenance fee, up from 35 percent for the first part of the year, according to a survey of the 50 largest banks and 50 midsize and small banks by MoneyRates.com.
Even at the big banks that charged a fee for checking accounts, the average cost fell to $11.28 from $11.75, the survey found. The average minimum balance required to avoid a monthly fee also fell, to $391.41 from $412.53 in mid-2011.
Third, small banks have benefitted from the reforms. The rates those banks charge on debit cards has not been driven down at all by Durbin, which does not apply to them.
"So far, it has turned out to be not nearly as bad as we were concerned it might have been," says Bill Hampel, chief economist for the Credit Union National Association, the trade association for credit unions.
Debit cards are still offering rewards, though some programs have changed strategies. “Instead of cash back or miles, some banks have switched to rewards programs that give debit-card holders points that can be used to get discounts on specific purchases," said Alex Matjanec, co-founder of MyBankTracker.com.
For example, a consumer who buys a lot of coffee might receive points that can be used to get a discount at Starbucks.
Finally, savings for consumers would have been bigger, but the Federal Reserve’s mistakes in setting its rules let banks charge more for small purchases.
Retailers who previously paid as little as 4 cents on a small debit card transaction found themselves hit with a 21-cent fee.
"A customer buying a can of soda on a debit card is costing me more today than it did before the legislation," said Ari Haseotes, president of Cumberland Farms, which operates almost 600 gas and convenience stores in 11 states across the Northeast and in Florida.
Meanwhile Visa and MasterCard announced big jumps in profit for their latest quarter, and Visa said it was under a federal antitrust investigation into the way it handles debit card fees.
“Were the Fed to reform its rules,” said Doug Kantor, counsel to the Merchants Payments Coaliton, a group of retailers that fights exorbitant swipe fees, “consumers would be saving even more. “And that’s not even counting credit cards; reforming that broken market should be the next step toward fairness.”
Man Sentenced in $400 Million Ponzi Scheme
BEAUMONT, Texas – 5/9/2012 - A federal judge has sentenced a 36-year-old Dallas man in connection with his role in a pair of complex, lucrative oil and gas Ponzi schemes that operated in Michigan and Texas, U.S. Attorney for the Eastern District of Texas John M. Bales announced on May 4.
Joseph Blimline was sentenced to 240 months in federal prison on each of the charges related to the Ponzi schemes following a five-hour sentencing hearing on May 3 before U.S. District Judge Marcia A. Crone, who ordered the sentences to run concurrently and ordered that restitution be made to the victims of the schemes.
“The Michigan agents worked hand in hand with the agents in Texas and with federal and state securities regulators to untangle both of these complicated Ponzi schemes and bring the perpetrators to justice for their abuse of the trust of others to obtain criminal profits,” Bales said. “To all potential investors, I urge you to be wary of investment vehicles that promise exorbitant rates of return. Remember: If the opportunity appears too good to be true, then it probably is.”
At the sentencing hearing, the government presented testimony and evidence which established that Blimline and others began operating a Ponzi scheme in Michigan between November 2003 and December 2005, specifically by promising inflated rates of return in order to obtain payments from investors. Lacking any legitimate source of income with which to make payouts to the investors, Blimline directed that later investor payments be used to pay previous investors and diverted investor payments for his own personal benefit. The Michigan scheme netted over $28 million from its investor victims before its collapse.
In early 2006, Blimline exported the Michigan Ponzi scheme to Texas, where Blimline and his new co-conspirators began the operation of Provident Royalties in Dallas. Consistent with his previous actions in Michigan, Blimline made materially false representations and failed to disclose material facts to their investors in order to induce the investors into providing payments to Provident. Blimline received millions of dollars in unsecured loans from investor funds and also directed the purchase by Provident of worthless assets from his Michigan enterprise. In the Provident scheme, funds from later investors were also consistently used to make payments to early investors, resulting in the collapse of the scheme in 2009. The Provident scheme netted over $400 million from approximately 7,700 investor victims.
U.S. Attorney for the Western District of Michigan Donald A. Davis praised the diligent work and cooperation of all involved. “Stealing money through fraud and deceit will not be tolerated,” he said.
The Michigan case was investigated by the FBI and the U.S. Postal Inspection Service and was prosecuted by Assistant U.S. Attorney for the Western District of Michigan Nils Kessler. The Texas case was investigation by the FBI and prosecuted by Assistant U.S. Attorney for the Eastern District of Texas Shamoil T. Shipchandler.
Source: www.stopfraud.gov.
Joseph Blimline was sentenced to 240 months in federal prison on each of the charges related to the Ponzi schemes following a five-hour sentencing hearing on May 3 before U.S. District Judge Marcia A. Crone, who ordered the sentences to run concurrently and ordered that restitution be made to the victims of the schemes.
“The Michigan agents worked hand in hand with the agents in Texas and with federal and state securities regulators to untangle both of these complicated Ponzi schemes and bring the perpetrators to justice for their abuse of the trust of others to obtain criminal profits,” Bales said. “To all potential investors, I urge you to be wary of investment vehicles that promise exorbitant rates of return. Remember: If the opportunity appears too good to be true, then it probably is.”
At the sentencing hearing, the government presented testimony and evidence which established that Blimline and others began operating a Ponzi scheme in Michigan between November 2003 and December 2005, specifically by promising inflated rates of return in order to obtain payments from investors. Lacking any legitimate source of income with which to make payouts to the investors, Blimline directed that later investor payments be used to pay previous investors and diverted investor payments for his own personal benefit. The Michigan scheme netted over $28 million from its investor victims before its collapse.
In early 2006, Blimline exported the Michigan Ponzi scheme to Texas, where Blimline and his new co-conspirators began the operation of Provident Royalties in Dallas. Consistent with his previous actions in Michigan, Blimline made materially false representations and failed to disclose material facts to their investors in order to induce the investors into providing payments to Provident. Blimline received millions of dollars in unsecured loans from investor funds and also directed the purchase by Provident of worthless assets from his Michigan enterprise. In the Provident scheme, funds from later investors were also consistently used to make payments to early investors, resulting in the collapse of the scheme in 2009. The Provident scheme netted over $400 million from approximately 7,700 investor victims.
U.S. Attorney for the Western District of Michigan Donald A. Davis praised the diligent work and cooperation of all involved. “Stealing money through fraud and deceit will not be tolerated,” he said.
The Michigan case was investigated by the FBI and the U.S. Postal Inspection Service and was prosecuted by Assistant U.S. Attorney for the Western District of Michigan Nils Kessler. The Texas case was investigation by the FBI and prosecuted by Assistant U.S. Attorney for the Eastern District of Texas Shamoil T. Shipchandler.
Source: www.stopfraud.gov.
Subjects
investors,
ponzi scheme