Cognitive-enhancing effects of vagus nerve stimulation (VNS) have been reported during 6 months of treatment in a pilot study of patients with Alzheimer's disease (AD). Data through 1 year of VNS ...(collected from June 2000 to September 2003) are now reported.
All patients (N = 17) met the National Institute of Neurological and Communicative Disorders and Stroke and the Alzheimer's Disease and Related Disorders Association (NINCDS-ADRDA) criteria for probable AD. Responder rates for the Alzheimer's Disease Assessment Scale-cognitive subscale (ADAS-cog) and Mini-Mental State Examination (MMSE) were measured as improvement or absence of decline from baseline. Global change, depressive symptoms, and quality of life were also assessed. Cerebrospinal fluid (CSF) levels for total tau, tau phosphorylated at Thr181 (phosphotau), and Abeta42 were measured by standardized enzyme-linked immunosorbent assay (ELISA).
VNS was well tolerated. After 1 year, 7 (41.2%) of 17 patients and 12 (70.6%) of 17 patients improved or did not decline from baseline on the ADAS-cog and MMSE, respectively. Twelve of 17 patients were rated as having no change or some improvement from baseline on the Clinician Interview-Based Impression of Change (CIBIC+). No significant decline in mood, behavior, or quality of life occurred during 1 year of treatment. The median change in CSF tau at 1 year was a reduction of 4.8% (p = .057), with a 5.0% increase in phosphotau (p = .040; N = 14).
The results of this study support long-term tolerability of VNS among patients with AD and warrant further investigation.
As the sole plausible military threat facing Sweden, the Soviet Union and then Russia have consistently been at the top of Swedish intelligence collection priorities. In fact, understanding Russia ...and its military forces well is a source of pride and self-perceived comparative advantage of the Swedish intelligence community. This article contextualizes Swedish intelligence collection on Russia, including its Cold War antecedents and the persistent counterintelligence threat. It then describes Swedish intelligence reporting in anticipation of the war in Ukraine, including a reported misjudgement that Russia would ultimately not conduct a full-scale war of aggression against Ukraine in its entirety. This 'intelligence failure' was reportedly based on the assessment that Russia had assembled insufficient military capabilities to subjugate Ukraine, and that such an operation would be too risky and costly. Coming full circle in again beginning to focus mainly on great power competition and military capabilities in its near abroad, Swedish military intelligence has since reported valuable intelligence on Russian military capabilities, drawing on a combination of collection capabilities.
As War rages in Ukraine, counterintelligence has again taken centre stage for European intelligence agencies. In spite of the long-ascendant espionage threat, to date little is known about who is ...recruited, what motivated them and how they were caught. This article presents an analysis of espionage against European NATO and/or EU members, based on court convictions in 2010-2021. This provides a first overview of contemporary espionage in Europe, and complements previous research, which is dominated by single-case studies, mainly of Anglo-Saxon cases. Replicating large-N studies of American espionage, the study identifies transatlantic commonalities, including perpetrators being overwhelmingly male, middle-aged, and a mainly working outside of defence or intelligence agencies. But also differences, with Russia being by far the main instigator of espionage in Europe, a strong concentration of cases in Northern Europe, and a diversity of legislation coinciding with equally variable outcomes in court. Generally, the similarities speak to the nature of contemporary espionage, whereas the differences are chiefly attributable to geopolitical differences between the US and Europe.
Vagus nerve stimulation (VNS) is an established treatment method for therapy-refractory epilepsy and, in Europe, for treatment-resistant depression also. Clinical and experimental investigations have ...also shown positive effects of VNS on cognition in epilepsy and depression. The purpose of the present pilot study was to investigate the effect of VNS on cognition in patients with Alzheimer's disease.
All the included patients (N = 10) met the National Institute of Neurological and Communicative Disorders and Stroke and the Alzheimer's Disease and Related Disorders Association criteria for the diagnosis of Alzheimer's disease. Before the implantation of the vagus stimulator (NeuroCybernetic Prosthesis), the patients underwent neuropsychological tests (e.g., Alzheimer's Disease Assessment Scale-cognitive subscale ADAS-cog and Mini-Mental State Examination MMSE), computerized tomography of the brain, medical/neurologic and psychological examinations (status evaluation), and lumbar puncture with investigation of the cerebrospinal fluid. The presence of depressive symptoms was rated using the Montgomery-Asberg Depression Rating Scale. The VNS was initiated 2 weeks after the implantation, and the patients were followed up with regular investigations and tests over 6 months. Response was defined as improvement or absence of impairment in ADAS-cog and MMSE scores after 3 and 6 months.
After 3 months of treatment, 7 of 10 patients were responders according to the ADAS-cog (median improvement of 3.0 points), and 9 of 10 patients were responders according to the MMSE (median improvement of 1.5 points). After 6 months of treatment, 7 patients were responders on the ADAS-cog (median improvement of 2.5 points), and 7 patients were responders on the MMSE (median improvement of 2.5 points). VNS was well tolerated, and its side effects were mild and transient.
The results of this open-label pilot study suggest a positive effect of VNS on cognition in patients with Alzheimer's disease. Further studies are warranted.
In the years after the collapse of the Soviet Union and its zone of influence, few insurgent groups had the resources necessary to confront regular armies. At the same time, state-sponsored financial ...support for insurgencies dramatically decreased. The pressing need to raise funds for war and the weakness of law enforcement in conflict zones create fertile conditions for organized crime; indeed, there is a mounting body of evidence correlating armed conflict and illicit economy, though the nature of this link and its impact on regional politics has not been well understood.Conflict, Crime, and the State in Postcommunist Eurasiaexplores the relationship between ideologically motivated insurgents, profit-motivated crime, and state institutions in eight conflict zones. Through detailed case studies, the contributors demonstrate how the operations and incentives of insurgents may emerge and shift over time: for some armed groups, crime can become an end in itself beyond a financial means, but not all armed groups equally adapt to illicit commerce. They also show how the criminalization of state institutions is a lingering concerns even after armed conflicts end.Conflict, Crime, and the State in Postcommunist Eurasiaplaces the case studies along a continuum of political and criminal behavior, examining the factors that motivate insurgents to seek out criminal alliance, how this connection affects the dynamics of conflict, and what risks remain during postconflict transition. These findings will provide a better understanding of the types of challenges likely to confront peacekeeping and statebuilding endeavors in other parts of the world.Contributors:Jana Arsovska, Svante Cornell, Johan Engvall, Michael Jonsson, Alexandru Molcean, Niklas Nilsson, Murad Batal al-Shishani, Natalie Verständig.
Subjective cognitive decline (SCD) and biomarker-based “at-risk” concepts such as “preclinical” Alzheimer's disease (AD) have been developed to predict AD dementia before objective cognitive ...impairment is detectable. We longitudinally evaluated cognitive outcome when using these classifications.
Memory clinic patients (n = 235) were classified as SCD (n = 122): subtle cognitive decline (n = 36) and mild cognitive impairment (n = 77) and subsequently subclassified into SCDplus and National Institute on Aging–Alzheimer's Association (NIA-AA) stages 0 to 3. Mean (standard deviation) follow-up time was 48 (35) months. Proportion declining cognitively and prognostic accuracy for cognitive decline was calculated for all classifications.
Among SCDplus patients, 43% to 48% declined cognitively. Among NIA-AA stage 1 to 3 patients, 50% to 100% declined cognitively. The highest positive likelihood ratios (+LRs) for subsequent cognitive decline (+LR 6.3), dementia (+LR 3.4), and AD dementia (+LR 6.5) were found for NIA-AA stage 2.
In a memory clinic setting, NIA-AA stage 2 seems to be the most successful classification in predicting objective cognitive decline, dementia, and AD dementia.
Rebel involvement in drug trafficking is broadly found to prolong and intensify civil wars. Being an illicit good with strong demand, high profit margins, limited barriers to entry, and few ...interdiction opportunities, narcotic drugs disproportionately benefit rebel groups as a source of funding in civil wars. Furthermore, drug trafficking is believed to prolong civil wars by creating war economies that benefit rebel groups, making them reluctant to engage in peace negotiations. However, recent peace agreements suggest that drug trafficking can in some cases be used to "buy off" rebel leaders, whereas other insurgents willingly relinquish this source of funding. This article compares attempts at conflict resolution in Colombia and Myanmar, focusing on the impact drug trafficking by Fuerzas Armadas Revolucionarias de Colombia (Revolutionary Armed Forces of Colombia) and United Wa State Army has on contemporary peace negotiations.
After Vladimir Putin declared a partial Russian mobilisation in late September 2022 and annexed four additional Ukrainian regions, there was little to suggest that a negotiated settlement would be ...possible while he remained in power. This article instead explores three possible military outcomes of the war - an outright Ukrainian or Russian military victory, and a war of attrition. As of November 2022, a Ukrainian victory, so unlikely at the outset of Russia's invasion, is a distinct possibility, provided the West offers sufficient military materiel and training swiftly enough. Russian forces have suffered heavy casualties and are low on precision-guided munitions, with their logistics under fire and having lost much of what air dominance they had. Hence, Moscow's battlefield fortunes hinge on whether mobilised, poorly trained and equipped forces will be able to hold defensive lines over the winter to buy time to build new, more capable units, with troop morale ever more crucial, but also brittle. A key unknown, however, is the state of Ukrainian forces. Importantly, the scale and intensity of the war, the vital interests at stake and international involvement on both sides all gravitate towards a more drawn-out war over the winter and beyond.
Russian armed forces' lacklustre performance in Ukraine has surprised military analysts. Shortcomings have included breakdowns in logistics, poor equipment and morale, abysmal communications, and ...muddled command and control, as well as a weak showing by the Russian Aerospace Forces, air defence, and cruise and ballistic missiles. Chief among the contributing factors are wishful political thinking, overreliance on esoteric doctrine and endemic corruption. War, however, brutally exposes peacetime cheating. Consequently, estimates of Russian military capabilities - in particular, for large-formation combined-arms operations, logistics, air defence and intangibles such as morale - need to be carefully reassessed. Earlier analyses of a Russia-NATO conflict appear to have overstated the challenge of defending Europe. Looking ahead, the conventional threat from Russia seems less daunting than previously thought, and the country faces a formidable task in repairing depleted capabilities. That said, President Vladimir Putin's appetite for risk is greater than anticipated.
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