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Neuroinflammation in Alzheimer disease
Get PDFIncreasing evidence points to a pivotal role of immune processes in the pathogenesis of Alzheimer disease, which is the most prevalent neurodegenerative and dementia-causing disease of our time. Multiple lines of information provided by experimental, epidemiological, neuropathological and genetic studies suggest a pathological role for innate and adaptive immune activation in this disease. Here, we review the cell types and pathological mechanisms involved in disease development as well as the influence of genetics and lifestyle factors. Given the decade-long preclinical stage of Alzheimer disease, these mechanisms and their interactions are driving forces behind the spread and progression of the disease. The identification of treatment opportunities will require a precise understanding of the cells and mechanisms involved as well as a clear definition of their temporal and topographical nature. We will also discuss new therapeutic strategies for targeting neuroinflammation, which are now entering the clinic and showing promise for patients
“The role of national parliaments and European Parliament as guardians of European values: the case of democracy and the rule of law in Cyprus”
Get PDFNational parliaments, alongside the European Parliament, form a constituent part of the democratic legitimacy chain of the Union and play an integral role in promoting EU values in decision-making. This paper aims to assess the role of national parliaments, supranationally within the governance of the EU, but also the democratic standards that national parliaments must meet when acting internally, outside the scope of EU law. These findings will then be put into practice to assess the Cypriot Parliament as a guardian of European values nationally, which provides for valuable insights due to its unique constitutional setting. The assessment is specifically conducted in relation to: (a) the internal organisation and composition of the national Parliament and preparatory procedures and (b) the proposal, drafting and implementation of national laws. The paper then assesses the role of the EP in further supporting national parliaments in their role as guardians of European values nationally
New Revision of China’s Marine Environmental Protection Law
Get PDFChina’s Marine Environmental Protection Law was first adopted in August 1982 and came into force on 1 March 1983, and since then, it has gone through two revisions and three amendments. The latest revision in 2023 reflects China’s determination to further strengthen the protection of the marine environment and to prepare itself to meet new challenges and needs. This short article first provides a brief historical background of the Law and then evaluates some key changes in the 2023 revision. Finally, it highlights some features of the changes and pinpoints some concerns remaining in the Law even after the revision
Defining and identifying potentially morally injurious experiences for secure mental healthcare workers: A Delphi study
Get PDFPurpose: Staff in secure mental healthcare settings face unique occupational challenges that may conflict with their personal or professional moral code. Initial research has established the presence of moral injury in this population, though insight into the specific sources and driving factors at the root of this syndrome is limited.
Method: To address this gap, a three-round expert Delphi survey was conducted to gain consensus on the conceptualisation, types and drivers of potentially morally injurious
experiences (PMIEs) for secure mental healthcare workers. Healthcare professionals and academics in the field were recruited.
Findings: A high level of consensus (≥80%) was achieved on several sources of moral injury, which related to aspects of the healthcare system, the secure context, relational dynamics and individual practices, behaviours and attitudes. Experts also agreed on several items relating to the definition of a PMIE, the factors driving the occurrence of PMIEs, and the factors increasing risk for the subsequent development of moral injury.
Practical implications: The findings suggest that current definitions of PMIEs may, in isolation, be too narrow, prompting the need to attend to the broad range of PMIEs
experienced by secure mental healthcare staff. Additionally, recommendations for the primary and secondary prevention of moral injury in secure mental healthcare staff are
offered, recognising the particular need for intervention at a systemic level.
Originality: This study is the first to consider the range of sources of moral injury faced by staff providing for people with complex forensic and mental health needs
950 Comparison of Magseed and Savi Scout Localisation Systems in Wide Local Excision of Non-Palpable Breast Lesions: A Retrospective Cohort Analysis of Surgical Outcomes, Positive Margins, Re-Excision Rates, and Specimen-to-Tumour Size Ratios
No full textAim
This study compares the surgical outcomes of Magseed and Savi Scout localisation systems in wide local excision of non-palpable breast lesions across two hospitals. Factors analyzed include positive margin rates, re-excision rates, specimen volumes, and specimen-to-tumour size ratios.
Method
A retrospective cohort analysis was conducted on 200 lesions (100 localized with Magseed and 100 with Savi Scout). Data were extracted from electronic medical records, including patient demographics, tumour characteristics, and surgical outcomes. Positive margins were defined as tumour cells at the inked margin or within 2 mm for ductal carcinoma in situ (DCIS) and 1 mm for invasive ductal carcinoma (IDC). Statistical analyses evaluated differences in surgical outcomes and specimen-to-tumour size ratios.
Results
Both systems achieved 100% localisation success rates and identical positive margin rates (13%). However, Savi Scout specimens were significantly larger, with a specimen volume-to-tumour size ratio of 5617.06 mm³/mm compared to 3935.78 mm³/mm for Magseed (p < 0.01). Larger specimen volumes correlated with reduced positive margins, with 69% and 92.3% of positive margins occurring at specimen-to-tumour size ratios ≤1.60 and ≤3.50 for Magseed and Savi Scout, respectively. Differences in re-excision rates (Magseed: 10%, Savi Scout: 13%) reflected institutional protocols.
Conclusions
Both localisation systems achieve similar positive margin rates, but Savi Scout's larger specimen volumes may confer a potential advantage in margin clearance. Institutional protocols and tumour types influence re-excision rates. These findings highlight the importance of tailoring localisation methods to surgical and institutional practices
Substance Abuse in Teenage Pregnancies – The Current Role of Psycho-Education
Get PDFAims: To explore the current availability of psycho-education as a primary prevention against substance misuse in unplanned pregnancies for adolescents in the UK. It was noted that 80% of young adults registered with drugs and alcohol services started misusing substances under the age of 15 years. This poses an apparent risk of young mothers who are abusing drugs to have unplanned pregnancies. Moreover, pregnancies occurring sooner than desired are associated with higher risks to the health of the fetus because of delayed recognition. A study from the United States shows that women who reported using hard drugs, cannabis or smoking cigarettes at age 18 had an increased likelihood of risk behaviours and subsequent unplanned pregnancies.
Methods: The National Office of Statistics and the UK Government website were scanned to retrieve data appropriate to adolescent substance misuse and unplanned pregnancies. It was found that the conception rate for women aged under 18 years in England and Wales in 2021 was 13.2 per 1,000 women. Additionally, 11,326 young people were found to be in contact with alcohol and drug services between April 2021 and March 2022. Out of which 234 (5%) were young mothers or pregnant.
Results: The need for psychological intervention for young women focussing on substance misuse has been an ongoing dilemma. The UK government introduced programmes such as the 10-year Teenage Pregnancy Strategy for England which aimed to reduce the conception rate for women under 18 years. However, medical services often do not have data on substance misuse in young people with unplanned pregnancies as they have not had prior contact with the service. This puts them at increased risk of health complications during the pregnancy and ultimately risk of neonatal withdrawal syndromes. This demonstrates an increasing requirement to introduce psycho-education accessible to adolescents between 16–18 years to create awareness of risks of substance misuse and unplanned pregnancies.
Conclusion: Even though there are programmes preventing and educating regarding unplanned pregnancies, there is little support available to adolescent mothers who have ongoing substance misuse behaviours. Misusing substances while pregnant poses a risk not just to the fetus, but increases the complexities of bearing the responsibility of being a parent with a misuse disorder. Therefore, there is an emergent need for psycho-education accessible to adolescents to educate them against substance misuse during unplanned pregnancies
Shared Neural Signatures in Functional Neurological Disorder and Chronic Pain: A Multimodal Narrative Review
No full textBackground Functional neurological disorder (FND) frequently co-exists with chronic pain (CP), notably nociceptive and nociplastic (primary) pain disorders. The considerable overlap implies shared underlying mechanisms because of their similar clinical and epidemiological profiles. Although standard neuroimaging and electrophysiological tests typically show normal results in both FND and primary pain disorders, recent advancements in neuroimaging techniques have begun identifying neural biomarkers common to both conditions, though these findings remain preliminary and require further exploration.
Method We performed a detailed literature review of studies investigating neural activity in FND and chronic pain using electroencephalogram, magneto-encephalography, functional MRI, positron emission tomography and single photon emission computed tomography. Given the diverse nature of the reviewed studies, the synthesis is presented narratively.
Results Despite methodological differences, convergent data suggest disrupted neural networks across both FND and CP. Common findings include (1) hyperactivation of sensorimotor networks, (2) altered activity within the default mode network—a critical region for self-referential thought—and (3) dysfunction in emotional processing regions, notably the anterior cingulate cortex and insula. Thalamocortical dysrhythmia was identified as a potential unifying concept, characterised by abnormal theta and beta oscillations that enhance pain perception in CP and trigger functional symptoms in FND. Both conditions also exhibit reduced alpha oscillations, likely amplifying sensory sensitivity and emotional responsiveness.
Conclusion This review highlights shared neural abnormalities (Triple Network model) and introduces thalamocortical dysrhythmia as a novel explanatory framework linking FND and CP. Future research should target populations with coexisting disorders, potentially paving the way for innovative treatments, including hypnosis and neuromodulation/neurofeedback
The Legacy of Colonialism in the Recognition of Religions
Get PDFDuring the New Imperialism (1884–1920) period, an attitude pervaded the Western mindset that non-Christian religions were inferior and unsophisticated. At the heart of the colonialist view was ‘the white man’s burden’ of civilising primitive societies, including converting Indigenous peoples to Christianity. This aim escalated into a conscious effort among colonial powers to exert dominance over their subjects by othering and stereotyping non-Christians by presenting their religions through the prism of exoticism and orientalism. This article explores how colonialism accelerated modern recognition and registration issues for religious communities and continues to influence state-religion relations today, including how governments restrict religious freedom
The Efficacy of Biodiversity Mitigation Plans and Stakeholder Engagement in the North-Western Himalayan Region of India
Get PDFThis study explores the factors influencing the effectiveness of Biodiversity Mitigation Plans (BMPs) in the north-western Himalayan region of India. Using a case study approach, field surveys, stratified systematic sampling, random transect walks, and a bilingual questionnaire (English–Hindi) were conducted across the Project Influence Area (PIA). The questionnaire, comprising 24 translated questions across seven themes, was distributed to 50 respondents, with additional structured face-to-face interviews (n = 3) providing deeper insight into local perspectives.
Findings highlight a clear gap between regulatory frameworks and their implementation on the ground. In particular, the involvement of local Consultancies emerged as a critical factor in BMP effectiveness. These entities operate at the intersection of national and international agencies, environmental policy, and local communities, mediating knowledge, education, and practice.
The paper offers a theoretical framework positioning Consultancies as key agents in translating policy into action. It underscores the need for context-sensitive education, effective communication, and stakeholder collaboration to improve the implementation and impact of BMPs. Given the ecological sensitivity of the Himalayan region to threats such as climate change, deforestation, and infrastructure development, continued biodiversity research is essential to inform future mitigation strategies