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Our aim was to find out whether speech-related temporal parameters (SRTPs) are sensitive indicators of the clinical outcome in acetylcholinesterase (AChE) inhibitor therapy with donepezil, compared to the standard cognitive Alzheimer's Disease Assessment Scale-Cognitive Subscale (ADAS-Cog) used in clinical trials. In this 24-week-long, naturalistic, self-control, open-labeled, prospective pilot study with 10 mg donepezil on 20 mild AD patients, cognitive functions were evaluated using 15 different SRTPs analyzed by automatic speech recognition in the Speech-Gap Test® compared to ADAS-Cog test results. Among the SRTPs, the filled pause duration ratio significantly improved after 12 weeks of donepezil treatment. During the 24-week follow-up, additional SRTPs such as the filled pause count ratio and the filled pause frequency showed significant benefits. ADAS-Cog total scores showed a slight but not significant improvement compared to baseline after 12 and 24 weeks of donepezil treatment. Among the ADAS-Cog subtests, only orientation improved significantly after 24 weeks of donepezil treatment. Our results indicate that subtle changes in SRTPs measured by the Speech-Gap Test® could be considered as sensitive indicators of the efficacy of the pharmacotherapy in mild AD. According to our data, other cognitive domains did not show improvement in response to donepezil therapy rating by ADAS-Cog. Based on all of this, it is likely that examining and evaluating speech parameters may play an important role in determining the effects of pharmacological treatment of mild AD. The novelty of our study is that it applies the measurement of linguistic parameters as primary outcomes during a drug trial of mild AD in scientific research for the first time. [ABSTRACT FROM AUTHOR]

General practitioners (GPs) play a pivotal role in dementia recognition, yet research suggests that dementia often remains undetected in primary care. Lack of knowledge might be a major contributing factor to low recognition rates. Our objective was to address a gap in the scientific literature by exploring GPs' knowledge on dementia and mild cognitive impairment (MCI) for the first time in Hungary by conducting a cross-sectional, questionnaire study among practicing GPs. Recruitment of the participants (n = 402) took place at mandatory postgraduate training courses and at national GP-conferences; the applied questionnaire was self-administered and contained both open-ended and fixed-response questions.Results showed that GPs highlighted vascular and metabolic factors (38.3% of the answer items) and unhealthy lifestyle (29.1% of the answer items) as dementia risk factors. They perceived vascular dementia as the most common dementia form, followed by Alzheimer's disease. Almost half of the respondents (44.9%) were not familiar with MCI. Most GPs identified memory problems (98.4%) and personality change (83.2%) as the leading symptoms of dementia.In summary, GPs demonstrated adequate knowledge on areas more relevant to their practices and scope of duties (risk and preventive factors, main types and symptoms of dementia); however, uncertainties were uncovered regarding epidemiology, MCI, and pharmacological therapy. As only one-fifth (19.4%) of the GPs could participate recently in dementia-focused trainings, continued education might be beneficial to improve dementia detection rates in primary care.

This article deals with the liability of the supervisory authority of the financial market. It could be questioned whether the supervisory authority, as the public authority, is liable for the supervisory performance. If the answer is yes, then the question is what kind of liability could be found and if any special conditions (prerequisites) are needed. In general, there could be two lines of public liability found. One is systemic liability for the safe financial market—e.g., financial market stability. The other perspective is individual liability for damages caused by unlawful administrative procedure or maladministration, where unlimited strict liability is granted. This kind of liability might be widely questioned, especially when the central bank is the supervisory authority, like in the Czech Republic, Slovakia, Hungary, and other EU member states. This article aims to evaluate the liability of the supervisory authority in the Czech Republic and Hungary concerning the European level of such liability. [ABSTRACT FROM AUTHOR]

The study examines the main components of the organizational framework for macro-prudential management in the Member States of the European Union. The organizational design of macroprudential management is a competence of the Member States, which can themselves be grouped into different models. First, the study provides an overview of the international and EU standards and recommendations on the legal status of macro-prudential bodies in the Member States. Then, it lists those basic features of the legal status of macro-prudential bodies which are relevant with a view to the present inquiry before finally turning to address those very features. The study concludes that there is a tendency for the EU macro-prudential body to standardize the basic elements of the legal status of the Member State macro-prudential bodies. However, the process of standardization, in terms of the content of the institutional framework, is still at an early stage and a variety of legal solutions may be identified for each of the substantive aspects. As such, we claim that the institutional framework of macro-prudential policy is best described by a coordinated standardization of the substantive pillars with different formal features and with different legal solutions. [ABSTRACT FROM AUTHOR]

Ensuring the sustainability of public finances is a crucial concern for the European Union, particularly in the context of transfer pricing, which is focused on tax base erosion and profit shifting. Transfer pricing, involving the internal transfer of goods, services, or intellectual property between related entities, can significantly impact member states' tax revenues and overall economic stability. Base erosion and profit shifting is a term used to describe tax planning strategies that multinational companies use to exploit gaps and mismatches in tax rules to artificially shift profits to low or no-tax jurisdictions, thereby reducing their overall tax liability. The scope of this study examines these two topics, mainly by using jurisprudential methods and analysis of scientific sources, as well as to research the effect of tax-based erosion and inequality among state jurisdictions. The assessment and analysis of the problems in these areas have been going on for years, and in essence, the neuralgic points are clear in terms of problem definition. Nevertheless, appropriate normative solutions have either not been developed to a full extent or are being implemented slowly. Considering the lengthy process of adopting normative rules, the main aim of this study is to make suggestions for the field of law enforcement and organs of public administration that could lead to changes in the areas of transfer-pricing, base erosion, and profit shifting. In conclusion, three key areas of action are proposed. Firstly, the promotion and everyday implementation of digital taxation contribute to the efficient exchange of data. Secondly, much closer cooperation between tax authorities on this basis can be strengthened at the Member State level in practical administration. Thirdly, the more effective safeguarding of the single market by national administrations. [ABSTRACT FROM AUTHOR]

This article examines how addressing climate-related risks and supporting mitigation and adaptation policies fit into central bank mandates. According to this goal, the research conducts an empirical examination of current central bank mandates to investigate the extent to which central banks are equipped with objectives that task them to enhance sustainability and mainstream green finance. The analysis of mandates and objectives using the IMF's Central Bank Legislation Database. Out of 159 IMF member countries and monetary unions, only 12 % have explicit sustainability mandates, while 33 % are mandated to support the government's policy priorities, which mostly include sustainability goals. The research concludes that it should be clear that climate change and mitigation policies will have very profound impacts on economies, with potentially significant implications for price, macroeconomic, and financial stability. These need to be tackled by central banks as part of their core responsibilities. A central bank that does not address climate risks is failing to do its job. [ABSTRACT FROM AUTHOR]

In the 21st century, the two administrative instruments that have the greatest impact on the legal situation of members of society, administrative enforcement and administrative legislation, have been and are being confronted with a number of social challenges (global economic crisis, refugee crisis, epidemics and pandemics). The challenges of the 21st century require public intervention to provide a rapid, accurate and effective response to the problems that arise, while ensuring legality and the protection of the rights of the citizens. The first responses to social problems are provided by sectoral regulations, which may conflict with general rules of administrative procedure. The study analyses administrative decisions of general scope in the light of special sectoral regulation and review the points of conflict with general rules of administrative procedure. The study concludes with a proposal. [ABSTRACT FROM AUTHOR]

Objective: Most recordings of verbal fluency tasks include substantial amounts of task-irrelevant content that could provide clinically valuable information for the detection of mild cognitive impairment (MCI). We developed a method for the analysis of verbal fluency, focusing not on the task-relevant words but on the silent segments, the hesitations, and the irrelevant utterances found in the voice recordings. Methods: Phonemic ('k', 't', 'a') and semantic (animals, food items, actions) verbal fluency data were collected from healthy control (HC; n = 25; M age = 67.32) and MCI (n = 25; M age = 71.72) participants. After manual annotation of the voice samples, 10 temporal parameters were computed based on the silent and the task-irrelevant segments. Traditional fluency measures, based on word count (correct words, errors, repetitions) were also employed in order to compare the outcome of the two methods. Results: Two silence-based parameters (the number of silent pauses and the average length of silent pauses) and the average word transition time differed significantly between the two groups in the case of all three semantic fluency tasks. Subsequent receiver operating characteristic (ROC) analysis showed that these three temporal parameters had classification abilities similar to the traditional measure of counting correct words. Conclusion: In our approach for verbal fluency analysis, silence-related parameters displayed classification ability similar to the most widely used traditional fluency measure. Based on these results, an automated tool using voiced-unvoiced segmentation may be developed enabling swift and cost-effective verbal fluency-based MCI screening. [ABSTRACT FROM AUTHOR]

Background This study reports the findings of the first large-scale Phase III investigator-driven clinical trial to slow the rate of cognitive decline in Alzheimer disease with a dihydropyridine (DHP) calcium channel blocker, nilvadipine. Nilvadipine, licensed to treat hypertension, reduces amyloid production, increases regional cerebral blood flow, and has demonstrated anti-inflammatory and anti-tau activity in preclinical studies, properties that could have disease-modifying effects for Alzheimer disease. We aimed to determine if nilvadipine was effective in slowing cognitive decline in subjects with mild to moderate Alzheimer disease. Methods and findings NILVAD was an 18-month, randomised, placebo-controlled, double-blind trial that randomised participants between 15 May 2013 and 13 April 2015. The study was conducted at 23 academic centres in nine European countries. Of 577 participants screened, 511 were eligible and were randomised (258 to placebo, 253 to nilvadipine). Participants took a trial treatment capsule once a day after breakfast for 78 weeks. Participants were aged >50 years, meeting National Institute of Neurological and Communicative Disorders and Stroke/Alzheimer's disease Criteria (NINCDS-ADRDA) for diagnosis of probable Alzheimer disease, with a Standardised Mini-Mental State Examination (SMMSE) score of [greater than or equal to]12 and Conclusions The results do not suggest benefit of nilvadipine as a treatment in a population spanning mild to moderate Alzheimer disease. Trial registration Clinicaltrials.gov NCT02017340, EudraCT number 2012-002764-27., Author(s): Brian Lawlor 1,2,*, Ricardo Segurado 3,4, Sean Kennelly 5,6, Marcel G. M. Olde Rikkert 7, Robert Howard 8, Florence Pasquier 9, Anne Börjesson-Hanson 10, Magda Tsolaki 11, Ugo Lucca [...]