Soviet military pilots secretly flew missions during the Korean War and in Yemen in the s and s. A secret operation by the Israeli Air Force later successfully lured Soviet pilots into unexpected aerial combat, leading to the unpublicized downing of five Soviet MiG aircraft.
The most sinister tool at the disposal of the Kremlin during the Cold War was the assassination of political enemies and defectors. The assassin spent two decades in prison, but upon his release he was awarded the highest Soviet decoration for bravery.
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The Soviet leadership rarely viewed senior foreign political figures as assassination targets. Known examples include aborted plans in the mids for an attack on Yugoslav leader Josip Broz Tito and KGB involvement in the turmoil and high-level political killings that preceded the Soviet invasion of Afghanistan in Most of these Soviet activities ceased with the collapse of the Soviet economy and the political turbulence that brought the Soviet Union to its end.
Rather, they provide contemporary Russian foreign policy with important historical roots that feed it. Politically, economically, and militarily, the country was in ruins. In the Caucasus, Russia ceded parts of its territory to Turkey. Meanwhile, Armenia, Azerbaijan, and Georgia declared independence. A decade later, most of these lands were back in the Soviet Union.
In , the Soviet Union, with its economy and its political system collapsed, dissolved peacefully, retreating from Ukraine, Belarus, the Baltic states, Moldova, the South Caucasus, and Central Asia. A decade later, with economic and political restoration under way, Russia was in the process of reestablishing various forms of control over its neighbors. Again in , Russia reaffirmed its determination and willingness to use force with the annexation of Crimea. Technological breakthroughs—virtual reality and artificial intelligence, to name just two of the most frequently mentioned areas of progress—will undoubtedly be adopted by Russian state actors and their agents, adapted to their needs, and if need be weaponized for the ongoing confrontation with the West.
These technologies may be new, and they hold out the possibility of expanding and enriching the arsenal of Russian foreign policy.
This statement was submitted to all Communist parties by the Executive Committee in May Approved for release on May 25, Declassified, redacted version approved for release on December 9, Follow the conversation— Sign up to receive email updates when comments are posted to this article. Interesting, but just remind me of how many countries the USA is fighting in, and how many regime changes it has promoted since the second world war.
I look forward to a similar indepth analysis of the USA's international agenda. Be interesting to see this given that the USA lacks both Russia's history and geography. Good wishes Robert Moore. I think the formatting is off. When I click the "print button", chunks of text are missing. It takes two to tango.
And it is the denial of that that makes this to a rather typical Carnegie anti-Russian piece. A more balanced evaluation would have considered the attitudes of Europe and the US towards Russia. It would for example have explored why the Western countries for so long kept up a story of World War II that minimized the Russian contribution to the defeat of Hitler.
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The Return of Global Russia.
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Her research focus is on trends in Russian foreign policy and Russia-U. Rumer, a former national intelligence officer for Russia and Eurasia at the U. No links or markup permitted.
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Sort by: Date Posted Recommended. In January , we received orphan drug designation from the FDA for our ready-to-use glucagon for the treatment of patients with hyperinsulinemic hypoglycemia, of which PBH is a category. Post-Bariatric Hypoglycemia Market. Obesity and related comorbidities such as T2D and cardiovascular disease are increasingly recognized as a major threat to individual and public health, with sustained weight loss difficult to achieve.
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Clinicians and patients alike have embraced the results of recent controlled clinical trials demonstrating the efficacy of surgical procedures performed on the stomach or intestines, known as bariatric surgery, to not only induce sustained weight loss but also to improve or normalize obesity-related comorbidities, including T2D. The number of bariatric surgeries performed in the United States has increased from an estimated , procedures per year in to , in. While benefits of bariatric surgery are now achieved with a lower risk of surgical complications, longer-term intestinal and nutritional complications can still occur.
One challenging and sometimes severe complication of bariatric surgery is hyperinsulinemic hypoglycemia. Hyperinsulinemic hypoglycemia, and more specifically PBH, is most commonly associated with Roux-en-Y gastric bypass, or RYGB, a procedure in which the small intestine is re-routed to a small resected stomach pouch. However, PBH has also been observed following sleeve gastrectomy, a procedure that reduces the size of the stomach. Symptoms include palpitations, lightheadedness and sweating. A subset of post-bariatric patients develops very severe hypoglycemia involving a shortage of glucose in the brain, known as neuroglycopenic symptoms, typically occurring one to three years following bariatric surgery, associated with confusion, decreased attentiveness, seizure and loss of consciousness.
For these patients, quality of life can be severely affected as many cannot care for themselves or even be left alone and may ultimately lose their employment due to this disability. Hypoglycemia typically occurs after meals, particularly those rich in simple carbohydrates. Due to the change in gastric anatomy resulting from bariatric surgery, plasma insulin concentrations are inappropriately high at the time of hypoglycemia in these patients.
Treatment of hypoglycemia requires rapid-acting carbohydrates such as glucose tablets, which in PBH patients can contribute to rebound hyperglycemia that triggers further insulin secretion and recurrent hypoglycemia. There are currently no approved treatments for PBH. Current strategies to manage PBH include dietary modification aimed at reducing intake of high glycemic index carbohydrates.
Both diet and off-label administration of pre-meal acarbose, an anti-diabetic drug used to treat T2D, aim to minimize rapid post-meal surges in glucose that trigger insulin secretion. Additional off-label therapies include those aimed at reducing insulin secretion. In severe cases, gastric restriction or banding has been required to slow gastric emptying and gastrostomy tubes have been used to provide the sole source of nutrition.
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Despite strict adherence to medical nutrition therapy and clinical use of multiple medical options, patients continue to have frequent hypoglycemia. While hypoglycemia most commonly occurs following meals, it can also occur in response to increased activity and emotional stress. Importantly, patient safety is additionally compromised when hypoglycemia unawareness develops with recurrent hypoglycemia.
We believe there is an urgent need for therapeutic options to allow optimal nutrition, maintain health and quality of life and improve safety in patients with PBH. As bariatric procedures have been performed for over ten years, based on our analysis of market research, we estimate a standing population of approximately 85, patients who fail meal time nutritional therapy and experience PBH in the United States and require additional treatment options. A similar size patient population is estimated to exist in Europe.
Depending on the severity of their condition, these patients may require chronic episodic administration of glucagon ranging from multiple times a month to multiple times a day. We have developed a ready-to-use glucagon formulation that can be easily and quickly injected or infused subcutaneously from a syringe, pen or pump. Injection of small doses of our liquid-stable glucagon after meals may offer a novel mechanism for PBH patients to treat or prevent hypoglycemia. Importantly, these smaller and more physiologic doses are designed to prevent rebound hyperglycemia associated with glucose tablets, carbohydrate intake and rescue doses of glucagon.
Further, small doses of glucagon may offer a direct treatment mechanism for PBH, as opposed to indirect methods aimed at preventing hypoglycemia that are currently employed using various off-label therapeutic options. As there are currently no therapeutic options indicated for treatment of PBH and the condition has been designated a rare disease, we believe that payors will include our ready-to-use glucagon on their formularies, if approved.
We intend to conduct additional payor research as product development progresses. Collaborators on this grant include endocrinologists at the Joslin Diabetes Center and device engineers at the Harvard University John R.
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