scholarly journals On the Downside of Heroism: Grey Zone Limitations on the Value of Social and Physical Risk Heroism

2019 ◽  
Vol 4 (2) ◽  
Author(s):  
James K. Beggan
Keyword(s):  
Grey Zone ◽  
Physical Risk

Confronting the grey zone after severe brain injury

2019 ◽  
Vol 3 (6) ◽  
pp. 707-711 ◽  
Author(s):  
Andrew Peterson ◽  
Adrian M. Owen
Keyword(s):  
Brain Injury ◽  
Ethical Issues ◽  
Vegetative State ◽  
Clinical Care ◽  
Grey Zone ◽  
Severe Brain Injury ◽  
New Methods ◽  
Legal Decision Making ◽  
Technological Developments ◽  
The Brain

In recent years, rapid technological developments in the field of neuroimaging have provided several new methods for revealing thoughts, actions and intentions based solely on the pattern of activity that is observed in the brain. In specialized centres, these methods are now being employed routinely to assess residual cognition, detect consciousness and even communicate with some behaviorally non-responsive patients who clinically appear to be comatose or in a vegetative state. In this article, we consider some of the ethical issues raised by these developments and the profound implications they have for clinical care, diagnosis, prognosis and medical-legal decision-making after severe brain injury.

Grey Zone Lymphoma in Children and Adolescents: Experience of Pediatric Hodgkin and Non-Hodgkin Study Groups

2014 ◽  
Vol 226 (02) ◽  
Author(s):  
B Burkhardt ◽  
D Körholz ◽  
W Klapper ◽  
W Woessmann ◽  
C Mauz-Körholz
Keyword(s):  
Children And Adolescents ◽  
Study Groups ◽  
Grey Zone

Fractional Flow Reserve: Does a Cut-off Value add Value?

2016 ◽  
Vol 11 (1) ◽  
pp. 17
Author(s):  
Shah R Mohdnazri ◽  
◽  
◽  
◽  
Thomas R Keeble ◽  
...  
Keyword(s):  
Fractional Flow Reserve ◽  
Coronary Intervention ◽  
Grey Zone ◽  
Fractional Flow ◽  
Non Invasive ◽  
Invasive Test ◽  
Flow Reserve ◽  
A Value ◽  
Percutaneous Coronary ◽  
Value Add

Fractional flow reserve (FFR) has been shown to improve outcomes when used to guide percutaneous coronary intervention (PCI). There have been two proposed cut-off points for FFR. The first was derived by comparing FFR against a series of non-invasive tests, with a value of ≤0.75 shown to predict a positive ischaemia test. It was then shown in the DEFER study that a vessel FFR value of ≥0.75 was associated with safe deferral of PCI. During the validation phase, a ‘grey zone’ for FFR values of between 0.76 and 0.80 was demonstrated, where a positive non-invasive test may still occur, but sensitivity and specificity were sub-optimal. Clinical judgement was therefore advised for values in this range. The FAME studies then moved the FFR cut-off point to ≤0.80, with a view to predicting outcomes. The ≤0.80 cut-off point has been adopted into clinical practice guidelines, whereas the lower value of ≤0.75 is no longer widely used. Here, the authors discuss the data underpinning these cut-off values and the practical implications for their use when using FFR guidance in PCI.

Why Do We Need New Markers for Male Hypogonadism and How Seminal Proteomics Might Solve the Problem?

2020 ◽  
Vol 27 (12) ◽  
pp. 1186-1191
Author(s):  
Giuseppe Grande ◽  
Domenico Milardi ◽  
Silvia Baroni ◽  
Andrea Urbani ◽  
Alfredo Pontecorvi
Keyword(s):  
Serum Testosterone ◽  
Clinical Syndrome ◽  
Testosterone Replacement ◽  
Total Testosterone ◽  
Male Hypogonadism ◽  
Grey Zone ◽  
Testosterone Levels ◽  
Normal Number ◽  
Replacement Treatment

Male hypogonadism is “a clinical syndrome that results from failure of the testis to produce physiological concentrations of testosterone and/or a normal number of spermatozoa due to pathology at one or more levels of the hypothalamic– pituitary–testicular axis”. The diagnostic protocol of male hypogonadism includes accurate medical history, physical exam, as well as hormone assays and instrumental evaluation. Basal hormonal evaluation of serum testosterone, LH, and FSH is important in the evaluation of diseases of the hypothalamus-pituitary-testis axis. Total testosterone levels < 8 nmol/l profoundly suggest the diagnosis of hypogonadism. An inadequate androgen status is moreover possible if the total testosterone levels are 8-12 nmol/L. In this “grey zone” the diagnosis of hypogonadism is debated and the appropriateness for treating these patients with testosterone should be fostered by symptoms, although often non-specific. Up to now, no markers of androgen tissue action can be used in clinical practice. The identification of markers of androgens action might be useful in supporting diagnosis, Testosterone Replacement Treatment (TRT) and clinical follow-up. The aim of this review is to analyze the main findings of recent studies in the field of discovering putative diagnostic markers of male hypogonadism in seminal plasma by proteomic techniques. The identified proteins might represent a “molecular androtest” useful as a seminal fingerprint of male hypogonadism, for the diagnosis of patients with moderate grades of testosterone reduction and in the follow-up of testosterone replacement treatment.

Reconsidering American Civil-Military Relations

2020 ◽  
Keyword(s):  
Cold War ◽  
Armed Conflict ◽  
New Technology ◽  
The United States ◽  
Grey Zone ◽  
Post Cold War ◽  
Asymmetric Warfare ◽  
Civil Military Relations ◽  
Military Relations ◽  
Civilian Leadership

This book explores contemporary civil-military relations in the United States. Much of the canonical literature on civil-military relations was either written during or references the Cold War, while other major research focuses on the post-Cold War era, or the first decade of the twenty-first century. A great deal has changed since then. This book considers the implications for civil-military relations of many of these changes. Specifically, it focuses on factors such as breakdowns in democratic and civil-military norms and conventions; intensifying partisanship and deepening political divisions in American society; as well as new technology and the evolving character of armed conflict. Chapters are organized around the principal actors in civil-military relations, and the book includes sections on the military, civilian leadership, and the public. It explores the roles and obligations of each. The book also examines how changes in contemporary armed conflict influence civil-military relations. Chapters in this section examine the cyber domain, grey zone operations, asymmetric warfare and emerging technology. The book thus brings the study of civil-military relations into the contemporary era, in which new geopolitical realities and the changing character of armed conflict combine with domestic political tensions to test, if not potentially redefine, those relations.

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