Controversial Approach Research Articles

Systematisation of Conceptual Approaches to Formation of Business Ethics in the Context of Legal Regulation of Entrepreneurial Activity

Introduction. In the frame of entrepreneurship development, promotion of business ethics becomes particularly important as a mechanism for business harmonization, ensuring legal equality, healthy competition and fair attitudes to consumers. However, the controversial approaches to defining the concept of “business ethics” and the multiple interpretations thereof prevent from boosting the global spread of business culture in the legal regulation framework. In this regard, the aim of the study is to systematise the conceptual approaches to substantiation and formation of business ethics in the context of legal regulation of entrepreneurial activity.Materials and Methods. The methodological basis of the research includes the general and specific scientific methods. The methods of analysis, comparison and systematisation enable the study of the integral parts of business ethics to get deep understanding of this concept. By comparing different interpretations, the common grounds in the interdisciplinary approaches to substantiation of this concept are revealed. Systematisation fosters organisation of the legal and moral values into a single hierarchical structure that forms the essence of business ethics. The philosophical-juridical method reveals the interrelation of the philosophical approach contained in the entrepreneurial value reference points and the legislative norms of society.Results. The research has revealed a pattern of business ethics development in the context of global and national wellbeing. The hierarchical structure of business ethics has a top-down nature: the international level, the macro level and the micro level. Despite the influence of cultural specifics on the development of the moral value system, the formation of business culture should go in correlation with the norms of law and the needs of society, along with establishment of the corporate boundaries and general entrepreneurial principles. At the corporate level, the integration of business ethics into the enterprise strategy is beneficial for its image and reputation, and the efficiency lies in promotion of the socio-economic, legal and other aspects fostering creation of fair, sustainable and conscious business.Discussion and Conclusion. The concept of “business ethics” is studied in the various scientific contexts. Despite all differences in interpretation, the mechanism of forming the business ethics in the framework of entrepreneurial activity is uniform, it includes creation of the code of ethics, training in ethical principles, development of a system of incentives, elaboration of the methods of prevention and punishment. In various contexts, this mechanism is aimed at eliminating unlawful forms of competition, ensuring economic, social and legal security, increasing the level of responsibility and creating an efficient system of business values.

Towards a safe haven: Students from post‐Soviet countries pursuing education in Sweden during the COVID‐19 pandemic

AbstractThis article delves into the motivations and aspirations of students from post‐Soviet countries who opted for education in Sweden amid the COVID‐19 pandemic. In stark contrast to most nations which enforced stringent lockdown measures to curb the transmission of the coronavirus, Sweden adopted a relatively laissez‐faire approach, keeping significant sectors of society operational. While Sweden's strategy garnered considerable global scrutiny and critique, the students in this study exhibited a notable lack of apprehension regarding the global health crisis or Sweden's controversial approach to the pandemic. For these students, the COVID‐19 pandemic primarily manifested as a practical impediment to their forthcoming academic endeavours. Conversely, they perceived various enduring societal challenges in their countries of origin–such as unemployment, anxiety and distrust towards governmental authorities, and even armed conflict–as possessing a more entrenched and formidable nature, posing a greater threat to their overall well‐being. Against this backdrop, Sweden emerged as a perceived sanctuary capable of reinstating a state of ontological security, especially for the students identifying as members of the LGBTQ+ community and with political convictions frowned upon by the government of their home country. By focusing on the narratives of these individuals and adopting a conceptual framework that views ‘crisis’ as a relational construct, this study sheds light on the divergent experiences and perceptions of the COVID‐19 pandemic among international student cohorts. This approach underscores the nuanced and context‐dependent nature of their responses to the pandemic, emphasising the imperative of empirically accounting for these variations.

Is a Passenger’s Death Onboard the Aircraft an ‘Accident’ Within the Meaning of Article 17 of the Montreal Convention 1999?: An Analysis of the Chinese Case Qatar Airways Group Q.C.S.C. v. Zhao et al.

The meaning of the undefined term ‘accident’ in Article 17(1) of the Montreal Convention 1999 (MC99) has been unclear in Chinese cases for several years. In 2020, for the first time, the appellate court in Qatar Airways Group Q.C.S.C. v. Zhao et al. (‘Zhao’) defined ‘accident’ with the meaning almost the same as the one defined by the US Supreme Court in Air France v. Saks, yet concluded that the passenger’s death onboard the aircraft which was not timely detected by the carrier constituted an Article 17 ‘accident’, and held the carrier liable, even if the death caused by the passenger’s acute heart and respiratory failure was due to natural causes. The Zhao ruling also contains unsatisfactory rationales as reflected in the court’s inconsistent and controversial approaches in identifying the ‘accident’. After explaining the representative practice in other MC99 jurisdictions regarding the meaning of ‘accident’, this article introduces the Zhao case and discusses three unresolved issues pertaining to the Zhao ruling, namely the misidentification of death per se as an ‘accident’, the tendency and ambiguity of identifying the carrier’s omissions as de facto ‘accidents’ and, the flawed application of the Saks test in identifying some usual and expected conditions in normal flight activities as de facto ‘accidents’. It concludes that though the Zhao ruling can serve as an example to show the trend of acknowledging the Saks definition in Chinese practice, the meaning of ‘accident’ in a case regarding passenger death onboard the aircraft remains unsettled.

Поняття юридичної особи в праві України: ознаки, теорії, доктрини, правосуб’єктність

The article provides an overview of the formation of the concept of a legal entity, its features in the historical aspect and under Ukrainian law, theories of legal entities and their importance in the modern legal environment. The author analyzes the concepts of legal personality, legal capacity and legal capacity of a legal entity through the prism of its characteristics. The author identifies the principles of property separation of a legal entity and the importance of the ultimate beneficiary in the ownership structure and in the context of independence of property liability of a legal entity. The author reveals the feature of organizational unity of a legal entity through the procedure of its creation, indicating the presence of features inherent in a legal entity even before its state registration (pro-legal entity), as well as through the formation and operation of legal entity bodies. The author identifies controversial approaches to a legal entity’s acting in civil turnover on its own behalf and related issues of whether the actions of persons acting on behalf of a legal entity have features similar to the institution of representation. The author analyzes the consequences of a person acting on behalf of a legal entity going beyond his/her powers. The author emphasizes the problematic nature of understanding the representative of a legal entity in the practice of the Supreme Court.

Issue Fields and Echo Chambers: Increasing Field Contestation Fueled by Moral Emotions

We investigate how issue fields with increasing levels of contestation can develop into fields characterized by echo chambers. Studying the introduction of a controversial new approach to addiction services – harm reduction – we explain how proponents’ and opponents’ rhetorical arguments changed over time, transitioning the issue field through different configurations. Our findings reveal how field actors were initially differentiated by moral convictions, and as their expression of moral emotions became more intense, the two groups became increasingly divided and polarized in their views, leading to an issue field characterized by echo chambers. Through our analysis of archival materials and interview data, we explicate this process by identifying three phases of issue field transition: (1) Creating a moral emotional divide; (2) Intensifying antagonization; (3) Insulating against the other side. We contribute to the literature by presenting a model of change explaining how emotional rhetoric, together with different types of triggering events, can fuel increasing levels of contestation and drive the field toward developing echo chambers. Second, by taking a discursive view of issue fields with particular attention to rhetorical arguments, we provide foundational work for an institutional perspective on echo chamber – that echo chambers result from ongoing social processes where people encapsulate themselves based on a sense of right and wrong, in contrast to the predominant view of becoming trapped in an enclosed space. Third, through our focus on the role of moral emotions and how they can escalate in situations of contestation, we advance knowledge regarding the importance of emotions in field dynamics.

Retuning Ears & Rewiring Brains for Effective Communication: Foreign-Accent Perception & Sensitivity Training (FAPST)™

Purpose: Communication and psychosocial challenges are associated with processing regional or foreign accents. These challenges result in discrimination, marginalization, and reduced opportunities for culturally, linguistically, or racially diverse people. As a departure from the controversial approaches of training speakers to speak more effectively, this paper presents an innovative and effective methodology to train listeners instead and make the communication environment more “accent friendly”. Built upon two decades of testing and evidence, the Foreign Accent Perception & Sensitivity Training (FAPST)TM is used to develop skills in listening to accents, reducing implicit biases, and increasing appreciation and enjoyment for interacting with accents and cultures. Methodology: 320 undergraduate students from eight sections of a Diversity Issues course were provided the FAPST training online that included 15-20 minutes of gamified experience, over four weeks, in listening and identifying 54 varieties of accent in a structured, multimedia procedure. Assessments included weekly Accent Identification Scores as well as a pre- and post-survey using the CCQ tool to assess listeners’ baseline knowledge, attitudes, stereotypes, preferences, and skills related to processing accents. They also received formative assessments, feedback, and engaged in self-reflections. Results: Paired t-tests showed significant improvement in Accent Identification Scores which increased from 52% in week 1 and reached 75% by week 4, significant at p <0.05 level. The post-training CCQ survey results showed that Factual Knowledge scores improved significantly from 42% to 78%, Stereotypes scores reduced significantly from 89% to 22%, and Competence scores improved significantly from 23% to 76%. Participants reported increased confidence in listening accuracy and improvement in noticing details in accent patterns. Participants reported increased interest and willingness to interact with diversity. Participants also reported increased awareness of discrimination, and willingness to show allyship and advocacy for diverse individuals. Conclusion: This project confirmed that students have preconceived attitudes and biases as well as lower skills and confidence in interacting with diversity and accents which factor in their decisions and preferences to communicate with people with certain accents. It becomes imperative to set students up for success and engagement in a globalized world by training them with skills to navigate diversity. Results show that such a training improves listening accuracy as well as develops increased confidence and interest in engaging with diversity, while reducing implicit biases and stereotypes, along with increased factual knowledge of, and competence with accents.

Is laparoscopic approach as treatment of large gastric GIST acceptable?

Laparoscopic surgery is widely used for small gastric gastrointestinal stromal tumors (GISTs) (≤ 5cm) but remains a controversial approach for larger gastric GISTs (> 5cm). This study aims to compare short- and long-term outcomes of laparoscopic resection in comparison with open resection for gastric GISTs measuring over 5cm. All patients receiving surgery for gastric GIST > 5cm between 2000 and 2021 in a single tertiary hospital were included. Data were collected from prospectively maintained records. Kaplan-Meier method and log rank test were used to compare survival outcomes. Among 108 included patients, 59 patients had minimally invasive (MI) surgery (54.6%) whereas 49 patients had open surgery (46.4%). The rate of overall postoperative morbidity was 14.8% and the median length was significantly shorter in the MI group [4 (range 2-30) vs. 7 (range 4-33) days; P = 0.007]. The overall R0 resection rate was 98.2% and the rate of tumor rupture was 13%, not different between the two groups. Recurrence occurred in 24% of the whole population without any difference between groups (20.3% vs. 28.7%, p = 0.31). Minimally invasive surgery was not found as a negative prognostic disease-free survival factor. Laparoscopic surgery could be a safe and feasible alternative to open surgery in large gastric GIST, bringing the benefits of minimally invasive surgery without compromising oncologic results.

A critical juncture: promoting responsible innovation in the self-driving automobile sector while improving human factors

Navigating the future of autonomous vehicles (AVs) brings promise and peril. This paper zeroes in on Tesla’s innovative yet sometimes controversial approach to AVs, spotlighting the intersection of human cognition, vehicle automation, and safety. Amid the excitement of rapid tech advancements, we highlight the risks of over-reliance and potential misperceptions fueled by marketing overreach. Introducing the “Quick Car Scorecard,” we offer a solution to empower consumers in deciphering AV usability, bridging tech specs with real-world needs. As AVs steer our future, it is crucial to prioritize human life and responsible innovation. The journey to automation demands not just speed, but utmost caution and clarity.

Impact of COVID-19 Infection in Kidney Transplant Patients: A Review

Managing COVID-19 in kidney transplant patients is complex due to limited data on its severity, treatment, and management. Conflicting information from studies necessitates case-by-case treatment decisions. Atypical symptoms can lead to misdiagnosis, so a thorough evaluation is crucial. Immunosuppressants and comorbidities can worsen the disease, leading to the controversial approach of discontinuing or reducing immunosuppressive drugs. Kidney transplantation is challenging due to the surgical procedure’s sensitivity and high risk of transmission. While vaccines offer protection, their efficacy may be altered by immunosuppressive drugs in these patients. This review summarizes the management of COVID-19 in kidney transplant patients, addressing these complexities. Kidney transplant patients face unique COVID-19 challenges due to weakened immunity. They are at higher risk for severe illness and complications from both the virus and immunosuppressant medications. Early identification and intervention are crucial, including antiviral treatment like remdesivir in severe cases. Managing immunosuppressants is critical to balancing the risk of transplant rejection with COVID-19 severity. Drug interactions with COVID-19 treatments require careful consideration, potentially necessitating dose adjustments or alternative medications. The pandemic has disrupted transplant services, highlighting the need for prioritized vaccination and safe access to care. Telemedicine can help minimize virus exposure during post-transplant follow-up. While immunosuppression may impact vaccine responses, vaccination remains crucial to reducing the severe COVID-19 risk. Booster doses and continued precautions are important. Mental health support is essential to address pandemic-related anxiety, depression, and social isolation. More data is needed on the safety and effectiveness of COVID-19 treatments and vaccines in this population. A multidisciplinary approach, including close monitoring, careful medication management, vaccination, and psychosocial support is needed to optimize management and improve outcomes.

565 Robot-Assisted Surgery for Thoracic Endometriosis Syndrome – a Single-Centre, Retrospective Review of the First Fifty Cases

Abstract Aim Thoracic endometriosis syndrome (TES) is underdiagnosed, due to cyclical thoracic symptoms being underreported. Management of TES also remains controversial, with abdominal and thoracic approaches proposed, both laparoscopically and robotically, and no guidelines available. We aimed to characterise our experience with a multidisciplinary, robot-assisted approach, with a focus on symptom prevalence and surgical outcomes. Method A retrospective review of all consecutive procedures for TES between July 2020 and March 2023 surgery was performed. Robot-assisted removal of endometriosis from the underside of the diaphragm, from the pleura or superior diaphragm, or wedge resection of the lung through videoscope-assisted thoracic surgery, in any combination with or without pelvic endometriosis removal, were included. Presenting symptoms, intra-operative, and histological outcomes were analysed. Results Fifty robotic TES procedures, on forty-six patients were undertaken; median age was 32 (IQR 26–36). Cyclical shoulder tip pain (n = 29, 63%), costal margin pain (n=18, 39.1%), and scapular pain (n=11, 23.9%). There were no major Clavien-Dindo complications. Median blood loss was 10ml (IQR 6.25–27.25), and median length of stay was 1 day (IQR 1–2 ). The majority of the underside of the diaphragm specimen (n=35, 77.8%), and the pleural, and lung specimens (n=17, 85%) were either histologically positive for endometriosis or showed inflammation consistent with endometriosis. Conclusions Robotic-assisted surgery can be safely used for TES. Management of TES should involve an MDT including gynaecologic, hepato-pancreatico-billary, and thoracic surgeons, with minimally invasive experience. Going forward, long-term, patient-reported outcomes need to be analysed to ensure the effectiveness of robot-assisted surgery in TES.

History meets the ‘mafia state’? Hungary and the (de)securitisation of built cultural heritage in Slovakia

ABSTRACT The article examines the securitisation of Hungarian purchases of cultural built heritage in Slovakia in 2021–2023. It demonstrates that, while the material existence of this heritage had not been in any way endangered, it nevertheless became intimately intertwined with the broader anxieties and fears of irredentism and territorial revisionism, stemming from persisting conflicts in memory politics and from the Hungarian government’s controversial and non-transparent approach to its neighbours. It demonstrates how the conflicting national(ist) narratives are reinforced by a lack of basic transparency, resulting from the political economy and power techniques of the ‘illiberal’ political regimes which some political scientists dub ‘the mafia state’. The article draws on insights from critical security studies, critical heritage studies and the ontological security theory.

The Threshold of Beauty in Creation and Art Appreciation

ABSTRACT Art appreciation is a remarkable human activity that begins the moment someone first perceives a work of art until they have fully contemplated the art, including purposefully discovering resources to enhance perceptions, reflections, and memorization. In this paper, the author first presents personal conjectures about the origins of the perception of beauty and art. He then explores three ways in which the art appreciation phenomenon has been researched and understood: the traditional art history approach; the opposite scientific neuroaesthetic stream; and a third and often controversial approach, art appreciation assisted by psychoanalytical theory and praxis. Finally, he suggests a method to foster, develop, and refine art appreciation based on personal analysis and his experience with students in immersion courses.

Влияние принципа деления земель по целевому назначению на категории на развитие судебной практики в России

The work is devoted to the application of the principle of dividing land according to its intended purpose into categories in judicial practice. The controversial approaches to applying this principle are considered, the systemforming importance of this principle and the need to preserve it with further improvement of land and related legislation are substantiated.

Current management of atrial fibrillation in routine practice according to the last ESC guidelines: an EHRA physician survey-how are we dealing with controversial approaches?

Although guidelines for the management of atrial fibrillation (AF) are regularly published, many controversial issues remain, limiting their implementation. We aim to describe current clinical practice among European Heart Rhythm Association (EHRA) community according to last guidelines. A 30 multiple-choice questionnaire covering the most controversial topics related to AF management was distributed through the EHRA Research Network, National Societies, and social media between January and February 2023. One hundred and eighty-one physicians responded the survey, 61% from university hospitals. Atrial fibrillation screening in high-risk patients is regularly performed by 57%. Only 42% has access to at least one programme aiming at diagnosing/managing comorbidities and lifestyle modifications, with marked heterogeneity between countries. Direct oral anticoagulants are the preferred antithrombotic (97%). Rhythm control is the preferred strategy in most AF phenotypes: symptomatic vs. asymptomatic paroxysmal AF (97% vs. 77%), low vs. high risk for recurrence persistent AF (90% vs. 72%), and permanent AF (20%). I-C drugs and amiodarone are preferred while dronedarone and sotalol barely used. Ablation is the first-line therapy for symptomatic paroxysmal AF (69%) and persistent AF with markers of atrial disease (57%) and is performed independently of symptoms by 15%. In persistent AF, 68% performs only pulmonary vein isolation and 32% also additional lesions. There is marked heterogeneity in AF management and limited accordance to last guidelines in the EHRA community. Most of the discrepancies are related to the main controversial issues, such as those related to AF screening, management of comorbidities, pharmacological treatment, and ablation strategy.

Making sense of policy development of inclusive education for children with disabilities in China

Inclusion is integral to the education policy in countries across the world. In China, inclusion has been reaffirmed in recent policies as a priority in enhancing educational quality for disabled children. However, the growing scale of special schools and the increasing number of students enrolled seem to convey a conflicting message with inclusion. This paper critically examines the policy development from 1987 to 2023 concerning education for disabled children in China to make clearer sense of China’s inclusion agenda. The analysis highlights a policy vision where special schools are seen as key resources to enhance inclusive provisions and will continue to grow in scale in the short term as they transform to be an integral and inter-connected part within the wider education system rather than segregated settings, while Learning in Regular Classrooms and inclusion remain a primary objective and rationale underpinning the educational development for disabled children. This means a broader understanding of special education/schools in China is needed. The Chinese government has forged and embraced a unique, if not controversial approach that is adapted to suit the local contexts. This may set an example for the global community to explore localised strategies for inclusion to enhance education for all.

The action of rights in rem on the relations of merchant shipping

The article explores the legal nature and analyzes the relationship of property, obligation and public law relations arising in the field of merchant shipping. The conclusion about the leading role of civil law in the regulation of these relations is substantiated. At the same time, the basis for the construction of both obligations and public marine legal relations are proprietary relations and rights ("rights in rem"), that establish the affiliation of material objects which are used for merchant shipping. Considering the inconsistency of the current real law regulation with existing socio-economic needs, the author analyzes the content of the bills prepared in the process of reforming civil legislation. In author`s opinion, these bills do not fully solve the tasks of establishing in the Civil Code of the Russian Federation a closed list of rights in rem («numerus clausus») and proper regulation of possession. In particular, the unresolved problems of regulating proprietary rights on natural resources, the controversial approach of the legislator and the authors of the reform to determining the legal status of a sea vessel are noted. The author does not agree with the exclusivity of the principle of a single real estate object and justifies the need to preserve the status of a sea vessel as a real thing. The article defends the position of a consistent distinction between real and obligation, absolute and relative, as well as private law and public law relations. However, the author does not agree with the self-removal of civilists from the tasks of coordinating civil and administrative legislation. The right of ownership and other absolute proprietary rights (rights in rem) are regulated exclusively by civil law. Their connection with such public law obligations as obligations to ensure the safety and environmental friendliness of merchant shipping is realized by concretizing in relative public legal relations the general passive legal obligation of the owner not to violate the subjective rights of other persons. This obligation is enshrined in the provisions of the Civil Code of the Russian Federation and is characterized in modern civil science as a general regulatory and protective obligation of a public law nature. The author of the article substantiates that such an obligation may arise not only from the owner, but also in cases where a person owns a material object on other titles (bareboat charter, possession of cargo, etc.). The above justifies the need to formulate the general provisions of rights in rem not only considering the tasks of ensuring civil circulation, but also taking into account the needs of public law regulation of such areas as merchant shipping.

Byzantine music in the educational and scientific space of modern Ukraine

Relevance of the research. The persistent revival of early music in the twentieth century led to a number of large and small discoveries that significantly enriched the history of European music. Byzantine music became one of the new continents that appeared on the map of European musicology in the twentieth century. The process of comprehending the millennial history of Byzantine music as an important component of European musical culture, as a musical expression of Christian culture, as a tradition that had a powerful influence on the whole of Europe is far from been completed. The revival of the Ukrainian monodic church repertoire, that we observe today, is accompanied by an active search for historical information and appropriate vocal manners and style that lead to the Greek-Byzantine tradition. Comparative studies of Byzantine and East Slavic musical manuscripts have enormous heuristic potential and open up the opportunity to represent the thousand-year history of Ukrainian music, and not be limited to its modern period.
 The purpose of our work is to analyze the controversial concepts and approaches to understanding the Byzantine church chant tradition (“Byzantium after Byzantium”, in the words of Nicolae Iorga, traditionalism versus historicism); to show the prospects of Byzantine-Slavic musicological research and the need for its actualization in Ukraine; to present the educational course “Byzantine Music: Theory and Practice”. Methodological framework. The study is based on historicaltypological and comparative research methods.
 Results and scientific novelty of the work. The experience of comprehending the Byzantine church chant tradition as an important component of European musical culture was analyzed, discussion concepts and approaches in the development of musical Byzantinology of the twentieth century were highlighted. The prospects and relevance of Byzantine-Slavic music research were shown. The necessity of studying Byzantine music in musical institutions in modern Ukraine was substantiated, the current status of development of Ukrainian musical Byzantine studies was analyzed. An educational program on Byzantine music was presented, and the range of related scientific and methodological discussion topics was outlined.

Chemoradiation, Consolidation Chemotherapy, and Watch and Wait for Early Rectal Cancer.

As watch and wait has become an attractive management alternative among patients with rectal cancer who achieve a clinical complete response to neoadjuvant chemoradiation, the focus of organ preservation has now shifted toward the use of this approach in patients with early rectal cancer. These patients would otherwise be treated without the use of neoadjuvant therapy for oncological reasons. The sole purpose of any neoadjuvant treatment here would be the achievement of a complete clinical response in an attempt to avoid total mesorectal excision. This has become particularly interesting after the incorporation of total neoadjuvant therapy regimens. These regimens have resulted in significantly higher rates of complete tumor regression and therefore become an interesting alternative among early rectal cancer patients where organ preservation is desired. The present review provides an overview of the currently available evidence and the preliminary experience with this rather controversial approach.

Creating policy change and new gender dynamics in China: situating lala activists’ politics of assimilation in the Chinese anti-domestic violence movement

ABSTRACT The assimilationist approach has been used controversially by lesbian, gay, bisexual, transgender, and queer (LGBTQ+) activists to engage the state for legal reform in Europe and the United States (US). Drawing insight from the concept of situated knowledges, this article explores the historical and political particularities that enabled lala (queer women) activists to adopt a politics of assimilation in the Chinese anti-domestic violence movement. It unravels the specific features of their assimilation to effect policy change and their entanglements with feminists. Through participant observation and in-depth interviews, the article first delineates the contours of lala activists’ struggle and traces their strategic choice of assimilation in the Chinese context from the 1990s to the 2000s. Second, the article elaborates on two aspects of lala activists’ assimilation: establishing an ambiguous position toward institutions and orienting activism toward indirect legal provisions. Third, the article illuminates how lala activists created new gender dynamics through this politics and developed their own strand of lesbian–feminist cooperation characterized by restricted visibility in the mainstream women’s movement and an open coalition with different feminists. I also discuss the limitations of lala activists’ politics and conclude by summarizing how lala activism can enrich global dialogues on the controversial assimilationist approach and the diversity of lesbian–feminist relationships.

Radiomic Features Are Predictive of Response in Rectal Cancer Undergoing Therapy.

Rectal cancer is a major mortality cause in the United States (US), and its treatment is based on individual risk factors for recurrence in each patient. In patients with rectal cancer, accurate assessment of response to chemoradiotherapy has increased in importance as the variety of treatment options has grown. In this scenario, a controversial non-operative approach may be considered in some patients for whom complete tumor regression is believed to have occurred. The recommended treatment for locally advanced rectal cancer (LARC, T3-4 ± N+) is total mesorectal excision (TME) after neoadjuvant chemoradiotherapy (nCRT). Magnetic resonance imaging (MRI) has become a standard technique for local staging of rectal cancer (tumor, lymph node, and circumferential resection margin [CRM] staging), in both the US and Europe, and it is getting widely used for restaging purposes. In our study, we aimed to use an MRI radiomic model to identify features linked to the different responses of chemoradiotherapy of rectal cancer before surgery, and whether these features are helpful to understand the effectiveness of the treatments. We retrospectively evaluated adult patients diagnosed with LARC who were subjected to at least 2 MRI examinations in 10-12 weeks at our hospital, before and after nCRT. The MRI acquisition protocol for the 2 exams included T2 sequence and apparent diffusion coefficient (ADC) map. The patients were divided into 2 groups according to the treatment response: complete or good responders (Group 1) and incomplete or poor responders (Group 2). MRI images were segmented, and quantitative features were extracted and compared between the two groups. Features that showed significant differences (SF) were then included in a LASSO regression method to build a radiomic-based predictive model. We included 38 patients (26 males and 12 females), who are classified from T2 and T4 stages in the rectal cancer TNM. After the nCRT, the patients were divided into Group 1 (13 patients), complete or good responders, and Group 2 (25 patients), incomplete or poor responders. Analysis at baseline generated the following significant features for the Mann-Whitney test (out of a total of 107) for each sequence. Also, the analysis at the end of the follow-up yielded a high number of significant features for the Mann-Whitney test (out of a total of 107) for each image. Features selected by the LASSO regression method for each image analyzed; ROC curves relative to each model are represented. We developed an MRI-based radiomic model that is able to differentiate and predict between responders and non-responders who went through nCRT for rectal cancer. This approach might identify early lesions with high surgical potential from lesions potentially resolving after medical treatment.