Gray Zone Research Articles

Quantitative peritumoral magnetic resonance imaging fingerprinting improves machine learning-based prediction of overall survival in colorectal cancer.

To investigate magnetic resonance imaging (MRI)-based peritumoral texture features as prognostic indicators of survival in patients with colorectal liver metastasis (CRLM). From 2007-2015, forty-eight patients who underwent MRI within 3 months prior to initiating treatment for CRLM were identified. Clinicobiological prognostic variables were obtained from electronic medical records. Ninety-four metastatic hepatic lesions were identified on T1-weighted post-contrast images and volumetrically segmented. A total of 112 radiomic features (shape, first-order, texture) were derived from a 10 mm region surrounding each segmented tumor. A random forest model was applied, and performance was tested by receiver operating characteristic (ROC). Kaplan-Meier analysis was utilized to generate the survival curves. Forty-eight patients (male:female = 23:25, age 55.3 years ± 18 years) were included in the study. The median lesion size was 25.73 mm (range 8.5-103.8 mm). Microsatellite instability was low in 40.4% (38/94) of tumors, with Ki-ras2 Kirsten rat sarcoma viral oncogene homolog (KRAS) mutation detected in 68 out of 94 (72%) tumors. The mean survival was 35 months ± 21 months, and local disease progression was observed in 35.5% of patients. Univariate regression analysis identified 42 texture features [8 first order, 5 gray level dependence matrix (GLDM), 5 gray level run time length matrix (GLRLM), 5 gray level size zone matrix (GLSZM), 2 neighboring gray tone difference matrix (NGTDM), and 17 gray level co-occurrence matrix (GLCM)] independently associated with metastatic disease progression (P < 0.03). The random forest model achieved an area under the curve (AUC) of 0.88. MRI-based peritumoral heterogeneity features may serve as predictive biomarkers for metastatic disease progression and patient survival in CRLM.

Paracrine and endocrine pathways of natriuretic peptides assessed by ligand-receptor mapping in the Japanese eel brain.

The natriuretic peptide (NP) family consists of cardiac NPs (ANP, BNP, and VNP) and brain NPs (CNPs) in teleosts. In addition to CNP1-4, a paralogue of CNP4 (named CNP4b) was recently discovered in basal teleosts including Japanese eel. Mammals have lost most Cnps during the evolution, but teleost cnps were conserved and diversified, suggesting that CNPs are important hormones for maintaining brain functions in teleost. The present study evaluated the potency of each Japanese eel CNP to their NP receptors (NPR-A, NPR-B, NPR-C, and NPR-D) overexpressed in CHO cells. A comprehensive brain map of cnps- and nprs-expressing neurons in Japanese eel was constructed by integrating the localization results obtained by in situ hybridization. The result showed that CHO cells expressing NPR-A and NPR-B induced strong cGMP productions after stimulation by cardiac and brain NPs, respectively. Regarding brain distribution of cnps, cnp1 is engaged in the ventral telencephalic area and periventricular area including the parvocellular preoptic nucleus (Pp), anterior/posterior tuberal nuclei, and periventricular gray zone of the optic tectum. cnp3 is found in the habenular nucleus and prolactin cells in the pituitary. cnp4 is expressed in the ventral telencephalic area, while cnp4b is expressed in the motoneurons in the medullary area. Such CNP isoform-specific localizations suggest that function of each CNP has diverged in the eel brain. Furthermore, the Pp lacking the blood-brain barrier expressed both npra and nprb, suggesting that endocrine and paracrine NPs interplay for regulating the Pp functions in Japanese eels.

Financial Distress During the COVID-19 Pandemic: Altman and Springate Model Prediction

Background: The retail trade industry has experienced a sharp decline in economic growth during the COVID-19 pandemic. Regulation of social distancing, restrictions on retail shop operating hours, and disruption of online shopping behavior contribute to worsen the financial performance of retail trade companies. &lt;/p&gt; &lt;p&gt; Purpose: The purpose of this research is to analyze the prediction of financial distress of retail trade companies. This research chose to use the Altman and Springate Model since both of them are the most accurate and conservative models to predict. &lt;/p&gt; &lt;p&gt; Research Methodology: The financial distress analysis technique used is Altman and Springate Model. The calculation of the Altman and Springate Score is based on an equation formula for data in the period before and during the COVID-19 pandemic. The Altman’s Score are grouped in the Safe Zone, Grey Area, and Financial Distress; while the Springate’s Score are grouped in the Safe Zone and Financial Distress categories. &lt;/p&gt; &lt;p&gt; Findings: Altman Model Analysis stated that most of the companies experienced a decreased scores, the company’s financial performance during COVID-19 pandemic was predicted financial distress and belong to the Grey Zone category than before COVID-19 pandemic. Springate Model Analysis states that all companies have decreased scores, and the company’s financial performance during COVID-19 pandemic is predicted financial distress than before COVID-19 pandemic. Springate Model revealed a more conservative indicator, but both models stated there were still exist several companies in the Safe Zone category to continue their business. &lt;/p&gt; &lt;p&gt; Research limitations: The limitations of this study are only using Altman and Springate Model. The object of this research is the retail trade industry only, then future research may be able to expand the analyzed industry in the new normal conditions. &lt;/p&gt; &lt;p&gt; Originality/value: The originality of this research is focused on the retail trade companies as the most affected industry by COVID-19 pandemic. In addition, this research analyzes financial distress based on Altman Z-Score and Springate Model as the most powerful model to predict.

Enhancing HLA-B27 antigen detection: Leveraging machine learning algorithms for flow cytometric analysis.

As the association of human leukocyte antigen B27 (HLA-B27) with spondylarthropathies is widely known, HLA-B27 antigen expression is frequently identified using flow cytometric or other techniques. Because of the possibility of cross-reaction with off target antigens, such as HLA-B7, each flow cytometric technique applies a "gray zone" reserved for equivocal findings. Our aim was to use machine learning (ML) methods to classify such equivocal data as positive or negative. Equivocal samples (n = 99) were selected from samples submitted to our institution for clinical evaluation by HLA-B27 antigen testing. Samples were analyzed by flow cytometry and polymerase chain reaction. Features of histograms generated by flow cytometry were used to train and validate ML methods for classification as logistic regression (LR), decision tree (DT), random forest (RF) and light gradient boost method (GBM). All evaluated ML algorithms performed well, with high accuracy, sensitivity, specificity, as well as negative and positive predictive values. Although, gradient boost approaches are proposed as high performance methods; nevertheless, their effectiveness may be lower for smaller sample sizes. On our relatively smaller sample set, the random forest algorithm performed best (AUC: 0.92), but there was no statistically significant difference between the ML algorithms used. AUC values for light GBM, DT, and LR were 0.88, 0.89, 0.89, respectively. Implementing these algorithms into the process of HLA-B27 testing can reduce the number of uncertain, false negative or false positive cases, especially in laboratories where no genetic testing is available.

CONQUERING THE AMBIGUITY OF OPTIC ATROPHY IN NORMAL TENSION GLAUCOMA: FROM MYSTERY TO MASTERY

Introduction : The dilemma in diagnosing glaucoma often arises when optic atrophy is found alongside nonspecific glaucomatous findings and normal intraocular pressure (IOP), particularly in cases of normal tension glaucoma (NTG). This gray zone often leads to doubt and misdiagnosis.&#x0D; Case Illustration : A 70-year-old man previously diagnosed with idiopathic bilateral optic atrophy complained of blurred vision in both eyes. The visual acuity was 5/5 in the right eye (RE) and hand movement in the left eye (LE). Both eyes had normal IOP, open angles with Sampaolesi lines on gonioscopy, fibrin deposits at pupillary margins, and a large cup-to-disc ratio with baring and peripapillary atrophy on funduscopy. The OCT examination revealed thinning in the ONH-RNFL, ILM-RPE, and GCL-IPL complexes. HFA revealed tunnel vision in RE and general depression in LE. The patient was suspected of having NTG. We performed BMO-MRW (less than 100 ?m in both eyes) and 24-hour ocular perfusion pressure (OPP) measurements (less than 50 mmHg at night) to support the diagnosis.&#x0D; Discussion : The BMO-MRW examination is a new parameter that can help establish the diagnosis of glaucoma. A thin BMO-MRW finding suggests that optic atrophy originates from glaucoma. It is important to perform a comprehensive examination in cases of NTG to identify risk factors and prevent the development of glaucoma. Decreased OPP to less than 50 mmHg and PEX syndrome may be risk factors for NTG.&#x0D; Conclusion : In cases of doubtful optical atrophy, it is important to consider the possibility of NTG by performing a comprehensive examination, including BMO-MRW and twenty-four hour OPP measurements.

Should Indications for Antiviral Therapy for Hepatitis B Be Broadened to Include Immune-Tolerant Patients, Inactive Carriers, or Patients in the “Gray Zone”?

Should Indications for Antiviral Therapy for Hepatitis B Be Broadened to Include Immune-Tolerant Patients, Inactive Carriers, or Patients in the “Gray Zone”?

Candiduria in the Critically Ill: A Gray Zone for the Microbiologist and Clinician Alike!

Abstract Diagnosis and management of candiduria in hospitalized patients is often a gray zone for clinicians and microbiologists alike. The presence of Candida in urine could mean anything ranging from contamination and colonization to frank urinary tract infection. This study aims to enhance the understanding of candiduria among critically ill patients admitted in the intensive care unit (ICU). Out of 226 urine samples received in the laboratory from patients admitted in the ICU with an indwelling urinary catheter, 15 were found to have candiduria, prevalence being 6.6%. Various species isolated were Candida tropicalis (40%), Candida albicans (33.33%), Candida lusitaniae (13.33%), Candida parapsilosis (6.66%), and Candida dubliniensis (6.66%). In all patients, candiduria resolved spontaneously upon removal of the catheter. No antifungal was administered, and no concurrent positive blood culture was found in any of these patients. This study emphasizes that simply culturing the organism does not imply clinical significance. Removal or change of catheter must be undertaken once such a report is received from the laboratory.

Clinical trial and performance evaluation of the Wantai HBsAg (CMIA) diagnostic kit for screening blood donors in China

In China, according to the ‘Technical Operating Procedures for Blood Stations (2019 Edition),’ blood stations are authorized to utilize Chemiluminescence Immunoassay (CLIA) to detect pathogen markers linked with transfusion-transmissible infections. However, currently, there is no approved CLIA reagent for the screening of blood-borne diseases in China, specifically for the detection of Hepatitis B surface antigen. The objective of this research project is to conduct a comprehensive evaluation of the performance of the Wantai Chemiluminescent Microparticle Hepatitis B surface antigen reagent. This study evaluates the performance of the Wantai Chemiluminescent Microparticle Immunoassay (CMIA) on the Wan200 + analyzer in screening for Hepatitis B Surface Antigen (HBsAg) in blood samples. The clinical trial component of this evaluation is included as part of the documentation submitted to the National Medical Products Administration (NMPA) of China for the approval of blood screening reagents. The evaluation plan of this study encompasses two main components: clinical trials and performance assessment. We adopted a controlled trial design, utilizing the WanTai Chemiluminescent Microparticle Immunoassay (CMIA) on the Wan200 + analyzer and the Enzyme-Linked Immunosorbent Assay (ELISA) to screen for Hepatitis B Surface Antigen (HBsAg) in routine blood donor samples and reference serum panel samples. To ensure the accuracy of the screening, we additionally employed Abbott's ELISA reagents and HBV DNA for validation. The assessment primarily focused on key performance indicators such as sensitivity, specificity, and analytical sensitivity. Moreover, this clinical trial data has been included as part of the submission to China's National Medical Products Administration (NMPA). In the clinical trials of this study, a total of 10,470 blood donor samples underwent simultaneous testing using both CMIA and ELISA methods. Across two clinical trials, there was remarkable concordance between CMIA and the two ELISA reagents, with Kappa values exceeding 0.82. Among the 269 samples that were double-reactive in the enzyme immunoassay (ELISA) tests, CMIA exhibited a 100% reactivity detection rate. However, CMIA produced 14 and 6 false-positive results in the respective clinical trials, resulting in specificities of 99.73% and 99.89%. In contrast, the specificities for Wantai ELISA and Xin Chuang ELISA were both greater than 99.94%.When testing samples in the gray zone serum plates, CMIA's detection limit significantly exceeded that of the two ELISA assays. CMIA had a detection cutoff of 0.05 IU/mL, while the two ELISA reagents had cutoffs of 0.1 IU/mL and 0.09 IU/mL, respectively. CMIA's detection limits for the adr and adw subtypes were 0.05 IU/mL, and for the ay subtype, it was 0.1 U/mL. The detection limit for 10 HBV mutant samples was 0.5 U/mL. In 165 cases where ELISA tested negative but HBV DNA tested positive, CMIA detected 5 HBsAg-positive samples. This study evaluated the performance of the Wantai CMIA in screening for HBsAg among blood donors. The results demonstrate outstanding performance of CMIA in both clinical trials and performance assessments, detecting all true positive samples with a sensitivity of 100%. It exhibits excellent concordance with the two ELISA assays. Of particular note is its superiority in early detection of HBsAg in the screening of early-stage hepatitis B infections, reducing the window period compared to ELISA. CMIA achieves a specificity exceeding 99.73% for negative blood donors, aligning with the European Union's standards for blood screening assay specificity. In summary, Wantai's CMIA displays high sensitivity and specificity in blood donor screening, making it suitable for screening blood donors in China.

Improving the Near-Surface Wind and Turbulence at the Edge of the Orographic Drag Gray Zone by Tuning the Roughness Length

Abstract In this paper, we present the implementation and evaluate the impact of the new roughness length configuration in the ALARO canonical model configuration of the ALADIN system at the edge of the orographic gravity wave drag gray zone. As an essential input for turbulence parameterization, the roughness length affects the near-surface turbulent fluxes and the screen-level interpolation of meteorological parameters. We utilize GMTED2010 and ECOCLIMAP-II databases to derive orographic and vegetation components of the effective roughness length and introduce tuning parameters enabling us to optimize predicted near-surface turbulent momentum fluxes and 10-m wind speed. Based on sensitivity tests, we (i) prove the necessity of tuning the roughness length fields, (ii) considerably reduce the RMSE of near-surface turbulent momentum fluxes (6%–7%) and 10-m wind speed for different groups of stations (3%–10%), and (iii) identify the tree height as the most influential input parameter in our computational domain. The RMSE decomposition indicates that the improvement of 10-m wind speed mostly comes from a decrease in the random error and bias of the mean. The variability is slightly underestimated, thus reducing the model accuracy for wind speeds above the 95th percentile but at an acceptable level. We explain that roughness length tuning also compensates for the missing roughness sublayer correction in our system. Finally, we show that, although the impact of the orographic gravity wave drag scheme at a horizontal mesh size of 1.8 km is generally small, it is still beneficial for capturing some finer features observed in atmospheric soundings. Significance Statement Aiming to improve the 10-m wind speed forecast without sacrificing the accuracy of turbulent momentum fluxes in the kilometric resolution numerical weather prediction model, we derived new roughness length fields from high-resolution physiography databases. Therein, we proved the importance of tuning the input orography and vegetation fields and, depending on the time of day and year, reduced the root-mean-square error of 10-m wind speed by 3%–10%. Further, we demonstrated that orographic gravity wave drag parameterization is still needed to predict finer details seen in wind profiles from atmospheric soundings. Finally, we discussed the related simplifications in our model and their implications and proposed steps toward a more consistent and complete treatment of the near-surface turbulence.

A gray zone in canakinumab tapering: dose reduction or interval prolongation?

A gray zone in canakinumab tapering: dose reduction or interval prolongation?

Navigating the post-Dobbs landscape: ethical considerations from a perinatal perspective.

Restrictive abortion laws have impacts reaching far beyond the immediate sphere of reproductive health, with cascading effects on clinical and ethical aspects of neonatal care, as well as perinatal palliative care. These laws have the potential to alter how families and clinicians navigate prenatal and postnatal medical decisions after a complex fetal diagnosis is made. We present a hypothetical case to explore the nexus of abortion care and perinatal care of fetuses and infants with life-limiting conditions. We will highlight the potential impacts of limited abortion access on families anticipating the birth of these infants. We will also examine the legally and morally fraught gray zone of gestational viability where both abortion and resuscitation of live-born infants can potentially occur, per parental discretion. These scenarios are inexorably impacted by the rapidly changing legal landscape in the U.S., and highlight difficult ethical dilemmas which clinicians may increasingly need to navigate.

Further understanding of chronic hepatitis B in the indeterminate phase or in the grey zone

Further understanding of chronic hepatitis B in the indeterminate phase or in the grey zone

Navigating the ‘grey zone’: teachers’ practices around students’ online interactions

ABSTRACT Background A wide variety of information and communication technologies (ICTs) is increasingly embedded into numerous facets of everyday life. Young people, in particular, are often viewed as eager and skilful users of new ICTs who have various educational and leisure-related purposes for ICT use. Although school and home lives have traditionally been viewed as separate, ICT use has blurred the lines between these environments. This study focuses attention on the negotiation of this ‘grey zone’ within the school setting, in terms of teachers’ practices around students’ online interactions. Purpose This study sought to gain insight into teachers’ perceptions of the challenges related to students’ online interactions and how these become visible in the school context. This included exploring strategies identified by teachers in efforts to surmount difficulties. Methods Data collection involved semi-structured interviews with 15 teachers in Finland working in primary and/or lower secondary education. The transcribed data were analysed qualitatively, using a thematic approach. Findings According to the teachers, there were significant challenges associated with young people’s online interactions that affected their students and the flow of school life, such as online conflicts and dysfunctional behaviour in messaging groups. Although teachers found that the boundaries and the obscurity of their roles made it difficult to address some situations, they nonetheless identified strategies to overcome challenges, often including collaboration with students and parents. Conclusions The study highlights how students’ online interactions can affect the ways that teachers view themselves and their roles as educators. Given the pace with which ICT, and young people’s use of it evolves, the study suggests that there is a need for frequently reviewed guidelines or practices that help clarify the roles of different actors in relation to the realities of students’ ICT use.

Creative nonfiction approach to explore peer mentorship for individuals with spinal cord injury.

Research has examined peer mentorship to understand how it may help people with spinal cord injury (SCI) adapt and thrive. We still lack an in-depth understanding of the perspectives of SCI peer mentors and mentees on their dyadic relationship. This study was to explore the dyadic interactions and relationships between SCI peer mentors and mentees in a peer mentorship program delivered at a rehabilitation center. Between 2016 and 2017, we recruited two dyads of peer mentor and mentee with SCI (N = 4). Each participant completed three one-on-one interviews (N = 12). Data were analyzed using a creative nonfiction approach. Three unique dialogical stories were developed. Story 1 (A slow and steady start) described how mentors took a mentee-centered approach in building the relationship. Story 2 (Mentorship and friendship: negotiating the "grey zone") highlighted how mentees and mentors experienced challenges in navigating the boundaries between mentorship and friendship. Story 3 (The "endless" job for mentor) showcased how the relationship could enter a phase in which it could affect mentors' well-being. The stories highlighted important attributes to the relationships between SCI mentors and mentees. Considerations were suggested for community-based SCI organizations to integrate peer mentorship into rehabilitation settings, including optimizing mentorship introductions and matching, defining mentors' role explicitly, and building support systems for mentors. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Beyond the Grey Zone: The Production of Space in Eastern European Neo-Avantgarde

The spatial metaphor that dominates the historical overviews dedicated to neo-avantgarde art of Eastern Europe from the last decades of state socialism is the “grey zone”—a metaphor deeply rooted in the dichotomies of Cold War discourses, which understood the “socialist space” as being roughly split between an “official” and an “unofficial”/underground/hidden space of dissent. However, the grey zone metaphor fails to account for the diverse, complex, and nuanced ways in which unconventional art practices from the region engaged with a wide range of spaces, from the institutional (and official) ones to spaces of everyday life, delocalized spaces of a likeminded artistic community, and to the space of the image understood outside of the confined territory of traditional practices. By engaging a theoretical perspective drawn from the so-called “spatial turn” in the post-colonial discourse, I will try to argue that the “species of spaces” (Kemp-Welch) defining the neo-avantgarde art practices in the region were not conquering but were producing cultural and socially relevant spaces while blurring/widening the conventional boundaries of art’s territory, and that this complexity cannot be understood by relying on the binary terminology of the geopolitical discourses of the Cold War.

Disguised Among the Sea: The Implications of Artificial Islands on Casualty Care in the Indo-Pacific.

As reported in the 2022 Biden-Harris National Security Strategy, China is perceived as the primary U.S. competitor with the intent and means to become the world's greatest superpower. China's efforts, which are at odds with America's ambition to maintain its global influence, are complemented by ostensibly harmless "gray zone tactics," defined as coercive geopolitical, economic, military, and cyber activities below the use of kinetic military force. Such tactics may be utilized with seemingly innocuous intentions, but in reality, they can complicate U.S. combat casualty care in the event of an Indo-Pacific conflict. One tactic of particular impact is China's development of artificial islands throughout the South China Sea. By creating these islands, China is expanding its reach beyond its continental borders. These islands, alongside China's well-developed naval and missile capabilities, will cause disruptions to U.S. casualty care staging, medical resupply, and aeromedical evacuations. To mitigate those threats, the USA should implement a robust regional Combatant Command Trauma System, improve global health security cooperation with local partner nations, and implement irregular or guerilla trauma systems that meet medical needs in impromptu, clandestine settings. Operational recommendations based on these efforts could include pre-positioning tactical combat casualty care and damage control resuscitation supplies and developing with nearby host-nation evacuation platforms such as small boat operators. These solutions, among others, require years of training, relationship-building, and capability development to institute successfully. As a result, U.S. Military leaders should act now to incorporate these strategies into their irregular warfare, low-intensity conflict, and large-scale combat operation toolkits.

The constitutive values of fair play

Fair play as a phenomenon of sporting life is present even if only in the form of small acts or gestures in most competitions; its absence is present in cases of foul play. The daily press comments its presence or absence every day in, and not only in the sports sections. Both the public and experts discuss acts from so called grey zone (forms of gamesmanship). Deciding unequivocally on the moral quality of a diverse range of actions, attitudes or statements requires clarity about the values underpinning fair play. Our aim is therefore to find the constitutive values of fair play by examining a set of values from the field of sport, rel¬evant offerings from fundamental ethics, using Abraham Maslow’s meta-value system and selection from the fundamental values of fair play considered so far. Organizing the selected values into a meaningful system is the final aim. We used a hermeneutic method to interpret the role of values within fair play. We identify five values and five meta-values as constitutive of fair play, the meta-values of goodness, truth, and transcendence as the basis of the entire system. We identify character (of athletes) and ethos (of sports communities) as both initiators of activities within the system and recipients of benefits.

Indonesia's Defense Diplomacy Strategy in Facing China's Gray Zone in the South Chine Sea

Purpose: This study aims to identify an effective strategy for Indonesia to counter China's gray zone tactics in the South China Sea.   Theoretical Reference: Employing a quantitative method with a descriptive approach rooted in the positivist philosophy, this research follows the principles outlined by Sugiyono (2011). This method is chosen for investigating specific populations or samples, with a focus on quantitative/statistical data analysis to test predetermined hypotheses.   Method: The research employs multiple regression analysis to assess the significance of Soft Power Diplomacy and Smart Power Diplomacy strategies as essential national resources for persuading China to undertake desired actions in addressing the challenges posed by China's Gray Zone in the South China Sea. Smart power, as defined by Jr J.N. (2007), involves integrating soft and hard power for a comprehensive strategy. According to R. Wilson (2008), smart power effectiveness lies in combining a robust military force with investments in alliances, partnerships, and cooperation.   Result and Conclusion: The findings indicate that both Soft Power Diplomacy and Smart Power Diplomacy are influential tools and strategies within Indonesia's foreign policy context to effectively navigate and counteract China's Gray Zone activities in the South China Sea.   Implications of Research: The identified strategies hold significant implications for shaping Indonesia's defense diplomacy against China's gray zone tactics, emphasizing the importance of integrating soft and hard power elements for a more comprehensive and efficient approach.   Originality/Value: This research contributes to the field by highlighting the relevance and effectiveness of Soft Power Diplomacy and Smart Power Diplomacy as key components in Indonesia's defense diplomacy strategy, providing a nuanced understanding of countering China's Gray Zone activities in the South China Sea.

Artificial Intelligence and Our Secret Mind: Human Mediation in Grey Zones

CIRET has set up an AI research group to highlight the need for human ethical mediation in theage of digital technology and binary logic. Francisco Varela has observed that cognition can take place inthe computer field without appealing to consciousness. Yet human decision-making cannot be the resultof cognition alone and requires the interaction between cognition and consciousness. In fact, rationalistand reductionist models borrowed from the hard sciences have only shown a mechanistic vision of AI ora biological-environmental vision, which cannot be applied to complex human phenomena occurring in agrey zone. In this grey or fuzzy zone of mediation, conciliation, and repair, we need the dialectical processor dialogue between consciousness and cognition. In this context, the proposal of mediating leaders andmanagers appears as a possible ethical alternative to demonstrate that consciousness is beyond the logicof the computer. Humans must remain responsible for all the effective decisions that will help us solveproblems theoretically and concretely. We therefore need an emerging global wisdom that flows from ourconversations about AI and appeals to human consciousness at all its levels of reality. This group produceda Symposium on November 21 and 22, 2023, in which we imagine that AI may be at the service of humanevolution and resiliency in “learning to be societies” instead of contributing to block our evolutions: if AIremains a work tool. . . Certainly it will because the creation sparkles still a mystery for men themselves.

The “Gray Zone” Conflicts in China- U.S. Relations: From a Geopolitical Perspective

The “gray zone”, referring to actions below the threshold of war, is also known to as hybrid threats, sharp power, political warfare, malign influence, irregular warfare, and modern deterrence. Recently, there has been a good deal of discussion about China- U.S. “gray zone” conflicts. These conflicts can be best characterized as activity that is coercive and aggressive in nature, but that is deliberately designed to beyond conventional military conflict and open interstate war. Although the United States and China are highly interconnected in many ways, the U.S. government has deployed extensive and diverse gray zone tactics against China, seriously infringing upon China’s sovereignty and territorial integrity. The United States’ position on the South China Sea, Taiwan, Vietnam, India, Japan and South Korea are best understood as a gray zone conflicts. These conflicts heavily undermine strategic stability, disrupt policy-making, and cause unintended escalation, causing “gray zone challenges” to both China and the United States. However, these challenges are difficult for the two government to address in today’s complex and competitive international environment. Through a geopolitical perspective, this paper aims to offer a deep understanding of the complex gray zone conflicts within China-U.S. relations and provide feasible recommendations for Chinese government to counter U.S. gray zone aggression.