Grey Area Research Articles

Financial speculation meets cultural heritage in China's wildlife markets.

Environmental regulations restricting the use of a natural resource or species often have unintended consequences. One example is prohibitions on the international trade in culturally important endangered wildlife. Trade restrictions may artificially increase scarcity and, consequently, value. In China, international trade restrictions may trigger bouts of speculative investment that have the opposite effect of the restrictions' intent. We examined how China's speculative economy and cultural history have together led to unintended consequences when regulating wildlife trade. In China, wildlife markets occupy a legal gray area that can make regulations ineffectual or even counterproductive. In extreme cases, prohibiting trade can provoke market booms. Further unintended consequences include potential cultural backlash. In China and across the Global South, international trade restrictions are sometimes considered a continuation of a longstanding history of Western intervention and thus may not be enforced as strongly or may generate resentment. This pushback has contributed to rising calls to decolonialize conservation and may lead to growing alliances between China and other Global South countries when negotiating international wildlife trade restrictions in the future.

An Overview on Evolving Role, Unmet Needs and Grey Areas in Anticoagulation in Cardiac Patients

An Overview on Evolving Role, Unmet Needs and Grey Areas in Anticoagulation in Cardiac Patients

Small grazing angle reflection and the sound siphon effect over a low velocity layer of sediments.

The low-order normal modes with small grazing angles (SGA) often control long-range sound field characteristics in shallow water. The SGA reflection loss from a half-space low-velocity bottom (LVB) is independent of the sound attenuation, except around the angle of complete transmission; the SGA bottom reflection loss (BRL) from a seafloor with a top low-velocity layer is very insensitive to the LVB attenuation also, except around a few selected frequencies. Thus, the "seafloor velocity-attenuation coupling" problem will be more fatal for LVB geo-acoustic inversions. The dispersion equation of the normal modes in the LVB layer is coincidentally the same as the singularity expression of the SGA reflection coefficient in the water column, resulting in a sound siphon effect that causes the abnormally high SGA BRL and transmission loss in the water at the siphon frequencies. The siphon effect is very sensitive to seafloor acoustic parameters, might offer a physical base for geo-acoustic inversion, and show a dim light in a "gray area" for inverting the LVB sound attenuation at low to mid frequencies. As an example, the acoustic siphon effect and related seafloor geophysical parameters forming it in the Yellow Sea are reported in this paper.

Features and Major Issues of Indian Economy

Theodore Roosevelt remarked, “A peep in the past prepares you better for the future”. Thus, for understanding the present state of the Indian economy and its future prospects a brief comment on its past will be appropriate. The Indian economy, before the British came around the middle of the nineteenth century, was quite sound. According to an estimate, the Gross Domestic Product (GDP) of India in the sixteenth century was about 25% of the world economy, the second largest in the world. However, after the arrival of the colonial rule the Indian economy faced disaster; from being an exporter of processed goods it changed to being an exporter of raw materials and a buyer of manufactured goods. As per British economist, Angus Maddison, India’s share of the world income went from 27% in 1700 A.D. (compared to Europe share of 23%) to 3% in 1950. After India got independence in 1947, the process of rebuilding the economy started. However, it was mostly centralized and the period from 1947 to 1991 was termed as the licence raj, because the successive governments followed protectionist economic policies. This trend led to a balance of payments crisis in the year 1990. The year 1991 turned out to be watershed in the Indian economy when the government of India in June 1991 announced major liberalization policies in Indian economy. The emergence of India as a major economic power in the world happens to be one such idea. Since then, Indian economy has progressed immensely with GDP progressing at the rate of 6 to 8% per annum and is expected to be one of the top three economic powers in the world over the next 10-15 years. India is also backed by its robust democracy and strong partnerships. India has finally arrived in the category of fast emerging economies. It is fast entering the league of high growth nations. The future seems to have much more in store. But a lot depends on how the grey areas are tackled. We have finally been able to unshackle ourselves from the stigma of being a low growth economy and have infused dynamism into our economic system. Not only is India achieving higher growth rates year after year, the rate at which it is moving towards higher growth targets is also higher. In this research paper discuss the features of Indian economy and major issues of Indian economy.

The cerebrospinal fluid (CSF)-contacting raphe nucleus (CsfR) in mice

A unique nucleus, the cerebrospinal fluid-contacting nucleus (CsfR), has been identified in the brain parenchyma. This nucleus features neurons with somas located within the parenchyma and processes extending into the cerebrospinal fluid (CSF). This anatomical configuration suggests that the CsfR may serve as a crucial interface between the nervous and body fluid regulatory systems, potentially playing a significant role in overall physiological modulation. Despite its importance, the precise biological significance of the CsfR remains to be fully elucidated. Previous research has characterized the CsfR, providing detailed information on its position, neighboring structures, neuron distribution, and 3D reconstruction in both rats and non-human primates, with stereotaxic coordinates specifically provided for the rat model. Given the relevance of mice as a model organism, especially the C57BL/6J strain, this study aims to explore the existence and morphology of the CsfR in mice. Our findings confirm the presence of the CsfR, consistently located in the ventral gray area of the lower part of the aqueduct and the upper part of the fourth ventricle floor. It is bilaterally symmetrical and heart-shaped in the coronal plane, which differs slightly from the Y-shape observed in coronal sections of rats. This study provides significant references for researchers investigating this specialized nucleus.

The gray area of scientific adequacy

The gray area of scientific adequacy

Negotiating grey areas: an interview-based analysis of paramedic uncertainty and decision-making in cardiac arrest events

BackgroundParamedics are responsible for critical resuscitation decisions when attending Out of Hospital Cardiac Arrests (OHCA). Existing research indicates that a range of clinical and non-clinical factors moderate their decision-making. Within the United Kingdom (UK), there is little evidence on how and why paramedics make their decisions at actual OHCA events.MethodsWe explored the experiences of UK paramedics using individually recalled OHCA events as catalysts for discussion. Pen portraits developed from semi-structured interviews with 31 paramedics across two UK ambulance services were thematically analysed, enabling cross-participant comparisons whilst retaining depth and context.ResultsWe identified four themes: uncertainties encountered in resuscitation guidelines, influences on decision-making, holistic perspectives, and indirect moderators. We found that paramedics experienced uncertainty at all stages of the resuscitation process. Uncertainties arose from indeterminate, ambiguous or complex information and were described as having both clinical and ethical dimensions. Whilst guidelines drove paramedics’ decisions, non-clinical personal, practical and relational factors moderated their assessments of survivability and decision-making, with attitudes to interactions between patient age, frailty and quality of life playing a substantial role. Coping strategies such as uncertainty reduction, assumption-based reasoning and weighing pros and cons were evident from interviews.ConclusionsThe complexity of interactions between clinical and non-clinical factors points to an element of variability in paramedics’ responses to uncertainty. Exploring UK paramedics’ uncertainties and decision-making during specific OHCA events can help acknowledge and address uncertainties in resuscitation guidelines and paramedic training, providing paramedics with the tools to manage uncertainty in a consistent and transparent way.

A Decade of Eco-Friendly Active and Intelligent Food Packaging Research: A Quantitative Review

The thrust for active and intelligent food packaging systems utilizing sustainable biopolymer resources has gained significant momentum in recent years as the global food industry seeks innovative solutions to enhance product freshness and safety while reducing environmental impact. Active packaging aims to extend the shelf life of packaged foods through the incorporation of substances. Intelligent packaging, on the other hand, is intended to offer up-to-date data on the quality, freshness, or safety of packaged foods by integrating various indicators into the packaging film that displays variations in storage conditions, gas levels, pH, and other factors. The present quantitative review is targeted to investigate quantitatively the research activity in the biodegradable multifunctional packaging utilizing the Web of Science database data. The top ten authors, countries, and journals associated with the present topic have been analyzed using the Bibliometrix-Biblioshiny package of R. This software package also utilizes the thematic evolution in terms of trend topic analysis. In addition, the VOS viewer software package has been used to predict inter-country collaboration, as well as, collaboration between authors. This software package also predicts co-occurrences and the evolution of keywords. Such an extensive computational approach thus expected to predict the grey areas in eco-friendly active and smart food packaging research both in terms of synthesis and properties.

Characteristics of bethesda 3 and 4 thyroid nodules: bethesda grey area

Characteristics of bethesda 3 and 4 thyroid nodules: bethesda grey area

Standardizing Attention Process Training-III for a Multisite Clinical Trial of Neuromodulation.

The Control Network Neuromodulation to Enhance Cognitive Training in Complex Traumatic Brain Injury (CONNECT-TBI) study is an ongoing randomized, double-blinded, sham-controlled multisite clinical trial to determine the enhancing effects of noninvasive neuromodulation when paired with cognitive training in military participants (Veterans and active duty) with mild TBI. Attention Process Training-III (APT-III) was selected for its strong evidence base, manualized procedures, and computerized program. However, many aspects of APT-III that make it ideal for personalization make it less ideal for reliable implementation across participants, clinicians/technicians, and sites. The purpose of this feature article is to highlight APT-III procedures that require additional standardization for reliable administration across participants and sites. Ten studies using APT-III were reviewed for methodology of APT-III administration. The manual was also scrutinized; aspects of administration that involved clinical decision-making, subjectivity, flexibility, and/or that were identified by the APT-III developers as areas in need of "empirical evaluation" were flagged by clinicians. Literature and manual review findings were presented to the team for discussion and solution-finding. The authors created and refined a standardized process that would allow participants to move through APT-III training, including task movement algorithms and new materials drafts. Refining of algorithms and drafts continued until there was a consensus from team members. Many gray areas were identified, but we will limit our reporting to focus on (1) dosage, (2) adaptation, (3) metacognitive strategy instruction, and (4) goal attainment scaling. We present APT-III manual details, literature review findings, and CONNECT-TBI decisions and materials for each of these areas of focus. We have highlighted some of the major gray areas of APT-III administration so that fellow researchers can understand the need to take similar steps in clinical trials using APT-III. We provide examples of our standardization process and resultant rules and materials. Our algorithm, based on prior studies using the APT-III and our own iterative adjustments, allows for adjustment of the difficulty and speed of the training tasks (but within certain parameters) in order to achieve the best balance between individualization and consistency across participants and sites. We provide an example of a workflow and reporting process for future studies.

Concurrent and longitudinal neurostructural correlates of irritability in children

Irritability, or an increased proneness to frustration and anger, is common in youth; however, few studies have examined neurostructural correlates of irritability in children. The purpose of the current study was to examine concurrent and longitudinal associations between brain structure and irritability in a large sample of 9–10-year-old children. Participants included 10,647 children from the Adolescent Brain Cognitive Developmentsm Study (ABCD Study®). We related a latent irritability factor to gray matter volume, cortical thickness, and surface area in 68 cortical regions and to gray matter volume in 19 subcortical regions using structural equation modeling. Multiple comparisons were adjusted for using the false discovery rate (FDR). After controlling for age, sex, race/ethnicity, scanner model, parent’s highest level of education, medication use, and total intracranial volume, irritability was associated with smaller volumes in primarily temporal and parietal regions at baseline. Longitudinal analyses showed that baseline gray matter volume did not predict irritability symptoms at the 3rd-year follow-up. No significant associations were found for cortical thickness or surface area. The current study demonstrates inverse associations between irritability and volume in regions implicated in emotional processing/social cognition, attention allocation, and movement/perception. We advance prior research by demonstrating that neurostructural differences associated with irritability are already apparent by age 9–10 years, extending this work to children and supporting theories positing socioemotional deficits as a key feature of irritability.

79. The role of combination surgery and radiotherapy in patients with metastatic spinal cord compression: what are the remaining grey areas?

79. The role of combination surgery and radiotherapy in patients with metastatic spinal cord compression: what are the remaining grey areas?

Transcallosal white matter and cortical gray matter variations in autistic adults ages 30-73 years: A bi-tensor free water imaging approach.

Background: Autism spectrum disorder (ASD) has long been recognized as a lifelong condition, but brain aging studies in autistic adults aged >30 years are limited. Free water, a novel brain imaging marker derived from diffusion MRI (dMRI), has shown promise in differentiating typical and pathological aging and monitoring brain degeneration. We aimed to examine free water and free water corrected dMRI measures to assess white and gray matter microstructure and their associations with age in autistic adults. Methods: Forty-three autistic adults ages 30-73 years and 43 age, sex, and IQ matched neurotypical controls participated in this cross-sectional study. We quantified fractional anisotropy (FA), free water, and free water-corrected FA (fwcFA) across 32 transcallosal white matter tracts and 94 gray matter areas in autistic adults and neurotypical controls. Follow-up analyses assessed age effect on dMRI metrics of the whole brain for both groups and the relationship between dMRI metrics and clinical measures of ASD in regions that significantly differentiated autistic adults from controls. Results: We found globally elevated free water in 24 transcallosal tracts in autistic adults. We identified negligible differences in dMRI metrics in gray matter between the two groups. Age-associated FA reductions and free water increases were featured in neurotypical controls; however, this brain aging profile was largely absent in autistic adults. Additionally, greater autism quotient (AQ) total raw score was associated with increased free water in the inferior frontal gyrus pars orbitalis and lateral orbital gyrus in autistic adults. Limitations: All autistic adults were cognitively capable individuals, minimizing the generalizability of the research findings across the spectrum. This study also involved a cross-sectional design, which limited inferences about the longitudinal microstructural changes of white and gray matter in ASD. Conclusions: We identified differential microstructural configurations between white and gray matter in autistic adults and that autistic individuals present more heterogeneous brain aging profiles compared to controls. Our clinical correlation analysis offered new evidence that elevated free water in some localized white matter tracts may critically contribute to autistic traits in ASD. Our findings underscored the importance of quantifying free water in dMRI studies of ASD.

Factors influencing nurse practitioner panel size in team-based primary care: a qualitative case study

BackgroundLack of access to health care is a worldwide public health crisis. In primary care it has led to increases in the implementation of nurse practitioners and heightened interest in their patient panel capacity. The aim of this study was to examine factors influencing nurse practitioner patient panel size in team-based primary care in Ontario, Canada.MethodsWe used a multiple case study design. Eight team-based primary care practices including rural and urban settings were purposively selected as cases. Each case had two or more nurse practitioners with a minimum of two years experience in the primary care setting. Interviews were conducted in-person, audio recorded, transcribed and analysed using content analysis.ResultsForty participants, including 19 nurse practitioners, 16 administrators (inclusive of executives, managers, and receptionists), and 5 physicians were interviewed. Patient, provider, organizational, and system factors influenced nurse practitioner patient panel size. There were eight sub-factors: complexity of patients’ health and social needs; holistic nursing model of care; nurse practitioner experience and confidence; composition and functioning of the multidisciplinary team; clerical and administrative supports, and nurse practitioner activities and expectations. All participants found it difficult to identify the panel size of nurse practitioners, calling it— “a grey area.” Establishing and maintaining a longitudinal relationship that responded holistically to patients’ needs was fundamental to how nurse practitioners provided care. Social factors such as gender, poverty, mental health concerns, historical trauma, marginalisation and literacy contributed to the complexity of patients’ needs. Participants indicated NPs tried to address all of a patient’s concerns at each visit.ConclusionsNurse practitioners have a holistic approach that incorporates attention to the social determinants of health as well as acute and chronic comorbidities. This approach compels them to try to address all of the needs a patient is experiencing at each visit and reduces their panel size. Multidisciplinary teams have an opportunity to be deliberate when structuring their services across providers to meet more of the health and social needs of empanelled patients. This could enable increases in nurse practitioner panel size.

Navigating the Grey Area: Students' Ethical Dilemmas in Using AI Tools for Coding Assignments

<div align="center"><table width="100%" border="0" cellspacing="0" cellpadding="0"><tbody><tr><td valign="top" width="605"><p>Integrating artificial intelligence (AI) in higher education, particularly in coding assignments for Information Technology (IT) students, represents a rapidly evolving research area with significant implications for academic practices and integrity. This study focuses on the ethical challenges faced by IT students when using AI tools like ChatGPT for coding assignments. Despite the growing use of AI in education, there is a notable gap in understanding how students perceive and navigate the ethical dilemmas associated with these technologies. To address this gap, this study employed a thematic analysis of qualitative data collected from interviews with IT students. The results reveal a complex landscape of ethical considerations, including issues of originality, academic integrity, and the potential for misuse of AI tools. Students reported challenges in balancing the benefits of AI assistance with the need to maintain independent learning and adhere to ethical standards. The implications of this research are significant for educators, institutions, and policymakers. Understanding the ethical challenges students face can inform the development of more effective teaching strategies, assessment methods, and institutional policies. This study contributes to the ongoing dialogue about AI ethics in academia, providing valuable insights for creating an educational environment that leverages the power of AI while upholding the principles of academic integrity and meaningful learning.</p></td></tr></tbody></table></div>

Persistent Gene Flow Suggests an Absence of Reproductive Isolation in an African Antelope Speciation Model.

African antelope diversity is a globally unique vestige of a much richer world-wide Pleistocene megafauna. Despite this, the evolutionary processes leading to the prolific radiation of African antelopes are not well understood. Here, we sequenced 145 whole genomes from both subspecies of the waterbuck (Kobus ellipsiprymnus), an African antelope believed to be in the process of speciation. We investigated genetic structure and population divergence and found evidence of a mid-Pleistocene separation on either side of the eastern Great Rift Valley, consistent with vicariance caused by a rain shadow along the so-called 'Kingdon's Line'. However, we also found pervasive evidence of both recent and widespread historical gene flow across the Rift Valley barrier. By inferring the genome-wide landscape of variation among subspecies, we found 14 genomic regions of elevated differentiation, including a locus that may be related to each subspecies' distinctive coat pigmentation pattern. We investigated these regions as candidate speciation islands. However, we observed no significant reduction in gene flow in these regions, nor any indications of selection against hybrids. Altogether, these results suggest a pattern whereby climatically driven vicariance is the most important process driving the African antelope radiation, and suggest that reproductive isolation may not set in until very late in the divergence process. This has a significant impact on taxonomic inference, as many taxa will be in a gray area of ambiguous systematic status, possibly explaining why it has been hard to achieve consensus regarding the species status of many African antelopes. Our analyses demonstrate how population genetics based on low-depth whole genome sequencing can provide new insights that can help resolve how far lineages have gone along the path to speciation.

Gray areas: How the way we work perpetuates racism and what we can do to fix it. By Adia HarveyWingfield, New York: HarperCollins Amistad. 2023. 304 pages. ISBN: 9780063079816

Gray areas: How the way we work perpetuates racism and what we can do to fix it. By Adia HarveyWingfield, New York: HarperCollins Amistad. 2023. 304 pages. ISBN: 9780063079816

Detecting heart stress using NT-proBNP in patients with type 2 diabetes mellitus and hypertension or high-normal blood pressure: a cross-sectional multicentric study

BackgroundWe evaluated the prevalence of “heart stress” (HS) based on NT-proBNP cut-points proposed by the 2023 Consensus of the Heart Failure Association (HFA) of the European Society of Cardiology (ESC) in asymptomatic patients with T2DM and hypertension or high-normal blood pressure (BP) eligible for SGLT2 inhibitors (SGLT2i) and/or GLP-1 receptor agonists (GLP1-RA), drugs with proven benefits on reducing the incidence of HF, hospitalizations, cardiovascular events and mortality.MethodsA cross-sectional multicentric study was conducted on 192 consecutive outpatients, aged ≥ 55 years, with hypertension or high-normal BP, referred to three diabetology units. NT-proBNP was collected before starting new anti-diabetic therapy. Patients with known HF were excluded, and participants were classified based on the age-adjusted NT-proBNP cut-points.ResultsMean age: 70.3 ± 7.8 years (67.5% males). Patients with obesity (BMI ≥ 30 Kg/m2): 63.8%. Median NT-proBNP: 96.0 (38.8–213.0) pg/mL. Prevalence of chronic kidney disease (CKD, eGFR < 60 mL/min/1.73m2): 32.1%. Mean arterial BP: 138.5/77.0 ± 15.8/9.9 mmHg. The NT-proBNP values, according to the proposed age-adjusted cut-points, classified 28.6% of patients as “HS likely” (organize elective echocardiography and specialist evaluation), 43.2% as “HS not likely” (a grey area, repeat NT-proBNP at six months) and 28.2% as “very unlikely HS” (repeat NT-proBNP at one year). The presence of CKD and the number of anti-hypertensive drugs, but not glycemic parameters, were independently associated with HS.ConclusionsAccording to NT-proBNP, over a quarter of T2DM patients with hypertension/high-normal BP, among those eligible for SGLT2i and/or GLP1-RA, were already at risk of cardiac damage, even subclinical. Most would receive an indication to echocardiogram and be referred to a specialist, allowing the early implementation of effective strategies to prevent or delay the progression to advanced stages of cardiac disease and overt HF.

Video Game Addiction in Young People (8-18 Years Old) after the COVID-19 Pandemic: The Grey Area of Addiction and the Phenomenon of "Gaming Non-Pathological Abuse (GNPA)".

In the literature, video game addiction in youths is correlated with dysfunctional symptoms of anxiety, emotional disorders, and mood disorders, and the pandemic period of 2020-2022 has favored the aggravation of this behavioral addiction. Therefore, we identified the need to analyze this phenomenon with an emphasis on the risks and correlates related to deviance and maladjustment from a prospective perspective, seeking to understand the impact of the individual variables examined. To demonstrate whether the condition of "gaming non-pathological abuse" (GNPA) promotes psychopathological features of clinical interest, in the absence of a diagnosis of "gaming disorder" (GD). A search performed on PubMed and administration of an ad hoc sociological questionnaire were used to investigate individual variables of criminological interest in a representative population sample (531 males/females, 8-18 years old, M: 14.4, SD: 2.5). Statistical analysis showed that after the pandemic period, digital video game addiction was reinforced, feeding psychopathological traits consistent with anxiety, emotional disorders, and mood disorders. Variables correlated with impulsive, aggressive, and violent behavior related to age, gender, socio-environmental and economic background, and the severity of digital video game addiction. In the youth population (8-18 years), "gaming non-pathological abuse" (GNPA) is related to aggressive, impulsive and violent behaviors that foster phenomena of social maladjustment and deviance, especially in individuals living in disadvantaged or otherwise complex socio-economic and family contexts. Looking forward, the study of structural and functional personality profiles is essential in order to anticipate and reduce the future risk of psychopathological and criminal behavior.

Organ Transplantation – Judgements Beyond Customary Rules and Concepts

Abstract The permission for transplantation granted by the Authorisation Committee (District Level/State Level Committee for approval of unrelated transplants) and the Competent Authority (Hospital-based committee for approval of related transplants) is pivotal in preventing illegal practices in human organ transplantation. Interpreting some complex and challenging aspects of the Transplant Act sometimes makes the Authorisation Committees and Transplant Centres become excessively cautious and reluctant in granting permission for transplantation. This article recounts some significant judgements passed by the Honourable High Courts of India where the courts overruled the decisions of the aforesaid sanctioning authorities and granted permission for transplant either by bringing in amendments or by changing the way of interpretation of the transplant laws. Apart from resolving the mental and physical anguish of the patients and their families, these judgements also shed light on some of the grey areas of the transplant act.