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Gray Zone Free Download ^NEW^

In this startling and thought-provoking book, which will remind listeners of works by Oliver Sacks and Atul Gawande, a world-renowned neuroscientist reveals his controversial, groundbreaking work with patients whose brains were previously thought vegetative or nonresponsive but turn out - in up to 20 percent of cases - to be vibrantly alive, existing in the "gray zone".

Gray Zone Free Download

Into the Gray Zone takes listeners to the edge of a dazzling, humbling frontier in our understanding of the brain: the so-called "gray zone" between full consciousness and brain death. People in this middle place have sustained traumatic brain injuries or are the victims of stroke or degenerative diseases, such as Alzheimer's and Parkinson's. Many are oblivious to the outside world, and their doctors believe they are incapable of thought. But a sizeable number are experiencing something different: intact minds adrift deep within damaged brains and bodies. An expert in the field, Adrian Owen led a team that, in 2006, discovered this lost population and made medical history. Scientists, physicians, and philosophers have only just begun to grapple with the implications.

Recent literature suggests that the conventional conceptions of deterrence are inadequate to address burgeoning threats in the gray zone. In the most basic framework of war, a state deters challengers by demonstrating how costly war would be for them. Gray-zone conflict complicates this model, as defenders can turn to gray-zone conflict to test their adversaries or gain concessions without going to war. Capable defenders, in turn, appear ill-equipped to respond to revisionism in the gray zone. While these conflicts may not be the bloodiest, they still create international instability and undermine the existing international order. In this framing, the gray zone conflict observed today constitutes a deterrence failure.

Our research challenges this convention by viewing gray-zone conflict as a symptom of deterrence success, not failure. Just as conflict is a continuum, so too is deterrence. Deterrence not only shapes whether a challenge emerges but also how challenges manifest. The more aggressive a transgression or a challenge is, the less deterrence has worked. An enemy that pulls its punches to avoid triggering a larger contest is not fighting as effectively as it might in unconstrained circumstances. Even if the challenger resorts to force, fear of escalation by the defender could cause the challenger to adopt a less productive military strategy.

We thus have two alternative theories: gray zone conflict could represent a deterrence failure or a deterrence success. On one hand, gray-zone attacks could be the best option for a challenger, where low-level conflict can be effective and maximize cost-benefit analyses by reducing resources spent in conflict. On the other hand, gray-zone conflict might be a compromise, second-best option for a challenger, where the challenger is externally deterred from more aggressive action.

We find that Russian behavior in Europe is consistent with Russia being deterred. Consider the Russian interventions in Estonia, Ukraine, and Georgia, which vary in their relationship to NATO. In 2004, Estonia joined NATO. Then in 2007, Russia launched a wave of denial-of-service cyber-attacks against Estonia when a Soviet-era statue was removed. While these cyber-attacks were shocking at the time, they were addressed by Estonian domestic law enforcement, and they represent the low end of Russian gray zone aggression. Russia thus exercised relative restraint against a NATO target.

In areas where NATO has greater access and interest (e.g., Estonia), Russia has greatly limited its gray zone activities. In areas with low NATO resolve (e.g., Georgia), Russia pulled no punches. Ukraine illustrates the continuum of increasing gray zone force with decreasing deterrent threat, marking a moderate level of both factors. The Ukraine case also demonstrates that Russia did indeed select its level of gray zone force based on NATO deterrence, rather than optimizing its level of aggression. Crimea is strategically important to Moscow due to the Black Sea port of Sevastopol; if Russia acted solely based on its resolve, it would prioritize Ukrainian intervention over Georgia. However, despite higher stakes in Ukraine, Russia exhibited restraint.

NBR research director Alison Szalwinski interviews Admiral Jonathan Greenert, who holds the John M. Shalikashvili Chair in National Security Studies at NBR. Admiral Greenert discusses the recent report "Murky Waters in the East China Sea: Chinese Gray-Zone Operations and U.S.-Japan Alliance Cooperation," which examines key obstacles for the U.S.-Japan alliance in responding to Chinese gray-zone operations.

The West does, indeed, have some advantages in defending against gray-zone operations. For instance, a free and open press is particularly critical in calling out the activities of adversaries that flourish best in the dark. Whether that includes identifying Russian special-operations forces in Crimea or fact-checking disinformation campaigns originating from the Russian Internet Research Agency, the proverbial sunshine afforded by a free society remains a powerful weapon. Likewise, close partnership between like-minded international partners (and a coherent strategy developed from this partnership) would allow democracies to bring more weight to a problem that is otherwise difficult to counter on your own.

A mindset shift is required. As a foundational first step, US policymakers should develop a cross-government strategy for competing with adversaries in the gray zone. This would involve developing a common language and shared understandings of the challenge across all domains where gray-zone activity occurs, including economic, diplomatic, information, and cyber. The US should develop coordinated interagency response options, both offensive and defensive, to attacks in the gray zone and determine the US national objective by defining its desired end state in gray-zone competition. In the cyber domain, this could involve expanding offensive cyber capabilities, while in the information domain, this could mean responding to and mitigating disinformation while simultaneously and proactively shaping the information environment. Through aligned messaging with allies and partners, the United States can transparently expose Russian and Chinese abuses and malign activity, all while illuminating the values of freedom and democracy.

The panel discussions surfaced several questions that will merit additional consideration by the United States, its allies, and its partners to respond effectively to future gray zone challenges from authoritarian states and nonstate actors.

One key question is whether gray zone activity is warfare or something else. While such a discussion may seem semantic, how the challenge is framed will likely influence how publics and governments consider responding to it and which actors are given the resources and responsibility to counter future gray zone threats. Managing escalation dynamics will be critical.

Finally, how can the United States can bolster civil society, private-sector engagement, and citizen education to identify and address some aspects of gray zone competition? The federated nature of the American political system, and its tradition of limited government, can be both an aid and a hindrance for fostering civic engagement initiatives.

U.S. leadership in an era of gray zone competition will require more than the largest economy or strongest military. National security begins at home and the United States must reinvigorate confidence in its institutions, its leaders, and its policy approaches. The United States can choose to strengthen and reinforce alliance structures, multilateral institutions, and democratic processes that have bolstered American economic prosperity and enhanced its security for 70 years or it can choose to degrade them. To compete more successfully, the United States must rapidly identify gray zone challenges and develop unified policy responses with allies and partners. These goals are achievable but will require the United States to restructure and reinvigorate its interagency structures, better prepare its citizens for gray zone competition, and ensure a whole-of-society approach. Maintaining an ongoing and comprehensive dialogue with allies and partners related to gray zone adaptation and best practices would also be extremely beneficial. Without these steps, the United States, its allies, and partners will likely continue to repeat avoidable mistakes and allow competitors to erode the integrity of Western financial, political, and security institutions. The result would be diminished American and allied power and sovereignty.

Myocardial infarct heterogeneity indices including peri-infarct gray zone are predictors for spontaneous ventricular arrhythmias events after ICD implantation in patients with ischemic heart disease. In this study we hypothesize that the extent of peri-infarct gray zone and papillary muscle infarct scores determined by a new multi-contrast late enhancement (MCLE) method may predict appropriate ICD therapy in patients with ischemic heart disease.

The cardiovascular magnetic resonance (CMR) protocol included LV functional parameter assessment and late gadolinium enhancement (LGE) CMR using the conventional method and MCLE post-contrast. The proportion of peri-infarct gray zone, core infarct, total infarct relative to LV myocardium mass, papillary muscle infarct scores, and LV functional parameters were statistically compared between groups with and without appropriate ICD therapy during follow-up.

Peri-infarct gray zone measurement using MCLE, compared to using conventional LGE-CMR, might be more sensitive in predicting appropriate ICD therapy for ventricular arrhythmia events. Papillary muscle infarct scores might have a specific role for predicting appropriate ICD therapy although the exact mechanism needs further investigation. 041b061a72

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