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Soundscapes of war: the audio-visual performance of war by Shi'a militias in Iraq and Syria

7 May 2020 , Volume 96, Number 3

Helle Malmvig

This article sets out to bring sound and music to the field of visual studies in International Relations. It argues that IR largely has approached the visual field as if it was without sound; neglecting how audial landscapes frame and direct our interpretation of moving imagery. Sound and music contribute to making imagery intelligible to us, we ‘hear the pictures’ often without noticing. The audial can for instance articulate a visual absence, or blast visual signs, bring out certain emotional stages or subjects’ inner life. Audial frames steer us in distinct directions, they can mute the cries of the wounded in war, or amplify the sounds of joy of soldiers shooting in the air. To bring the audial and the visual analytically and empirically together, the article therefore proposes four key analytical themes: 1) the audial–visual frame, 2) point of view/point of audition, 3) modes of audio-visual synchronization and 4) aesthetics moods. These are applied to a study of ‘war music videos’ in Iraq and Syria made and circulated by Shi'a militias currently fighting there. Such war music videos, it is suggested, are not just artefacts of popular culture, but have become integral parts of how warfare is practiced today, and one that is shared by soldiers in the US and Europe. War music videos are performing war, just as they shape how war is known by spectators and participants alike.




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18F-Fluorocholine PET/CT in Primary Hyperparathyroidism: Superior Diagnostic Performance to Conventional Scintigraphic Imaging for Localization of Hyperfunctioning Parathyroid Glands

Primary hyperparathyroidism (PHPT) is a common endocrine disorder, definitive treatment usually requiring surgical removal of the offending parathyroid glands. To perform focused surgical approaches, it is necessary to localize all hyperfunctioning glands. The aim of the study was to compare the efficiency of established conventional scintigraphic imaging modalities with emerging 18F-fluorocholine PET/CT imaging in preoperative localization of hyperfunctioning parathyroid glands in a larger series of PHPT patients. Methods: In total, 103 patients with PHPT were imaged preoperatively with 18F-fluorocholine PET/CT and conventional scintigraphic imaging methods, consisting of 99mTc-sestamibi SPECT/CT, 99mTc-sestamibi/pertechnetate subtraction imaging, and 99mTc-sestamibi dual-phase imaging. The results of histologic analysis, as well as intact parathyroid hormone and serum calcium values obtained 1 d after surgery and on follow-up, served as the standard of truth for evaluation of imaging results. Results: Diagnostic performance of 18F-fluorocholine PET/CT surpassed conventional scintigraphic methods (separately or combined), with calculated sensitivity of 92% for PET/CT and 39%–56% for conventional imaging (65% for conventional methods combined) in the entire patient group. Subgroup analysis, differentiating single and multiple hyperfunctioning parathyroid glands, showed PET/CT to be most valuable in the group with multiple hyperfunctioning glands, with sensitivity of 88%, whereas conventional imaging was significantly inferior, with sensitivity of 22%–34% (44% combined). Conclusion: 18F-fluorocholine PET/CT is a diagnostic modality superior to conventional imaging methods in patients with PHPT, allowing for accurate preoperative localization.




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Doctor alleged to have performed “designer vagina” surgery won’t be prosecuted




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Performance of High-Sensitivity Cardiac Troponin Assays To Reflect Comorbidity Burden and Improve Mortality Risk Stratification in Older Adults With Diabetes

OBJECTIVE

Incorporation of comorbidity burden to inform diabetes management in older adults remains challenging. High-sensitivity cardiac troponins are objective, quantifiable biomarkers that may improve risk monitoring in older adults. We assessed the associations of elevations in high-sensitivity cardiac troponin I (hs-cTnI) and T (hs-cTnT) with comorbidities and improvements in mortality risk stratification.

RESEARCH DESIGN AND METHODS

We used logistic regression to examine associations of comorbidities with elevations in either troponin (≥85th percentile) among 1,835 participants in the Atherosclerosis Risk in Communities (ARIC) Study with diabetes (ages 67–89 years, 43% male, 31% black) at visit 5 (2011–2013). We used Cox models to compare associations of high cardiac troponins with mortality across comorbidity levels.

RESULTS

Elevations in either troponin (≥9.4 ng/L for hs-cTnI, ≥25 ng/L for hs-cTnT) were associated with prevalent coronary heart disease, heart failure, chronic kidney disease, pulmonary disease, hypoglycemia, hypertension, dementia, and frailty. Over a median follow-up of 6.2 years (418 deaths), both high hs-cTnI and high hs-cTnT further stratified mortality risk beyond comorbidity levels; those with a high hs-cTnI or hs-cTnT and high comorbidity were at highest mortality risk. Even among those with low comorbidity, a high hs-cTnI (hazard ratio [HR] 3.0 [95% CI 1.7, 5.4]) or hs-cTnT (HR 3.3 [95% CI 1.8, 6.2]) was associated with elevated mortality.

CONCLUSIONS

Many comorbidities were reflected by both hs-cTnI and hs-cTnT; elevations in either of the troponins were associated with higher mortality risk beyond comorbidity burden. High-sensitivity cardiac troponins may identify older adults at high mortality risk and be useful in guiding clinical care of older adults with diabetes.




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How a Self-Fulfilling Stereotype Can Drag Down Performance

Here's a trick question, so think carefully before you answer: If someone mentions the word "beast" to you, which word would you match it with?




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Performance of the ESC 0/1-h and 0/3-h Algorithm for the Rapid Identification of Myocardial Infarction Without ST-Elevation in Patients With Diabetes

OBJECTIVE

Patients with diabetes mellitus (DM) have elevated levels of high-sensitivity cardiac troponin (hs-cTn). We investigated the diagnostic performance of the European Society of Cardiology (ESC) algorithms to rule out or rule in acute myocardial infarction (AMI) without ST-elevation in patients with DM.

RESEARCH DESIGN AND METHODS

We prospectively enrolled 3,681 patients with suspected AMI and stratified those by the presence of DM. The ESC 0/1-h and 0/3-h algorithms were used to calculate negative and positive predictive values (NPV, PPV). In addition, alternative cutoffs were calculated and externally validated in 2,895 patients.

RESULTS

In total, 563 patients (15.3%) had DM, and 137 (24.3%) of these had AMI. When the ESC 0/1-h algorithm was used, the NPV was comparable in patients with and without DM (absolute difference [AD] –1.50 [95% CI –5.95, 2.96]). In contrast, the ESC 0/3-h algorithm resulted in a significantly lower NPV in patients with DM (AD –2.27 [95% CI –4.47, –0.07]). The diagnostic performance for rule-in of AMI (PPV) was comparable in both groups: 0/1-h (AD 6.59 [95% CI –19.53, 6.35]) and 0/3-h (AD 1.03 [95% CI –7.63, 9.7]). Alternative cutoffs increased the PPV in both algorithms significantly, while improvements in NPV were only subtle.

CONCLUSIONS

Application of the ESC 0/1-h algorithm revealed comparable safety to rule out AMI comparing patients with and without DM, while this was not observed with the ESC 0/3-h algorithm. Although alternative cutoffs might be helpful, patients with DM remain a high-risk population in whom identification of AMI is challenging and who require careful clinical evaluation.




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Educational Opportunities and Performance in Massachusetts

This Quality Counts 2019 Highlights Report captures all the data you need to assess your state's performance on key educational outcomes.




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Educational Opportunities and Performance in Massachusetts

This Quality Counts 2020 Highlights Report captures all the data you need to assess your state's performance on key educational outcomes.




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Educational Opportunities and Performance in North Carolina

This Quality Counts 2020 Highlights Report captures all the data you need to assess your state's performance on key educational outcomes.




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Educational Opportunities and Performance in West Virginia

This Quality Counts 2019 Highlights Report captures all the data you need to assess your state's performance on key educational outcomes.




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Educational Opportunities and Performance in Virginia

This Quality Counts 2019 Highlights Report captures all the data you need to assess your state's performance on key educational outcomes.




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Educational Opportunities and Performance in West Virginia

This Quality Counts 2020 Highlights Report captures all the data you need to assess your state's performance on key educational outcomes.




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Educational Opportunities and Performance in Virginia

This Quality Counts 2020 Highlights Report captures all the data you need to assess your state's performance on key educational outcomes.




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Educational Opportunities and Performance in Maine

This Quality Counts 2019 Highlights Report captures all the data you need to assess your state's performance on key educational outcomes.




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Educational Opportunities and Performance in Maine

This Quality Counts 2020 Highlights Report captures all the data you need to assess your state's performance on key educational outcomes.




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Educational Opportunities and Performance in Ohio

This Quality Counts 2019 Highlights Report captures all the data you need to assess your state's performance on key educational outcomes.




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Educational Opportunities and Performance in Ohio

This Quality Counts 2020 Highlights Report captures all the data you need to assess your state's performance on key educational outcomes.




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Educational Opportunities and Performance in Oklahoma

This Quality Counts 2019 Highlights Report captures all the data you need to assess your state's performance on key educational outcomes.




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Educational Opportunities and Performance in Oklahoma

This Quality Counts 2020 Highlights Report captures all the data you need to assess your state's performance on key educational outcomes.




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Educational Opportunities and Performance in Wyoming

This Quality Counts 2019 Highlights Report captures all the data you need to assess your state's performance on key educational outcomes.




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Educational Opportunities and Performance in Wyoming

This Quality Counts 2020 Highlights Report captures all the data you need to assess your state's performance on key educational outcomes.




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Educational Opportunities and Performance in Texas

This Quality Counts 2019 Highlights Report captures all the data you need to assess your state's performance on key educational outcomes.




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Educational Opportunities and Performance in Texas

This Quality Counts 2020 Highlights Report captures all the data you need to assess your state's performance on key educational outcomes.




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Educational Opportunities and Performance in North Dakota

This Quality Counts 2020 Highlights Report captures all the data you need to assess your state's performance on key educational outcomes.




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Educational Opportunities and Performance in Nevada

This Quality Counts 2019 Highlights Report captures all the data you need to assess your state's performance on key educational outcomes.




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Educational Opportunities and Performance in Nevada

This Quality Counts 2020 Highlights Report captures all the data you need to assess your state's performance on key educational outcomes.




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Educational Opportunities and Performance in Kentucky

This Quality Counts 2019 Highlights Report captures all the data you need to assess your state's performance on key educational outcomes.




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Educational Opportunities and Performance in Kentucky

This Quality Counts 2020 Highlights Report captures all the data you need to assess your state's performance on key educational outcomes.




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Educational Opportunities and Performance in Nebraska

This Quality Counts 2019 Highlights Report captures all the data you need to assess your state's performance on key educational outcomes.




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Educational Opportunities and Performance in Nebraska

This Quality Counts 2020 Highlights Report captures all the data you need to assess your state's performance on key educational outcomes.




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Educational Opportunities and Performance in Alabama

This Quality Counts 2019 Highlights Report captures all the data you need to assess your state's performance on key educational outcomes.




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Educational Opportunities and Performance in Alabama

This Quality Counts 2020 Highlights Report captures all the data you need to assess your state's performance on key educational outcomes.




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Educational Opportunities and Performance in Maryland

This Quality Counts 2019 Highlights Report captures all the data you need to assess your state's performance on key educational outcomes.




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Educational Opportunities and Performance in Maryland

This Quality Counts 2020 Highlights Report captures all the data you need to assess your state's performance on key educational outcomes.




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Educational Opportunities and Performance in Tennessee

This Quality Counts 2019 Highlights Report captures all the data you need to assess your state's performance on key educational outcomes.




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Educational Opportunities and Performance in Tennessee

This Quality Counts 2020 Highlights Report captures all the data you need to assess your state's performance on key educational outcomes.




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Educational Opportunities and Performance in Colorado

This Quality Counts 2019 Highlights Report captures all the data you need to assess your state's performance on key educational outcomes.




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Educational Opportunities and Performance in Colorado

This Quality Counts 2020 Highlights Report captures all the data you need to assess your state's performance on key educational outcomes.




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Educational Opportunities and Performance in Wisconsin

This Quality Counts 2019 Highlights Report captures all the data you need to assess your state's performance on key educational outcomes.




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Educational Opportunities and Performance in Wisconsin

This Quality Counts 2020 Highlights Report captures all the data you need to assess your state's performance on key educational outcomes.




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Educational Opportunities and Performance in California

This Quality Counts 2019 Highlights Report captures all the data you need to assess your state's performance on key educational outcomes.




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Educational Opportunities and Performance in California

This Quality Counts 2020 Highlights Report captures all the data you need to assess your state's performance on key educational outcomes.




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Educational Opportunities and Performance in Montana

This Quality Counts 2019 Highlights Report captures all the data you need to assess your state's performance on key educational outcomes.




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Educational Opportunities and Performance in Montana

This Quality Counts 2020 Highlights Report captures all the data you need to assess your state's performance on key educational outcomes.




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Educational Opportunities and Performance in Hawaii

This Quality Counts 2019 Highlights Report captures all the data you need to assess your state's performance on key educational outcomes.




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Educational Opportunities and Performance in Hawaii

This Quality Counts 2020 Highlights Report captures all the data you need to assess your state's performance on key educational outcomes.




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Educational Opportunities and Performance in Utah

This Quality Counts 2019 Highlights Report captures all the data you need to assess your state's performance on key educational outcomes.




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Educational Opportunities and Performance in Utah

This Quality Counts 2020 Highlights Report captures all the data you need to assess your state's performance on key educational outcomes.




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Educational Opportunities and Performance in Pennsylvania

This Quality Counts 2019 Highlights Report captures all the data you need to assess your state's performance on key educational outcomes.




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Educational Opportunities and Performance in Pennsylvania

This Quality Counts 2020 Highlights Report captures all the data you need to assess your state's performance on key educational outcomes.