bluuebunny/crossref_metadata_2025 huggingface dataset:
A pedagogical model for integrating film education and audio
description in foreign language acquisition
Authors: Herrero Carmen , Escobar Manuela
Published: April 2020

Films are particularly powerful pedagogical tools that can help improve the
linguistic skills of foreign language learners. Audio describing tasks can
provide additional benefits. However, for an efficient use of feature films,
learners need to be trained on how to elaborate audio description texts and
develop active viewing strategies. This article discusses a language teaching
approach that advocates the addition of Film Literacy education and audio
description tasks to the language curriculum. It focuses on the application of
audio description, in both oral and written form, to the acquisition of Spanish
as a foreign language in Higher Education. It presents a pedagogical model
designed to help students develop linguistic, cultural and intercultural
competences while encouraging the aesthetic appreciation of films as cultural
objects that can be evaluated through a wide range of critical approaches.
The implications of Cognitive Load Theory and exposure to subtitles
in English as a Foreign Language (EFL)
Authors: Frumuselu Anca Daniela
Published: April 2020

The pedagogical use of subtitled and captioned material in the foreign language
classroom is upheld by various theories which reveal the cognitive processing
activated when students are exposed to multimedia and subtitled audiovisual
materials. The three theories that will be considered here are Cognitive Load
Theory (CLT), Cognitive Theory of Multimedia Learning (CTML) and Cognitive
Affective Theory of Learning with Media (CATLM). The main purpose of the paper
is to illustrate the internal mechanisms triggered in learners when various
sensorial channels (visual, auditory and textual) coincide simultaneously on
screen and how this may affect their cognitive engagement and motivation while
learning a foreign language. Additionally, two empirical studies will be
presented in the second part of the article in order to provide evidence of the
benefits of using subtitled audiovisual materials in the English as a Foreign
Language (EFL) classroom in Higher Education. The results show that both
interlingual (L1) and intralingual (L2) subtitles prove to have a facilitating
role in informal and colloquial language learning in this context.
Exploring the possibilities of interactive audiovisual activities for language learning
Authors: Sokoli Stavroula
Published: April 2020

Language teachers often resort to video to familiarise their students with contextualised linguistic and cultural aspects of
communication. Since they tend to consider learning-by-doing more effective than learning-by-viewing, they try to further
exploit this valuable asset through active tasks, such as taking notes or answering comprehension questions, silent viewing
and predicting, ordering sentences, role-playing, analysing, summarising and describing (Zabalbeascoa et al. 2015). Advances in ICT have enabled more interactive options, with a view to
expanding the range of available activities to include audiovisual translation (AVT) activities, such as subtitling and
dubbing. This is the focus of ClipFlair, a project which developed a platform for creating and hosting such activities and a
pedagogical proposal based on the idea that language learning can be enhanced with the use of activities asking learners to
work from a video by inserting their own writing (captioning) or speech (revoicing). Based on this framework, a whole range of
possible activities are open to teachers, beyond standard subtitling and dubbing.

This paper starts out by briefly describing previous work done in the area and goes on to illustrate the ClipFlair conceptual
framework including the educational specifications for the web platform, after the description of which concrete examples are
provided in order to expand on the possible audiovisual activities that can be used in a language classroom and beyond.
Finally, the paper gives an account of the learner survey carried out during the pilot phase of the project, which included
feedback provided by more than a thousand learners and teachers.
Intralingual dubbing as a tool for developing speaking
skills
Authors: Sánchez-Requena Alicia
Published: April 2020

Communicating verbally with others is one of the main features of human
behaviour, but the time employed in class to practise this skill is often
insufficient. In an attempt to overcome the need to practise oral conversations
and help students feel less anxious in foreign language (FL) contexts, new
didactic approaches are being considered. Amongst those, the active use of
techniques traditionally employed in audiovisual translation (AVT) has proved to
have a positive impact on FL learning.

This paper examines the relationship between intralingual dubbing (students'
replacement of the original voices of actors in one-minute long clips) and FL oral
expression. The main aim is to provide objective evidence that the use of
intralingual dubbing can enhance speed, intonation and pronunciation when
speaking spontaneously in Spanish as an FL. A total of 47 participants aged 16–18
with a B1 level of Spanish dubbed videos for 12 weeks. Data is triangulated both
qualitatively and quantitatively. Results confirm the main hypothesis and serve
as evidence to support theoretical aspects of the inclusion of active AVT
techniques in FL speaking classes.
The use of audio description in foreign language education
Authors: Navarrete Marga
Published: April 2020

Audio description (AD) is a type of audiovisual translation (AVT) used for making video content accessible to the blind and
visually impaired. Over the last decade, the pedagogic potential of AVT in foreign language learning (FLL) has gained
increasing recognition by experts. However, AD as a didactic tool in FLL is an innovative area that has received very little
attention so far, despite its significant potential for language learners. In addition, many experts in Applied Linguistics
have shown a growing interest in the study of fluency, pronunciation and intonation.

With these ideas in mind the author of the present article has carried out a small scale preliminary experiment with university
students of Spanish as a Foreign Language. This article presents the methodological framework of the experiment which includes
the instruments for data gathering. Although only six students completed the experiment, their responses were positive and
encouraging as they found active AD tasks useful for language learning. It is hoped that the lessons learnt will inform the
methodological framework for larger scale studies.
Why is that creature grunting?
Authors: Costal Tomás
Published: April 2020

Video games today are highly complex audiovisual products. Their nature is not
only multisemiotic but also interactive. Their potential audience has certain
expectations and, especially in the case of digital blockbusters, final users
need the advantage of knowledge and the force of numbers. A faux
pas in design, continuity or playability will most likely be
conducive to social media outrage, and will see official apologies be released
presently. Conversely, accessibility shortcomings rarely or never have the same
impact.

The present study puts forward the advantages of including Subtitles for the Deaf and Hard of Hearing (SDH) in
popular video games and offers an in-depth analysis of a selection of recent
multimedia titles. Drawing on the work of Bernal Merino (2015), O’Hagan
and Mangiron (2013) and Trabattoni (2014) on the special characteristics of video games, the
main elements around which they are structured and the aspects that determine
their success or failure, the author will endeavour to advance a convincing
argument in favour of the introduction of SDH subtitling conventions.
Studying the language of Dutch audio description
Authors: Reviers Nina
Published: April 2020

The present paper aims to combine insights from Applied Linguistics, Corpus Linguistics, Multimodality Research and Audiovisual
Translation Studies in order to explore language use in a specific form of audiovisual translation, namely Audio Description
(AD) for the blind and visually impaired. It is said that the communicative function of ADs and their multimodal context have
a significant influence on the lexical, grammatical and syntactical choices describers make. This article aims to uncover
these idiosyncratic linguistic patterns by conducting a quantitative and qualitative analysis of an annotated, audiovisual
corpus of 39 Dutch films and series that have been released with AD in Flanders and the Netherlands. The paper analyses
frequency lists, keywords, part-of-speech distributions and type-token ratios statistically, and subsequently conducts a
qualitative analysis taking systemic functional linguistics as a theoretical framework. The results confirm the hypothesis
that the language of AD is idiosyncratic and highlight the most salient lexico-grammatical features characterising the
language of Dutch AD.
Translaboration in the rehearsal room
Authors: Pfeiffer Kerstin , Richardson Michael , Wurm Svenja
Published: April 2020

This article explores the role of translaboration in an area where collaborative translation and co-creative
processes intertwine: a bilingual devised theatre rehearsal room. Scholarship has tended to focus on translated plays as cultural
products and on the difficulty associated with making bilingual theatrical products accessible to unilingual audiences. Here,
however, our focus is on translation within the creative process. We use two bilingual projects as examples. Each project brought
together participants from two cultural backgrounds: in one case, German and Czech young people; in the other, deaf and hearing
people from the UK. Possessing varying bilingual competencies, these participants employed their shared communicative repertoire
to ensure the collaborative creation of new, bilingual theatrical material. Their diverse communication strategies can be regarded
as translanguaging: a fluid, non-hierarchical practice that challenges the notion of uni-directional translation from a source
text. We argue that in this setting, translanguaging is the practice that enables translaboration. This practice is compromised by
the imposition of top-down structures that inhibit the organic development of democratic and potentially transformative
environments in which problematic power relationships can be reworked. Such transformativity relies on collaboration in both
devising and translation, co-creation and translaboration, and the two are mutually interdependent.
Occupational Dermatitis in Welding: Does Nickel Exposure Account for Higher Rates in Women? Analysis of a Canadian Cohort
Authors: Cherry Nicola , Galarneau Jean-Michel
Published: April 2020

Objectives

Women are reported to have higher rates of nickel sensitization than men, but there have been few studies of sex-related differences in dermatitis associated with occupational nickel exposure. This analysis examines dermatitis in a large cohort of women and men in welding and electrical occupations and considers how far differences in rates of dermatitis may be accounted for by nickel exposure.

Methods

Women and men were recruited to cohorts of workers who had entered welding and electrical apprenticeships (the WHAT-ME and WHAT-MEN studies). Participants completed questionnaires at baseline and every 6 months for up to 5 years. At each contact, cohort members were asked about current dermatitis and whether it was made worse by work. From the first follow-up after recruitment, those working in their trade completed detailed subroutines about tasks in their trade including, for welders, the process, base metal, and consumables. Exposures were considered by trade and, within welding, by stainless or high alloy steel (SOHAS) as the base metal. Urinary nickel concentration was also examined. Using only report of dermatitis that began after entry to the trade, new-onset dermatitis, all episodes of dermatitis, and dermatitis made worse by work were examined against exposure by multilevel, multivariable logistic regression, allowing for potential confounding.

Results

Among 1885 participants (welders; 447 women, 554 men: electrical trades; 438 women, 446 men), 200 reported dermatitis that started before they entered the trade, leaving 1685 for analysis. Women, but not men, who had entered the welding trades were more at risk of new onset [odds ratio (OR) = 1.54; 95% confidence interval (CI) 1.02–2.32] or dermatitis episodes (OR = 1.75; 95% CI 1.10–2.77) than those entering the electrical trades. Within welding, women were more at risk than men of new-onset dermatitis (OR = 1.85; 95% CI 1.15–2.96) and dermatitis episodes (2.14; 95% CI 1.24–3.68) but were not more likely to report these were made worse by work. Use of SOHAS as the base metal was associated with reports that dermatitis was made worse by work (3.54; 95% CI 1.04–12.03), but having adjusted for SOHAS use, women still remained at greater risk. A final analysis considered the effect on risk estimates of removing those welding SOHAS from the analysis. The risk for women of episodes of dermatitis was essentially unchanged, whether the comparison group was male welders or women in the electrical trades.

Conclusions

Welding is associated with risk of dermatitis in women. Although welding of SOHAS was associated with dermatitis that was made worse by work, it does not importantly explain the higher female rates in welding and other causes must be examined to support preventive measures.
Male rock lizards may compensate reproductive costs of an immune challenge affecting sexual signals
Authors: Rodríguez-Ruiz Gonzalo , Ortega Jesús , Cuervo José Javier , López Pilar , Salvador Alfredo , Martín José
Published: April 2020

Sexual signals can be evolutionarily stable if they are condition dependent or costly to the signaler. One of these costs may be the trade-off between maintaining the immune system and the elaboration of ornaments. Experimental immune challenges in captivity show a reduction in the expression of sexual signals, but it is not clear whether these detrimental effects are important in nature and, more importantly, whether they have reproductive consequences. We designed a field experiment to challenge the immune system of wild male Carpetan rock lizards, Iberolacerta cyreni, with a bacterial antigen (lipopolysaccharide). The immune challenge decreased relative reflectance of ultraviolet structural and melanin-dependent sexual coloration in the throat and the lateral ocelli, whereas the carotenoid-dependent dorsal green coloration was not affected. Immune activation also decreased proportions of ergosterol and cholesta-5,7-dien-3-ol in femoral secretions. These results support a trade-off between the immune system and both visual and chemical sexual ornaments. Moreover, the reproductive success of males, estimated with DNA microsatellites, depended on the expression of some color and chemical traits. However, the immune challenge did not cause overall differences in reproductive success, although it increased with body size/age in control but not in challenged males. This suggests the use of alternative reproductive strategies (e.g., forced matings) in challenged males, particularly in smaller ones. These males might consider that their survival probabilities are low and increase reproductive effort as a form of terminal investment in spite of their “low-quality” sexual signals and potential survival costs.
Nonparametric targeted Bayesian estimation of class proportions in unlabeled data
Authors: Díaz Iván , Savenkov Oleksander , Kamel Hooman
Published: April 2020

We introduce a novel Bayesian estimator for the class proportion in an unlabeled dataset, based on the targeted learning framework. The procedure requires the specification of a prior (and outputs a posterior) only for the target of inference, and yields a tightly concentrated posterior. When the scientific question can be characterized by a low-dimensional parameter functional, this focus on target prior and posterior distributions perfectly aligns with Bayesian subjectivism. We prove a Bernstein–von Mises-type result for our proposed Bayesian procedure, which guarantees that the posterior distribution converges to the distribution of an efficient, asymptotically linear estimator. In particular, the posterior is Gaussian, doubly robust, and efficient in the limit, under the only assumption that certain nuisance parameters are estimated at slower-than-parametric rates. We perform numerical studies illustrating the frequentist properties of the method. We also illustrate their use in a motivating application to estimate the proportion of embolic strokes of undetermined source arising from occult cardiac sources or large-artery atherosclerotic lesions. Though we focus on the motivating example of the proportion of cases in an unlabeled dataset, the procedure is general and can be adapted to estimate any pathwise differentiable parameter in a non-parametric model.
Current dietary advice and challenges for adolescents
Authors: Partridge Stephanie R
Published: April 2020

Background

The major risk factors driving the global burden of disease are diet related. Adolescence presents a window of opportunity for establishing healthy dietary trajectories. Yet around the world, adolescents experience many barriers that prevent them from consuming diets that would give them the foundation for long, healthy and productive adult lives.

Sources of data

A narrative literature search of most relevant original, review and meta-analyses, restricted to English was conducted in Medline, Web of Science and PubMed up to December 2019 together with published papers known to the author concerning the current dietary advice and challenges for adolescent nutrition.

Areas of agreement

Adolescence is a critical period of growth and development and adequate nutrition is essential. Sufficient population data indicate adolescents are not meeting dietary recommendations and are a vulnerable population group for malnutrition in all its forms.

Areas of controversy

Despite extensive studies on dietary risk factors and the global burden of disease and population data demonstrating inadequate nutritional intake in adolescent populations, few effective interventions and policies have been scaled up to support adolescent nutrition.

Growing points

Improving the diets of adolescents, especially vulnerable adolescents from low- and middle-income countries and socioeconomically disadvantaged backgrounds, has the potential to impact individuals, societies and economies.

Areas timely for developing research

Future research should focus on vulnerable adolescent populations by addressing food environments, food insecurity and ensuring effective programmes and strategies are integrated within broader adolescent health strategies and implemented into government policies.
Review of Methods Suitable for Environmental Surveillance of Salmonella Typhi and Paratyphi
Authors: Matrajt Graciela , Lillis Lorraine , Meschke J Scott
Published: April 2020

Typhoid fever is an enteric disease caused by the pathogens Salmonella Typhi and Salmonella Paratyphi. Clinical surveillance networks are lacking in many affected areas, thus presenting a need to understand transmission and population prevalence. Environmental surveillance (ES) has been suggested as a potentially effective method in the absence of (or in supplement to) clinical surveillance. This review summarizes methods identified in the literature for sampling and detection of typhoidal Salmonella from environmental samples including drinking water, wastewater, irrigation water, and surface waters. Methods described use a trap or grab sampling approach combined with various selective culture and molecular methods. The level to which the performance of identified methods is characterized for ES in the literature is variable, thus arguing for the optimization and standardization of ES techniques.
Status at the Margins: Why Paraguay Recognizes Taiwan and Shuns China
Authors: Long Tom , Urdinez Francisco
Published: April 2020

Why do some states choose to recognize de facto states, even when this involves potential costs? We explore this question through the case of Paraguay–Taiwan relations, arguing that Paraguay uses its diplomatic recognition policy for status seeking, which generates intangible and material benefits that offset the macroeconomic opportunity costs of foregone Chinese investment, aid and credit. We build an econometric model to estimate Paraguay's “Taiwan cost” and then develop a qualitative case study that draws on semi-structured interviews with actors in Paraguayan foreign policymaking to explain the domestic dynamics that underpin the relationship. We advance recent work on small states’ pursuit of international status by illustrating how small and de facto states follow different status-seeking rationales than those commonly recognized in the literature. We also build on that literature by exploring how elite structures shape status seeking. Though unusual, the case of Paraguay–Taiwan relations has broader implications for bilateral relationships with de facto states and status-seeking strategies of small states.
Trickle Down Soft Power: Do Russia's Ties to European Parties Influence Public Opinion?
Authors: Fisher Aleksandr
Published: April 2020

Do states’ partnerships with foreign elites influence international public opinion? During Russia's annexation of Crimea, the Kremlin strengthened its ties with far-left and far-right European parties—leading some European elites to express more explicit pro-Russian positions. This paper analyzes how these elite-level ties influence ordinary individuals’ foreign policy attitudes, offering insight into the conditions under which soft power “trickles down.” By leveraging public opinion data before and after the conflict in Crimea (2012–2017), and employing an estimation strategy that follows the same logic as a standard differences-in-differences strategy, I demonstrate that Russia's linkages with anti-establishment parties led to greater confidence in Vladimir Putin over time, but had limited impact on favorability toward Russia, the United States, and NATO. These findings have important implications for autocratic public diplomacy, our conceptualization of soft power, and Russian foreign policy.
Outcomes of a modified Bresler procedure for the treatment of rectocele with rectal intussusception
Authors: Deng Qun , Yu Kai-Lin , Liu Zhi-Yong , Shen Zhong , Wang Ya-Hui , Song Yong-Mao , Wang Chang-Jian , Xu Xiao-Ping , Wang Jian-Wei
Published: April 2020

Background

Obstructed defecation syndrome (ODS) is a condition that is frequently caused by rectocele and rectal intussusception. This study aimed to evaluate the effectiveness of a modified Bresler procedure for the treatment of ODS. The outcomes of this modified procedure were compared with the stapled transanal rectal resection (STARR) procedure.

Methods

We performed a retrospective analysis of the clinical data from 76 female patients who presented with ODS between June 2014 and June 2016. The patients were divided into two treatment groups, namely Modified and STARR. Patients in the Modified group (n = 36) underwent the modified Bresler procedure, which involved posterior rectal-wall resection using a circular tubular stapler with multilevel purse-string sutures. Patients in the STARR group (n = 40) underwent the standard STARR procedure. We analysed post-operative complications, Wexner constipation scores (WCS), rectocele depths, and four-point post-operative satisfaction scales.

Results

Patients in the Modified group exhibited shorter operative times and fewer post-operative complications (both P < 0.05). At 12 months post-operatively, both the Modified and STARR groups displayed a significant improvement in the Wexner constipation score and the depth of rectocele. The post-operative WCS for the Modified group were significantly improved compared to those for the STARR group (P < 0.05), while there was no significant difference in the rectocele depth between the two groups (P > 0.05). Post-operative interviews at post-operative 12 months showed that patients in the Modified group had a better satisfaction (P = 0.05).

Conclusions

Our modified procedure may be an effective treatment strategy for patients experiencing ODS caused by rectocele and rectal intussusception, with fewer complications and effective relief of symptoms.
Social cognitive theory as a guide for exercise engagement in persons with multiple sclerosis who use wheelchairs for mobility
Authors: Silveira Stephanie L , Richardson Emma V , Motl Robert W
Published: April 2020

Multiple sclerosis (MS) is an immune-mediated neurodegenerative disease of the brain, optic nerves and spinal cord. Among persons with MS, 30% experience significant mobility impairment that requires use of a wheelchair for mobility. Exercise is an evidence-based second-line therapy that can improve mobility; however, little research has focused on individuals that use wheelchairs for mobility. Framed by social cognitive theory (SCT), we conducted a formative qualitative study examining exercise status and perceptions among 20 persons with MS who use wheelchairs for mobility. Using deductive, semantic thematic analysis, we coded for SCT variables (i.e. self-efficacy, knowledge, outcome expectations, barriers and facilitators) and identified participants as regular or inconsistent exercisers. In total, 12 participants were classified as regular exercisers and 8 inconsistent exercisers. Regular exercisers more frequently reported high self-efficacy, consistent exercise knowledge and numerous facilitators. All participants reported some positive outcome expectations and several barriers and facilitators. These findings can inform future intervention studies supporting exercise behavior change through SCT. Strategies such as increasing self-efficacy, imparting instructional materials, shaping realistic outcome expectations and providing tools directed toward overcoming barriers and identifying facilitators may work to support the exercise endeavor of persons with MS who use wheelchairs for mobility.
Machine Learning Analysis of Blood microRNA Data in Major Depression: A Case-Control Study for Biomarker Discovery
Authors: Qi Bill , Fiori Laura M , Turecki Gustavo , Trakadis Yannis J
Published: April 2020

Background

There is a lack of reliable biomarkers for major depressive disorder (MDD) in clinical practice. However, several studies have shown an association between alterations in microRNA levels and MDD, albeit none of them has taken advantage of machine learning (ML).

Method

Supervised and unsupervised ML were applied to blood microRNA expression profiles from a MDD case-control dataset (n = 168) to distinguish between (1) case vs control status, (2) MDD severity levels defined based on the Montgomery-Asberg Depression Rating Scale, and (3) antidepressant responders vs nonresponders.

Results

MDD cases were distinguishable from healthy controls with an area-under-the receiver-operating characteristic curve (AUC) of 0.97 on testing data. High- vs low-severity cases were distinguishable with an AUC of 0.63. Unsupervised clustering of patients, before supervised ML analysis of each cluster for MDD severity, improved the performance of the classifiers (AUC of 0.70 for cluster 1 and 0.76 for cluster 2). Antidepressant responders could not be successfully separated from nonresponders, even after patient stratification by unsupervised clustering. However, permutation testing of the top microRNA, identified by the ML model trained to distinguish responders vs nonresponders in each of the 2 clusters, showed an association with antidepressant response. Each of these microRNA markers was only significant when comparing responders vs nonresponders of the corresponding cluster, but not using the heterogeneous unclustered patient set.

Conclusions

Supervised and unsupervised ML analysis of microRNA may lead to robust biomarkers for monitoring clinical evolution and for more timely assessment of treatment in MDD patients.
“Supermaids”: Hyper-resilient Subjects in Neoliberal Migration Governance
Authors: Chee Liberty
Published: April 2020

Resilience is a concept in world politics that emerged as a way to respond to the impossibility of guaranteeing security in an era of complexity. Without a central authority to provide security, risk is devolved to the individual. Those who cannot secure themselves are enjoined to constantly adapt to the unknown. Where control over complex systems is now thought to be impossible, the path to managing risks is through self-control. This paper demonstrates how such a subject is produced, and indeed whose production, I argue, is crucial to the functioning of a global labor market that is governed “without government.” Migrant domestic workers acutely instantiate the kind of human subjectivity called forth by neoliberalism—a “resilient subject.” The paper describes how this ideal worker is produced through resilience training in various stages of the migration trajectory—during recruitment, training prior to deployment, and while on their overseas residency. This paper demonstrates how managing the insecurities of migrant domestic work means working on the “self” rather than addressing gaps in legal or regulatory mechanisms. In resilience training, the worker becomes the necessary component of neoliberalism as a governmental rationality, one that is enjoined to transform risk into opportunity.
Interpreting the Uninterpretable: The Ethics of Opaqueness as an Approach to Moments of Inscrutability in Fieldwork
Authors: Kurowska Xymena
Published: April 2020

This paper develops what I call “the ethics of opaqueness” as a response to conceptual impasses concerning the uninterpretability of intersubjective knowledge production in narrative practice. The ethics of opaqueness sees the other as inscrutable and radically heterogenous, and confronts interpretations of the other by the self as suspicious projections. Thus, such an ethics addresses the self, not the other, as the object of the “hermeneutics of suspicion.” In order to conceptualize the ethics of opaqueness, I look to relational psychoanalysis, which understands the unconscious as being inherently intersubjective. This results in a reformulation of the process of recognition, and deeper acknowledgment of countertransference—that is, the partly unconscious conflicts activated in the researcher through the research encounter, which may lead to imposing meaning on the other. The apparatus of relational psychoanalysis concretizes the limits of knowing either the other or the self and supplies a vocabulary to crystallize the double quality of “uninterpretable moments” in narrative practice. They may trigger an imposition of a frame and therefore an interpretive closure; however, they also supply a potentially transformative space for the contentious co-construction of meaning, often in the form of metaphors, which subverts any claim to interpretive mastery.
The Nakba in a Livestream: Empathic Encounters and the Solidarity of Shared Precariousness
Authors: Givoni Michal
Published: April 2020

Since the summer of 2015, hundreds of Arab Palestinians from Israel have joined the massive number of volunteers who flocked to Greece and other locations in Europe to assist refugees from Syria, Iraq, Afghanistan, and other countries. Based on their stories about their experiences of volunteering, this essay examines how the affective regime of humanitarian action in crises mutates when such action is practiced by ordinary people who are living through their own protracted political crisis. Focusing on the empathy that Palestinian volunteers have practiced in their encounters with refugees, I show that the Palestinian relief actions and the solidarity of shared precariousness they embody challenge the premises of Western humanitarianism but also complicate the picture sketched by studies on “other humanitarianisms” from beyond the Western and universalist frame. I claim that empathy—one of the main humanitarian resources the Palestinian helpers have mobilized—has prompted a composite sense of affinity in which the similarities between the helpers and the refugees were both stressed and qualified. This affinity, as I further show, draws not just on the helpers’ traumatic memories and cultural and ethnic affiliations but also on their fears of the future.
Empirical assessment of bias in machine learning diagnostic test accuracy studies
Authors: Crowley Ryan J , Tan Yuan Jin , Ioannidis John P A
Published: April 2020

Objective

Machine learning (ML) diagnostic tools have significant potential to improve health care. However, methodological pitfalls may affect diagnostic test accuracy studies used to appraise such tools. We aimed to evaluate the prevalence and reporting of design characteristics within the literature. Further, we sought to empirically assess whether design features may be associated with different estimates of diagnostic accuracy.

Materials and Methods

We systematically retrieved 2 × 2 tables (n = 281) describing the performance of ML diagnostic tools, derived from 114 publications in 38 meta-analyses, from PubMed. Data extracted included test performance, sample sizes, and design features. A mixed-effects metaregression was run to quantify the association between design features and diagnostic accuracy.

Results

Participant ethnicity and blinding in test interpretation was unreported in 90% and 60% of studies, respectively. Reporting was occasionally lacking for rudimentary characteristics such as study design (28% unreported). Internal validation without appropriate safeguards was used in 44% of studies. Several design features were associated with larger estimates of accuracy, including having unreported (relative diagnostic odds ratio [RDOR], 2.11; 95% confidence interval [CI], 1.43-3.1) or case-control study designs (RDOR, 1.27; 95% CI, 0.97-1.66), and recruiting participants for the index test (RDOR, 1.67; 95% CI, 1.08-2.59).

Discussion

Significant underreporting of experimental details was present. Study design features may affect estimates of diagnostic performance in the ML diagnostic test accuracy literature.

Conclusions

The present study identifies pitfalls that threaten the validity, generalizability, and clinical value of ML diagnostic tools and provides recommendations for improvement.
Environment and the Law: The Normative Force of Context and Constitutional Challenges
Authors: Warnock Ceri
Published: April 2020

The inherent structural features of environmental problems cause environmental law to be written in a particular way and have led to the creation of novel adjudicative institutions, such as specialist environment courts and tribunals. But they also force us to view core constitutional principles, such as the rule of law and separation of powers, from different perspectives. By placing greater weight on certain components of these principles and lessening the force of others, solving environmental problems through law is rebalancing legal thought. Using New Zealand as a case study, this article explores how the legal infrastructure might respond to this contextual force by ensuring decision-making institutions operate with integrity and reflect public reasoned thoughtfulness, so fostering the rule of law within this unusual legal landscape.
Factors affecting enrollment in randomized controlled trials conducted for patients with metastatic breast cancer
Authors: Ohsumi Shozo , Mukai Hirofumi , Takahashi Masato , Hozumi Yasuo , Akabane Hiromitsu , Park Youngjin , Tokunaga Eriko , Takashima Tsutomu , Watanabe Takanori , Sagara Yoshiaki , Kaneko Tetsuji , Ohashi Yasuo
Published: April 2020

Background

It is critical to obtain informed consent from eligible patients to complete clinical trials. We investigated the factors that affect the participation rates of eligible patients.

Patients and methods

Patients with metastatic breast cancer who were eligible for SELECT BC or SELECT BC-CONFIRM trials, randomized controlled trials conducted for patients with chemotherapy-naive metastatic breast cancer were recruited to prospective studies, SELECT BC-FEEL and SELECT BC-FEEL II, respectively. SELECT BC FEEL and SELECT BC-FEEL II were conducted to identify the factors affecting the rates at which informed consent was obtained, using a self-administered questionnaire we developed.

Results

In total, 232 patients participated in the studies. The patients who agreed to take part in the randomized trials were more likely than the refusers to answer that they decided to participate because: ‘My doctor wanted me to participate in this trial’ (P = 0.00000), ‘ My family or friends wanted me to participate in this trial’ (P = 0.00000), ‘Both treatment regimens used in the trial are suitable to me’ (P = 0.00383), ‘I know that the trial is conducted to determine which is a better treatment’ (P = 0.01196), and ‘ I think that my participation in the trial will contribute to the benefit to future patients with the same disease’ (P = 0.00756).

Conclusions

To enhance the consent rate in randomized trials of metastatic breast cancer patients, concepts of the trials must be considered important and acceptable not only by patients but also by doctors and their families.
Modification of the Cervical Transforaminal Epidural Steroid Injection Technique Based Upon the Anatomic Angle of the Superior Articular Process on MRI
Authors: Levi David , Horn Scott , Murphy Jestine , Smuck Matt , Levin Josh
Published: April 2020

Objective

A modification of the conventional technique for cervical transforaminal epidural steroid injection (CTFESI) has been developed. This technique may, theoretically, decrease the likelihood of the needle encountering the vertebral artery and spinal nerve. The approach uses angle measurements of the superior articular process ventral surface from the patient’s axial MRI as a guide for fluoroscopic set-up and needle trajectory. This report aims to compare contrast flow patterns of the modified approach with those of the conventional technique.

Design

Retrospective chart review and prospective blinded analysis of contrast flow patterns. Setting. Outpatient interventional physiatry practice.

Methods

A retrospective blinded qualitative review of fluoroscopic images was performed to compare contrast flow patterns of CTFESIs performed using the modified approach with those using the conventional technique. A detailed description of the modified approach is provided in this report.

Results

Ninety-seven CTFESI procedures were used for flow analysis. The modified approach resulted in a statistically significant greater percentage of injections with epidural flow: 69% [95% CI = 57–82%] modified approach vs. 42% [95% CI = 28–56%] conventional approach. The modified technique also showed a statistically significant higher percent of injections categorized as having an ideal flow pattern, that of predominate epidural and/or intraforaminal flow: 65% [95% CI = 52–78%] vs. 27% [95% CI = 14–40%].

Conclusions

A modification of the conventional CTFESI technique, developed for the purpose of improved safety, may provide superior contrast flow patterns when compared to the conventional approach.
Economic crisis, social networks, and political preferences
Authors: Liu Lisha , Kuo Alexander , Fernandez-Albertos Jose
Published: April 2020

How did the great recession affect policy and partisan preferences in the most afflicted countries? We theorize the role of a previously under-emphasized source of preferences: the size and scope of one’s exposure to other individuals who have been exposed to the crisis. Contact with others who have economically suffered should be an additional channel for the crisis’ effects on policy preferences. We gathered data during the recession from a crisis-hit country, Spain, to measure the size of the respondent’s social networks in different ways and the impact of the crisis upon them. We also measured a battery of policy and political preferences (support for austerity, the euro, supranational institutions and new parties). We find strong associations between support for anti-status quo policies and anti-establishment parties and exposure to economic suffering within one’s social networks in ways that enrich our understanding of the process of preference formation in times of crisis.
Evaluation of hepatic fibrosis by elastography in patients with schistosomiasis mansoni
Authors: Lima Leila Maria Soares Tojal de Barros , Lacet Celina Maria Costa , Viana Mônica Salum Valverde Borsoi , da Costa Bernadete de Lourdes Novais , Parise Edison Roberto
Published: April 2020

Background

Periportal fibrosis is associated with the main complications of schistosomiasis mansoni. The usefulness of hepatic transient elastography (TE) in its evaluation remains to be clarified.

Methods

We conducted a cross-sectional study of schistosomal patients, where the measurements obtained by FibroScan TE were correlated with the degree of liver fibrosis according to the Niamey sonographic protocol, adopted as the gold standard, and its performance was calculated as the area under the receiver operating characteristics curve (AUROC).

Results

A total of 117 of 141 adult schistosomiasis patients from endemic areas were selected between May and August 2015. Applying the Niamey protocol, the patients were regrouped into absent fibrosis (A; 34.2%), mild to moderate fibrosis (MM; 27.4%) and intense fibrosis (I; 38.5%). The median of the TE values in the patients of group A was 4.7 kPa, the group MM 9.3 kPa and the group I 10.3 kPa. There was a difference in the TE values between the group A and the groups MM and I (p < 0.05). The TE also presented strong and direct correlation with the clinical form (r ≥ 0.77). The AUROC value to define the presence of fibrosis was 0.92 and for significant fibrosis was 0.79, with cut-offs of 6.1 kPa and 8.9 kPa, respectively.

Conclusions

In this study, the TE was effective in the diagnosis of schistosomal fibrosis, being able to identify the advanced forms of the disease and thus predict the risk of clinical complications in endemic regions.
Identification of Cervical Human Papillomavirus by Self-Collection in Grenada [OP02-6B]
Authors: Manglardi Erin E. , Lendore Jessica , Balhotra Kimen , Bahadoor-Yetman Avi , Fields Paul J. , McGill Frances Mary
Published: April 2020

INTRODUCTION:

Cervical cancer and Human Papillomavirus (HPV) screening with the Papanicolaou (Pap) smear/cervical cytology is widely accessible, however, it’s underutilized in developing countries worldwide. A self-sampling device evaluated in Grenada in 2017 was determined to be acceptable to women, and adequate in obtaining and evaluating cervical cells. Additionally, testing for Human Papillomavirus (HPV), the precursor for the development of cervical cancer, was performed.

METHODS:

Following IRB approval, women were recruited to the St. George’s University clinic in St. George’s, Grenada. Two cervical samples were obtained from each woman: one via the self-sampling device, and one by a physician. With informed consent, 101 women provided samples, of which the first isolate was tested for the presence of HPV DNA. If HPV was identified, it was further subtyped.

RESULTS:

HPV was detected in 49/101 (48%) samples: 25/50 (50%) from physician obtained samples and 24/51 (47%) via the self-sampling device. The difference in detection rates was not statistically significant. A total of 24 different genotypes were detected, and classified into low-risk, high-risk or mixed. Women with abnormal results were appropriately evaluated by close follow-up, colposcopy or biopsy.

CONCLUSION:

The self-screening device was adequate in obtaining cervical cells with co-testing for HPV. In a group of self-referred women living in Grenada, results showed additional HPV genotypes to the usual 6, 11, 16 & 18 commonly described in the literature. Self-sampling may be an effective method of identifying HPV in a developing country, conserving limited resources for further evaluation of women at risk.
Testicular Sperm Extraction Versus Ejaculated Sperm Use for Non-azoospermic Male Factor Infertility [OP02-7B]
Authors: Kim Tana , Rauchfuss-Kendall Lauren , Bleess Jessica , Shenoy Chandra
Published: April 2020

INTRODUCTION:

Testicular sperm extraction (TESE) has traditionally been reserved for couples with azoospermia. However, recent data suggests TESE may be beneficial for men with abnormal semen parameters without azoospermia. The objective of this study was to compare in vitro fertilization (IVF) outcomes between TESE and ejaculated sperm (ES) for non-azoospermic male factor infertility.

METHODS:

Following IRB exemption, couples undergoing IVF for non-azoospermic male factor infertility with total motile sperm (TMS) <25 million motile/ejaculate from 1/2016 to 1/2019 were included. Men were grouped by whether TESE or ES was utilized for insemination. Couple characteristics and cycle outcomes were analyzed. Wilcoxon rank sum and Fisher exact tests were utilized as appropriate. Values are reported in medians.

RESULTS:

The analysis included 36 men who utilized ES and 23 men who utilized TESE. The median female age was 32 while the median male age was 35 with ES and 37 with TESE. TMS (6.1 vs 3.9 million motile/ejaculate, P=.46), motility (40% vs 30%, P=.07), and strict morphology (2.5% vs 1.0%, P=.15) were similar between ES and TESE. The total mature oocytes retrieved was similar between the groups but compared to ES, TESE was associated with 20% decrease in fertilization (80.6% vs 60.0%, P=.02) and half the number of blastocyst embryos (4 vs 2 embryos, P=.02). Although not statistically significant, TESE also had >10% decrease in live birth (48.5% vs 36.8%, P=.56).

CONCLUSION:

TESE is associated with lower fertilization and blastocyst embryos as well as decreased live birth rates compared to ES use for non-azoospermic male factor infertility.
Use of Medicaid Coverage for Abortion Is Associated With Improved Abortion Access [OP03-3C]
Authors: McDonnell Jill , Vinekar Kavita
Published: April 2020

INTRODUCTION:

Low income women disproportionately face barriers to abortion access. It remains unknown whether Medicaid coverage for abortion improves abortion access measures.

METHODS:

We performed a secondary analysis of the 2014 Guttmacher Abortion Patient Survey. Respondents were included if they selected “Medicaid” as their primary insurance. The exposure was self-report of using Medicaid to pay for the abortion. NARAL state legislative classifications and patient demographics were used as covariates. Chi-square testing and t-tests for unequal variance were used for categorical and continuous variables, respectively. Multivariate regression was performed for the primary outcome of >7 days wait time between decision for abortion and abortion appointment. All statistical analysis was performed in StataSE v15. This study was IRB exempt.

RESULTS:

Of 2,549 respondents on Medicaid, 1,482 had Medicaid coverage for their abortions and 1,067 did not. Patients with Medicaid coverage had their abortions at an earlier gestational age (8.61 vs. 8.94 weeks, P=.02). Patients using Medicaid for abortion had shorter mean wait times (3.84 vs. 4.37 days, P=.01), traveled less time (32.15 vs. 48.63 minutes, P<.0001) and shorter distances (28.62 vs. 42.91 miles, P=.0003) for their abortions, and were less likely to cross state lines (0.81% vs 7.97%, P < .0001). Patients with Medicaid coverage for abortion were less likely to wait >7 days (83.14% vs. 86.97%, P=.008), which remained true in multivariate regression with OR 0.71 (CI 0.51-0.99).

CONCLUSION:

Utilization of Medicaid coverage for abortion is associated with increased abortion access, as evidenced by decreased wait times, earlier gestational ages, and decreased travel measures.