Standing on the shoulders of tech giants: Media delivery, streaming television, and the rise of global suppliers

This article uses the case study of Internet Protocol (IP) delivery for streaming television to demonstrate how technology and globalization combine to change what media firms do, how they create value, and with whom. Media delivery - the sum of the value-adding tasks necessary to transfer content from source to audience - has become a mosaic of technologies that sustain a complex and fast-evolving video ecosystem. Broadcasters had been in charge of the full transmission process once, of tasks deemed core to their business. Today, media delivery is externalized to the market and devolved to a network of suppliers. These suppliers are no ordinary firms, but tech giants that have developed deep global capabilities. They gain further leverage by being cross-sectoral, serving clients across multiple industries. Who are these suppliers? What makes them unique? And what are the implications for the television industry

Towards an analytics of mediation

In this paper I discuss a framework for the analysis of media discourse - the 'analytics of mediation' - that takes into account the embeddedness of media texts both in technological artefacts and in social relationships and, hence, seeks to integrate the multi-modal with the critical analysis of discourse. On the methodological level, the analytics of mediation applies a multi-modal discourse analysis onto media texts in order to study their visual and linguistic properties: camera/visual; graphic/pictorial or aural/linguistic. On the social theory level, the analytics of mediation addresses critical concerns on the ethical and political role of television and other media in our 'global village'. Can television foster a cosmopolitan consciousness or does its 'fake proximity' alienate the spectator from the rest of the world? Can we talk about the media as agents of global citizenship or do the media lead to compassion fatigue - a Western denial of humanitarian problems? I illustrate such questions by drawing on one concrete example of television news

Multi-institutional review of the preoperative diagnostic accuracy for pediatric ovarian mature cystic teratomas

Study objective: To assess the preoperative imaging impression and surgeon diagnostic accuracy for pediatric ovarian mature cystic teratomas (MCTs) DESIGN: Retrospective review SETTING: Eleven pediatric hospitals PARTICIPANTS: Patients ages 2 to 21 who underwent surgical management of an ovarian neoplasm or adnexal torsion with an associated ovarian lesion INTERVENTION: None MAIN OUTCOME MEASURES: Preoperative imaging impression, surgeon diagnosis, tumor markers, and pathology RESULTS: Our cohort included 946 females. Final pathology identified 422 (45%) MCTs, 405 (43%) other benign pathologies, and 119 (12%) malignancies. Preoperative imaging impression for MCTs had a 70% sensitivity, 92% specificity, 88% positive predictive value (PPV), and 79% negative predictive value (NPV). For the preoperative surgeon diagnosis, sensitivity was 59%, specificity 96%, PPV 92%, and NPV 74%. Some measures of diagnostic accuracy were affected by the presence of torsion, size of the lesion on imaging, imaging modality, and surgeon specialty. Of the 352 masses preoperatively thought to be MCTs, 14 were malignancies (4%). Eleven patients with inaccurately diagnosed malignancies had tumor markers evaluated and 82% had at least 1 elevated tumor marker, compared with 49% of those with MCTs. Conclusions: Diagnostic accuracy for the preoperative imaging impression and surgeon diagnosis is lower than expected for pediatric ovarian MCTs. For all ovarian neoplasms, preoperative risk assessment including a panel of tumor markers and a multidisciplinary review is recommended. This process could minimize the risk of misdiagnosis and improve operative planning to maximize the use of ovarian-sparing surgery for benign lesions and allow for appropriate resection and staging for lesions suspected to be malignant