bluuebunny/crossref_metadata_2025_split huggingface dataset:
Current dietary advice and challenges for adolescents
Authors: Partridge Stephanie R 
Published: April 2020

Abstract

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

Abstract
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

AbstractWhy 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

Abstract
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

Abstract

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 &lt; 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 &lt; 0.05), while there was no significant difference in the rectocele depth between the two groups (P &gt; 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

AbstractMultiple 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

Abstract

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

AbstractResilience 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

AbstractThis 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

AbstractSince 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

Abstract

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

Abstract
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

Abstract

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

AbstractObjectiveA 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.DesignRetrospective chart review and prospective blinded analysis of contrast flow patterns. Setting. Outpatient interventional physiatry practice.MethodsA 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.ResultsNinety-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%].ConclusionsA 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

Abstract
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.