bluuebunny/crossref_metadata_2025_split huggingface dataset:
Hedging between the United States and China? South Korea’s ideology-driven behavior and its implications for national security
Authors: Kim Min-hyung 
Published: September 2021

Abstract
Given the limits of the prevailing hedging account for Seoul’s puzzling behavior that is in conformity with the interests of its adversary (i.e. North Korea) and potential threat (i.e. China) rather than those of its principal ally (i.e. the United States) and security cooperation partner (i.e. Japan), this article emphasizes the impact of the progressive ideology on Seoul’s security policy. In doing so, it calls for attention to a domestic source of ideology in explaining the security behaviors of a secondary state, which is under-researched and thus is poorly understood.
Access to Whose Justice? Survivor-Centered Justice for Sexual and Gender-Based Violence in Northern Shan State
Authors: Oo Phyu Phyu , Davies Sara E 
Published: September 2021

Abstract
In 2019, the United Nations (UN) Security Council adopted Resolution 2467. The resolution was to encourage the international system to promote a survivor-centered response to conflict-related sexual violence. The role of local women-led civil society organizations has been identified as the crucial “first-response” mechanism to institute survivor-centered justice. In a situation of ongoing conflict, what agency do civil society organizations have to safely operate “first-response” survivor-centered justice? In this article, we examine the local practices of responding to conflict-related sexual violence in northern Shan State in Myanmar. This article finds that women-led local civil society organizations are indeed crucial first responders and a vital resource for promoting survivor-centered justice-seeking practices. The article also identifies the compromises and risks these civil society organizations experience that limit their agency to deliver survivor-centered justice. Local civil society organizations are constantly navigating local gendered norms, a patriarchal, unrepresentative formal legal system, and a hostile conflict environment. The positionality of local civil society organizations to local armed ethnic organizations and the state itself requires strategic consideration by the international community when recommending local civil society to deliver survivor-centered justice.
Opportunity for Gendering the Responsibility to Protect Agenda at the United Nations?
Authors: Stefan Cristina G 
Published: September 2021

AbstractDespite its rapid diplomatic rise in the UN setting and global recognition as an established norm, the Responsibility to Protect (R2P) has yet to substantially incorporate gender and directly engage with the complementary Women, Peace, and Security (WPS) agenda. The article discusses this R2P limitation and ways to rectify it through capitalizing on a landmark UN annual report on R2P and cross-cutting areas of engagement with the WPS agenda. To do so, the article proceeds in three sections that mirror the three-pronged classification of overlapping knowledge projects identified for early feminist scholarship. First, the article exposes the extent and effect of masculinist bias in early R2P formulations and R2P's failure to engage explicitly with gender perspectives until the pathbreaking twelfth annual report on R2P. Second, the complementarities between the WPS, gender equality, and R2P are examined in order to highlight the commonalities seen when “adding women” to these agendas. Third, the article examines what gendering the R2P agenda at the United Nations would entail through a reconstruction of R2P that recognizes gender as an analytical and structural category. It is argued that while the progressive 2020 Annual Report on R2P will likely become the reference point for weighing what a gendered R2P agenda should look like, and will hopefully trigger a much-needed reorientation of existing R2P policies as gender-responsive, limitations remain due to three factors: the lack of gender-sensitive analysis at the United Nations, lingering analytical tensions between the WPS and R2P communities, and the current politically resistant climate, which limits a gender audit.
Introduction: WPS 20 Years On: Where Are the Women Now?
Authors: Newby Vanessa F , O'Malley Alanna 
Published: September 2021

ABSTRACTTo commemorate the twentieth anniversary of Resolution 1325, this introduction discusses the state of the field in the women peace and security (WPS) agenda and outlines the challenges to implementation. It begins by introducing the current gaps we see in WPS practice, many of which are driven by insufficient data and lack of funding. The section that follows provides a brief discussion of the global diffusion of the WPS agenda. We highlight the important contribution the Global South has made in implementing the agenda in the absence of great power leadership and the stultified progress of the Global North. We argue that the WPS agenda remains hampered by poor national implementation, a lack of support for civil society initiatives and a failure to recognize the importance of its application in context. The final section introduces the articles in this issue, showing how they advance an emerging human security agenda: integrating WPS into UN-led security initiatives like R2P, and the challenges of the implementation of the WPS agenda in varied local and national contexts. We conclude by arguing that to meet future challenges, the WPS agenda must be broadened to include areas outside traditional conceptions of security and embrace the full remit of evolving security threats; in particular, structural barriers that prevent the empowerment of women across the board.
Practice Theory and the Opening Up of International Organizations
Authors: Holthaus Leonie 
Published: September 2021

Abstract
Scholars researching international organizations’ (IO) inclusion of transnational and local civil society organization (CSO) have provided compelling insights; however, according to their self-evaluation, many of these insights remain at a general level. Against this backdrop, I propose two complementary claims. First, I identify a bias in the literature that has focused on large, Western IOs. What non-Western or small IOs do and how their practices interact with CSO inclusion in different localities is often missed. Second, based on bourgeoning practice theoretical literature on IOs and CSOs, I claim that practice theory can add to research on IO-CSO. In spite of internal pluralism, practice theory refines constructivist methodologies for zooming in on IOs’ internal dynamics, daily practices, and performances of the practice of CSO inclusion, including in IO country offices. On the basis of my own field research, I also suggest that the practice of CSO inclusion interacts with power, gender, and race dynamics. In sum, practice theory can inform research on marginalized and often power-ridden specificities among and within IOs in relation to IO-CSO interaction.
Partisan Technocrats: How Leaders Matter in International Organizations
Authors: Copelovitch Mark , Rickard Stephanie 
Published: September 2021

AbstractInternational organizations make policy decisions that affect the lives of people around the world. We argue that these decisions depend, in part, on the political ideology of the organization's chief executive. In this study, we investigate the influence of the leader of one of the most powerful international organizations: the Managing Director of the International Monetary Fund (IMF). We find that when the Managing Director is politically left of center, the IMF requires less labor market liberalization from borrowing countries in exchange for a loan. We also find evidence suggesting that the Managing Director's influence on labor-related loan conditions is independent of the Fund's most powerful members, including the United States. While Managing Directors rarely engage in overtly political behavior, they appear to act as “partisan technocrats” whose ideology influences international financial rescues and specifically the conditions attached to countries’ loans, which shape the distributive consequences of IMF lending.
Refugees or Illegal Immigrants: The Problem of the Group in Refugee Protection
Authors: Innes Alexandria J 
Published: September 2021

ABSTRACTThis research excavates the case of Jewish refugees in Cyprus between 1946 and 1948. I argue that this case is formative of the development not just of the refugee, but—perhaps more interestingly—of the concept of “illegal immigration,” which relies on the constructed impossibility of group-based refugee protection. I contend that there is a paradox residing at the heart of the 1951 Refugee Convention definition of a refugee that produces the refugee as a singular victim while supporting the very conditions that create that victimhood—that is, persecution targeted at an identity group where the persecution is motivated by the shared identity (defined in the Refugee Convention by race, religion, nationality, membership of a particular social group, or political opinion). As the architecture of international human rights was built, the refugee definition was drafted in a way that embedded group-based exclusion in the design of the definition. I exemplify this through the case of Jewish refugees attempting to reach British Mandate Palestine in the 1940s, who were intercepted and detained in Cyprus. The case is worthy of attention because it exposes the absence of group protection in the refugee definition and the effect of that absence: a group is constituted as a threat and cannot be defined collectively as refugees. Instead, they become “illegal immigrants.” This case study of Jewish detention in Cyprus provides a key empirical example of oppression residing inside a historically liberal movement and in the resulting conditions of refugee protection.
Drilling Down in Norm Diffusion: Norm Domestication, “Glocal” Power, and Community-Based Organizations in Global Health
Authors: Restoy Enrique , Elbe Stefan 
Published: September 2021

ABSTRACTNorm diffusion scholarship analyzes how states come to agree and adopt new international norms. Yet, formal adoption of a new norm does not in itself guarantee that a government will also implement it domestically, and very little international relations scholarship drills down deep enough to examine whether and how new international norms are subsequently integrated, incorporated, and translated at sub-state level. This article initiates a research agenda on norm “domestication” through the first in-depth study of how international norms in the field of global health are locally incorporated by community-based organizations (CBOs). Drawing upon multi-sited international fieldwork in Uganda, Ukraine, and El Salvador, the paper uncovers three norm domestication strategies used by CBOs of people affected by HIV/AIDS: harnessing political divisions within national governments, circumventing government policy with international help, and mounting legal challenges to government policy. The article argues that these CBO strategies represent “glocal” forms of power capable of forging local–global connections through combined practices of norm allying, norm implementation, and norm intertwining. These subtler processes of norm domestication, the article concludes, ultimately require a reconceptualization of norm diffusion not just as a transnational phenomenon, but as a “multi-local” process during which norms are concurrently localized across diverse geographic locales.
Levofloxacin pharmacodynamics against Stenotrophomonas maltophilia in a neutropenic murine thigh infection model: implications for susceptibility breakpoint revision
Authors: Fratoni Andrew J , Nicolau David P , Kuti Joseph L 
Published: September 2021

Abstract

Background
Levofloxacin displays in vitro activity against Stenotrophomonas maltophilia (STM); however, current susceptibility breakpoints are supported by limited data. We employed the murine neutropenic thigh infection model to assess levofloxacin pharmacodynamics against STM.

Methods
Twenty-six clinical STM were studied using the neutropenic murine thigh infection model. Human simulated regimens (HSR) of levofloxacin 750 mg q24h were administered over 24 h. Efficacy was measured as the change in log10 cfu/thigh at 24 h compared with 0 h. Composite cfu data were fitted to an Emax model to determine the fAUC/MIC needed for stasis and 1 log10 reduction at 24 h. Monte Carlo simulation was performed to determine PTA.

Results
Levofloxacin MICs ranged from 0.5–8 mg/L. Mean bacterial burden at 0 h was 6.21 ± 0.20 log10 cfu/thigh. In the 24 h controls, bacterial growth was 1.64 ± 0.66 log10 cfu/thigh. In isolates with levofloxacin MICs ≤1, 2 and ≥4 mg/L, changes in bacterial density following levofloxacin HSR were −1.66 ± 0.89, 0.13 ± 0.97 and 1.54 ± 0.43 log10 cfu/thigh, respectively. The Emax model demonstrated strong agreement between fAUC/MIC and change in bacterial density (R2 = 0.82). The fAUC/MIC exposure needed for stasis and 1 log10 reduction was 39.9 and 54.9, respectively. PTAs for the 1 log10 reduction threshold were 95.8, 72.2, and 26.6% at MICs of 0.5, 1 and 2 mg/L, respectively.

Conclusions
These are the first data to describe fAUC/MIC thresholds predictive of cfu reductions for levofloxacin against STM. Due to poor in vivo efficacy and PTA at MICs ≥2 mg/L, reassessment of the current susceptibility breakpoint is warranted.
Gastric acid suppression, lifestyle factors and intestinal carriage of ESBL and carbapenemase-producing Enterobacterales: a nationwide population-based study
Authors: Willems Roel P J , van Dijk Karin , Dierikx Cindy M , Twisk Jos W R , van der Klis Fiona R M , de Greeff Sabine C , Vandenbroucke-Grauls Christina M J E 
Published: September 2021

Abstract

Background
Gastric acid-suppressive therapy has been suggested to increase the risk for intestinal carriage of MDR Enterobacterales, but there is scarce community-based evidence substantiating this risk.

Objectives
To investigate if acid-suppressant use is associated with a risk of intestinal carriage of ESBL and carbapenemase-producing Enterobacterales (ESBL-E) in the open population, and to assess possible modifying factors.

Methods
Within the framework of a nationwide seroprevalence study, we identified a population-based cross-sectional cohort comprising 2746 adults (≥18 years), who provided stool specimens between February 2016 and June 2017. Specimens were tested by phenotypic assays and confirmatory genotype analysis to detect carriage of ESBL-E. Covariate data were extracted from self-administered questionnaires. ORs and 95% CIs were estimated using multivariable multilevel logistic regression, controlling for confounders informed by directed acyclic graphs.

Results
Among 2746 participants, 316 (11.5%) used acid suppressants; the prevalence of ESBL-E carriage was 7.4% (95% CI, 6.1%–8.6%). Current use of acid suppressants was not associated with ESBL-E carriage (adjusted OR [aOR], 1.05; 95% CI, 0.64–1.74); lifestyle and comorbidity did not modify this association. A higher BMI (≥25 kg/m2) (aOR, 1.42 [95% CI, 1.02–1.98]), non-Western ethnic origin (aOR, 1.96 [95% CI, 1.34–2.87]), travel to Eastern-Mediterranean, Western-Pacific or South-East Asia regions (aOR, 3.16 [95% CI, 1.71–5.83]) were associated with ESBL-E carriage. Sensitivity analyses confirmed these results; spline analysis supported a BMI-associated risk.

Conclusions
In this open population study, current use of acid suppressants was not associated with ESBL-E carriage. Travel to high-endemic regions and non-Western ethnicity were confirmed as risk factors, while a higher BMI emerged as a potential new risk for ESBL-E carriage.
Outcome selection in primary care antimicrobial stewardship research
Authors: Gágyor Ildikó , Hay Alastair D 
Published: September 2021

Abstract
Clinical and antimicrobial stewardship (AMS) outcomes are highly relevant to pragmatic primary care trials, reflecting aspects, such as persistent symptoms and relapses, or antibiotic use and antimicrobial resistance. Sometimes both can be equally important. We present evidence demonstrating the wide range of outcome measures used in previous primary care trials and observe that there are no agreed standards for their design. We describe AMS interventions and outcomes in terms of intervention types and targets, and we make recommendations for future research designs. Specifically, we argue that: (i) where co-primary outcomes are considered appropriate, investigators should pre-specify interpretation of conflicting results; (ii) intervention evaluation should ensure prescriptions from sources outside of the usual provider are included in any AMS effectiveness measure; (iii) where possible, outcomes should include antimicrobial resistance; (iv) in some contexts, it may be necessary to include the antibiotics used within the intervention as part of the outcome; and (v) patient involvement is needed to establish the principles investigators should use when deciding whether the AMS or clinical outcomes should be prioritized.
Compliance with the 4Ds of antimicrobial stewardship practice in a tertiary care centre
Authors: Dixit Diksha , Ranka Rajat , Panda Prasan Kumar 
Published: September 2021

Abstract

Background
Antimicrobial stewardship describes the practice of promoting the selection of the right drug, dosage, delivery and duration of antimicrobial therapy (the 4Ds) in order to curtail the emergence of resistant organisms. It is important to quantify the inappropriate use of antimicrobials in terms of percentage adherence to each of the 4Ds mentioned.

Methods
We undertook a prospective review of medical records of patients admitted to the medical wards of a tertiary care centre in North India. All patients on antimicrobials were included and their records reviewed for indication, drug, dose, delivery and duration (or by asking the treating physician if not documented). Adherence to the 4Ds was determined by referring to updated literature-based standard treatment guidelines (STGs) for each specific disease.

Results
Of 304 patients, drugs were appropriate and matched STGs in 218 (72%) patients, with adherence to the right dose in 210 (69%), route of delivery in 216 (71%) and duration in 197 (65%). Full adherence to the 4Ds was observed in 196 (64.5%). Maximum adherence was observed in treating skin and soft tissue infections (100%), while minimum adherence was observed in administering medical prophylaxis (40%). WHO Access, Watch and Reserve categories comprised 29%, 63% and 8.5% of all prescribed antibiotics, respectively.

Conclusions
The right drug, dose, delivery and duration of therapy are prescribed in 72%, 69%, 71%, and 65% of patients, respectively. In order to increase the adherence to 100%, bedside stewardship practices in the form of prospective audits and feedback must be improved. There is a need to integrate WHO AWaRe classification of antibiotics into treatment guidelines.
Autoimmune Encephalitis and Autoantibodies: A Review of Clinical Implications
Authors: Hébert Julien , Muccilli Alexandra , Wennberg Richard A , Tang-Wai David F 
Published: September 2021

Abstract

Background
Autoimmune encephalitis (AE) is a common cause of encephalitis. We review the most recent evidence on this neuroimmune condition and autoantibody testing currently available.

Content
Clinical criteria, neuroimaging and electroencephalography can facilitate the diagnosis of AE prior to obtaining autoantibody testing results, and lead to a diagnosis of AE even in the absence of a recognized antibody. Early treatment of AE has been found to correlate with improved long-term functional and cognitive outcomes. We suggest a clinical approach to diagnosis based on the predominant area of nervous system involvement and the results of ancillary testing that are widely available. We also propose a 2-tiered approach to the acute management of probable or definite AE. We, finally, provide guidance on the long-term management of AE—a challenging and understudied area.

Summary
Much work remains to be done to improve the care of patients with AE. As understanding of the pathophysiology and predisposing factors underlying this condition steadily increases, a more evidence-based, targeted approach to the treatment of AE is still desired. Nonetheless, looking at the progress made over the past 2 decades, since the discovery of the first autoantibodies associated with AE, one cannot help but feel optimistic about the road ahead.
Toward an inclusive digital health system for sexual and gender minorities in Canada
Authors: Antonio Marcy , Lau Francis , Davison Kelly , Devor Aaron , Queen Roz , Courtney Karen 
Published: September 2021

Abstract
Most digital health systems (DHS) are unable to capture gender, sex, and sexual orientation (GSSO) data beyond a single binary attribute with female and male options. This binary system discourages access to preventative screening and gender-affirming care for sexual and gender minority (SGM) people. We conducted this 1-year multi-method project and cocreated an action plan to modernize GSSO information practices in Canadian DHS. The proposed actions are to: (1) Envisage an equity- and SGM-oriented health system; (2) Engage communities and organizations to modernize GSSO information practices in DHS; (3) Establish an inclusive GSSO terminology; (4) Enable DHS to collect, use, exchange, and reuse standardized GSSO data; (5) Integrate GSSO data collection and use within organizations; (6) Educate staff to provide culturally competent care and inform patients on the need for GSSO data; and (7) Establish a central hub to coordinate efforts.
ATLAS: an automated association test using probabilistically linked health records with application to genetic studies
Authors: Zhang Harrison G , Hejblum Boris P , Weber Griffin M , Palmer Nathan P , Churchill Susanne E , Szolovits Peter , Murphy Shawn N , Liao Katherine P , Kohane Isaac S , Cai Tianxi 
Published: September 2021

AbstractObjectiveLarge amounts of health data are becoming available for biomedical research. Synthesizing information across databases may capture more comprehensive pictures of patient health and enable novel research studies. When no gold standard mappings between patient records are available, researchers may probabilistically link records from separate databases and analyze the linked data. However, previous linked data inference methods are constrained to certain linkage settings and exhibit low power. Here, we present ATLAS, an automated, flexible, and robust association testing algorithm for probabilistically linked data.Materials and MethodsMissing variables are imputed at various thresholds using a weighted average method that propagates uncertainty from probabilistic linkage. Next, estimated effect sizes are obtained using a generalized linear model. ATLAS then conducts the threshold combination test by optimally combining P values obtained from data imputed at varying thresholds using Fisher’s method and perturbation resampling.ResultsIn simulations, ATLAS controls for type I error and exhibits high power compared to previous methods. In a real-world genetic association study, meta-analysis of ATLAS-enabled analyses on a linked cohort with analyses using an existing cohort yielded additional significant associations between rheumatoid arthritis genetic risk score and laboratory biomarkers.DiscussionWeighted average imputation weathers false matches and increases contribution of true matches to mitigate linkage error-induced bias. The threshold combination test avoids arbitrarily choosing a threshold to rule a match, thus automating linked data-enabled analyses and preserving power.ConclusionATLAS promises to enable novel and powerful research studies using linked data to capitalize on all available data sources.