dataesr/scientific-paragraphs-categorization huggingface dataset:
Library Trusted evidence. Informed decisions. Better health. Cochrane Database of Systematic Reviews • Other clinical characteristics (e. g. morbidities such as cardiovascular diseases, diabetes, psychiatric disorders) • Socioeconomic status (e. g. occupational status; education; income; food insecurity; welfare receipt) • Summary risk of bias These participant characteristics cover several categories of social di erentiation relevant to health equity, namely: age, ethnicity, gender, occupation, education, income and other proxy measures of socioeconomic status. The incorporation of study-level data on these participant characteristics into our proposed metaregression analysis (see 'Data synthesis') was in part intended to enable us to interpret any di erential e ects through a health equity lens (Welch 2012) (see also Objectives 2c).
Cochrane Database of Systematic Reviews For included studies that investigated a size manipulation, we always coded exposure to the larger of the two portions, packages, individual units or items of tableware as the intervention, whilst we always coded exposure to the smaller of the two as the comparator. For included studies that investigated a shape manipulation, we always coded exposure to the shorter, wider of the two items of tableware as the intervention, whilst we always coded exposure to the taller, narrower of the two as the comparator. For all outcome data we collected information on: outcome variable type (in practice, this was invariably continuous); outcome variable definition; unit of measurement (natural units); specific metric (final values, change from baseline); method of aggregation (mean); timing of measurement (immediate (that is, ≤ 1 day) or longer-term (that is, > 1 day)); and type of measure (objective, self report).
Library Trusted evidence. Informed decisions. Better health. Cochrane Database of Systematic Reviews experts' knowledge of theory and evidence for determinants of between-person variation in levels of food and energy intake (since the majority of studies included in this review focused on food -see Description of studies). The six selected covariates (variable type) were: age (continuous), gender (categorical), BMI (continuous), dietary restraint (continuous), dietary disinhibition (continuous) and hunger (continuous). All six had been pre-specified in the original version of the conceptual model (Figure  1 ) and had been measured at baseline in at least one included study. We decided in advance of conducting univariable meta-regression analyses that candidate covariates would be excluded if they had been measured in fewer than 10 independent comparisons feeding into an analysis (insu icient data) or if there was no variation in the value of the covariate between independent comparisons feeding into an analysis (absence of variation, which precluded estimation).
Results of the search The flow of studies through the systematic review process is shown in Figure  2. Electronic database searches retrieved a total of 76,279 study records, including duplicates. Searches of other resources identified 23 additional study records not retrieved by electronic database searches, comprising 15 records identified by searching reference lists of eligible study reports or forward citation tracking and eight records identified within our preceding, broader scoping review (Hollands 2013a). Automatic and manual de-duplication identified 24,624 duplicate records, which we discarded. Therefore, 51,655 unique records entered title/abstract screening. Of these, we excluded 51,472 records and obtained corresponding full-text study reports for the remaining 183 records assessed as potentially eligible.
Library Trusted evidence. Informed decisions. Better health. Cochrane Database of Systematic Reviews basis we took the pragmatic decision (in consultation with the Cochrane Public Health Review Group) to defer full integration of these 11 studies until the first major update of this review. Therefore, as highlighted above, all results and findings presented in the remainder of the main text of this review are based exclusively on evidence collected from the 72 included studies identified by the original search up to and including 20 November 2012.
Library Trusted evidence. Informed decisions. Better health. Cochrane Database of Systematic Reviews eight to be at high risk of bias  (Coelho do Vale 2008 (S2); Fisher 2003; Fisher 2007c; Fisher 2013; Leahy 2008; Looney 2011; Marchiori 2011; Mathias 2012) , with four studies assessed as at unclear risk of bias (Mishra 2012 (S1); Mishra 2012 (S2)  ; Rolls 2007a; Russell 1980). We judged the remaining 53 studies as at low risk of bias. We judged studies to be at high risk of bias for this domain if > 10% of participants' data had been excluded from the analysis due to low (or zero) levels of selection or consumption, or due to being outliers.
Selective reporting We judged 67 of 72 studies to be at unclear risk of bias in this domain. This was determined by searching for record(s) containing details of the study protocol in online trial registries (ClinicalTrials. gov and the WHO International Clinical Trials Registry Platform (ICTRP)) and finding no corresponding records. As such, there was insu icient information to permit judgement of 'low risk' or 'high risk'. We assessed this domain to be at low risk of bias in four studies for which records were found and the comparison of the trial registry entries and published studies confirmed no selective outcome reporting  (Ebbeling 2007; Fisher 2007b; Looney 2011; Raynor 2009). We classified one study as being at high risk of bias due to a discrepancy between the trial registry entry and the published study regarding the specified primary outcomes  (Raynor 2007).
Library Trusted evidence. Informed decisions. Better health. Cochrane Database of Systematic Reviews • E ect sizes were larger in studies of food products in which outcome data mapped directly onto the manipulated food(s), as opposed to a wider set of foods including, but not limited to, the manipulated food(s). Specifically, increases in the amount of food consumed as a result of exposure to larger sizes were, on average, 0. 32 units larger (95% CI 0. 16 to 0. 48) in studies of food products in which outcome data mapped directly onto the manipulated food(s) than in studies of food products in which outcome data mapped to a wider set of foods including, but not limited to, the manipulated food(s). • Meta-regression analysis did not find evidence that the size of the e ect of larger size on consumption was associated with the target of the manipulation (i.
Library Trusted evidence. Informed decisions. Better health. Cochrane Database of Systematic Reviews level covariates were excluded due to either insu icient data (< 10 included studies) or were not estimable due to the absence of variability in data values between studies. A full set of results of these univariable meta-regression analyses is provided in Appendix 4. Of 15 study-level covariates investigated in these analyses, we observed two to be associated with the e ect of larger-sized portions, packages and/or tableware on the quantities of food participants selected for consumption. Below, we report results from each stage of our meta-regression analyses (as described in the Data synthesis section) and for each stage highlight any variables that we observed to be associated with the intervention e ect.
Library Trusted evidence. Informed decisions. Better health. Cochrane Database of Systematic Reviews We conducted no meta-regression analyses to investigate the extent to which this statistical heterogeneity could be explained by study-level covariates, due to insu icient data. However, it is likely that the considerable between-studies variance in estimates of this e ect may be attributable to the influence of variations between the three source studies providing data incorporated into this metaanalysis in terms of their participants, interventions.
Library Trusted evidence. Informed decisions. Better health. Cochrane Database of Systematic Reviews equivalent to an absolute change in average daily energy intake from food (that is, energy intake from food and non-alcoholic beverages, but excluding energy intake from alcoholic beverages and dietary supplements) of 215 to 279 kcal among UK adults (a 12% to 16% change from a baseline of 1727 kcal per day -see Figure  4 ) (National Centre for Social Research 2012). Sustained reductions in daily energy intake from food of this size would have the potential to make meaningful contributions to the prevention and treatment of major risk factors for non-communicable diseases. For example, 10-year weight gain between 1999 and 2009 among adults in England (that is, 9 kg at the 90th percentile) has been estimated to be equivalent to extra energy intake of around 24 kcal per day over the same period (Department of Health 2011).
Library Trusted evidence. Informed decisions. Better health. Cochrane Database of Systematic Reviews children, but we are not aware of any current evidence for whether this process continues over the adult life course. It is noteworthy that, with the exception of age, no evidence was found in this review to support claims that the e ects of exposure to di erent portion, package, individual unit or tableware sizes vary between men and women, between individuals with a di erent body mass index, or between those with di erent baseline levels of dietary restraint, dietary disinhibition or hunger (that is, those participant characteristics identified in advance as most likely to modify e ects). With respect to gender and body mass index, we note that these findings di er from those suggested by the results of another recent review of food portion size e ects (Zlatevska 2014).
Library Trusted evidence. Informed decisions. Better health. Cochrane Database of Systematic Reviews size calculation for a single adequately powered trial (that is, the optimal information size), which strengthens confidence that these studies were su icient to enable us to address our first objective to assess the e ects of eligible interventions on unregulated selection or consumption of food products in adults and children. Moreover, included food studies encompassed a range of participants in terms of their age, gender and other trait or state characteristics, a range of specific manipulations (for example, various types of foods), and a variety of eating or drinking contexts (encompassing both laboratory and naturalistic field settings). This confers a degree of confidence that our findings concerning food are likely to be widely applicable.
Moreover, evidence for e ects on selection and consumption of food was derived mainly from studies conducted in US samples, with no included studies conducted in low or middle-income countries (LMICs). Cochrane Database of Systematic Reviews cultural, economic and contextual di erences surrounding dietrelated behaviours between people living in HICs and LMICs may also plausibly modify these e ects. For these reasons, the predominance of US evidence may limit the applicability of findings of this review to LMICs (and also to other HICs) to some extent. This review identified three studies that investigated the e ects of exposure to longer versus shorter cigarettes on tobacco consumption (Jarvik 1978 (E1); Jarvik 1978 (E2); Russell 1980). We did not identify any tobacco studies investigating the e ects of exposure to di erent sizes (or shapes) of cigarette packs, which may be an alternative target for interventions to reduce exposure to single cigarettes or packs containing smaller than standard numbers of cigarettes.
Library Trusted evidence. Informed decisions. Better health. Cochrane Database of Systematic Reviews compensatory consumption of other foods is not elucidated by this review. A further set of challenges to implementing policies to reduce exposure to larger-sized portions of food and non-alcoholic beverages is provided by the commercial and legal contexts in which these products are sold. The likely strength of resistance among food and beverage industry representatives was evident in an unsuccessful attempt in New York to cap the portion sizes of sugar-sweetened beverages sold in restaurants and other venues serving food (Gabbatt 2013; Grynbaum 2012). However, policies of this kind appear to be more acceptable among the general public (Diepeveen 2013; Petrescu under review), which raises the possibility of pursuing alternative strategies such as engaging civil and other organisations at local, national and international levels to advocate for reconfiguration of systems of production and consumption  (Freudenberg 2014; Jackson 2009; Skidelsky 2013).
Library Trusted evidence. Informed decisions. Better health. Cochrane Database of Systematic Reviews are able to freely select and consume from a typically wide range of products and over a number of weeks or months. Moreover, the studies need to be designed to contribute to summary estimates of corollary impacts on health inequalities. This would not only ensure that policies found to be e ective do not cause "intervention generated inequalities" (Lorenc 2013), but would also increase understanding of their potential to reduce inequalities arising from excessive consumption of less healthy products by more socially and materially deprived people, such as those with low levels of education or income. None of the included studies assessed (or indeed were powered to assess) the moderation of intervention e ects by socioeconomic status, or potential interactions between product size and cost in influencing selection with purchasing.
Library Trusted evidence. Informed decisions. Better health. Cochrane Database of Systematic Reviews ing each visit, the reported values were averaged and overall compliance was calculated as: compliance of use of rice bowl (%) = frequency of using bowls/ number of total meals × 100. Between the small and regular rice bowl groups, there was no significant difference in frequency of usage. " Comment: information and instructions to participants appear to have been standardised between the compared study conditions. Participants' compliance with the protocol for rice bowl usage was monitored and study authors state there was no difference between comparison groups in level of compliance.
Cochrane Database of Systematic Reviews Comment: the reason for missing outcome data for consumption outcome is the study authors' decision to exclude participants who le ≤ 20 g of the entrée in both of the small portion conditions ('plate cleaners') from the analysis. The review authors judge that this decision is reasonable, as it produces a more conservative estimate of the effect of the intervention on consumption. Any attrition bias due to handling of incomplete outcome data produces a more conservative estimate of the effect of the intervention on consumption Selective reporting (reporting bias) Unclear risk Comment: search for record(s) containing details of study protocol conducted in ClinicalTrials. gov and the WHO International Clinical Trials Registry Platform (ICTRP). No records found.
provide some basic demographic information (age, height, and weight, which were used to calculate their BMI). Prior to the main analyses, correlational analyses were conducted to identify potential covariates. Ratings of initial hunger. and liking of the food. were sig- Cochrane Database of Systematic Reviews nificantly associated with total food consumed, but BMI was unrelated to food intake. Thus, only hunger and liking were included as covariates in all subsequent analyses relating to total food consumed. " Comment: study uses a between-subjects design. Difference between comparison groups in terms of baseline ratings of hunger and liking of the manipulated foods. The statistical analysis of outcome data controls for these differences. No information pertaining to differences between comparison groups in terms of age is reported Other bias #2 -Consistency in intervention delivery Low risk Quote: "Next, participants completed an initial hunger questionnaire and took part in the tasting component of the study.
Cochrane Database of Systematic Reviews No analysis of potential differences in measured outcomes between condition orders appears to have been conducted and the statistical analysis of outcome data does not appear to control for condition order. Risk of bias due to period effects is therefore unclear. Insufficient information to permit judgement of 'low risk' or 'high risk' Other bias #2 -Consistency in intervention delivery Unclear risk Quote: "Subjects were instructed to follow a 10 [hour] overnight fast on the evening before each study day. Upon arrival for each meal they were instructed to eat as much as they wanted and, if they desired, more food would be provided. Participants were permitted to leave the laboratory between meals and were instructed not to consume foods or beverages outside of the laboratory.
Bias Authors' judgement Support for judgement Random sequence generation (selection bias) Unclear risk Quote: "On 10 days over 5 months, we covertly recorded the food intake of customers who purchased a baked pasta entrée from a serving line at lunch. On 5 of the days, the portion size of the entrée was the standard (100%) portion, and on 5 different days, the size was increased to 150% of the standard portion. The same portion size of the entrée was sold on two consecutive days of a given study week (Monday to Thursday). Study weeks were separated by Cochrane Database of Systematic Reviews at least 2 weeks, and the portion size sold in a given week was randomly determined. ".
Few comments were made regarding portion size throughout the experiment. During 2 reference-portion lunches and 2 largeportion lunches at which behavioral observations were made, none of the children described the portion sizes as "small" or "okay. " The reference por- Cochrane Database of Systematic Reviews tion size was described as being "big" by 1 child during a reference-portion lunch, and the large portion size was described as being "big" by 6 children during the large-portion lunches. In the present study, few children made comments about portion size, and the children's self-selected portions of the entrée did not change with repeated exposure to large portions. It is possible that changes in portion size may have been visually difficult to discern because of the use of an amorphous entrée.
Incomplete outcome data (attrition bias) Consumption outcome High risk Quote: "Data are reported for 30 of the 35 children; the data from 5 children were excluded from analyses because their mean intake of the main entrée was < 10 g across the 4 lunches in which the reference portion was served. The children whose data were excluded were not significantly different from all others in terms of age (P = 0. 74) or body mass index (BMI)-for-age z score (P = 0. 44). " Comment: the reason for missing outcome data for consumption outcome is the study authors' decision to exclude participants with < 10 g consumption across the 4 lunches in which the reference portion was served from the analysis. The substantial proportion (5 participants, 14% of study sample) of exclusions due to low consumption means that the review authors judge that it is plausible that the effect size among these missing data is enough to have had an important impact on the observed effect size Selective reporting (reporting bias) Unclear risk Comment: search for record(s) containing details of study protocol conducted in ClinicalTrials.
Cochrane Database of Systematic Reviews Comment: information and instructions provided to participants appear to have been standardised between the compared study conditions. Compliance with the instruction for parents to refrain from giving their child any foods or beverages for 2 hours before each study visit was monitored via parent interview; however no monitoring results are reported with respect to this instruction. Although not explicitly stated, it is likely that compliance with the instruction for children not to share food was monitored by the research sta member present with each group of children for the duration of each dinner visit; however no monitoring results are reported with respect to this instruction. No further specific instructions were provided to participants, other than the instruction to eat as little or as much as desired during each 20-min timed dinner.
Fisher 2007c (Continued) Cochrane Library Trusted evidence. Informed decisions. Better health. Cochrane Database of Systematic Reviews itly reinforce greater consumption as being normative or appropriate. Behavioral observations made in the present study, however, suggest that children were unlikely to be affected by such norms because they were relatively unaware of the increases to entrée portion size. " Comment: blinding of study participants attempted but it is possible that blinding was broken in some cases and that the outcome may be influenced by lack of blinding (due to potential carry-over effects between conditions). Very unlikely that key study personnel were blinded, but the review authors judge that the outcome is not likely to be influenced by lack of blinding of key study personnel.
Unclear risk Quote: "To avoid visual comparisons of differences across conditions, each child was assigned to eat with 3-4 children in the same condition sequence. " Comment: blinding of study participants attempted but it is possible that blinding was broken in some cases and that the outcome may be influenced by lack of blinding (due to potential carry-over effects between conditions). Very unlikely that key study personnel were blinded, but the review authors Cochrane Database of Systematic Reviews judge that the outcome is not likely to be influenced by lack of blinding of key study personnel Blinding of participants and personnel (performance bias) Consumption outcome.
Unclear risk Quote: "To avoid visual comparisons of differences across conditions, each child was assigned to eat with 3-4 children in the same condition sequence. " Comment: blinding of study participants attempted but it is possible that blinding was broken in some cases and that the outcome may be influenced by lack of blinding (due to potential carry-over effects between conditions). Very unlikely that key study personnel were blinded, but the review authors judge that the outcome is not likely to be influenced by lack of blinding of key study personnel Cochrane Database of Systematic Reviews ipant characteristics between groups Comment: study uses a within-subjects design. No measurement of participant pre-condition 'state' characteristics is reported. Analysis of potential differences in measured outcomes between condition orders appears to have been conducted and the statistical analysis appears to control for any influence of condition order on measured outcomes (condition by time interaction terms).
Cochrane Database of Systematic Reviews Other bias #1 -Baseline comparability of participant characteristics between groups Unclear risk Quote: "Before. each meal, subjects filled out a series of 100-mm visual analog scales. to assess hunger, thirst, fullness, prospective consumption, and nausea. There were no significant differences across experimental conditions in ratings of hunger, fullness, thirst, prospective consumption, or nausea before lunch was served (data not shown). " Comment: study uses a within-subjects design. No differences between conditions in terms of measured pre-condition participant 'state' characteristics, but not reported whether there were differences between condition orders in terms of measured pre-condition participant 'state' characteristics. No analysis of potential differences in measured outcomes between condition orders appears to have been conducted and the statistical analysis of outcome data does not appear to control for condition order.