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    Quality of the Evidence Supporting the Role of Oral Nutritional Supplements in the Management of Malnutrition:An Overview of Systematic Reviews and Meta-Analyses

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    There is considerable heterogeneity across the findings of systematic reviews of oral nutritional supplement (ONS) interventions, presentingdifficulties for healthcare decision-makers and patients alike. It is not known whether heterogeneity arises from differences in patient populationsor relates to methodological rigor. This overview aimed to collate and compare findings from systematic reviews of ONSs compared with routinecare in adult patients who were malnourished or at risk of malnutrition with any clinical condition and to examine their methodological quality.Three electronic databases were searched to July 2019, supplemented with hand-searching. Data on all outcomes were extracted and reviewmethodological quality assessed using A MeaSurement Tool for Assessment of systematic Reviews (AMSTAR). Twenty-two reviews were included,11 in groups from mixed clinical backgrounds and 11 in specific clinical conditions. Ninety-one meta-analyses were identified for 12 differentoutcomes but there was discordance between results. Significant benefits of ONSs were reported in 4 of 4 analyses of energy intake, 7 of 11analyses of body weight, 7 of 22 analyses of mortality, 10 of 17 analyses of complications (total and infectious), 1 of 3 analyses of muscle strength,4 of 9 analyses of body composition/nutritional status, 2 of 14 analyses of length of stay, and 2 of 5 analyses of hospital readmissions. Ten reviewswere high quality (AMSTAR scores 8–11), 9 moderate (AMSTAR scores 3–8), and 3 poor (AMSTAR scores 0–3). Methodological deficiencies werelimitations to searches, poor reporting of heterogeneity, and failure to incorporate quality of evidence into any recommendations. Discordancebetween reviews was not markedly reduced when only high-quality reviews were considered. Evidence for the effects of ONS in malnourishedpatients or those who are at risk of malnutrition is uncertain, and discordance in results can arise from differences in clinical background of patientsor the etiological basis of malnutrition

    Non-Analytical Obstacles to Stateless Law

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    This article reviews legal scholars’ key prudential and moral reasons to oppose the view that law can exist without the state. After a discussion of the real-world impact of views on what counts as law, the article discusses the following grounds for resistance to stateless law: law as something necessarily produced by states scores quite high on criteria to determine how good a theory is; paradigms intrinsically resist change; certain forgotten prudential political rules are wrongly remembered as analytical precepts; there is sheer political resistance to the emancipation of powers outside the state; attempts are made by those who shape our understanding of law to please their constituencies; the pursuit by academics of a legal practice interferes with rigorous legal thinking; there are important vested interests in the current state-centred system; and a sense of anti-intellectualism dominates certain areas of the legal academy

    Dynamic random distribution learning rate for neural networks training

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    The learning rate is the most crucial hyper-parameter of a neural network that has a significant impact on its performance. In this article, a novel learning rate setting idea termed randomness distribution learning rate (RDLR) is presented to regulate the learning rate value. The proposed RDLR shifts the learning rate from deterministic to random and sets the value based on the state of the network. The RDLR uses the distance between neurons rather than the covariance matrix to get the redundancy of the network, as well as the Monte Carlo method, and to simplify the neuron to a point to reduce calculation costs. The proposed algorithms do not regulate the learning rate value of each epoch but rather the mathematical expectation and distribution of the learning rate during the training process. The neural network can jump out of the local minimum or unstable area using our algorithms and obtain the minimum point of the area in gradient space. The RDLR algorithms reduce the impact of tiny changes in learning rate value and streamline the tuning process of neural networks. The RDLR saves calculation costs and can work independently or cooperate with the traditional algorithms. In conjunction with traditional learning rate algorithms, the RDLR can set the same learning rate strategy for all layers in a neural network or keep the same mathematical expectation of the learning rate of each layer while adjusting their impulse. The experiments show that the RDLR can improve the performance of a neural network while keeping other hyper-parameters not changed. It is a novel method for adjusting the training process by dynamically changing the random distribution of the learning rate. Our algorithm can monitor the state of the neural network and keep injecting randomness into the neural network training based on the redundancy of the neurons. Furthermore, our algorithm does not require any additional hyper-parameters. The experiments show that our RDLR can improve the performance of multiple structure neural networks in various tasks when applied to a variety of loss functions and data augment methods.</p

    Accurate coverage metrics for compiler-generated debugging information

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    Many debugging tools rely on compiler-produced metadatato present a source-language view of program states, suchas variable values and source line numbers. While this tendsto work for unoptimised programs, current compilers oftengenerate only partial debugging information in optimisedprograms. Current approaches for measuring the extent ofcoverage of local variables are based on crude assumptions(for example, assuming variables could cover their wholeparent scope) and are not comparable from one compilationto another. In this work, we propose some new metrics, com-putable by our tools, which could serve as motivation forlanguage implementations to improve debugging quality.<br/

    Prospective Associations Between Recalled Parental Bonding and Postnatal Depression: A Cohort Study in Urban and Rural Turkey

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    Background: Recalled experiences of parental bonding may be important in the aetiology of perinatal depression. We hypothesized that lower recalled parental bonding would be associated with perinatal depression.Method: In a cohort study of perinatal depression in Turkey, 677 women were recruited in their third trimester. Parental Bonding Inventory(PBI) scores at baseline were investigated as predictors of depression on the Edinburgh Postnatal Depression Scale(EPDS) at 4, 14 and 21 months after childbirth in mothers without depression at baseline. Results: Poor parental bonding scores, apart from paternal control and overprotection, were independently associated with antenatal depression. Incident postnatal depression at 4 months was predicted by parental overprotection, at 14 months by parental care and overprotection,and at 21 months by paternal control and overprotection.Conclusions: Less satisfactory parenting recalled in the antenatal period was an independent predictor of postnatal depression; however, the different bonding subscales varied as predictors according to the timing of the depression assessment after childbirth.Declaration of interest: None.<br/

    Disgrace and Recovery:Thomas Sackville, lord Buckhurst's letters from the Low Countries 1587, the 'quarrels of my lord of Leicester', and the rhetoric of political survival

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    When Lord Buckhurst defied Elizabeth I and the Earl of Leicester to champion Anglo-Dutch relations he exposed complex tensions within the queen's 'inner circle' that cut across presumptions about political alliances and ideologies often taken for granted. Analysis of Buckhurst's letters shows how the rhetoric of counsel actually operated, in circumstances of acute pressure, and how relationships among the Elizabethan political elite developed accordingly. Buckhurst's description of letters as 'weapons of defence' in the dangerous quarrel that developed with Leicester summarised his strategy for political survival and reveals a rhetorical modus operandi that is too little regarded

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