Consensus and contentious statements on the use of probiotics in clinical practice: A south east Asian gastro‐neuro motility association working team report

The concept of consuming microorganisms in the treatment of a medical condition and in health maintenance has gained much attraction, giving rise to an abundance of medical claims and of health supplements. This study identified relevant clinical questions on the therapeutic use of probiotics and reviewed the literature in irritable bowel syndrome, inflammatory bowel disease, impaired intestinal immunity, liver disease, intestinal infections, and common childhood digestive disorders. Statements were developed to address these clinical questions. A panel of experienced clinicians was tasked to critically evaluate and debate the available data. Both consensus and contentious statements are presented to provide to clinicians a perspective on the potential of probiotics and importantly their limitations.     

Diminished EEG habituation to novel events effectively classifies Parkinson’s patients

Objectives

We aimed to test if EEG responses to novel events reliably dissociated individuals with Parkinson’s disease and controls, and if this dissociation was sensitive and specific enough to be a candidate biomarker of cognitive dysfunction in Parkinson’s disease.

The association between serum vitamin B<Subscript>12</Subscript> deficiency and tension-type headache in Turkish children

This study aimed to determine the relationship between serum vitamin B₁₂ level and tension-type headache. The study groups consisted of 75 patients (40 females, 35 males) with headache and a control group of 49 healthy children (25 females, 24 males). Serum vitamin B₁₂ level <?200 pg/ml was defined as deficient, and <?160 pg/ml as severely deficient. The serum vitamin B₁₂ level was measured by the electrochemiluminescence (ECLIA) method. The serum vitamin B₁₂ levels in the headache and control groups were 273.01?±?76.77 and 316.22?±?74.53 pg/ml, with the difference determined as statistically significant (p?=?0.003). In the case group, 18/75 patients (24%) had a serum vitamin B12 level below the normal of 200 pg/ml, and in the control group 4/49 (8%) patients were also below the normal range (p?=?0.021). The serum vitamin B₁₂ level in the children with tension-type headache was significantly lower than that in the control group. From the results of the study, it was concluded that there may be an association between vitamin B₁₂ level and tension-type headache. However, further clinical studies are needed.     

A Machine Learning Approach to Detect Router Advertisement Flooding Attacks in Next-Generation IPv6 Networks

Router advertisement (RA) flooding attack aims to exhaust all node resources, such as CPU and memory, attached to routers on the same link. A biologically inspired machine learning-based approach is proposed in this study to detect RA flooding attacks. The proposed technique exploits information gain ratio (IGR) and principal component analysis (PCA) for feature selection and a support vector machine (SVM)-based predictor model, which can also detect input traffic anomaly. A real benchmark dataset obtained from National Advanced IPv6 Center of Excellence laboratory is used to evaluate the proposed technique. The evaluation process is conducted with two experiments. The first experiment investigates the effect of IGR and PCA feature selection methods to identify the most contributed features for the SVM training model. The second experiment evaluates the capability of SVM to detect RA flooding attacks. The results show that the proposed technique demonstrates excellent detection accuracy and is thus an effective choice for detecting RA flooding attacks. The main contribution of this study is identification of a set of new features that are related to RA flooding attack by utilizing IGR and PCA algorithms. The proposed technique in this paper can effectively detect the presence of RA flooding attack in IPv6 network.     

A Novel Spatiotemporal Longitudinal Methodology for Predicting Obesity Using Near Infra<Emphasis Type="Bold">r</Emphasis>ed Spectroscopy (NIRS) Cerebral Functional Activity Data

Globally, there has been a dramatic increase in obesity, with prevalence in males and females expected to increase to 18 and 21%, respectively (NCD Risk Factor Collaboration, Lancet 387(10026):1377–96, 2016). However, there are hardly any data-analytic calorie-based cognitive studies, especially using non-invasive near infrared spectroscopy (NIRS) data that predict obesity using predictive data mining. Obesity is linked with neurodegenerative diseases, diabetes, and cardiovascular diseases. Thus, understanding, predicting, preventing, and managing obesity have the potential to save the lives of millions. Behavioral studies suggest that overeating in obese individuals is triggered by exaggerated brain reward center (BRC) activity to high-calorie food stimuli (Shefer et al., Neurosci Biobehav Rev 37(10):2489–503, 2013). In this paper, details of a novel research methodology are presented for a 24-month longitudinal study using a 44-channel NIRS device with the subjects in a natural environment. The proposed methodology consists of using visual stimuli of low/high calorie food items under fasting and satiated conditions for three types of subjects. The experiments consist of block design, longitudinal plan, data smoothing, BRC activation mapping, stereotactic normalization, generating paired t-test maps under fasting and non-fasting conditions and subsequently using Naïve Bayes modeling to generate obesity prediction maps for the control subjects. The simulated results consist of generation of Bayesian prediction maps using layers of paired t-test cerebral activity maps for the four BRC functional regions considered for three types of subjects, i.e., obese, control, and control subjects fed high calorie diet. We have demonstrated how cerebral functional activity data in response to visual food stimuli can be used to predict obesity in the non-obese, thus offering a non-invasive preventive measure.     

Effects of the Reread-Adapt and Answer-Comprehend and goal setting intervention on decoding and reading comprehension skills of young adults with intellectual disabilities

Objective: Reread-Adapt and Answer-Comprehend (RAAC) + Goal Setting intervention is a reading intervention that addresses both oral reading fluency (ORF) and reading comprehension while supporting persistence and motivation for learners who struggle with reading. Method: We delivered the RAAC + Goal Setting intervention to five young adult learners with intellectual disabilities (ID) in a postsecondary education setting. In the study, we investigated the effects of the intervention on generalization of reading skills to novel passages. Results: Utilizing a response-guided and randomized multiple-baseline across the participants’ design, we failed to reject the null hypothesis of no treatment effects based on the computed p-value. Traditional visual analysis of the data also reached a similar conclusion, however, we found that two participants’ decoding skills improved during the intervention. Conclusions: We did not find a functional relation between the intervention and student reading performance.     

Impact of delirium on patients hospitalized for myocardial infarction: A propensity score analysis of the National Inpatient Sample

Background

Delirium is associated with worse outcomes in critically ill patients. In the subset of patients with myocardial infarction (MI), the impact on clinical outcomes of delirium is not as well elucidated.

Hypothesis

Delirium is associated with increased mortality in patients hospitalized for MI.

Methods

The study used data from the National Inpatient Sample 2012 to 2014, Healthcare Cost and Utilization Project. We included discharges associated with the primary diagnosis of MI using the relevant International Classification of Diseases, Ninth Revision, Clinical Modification codes. The outcome was inpatient mortality between the delirium group and propensity score–matched controls without delirium.

Results

The study included 1 330 020 weighted discharges with MI as the principal diagnosis. Within this cohort, 18 685 discharges (1.4%) had delirium. Delirium was associated with older age, lower rates of percutaneous coronary intervention, and increased comorbid conditions. The delirium group had higher mortality (10.5% vs 2.6%, P < 0.001). Propensity score–matching analysis showed increased mortality in the delirium group (10.5% vs 7.6%, relative risk: 1.39 [95% confidence interval: 1.2–1.6, P < 0.001) using nearest neighbor 1:1 matching.

Conclusions

In individuals with MI, delirium was associated with increased inpatient mortality.     

Intraductal Papillary Neoplasia of Bile Duct: A Rare Liver Tumor

Hellenic Journal of Surgery - Intraductal biliary papillary neoplasia (IPNB) is a rare disease involving both the intrahepatic and the extrahepatic biliary tract. It usually occurs in the 6th and...