Over-the-Air Federated Edge Learning with Hierarchical Clustering

We examine federated learning (FL) with over-the-air (OTA) aggregation, where mobile users (MUs) aim to reach a consensus on a global model with the help of a parameter server (PS) that aggregates the local gradients. In OTA FL, MUs train their models using local data at every training round and transmit their gradients simultaneously using the same frequency band in an uncoded fashion. Based on the received signal of the superposed gradients, the PS performs a global model update. While the OTA FL has a significantly decreased communication cost, it is susceptible to adverse channel effects and noise. Employing multiple antennas at the receiver side can reduce these effects, yet the path-loss is still a limiting factor for users located far away from the PS. To ameliorate this issue, in this paper, we propose a wireless-based hierarchical FL scheme that uses intermediate servers (ISs) to form clusters at the areas where the MUs are more densely located. Our scheme utilizes OTA cluster aggregations for the communication of the MUs with their corresponding IS, and OTA global aggregations from the ISs to the PS. We present a convergence analysis for the proposed algorithm, and show through numerical evaluations of the derived analytical expressions and experimental results that utilizing ISs results in a faster convergence and a better performance than the OTA FL alone while using less transmit power. We also validate the results on the performance using different number of cluster iterations with different datasets and data distributions. We conclude that the best choice of cluster aggregations depends on the data distribution among the MUs and the clusters.Comment: 30 pages, 6 figure

Effects of Saccharomyces boulardii on antibiotic induced orocecal transit in rats

Clarithromycin is an antibiotic widely used for Helicobacter pylori (H. pylori) eradication and together with amoxicillin and proton pump inhibitors they constitute the first line triple treatment regimen against H. pylori. Diarrhoea is one of the major drawbacks during H. pylori eradication and is majorly attributed to clarithromycin, while Saccharomyces boulardii is a probiotic and is shown to be effective in the treatment of antibiotic associated diarrhoea. We aimed to evaluate the effect of clarithromycin on orocecal transit in rats and to identify whether the supplementation with S. boulardii has a role on orocecal transit index. Adult rats of both sexes were divided into two groups to determine immediate or chronic effects of S. boulardii and clarithromycin on orocecal transit. The first group was given single dose of the test drug, while the second group received the test drugs for one week through orogastric intubation. Both groups were randomly distributed into four subgroups; the placebo group (group A), the S. boulardii group (group B), the clarithromycin group (group C), and the co-administration that is clarithromycin plus S. boulardii group (group D). Rats were given 20 mg kg−1 clarithromycin and 500 mg kg−1S. boulardii. We did not find any difference among the subgroups in group 1, where only single dose of the test drugs was administered. In chronic administration group, that is group 2, significant differences among the subgroups were observed (P=0.004). Post-hoc comparisons of orocecal transit index between group “2A and 2C” and “2C and 2D” were significantly different (P=0.013 and P=0.005, respectively). Our results show that long term clarithromycin administration leads to rapid orocecal transit index and S. boulardii supplementation to clarithromycin can abolish this adverse effect in rats. Those findings suggest the beneficial use of S. boulardii in H. pylori eradication regimens

Advanced endoscopic ultrasound management techniques for preneoplastic pancreatic cystic lesions

Pancreatic cystic lesions can be benign, premalignant or malignant. The recent increase in detection and tremendous clinical variability of pancreatic cysts has presented a significant therapeutic challenge to physicians. Mucinous cystic neoplasms are of particular interest given their known malignant potential. This review article provides a brief but comprehensive review of premalignant pancreatic cystic lesions with advanced endoscopic ultrasound (EUS) management approaches. A comprehensive literature search was performed using PubMed, Cochrane, OVID and EMBASE databases. Preneoplastic pancreatic cystic lesions include mucinous cystadenoma and intraductal papillary mucinous neoplasm. The 2012 International Sendai Guidelines guide physicians in their management of pancreatic cystic lesions. Some of the advanced EUS management techniques include ethanol ablation, chemotherapeutic (paclitaxel) ablation, radiofrequency ablation and cryotherapy. In future, EUS-guided injections of drug-eluting beads and neodymium:yttrium aluminum agent laser ablation is predicted to be an integral part of EUS-guided management techniques. In summary, International Sendai Consensus Guidelines should be used to make a decision regarding management of pancreatic cystic lesions. Advanced EUS techniques are proving extremely beneficial in management, especially in those patients who are at high surgical risk

Investigation of the PD-1/PD-L1 Expression in the Lesional Skins of Patients with Psoriasis

Introduction: Psoriasis is an immune-mediated, chronic and inflammatory disease whose pathogenesis is affected by the interactions of several immune cells and cytokines. PD-1 is an inhibitor receptor that is expressed to a large extent in T lymphocytes and responsible for regulating autoimmunity and self-tolerance. Objectives: In this study, we aimed to investigate the expression of PD-1/PD-L molecules in the lesioned skins of psoriasis patients. Methods: The study included 30 psoriasis patients, and 15 healthy volunteers as the control group. Anti PD-1 and PD-L1 antibodies were applied to the skin biopsy samples that were collected from the patient and control groups. Cytoplasmic and membranous staining of PD-1 and PD-L1 were considered positive. The number of stained immune cells that was examined for each case. Results: The percentage of the tissues with high PD-1 (+) and PDL-1 (+) immune cell counts were significantly higher in the psoriasis patients compared to healthy controls (P values = 0.004 and 0.002, respectively). A negative and statistically significant correlation was detected between PDL-1(+) immune cell numbers and PASI scores (P = 0.033, r=-0.57). Conclusions: In the lesioned skin samples of psoriasis patients, the PD-1 and PD-L1 expressions were significantly higher in immune cells than that in the skin samples of the healthy controls. This study was the first investigation of the expression of PD-1/PD-L molecules in the immune cells in found the lesioned skins of psoriasis patients

A comparative ID migraine screener study in ophthalmology, ENT and neurology out-patient clinics

Migraine is more likely to be misdiagnosed in patients with comorbid diseases. Not only primary care physicians, but also specialists might misdiagnose it due to the lack of diagnostic criteria awareness. The ID migraine test is a reliable screening instrument that may facilitate and accelerate migraine recognition. This study aimed to compare the prevalence and characteristics of migraine in a large sample of patients admitted to clinics of ophthalmology (OC), ear, nose and throat diseases (ENTC) and neurology (NC), as well as to validate the use of the ID migraine test in OC and ENTC settings. This was a multicentre (11 cites) study of out-patients admitting either to NC, ENTC or OC of the study sites during five consecutive working days within 1 week. From each of the clinics, 100 patients were planned to be recruited. All recruited patients were interviewed and those having a headache complaint received an ID migraine test and were examined for headache diagnosis by a neurologist, blinded to the ID migraine test result. A total of 2625 subjects were recruited. Only 1.3% of OC patients and 5.4% of ENTC patients have been admitted with a primary complaint of headache, whereas the percentage of NC patients suffering from headache was 37.6%. Whereas 138 patients (19.3%) in OC, 154 (17.3%) in ENTC and 347 (34%) in NC were found to be ID migraine test positive, 149 patients (20.8%) in OC, 142 (16%) in ENTC and 338 (33.1%) in NC were diagnosed with migraine. The sensitivity, specificity, and positive and negative predictive ratios of the ID migraine test were found to be similar in all clinics. An important fraction of the patients admitted to NC, as well as to OC and ENTC, for headache and/or other complaints were found out to have migraine by means of a simple screening test. This study validated the ID migraine test as a sensitive and specific tool in OC and ENTC, encouraging its use as a screening instrument.Pfizer-Türkiy

Advanced endoscopic ultrasound management techniques for preneoplastic pancreatic cystic lesions

Pancreatic cystic lesions can be benign, premalignant or malignant. The recent increase in detection and tremendous clinical variability of pancreatic cysts has presented a significant therapeutic challenge to physicians. Mucinous cystic neoplasms are of particular interest given their known malignant potential. This review article provides a brief but comprehensive review of premalignant pancreatic cystic lesions with advanced endoscopic ultrasound (EUS) management approaches. A comprehensive literature search was performed using PubMed, Cochrane, OVID and EMBASE databases. Preneoplastic pancreatic cystic lesions include mucinous cystadenoma and intraductal papillary mucinous neoplasm. The 2012 International Sendai Guidelines guide physicians in their management of pancreatic cystic lesions. Some of the advanced EUS management techniques include ethanol ablation, chemotherapeutic (paclitaxel) ablation, radiofrequency ablation and cryotherapy. In future, EUS-guided injections of drug-eluting beads and neodymium:yttrium aluminum agent laser ablation is predicted to be an integral part of EUS-guided management techniques. In summary, International Sendai Consensus Guidelines should be used to make a decision regarding management of pancreatic cystic lesions. Advanced EUS techniques are proving extremely beneficial in management, especially in those patients who are at high surgical risk

Microbial Preparations (Probiotics) for the Prevention of Clostridium difficile Infection in Adults and Children: An Individual Patient Data Meta-analysis of 6,851 Participants

OBJECTIVE. To determine whether probiotic prophylaxes reduce the odds of Clostridium difficile infection (CDI) in adults and children. DESIGN. Individual participant data (IPD) meta-analysis of randomized controlled trials (RCTs), adjusting for risk factors. METHODS. We searched 6 databases and 11 grey literature sources from inception to April 2016. We identified 32 RCTs (n=8,713); among them, 18 RCTs provided IPD (n=6,851 participants) comparing probiotic prophylaxis to placebo or no treatment (standard care). One reviewer prepared the IPD, and 2 reviewers extracted data, rated study quality, and graded evidence quality. RESULTS. Probiotics reduced CDI odds in the unadjusted model (n=6,645; odds ratio [OR] 0.37; 95% confidence interval [CI], 0.25-0.55) and the adjusted model (n=5,074; OR, 0.35; 95% CI, 0.23-0.55). Using 2 or more antibiotics increased the odds of CDI (OR, 2.20; 95% CI, 1.11-4.37), whereas age, sex, hospitalization status, and high-risk antibiotic exposure did not. Adjusted subgroup analyses suggested that, compared to no probiotics, multispecies probiotics were more beneficial than single-species probiotics, as was using probiotics in clinical settings where the CDI risk is 5%. Of 18 studies, 14 reported adverse events. In 11 of these 14 studies, the adverse events were retained in the adjusted model. Odds for serious adverse events were similar for both groups in the unadjusted analyses (n=4,990; OR, 1.06; 95% CI, 0.89-1.26) and adjusted analyses (n=4,718; OR, 1.06; 95% CI, 0.89-1.28). Missing outcome data for CDI ranged from 0% to 25.8%. Our analyses were robust to a sensitivity analysis for missingness. CONCLUSIONS. Moderate quality (ie, certainty) evidence suggests that probiotic prophylaxis may be a useful and safe CDI prevention strategy, particularly among participants taking 2 or more antibiotics and in hospital settings where the risk of CDI is >= 5%

To close the eyes or not : the effects of occipital alpha power induced by eye closure on auditory entrainment

Neuronal oscillations facilitate extracting sensory information from the environment through optimization of rhythmic fluctuation in excitation and inhibition cycles of neurons; which is defined as neural entrainment. Although research suggests entrainment to frequency modulated (FM) speech-like rhythmic sounds, factors influencing entrainment are still open for discovery. With this purpose, the current work tackled the understudied daily strategy, eye closure, in auditory perception domain. Neural and behavioral effects of eye closure on auditory entrainment were investigated. Eleven participants detected near-threshold gaps (sound breaks) embedded in 2.8 Hz FM stimuli both eyes open and closed conditions. Electroencephalogram (EEG) data were also obtained from eight of the participants. Eye closure was hypothesized to induce occipital alpha oscillations, associated with decreased neural and behavioral effects of entrainment and results in enhanced gap detection performance compared with eyes open condition. Results revealed that, as hypothesized, eye closure increased occipital alpha power. Moreover, increased 2.8 Hz neural activity and participants’ modulated behavioral gap detection performance suggested neural and behavioral auditory entrainment to 2.8 Hz FM sound stimuli both in eyes open and closed conditions. Contrary to the main hypothesis, closing the eyes did not influence the overall gap detection performance. However, first evidence of auditory entrainment under eye closure condition was provided. Although the current data have limitations, all in all, an interaction of two distinct auditory perception mechanisms -neural entrainment and cortical alpha band oscillations- are suggested to involve in perception of speech-like sound stimuli. Further, this interaction was proposed to influence auditory perception differently under eye open and closed periods, raising a firm background for further research on possible benefits of eye closure on sensory information processing