The evidence for the low-FODMAP diet in managing symptoms of Irritable Bowel Syndrome

Background: Irritable bowel syndrome (IBS) is a very common gastrointestinal disorder, with significant impact on quality of life. Until recently, there has been little evidence-base for treating GI symptoms through dietary therapy; clinical treatment is often unsuccessful or unsatisfactory. The low-FODMAP diet (LFD) has emerged as a potential therapy for alleviating GI symptoms. Purpose: The purpose of this project is to evaluate the most current literature to determine the effectiveness of the low-FODMAP diet in managing the characteristic symptoms of IBS and to potentially identify a subset of the IBS population most likely to benefit from this approach. Ideally, this information may be translated into evidence-based and effective clinical treatment. Methods: An electronic search was performed of the Academic Search Complete/EBSCO, Google Scholar, and PubMed databases to find related peer-reviewed, full-text articles which pertained to the research question. Randomized, controlled trials, descriptive trials, and metaanalysis studies published between January 2010 and June 2018 were included. Using methodology based on the Evidence Analysis process, pertinent data was collected on each study and a quality rating was assigned to studies to determine their “weight” in providing evidence for the research purpose. Results: There were 15 RCTs found and 11 of these RCTs received a positive quality rating. All of the positively rated RCTs except for one found benefit to the LFD relative to IBS symptom control, although two studies of neutral quality found the LFD to be similar in effectiveness to the alternative intervention given to the comparator group. Three observational or nonrandomized studies also found significant benefit(s) to the LFD in improving IBS symptoms, 3 with two of these studies indicating potential longer-term benefit to the LFD. Abdominal pain, bloating, flatulence, and bowel habit status scores were commonly analyzed as variables of interest, and most studies found benefit to the LFD for these particular symptoms. Most studies did not analyze or include the IBS-C subtype. Conclusions: The LFD may be a good approach to use for IBS patients in the alleviation of abdominal pain, bloating, flatulence, and other symptoms. There is little evidence to support the use of the LFD for IBS-C. Further research should elucidate long-term effects and potential risk vs. benefit analysis in utilizing this approach

Judicial Engagement, Written Constitutions, and the Value of Preservation: The Case of Individual Rights

When judges alter a written constitution because its original meaning is no longer convenient, useful or modern, they engage in judicial activism. They are actively seeking to modify the written social compact to suit their own, or their perception of society’s, current preferences. Judicial activism is a usurpation of the proper judicial role, and it undermines the proper role of We the People. Only the People may amend the written constitution when a sufficiently large number (i.e., a supermajority) believes strongly enough that a formal, written modification of the social charter is necessary. Judicial engagement refers to the need for judges to enforce the written constitution, even when doing so may strike the judge as pragmatically difficult, politically unpalatable, or even morally wrong. A judge who is properly engaged, in other words, is a judge who views her job as one of enforcing and preserving the written Constitution. This Article will explore the difference between judicial activism and judicial engagement by examining the Supreme Court’s evolutionary approach to individual rights. I hope to convince the reader that judges have strayed too far from the Constitution’s original meaning in the realm of individual rights, engaging in judicial activism rather than appropriate judicial engagement. Following this analysis, I will offer a plausible and familiar solution to the problem of activism — a blueprint, if you will, for getting our judges properly engaged in enforcing our written Constitution

Human Cloning & the Right to Reproduce

Explores the contours of the right to reproduce, recognized as a substantive liberty under the Due Process Clauses. Specifically, is the right a positive as well as negative right? Does the right encompass the right to use artificial reproductive technologies (ARTs) such as in vitro fertilization, artificial insemination, or reproductive cloning

Bias, Corruption & Obstruction, Oh My: The Due Process Shocks the Conscience Limit on Investigative & Prosecutorial Conduct

Due process guarantees the government will not exercise its power in a manner falling below the standard of civilized decency. Under Supreme Court precedent, behavior by government officials, including prosecutors and investigators, that objectively may be characterized as outrageous, arbitrary, capricious, biased, vindictive, or conscience shocking violates due process. Whether officials’ behavior crosses the constitutional threshold requires an assessment of the totality of the circumstances and is, accordingly, a factually sensitive inquiry. Facts disinterred thus far suggest that the “collusion” narrative—alleging that Russia and Donald Trump’s campaign colluded to throw the 2016 presidential election—may have a corrupt or politically biased genesis. As the facts continue to unfold, the depth and breadth of bias against Trump by Executive Branch officials, including those at the FBI and DOJ, may well rise to conscience shocking levels. The taint of antecedent corruption or bias, in turn, could infect the prosecutorial effort of Special Counsel Robert Mueller

The War Against Crime: Ferguson, Police Militarization and the Third Amendment

The shooting death of eighteen-year-old Michael Brown by Ferguson, Missouri police officer Darren Wilson has sparked a renewed national conversation about the militarization of police. While Officer Wilson’s deadly encounter with Brown did not involve militarized force, subsequent protests, looting, and riots have triggered the display and use of armored vehicles, M4 assault rifles, Humvees, Kevlar vests, grenades, camouflage, and other military-style equipment by state and local police. U.S. Attorney General Eric Holder criticized the police response, asserting, “At a time when we must seek to rebuild trust between law enforcement and the local community, I am deeply concerned that the deployment of military equipment and vehicles sends a conflicting message.” Holder’s comment—and the civil unrest in Ferguson—evinces a broader societal concern about the changing role and increasing firepower of police. In an era when police seem to be “at war” with drugs and crime generally, are they essentially becoming local “soldiers”? This question, in turn, raises interesting questions about the applicability of the Third Amendment that declares, “No soldier shall, in time of peace be quartered in any house, without the consent of the Owner, nor in time of war, but in a manner to be prescribed by law.” Depending on whom one asks, the Third Amendment is either the most or least successful portion of the Bill of Rights. As Professor Glenn Reynolds put it recently, “I often tell my constitutional law students that the Third Amendment is the only part of the Bill of Rights that really works—because there are almost no cases of troop-quartering.” But as Reynolds also acknowledges, the paucity of Third Amendment litigation likely belies workability, reflecting instead a deep uncertainty about the scope and meaning of the amendment itself. Part I of this article will examine the nature and extent of police militarization, and why such militarization likely plays a role in minority communities’ protests—such as those in Ferguson, Missouri—about the excessive use of force by state and local police. It will also examine a couple of recent cases that suggest that the Third Amendment may have relevant application to civil rights lawsuits involving militarized force. Part II will explore whether the Third Amendment is binding on the States as well as the federal government. Finally, Part III will consider the meaning of the word “soldier” and its potential application to state and local police

Persistent Effects of the Ketogenic Diet on the Core Symptoms of Autism in BTBR Mice

ABSTRACT BACKGROUND: The Ketogenic Diet (KD), is a high fat, low carbohydrate dietary regimen, that has been shown to treat a diverse array of medical conditions, most notably the seizure associated with epilepsy. Recent studies have demonstrated that in addition to reducing seizure frequency, the KD has antiepileptogenic effects that continue after reversal to control diet (CD). Such results indicate that the KD does not only suppress seizures in adult mice and rats, but it is potentially effective in attenuating long-term disease progression. Furthermore, studies on autism spectrum disorder (ASD) in a murine mouse model (BTBR mice) found that KD treatment improved autistic behaviors by increasing sociability in a three-chamber test and decreasing self-directed repetitive behavior. This study will use the BTBR mouse model to determine if improvement in ASD-associated behaviors persists when animals are returned to a CD. METHODS: BTBR mice at 5 weeks of age were randomly assigned to one of three diet groups: CD, KD, and KD reversal. All mice underwent three-chamber behavioral testing (a test of sociability and self-directed repetitive behaviors in autistic models of mice) followed by two periods lasting three weeks. During the first period, both KD group and KD reversal groups were switched to KD for three weeks and underwent three-chamber behavioral testing. Subsequently, both groups underwent three additional weeks of KD, however in the last 5 days of the second period the reversal group was reverted to the CD and underwent their final three-chamber behavioral test. Body weights and blood chemistry (glucose and ketone levels) of each mouse was measured before treatment (five weeks of age; Test 1) as well as after three weeks of diet administration (eight weeks of age; Test 2) and after 6 weeks of diet administration (eleven weeks of age; Test 3). RESULTS: Although it was expected that enhanced sociability would be observed and continue after reversal to the CD, no significant improvements in sociability (characterized by ratio of phase 2, preference for sociability phase, compared to phase 1, the non-social phase) were found in any treatment group. Blood analysis revealed the hallmark characteristics of KD treatment, including weight loss, decreased glucose, and increased β –hydroxybutyrate levels were found in the KD and KD reversal group in Test 2. Additionally, weight glucose, β –hydroxybutyrate levels returned to baseline levels after 5-day reversal to CD. CONCLUSION: Despite detected metabolic changes induced by the KD, no notable improvements in sociability were detected when the entire sample size was analyzed. These data conflict with previous research thus ongoing research will consider methodological differences and include additional measures of sociability including frontal contact and self-directed repetitive behaviors

Sovereignty, Rebalanced: The Tea Party and Constitutional Amendments

Arguably since the Marshall Court and undoubtedly since the New Deal, the U.S. Constitution has been subverted to the point where its original meaning has been substantially lost inside a tangled knot of Supreme Court case law. Like termites eating away at the constitutional architecture, Supreme Court interpretations of provisions such as the Commerce Clause, taxing and spending power, Privileges or Immunities Clause, Ninth Amendment, Tenth Amendment, and Eleventh Amendment have so rotted them that they no longer serve the critical functions originally envisioned