Bariatric surgery and brain health: A longitudinal observational study investigating the effect of surgery on cognitive function and gray matter volume

Dietary modifications leading to weight loss have been suggested as a means to improve brain health. In morbid obesity, bariatric surgery (BARS)—including different procedures, such as vertical sleeve gastrectomy (VSG), gastric banding (GB), or Roux-en-Y gastric bypass (RYGB) surgery—is performed to induce rapid weight loss. Combining reduced food intake and malabsorption of nutrients, RYGB might be most effective, but requires life-long follow-up treatment. Here, we tested 40 patients before and six months after surgery (BARS group) using a neuropsychological test battery and compared them with a waiting list control group. Subsamples of both groups underwent structural MRI and were examined for differences between surgical procedures. No substantial differences between BARS and control group emerged with regard to cognition. However, larger gray matter volume in fronto-temporal brain areas accompanied by smaller volume in the ventral striatum was seen in the BARS group compared to controls. RYGB patients compared to patients with restrictive treatment alone (VSG/GB) had higher weight loss, but did not benefit more in cognitive outcomes. In sum, the data of our study suggest that BARS might lead to brain structure reorganization at long-term follow-up, while the type of surgical procedure does not differentially modulate cognitive performance

An empirical analysis of terminological representation systems

The family of terminological representation systems has its roots in the representation system KL-ONE. Since the development of this system more than a dozen similar representation systems have been developed by various research groups. These systems vary along a number of dimensions.In this paper, we present the results of an empirical analysis of six such systems. Surprisingly, the systems turned out to be quite diverse leading to problems when transporting knowledge bases from one system to another. Additionally, the runtime performance between different systems and knowledge bases varied more than we expected. Finally, our empirical runtime performance results give an idea of what runtime performance to expect from such representation systems. These findings complement previously reported analytical results about the computational complexity of reasoning in such systems

Resolution of cor pulmonale after medical management in a patient with cblC-type methylmalonic aciduria and homocystinuria: a case report

We describe a 3-year-old Hispanic male with cblC-type methylmalonic aciduria and homocystinuria who presented to the emergency department with progressive tachypnea, vomiting, and edema secondary to pulmonary embolism and cor pulmonale. With aggressive medical management, there was complete resolution of right heart failure and pulmonary hypertension after 3 months. Pulmonary embolism is rare in the pediatric population. Children with cblC-type methylmalonic aciduria and homocystinuria may be at increased risk for thrombus formation and pulmonary embolism due to chronic hyperhomocystinemia, a risk factor for thrombus formation in the adult population. Aspirin therapy may be indicated in children with inborn errors of metabolism that predispose to hyperhomocystinemia

An empirical analysis of optimization techniques for terminological representation systems : or: \u27Making KRIS get a move on\u27

We consider different methods of optimizing the classification process of terminological representation systems, and evaluate their effect on three different types of test data. Though these techniques can probably be found in many existing systems, until now there has been no coherent description of these techniques and their impact on the performance of a system. One goal of this paper is to make such a description available for future implementors of terminological systems. Building the optimizations that came off best into the KRIS system greatly enhanced its efficiency

Plan-based integration of natural language and graphics generation

Multimodal interfaces combining natural language and graphics take advantage of both the individual strength of each communication mode and the fact that several modes can be employed in parallel. The central claim of this paper is that the generation of a multimodal presentation system WIP which allows the generation of alternate presentations of the same content taking into account various contextual factors. We discuss how the plan-based approach to presentation design can be exploited so that graphics generation influences the production of text and vice versa. We show that well-known concepts from the area of natural language processing like speech acts, anaphora, and rhetorical relations take on an extended meaning in the context of multimodal communication. Finally, we discuss two detailed examples illustrating and reinforcing our theoretical claims

Terminological knowledge representation : a proposal for a terminological logic

This paper contains a proposal for a terminological logic. The formalisms for representing knowledge as well as the needed inferences are described

Guidelines for diagnosis and management of the cobalamin-related remethylation disorders cblC, cblD, cblE, cblF, cblG, cblJ and MTHFR deficiency

BACKGROUND: Remethylation defects are rare inherited disorders in which impaired remethylation of homocysteine to methionine leads to accumulation of homocysteine and perturbation of numerous methylation reactions. OBJECTIVE: To summarise clinical and biochemical characteristics of these severe disorders and to provide guidelines on diagnosis and management. DATA SOURCES: Review, evaluation and discussion of the medical literature (Medline, Cochrane databases) by a panel of experts on these rare diseases following the GRADE approach. KEY RECOMMENDATIONS: We strongly recommend measuring plasma total homocysteine in any patient presenting with the combination of neurological and/or visual and/or haematological symptoms, subacute spinal cord degeneration, atypical haemolytic uraemic syndrome or unexplained vascular thrombosis. We strongly recommend to initiate treatment with parenteral hydroxocobalamin without delay in any suspected remethylation disorder; it significantly improves survival and incidence of severe complications. We strongly recommend betaine treatment in individuals with MTHFR deficiency; it improves the outcome and prevents disease when given early