scholarly journals Gut microbiomes from Gambian infants reveal the development of a non-industrialized Prevotella-based trophic network

2021 ◽  
Author(s):  
Marcus C. de Goffau ◽  
Amadou T. Jallow ◽  
Chilel Sanyang ◽  
Andrew M. Prentice ◽  
Niamh Meagher ◽  
...  
Keyword(s):  
Gut Microbiota ◽  
Age Groups ◽  
Abundant Species ◽  
Time Frame ◽  
Developmental Time ◽  
Secondary Outcome ◽  
Industrialized Countries ◽  
Double Blind ◽  
Trophic Networks ◽  
Trophic Network

AbstractDistinct bacterial trophic networks exist in the gut microbiota of individuals in industrialized and non-industrialized countries. In particular, non-industrialized gut microbiomes tend to be enriched with Prevotella species. To study the development of these Prevotella-rich compositions, we investigated the gut microbiota of children aged between 7 and 37 months living in rural Gambia (616 children, 1,389 stool samples, stratified by 3-month age groups). These infants, who typically eat a high-fibre, low-protein diet, were part of a double-blind, randomized iron intervention trial (NCT02941081) and here we report the secondary outcome. We found that child age was the largest discriminating factor between samples and that anthropometric indices (collection time points, season, geographic collection site, and iron supplementation) did not significantly influence the gut microbiome. Prevotella copri, Faecalibacterium prausnitzii and Prevotella stercorea were, on average, the most abundant species in these 1,389 samples (35%, 11% and 7%, respectively). Distinct bacterial trophic network clusters were identified, centred around either P.stercorea or F.prausnitzii and were found to develop steadily with age, whereas P.copri, independently of other species, rapidly became dominant after weaning. This dataset, set within a critical gut microbial developmental time frame, provides insights into the development of Prevotella-rich gut microbiomes, which are typically understudied and are underrepresented in western populations.

scholarly journals The gut microbiome of 7-37 month old children from The Gambia shows the development of a distinct non-industrial Prevotella-based trophic network

2021 ◽  
Author(s):  
Marcus de Goffau ◽  
Amadou Jallow ◽  
Chilel Sanyang ◽  
Andrew Prentice ◽  
Julian Parkhill ◽  
...  
Keyword(s):  
Gut Microbiota ◽  
Gut Microbiome ◽  
Age Groups ◽  
Abundant Species ◽  
Industrialized Countries ◽  
Data Set ◽  
High Fiber ◽  
Network Cluster ◽  
Faecalibacterium Prausnitzii ◽  
Trophic Network

Abstract Distinctive bacterial trophic networks exist in the gut microbiota of individuals in industrialized and non- industrialized countries. To study the development of these networks, we investigated the gut microbiota of 7-37 month old children living in rural Gambia (616 children, 1407 stool samples, stratified by 3-month age groups). We found that child age was the largest discriminating factor between samples, and that anthropometric indices WAZ, HAZ, and WHZ, collection timepoints, and iron supplementation did not significantly influence the gut microbiome in this data set. Prevotella copri, Faecalibacterium prausnitzii, and Prevotella stercorea were the most abundant species (35%, 11%, and 7%, respectively). Distinct bacterial trophic network clusters were identified, centered around Prevotella stercorea and Faecalibacterium prausnitzii, which were found to develop steadily as the gut microbiome matured. The Prevotella stercorea trophic network cluster is distinct from those found in individuals in industrialized countries and therefore this dataset, set within a critical developmental timeframe, provides an excellent opportunity to understand the influence of a high fiber, low-protein diet on the development of a Prevotella-enriched gut microbiome.

Effects of Consumption of Probiotic Powder Containing Lactobacillus Plantarum Dad-13 on Fecal Bacterial Population in School-Age Children in Indonesia

2019 ◽  
Vol 14 (1) ◽  
pp. 1-8 ◽  
Author(s):  
Banin Maghfirotin Marta ◽  
Utami Tyas ◽  
Cahyanto Muhammad Nur ◽  
Widada Jaka ◽  
Rahayu Endang Sutriswati
Keyword(s):  
Placebo Group ◽  
Gut Microbiota ◽  
Lactobacillus Plantarum ◽  
Coliform Bacteria ◽  
School Age Children ◽  
Controlled Study ◽  
School Age ◽  
Double Blind ◽  
Probiotic Group ◽  
E Coli

Consumption of probiotics is known to influence the gut microbiota. The aim of this study was to assess the effect of probiotic powder containing Lactobacillus plantarum Dad-13 on bacterial composition in the gut by examining fecal samples of school-age children in Yogyakarta, Indonesia. This is a randomized, double-blind, placebo-controlled study. A total of 40 healthy subjects were recruited for this study and were divided into two groups: placebo group and probiotic group. The placebo group consumed skim milk and the probiotic group consumed probiotic powder containing L. plantarum Dad-13 (2 × 109 CFU/g) for 65 days. The results showed that placebo intake had no significant effect on gut microbiota; however, probiotic caused a significant increase in L. plantarum and Lactobacillus population, while decreasing the population of E. coli and non-E. coli coliform bacteria by 55% and 75%, respectively and Bifidobacteria count did not change significantly. The study concluded that consumption of probiotic powder L. plantarum Dad-13 could increase propionic acid thereby decreasing the gut pH which has an effect on the microbial population.

scholarly journals Sex differences in the phylum‐level human gut microbiota composition

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Alexander Koliada ◽  
Vladislav Moseiko ◽  
Mariana Romanenko ◽  
Oleh Lushchak ◽  
Nadiia Kryzhanovska ◽  
...  
Keyword(s):  
Sex Differences ◽  
Gut Microbiota ◽  
Age Groups ◽  
Microbiota Composition ◽  
Human Gut ◽  
Cross Sectional ◽  
Total N ◽  
Human Gut Microbiota ◽  
Gut Microbiota Composition

Abstract Background Evidence was previously provided for sex-related differences in the human gut microbiota composition, and sex-specific discrepancy in hormonal profiles was proposed as a main determinant of these differences. On the basis of these findings, the assumption was made on the role of microbiota in the sexual dimorphism of human diseases. To date, sex differences in fecal microbiota were demonstrated primarily at lower taxonomic levels, whereas phylum-level differences between sexes were reported in few studies only. In the present population-based cross-sectional research, sex differences in the phylum-level human gut microbiota composition were identified in a large (total n = 2301) sample of relatively healthy individuals from Ukraine. Results Relative abundances of Firmicutes and Actinobacteria, as determined by qRT-PCR, were found to be significantly increased, while that of Bacteroidetes was significantly decreased in females compared to males. The Firmicutes to Bacteroidetes (F/B) ratio was significantly increased in females compared to males. Females had 31 % higher odds of having F/B ratio more than 1 than males. This trend was evident in all age groups. The difference between sexes was even more pronounced in the elder individuals (50+): in this age group, female participants had 56 % higher odds of having F/B ratio > 1 than the male ones. Conclusions In conclusion, sex-specific differences in the phylum-level intestinal microbiota composition were observed in the Ukraine population. The F/B ratio was significantly increased in females compared to males. Further investigation is needed to draw strong conclusions regarding the mechanistic basis for sex-specific differences in the gut microbiota composition and regarding the role of these differences in the initiation and progression of human chronic diseases.

scholarly journals O26 Testing an intervention to reduce fatigue impact in inflammatory arthritis: design and outcomes of a single-arm feasibility study

Rheumatology ◽  
2021 ◽  
Vol 60 (Supplement_1) ◽  
Author(s):  
Susan Bridgewater ◽  
Joe Lomax ◽  
Bryan Abbott ◽  
Jo Adams ◽  
Alice Berry ◽  
...  
Keyword(s):  
Feasibility Study ◽  
Inflammatory Arthritis ◽  
Primary Outcome ◽  
Time Frame ◽  
Secondary Outcome ◽  
Control Group ◽  
Regression To The Mean ◽  
Intervention Delivery ◽  
Cognitive Behavioural ◽  
One To One

Abstract Background/Aims  Patients with inflammatory arthritis report that fatigue can be a challenging symptom to manage, with little support available. In response, we developed a brief one-to-one cognitive-behavioural manualised intervention, delivered by rheumatology health professionals (RHPs), to help patients manage their fatigue. Methods  We designed a single-arm feasibility study called FREE-IA (Fatigue - Reducing its Effects through individualised support Episodes in Inflammatory Arthritis). Patients were eligible if they were ≥18 years, had a clinician confirmed diagnosis of inflammatory arthritis, scored ≥6/10 on the BRAF NRS Fatigue Impact with fatigue that they considered recurrent, frequent, and/or persistent, and were not accessing support for their fatigue. Following training, RHPs delivered 2-4 one-to-one sessions to participants. The initial two core sessions were delivered face-to-face in clinic; participants then had the option of up to two further sessions, either in clinic, by telephone or online. We proposed delivering sessions 1 and 2 within two weeks of each other, and sessions 3 and 4 in the following two weeks. Baseline data were collected before the first session (T0), and outcomes at six weeks (T1) and six months (T2). The primary outcome was fatigue impact (BRAF NRS Fatigue Effect), collected by telephone. Secondary outcomes included fatigue severity, fatigue coping, multi-dimensional impact of fatigue, disease impact and disability and measures of therapeutic mechanism (self-efficacy, and perceived confidence and autonomy to manage health). These outcomes were collected by post. This study allowed us to test the feasibility and acceptability of RHP training, study design and materials, intervention delivery and outcome collection, ahead of a possible RCT to determine intervention effectiveness. Results  Eight RHPs at five hospitals delivered 113 sessions to 46 participants. Four sessions were delivered by phone and none online. Session 2 was only delivered within the two-week time frame for 37% of participants attending both core sessions. Out of a potential 138 primary and secondary outcome responses at T0, T1 and T2, there were 13 missing primary outcome responses and 27 missing secondary outcome responses. Results indicated improvements in all measures except disability at either T1 or T2, or both, with confidence intervals supporting an interpretation of improvement. Conclusion  We were able to design and deliver FREE-IA training to RHPs, deliver FREE-IA sessions to patients, and collect outcomes at three time points with low levels of attrition. Outcomes in all measures except disability were in a direction to suggest improvement at T1, T2, or both. Study numbers were small, there was no control group and regression to the mean was a possibility. However, outcomes were in the direction to cautiously suggest benefit, and there is evidence of promise of the intervention. A definitive RCT is the next step to test clinical and cost effectiveness of the intervention. Disclosure  S. Bridgewater: None. J. Lomax: None. B. Abbott: None. J. Adams: None. A. Berry: None. S. Creanor: None. P. Ewings: None. S. Hewlett: None. L. McCracken: None. M. Ndosi: None. J. Thorn: None. M. Urban: None. E. Dures: None.

scholarly journals How does general practitioner discontinuity affect healthcare utilisation? An observational cohort study of 2.4 million Norwegians 2007–2017

BMJ Open ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. e042391
Author(s):  
Lena Janita Skarshaug ◽  
Silje Lill Kaspersen ◽  
Johan Håkon Bjørngaard ◽  
Kristine Pape
Keyword(s):  
Cohort Study ◽  
General Practitioner ◽  
Service Use ◽  
Hospital Admissions ◽  
Age Groups ◽  
Healthcare Utilisation ◽  
Acute Hospital ◽  
Secondary Outcome ◽  
Out Of Hours ◽  
Adult Age

ObjectivesPatients may benefit from continuity of care by a personal physician general practitioner (GP), but there are few studies on consequences of a break in continuity of GP. Investigate how a sudden discontinuity of GP care affects their list patients’ regular GP consultations, out-of-hours consultations and acute hospital admissions, including admissions for ambulatory care sensitive conditions (ACSC).DesignCohort study linking person-level national register data on use of health services and GP affiliation with data on GP activity and GP characteristics.SettingPrimary care.Participants2 409 409 Norwegians assigned to the patient lists of 2560 regular GPs who, after 12 months of stable practice, had a sudden discontinuity of practice lasting two or more months between 2007 and 2017.Primary and secondary outcome measuresMonthly GP consultations, out-of-hours consultations, acute hospital admissions and ACSC admissions in periods during and 12 months after the discontinuity, compared with the 12-month period before the discontinuity using logistic regression models.ResultsAll patient age groups had a 3%–5% decreased odds of monthly regular GP consultations during the discontinuity. Odds of monthly out-of-hours consultations increased 2%–6% during the discontinuity for all adult age groups. A 7%–9% increase in odds of ACSC admissions during the period 1–6 months after discontinuity was indicated in patients over the age of 65, but in general little or no change in acute hospital admissions was observed during or after the period of discontinuity.ConclusionsModest changes in health service use were observed during and after a sudden discontinuity in practice among patients with a previously stable regular GP. Older patients seem sensitive to increased acute hospital admissions in the absence of their personal GP.

scholarly journals The Composition and Diversity of the Gut Microbiota in Children Is Modifiable by the Household Dogs: Impact of a Canine-Specific Probiotic

2021 ◽  
Vol 9 (3) ◽  
pp. 557
Author(s):  
Carlos Gómez-Gallego ◽  
Mira Forsgren ◽  
Marta Selma-Royo ◽  
Merja Nermes ◽  
Maria Carmen Collado ◽  
...  
Keyword(s):  
Gut Microbiota ◽  
Home Environment ◽  
Double Blind ◽  
Before And After ◽  
Probiotic Intervention ◽  
Probiotic Product ◽  
Acid Producing Bacteria ◽  
Double Blind Design ◽  
To Receive ◽  
Gut Microbiota Composition

The development of the infant gut microbiota is initiated during pregnancy and continued through early life and childhood, guided by the immediate environment of the child. Our aim was to characterize the shared microbiota between dogs and children as well as to determine whether introduction to dogs of a dog-specific probiotic combination modifies the transfer process. We studied 31 children from allergic families with pet dog(s) and 18 control families without a dog. Altogether 37 dogs were randomized for a 4-week period in a double-blind design to receive canine-derived probiotic product containing a mixture of L. fermentum, L. plantarum, and L. rhamnosus, or placebo. Fecal samples from children and dogs were taken before and after the treatment. Distinctive gut microbiota composition was observed in children with dogs compared to those without a dog, characterized by higher abundance of Bacteroides and short-chain fatty acid producing bacteria such as Ruminococcus and Lachnospiraceae. Probiotic intervention in dogs had an impact on the composition of the gut microbiota in both dogs and children, characterized by a reduction in Bacteroides. We provide evidence for a direct effect of home environment and household pets on children microbiota and document that modification of dog microbiota by specific probiotics is reflected in children’s microbiota.

scholarly journals Incidence of childhood injuries and modifiable household risk factors in rural Ghana: a multistage, cluster-randomised, population-based, household survey

BMJ Open ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. e039243
Author(s):  
Adam Gyedu ◽  
Barclay T Stewart ◽  
Easmon Otupiri ◽  
Kajal Mehta ◽  
Peter Donkor ◽  
...  
Keyword(s):  
Risk Factors ◽  
Protective Factor ◽  
Age Groups ◽  
Secondary Outcome ◽  
Older Children ◽  
Multilevel Regression ◽  
Sampling Weights ◽  
Effective Prevention ◽  
Childhood Injuries ◽  
Rural Ghana

ObjectiveWe aimed to describe the incidence of childhood household injuries and prevalence of modifiable household risk factors in rural Ghana to inform prevention initiatives.Setting357 randomly selected households in rural Ghana.ParticipantsCaregivers of children aged <5 years.Primary and secondary outcome measuresChildhood injuries that occurred within 6 months and 200 metres of the home that resulted in missed school/work, hospitalisation and/or death. Sampling weights were applied, injuries were described and multilevel regression was used to identify risk factors.ResultsCaregivers from 357 households had a mean age of 35 years (SD 12.8) and often supervised ≥2 children (51%). Households typically used biomass fuels (84%) on a cookstove outside the home (79%). Cookstoves were commonly <1 metre of the ground (95%). Weighted incidence of childhood injury was 542 per 1000 child-years. Falls (37%), lacerations (24%), burns (12%) and violence (12%) were common mechanisms. There were differences in mechanism across age groups (p<0.01), but no gender differences (p=0.25). Presence of older children in the home (OR 0.15, 95% CI 0.09 to 0.24; adjusted OR (aOR) 0.26, 95% CI 0.13 to 0.54) and cooking outside the home (OR 0.28, 95% CI 0.19 to 0.42; aOR 0.25, 95% CI 0.13 to 0.49) were protective against injury, but other common modifiable risk factors (eg, stove height, fuel type, secured cabinets) were not.ConclusionsChildhood injuries occurred frequently in rural Ghana. Several common modifiable household risk factors were not associated with an increase in household injuries. Presence of older children was a protective factor, suggesting that efforts to improve supervision of younger children might be effective prevention strategies.

scholarly journals Effect of Zinc Supplementation on Innate and Adaptive Immunity in Lao Children at Risk of Zinc Deficiency (P19-013-19)

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Gertrud Schuster ◽  
Chidchamai Kewcharoenwong ◽  
Maxwell Barffour ◽  
Guy-Marino Hinnouho ◽  
Janet Peerson ◽  
...  
Keyword(s):  
T Cell ◽  
Venous Blood ◽  
Analysis Of Covariance ◽  
T Cell Subsets ◽  
Secondary Outcome ◽  
Plasma Zinc ◽  
Blood Leukocytes ◽  
Double Blind ◽  
Significant Group ◽  
High Zinc

Abstract Objectives Determine if children (6 to 23 mo) who received daily preventive zinc (PZ; 7 mg/d), daily high-zinc, low-iron micronutrient powder (MNP; 10 mg/d zinc, 6 mg/d iron) or therapeutic zinc during episodes of diarrhea (TZ; 20 mg/d for 10 d per episode) have improved markers of innate and adaptive immune function, compared to placebo (PL). Methods Rural Laotian children were recruited into a double-blind, randomized, controlled intervention trial for 9 mo. Venous blood was collected at baseline (BL) and endline (EL) for analysis. Primary outcomes included T-cell subsets (naïve and memory CD4, CD8, Tregs) measured by flow cytometry and production of T-cell cytokines (IL-2, IL-10, IL-13, IL-17A, INF-γ) and LPS-induced cytokines (IL-1β, IL-6, IL-10, TNF-α by whole blood cultures. Blood leukocytes (including lymphocytes, neutrophils, monocytes and eosinophils) were measured as secondary outcome variables. Group means at EL were compared by analysis of covariance (controlling for BL values of the outcome, sex, child age, district, month of enrollment and plasma zinc concentration). If an interaction with BL plasma zinc (above/below median) was observed, group means were compared separately in children above and below the median. Results Mean BL plasma zinc in all children (N = 574) was 0.55 ± 0.12 mg/L. No significant group differences were seen at EL in the primary outcomes. For secondary outcomes, the counts (^103/μL) of lymphocytes from the PZ group (5.02 ± 0.16) were significantly lower than the PL group (5.64 ± 0.16; P = 0.032). The EL counts (^103/μL) of from the PZ group (0.144 ± 0.026) were significantly lower than in the PL (0.279 ± 0.048; P = 0.036) and TZ (0.285 ± 0.047; P = 0.025) groups among children with baseline zinc below the median. Conclusions Primary outcomes (T-cell subsets, and cytokine production) were not affected by the zinc intervention. Lymphocyte and eosinophil concentrations may be affected by zinc treatment but this result requires confirmation. Funding Sources ARS Project 2032-53000-001-00-D, Mathile Institute for the Advancement of Human Nutrition.

scholarly journals Methotrimeprazine versus haloperidol in palliative care patients with cancer-related nausea: a randomised, double-blind controlled trial

BMJ Open ◽  
2019 ◽  
Vol 9 (9) ◽  
pp. e029942 ◽  
Author(s):  
Janet Rea Hardy ◽  
Helen Skerman ◽  
Jennifer Philip ◽  
Phillip Good ◽  
David C Currow ◽  
...  
Keyword(s):  
Palliative Care ◽  
Outcome Measures ◽  
Controlled Trial ◽  
Response Rates ◽  
Complete Response ◽  
Response To Treatment ◽  
Secondary Outcome ◽  
Double Blind ◽  
Intention To Treat ◽  
Point Reduction

ObjectivesMethotrimeprazine is commonly used for the management of nausea but never tested formally against other drugs used in this setting. The aim was to demonstrate superior antiemetic efficacy.DesignDouble-blind, randomised, controlled trial of methotrimeprazine versus haloperidol.Setting11 palliative care sites in Australia.ParticipantsParticipants were >18 years, had cancer, an average nausea score of ≥3/10 and able to tolerate oral medications. Ineligible patients had acute nausea related to treatment, nausea for which a specific antiemetic was indicated, were about to undergo a procedure or had received either of the study drugs or a change in glucocorticoid dose within the previous 48 hours.InterventionsBased on previous studies, haloperidol was used as the control. Participants were randomised to encapsulated methotrimeprazine 6·25 mg or haloperidol 1·5 mg one time or two times per day and assessed every 24 hours for 72 hours.Main outcome measuresA ≥two-point reduction in nausea score at 72 hours from baseline. Secondary outcome measures were as follows: complete response at 72 hours (end nausea score less than 3), response at 24 and 48 hours, vomiting episodes, use of rescue antiemetics, harms and global impression of change.ResultsResponse to treatment at 72 hours was 75% (44/59) in the haloperidol (H) arm and 63% (36/57) in the methotrimeprazine (M) arm with no difference between groups (intention-to-treat analysis). Complete response rates were 56% (H) and 51% (M). In theper protocolanalysis, there was no difference in response rates: (85% (44/52) (H) and 74% (36/49) (M). Completeper protocolresponse rates were 64% (H) and 59% (M). Toxicity worse than baseline was minimal with a trend towards greater sedation in the methotrimeprazine arm.ConclusionThis study did not demonstrate any difference in response rate between methotrimeprazine and haloperidol in the control of nausea.Trial registration numberACTRN 12615000177550.

Digital Medical Interview Assistant AnCha for Obtaining the Medical History in General Medicine: Case study (Preprint)

2021 ◽  
Author(s):  
Selina Florence Regli ◽  
Floriana Gashi ◽  
Kerstin Denecke
Keyword(s):  
Medical History ◽  
User Interfaces ◽  
Pilot Trial ◽  
Age Groups ◽  
General Medicine ◽  
Time Frame ◽  
Practical Implementation ◽  
Medical Interview ◽  
Digital Tool ◽  
Dialog System

BACKGROUND Collecting information on the medical history of a patient is an important step during the diagnosing process. Besides the interrogation by the physician, computerized questionnaires are used to collect the data. To facilitate interaction, implementation of digital medical interview assistants (DMIA) using conversational user interfaces (CUI) gain in interest. OBJECTIVE The aim of this research is to assess patient’s and physician’s perceptions towards a DMIA with CUI. Beyond, we want to understand how such DMIA can be used in real-world context, what issues and barriers exist in their usage. METHODS We developed a web-based DMIA with CUI (referred to as AnCha for anamnesis chatbot) as a research prototype in a participative and iterative development process. We conducted a pilot trial in a practice for general medicine. Patient perceptions were collected and physicians were interrogated regarding usefulness of collected information. RESULTS 31 patients were approached, and 9 participants were included in the pilot trial; 3 conversation protocols were used by the physicians to prepare for the encounter. Participants spanned all age groups from digital natives (n=5), and digital workers (n=3) to digital seniors (n=1). Patients can easily interact with AnCha and are willing to provide information to the digital tool. They recognize benefits while using the dialog system compared to the existing process. Important insights into practical implementation and integration into practice workflows could be gained. CONCLUSIONS Providing information on complaints and medical history before the actual encounter is considered useful. In order to be supportive for physicians, information has to be made available in a sufficient time frame before the encounter. Future work has to assess in particular whether AnCha is also well accessible for digital seniors.

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