Heritable components of the human fecal microbiome are associated with visceral fat

Background: Variation in the human fecal microbiota has previously been associated with body mass index (BMI). Although obesity is a global health burden, the accumulation of abdominal visceral fat is the specific cardio-metabolic disease risk factor. Here, we explore links between the fecal microbiota and abdominal adiposity using body composition as measured by dual-energy X-ray absorptiometry in a large sample of twins from the TwinsUK cohort, comparing fecal 16S rRNA diversity profiles with six adiposity measures.Results: We profile six adiposity measures in 3666 twins and estimate their heritability, finding novel evidence for strong genetic effects underlying visceral fat and android/gynoid ratio. We confirm the association of lower diversity of the fecal microbiome with obesity and adiposity measures, and then compare the association between fecal microbial composition and the adiposity phenotypes in a discovery subsample of twins. We identify associations between the relative abundances of fecal microbial operational taxonomic units (OTUs) and abdominal adiposity measures. Most of these results involve visceral fat associations, with the strongest associations between visceral fat and Oscillospira members. Using BMI as a surrogate phenotype, we pursue replication in independent samples from three population-based cohorts including American Gut, Flemish Gut Flora Project and the extended TwinsUK cohort. Meta-analyses across the replication samples indicate that 8 OTUs replicate at a stringent threshold across all cohorts, while 49 OTUs achieve nominal significance in at least one replication sample. Heritability analysis of the adiposity-associated microbial OTUs prompted us to assess host genetic-microbe interactions at obesity-associated human candidate loci. We observe significant associations of adiposity-OTU abundances with host genetic variants in the FHIT, TDRG1 and ELAVL4 genes, suggesting a potential role for host genes to mediate the link between the fecal microbiome and obesity.Conclusions: Our results provide novel insights into the role of the fecal microbiota in cardio-metabolic disease with clear potential for prevention and novel therapies

A Historicai Consideration on the Changes of the Wabicha (Tea Ceremony) and the Roji (Tea Garden) : Part 3: The Succession and development of Oribe\u27s Style for Tea Ceremony by Enshu

織部において, 茶室, 茶庭は客のためのよりよき茶を演出するための場としてとらえる立場をとる.この織部の茶を継承し, さらに展開した遠州は茶庭(露地)のための造形を含めて, かずかずの茶の造形をものしている.しかも, その中には, 後世に受けつがれ, 語りつがれる, すぐれた数々の成果がある.このすぐれた成果を生み出した基盤には, 彼の豊かな天賦の才があったこと勿論であるが, しかし, 一方, 彼を取り巻くすぐれた人びとが, 彼のこのすぐれた天賦の才をさらにみがき, そして大きく育てる役割を果したことも, また軽視できないといわねばならない.本報告では, このような遠州を取り巻くすぐれた人びとの中で, 特に松花堂昭乗を取りあげる.滝本坊客殿の幅広い東縁と, これから茶室・閑雲軒の躙口へ通じる狭い榑縁と, このひとつらなりの廊下がつくり出す構成は, 外露地から内露地への園路の構成に通じるものといえる.而して, この構成を, 遠州が先きに金地院八窓席の躙口まえにおいて試みた手法から, さらに一歩を踏み出したデザインとみる.また, その手水構えにおいても, ここ閑雲軒においては, 蹲踞構えではなく, 書院における縁先手水の構えを思わせる構成をとるものであって, それは廊下を園路と見立てる手法によって, はじめて成立する構成といえる.そして, この構成は, やがて, 書院茶室へと展開する遠州の新しい茶の造形に向う, 一階梯として大きな意義をもつ.また, 滝本坊茶立所の室内構成をみるとき, そこには遠州伏見屋敷におけるデザインからの発展といえるかずかずの特徴がみられる.さらに, この滝本坊茶立所における作事のかずかずの体験が, やがて, 遠州の造形デザインの世界を, さEnshu Kobori succeeded Oribe Furuta\u27s style for a wabicha (a tea ceremony in the special room or house for it) to recieve the quests with a tea in the hospitable settings of a room and a garden, and developed it cultivating his talent by the communicaion with several outstanding people of his salon like Shojo Shokado or a monk of Iwashimizu Hachimangu. One of the process of the development could be found in the approach from the kyakuden (a reception hall) of Takimotobo of Shojo\u27s living house to Kanunken of a special house for a tea ceremony through the verandah, and in the design of chatatedokoro, i.e. the room for a wabicha in a shoin style. The way from the kyakuden to Kanunken through the verandah would have been supposed as the way from a soto-roji to a uchi-roji, and a set of tsukubai or a basin for washing hands beside the verandah used like a ensaki-chouzu in case of a shoincha or a tea service in a shoin. And, we can point out several effects of Shojo in the design of chatatedokoro. Therefore, the design of Takimotobo is on the way to a wabicha in a shoin style, which is completed by Enshu in the design of Bosen of Kohoan, Daitokuji

Front of neck access: A survey among anesthetists and surgeons

Background and Aims: Emergency front of neck access (FONA) is the final step in a Can't Intubate–Can't Oxygenate (CICO) scenario. In view of maintaining simplicity and promoting standardized training, the 2015 Difficult Airway Society guidelines recommend surgical cricothyroidotomy using scalpel, bougie, and tube (SBT) as the preferred technique. Material and Methods: We undertook a survey over a 2-week period to evaluate the knowledge and training, preferred rescue technique, and confidence in performing the SBT technique. Data were collected from both anesthetists and surgeons. Results: One hundred and eighty-nine responses were collected across four hospitals in the United Kingdom. The majority of participants were anesthetists (55%). One hundred and eleven (59%) respondents were aware of the national guidelines (96.2% among anesthetists and 12.9% among surgeons). Only 71 (37.6%) respondents indicated that they had formal FONA training within the last one year. Seventy-five anesthetists (72.8%) knew that SBT equipment was readily available in their department, while most surgeons (81.2%) did not know what equipment available. One hundred and five (55.5%) respondents were confident in performing surgical cricothyroidotomy in a situation where the membrane was palpable and only in 33 (17.5%) where the cricothyroid membrane was not palpable. Conclusion: This survey has demonstrated that despite evidence of good training for anesthetists in FONA, there are still shortfalls in the training and knowledge of our surgical colleagues. In an emergency, surgeons may be required to assist or secure an airway in a CICO situation. Regular multidisciplinary training of all clinicians working with anesthetized patients should be encouraged and supported

Front of neck access : a survey among anesthetists and surgeons

Background and Aims: Emergency front of neck access (FONA) is the final step in a Can't Intubate–Can't Oxygenate (CICO) scenario. In view of maintaining simplicity and promoting standardized training, the 2015 Difficult Airway Society guidelines recommend surgical cricothyroidotomy using scalpel, bougie, and tube (SBT) as the preferred technique. Material and Methods: We undertook a survey over a 2-week period to evaluate the knowledge and training, preferred rescue technique, and confidence in performing the SBT technique. Data were collected from both anesthetists and surgeons. Results: One hundred and eighty-nine responses were collected across four hospitals in the United Kingdom. The majority of participants were anesthetists (55%). One hundred and eleven (59%) respondents were aware of the national guidelines (96.2% among anesthetists and 12.9% among surgeons). Only 71 (37.6%) respondents indicated that they had formal FONA training within the last one year. Seventy-five anesthetists (72.8%) knew that SBT equipment was readily available in their department, while most surgeons (81.2%) did not know what equipment available. One hundred and five (55.5%) respondents were confident in performing surgical cricothyroidotomy in a situation where the membrane was palpable and only in 33 (17.5%) where the cricothyroid membrane was not palpable. Conclusion: This survey has demonstrated that despite evidence of good training for anesthetists in FONA, there are still shortfalls in the training and knowledge of our surgical colleagues. In an emergency, surgeons may be required to assist or secure an airway in a CICO situation. Regular multidisciplinary training of all clinicians working with anesthetized patients should be encouraged and supported

Heritable components of the human fecal microbiome are associated with visceral fat

Variation in the human fecal microbiota has previously been associated with body mass index (BMI). Although obesity is a global health burden, the accumulation of abdominal visceral fat is the specific cardio-metabolic disease risk factor. Here, we explore links between the fecal microbiota and abdominal adiposity using body composition as measured by dual-energy X-ray absorptiometry in a large sample of twins from the TwinsUK cohort, comparing fecal 16S rRNA diversity profiles with six adiposity measures.status: publishe