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Effects of oral probiotic supplements on vaginal microbiota during pregnancy: a randomised, double-blind, placebo-controlled trial with microbiome analysis
OBJECTIVE: To determine the effects on the vaginal microbiota of an oral probiotic preparation administered from early pregnancy.
DESIGN: Randomised, double blind, placebo-controlled trial.
SETTING: Four maternity units in the UK.
POPULATION: Women aged 16 years or older recruited at 9-14 weeks' gestation.
METHODS: Participants were randomly allocated to receive oral capsules of probiotic containing Lactobacillus rhamnosus GR-1 and Lactobacillus reuteri RC-14 each at 2.5 × 109 colony-forming units (CFUs) or placebo once daily from recruitment until the end of pregnancy.
MAIN OUTCOME MEASURE: Rates of bacterial vaginosis (BV, defined as Nugent score ≥7) at 18-20 weeks' gestation compared by logistic regression adjusted for possible confounders.
RESULTS: The primary analysis included 78% (238/304) of participants who initially consented (probiotic group 123, placebo group 115). Of these participants, 95% (227/238) reported an intake of 93% or more of the required number of capsules. The rates of BV did not differ between groups at 18-20 weeks' gestation (15% (19/123) in the probiotic group vs. 9% (10/115) in the placebo group, adjusted odds ratio 1.82, 95% confidence interval 0.64-5.19). There were also no differences between the groups in the proportion of women colonised with the probiotic strains, Escherichia coli, Group B streptococci or other vaginal microbiota. There were no differences in the alpha diversity or composition of the bacterial communities between or within the probiotic and placebo groups at 9-14 and 18-20 weeks' gestation.
CONCLUSIONS: Oral probiotics taken from early pregnancy did not modify the vaginal microbiota.
TWEETABLE ABSTRACT: The oral probiotic preparation used in this study does not prevent BV in pregnant women
Key findings and comparisons from analogous case-cluster studies for dengue virus infection conducted in Machala, Ecuador, and Kamphaeng Phet, Thailand
The Thai research study presented here was funded by an R01 award from the National Institutes of Health (PI: TE, GM83224-01A1). This Ecuadorian research study was supported, in part, by the Department of Defense Global Emerging Infection Surveillance (GEIS) grant (P0220_13_OT) and the Department of Medicine of SUNY Upstate Medical University. AS-I and SR were additionally supported by NSF DEB EEID 1518681 and NSF DEB RAPID 1641145.Dengue viruses (DENV) pose a significant and increasing threat to human health across broad regions of the globe. Currently, prevention, control, and treatment strategies are limited. Promising interventions are on the horizon, including multiple vaccine candidates under development and a renewed and innovative focus on controlling the vector, Aedes aegypti. However, significant gaps persist in our understanding of the similarities and differences in DENV epidemiology across regions of potential implementation and evaluation. In this manuscript, we highlight and compare findings from two analogous cluster-based studies for DENV transmission and pathogenesis conducted in Thailand and Ecuador to identify key features and questions for further pursuit. Despite a remarkably similar incidence of DENV infection among enrolled neighborhood contacts at the two sites, we note a higher occurrence of secondary infection and severe illness in Thailand compared to Ecuador. A higher force of infection in Thailand, defined as the incidence of infection among susceptible individuals, is suggested by the higher number of captured Aedes mosquitoes per household, the increasing proportion of asymptomatic infections with advancing age, and the high proportion of infections identified as secondary-type infections by serology. These observations should be confirmed in long-term, parallel prospective cohort studies conducted across regions, which would advantageously permit characterization of baseline immune status (susceptibility) and contemporaneous assessment of risks and risk factors for dengue illness.Publisher PDFPeer reviewe
Mechanism of enhancement of ferroelectricity of croconic acid with temperature
A microscopic study of the thermal behaviour of atomic motions in the organic ferroelectric croconic acid is presented in the temperature range 5–300 K.</p
Yang-Mills instantons and dyons on homogeneous G_2-manifolds
We consider Lie G-valued Yang-Mills fields on the space R x G/H, where G/H is
a compact nearly K"ahler six-dimensional homogeneous space, and the manifold R
x G/H carries a G_2-structure. After imposing a general G-invariance condition,
Yang-Mills theory with torsion on R x G/H is reduced to Newtonian mechanics of
a particle moving in R^6, R^4 or R^2 under the influence of an inverted
double-well-type potential for the cases G/H = SU(3)/U(1)xU(1),
Sp(2)/Sp(1)xU(1) or G_2/SU(3), respectively. We analyze all critical points and
present analytical and numerical kink- and bounce-type solutions, which yield
G-invariant instanton configurations on those cosets. Periodic solutions on S^1
x G/H and dyons on iR x G/H are also given.Comment: 1+26 pages, 14 figures, 6 miniplot
Deep Underground Science and Engineering Laboratory - Preliminary Design Report
The DUSEL Project has produced the Preliminary Design of the Deep Underground
Science and Engineering Laboratory (DUSEL) at the rehabilitated former
Homestake mine in South Dakota. The Facility design calls for, on the surface,
two new buildings - one a visitor and education center, the other an experiment
assembly hall - and multiple repurposed existing buildings. To support
underground research activities, the design includes two laboratory modules and
additional spaces at a level 4,850 feet underground for physics, biology,
engineering, and Earth science experiments. On the same level, the design
includes a Department of Energy-shepherded Large Cavity supporting the Long
Baseline Neutrino Experiment. At the 7,400-feet level, the design incorporates
one laboratory module and additional spaces for physics and Earth science
efforts. With input from some 25 science and engineering collaborations, the
Project has designed critical experimental space and infrastructure needs,
including space for a suite of multidisciplinary experiments in a laboratory
whose projected life span is at least 30 years. From these experiments, a
critical suite of experiments is outlined, whose construction will be funded
along with the facility. The Facility design permits expansion and evolution,
as may be driven by future science requirements, and enables participation by
other agencies. The design leverages South Dakota's substantial investment in
facility infrastructure, risk retirement, and operation of its Sanford
Laboratory at Homestake. The Project is planning education and outreach
programs, and has initiated efforts to establish regional partnerships with
underserved populations - regional American Indian and rural populations
Evaluation of different bowel preparations for small bowel capsule endoscopy: a prospective, randomized, controlled study
To obtain an adequate view of the whole small
intestine during capsule endoscopy (CE) a clear liquid diet and overnight fasting
is recommended. However, intestinal content can hamper vision in spite of these
measures. Our aim was to evaluate tolerance and degree of intestinal cleanliness
during CE following three types of bowel preparation. PATIENTS AND METHODS: This
was a prospective, multicenter, randomized, controlled study. Two-hundred
ninety-one patients underwent one of the following preparations: 4 L of clear
liquids (CL) (group A; 92 patients); 90 mL of aqueous sodium phosphate (group B;
89 patients); or 4 L of a polyethylene glycol electrolyte solution (group C; 92
patients). The degree of cleanliness of the small bowel was classified by blinded
examiners according to four categories (excellent, good, fair or poor). The
degree of patient satisfaction, gastric and small bowel transit times, and
diagnostic yield were measured. RESULTS: The degree of cleanliness did not differ
significantly between the groups (P = 0.496). Interobserver concordance was fair
(k = 0.38). No significant differences were detected between the diagnostic
yields of the CE (P = 0.601). Gastric transit time was 35.7 +/- 3.7 min (group
A), 46.1 +/- 8.6 min (group B) and 34.6 +/- 5.0 min (group C) (P = 0.417).
Small-intestinal transit time was 276.9 +/- 10.7 min (group A), 249.7 +/- 13.1
min (group B) and 245.6 +/- 11.6 min (group C) (P = 0.120). CL was the best
tolerated preparation. Compliance with the bowel preparation regimen was lowest
in group C (P = 0.008). CONCLUSIONS: A clear liquid diet and overnight fasting is
sufficient to achieve an adequate level of cleanliness and is better tolerated by
patients than other forms of preparation
Impact of first-line antiretroviral therapy regimens on the restoration of the CD4/CD8 ratio in the CNICS cohort
Background: The CD4/CD8 ratio is an indicator of immunosenescence and a predictor of all-cause mortality in HIV-infected patients. The effects of different ART regimens on CD4/CD8 ratio recovery remain unclear. Methods: Clinical cohort study of ART-treated patients from the CFAR Network of Integrated Clinical Systems (CNICS). We included ART-naive adults with HIV infection who achieved undetectable HIV RNA during the first 48 weeks of treatment and had additional follow-up 48 weeks after virological suppression (VS). Primary endpoints included increase in CD4/CD8 ratio at both timepoints and secondary endpoints were CD4/CD8 ratio recovery at cut-offs of ≥0.5 or ≥1.0. Results: Of 3971 subjects who met the study criteria, 1876 started ART with an NNRTI, 1804 with a PI and 291 with an integrase strand transfer inhibitor (INSTI). After adjusting for age, sex, race, year of entry, risk group, HCV serostatus, baseline viral load and baseline CD4/CD8 ratio, subjects on an NNRTI showed a significantly greater CD4/CD8 ratio gain compared with those on a PI, either 48 weeks after ART initiation or after 48 weeks of HIV RNA VS. The greater CD4/CD8 ratio improvement in the NNRTI arm was driven by a higher decline in CD8 counts. The INSTI group showed increased rates of CD4/CD8 ratio normalization at the ≥1.0 cut-off compared with the PI group. Conclusions: NNRTI therapy was associated with a greater increase in the CD4/CD8 ratio compared with PIs. NNRTI- and INSTI-based first-line ART were associated with higher rates of CD4/CD8 ratio normalization at a cutoff of 1.0 than a PI-based regimen, which might have clinical implications
Measurement of the cosmic ray spectrum above eV using inclined events detected with the Pierre Auger Observatory
A measurement of the cosmic-ray spectrum for energies exceeding
eV is presented, which is based on the analysis of showers
with zenith angles greater than detected with the Pierre Auger
Observatory between 1 January 2004 and 31 December 2013. The measured spectrum
confirms a flux suppression at the highest energies. Above
eV, the "ankle", the flux can be described by a power law with
index followed by
a smooth suppression region. For the energy () at which the
spectral flux has fallen to one-half of its extrapolated value in the absence
of suppression, we find
eV.Comment: Replaced with published version. Added journal reference and DO
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