Probiotics and the Prevention of Clostridioides difficile: A Review of Existing Systematic Reviews

Clostridioides difficile is the leading cause of infectious diarrhea (Vernaya et al., 2017). Probiotics have been proposed to provide a protective benefit against Clostridioides difficile infection (CDI). The objective of this literature review was to examine the research evidence pertaining to the use of probiotics for the prevention of CDI in individuals receiving antibiotic therapy. A systematic literature review of studies published between 2015 and 2019 was performed. Five databases were searched, which yielded 10 systematic reviews that met strict inclusion criteria. Overall, the majority of evidence indicated that probiotics versus no treatment, placebo, or usual care have the potential to reduce CDIs in patients on antibiotic therapy by 50% or greater. There was no increased risk of adverse events among those taking probiotics. Benefit is greater when the background risk of CDIs was over 5%. The optimal probiotic dose, duration, species, and formulation is not known, although multispecies or Lactobacillus probiotics may be more effective in addition to taking probiotics within one to two days of starting antibiotics. These findings are limited to patients that are not immune compromised, pregnant, elderly, critically ill, have not had recent surgery, and do not have prosthetic heart valves. Overall, due to the magnitude of the effect of probiotics and their favorable safety profile, providers should consider including a shared decision-making conversation with their patients taking antibiotics regarding their personal risk versus benefit option to take probiotics concurrently

The Role of Tobacco, Alcohol, and Obesity in Neoplastic Progression to Esophageal Adenocarcinoma: A Prospective Study of Barrett's Esophagus

Background: Esophageal adenocarcinoma (EA) incidence in many developed countries has increased dramatically over four decades, while survival remains poor. Persons with Barrett's esophagus (BE), who experience substantially elevated EA risk, are typically followed in surveillance involving periodic endoscopy with biopsies, although few progress to EA. No medical, surgical or lifestyle interventions have been proven to safely lower EA risk. Design: We investigated whether smoking, obesity or alcohol could predict progression to EA in a prospective cohort of 411 BE patients. Data were collected during personal interview. Adjusted hazard ratios (HR) were estimated using Cox regression. Results: 39% had body mass index (BMI) over 30 and 64% had smoked cigarettes. Main analyses focused on those with at least 5 months of follow-up (33,635 person-months), in whom 45 developed EA. Risk increased by 3% per year of age (trend p-value 0.02), with approximate doubling of risk among males. EA risk increased with smoking pack-years (trend p-value 0.04) and duration (p-value 0.05). Compared to never-smokers, the HR for those in the highest pack-year tertile was 2.29 (95%CI 1.04–5.07). No association was found with alcohol or BMI, whereas a suggestion of increased risk was observed in those with higher waist-hip ratio, especially among males. Conclusion: EA risk significantly increased with increasing age and cigarette exposure. Abdominal obesity, but not BMI, was associated with a modest increased risk. Continued follow-up of this and other cohorts is needed to precisely define these relationships so as to inform risk stratification and preventive interventions

Effect of Insecticides and Plutella xylostella (Lepidoptera: Plutellidae) Genotype on a Predator and Parasitoid and Implications for the Evolution of Insecticide Resistance

In the laboratory and in cages in the greenhouse, we evaluated the toxicity of two insecticides (lambda-cyhalothrin and spinosad) on the parasitoid, Diadegma insulare (Cresson), and the predator, Coleomegilla maculate (DeGeer), both natural enemies of the diamondback moth, Plutella xylostella (L.). Lambda-cyhalothrin was very toxic to both natural enemies. Spinosad was less toxic to C. maculata adults and larvae, and slightly toxic to D. insulare. Both natural enemies suppressed P. xylostella populations in cages with 80% spinosad-treated and 20% nontreated plants; such suppression was not seen when lambda-cyhalothrin was used. Using broccoli, Brassica oleracea L. variety italica, a common host for P. xylostella, we also studied direct and indirect effects of both natural enemies in the presence and absence of the two insecticides and to different P. xylostella genotypes: resistant to the insecticide, susceptible, or heterozygous. Neither natural enemy could distinguish host genotype if P. xylostella were feeding on nontreated plants. They could also not distinguish between larvae feeding on spinosad-treated plants and nontreated plants, but D. insulare could distinguish between larvae feeding on lambda-cyhalothrin treated and nontreated plants. Our studies suggest that lambda-cyhalothrin has direct toxicity to these two natural enemies, can affect their host foraging and acceptance of P. xylostella and consequently would not be compatible in conserving these natural enemies in a program for suppression of P. xylostella. In contrast, our studies suggest that treatment with spinosad has much less effect on these natural enemies and would allow them to help suppress populations of P. xylostella. These findings are discussed in relation to the evolution of insecticide resistance and suppression of the pest population

Effect of Bt Broccoli or Plants Treated With Insecticides on Ovipositional Preference and Larval Survival of Plutella xylostella (Lepidoptera: Plutellidae)

The diamondback moth, Plutella xylostella (L.) (Lepidoptera: Plutellidae), a major pest of cruciferous crops throughout the world, has demonstrated an ability to develop resistance to many different classes of insecticides, including proteins from Bacillus thuringiensis that are expressed in plants (Bt plants). The ovipositional preferences and larval survival of strains (resistant strain, RR; heterozygous strain, RS; susceptible strain, SS) of P. xylostella to Cry1Ac-expressing broccoli or broccoli plants treated with lambda-cyhalothrin or spinosad were studied under greenhouse condition. Numbers of eggs per plant did not differ between Bt broccoli and non-Bt broccoli for Bt-RR, Bt-RS, and Bt-SS adults. Ovipositing adults (spinosad-RR, spinosad-RS, and spinosad-SS) also could not discriminate between spinosad-treated and untreated plants, and oviposition did not increase over the 13 d after spinosad treatment. For broccoli treated with lambda-cyhalothrin at the diagnostic dose of 20 ppm, all three insect strains (lc-RR, lc-RS, and lc-SS) had constant oviposition over time based on linear regressions. At the field dose of 80 ppm, the lc-RR strain had constant oviposition over time. The lc-SS susceptible strain had increasing oviposition over time, but the oviposition pattern on the nonsprayed broccoli also increased over time. Susceptible females layed fewer eggs on plants sprayed with lambda-cyhalothrin than on unsprayed plants. A residue-persistence test showed that spinosad and lambda-cyhalothrin could effectively control SS P. xylostella larvae for 7-9 d after application. These results are discussed in relation to their potential impact on insecticide resistance management strategie

Video-tracking and On-plant Tests Show Cry1Ab Resistance Influences Behavior and Survival of Neonate Ostrinia nubilalis Following Exposure to Bt Maize

To examine how resistance to Bacillus thuringiensis (Bt) toxins influences movement and survival of European corn borer (Ostrinia nubilalis [Hübner]) neonates, the responses of Cry1Ab-resistant , -susceptible, and hybrid (F1) larvae were examined using two different techniques. First, using an automated video-tracking system, aspects of O. nubilalis movement were quantified in the presence of artificial diet incorporating 50% non-Bt or insect-resistant Cry1Ab maize tissue. Second, O. nubilalis dispersal and survival were measured 48–72 h after hatching on a Cry1Ab maize plant surrounded by two non-Bt maize plants. Video tracking indicated the presence of Cry1Ab tissue increased the total distance moved (m), time moving (%), and time away from the diet (%) for O. nubilalis while decreasing meander (degrees/cm). However, resistant larvae showed reduced movement and increased meander (≈localized searching) relative to susceptible or hybrid larvae on diet incorporating Cry1Ab tissue. Conversely, when placed onto Cry1Ab maize plants, resistant larvae were more likely than susceptible O. nubilalis to disperse onto adjacent non-Bt plants. The difference in on-plant dispersal seems to reflect greater survival after toxin exposure for resistant larvae rather than increased activity. These results suggest that simplified ‘Petri dish’ tests may not be predictive of larval movement among non-Bt and insect-resistant Bt maize plants. Because models of O. nubilalis resistance evolution incorporate various movement and survival parameters, improved data for on-plant behavior and survival of Bt- resistant , -susceptible, and hybrid larvae should help preserve the efficacy of transgenic insect-resistant maize

Tailoring Hydrothermal Vent Biodiversity Toward Improved Biodiscovery Using a Novel in situ Enrichment Strategy

Deep-sea hydrothermal vents are amongst the most extreme environments on Earth and represent interesting targets for marine bioprospecting and biodiscovery. The microbial communities in hydrothermal vents are often dominated by chemolithoautotrophs utilizing simple chemical compounds, though the full extent of their heterotrophic abilities is still being explored. In the bioprocessing industry, where degradation of complex organic materials often is a major challenge, new microbial solutions are heavily needed. To meet these needs, we have developed novel in situ incubators and tested if deployment of recalcitrant materials from fish farming and wood-pulping industries introduced changes in the microbial community structure in hot marine hydrothermal sediments. The incubation chambers were deployed in sediments at the Bruse vent site located within the Jan Mayen vent field for 1 year, after which the microbial populations in the chambers were profiled by 16S rRNA Ion Torrent amplicon sequencing. A total of 921 operational taxonomic units (OTUs) were assigned into 74 different phyla where differences in community structure were observed depending on the incubated material, chamber depth below the sea floor and/or temperature. A high fraction of putative heterotrophic microbial lineages related to cultivated members within the Thermotogales were observed. However, considerable fractions of previously uncultivated and novel Thermotogales and Bacteroidetes were also identified. Moreover, several novel lineages (e.g., members within the DPANN superphylum, unidentified archaeal lineages, unclassified Thermoplasmatales and Candidatus division BRC-1 bacterium) of as-yet uncultivated thermophilic archaea and bacteria were identified. Overall, our data illustrate that amendment of hydrothermal vent communities by in situ incubation of biomass induces shifts in community structure toward increased fractions of heterotrophic microorganisms. The technologies utilized here could aid in subsequent metagenomics-based enzyme discovery for diverse industries.publishedVersio

Modeling Evolution of Resistance by Maruca vitrata (Lepidoptera: Crambidae) to Transgenic Insecticidal Cowpea in Africa

We created a detailed model of the Maruca vitrata (F.) and cowpea [Vigna unguiculata (L.) Walp] system to study the possible evolution of resistance by the insect to transgenic insecticidal cowpea, which is under development. We focused on population dynamics and genetics in a region of west Africa. We simulated single-toxin and pyramided (two-toxin) cowpea and emphasized conservative, worst-case scenarios in our analysis. The results indicate that as long as a pyramided, transgenic cowpea can be developed, seed saving by farmers and reliance on natural refuge are not major problems for resistance management. Furthermore, it is possible that one or both toxins in the pyramid may not need to be high dose for evolution to be delayed significantly (>20 yr or 80 generations for resistance to become a concern if transgenic cowpea is deployed in areas where M. vitrata is endemic). If efforts are made to deploy transgenic cowpea only into the regions where M. vitrata is not endemic, then there is little to no concern with resistance emerging in the M. vitrata populatio

"A little theatrical but mostly athletic": The mutable erotics of Miranda July's The First Bad Man

By attending to the inherent flux of sexual fantasy, Miranda July’s first novel The First Bad Man reveals a mobile and mutable erotics capable of generating an enlarged range of self-identification and relational intimacy, far from any essentialist assumptions of stable or coherent sexual identity. July focuses specifically upon role-play as the means to unpack the normative categories of hetero/homosexuality, masculinity and femininity, celebrating rather than pathologising qualities like superficiality and inconsistency. The novel touches upon many polarising issues (for example, sexual violence, sadomasochism and assisted reproductive technology), deftly avoiding the conventional language which colours perception. Both erotic and humorous, The First Bad Man helps to redefine the often highly charged discourse around sex and sexuality

MiRNA-Related SNPs and Risk of Esophageal Adenocarcinoma and Barrett's Esophagus: Post Genome-Wide Association Analysis in the BEACON Consortium.

Incidence of esophageal adenocarcinoma (EA) has increased substantially in recent decades. Multiple risk factors have been identified for EA and its precursor, Barrett's esophagus (BE), such as reflux, European ancestry, male sex, obesity, and tobacco smoking, and several germline genetic variants were recently associated with disease risk. Using data from the Barrett's and Esophageal Adenocarcinoma Consortium (BEACON) genome-wide association study (GWAS) of 2,515 EA cases, 3,295 BE cases, and 3,207 controls, we examined single nucleotide polymorphisms (SNPs) that potentially affect the biogenesis or biological activity of microRNAs (miRNAs), small non-coding RNAs implicated in post-transcriptional gene regulation, and deregulated in many cancers, including EA. Polymorphisms in three classes of genes were examined for association with risk of EA or BE: miRNA biogenesis genes (157 SNPs, 21 genes); miRNA gene loci (234 SNPs, 210 genes); and miRNA-targeted mRNAs (177 SNPs, 158 genes). Nominal associations (P0.50), and we did not find evidence for interactions between variants analyzed and two risk factors for EA/BE (smoking and obesity). This analysis provides the most extensive assessment to date of miRNA-related SNPs in relation to risk of EA and BE. While common genetic variants within components of the miRNA biogenesis core pathway appear unlikely to modulate susceptibility to EA or BE, further studies may be warranted to examine potential associations between unassessed variants in miRNA genes and targets with disease risk.This work was supported by the National Institutes of Health [R01CA136725 to T.L.V. and D.C.W, T32CA009168 to T.L.V, and K05CA124911 to T.L.V.]. Additional funding sources for individual studies included in the BEACON GWAS, and for BEACON investigators, have been acknowledged previously (16).This is the final version of the article. It first appeared from PLOS via http://dx.doi.org/10.1371/journal.pone.012861