Nutrient-based diet modifications impact on the gut microbiome of the Javan slow loris (Nycticebus javanicus).

Environment and diet are key factors which shape the microbiome of organisms. There is also a disparity between captive and wild animals of the same species, presumably because of the change in diet. Being able to reverse the microbiome to the wild type is thus particularly important for the reintroduction efforts of Critically Endangered animals. The Javan slow loris (Nycticebus javanicus) is a suitable model, being kept in the thousands within rescue centres throughout Southeast Asia. With next-generation sequencing, we show how a naturalistic diet impacts the gut microbiome of captive slow lorises (Primates: Nycticebus). A comparison of the microbiome of wild animals with captive animals that had been fed a standard captive or improved diet reveals strong microbiome differences between wild and captive animals; however, diet changes failed to alter the microbiome of captive populations significantly. Bifidobacterium was the most abundant genus in wild animals (46.7%) while Bacteroides (11.6%) and Prevotella (18.9%) were the most abundant in captive animals fed the captive and improved diets, respectively. Correlation analyses of nutrients with microbial taxa suggest important implications in using nutrition to suppress potential pathogens, with soluble fibre and water-soluble carbohydrates both being associated with opposing microbiome profiles. The improved diet significantly increased microbe diversity, which exemplifies the importance of high fibre diets; however, wild individuals had lower diversity, which contradicts recent studies. Detection of methanogens appeared to be dependent on diet and whether the animals were living in captivity or in the wild. This study highlights the potential of nutrition in modulating the microbiome of animals prior to release. Unexpectedly, the results were not as significant as has been suggested in recent studies.

Systematic review: human gut dysbiosis induced by non-antibiotic prescription medications.

BACKGROUND: Global prescription drug use has been increasing continuously for decades. The gut microbiome, a key contributor to health status, can be altered by prescription drug use, as antibiotics have been repeatedly described to have both short-term and long-standing effects on the intestinal microbiome. AIM: To summarise current findings on non-antibiotic prescription-induced gut microbiome changes, focusing on the most frequently prescribed therapeutic drug categories. METHODS: We conducted a systematic review by first searching in online databases for indexed articles and abstracts in accordance with PRISMA guidelines. Studies assessing the intestinal microbiome alterations associated with proton pump inhibitors (PPIs), metformin, nonsteroidal anti-inflammatory drugs (NSAIDs), opioids, statins and antipsychotics were included. We only included studies using culture-independent molecular techniques. RESULTS: Proton pump inhibitors and antipsychotic medications are associated with a decrease in α diversity in the gut microbiome, whereas opioids were associated with an increase in α diversity. Metformin and NSAIDs were not associated with significant changes in α diversity. ß diversity was found to be significantly altered with all drugs, except for NSAIDs. PPI use was linked to a decrease in Clotridiales and increase in Actinomycetales, Micrococcaceae and Streptococcaceae, which are changes previously implicated in dysbiosis and increased susceptibility to Clostridium difficile infection. Consistent results showed that PPIs, metformin, NSAIDs, opioids and antipsychotics were either associated with increases in members of class Gammaproteobacteria (including Enterobacter, Escherichia, Klebsiella and Citrobacter), or members of family Enterococcaceae, which are often pathogens isolated from bloodstream infections in critically ill patients. We also found that antipsychotic treatment, usually associated with an increase in body mass index, was marked by a decreased ratio of Bacteroidetes:Firmicutes in the gut microbiome, resembling trends seen in obese patients. CONCLUSIONS: Non-antibiotic prescription drugs have a notable impact on the overall architecture of the intestinal microbiome. Further explorations should seek to define biomarkers of dysbiosis induced by specific drugs, and potentially tailor live biotherapeutics to counter this drug-induced dysbiosis. Many other frequently prescribed drugs should also be investigated to better understand the link between these drugs, the microbiome and health status.

Effect of system of lamb rearing and season on early post-partum fertility of ewes and growth performance of lambs in Katahdin sheep.

The effect of season (S), lamb rearing system (RT) and grain supplementation (GS) on post-partum fertility in Katahdin ewes and growth in Katahdin lambs was evaluated. Katahdin ewes were bred to lamb in fall (n = 36) or spring (n = 56) and at approximately 2.5 months post-partum were randomly assigned to be permanently separated or to continue to suckle their lambs for an additional 3 months. All ewes were joined with rams following treatment to synchronize oestrus. Weaned (W, n = 84) and continuously suckled lambs (CSK, n = 88) were fed forage only (n = 84; hay and pasture for fall- and spring-born lambs respectively) or were supplemented (n = 88; 18% crude protein ration ad libitum) and all weighed biweekly. Ewes rebred in the fall had a shorter ram introduction to lambing interval (p < 0.05), higher prolificacy (p = 0.001) and higher lambing rates (p = 0.02); however, the proportion of ewes lambing was not affected by season. The first service lambing rate was lower in ewes continuously suckling lambs in the spring, but not in the fall breeding season (S × RT, p = 0.03). Lambs that continuously suckled their dams and were supplemented grew quicker and gained more (p < 0.001) than their weaned and unsupplemented counterparts. The effect of CSK on growth rate of lambs was greater in the spring (RT × S; p = 0.05), and the effect of supplementation on growth rate of lambs was greater in the fall (GS × S; p < 0.0001). In conclusion, Katahdin lambs achieved higher weight gains from continuous suckling and grain supplementation. Moreover, Katahdin ewes are capable of early rebreeding post-partum while suckling their lambs, which makes them suited for use in accelerated lambing programmes.

Chemotherapy-driven dysbiosis in the intestinal microbiome.

BACKGROUND: Chemotherapy is commonly used as myeloablative conditioning treatment to prepare patients for haematopoietic stem cell transplantation (HSCT). Chemotherapy leads to several side effects, with gastrointestinal (GI) mucositis being one of the most frequent. Current models of GI mucositis pathophysiology are generally silent on the role of the intestinal microbiome. AIM: To identify functional mechanisms by which the intestinal microbiome may play a key role in the pathophysiology of GI mucositis, we applied high-throughput DNA-sequencing analysis to identify microbes and microbial functions that are modulated following chemotherapy. METHODS: We amplified and sequenced 16S rRNA genes from faecal samples before and after chemotherapy in 28 patients with non-Hodgkin's lymphoma who received the same myeloablative conditioning regimen and no other concomitant therapy such as antibiotics. RESULTS: We found that faecal samples collected after chemotherapy exhibited significant decreases in abundances of Firmicutes (P = 0.0002) and Actinobacteria (P = 0.002) and significant increases in abundances of Proteobacteria (P = 0.0002) compared to samples collected before chemotherapy. Following chemotherapy, patients had reduced capacity for nucleotide metabolism (P = 0.0001), energy metabolism (P = 0.001), metabolism of cofactors and vitamins (P = 0.006), and increased capacity for glycan metabolism (P = 0.0002), signal transduction (P = 0.0002) and xenobiotics biodegradation (P = 0.002). CONCLUSIONS: Our study identifies a severe compositional and functional imbalance in the gut microbial community associated with chemotherapy-induced GI mucositis. The functional pathways implicated in our analysis suggest potential directions for the development of intestinal microbiome-targeted interventions in cancer patients.

Enteral feeding in patients with major burn injury: the use of nasojejunal feeding after the failure of nasogastric feeding.

Patients with major burn injury have increased protein and energy requirements and early feeding is an established part of their management. The optimal method of feeding is unknown. Nasogastric feeding is often unsuccessful and total parenteral nutrition has a number of potential disadvantages. Post pyloric feeding is an alternative means of providing enteral nutrition. We report our experience of enteral feeding of patients with significant burn injury. Nasogastric feeding was successful in only 7 of 17 patients (41%). The commonest reason that nasogastric feeding failed was gastric stasis. All patients who failed nasogastric feeding were commenced on nasojejunal feeding and a further two patients were fed by this route initially. Ten of these 12 patients (83%) were successfully fed nasojejunally. No major adverse events attributable to nasojejunal feeding were identified, a nasojejunal tube was successfully placed in all but 1 patient and the tubes were well tolerated. We conclude that nasojejunal tube feeding should be considered in all patients with significant burn injury who cannot tolerate nasogastric tube feeding.

The tussometer: accuracy and reproducibility.

Tussometry is a new non-invasive technique for objectively assessing laryngeal function by analysis of the airflow waveform produced by a maximum effort voluntary cough manoeuvre. We describe the technique and present the calibration data. The tussometer has been calibrated for flows of up to 1100 litre min-1 using a flowmeter with a quoted accuracy of +/- 1.75%. The variables measured (cough peak flow rate (CPFR) and peak velocity time (PVT)) were found to be reproducible; the within-subject variability for CPFR was found to be 23.9% and for PVT 9%. There was no inter-observer variation. We found that the size of the mask used did not influence the readings obtained, providing an adequate seal was achieved.

Theory as a guide to practice: staff nurses choose Parse's theory.

This paper describes the changes that occurred in staff nurses' thoughts and actions when Parse's theory was used as a guide for practice on an acute care medical unit. As participants in an eight month evaluation project of Parse's theory, nurses struggled to change in a process of growth which led to new approaches in practice. Ways of thinking about patients and practice before and after Parse's theory clarify how this approach is different from the traditional biomedical model. Nurses describe how their perspective of human beings changed from viewing patients as problems to viewing patients as unique individuals. Healing nurse-person relationships led to enhanced satisfaction and morale for nurses and improved quality of care for patients. This article offers challenging ideas for all nurses interested in testing nursing theory and in particular for nurses interested in Parse's humanistic approach.