Safety, Clinical Response, and Microbiome Findings Following Fecal Microbiota Transplant in Children With Inflammatory Bowel Disease.

Background: The role of fecal microbiota transplant (FMT) in the treatment of pediatric inflammatory bowel disease (IBD) is unknown. The aims of this study were to assess safety, clinical response, and gut microbiome alterations in children with Crohn's disease (CD), ulcerative colitis (UC), or indeterminate colitis (IC). Methods: In this open-label, single-center prospective trial, patients with IBD refractory to medical therapy underwent a single FMT by upper and lower endoscopy. Adverse events, clinical response, gut microbiome, and biomarkers were assessed at baseline, 1 week, 1 month, and 6 months following FMT. Results: Twenty-one subjects were analyzed, with a median age of 12 years, of whom 57% and 28% demonstrated clinical response at 1 and 6 months post-FMT, respectively. Two CD patients were in remission at 6 months. Adverse events attributable to FMT were mild to moderate and self-limited. Patients prior to FMT showed decreased species diversity and significant microbiome compositional differences characterized by increased Enterobacteriaceae, Enterococcus, Haemophilus, and Fusobacterium compared with donors and demonstrated increased species diversity at 30 days post-FMT. At 6 months, these changes shifted toward baseline. Clinical responders had a higher relative abundance of Fusobacterium and a lower diversity at baseline, as well as a greater shift toward donor-like microbiome after FMT compared with nonresponders. Conclusions: A single FMT is relatively safe and can result in a short-term response in young patients with active IBD. Responders possessed increased Fusobacterium prior to FMT and demonstrated more significant microbiome changes compared with nonresponders after FMT. Microbiome characteristics may help in predicting response.

Intraoperative monitoring for intracranial aneurysms: the Michigan experience.

Intraoperative neurophysiological monitoring is routinely used during the repair (endovascular or microsurgical) of intracranial aneurysms at major centers. There is a continued need of data sets from institutions with dedicated intraoperative neurophysiological monitoring services to further define the predictive factors of postoperative neurological deficits. We retrospectively reviewed and analyzed our database of all patients who underwent repair of intracranial aneurysms (endovascular or microsurgical). A total of 406 patients underwent 470 procedures. The changes were noted during monitoring in 3.83% of the cases. Most of the changes were first detected in somatosensory evoked potential (88.89%) followed by brainstem auditory evoked potential (16.67%). Changes were completely reversible in 44.44%, only partly reversible in 22.22%, and irreversible in 33.33% of cases. Intraoperative neurophysiological monitoring changes demonstrated high sensitivity, specificity, and negative predictive value for postoperative neurological deficits. The association between intraoperative neurophysiological monitoring changes and Glasgow outcome scale was significant for reversible changes compared against irreversible and partly reversible changes. Presence of any intraoperative neurophysiological monitoring modality change during repair of intracranial aneurysm may suggest a higher risk for postoperative neurological deficits. Reversibility of the changes is a favorable marker, whereas irreversible changes are predictive of postoperative neurological deficits with deterioration of Glasgow outcome scale on a longer follow-up.

Strain- and sex-specific differences in daily flight activity and the circadian clock of Anopheles gambiae mosquitoes.

Anopheles gambiae, the primary African malaria vector, is currently speciating into two incipient species, the so-called "molecular forms" M and S. While some geographic areas may contain only one form, in many areas both forms are found coexisting, but reproductively isolated. It appears that spatial segregation of mating swarms may contribute significantly to reproductive isolation as in many locales single-form swarms exist almost exclusively even though they are in close geographic proximity. The mechanism causing this spatial segregation is not well understood. Here, we compare the locomotor flight activity of M and S form male and female An. gambiae mosquitoes with the goal of identifying potential strain-specific temporal differences that could potentially serve as a mating barrier. We use an infrared beam break method to monitor flight activity of individual mosquitoes with a minute-to-minute time resolution under both LD cycle and constant dark conditions. We compare daily total flight activity, activity onset, peak in early nocturnal activity, the build up of dusk-related activity, and the free-running circadian period length. Our investigations revealed strain- and sex-specific differences in total daily activity. In both forms, males commenced nightly flight activity earlier than females, and this corresponded with a significantly shorter circadian period length in males compared to females. We note strain-specific differences in this response to dusk as males of the M form have a pronounced build up in flight activity relative to the S form males prior to complete darkness. This is likely driven by a differential response to the decreasing light intensity at dusk. We hypothesize that this behavioral difference could be a temporal factor contributing to the assembly of single-form swarms.