The oral microbiota in colorectal cancer is distinctive and predictive.

BACKGROUND AND AIMS: Microbiota alterations are linked with colorectal cancer (CRC) and notably higher abundance of putative oral bacteria on colonic tumours. However, it is not known if colonic mucosa-associated taxa are indeed orally derived, if such cases are a distinct subset of patients or if the oral microbiome is generally suitable for screening for CRC. METHODS: We profiled the microbiota in oral swabs, colonic mucosae and stool from individuals with CRC (99 subjects), colorectal polyps (32) or controls (103). RESULTS: Several oral taxa were differentially abundant in CRC compared with controls, for example, Streptococcus and Prevotellas pp. A classification model of oral swab microbiota distinguished individuals with CRC or polyps from controls (sensitivity: 53% (CRC)/67% (polyps); specificity: 96%). Combining the data from faecal microbiota and oral swab microbiota increased the sensitivity of this model to 76% (CRC)/88% (polyps). We detected similar bacterial networks in colonic microbiota and oral microbiota datasets comprising putative oral biofilm forming bacteria. While these taxa were more abundant in CRC, core networks between pathogenic, CRC-associated oral bacteria such as Peptostreptococcus, Parvimonas and Fusobacterium were also detected in healthy controls. High abundance of Lachnospiraceae was negatively associated with the colonisation of colonic tissue with oral-like bacterial networks suggesting a protective role for certain microbiota types against CRC, possibly by conferring colonisation resistance to CRC-associated oral taxa and possibly mediated through habitual diet. CONCLUSION: The heterogeneity of CRC may relate to microbiota types that either predispose or provide resistance to the disease, and profiling the oral microbiome may offer an alternative screen for detecting CRC.

Exercise and Self-Reported Limitations in Patients with Inflammatory Bowel Disease.

BACKGROUND: Limited evidence suggests that exercise may have beneficial, anti-inflammatory effects in patients with inflammatory bowel disease (IBD). AIMS: The purpose of this study was to evaluate the prevalence of exercise in patients with IBD and the limitations they experience secondary to their disease. METHODS: Two hundred and fifty IBD patients were prospectively enrolled in this study at an academic medical center at the time of their outpatient visits between March and October 2013. Subjects were asked to complete a one-time survey that asks questions about medical and surgical history, exercise frequency and intensity, and the limitations and barriers they experience. RESULTS: Two hundred and twenty-seven patients (148 female patients) completed the survey. Crohn's disease was present in 140 patients (61.5 %), while 87 had ulcerative colitis. Forty-one patients (16.4 %) never exercised, 82 patients (32.8 %) exercised 1-2 times per week, 59 (23.6 %) exercised 3-4 times per week, and 45 (18.0 %) exercised more than four times per week. Of the 186 who regularly exercise, 95 (51 %) reported moderate exercise intensity, 61 (33 %) reported light intensity, and 30 (16 %) reported vigorous intensity. Ninety-nine patients (44 %) reported that their IBD limited their exercise for reasons including fatigue (n = 81), joint pain (n = 37), embarrassment (n = 23), weakness (n = 21), and others. CONCLUSIONS: Although they may benefit from exercise, IBD patients experience considerable barriers to regular exercise secondary to the relapsing and remitting nature of IBD. Larger studies are needed to determine the effects of exercise on disease symptomatology and activity.

Enhancing the Longitudinal Compressive Strength of Freeform 3D-Printed Continuous Carbon Fiber-Reinforced Polymer Composite Laminate Using Magnetic Compaction Force and Nanofiber Z-Threads.

Low fiber-direction compressive strength is a well-recognized weakness of carbon fiber-reinforced polymer (CFRP) composites. When a CFRP is produced using 3D printing, the compressive strength is further degraded. To solve this issue, in this paper, a novel magnetic compaction force-assisted additive manufacturing (MCFA-AM) method is used to print CFRP laminates reinforced with carbon nanofiber (CNF) z-threads (i.e., ZT-CFRP). MCFA-AM utilizes a magnetic force to simultaneously levitate, deposit, and compact fast-curing CFRP prepregs in free space and quickly solidifies the CFRP laminate part without any mold nor supporting substrate plate; it effectively reduces the voids. The longitudinal compressive test was performed on five different sample types. ZT-CFRP/MCFA-AM samples were printed under two different magnetic compaction rolling pressures, i.e., 0.5 bar and 0.78 bar. Compared with the longitudinal compressive strength of a typical CFRP manufactured by the traditional out-of-autoclave-vacuum-bag-only (OOA-VBO) molding process at the steady-state pressure of 0.82 bar, the ZT-CFRP/MCFA-AM samples showed either comparable results (by -1.00% difference) or enhanced results (+7.42% improvement) by using 0.5 bar or 0.78 bar magnetic rolling pressures, respectively.

Skin disinfection with a single-step 2% chlorhexidine swab is more effective than a two-step povidone-iodine method in preventing bacterial contamination of apheresis platelets.

BACKGROUND: Skin commensal bacteria account for most septic reactions after apheresis platelet (PLT) transfusion. Consequently, we evaluated the effectiveness of two skin disinfection methods in preventing bacterial contamination of PLT collections. STUDY DESIGN AND METHODS: Three regional blood centers evaluated a one-step 2% chlorhexidine/70% isopropyl alcohol (2% CHX/IPA) skin disinfection method (trial group), while 32 blood centers (control group) continued to use a two-step povidone-iodine (P-I) method. Aerobic quality control bacterial culture results and adverse donor events were compared between April 1, 2009, and December 31, 2009. RESULTS: The rate of initial positive bacterial cultures was significantly lower in the trial regions compared to control regions in 2009 (143 vs. 321 per million: odds ratio [OR] 0.44, 95% confidence interval [CI] 0.23-0.86]). Trial regions also tended to have lower rates of both true-positive cultures (100 vs. 214 per million: OR 0.47, 95% CI 0.21-1.03) and false-positive (contamination) cultures (43 vs. 96 per million: OR 0.45, 95% CI 0.14-1.49). No differences were seen in the corresponding periods in 2007 and 2008 when all centers used P-I skin preparation. Allergic reactions were reported after 89 of 73,247 apheresis procedures (0.12%) in the trial regions representing a 16-fold increase (OR 15.9, 95% CI 9.9-25.6) compared to control regions. CONCLUSION: The 2% CHX/IPA single-step skin swabs are more effective in preventing bacterial contamination of apheresis PLT components than a two-step P-I skin disinfection method and may reduce the risk of septic transfusion reactions. Skin irritation and allergic reactions were more likely among donors in trial regions, but reactions were generally mild and self-limiting.

The Effect of Breathing, Movement, and Meditation on Psychological and Physical Symptoms and Inflammatory Biomarkers in Inflammatory Bowel Disease: A Randomized Controlled Trial.

BACKGROUND: This study evaluated the effects of the Breath-Body-Mind Workshop (BBMW) (breathing, movement, and meditation) on psychological and physical symptoms and inflammatory biomarkers in inflammatory bowel disease (IBD). METHODS: Twenty-nine IBD patients from the Jill Roberts IBD Center were randomized to BBMW or an educational seminar. Beck Anxiety Inventory, Beck Depression Inventory, Brief Symptom Inventory 18, IBD Questionnaire, Perceived Disability Scale, Perceived Stress Questionnaire, Digestive Disease Acceptance Questionnaire, Brief Illness Perception Questionnaire, fecal calprotectin, C-reactive protein, and physiological measures were obtained at baseline and weeks 6 and 26. RESULTS: The BBMW group significantly improved between baseline and week 6 on Brief Symptom Inventory 18 (P = 0.02), Beck Anxiety Inventory (P = 0.02), and IBD Questionnaire (P = 0.01) and between baseline and week 26 on Brief Symptom Inventory 18 (P = 0.04), Beck Anxiety Inventory (P = 0.03), Beck Depression Inventory (P = 0.01), IBD Questionnaire (P = 0.01), Perceived Disability Scale (P = 0.001), and Perceived Stress Questionnaire (P = 0.01) by paired t tests. No significant changes occurred in the educational seminar group at week 6 or 26. By week 26, median C-reactive protein values decreased significantly in the BBMW group (P = 0.01 by Wilcoxon signed-rank test) versus no significant change in the educational seminar group. CONCLUSIONS: In patients with IBD, participation in the BBMW was associated with significant improvements in psychological and physical symptoms, quality of life, and C-reactive protein. Mind-body interventions, such as BBMW, which emphasize Voluntarily Regulated Breathing Practices, may have significant long-lasting benefits for IBD symptoms, anxiety, depression, quality of life, and inflammation. BBMW, a promising adjunctive treatment for IBD, warrants further study.

Review of the safety and efficacy of ustekinumab.

Ustekinumab is a subcutaneously and intravenously administered fully human monoclonal immunoglobulin (IgG1) antibody targeting the interleukin (IL)-12/23 shared P40 subunit. The pivotal role of IL-12/23 inflammatory-mediated pathways is increasingly recognized in a plethora of immune-mediated inflammatory disorders including Crohn's disease, psoriasis, and multiple sclerosis. In a randomized controlled trial of ustekinumab in moderate-to-severe Crohn's disease, clinical response was achieved most notably in infliximab-experienced primary and secondary nonresponders and suboptimal responders.