Examining current trends and future outlook of bio-electrochemical systems (BES) for nutrient conversion and recovery: an overview.

Nutrient-rich waste streams from domestic and industrial sources and the increasing application of synthetic fertilizers have resulted in a huge-scale influx of reactive nitrogen and phosphorus in the environment. The higher concentrations of these pollutants induce eutrophication and foster degradation of aquatic biodiversity. Besides, phosphorus being non-renewable resource is under the risk of rapid depletion. Hence, recovery and reuse of the phosphorus and nitrogen are necessary. Over the years, nutrient recovery, low-carbon energy, and sustainable bioremediation of wastewater have received significant interest. The conventional wastewater treatment technologies have higher energy demand and nutrient removal entails a major cost in the treatment process. For these issues, bio-electrochemical system (BES) has been considered as sustainable and environment friendly wastewater treatment technologies that utilize the energy contained in the wastewater so as to recovery nutrients and purify wastewater. Therefore, this article comprehensively focuses and critically analyzes the potential sources of nutrients, working mechanism of BES, and different nutrient recovery strategies to unlock the upscaling opportunities. Also, economic analysis was done to understand the technical feasibility and potential market value of recovered nutrients. Hence, this review article will be useful in establishing waste management policies and framework along with development of advanced configurations with major emphasis on nutrient recovery rather than removal from the waste stream.

Efficacy of fecal microbiota transplantation in 2 children with recurrent Clostridium difficile infection and its impact on their growth and gut microbiome.

Fecal microbiota transplantation (FMT) is recognized as an alternative therapeutic modality for recurrent Clostridium difficile infection (RCDI); however, data on its efficacy in children are lacking, including its effect on their growth and fecal microbiota. We report on 2 young children (<3 years old) who failed available therapeutics for RCDI, but responded remarkably well to FMT. Besides resolution of clinical features of C difficile infection (CDI), FMT administration led to marked improvement in their growth, along with increased microbiota diversity, especially proportion of Bacteroides. Our 2 cases illustrate the efficacy of FMT in children with RCDI and its positive effect on their growth and gut microbiota.

Efficacy of combined jejunal and colonic fecal microbiota transplantation for recurrent Clostridium difficile Infection.

The prevalence of recurrent Clostridium difficile infection (RCDI) is increasing; fecal microbiota transplantation (FMT) is an effective therapy. However, there have been no studies of the efficacy of a single session of combined enteral and colonic FMT or characterizations of changes in the microbiota between donors and recipients. We performed a study of 27 patients with RCDI who were given a fixed volume of processed fecal filtrate via enteroscopy and colonoscopy in a single session. Patients were closely monitored, and fecal samples were collected from 2 patient-donor pairs for 16S rRNA analysis. All patients had reduced stool frequency, abdominal pain, white blood cell counts, and elimination of fecal C difficile toxin (P < .05). FMT increased microbial diversity, increasing proportions of Lachnospiraceae (phylum Firmicutes) and reducing proportions of Enterobacteriaceae. FMT was associated with marked changes in the composition of fecal microbiota in 2 patients with RCDI.

Microbiota dynamics in patients treated with fecal microbiota transplantation for recurrent Clostridium difficile infection.

Clostridium difficile causes antibiotic-associated diarrhea and pseudomembraneous colitis and is responsible for a large and increasing fraction of hospital-acquired infections. Fecal microbiota transplantation (FMT) is an alternate treatment option for recurrent C. difficile infection (RCDI) refractory to antibiotic therapy. It has recently been discussed favorably in the clinical and scientific communities and is receiving increasing public attention. However, short- and long-term health consequences of FMT remain a concern, as the effects of the transplanted microbiota on the patient remain unknown. To shed light on microbial events associated with RCDI and treatment by FMT, we performed fecal microbiota analysis by 16S rRNA gene amplicon pyrosequencing of 14 pairs of healthy donors and RCDI patients treated successfully by FMT. Post-FMT patient and healthy donor samples collected up to one year after FMT were studied longitudinally, including one post-FMT patient with antibiotic-associated relapse three months after FMT. This analysis allowed us not only to confirm prior reports that RCDI is associated with reduced diversity and compositional changes in the fecal microbiota, but also to characterize previously undocumented post-FMT microbiota dynamics. Members of the Streptococcaceae, Enterococcaceae, or Enterobacteriaceae were significantly increased and putative butyrate producers, such as Lachnospiraceae and Ruminococcaceae were significantly reduced in samples from RCDI patients before FMT as compared to post-FMT patient and healthy donor samples. RCDI patient samples showed more case-specific variations than post-FMT patient and healthy donor samples. However, none of the bacterial groups were invariably associated with RCDI or successful treatment by FMT. Overall microbiota compositions in post-FMT patients, specifically abundances of the above-mentioned Firmicutes, continued to change for at least 16 weeks after FMT, suggesting that full microbiota recovery from RCDI may take much longer than expected based on the disappearance of diarrheal symptoms immediately after FMT.

Nutritional support for head and neck cancer patients receiving radiotherapy: a systematic review.

PURPOSE: Squamous cell carcinoma of the head and neck (HNSCC) is associated with weight loss before, during, and after treatment with radiotherapy (RT). This systematic review addressed the question "Which interventions aimed at optimizing nutrition are of benefit to HNSCC patients receiving RT?" METHODS: Randomized controlled trials (RCTs) studying interventions directed at nutritional support of adult patients with HNSCC receiving RT with or without chemotherapy were eligible. RCTs studying prophylaxis of acute mucositis, perioperative nutrition, or palliative and non-HNSCC populations were excluded. A comprehensive literature search was done and meta-analyses planned. RESULTS: Ten unique RCTs were identified (n = 585). All randomized less than 50 patients per trial arm. Five trials studied dietary counseling and/or nutritional supplements, four studied drug interventions, and one studied prophylactic enteral tube feeding. Nutritional status appeared to be maintained or improved with dietary counseling, megestrol acetate, and prophylactic enteral tube feeding. CONCLUSIONS: Data from RCTs supporting the use of interventions to optimize nutrition in HNSCC patients receiving RT are limited in both quantity and quality. Potentially effective interventions have not been tested comparatively or in combination, and few patients receiving chemoradiotherapy were studied. Further research in this area is a priority.