The impact of faecal microbiota transplantation (FMT) on microbiota engraftment in patients with metabolic syndrome is uncertain. We aimed to study whether combining FMT with lifestyle modification ...could enhance the engraftment of favourable microbiota in obese patients with type 2 diabetes mellitus (T2DM).
In this double-blind, randomised, placebo-controlled trial, 61 obese subjects with T2DM were randomly assigned to three parallel groups: FMT plus lifestyle intervention (LSI), FMT alone, or sham transplantation plus LSI every 4 weeks for up to week 12. FMT solution was prepared from six healthy lean donors. Faecal metagenomic sequencing was performed at baseline, weeks 4, 16 and 24. The primary outcome was the proportion of subjects acquiring ≥20% of microbiota from lean donors at week 24.
Proportions of subjects acquiring ≥20% of lean-associated microbiota at week 24 were 100%, 88.2% and 22% in the FMT plus LSI, FMT alone, and sham plus LSI groups, respectively (p<0.0001). Repeated FMTs significantly increased the engraftment of lean-associated microbiota (p<0.05). FMT with or without LSI increased butyrate-producing bacteria. Combining LSI and FMT led to increase in
and
compared with FMT alone (p<0.05). FMT plus LSI group had reduced total and low-density lipoprotein cholesterol and liver stiffness at week 24 compared with baseline (p<0.05).
Repeated FMTs enhance the level and duration of microbiota engraftment in obese patients with T2DM. Combining lifestyle intervention with FMT led to more favourable changes in recipients' microbiota and improvement in lipid profile and liver stiffness.
NCT03127696.
This work aimed to understand the distribution of five bacterial pathogens in O’ahu coastal streams and relate their presence to microbial indicator concentrations, land cover of the surrounding ...watersheds, and physical–chemical measures of stream water quality. Twenty-two streams were sampled four times (in December and March, before sunrise and at high noon) to capture seasonal and time of day variation.
Salmonella,
Campylobacter,
Staphylococcus aureus,
Vibrio vulnificus, and
V. parahaemolyticus were widespread —12 of 22 O’ahu streams had all five pathogens. All stream waters also had detectable concentrations of four fecal indicators and total vibrio with log mean ± standard deviation densities of 2.2 ± 0.8 enterococci, 2.7 ± 0.7
Escherichia coli, 1.1 ± 0.7
Clostridium perfringens, 1.2 ± 0.8 F
+ coliphages, and 3.6 ± 0.7 total vibrio per 100 ml. Bivariate associations between pathogens and indicators showed enterococci positively associated with the greatest number of bacterial pathogens. Higher concentrations of enterococci and higher incidence of
Campylobacter were found in stream waters collected before sunrise, suggesting these organisms are sensitive to sunlight. Multivariate regression models of microbes as a function of land cover and physical–chemical water quality showed positive associations between
Salmonella and agricultural and forested land covers, and between
S. aureus and urban and agricultural land covers; these results suggested that sources specific to those land covers may contribute these pathogens to streams. Further, significant associations between some microbial targets and physical–chemical stream water quality (i.e., temperature, nutrients, turbidity) suggested that organism persistence may be affected by stream characteristics. Results implicate streams as a source of pathogens to coastal waters. Future work is recommended to determine infectious risks of recreational waterborne illness related to O’ahu stream exposures and to mitigate these risks through control of land-based runoff sources.
►
Salmonella,
Campylobacter,
Staphylococcus, and
Vibrio pathogens were widespread in O’ahu streams. ► Of five indicators, enterococci were best associated with bacterial pathogens. ► Microbial targets were associated with watershed land cover and stream water quality.
Obesity and type 2 diabetes mellitus (T2DM) are associated with changes in the gut bacterial composition, but little is known about the role of the viral community (virome) in disease development. ...This study aims to characterize the gut virome alterations in obese subjects with or without T2DM.
There were 128 obese subjects (body mass index ≥28 kg/m2) and 101 lean controls (body mass index ≥18.5 and <23 kg/m2) recruited from 2 regions in China (Hong Kong and Kunming). Fecal virome and bacteriome were profiled by shotgun metagenomic sequencing. Gut virome, bacteriome, and viral-bacterial correlations were compared between obese subjects and lean controls.
Obese subjects, especially those with T2DM (ObT2), had a decreased gut viral richness and diversity compared with lean controls in the Hong Kong cohort (P < .05), while no significant differences were observed in the Kunming cohort. Eleven viruses, including Escherichia phage, Geobacillus phage, and Lactobacillus phage were enriched in obese subjects (q < .1). Besides, 17 differentially abundant viruses were identified between ObT2 and lean controls (q < .1). Further ecologic analysis revealed that intensive transkingdom correlations between viruses and bacteria observed in lean controls were significantly decreased in ObT2 subjects (P < .001).
Obesity is characterized by altered viral taxonomic composition and weakened viral-bacterial correlations compared with lean controls. Obesity accompanied with T2DM may aggravate the obesity-associated virus signatures, signifying that the gut virome may play an important role in the development of obesity and T2DM. Geographic factors also contributed to the variations of gut virome in obesity and T2DM.
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Obese individuals have a dysbiotic gut virome, and type 2 diabetes mellitus further aggravates such dysbiosis.
Purpose
This study aimed to develop an industry-specific, original, valid and reliable scale for measuring hotel employees’ perceptions of CSR activities undertaken by their organizations.
...Design/methodology/approach
Based on the solid grounding of a conceptual framework and a systematic scale development process, both qualitative and quantitative research approaches were used. Data were collected from 18 in-depth interviews with CSR/HR managers and employees working in world-renowned international hotel companies and local hotel groups in Hong Kong. A pilot study of 204 employee samples was subjected to exploratory factor analysis to determine the underlying factorial structure of the scale. A further 732 usable samples in the main survey were used to assess the latent structure and validity of the scale using confirmatory factor analysis.
Findings
The scale revealed sound psychometric properties based on the findings from reliability and validity tests. The results of the analysis validated previous research that employees’ perceptions of CSR are a multidimensional construct and the five-dimensional model for the hotel industry consists of employees, guests, local community, the natural environment and owners/investors.
Practical implications
The developed scale can help organizational behavior researchers to examine the causal relationship between an organization’s CSR activities and employees’ outcomes, thereby enhancing further development of predictive and prescriptive studies that provide prescription to hotel managers with instrumental reason to pursue CSR in an organizational setting.
Originality/value
This study is one of the first scale development studies of employees’ perceptions in the context of the hotel industry.
Obesity is a major risk factor for cancers including hepatocellular carcinoma (HCC) that develops from a background of non-alcoholic fatty liver disease (NAFLD). Hypercholesterolemia is a common ...comorbidity of obesity. Although cholesterol biosynthesis mainly occurs in the liver, its role in HCC development of obese people remains obscure. Using high-fat high-carbohydrate diet-associated orthotopic and spontaneous NAFLD-HCC mouse models, we found that hepatic cholesterol accumulation in obesity selectively suppressed natural killer T (NKT) cell-mediated antitumor immunosurveillance. Transcriptome analysis of human liver revealed aberrant cholesterol metabolism and NKT cell dysfunction in NAFLD patients. Notably, cholesterol-lowering rosuvastatin restored NKT expansion and cytotoxicity to prevent obesogenic diet-promoted HCC development. Moreover, suppression of hepatic cholesterol biosynthesis by a mammalian target of rapamycin (mTOR) inhibitor vistusertib preceded tumor regression, which was abolished by NKT inactivation but not CD8
T cell depletion. Mechanistically, sterol regulatory element-binding protein 2 (SREBP2)-driven excessive cholesterol production from hepatocytes induced lipid peroxide accumulation and deficient cytotoxicity in NKT cells, which were supported by findings in people with obesity, NAFLD and NAFLD-HCC. This study highlights mTORC1/SREBP2/cholesterol-mediated NKT dysfunction in the tumor-promoting NAFLD liver microenvironment, providing intervention strategies that invigorating NKT cells to control HCC in the obesity epidemic.
Surgery is the most effective treatment of morbid obesity and leads to dramatic improvements in type 2 diabetes mellitus (T2DM). Gastrointestinal metabolic surgery has been proposed as a treatment ...option for T2DM. However, a grading system to categorize and predict the outcome of metabolic surgery is lacking. The study setting was a tertiary referral hospital (Taoyuan City, Taoyuan County, Taiwan).
We first evaluated 63 patients and identified 4 factors that predicted the success of T2DM remission after bariatric surgery in this cohort: body mass index, C-peptide level, T2DM duration, and patient age. We used these variables to construct the Diabetes Surgery Score, a multidimensional 10-point scale along which greater scores indicate a better chance of T2DM remission. We then validated the index in a prospective collected cohort of 176 patients, using remission of T2DM at 1 year after surgery as the outcome variable.
A total of 48 T2DM remissions occurred among the 63 patients and 115 remissions (65.3%) in the validation cohort. Patients with T2DM remission after surgery had a greater Diabetes Surgery Score than those without (8 ± 4 versus 4 ± 4, P < .05). Patients with a greater Diabetes Surgery Score also had a greater rate of success with T2DM remission (from 33% at score 0 to 100% at score 10); A 1-point increase in the Diabetes Surgery Score translated to an absolute 6.7% in the success rate.
The Diabetes Surgery Score is a simple multidimensional grading system that can predict the success of T2DM treatment using bariatric surgery among patients with inadequately controlled T2DM.
•Developed tailor-made prestressing procedures for CFRP-PCPs manufacturing for shear strengthening.•Proposed of using prestressed CFRP-PCPs for shear strengthening of beams with NSM ...approach.•Performed experimental study for NSM CFRP-PCPs strengthened RC beams.•Proposed design formula for NSM CFRP-PCPs strengthened RC beams.
This paper presents an experimental investigation of the shear performance of RC beams strengthened with near surface mounted (NSM) carbon fibre reinforced polymer (CFRP) prestressed concrete prisms (PCPs). The shear behaviour of strengthened beams can be affected by several design variables. In this research, the effect of the following parameters were considered: the prestress level, inclination and spacing of the CFRP-PCPs, and material type of the prism. The control beam had conventional shear steel reinforcement only while the other seven beams were shear strengthened with CFRP-PCPs by varying design parameters mentioned above. All the beams were tested under monotonic loading until they reached the failure load. The experimental results showed that the NSM CFRP-PCPs strengthening technique improves the shear performance of the beams effectively. The strengthened beams that applied the CFRP-PCPs at an inclination of 45° were more efficient in improving the shear capacity compared to vertical CFRP-PCPs. The shear capacity and deformation were enhanced with the increase of prestressing levels of CFRP rods and the decrease of CFRP-PCPs spacing. The failure modes of the strengthened beams were influenced mainly by the spacing and the inclination of the CFRP-PCPs. Moreover, the material type of the prism had little influence on the effectiveness of shear strengthening. The analytical model presented was developed to estimate the shear contribution of NSM CFRP-PCPs and the model was found to predict the shear capacity of the tested beams well.
Purpose
Intra-gastric balloon (IGB) therapy is the most established endoscopic treatment of obesity, but there is a paucity of literature on long-term efficacy. This study aims to evaluate the short- ...and long-term weight loss efficacy of IGB.
Materials and Methods
Double-blinded RCT with 6-month IGB vs with sham endoscopy, in body mass index (BMI) 27–35 patients. Anthropometric, fasting glucose, and lipid profile measurement as early outcomes (up to 2 years) and 10-year follow-up. Primary outcomes were total body weight loss (kg) and BMI. Secondary outcomes were new-onset diabetes mellitus, other new comorbidities, and willingness for further intervention.
Results
Initial RCT recruited 99 patients (50 IGB vs 49 sibutramine group). Forty-nine patients (26 IGB vs 23 control group) participated in a 10-year review (follow-up rate of 51.6%). Total body weight loss at 6 (9.75 vs 7.48 kg,
p
= 0.03), 12 (6.52 vs 4.42 kg,
p
= 0.05), 18 (5.42 vs 3.57,
p
= 0.32), and 24 months (4.07 vs 2.93 kg,
p
= 0.56) favored the IGB group. Total weight loss (TWL) at 10 years (0.03 vs − 2.32 kg,
p
= 0.05) and %TWL (− 0.16 ± 12.8% vs − 2.84 ± 5.6%,
p
= 0.39) were not significantly different between groups. Follow-up BMI (30.97 ± 1.6 vs 30.38 ± 1.8 kg/m
2
,
p
= 1.00) was similar. At 10 years, new-onset diabetes mellitus, sleep apnoea, metabolic syndrome, and arthralgia were not significant (
p
> 0.05). Twenty-three (81%) IGB group vs 13 (56%) control expressed a willingness for further intervention (
p
< 0.01).
Conclusion
IGB delivers weight loss to 2 years and is superior to control. However, new comorbidity development is not significantly different at 10 years. Patient that received IGB therapy were subsequently more willing for further bariatric metabolic intervention.
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