Safe and efficacious probiotics: what are they?

Each year, >20 billion doses of probiotics are used by healthy people and by those diagnosed with a range of medical conditions. Compared to many pharmaceutical agents, probiotics are well tolerated and extremely safe, and serious adverse effects rarely occur. Nevertheless, as many new researchers enter the field and companies launch "probiotic" products, it is essential that standards are set for naming a product "probiotic" to show that it meets an acceptable level of safety and efficacy, and to understand the strengths and limitations of its activity. In this Opinion article, recommendations are made based upon the current understanding of scientific, clinical and regulatory issues, with a special focus on safety.     

How Safe Do Teenagers Behave on Facebook? An Observational Study

The substantial use of social network sites by teenagers has raised concerns about privacy and security. Previous research about behavior on social network sites was mostly based on surveys and interviews. Observational research overcomes problems inherent to this research method, for example social desirability. However, existing observational research mostly focuses on public profiles of young adults. Therefore, the current observation-study includes 1050 public and non-public Facebook-profiles of teenagers (13–18) to investigate (1) what kind of information teenagers post on their profile, (2) to what extent they protect this information using privacy-settings and (3) how much risky information they have on their profile. It was found that young people mostly post pictures, interests and some basic personal information on their profile. Some of them manage their privacy-settings as such that this information is reserved for friends'' eyes only, but a lot of information is accessible on the friends-of-friends'' pages. Although general risk scores are rather low, more detailed analyses show that teenagers nevertheless post a significant amount of risky information. Moreover, older teenagers and girls post more (risky) information while there are no differences in applying privacy settings. We found no differences in the Facebook behavior of teenagers enrolled in different education forms. Implications of these results are discussed.     

Safe To Walk? Neighborhood Safety and Physical Activity Among Public Housing Residents

Background

Despite its health benefits, physical inactivity is pervasive, particularly among those living in lower-income urban communities. In such settings, neighborhood safety may impact willingness to be regularly physically active. We examined the association of perceived neighborhood safety with pedometer-determined physical activity and physical activity self-efficacy.

Methods and Findings

Participants were 1,180 predominantly racial/ethnic minority adults recruited from 12 urban low-income housing complexes in metropolitan Boston. Participants completed a 5-d pedometer data-collection protocol and self-reported their perceptions of neighborhood safety and self-efficacy (i.e., confidence in the ability to be physically active). Gender-stratified bivariate and multivariable random effects models were estimated to account for within-site clustering. Most participants reported feeling safe during the day, while just over one-third (36%) felt safe at night. We found no association between daytime safety reports and physical activity among both men and women. There was also no association between night-time safety reports and physical activity among men (p = 0.23) but women who reported feeling unsafe (versus safe) at night showed significantly fewer steps per day (4,302 versus 5,178, p = 0.01). Perceiving one''s neighborhood as unsafe during the day was associated with significantly lower odds of having high physical activity self-efficacy among both men (OR 0.40, p = 0.01) and women (OR 0.68, p = 0.02).

Conclusions

Residing in a neighborhood that is perceived to be unsafe at night is a barrier to regular physical activity among individuals, especially women, living in urban low-income housing. Feeling unsafe may also diminish confidence in the ability to be more physically active. Both of these factors may limit the effectiveness of physical activity promotion strategies delivered in similar settings.     

Are Non-cardiac Surgeries Safe for Dialysis Patients? – A Population-Based Retrospective Cohort Study

Background

End-stage renal disease represents a risk complex that complicates surgical results. The surgical outcomes of dialysis patients have been studied in specific fields, but the global features of postoperative adverse outcomes in dialysis patients receiving non-cardiac surgeries have not been examined.

Methods

Taiwan’s National Health Insurance Research Database was used to study 8,937 patients under regular dialysis with 8,937 propensity-score matched-pair controls receiving non-cardiac surgery between 2004 and 2007. We investigated the influence of hemodialysis and peritoneal dialysis, effects of hypertension and diabetes, and impact of additional comorbidities on postoperative adverse outcomes.

Results

Postoperative mortality in dialysis patients was higher than in controls (odds ratio [OR] 3.33, 95% confidence interval [CI] 2.56 to 4.33) when receiving non-cardiac surgeries. Complications such as acute myocardial infarction, pneumonia, bleeding, and septicemia were significantly increased. Postoperative mortality was significantly increased among peritoneal dialysis patients (OR 2.71, 95% CI 1.70 to 4.31) and hemodialysis patients (OR 3.42, 95% CI 2.62 to 4.47) than in controls. Dialysis patients with both hypertension and diabetes had the highest risk of postoperative complications; these risks increased with number of preoperative medical conditions. Patients under dialysis also showed significantly increased length of hospitalization, more ICU stays and higher medical expenditures.

Conclusion

Surgical patients under dialysis encountered significantly higher postoperative complications and mortality than controls when receiving non-cardiac surgeries. Different dialysis techniques, pre-existing hypertension/diabetes, and various comorbidities had complication-specific impacts on surgical adverse outcomes. These findings can help surgical teams provide better risk assessment and postoperative care for dialysis patients.     

Protected areas and prime hoverfly areas: Safe haven for hoverflies or not?

The efficiency of protected areas (PAs) has often been questioned due to global decline of biodiversity. Invertebrates, especially insects, have been historically underrepresented in conservation studies. Our study focuses on hoverflies, an important group of insect pollinators and proven to be good bioindicators. Research was focused in Serbia, one of Europe's hotspots of hoverfly diversity, with a long tradition of hoverfly research, which provided sufficient information for achieving our aims: identifying areas of high hoverfly diversity, evaluating the efficiency of PAs and prime hoverfly areas (PHAs) in the conservation of hoverflies, determining how well they cover the distribution of hoverfly species, especially those of conservation concern, and testing the importance of the size of the area for conservation of hoverfly diversity. We applied weighting of the species to help stress the importance of species of conservation concern. The results indicated that PHAs cover the areas with high hoverfly diversity better than PA networks, especially when it comes to species of conservation concern. Generalized linear model results showed that the area size was a significant predictor of number of species in both PA and PHA. This indicates that area size is key when designating new areas important for conservation, but there are also other factors that need to be taken into account, such as habitat quality or suitability. Studies like this are useful in aiding designation of new areas important for conservation of certain species and in identifying sampling gaps, which could potentially aim future research in that direction.     

A Simple,Sensitive and Safe Method to Determine the Human α/β-Tryptase Genotype

The human tryptase locus on chromosome 16 contains one gene encoding only β-tryptase and another encoding either β-tryptase or the homologous α-tryptase, providing α:β gene ratios of 0∶4, 1∶3 or 2∶2 in the diploid genome, these genotypes being of potential clinical relevance in severe atopy. Using an EcoRV restriction site in α- but not β- tryptase, PCR products, spanning intron 1 to exon 5, were used to determine α/β-tryptase gene ratios using non-radioactive labels, including ethidium bromide labeling of all PCR products, and either digoxigenin-primer or DY682-primer labeling of only the final PCR cycle products. Sensitivity increased ∼60-fold with each final PCR cycle labeling technique. Ethidium bromide labeling underestimated amounts of α-tryptase, presumably because heteroduplexes of α/β-tryptase amplimers, formed during annealing, were EcoRV resistant. In contrast, both final PCR cycle labeling techniques precisely quantified these gene ratios, because only homoduplexes were labeled. Using the DY682-primer was most efficient, because PCR/EcoRV products could be analyzed directly in the gel; while digoxigenin-labeled products required transfer to a nitrocellulose membrane followed by immunoblotting. This technique for determining the α/β-tryptase genotype is sensitive, accurate, simple and safe, and should permit high-throughput screening to detect potential phenotype-genotype relations for α/β-tryptases, and for other closely related alleles.     

Antepartum Membrane Stripping in GBS Carriers,Is It Safe? (The STRIP-G Study)

Objective

Stripping of the membranes is an established and widely utilized obstetric procedure associated with higher spontaneous vaginal delivery rates, reduced need for formal induction of labor and a lower likelihood of post-term pregnancy. Due to the theoretical concern of bacterial seeding during the procedure many practitioners choose not to sweep the membranes in Group B Streptococcus (GBS) colonized patients. We conducted ‘the STRIP-G study’ in order to determine whether maternal and neonatal outcomes are affected by GBS carrier status in women undergoing membrane stripping.

Study design

We conducted a prospective study in a tertiary referral center, comparing maternal and neonatal outcomes following membrane stripping among GBS-positive, GBS-negative, and GBS-unknown patients. We compared the incidence of composite adverse neonatal outcomes (primary outcome) among the three study groups, while secondary outcome measure was composite adverse maternal outcomes.

Results

A total of 542 women were included in the study, of which 135 were GBS-positive, 361 GBS-negative, and 46 GBS-unknown status. Demographic, obstetric, and intra-partum characteristics were similar for all groups. Adverse neonatal outcomes were observed in 8 (5.9%), 31 (8.6%), and 2 (4.3%) in the GBS-positive, GBS-negative, and unknown groups, respectively (P = 0.530), (Odds Ratio between GBS-Positive vs. GBS-Negative groups 0.67 (95%, CI = 0.30–1.50)); while composite adverse maternal outcomes occurred in 9 (6.66%), 31 (8.59%), and 5 (10.87%) in the GBS-positive, GBS-negative, and unknown groups, respectively (P = 0.617).

Conclusions

Antepartum membrane stripping in GBS carriers appears to be a safe obstetrical procedure that does not adversely affect maternal or neonatal outcomes.     

Controversies About the Chromosomal Stability of Cultivated Mesenchymal Stem Cells: Their Clinical Use is it Safe?

The usefulness of adult stem cells in research and therapeutic applications highly relies on their genomic integrity and stability. Many laboratories including ours have addressed this concern using methods such as karyotyping, Qbanding, fluorescent in situ hybridization, array CGH, flow cytometry and Pap test to evaluate number and structure of chromosomes and cellular phenotype. This review attempts to summarize the findings reported so far for the studies on chromosomal aberrations in adult stem cells and warrant to perform certain basic tests before transplantation to avoid any adverse reactions, which will thus aid in better therapeutic output after cellular transplantation in the treatment of various diseases.     

Is Paromomycin an Effective and Safe Treatment against Cutaneous Leishmaniasis? A Meta-Analysis of 14 Randomized Controlled Trials

Background

High cost, poor compliance, and systemic toxicity have limited the use of pentavalent antimony compounds (SbV), the treatment of choice for cutaneous leishmaniasis (CL). Paromomycin (PR) has been developed as an alternative to SbV, but existing data are conflicting.

Methodology/Principal Findings

We searched PubMed, Scopus, and Cochrane Central Register of Controlled Trials, without language restriction, through August 2007, to identify randomized controlled trials that compared the efficacy or safety between PR and placebo or SbV. Primary outcome was clinical cure, defined as complete healing, disappearance, or reepithelialization of all lesions. Data were extracted independently by two investigators, and pooled using a random-effects model. Fourteen trials including 1,221 patients were included. In placebo-controlled trials, topical PR appeared to have therapeutic activity against the old world and new world CL, with increased local reactions, when used with methylbenzethonium chloride (MBCL) compared to when used alone (risk ratio [RR] for clinical cure, 2.58 versus 1.01: RR for local reactions, 1.60 versus 1.07). In SbV-controlled trials, the efficacy of topical PR was not significantly different from that of intralesional SbV in the old world CL (RR, 0.70; 95% confidence interval, 0.26–1.89), whereas topical PR was inferior to parenteral SbV in treating the new world CL (0.67; 0.54–0.82). No significant difference in efficacy was found between parenteral PR and parenteral SbV in the new world CL (0.88; 0.56–1.38). Systemic side effects were fewer with topical or parenteral PR than parenteral SbV.

Conclusions/Significance

Topical PR with MBCL could be a therapeutic alternative to SbV in selected cases of the old world CL. Development of new formulations with better efficacy and tolerability remains to be an area of future research.     

‘Safe sites’ for the seed germination ofRhus javanica: A characterization by responses to temperature and light

Germination responses ofRhus javanica L. seeds to temperature and light were investigated with special reference to their gap-detecting mechanisms in germination, i.e., responses to elevated and/or fluctuating temperatures and sensitivity to leaf-canopy transmitted light. The seeds, which have water-impermeable coats to prevent imbibition, were shown to become permeable and germinable after exposure to higher temperatures of 48–74°C for a brief period depending on the temperature. Once the coat impermeability had been removed by such heat treatment, the seeds became readily germinable over a wide range of temperature and light conditions. The lower and higher temperature limits for germination were around 8° and 36°C, respectively, with an optimal temperature of around 25°C. Simple linear relationships were observed between the temperature and germination rates, i.e., the reciprocals of the time taken by the seed subpopulations to show 10–70% germination in the sub-optimal temperature range, where the required ‘thermal time’ for germination was 2300–3600 Kh. The presence or absence of light or a simulated ‘canopy light’ had little effect on the germination of this species. It was concluded that the seeds ofR. javanica are furnished with a gap-detecting mechanism in the form of a heat requirement for the breakage of water-impermeable seed dormancy, which may be fulfilled by either daytime elevation of the surface temperature of exposed soil, or more effectively by fire.     

Safe space in the woods: Mechanistic spatial models for predicting risks of human–bear conflicts in India

Human–wildlife interactions can have negative consequences when they involve large carnivores. Spatial risk modelling could serve as a useful management approach for predicting and pre-emptively mitigating negative interactions. We present a mechanistic modelling framework and examine interactions between humans and sloth bears (Melursus ursinus) in a multi-use forest landscape of central India. We first assessed patterns and determinants of bear distribution across the landscape using indirect sign surveys. At the same spatial scale, we then estimated spatial probabilities of bear attacks on people using information from 675 interviews with local residents, incorporating estimates of distribution probabilities from the previous step. We found the average occupancy probability across 128 grid-cells to be 0.77 (SE = 0.03). Bear occupancy was influenced by terrain ruggedness, forest composition and configuration, vegetation productivity and size of human settlements. The average probability of a bear attack in any given grid-cell was 0.61 (SE = 0.03), mostly determined by bear occurrence patterns, forest cover, terrain ruggedness, and size of human settlements. Using spatial information on people's dependence on forest resources, we identified locations with the highest risk of bear attacks. Our study demonstrates that human attacks by bears—generally believed to be random or incidental—in fact showed deterministic patterns. Our framework can be applied to other scenarios involving human–wildlife conflicts. Based on our findings, we propose that a proactive co-management approach which involves collaboration between wildlife managers and local residents could help better manage human–bear conflicts in central India and elsewhere across the species' range.     

West Africa - A Safe Haven for Frogs? A Sub-Continental Assessment of the Chytrid Fungus (Batrachochytrium dendrobatidis)

A putative driver of global amphibian decline is the panzootic chytrid fungus Batrachochytrium dendrobatidis (Bd). While Bd has been documented across continental Africa, its distribution in West Africa remains ambiguous. We tested 793 West African amphibians (one caecilian and 61 anuran species) for the presence of Bd. The samples originated from seven West African countries - Bénin, Burkina Faso, Côte d''Ivoire, Ghana, Guinea, Liberia, Sierra Leone - and were collected from a variety of habitats, ranging from lowland rainforests to montane forests, montane grasslands to humid and dry lowland savannahs. The species investigated comprised various life-history strategies, but we focused particularly on aquatic and riparian species. We used diagnostic PCR to screen 656 specimen swabs and histology to analyse 137 specimen toe tips. All samples tested negative for Bd, including a widespread habitat generalist Hoplobatrachus occipitalis which is intensively traded on the West African food market and thus could be a potential dispersal agent for Bd. Continental fine-grained (30 arc seconds) environmental niche models suggest that Bd should have a broad distribution across West Africa that includes most of the regions and habitats that we surveyed. The surprising apparent absence of Bd in West Africa indicates that the Dahomey Gap may have acted as a natural barrier. Herein we highlight the importance of this Bd-free region of the African continent - especially for the long-term conservation of several threatened species depending on fast flowing forest streams (Conraua alleni (“Vulnerable”) and Petropedetes natator (“Near Threatened”)) as well as the “Critically Endangered” viviparous toad endemic to the montane grasslands of Mount Nimba (Nimbaphrynoides occidentalis).     

Cell Therapy: A Safe and Efficacious Therapeutic Treatment for Alzheimer��s Disease in APP+PS1 Mice

Previously, our lab was the first to report the use of antigen-sensitized dendritic cells as a vaccine against Alzheimer’s disease (AD). In preparation of this vaccine, we sensitized the isolated dendritic cells ex vivo with Aβ peptide, and administered these sensitized dendritic cells as a therapeutic agent. This form of cell therapy has had success in preventing and/or slowing the rate of cognitive decline when administered prior to the appearance of Aβ plaques in PDAPP mice, but has not been tested in 2×Tg models. Herein, we test the efficacy and safety of this vaccine in halting and reversing Alzheimer’s pathology in 9-month-old APP+PS1 mice. The results showed that administration of this vaccine elicits a long-lasting antibody titer, which correlated well with a reduction of Aβ burden upon histological analysis. Cognitive function in transgenic responders to the vaccine was rescued to levels similar to those found in non-transgenic mice, indicating that the vaccine is capable of providing therapeutic benefit in APP+PS1 mice when administered after the onset of AD pathology. The vaccine also shows indications of circumventing past safety problems observed in AD immunotherapy, as Th1 pro-inflammatory cytokines were not elevated after long-term vaccine administration. Moreover, microhemorrhaging and T-cell infiltration into the brain are not observed in any of the treated subjects. All in all, this vaccine has many advantages over contemporary vaccines against Alzheimer’s disease, and may lead to a viable treatment for the disease in the future.     

A Low-Cost Al(OH)3-Modified Fire-Retardant and Shuttle-Limiting Separator for Safe and Stable Lithium–Sulfur Batteries

Lithium–sulfur battery (LSB) possesses high theoretical energy density, but its poor cycling stability and safety issues significantly restrict progress in practical applications. Herein, a low-cost and simple Al(OH)₃-based modification of commercial separator, which renders the battery outstanding fire-retardant and stable cycling, is reported. The modification is carried out by a simple blade coating of an ultrathin composite layer, mainly consisting of Al(OH)₃ nanoparticles and conductive carbon, on the cathode side of the separator. The Al(OH)₃ shows strong chemical absorption ability toward Lewis-based polysulfides and outstanding fire retardance through a self-decomposition mechanism under high heat, while the conductive carbon material acts as a top current collector to prevent dead polysulfide. LSB using the Al(OH)₃-modified separator shows an extremely low average capacity decade per cycle during 1000 cycles at 2 C (0.029%, 1 C = 1600 mA g⁻¹). The pouch cell exhibiting high energy density (426 Wh kg⁻¹) can also steadily cycle for more than 100 cycles with high capacity retention (70.2% at 0.1 C). The effectiveness and accessibility of this Al(OH)₃ modification strategy will hasten the practical application progress of LSBs.     

Urban air pollution and climate change: “The Decalogue: Allergy Safe Tree” for allergic and respiratory diseases care

Background

According to the World Health Organization, air pollution is closely associated with climate change and, in particular, with global warming. In addition to melting of ice and snow, rising sea level, and flooding of coastal areas, global warming is leading to a tropicalization of temperate marine ecosystems. Moreover, the effects of air pollution on airway and lung diseases are well documented as reported by the World Allergy Organization.

Methods

Scientific literature was searched for studies investigating the effect of the interaction between air pollution and climate change on allergic and respiratory diseases.

Results

Since 1990s, a multitude of articles and reviews have been published on this topic, with many studies confirming that the warming of our planet is caused by the “greenhouse effect” as a result of increased emission of “greenhouse” gases. Air pollution is also closely linked to global warming: the emission of hydrocarbon combustion products leads to increased concentrations of biological allergens such as pollens, generating a mixture of these particles called particulate matter (PM). The concept is that global warming is linked to the emission of hydrocarbon combustion products, since both carbon dioxide and heat increase pollen emission into the atmosphere, and all these particles make up PM10. However, the understanding of the mechanisms by which PM affects human health is still limited. Therefore, several studies are trying to determine the causes of global warming. There is also evidence that increased concentrations of air pollutants and pollens can activate inflammatory mediators in the airways. Our Task Force has prepared a Decalogue of rules addressing public administrators, which aims to limit the amount of allergenic pollen in the air without sacrificing public green areas.

Conclusions

Several studies underscore the significant risks of global warming on human health due to increasing levels of air pollution. The impact of climate change on respiratory diseases appears well documented. The last decades have seen a rise in the concentrations of pollens and pollutants in the air. This rise parallels the increase in the number of people presenting with allergic symptoms (e.g., allergic rhinitis, conjunctivitis, and asthma), who often require emergency medical care. Our hope is that scientists from different disciplines will work together with institutions, pharmaceutical companies and lay organizations to limit the adverse health effects of air pollution and global warming.