If I was the head of a funding agency like the NIH and could decide what projects to award funding to, I would be excited to fund a project related to the research article we read this term titled “Disruption of the microbiota across multiple body sites in critically ill children”. I thought this study was particularly interesting and important as the majority of the focus around critically ill patients has been on how to destroy the infections and harmful bacteria, and not enough about how to support the good bacteria and immune system. Researchers here looked at classifying and quantifying the bacteria in the gut of patients in the PICU and how the microbiota changes during critical illness. They found that not only do these patients present with pathogens but specifically a loss of commensal organisms from various body sites. Taking this research further, I would be interested in funding a study that looked at how giving treatment, such as probiotics, affected the microbiome and outcome of those in the PICU. I would like to see if it increased the number of good bacteria and helped them to fight infections and subsequently have better outcomes. From this project, we might discover new avenues of treatment in healthcare and ultimately be able to better support critically ill patients in the hospital and in general.

Part 1- 3 minutes, List Human Non-Infectious Diseases influenced by Microorganisms

• IBS, IBD, cardiovascular disease, diabetes, obesity, gestational diabetes, cancer, GERD, metabolic disease, Crohn’s disease, gingivitis, asthma, allergies, autoimmune diseases

Part 2: When looking back at my responses to this same prompt from week 1, I was able to come up with many more infectious diseases that are influenced by microorganisms in week 10. The first thing I noticed is that my responses in week one were just guesses as I had minimal prior knowledge in this field. Looking at this exercise in week 10, I am not only able to come up with more diseases, but I am certain in my answers and know a bit about why and how they are influenced by microbes. It demonstrates to me the vast amount of knowledge I have learned throughout the term and the interaction between microbes and human health. The most important pieces I will take away from this class are being able to critically evaluate scientific literature, techniques to support my gut health, and reasons that the gut microbiome plays such a large role in either maintaining health or being a culprit of disease.

I really enjoyed reading this article and the perspective it brought around being cautious and alert when reading scientific information related to the microbiome. It is a great reality check for me, and I am sure many others, to bring a healthy dose of skepticism to information in this field as it is still in the early stages and needs more data to be understood. Dr. Hanage’s key questions when interpreting scientific literature start with, “Can experiments detect differences that matter?.” This is important to think about when putting the data into the context of is this change significant enough to lead to real change or is on such a small scale it won’t really matter. The second question of “Does the study show causation or correlation?” is a critical distinction that must be made since causation is much more impactful than a correlation. Third, considering “What is the mechanism?” is essential for understanding how the results are proven and if the way of action describes what may be going on. His fourth question of “How much do experiments reflect reality?” is interesting because the main point of studies is to improve human health and if the findings don’t seem applicable to that, then what is the point. Lastly, “Could anything else explain the results?” is the question I believe is most helpful when discussing controversy. When engaging with other scientists about other avenues that may be causing a certain effect, the controversy about the topic and be explored and all the information for possible mechanisms can be evaluated as a whole. This hopefully can lead to ruling ideas out and coming up with new ones to be studied or an agreement on a mechanism of action.

Even though the gut-brain connection is still being studied, there is strong evidence so far to support the fact that microbial communities can influence the brain and mental health states. The gut is known as the “second brain” because many types of neurons and nerves in the gut communicate directly with the brain. There is a direct and systemic connection between the gut and the brain through vagal and sympathetic nerves, neurotransmitters, cytokines, and other molecules. When it comes to mental health, gut microbial communities have been shown to play a role in many disease states. Depression, stress, anxiety, autism spectrum disorder have stood out to scientists thus far as studies have shown the connection between the mental health issue and the dysbiosis of the gut bacteria. In the majority of the studies mentioned, supplementation of a good strain of bacteria was able to alter the microbial communities present and decrease symptoms related to a mental disorder. These relationships are very interesting because they could provide new avenues for better understanding the complexity of mental disorders and ways they could be treated.

I throughly enjoyed reading the papers my peers wrote and think I noticed things in their papers that I could revise in my final essay after being the peer reviewer. I thought both the topics that my peers choose to write about were very fascinating and relevant to this class, which I very much enjoy. It was neat to feel like I knew a decent amount about microbes and their influence on human health, but these papers made me think deeper and reason out if their arguments made sense based on what I know. One of the largest benefits of reading other papers was definitely noticing aspects of their papers that I had not thought about in mine. The different perspective puts me in the position of the reader/evaluator and what things need to be changed to improve the essay for when others read it. I learned that looking out for redundant phrases and ideas is hard to balance with the minimum word count and also wanting to hammer home the thesis at many points in the paper. I will apply this to my paper by reading it through and taking out redundant phrases as well as re-phrasing sentences if needed. Another big thing I noticed is how some paragraphs were choppy and didn’t flow well into the next. I will definitely pay attention to this in my final revision. Lastly, I will pay attention to the tone and formality of my paper and make sure I use appropriate language throughout.

The process of a peer review is an important step in the writing of our final essays, even though it is by and for someone who does not frequently read scientific articles. Despite the fact that both parties involved in the review process are not experts in the field, in this case, a peer review can be beneficial for many other aspects of the paper even if not all the content is understood. Some benefits of this process include the reviewer checking that there is an appropriate title, word count, font, and other formalities. Additionally, the reviews can check for the opinion that the authors have, if there is the appropriate vocabulary used, and if the paper is wordy or easy to read. It is important that the reviewer checks for the categories that are required for the assignment like if the controversy of the topic is explained and if they have the correct number and type of referenced sources. One downside of this is that our class only has the knowledge we have learned through BHS 323 and are not experts enough in the field to comment much on the content and credibility of the final essays. That being said, there is a lot that peer reviewers can look for to help improve the quality of the final essay and also learn some new things in the meantime.

When it comes to human behaviors that contribute to decreased exposure to microbes, there are many. It starts within the womb as the maternal microbiome exposes the fetus to various microorganisms. The health and variety of the bacteria a part of the mother can either be robust and contribute to a strong immune system for the baby, or be lacking and weak. Additionally, decreased exposure to microbes occurs through various forms of sanitation including hospital sterilization, handwashing, and personal hygiene. The treatment of our food and water systems also plays a role in decreased microbe exposure as companies use pesticides, herbicides, and fertilizer on their crops to kill microorganisms that are often beneficial to the soil systems and our health. As far as our water systems, treatment facilities often use chlorine and other chemicals to filter out harmful as well as beneficial bacteria. Another critical, and likely the most dramatic behavior leading to a decreased exposure to microbes would be the use of antibiotics. Since they are used to kill the harmful bacteria, but consequently also kill the good bacteria, they destroy a large amount of the bacteria residing in the gut microbiome.

Free Write #1- Most Interesting/ Surprising things I have learned or want to learn more about:

-how certain viruses can cause cancer, H. pylori and the vast range of diseases it can increase and decrease your risk for, how little is known about the microbiome in pregnancy, how probiotic supplements can be beneficial in reducing nosocomial infections and symptoms related to IBS, the role oral infections and other microbes have on cardiovascular health.

Free Write #2- about highlighted phrase

I have always been in interested in cardiovascular health and the impact is has on our nation as the leading cause of death for both men and women. Additionally, I have spent time shadowing a cardiologist and was fascinated with the field of work so much so that I would love to pursue that career. It would be great to combine my interest in that area and what I have learned in this class. Therefore, I am leaning towards choosing my final paper topic to be about how microbes influence the cardiovascular system and subsequently human health and disease.

Based on my free write above, I can now start thinking about what I will do to begin preparing to write my final paper. To start, I can search for journal articles related to my topic to see how much information is available and if it still seems interesting to me. Then, I can start to collect a series of sources and articles and begin reading them to gather information for my paper.

There is still a lot we do not know when it comes to the microbial composition of mom and baby during pregnancy. That being said, scientists have recently discovered that there are large changes that occur and various exposures that shape the infant’s microbiome. Whether it’s exposure to antibiotics, feeding, or delivery mode, these instances play a role in helping and harming the microbial development of the growing baby. Although only studied in rats, antibiotics taken during pregnancy have been shown to increase weight gain as well as significantly reduce bacterial diversity. This information and what we know about antibiotics, in general, are intriguing as the effects on immunity and the health of mom and baby come to light. On a more positive note, when babies can drink their mother’s milk, they are getting the optimal source of nutrition and are ingesting bacteria important in building a strong microbiome. Another important factor in microbiome development is the mode by which the baby is born. Although the microbial differences between a vaginal and cesarian birth only last for about 4-12 months, it’s important to note that vaginal delivery has shown to increase the diversity of bacterial species passed along to the baby. Whereas ceserian deliveries tend to cause delayed colonization of a few bacterial species and thus a lower alpha diversity is passed to the baby in this delivery mode. Although we know more now about pregnancy, birth, infancy, and how the microbiome is affected during these stages, there are still endless amounts to uncover.

My personal philosophy when it comes to antibiotics is that they have pros and cons that need to very carefully be understood and considered. To start, I firmly believe in science and western medicine that has discovered the incredible healing effects antibiotics have when you become very sick. That being said, I think there is a time and a place for them, but they should not be frivolously used when they are not really needed. I have had a few situations in my life where I have really needed to use antibiotics and feel grateful they exist and helped me in those situations. First of all, I had a bad case of chronic sphenoid sinusitis in high school that gave me horrible headaches and head pressure along with other uncomfortable symptoms. In this case, surgery and different antibiotics were needed to combat such an infection and I think the benefit of healing took priority over my gut health at the time. Also, I have had two hip surgeries over the past 12 months and know that these surgical scenarios called for antibiotics to avoid any complications or infections in my joint. Lastly, growing up with my dad as a physician has definitely impacted my view on antibiotics. It has helped inform me on the importance of them in critical situations and the importance of knowing there are negative effects, so their use is not a decision to be taken lightly.