Logan Davila - Blog for BHS 323

Prompt: Reflect on the peer-review process with you as the reviewer. How did it feel to read and critique someone else’s writing? What did you learn that you can apply to your own writing as you revise your final essay?

It felt rather odd to review and critique someone else’s writing. I felt kind of harsh, but I was trying my best to keep a formal tone that didn’t seem condescending. It feels as though you are finding every flaw possible in someone’s writing that they worked hard on, however, I was just trying to find any possible way to help them improve their writing. It is hard to critique someone else’s writing when you don’t necessarily know exactly what they were trying to convey in their writing, as everyone writes differently and has different writing styles. I learned helpful tips in doing this that will definitely help me improve and revise my final essay. It was helpful to look at other’s writing and see how other papers are organized and really go through them with a fine tooth comb. In seeing aspects that they did and did not include, or seeing that you long for information that may not have been provided helped me see what I truly hope is conveyed in my own paper. This was an interesting process and I think it will greatly supplement my own writing and help me make beneficial revisions to my final essay.

Prompt: Describe the process of peer review to someone who does not frequently read scientific articles. In your response, consider the pros and cons of peer review and how that might impact the credibility of the results that come from that scientific article.

• The process of peer-review is important because it subjects work written by researchers to criticism from other experts in the same field to check validity, clarity, integrity and suitability of a work for publication. Experts in the scientific community are actively involved in this process both by being the reviewer of other works, as well as having their work reviewed. 
• The process of peer-review begins with the submission of the paper. Once authors are satisfied with their manuscript draft, they select a journal that they wish to send the manuscript to. Once researchers have agreed on a journal they would like to send their manuscript to, the manuscript is sent to the journal’s editor, whose job is to work with the publisher of the journal to check the submitted manuscript’s composition and arrangement to see if it aligns with the journal’s philosophy. At this point the manuscript can be rejected and the authors must find another journal to submit to, or, if the editor doesn’t reject the manuscript, it gets sent out to be reviewed by typically 2-4 established, published researchers in the field of work related to the manuscript submitted. After the reviewers have received the manuscript, they are tasked with reading it in its entirety and evaluating it for scientific merit. At this point reviewers comb through the paper for sections included, is the topic relevant, is the data sufficient and correctly interpreted, and much more to provide substantial feedback. After reading through the manuscript with a fine tooth comb, the reviewers will then write a summary of their thoughts in a letter to the editor, as well as providing their overall impression of the manuscript. In this letter they provide their concerns, questions, as well as their recommendation as to whether the editor should reject or accept the manuscript. After this is done and the editor has received the feedback from the reviewers, the manuscript can either be accepted with no revisions required, which is rare, it can be rejected, or the comments can be sent back to the author to allow them to revise their manuscript. From here the authors have the opportunity to respond to the editor with changes they did and did not make in response to the criticisms. After this it is sent out to be reviewed again, and the process continues until the manuscript is published or ultimately rejected. 
• Pros 
  • Establishes validity of research and prevents acceptance of falsified work 
  • Allows for valuable feedback to be given to authors in order to improve their manuscripts prior to publication
• Cons 
  • The peer review process is very lengthy and can cause significant delay of access to research findings 
  • It can be hard to maintain anonymity of reviewers
  • Sometimes the review standards are lower in less prestigious journals and may not prevent publication of poor research 
  • Bias or conflict of interest: peer-review process has been accused of protecting the opinions of reviewers who are not open to new ideas which in turn can affect the credibility of results that come from journals

Reference: https://www.gcu.ac.uk/library/pilot/publication/peerreview/advantagesanddisadvantages/

• List and describe as many changes in human behaviors as you can think of that contribute to decreased exposure to microbes.
  • Differences in diet 
    • Less diverse diverse diets decrease exposure to microbes. Dietary choices that exclude food products from animals or plants narrow the microbiome even further.  
  • Stricter hygienic practices  
    • Constantly cleaning decreases exposure to microbes significantly 
    • Heavy use of things such as hand sanitizers, bleach, detergents all kill off microbes and decrease exposure 
  • Children born via C-section 
    • Children born via C-section face less exposure to microbes compared to vaginal birth where they are exposed to the mother’s vaginal microbes 
  • Mode of feeding
    • Feeding children via breastfeeding is an important factor in the colonization of the microbial community in infants as human milk contains bacteria important for establishing a “healthy” and diverse microbiome
    • Formula-fed infants are experienced to less microbes as they lack the bacteria found in human breast milk 
  • Not allowing children to play outside and be exposed to the bacteria that they wouldn’t be exposed to in the house alone. 
  • Antibiotic treatment decreases exposure to microbes as it kills off high abundances of bacteria

Prompt: Describe your personal philosophy about how and when you have taken, or would take, antibiotics. What experiences or prior knowledge do you have that shaped that personal philosophy?

Answer:

My personal philosophy on antibiotics is that they are necessary in today’s world. I think antibiotics have been our main defense against very harmful bacteria. I grew up in a household full of nurses who drilled the concept of antibiotic resistance in my head. From that, I have the philosophy that antibiotics should only be taken when absolutely necessary, and when prescribed by a physician. I also believe it is vital to take the entire prescription recommended by your doctor, even if you feel better.

I do think that antibiotics are abused in today’s society. Many times antibiotics are prescribed in situations that are not necessary. People also tend to disregard antibiotics if they start feeling better as opposed to taking the whole suggested regimen, which again, leads to increased antibiotic resistance and eventually we won’t be able to kill off these harmful bacteria anymore as they will have built up means to defend themselves against antibiotics. It is important that people don’t give antibiotics that they haven’t finished to others for any reason.

Overall, I believe that antibiotics should be taken only when necessary and prescribed by a physician. It is vital to take all of the antibiotics prescribed to you in the allotted time to decrease risks of antibiotic resistance. I think antibiotics are useful and a vital part of our society, but should not be abused.

Prompt: What choices do you make in terms of food/nutrition/product use and consumption that may have an impact on your microbial communities? Consider choices that are intentional and choices that are perhaps non-intentional.

Answer:

Prior to this class, I honestly haven’t put much thought into my diet and how that in turn affects the microbial community in my body.  I definitely think that I will pay more attention to this in the future. I don’t consume very much dairy, and I know products such as yogurt and kefir are really high in probiotic content, however, I don’t consume much of either. I think that I could definitely contribute to a greater diversity of my microbial communities if I eat a bit more dairy products. However, I do drink quite a bit of kombucha, which is a tea drink that is fermented by bacteria and yeast, so maybe that contributes a bit to my microbial communities. When I was younger, my mother also told me to eat a lot of bananas because she said they were high in fiber and would “make my gut healthy”.  It is interesting to finally understand the why behind those certain things. One main thing that may be unintentionally contributing to my microbial community is my consumption of bread. I eat a ton of bread! Thinking about it now, yeast contributes to the flavor and texture of bread, so maybe I am contributing to my microbial communities in that way. I definitely want to start thinking about my diet more and making more intentional choices that will further strengthen and diversity my own microbial community.

Prompt: Brainstorm a list of behaviors that an individual could engage in that could cause changes to their gut microbial community. Pick 3 specificbehaviors from you list. For each, discuss how that behavior could change the microbial community and the potential health impacts (beneficial, detrimental, neutral) that could result for the individual’s health.

• Various behaviors can cause changes to gut microbial communities. Some of these include: aging, antibiotic use, diet, environmental factors, and taking pre/probiotics
  • Taking prebiotics/probiotics
    • Taking prebiotics and probiotics have gained popularity over time. Prebiotics can promote growth of commensals and have potential to improve GI health. Probiotics have led to promising results as far as restoring the gut microbiota and treatment of intestinal disorders. Prebiotics and probiotics support the body in building and maintaining healthy bacterial colonies which in turn support gut health and can also aid in digestion. They help promote the growth of beneficial bacteria. Taking prebiotics and probiotics have beneficial impacts on health.
  • Antibiotic use
    • Antibiotic use can have potentially damaging effects to gut microbial communities. Although antibiotic use can be beneficial in curing infection, it can also have damaging effects in regards to the gut microbial community. Antibiotic use can lead to dysbiosis as they not only act on the bacteria that cause infection but also the resident microbiota that can be healthy in our systems. Although some resident microbiota can recover after antibiotic use, many cannot.
    • Antibiotic resistance also plays a role in the effect on gut microbial communities, as many of the harmful bacteria that cause infection find ways to evade antibiotic effects and in turn become stronger and more pathogenic. 
    • Overall, antibiotic use has detrimental impacts on health. Taking less antibiotics can help in limiting the detrimental health impacts that may occur.
  • Diet
    • Diet is a major contributor to changes in gut microbial communities. Maintaining a varied diet has beneficial impacts on health and gut microbial communities. Maintaining healthy proportions of fruits and vegetables as well as all other food groups ensures that you provide your gut’s microbial communities with beneficial resources for their survival. Diversity of gut microbial communities is typically associated with more stable, resilient communities and ensuring a diverse, healthy diet can promote the growth of diverse ranges of healthy microbes in the gut. 

As a healthcare professional, a colleague asks your opinion as to which HPV strains should be covered in a new treatment. Based on your reading from the Sarid and Gao 2011 article, what is your recommendation, and when should the treatment be administered? What evidence supports your opinion?

Human papillomavirus (HPV) is a very common virus that can lead to various types of cancers. According to the Sarid and Gao article, HPV is now recognized as the virus responsible for causing essentially all cases of cervical cancer in women, with a higher risk associated with certain strains. Today, over 100 types of HPV have been identified (1).

Although developing a vaccine for every strain of HPV would be an incredible advancement in the field of oncology, it is simply unplausible. The process of developing a vaccine for every HPV strain would take a lot of time, and a lot of money. Findings show that the cost of developing a vaccine from preclinical trials through to the end of phase 2a ranges from 31-68 million US dollars, and that is assuming no risk of failure (2). Cancerous cells are constantly (and rapidly) evolving and developing new abilities in order to evade detection. It would be nearly impossible to develop successful vaccines for every strain. The cost of vaccine development for every strain of HPV would also likely come at a great price to the public, therefore rendering it unaccessible to many individuals in general.

There are 12 different HPVs, and four of them, including HPVs 16, 18, 31 and 45 account for about 80% of cervical cancer. The remaining HPV types are also associated with cervical cancer and several have been classified as “probably carcinogenic to humans”, however, the four mentioned above are considered high-risk HPVs. Vaccines currently exist for HPV16 and HPV18, therefore, my recommendation would be to develop a vaccine for the other two high-risk HPVs, HPV31 and HPV45.

Because human papillomavirus is a sexually transmitted infection, the vaccine should be given to individuals before they have sexual contact with others and are exposed to HPV. I would recommend giving the vaccine around age 11 to begin protecting against HPV prior to possible exposure.

References:

Sarid R, Shou-Jiang G. 2011. Viruses and Human Cancer: From Detection to Causality. Cancer Lett 305(2):218-227.

Gouglas D, Le T, Henderson K, Kaloudis A, Danielsen T, Hammersland N, Robinson J, Heaton P, Rottingen J. 2018. Estimating the cost of vaccine development against epidemic infectious diseases: a cost minimisation study. Lancet Glob Health 6:e1386-1396. DOI: 10.1016/S2214-109X(18)30346-2

The first important aspect to focus on here is non-infectious diseases, which are diseases that are not contagious and are not caused by pathogens. These diseases are often caused by various lifestyle factors, mutations in genes, or toxins in the environment. The non-infectious diseases that come to my mind and may be modulated by microbes include cancer, diabetes, cardiovascular disease, asthma, and Alzheimer’s disease.