***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
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    ***EXAMPLES*** 
    Input: BACKGROUND Changes in gut microbiota induced by bariatric surgery have been associated with metabolic benefits . OBJECTIVES Our aim was to identify specific gut microbiota that may contribute to the improvement of  type 2 diabetes ( T2D ) after Roux-en-Y gastric bypass ( RYGB ) .  SETTING Laboratories of Shanghai Diabetes Institute and Shanghai Sixth People 's Hospital . METHODS Diabetic rats induced via a high-fat diet and low-dose streptozotocin administration  were r and omized to RYGB or sham surgery , and stool sample s were collected at baseline and at postoperative week 8 . The fecal microbiota was profiled using 16S ribosomal RNA gene sequencing . Additionally , we performed a case-control study of the gut microbial community profiles of T2D patients compared with those of healthy individuals via 16S ribosomal RNA gene sequencing of mucosal-luminal interface sample s collected from the ascending colon during colonoscopy . RESULTS RYGB significantly reduced the weight and improved glucose tolerance and insulin sensitivity in diabetic rats . Principal coordinate analysis showed that RYGB caused marked alterations in the gut microbiota . The RYGB group was postoperatively enriched for Bacteroidetes , Proteobacteria , Fusobacteria , and Actinobacteria , whereas the sham surgery group was enriched for Firmicutes and Verrucomicrobia . Based on the gut microbial patterns in the T2D patients , we found that the family Coriobacteriaceae within Actinobacteria might contribute to the beneficial effects of RYGB on T2D . CONCLUSIONS RYGB significantly improves glucose metabolism and alters the gut microbiota . Moreover , the family Coriobacteriaceae may partly mediate the beneficial effects of RYGB on T2D and thus possibly contribute to the development of novel bacteria-based therapeutic approaches Background and Objectives Bariatric surgery improves metabolic diseases and alters the intestinal microbiota in animals and humans , but different procedures reportedly have different impacts on the intestinal microbiota . We developed laparoscopic sleeve gastrectomy with duodenojejunal bypass ( LSG-DJB ) as an alternative to laparoscopic Roux-en-Y gastric bypass ( LRYGB ) in addition to laparoscopic sleeve gastrectomy ( LSG ) for Japanese patients with obesity . We investigated the precise change in the intestinal microbiota induced by these procedures in the present study . Methods A prospect i ve observational study of 44 Japanese patients with obesity was conducted [ 22 patients underwent LSG , 18 underwent LSG-DJB , and 4 underwent laparoscopic adjustable gastric b and ing ( LAGB ) ] . The patients ’ clinical parameters and intestinal microbiota were investigated before and for 6 months after surgery . The microbiota was analyzed by a 16S rDNA method . Results LSG and LSG-DJB significantly improved the metabolic disorders in the patients with obesity . The proportion of the phylum Bacteroidetes and order Lactobacillales increased significantly in the LSG group , and that of the order Enterobacteriales increased significantly in the LSG-DJB group . Conclusions LSG and LSG-DJB improved obesity and type 2 diabetes in Japanese patients with obesity , but the impact of LSG-DJB on the intestinal microbiota differed from that of LSG . This difference in the impact on the intestinal environment could explain the different efficacies of LSG and LSG-DJB in terms of their ability to resolve metabolic disorders in the clinical setting BACKGROUND Changes in the gut microbiome following  bariatric surgery  have been causally linked to metabolic benefits . OBJECTIVES We sought to characterize and assess the stability of gut microbiome shifts following  sleeve gastrectomy ( SG ) . SETTING University laboratories . METHODS Diet-induced obese mice were r and omized to SG or sham surgery . Mice were housed individually or cohoused such that one SG mouse was housed with one weight-matched , sham-operated mouse . Fecal sample s were collected before and on postoperative days 7 and 28 . Bacterial composition in feces was characterized by using next-generation Illumina sequencing of 16 S rRNA . RESULTS SG mice  lost more weight and were more insulin sensitive than sham mice independent of housing status ( P<.05 ) . One week following surgery , fecal sample s from all mice showed shifts in the microbiome that only persisted in SG-operated mice . Cohousing did not alter the microbial composition of SG-operated mice . Cohoused sham-operated mice showed a unique shift in microbial composition on postoperative day 28 that differed from individually housed , sham-operated mice ( P<.001 ) . Cohousing did not affect metabolic outcomes of either SG or sham surgeries . CONCLUSION SG results in acute and sustained shifts in the gut microbiome . SG associated shifts are not altered by reexposure to obesity-associated gut microbiota Background Roux-en-Y gastric bypass ( RYGB ) is an effective means to achieve sustained weight loss for morbidly obese individuals . Besides rapid weight reduction , patients achieve major improvements of insulin sensitivity and glucose homeostasis . Dysbiosis of gut microbiota has been associated with obesity and some of its co-morbidities , like type 2 diabetes , and major changes of gut microbial communities have been hypothesized to mediate part of the beneficial metabolic effects observed after RYGB . Here we describe changes in gut microbial taxonomic composition and functional potential following RYGB . Methods We recruited 13 morbidly obese patients who underwent RYGB  , carefully phenotyped them , and had their gut microbiomes quantified before ( n = 13 ) and 3 months ( n = 12 ) and 12 months ( n = 8) after RYGB . Following shotgun metagenomic sequencing of the fecal microbial DNA purified from stools , we characterized the gut microbial composition at species and gene levels followed by functional annotation . Results In parallel with the weight loss and metabolic improvements , gut microbial diversity increased within the first 3 months after RYGB and remained high 1 year later . RYGB led to altered relative abundances of 31 species ( P < 0.05 , q < 0.15 ) within the first 3 months , including those of Escherichia coli , Klebsiella pneumoniae , Veillonella spp . , Streptococcus spp . , Alistipes spp . , and Akkermansia muciniphila . Sixteen of these species maintained their altered relative abundances during the following 9 months . Interestingly , Faecalibacterium prausnitzii was the only species that decreased in relative abundance . Fifty-three microbial functional modules increased their relative abundance between baseline and 3 months ( P < 0.05 , q < 0.17 ) . These functional changes included increased potential ( i ) to assimilate multiple energy sources using transporters and phosphotransferase systems , ( ii ) to use aerobic respiration , ( iii ) to shift from protein degradation to putrefaction , and ( iv ) to use amino acids and fatty acids as energy sources . Conclusions Within 3 months after morbidly obese individuals had undergone RYGB , their gut microbiota featured an increased diversity , an altered composition , an increased potential for oxygen tolerance , and an increased potential for microbial utilization of macro- and micro-nutrients . These changes were maintained for the first year post-RYGB.Trial registration Current controlled trials ( ID NCT00810823 , NCT01579981 , and NCT01993511 ) Background The role of the gut microbiome in arresting pathogen colonization and growth is important for protection against Clostridium difficile infection ( CDI ) . Observational studies associate proton pump inhibitor ( PPI ) use and CDI incidence . We hypothesized that PPI use affected the distal gut microbiome over time , an effect that would be best explored by time-longitudinal study of healthy subjects on PPI in comparison to treatment-naïve CDI subjects . This study enrolled nine healthy human subjects and five subjects with treatment-naïve CDI . After r and om assignment to a low ( 20 mg/day ) or high ( 2 × 20 mg/day ) dose group , fecal sample s were collected from the nine healthy subjects before , during , and after 28 days of PPI use . This was done in conjunction with pre-treatment fecal collection from CDI subjects . High-throughput sequencing ( 16S rRNA ) was performed on time-longitudinal sample s to assess changes to the healthy gut microbiome associated with prolonged PPI usage . The healthy sample s were then compared to the CDI subjects to explore changes over time to the gut microbiome associated with PPI use and potentially related to CDI . Results We report that PPI usage at low and high dosages , administered for 28 days , result ed in decreases to observed operational taxonomic unit ( OTU ) counts after both 1 week and 1 month . This decrease result ed in observed OTU levels that were similar to those found in treatment-naïve CDI patients , which was partly reversible after a 1 month recovery period . We did not detect a dose-dependent difference in OTU levels nor did we detect significant changes in taxa previously reported to be affected by PPI treatment . Conclusion While our observation of diminishing observed OTU counts during PPI therapy is a preliminary finding in a small cohort , our hypothesis that PPIs disrupt the healthy human gut microbiome is supported in this group . We conclude that decreases in observed species counts were reversible after cessation of PPI usage within 1 month . This finding may be a potential explanation for the association between prolonged PPI usage and CDI incidence Summary Bariatric surgery is currently the most effective procedure for the treatment of obesity . Given the role of the gut microbiota in regulating host metabolism and adiposity , we investigated the long-term effects of bariatric surgery on the microbiome of patients r and omized to Roux-en-Y gastric bypass or vertical b and ed gastroplasty and matched for weight and fat mass loss . The two surgical procedures induced similar and durable changes on the gut microbiome that were not dependent on body mass index and result ed in altered levels of fecal and circulating metabolites compared with obese controls . By colonizing germ-free mice with stools from the patients , we demonstrated that the surgically altered microbiota promoted reduced fat deposition in recipient mice . These mice also had a lower respiratory quotient , indicating decreased utilization of carbohydrates as fuel . Our results suggest that the gut microbiota may play a direct role in the reduction of adiposity observed after bariatric surgery Despite substantial research efforts , the mechanisms proposed to explain weight loss after gastric bypass ( RYGB ) and sleeve gastrectomy ( SL ) do not explain the large individual variation seen after these treatments . A complex set of factors are involved in the onset and development of obesity and these may also be relevant for the underst and ing of why success with treatments vary considerably between individuals . This calls for explanatory models that take into account not only biological determinants but also behavioral , affective and context ual factors . In this prospect i ve study , we recruited 47 women and 8 men , aged 25–56 years old , with a BMI of 45.8 ± 7.1 kg/m2 from the waiting list for RYGB and SL at Køge hospital , Denmark . Pre-surgery and 1.5 , 6 and 18 months after surgery we assessed various endpoints spanning multiple domains . Endpoints were selected on basis of previous studies and include : physiological measures : anthropometrics , vital signs , biochemical measures and appetite hormones , genetics , gut microbiota , appetite sensation , food and taste preferences , neural sensitivity , sensory perception and movement behaviors ; psychological measures : general psychiatric symptom-load , depression , eating disorders , ADHD , personality disorder , impulsivity , emotion regulation , attachment pattern , general self-efficacy , alexithymia , internalization of weight bias , addiction , quality of life and trauma ; and sociological and anthropological measures : sociodemographic measures , eating behavior , weight control practice s and psycho-social factors . Joining these many endpoints and method ologies from different scientific disciplines and creating a multi-dimensional predictive model has not previously been attempted . Data on the primary endpoint are expected to be published in 2018 . Trial registration Clinical trials . gov ID NCT02070081 Background : Probiotics are commonly used after bariatric surgery ; however , uncertainty remains regarding their efficacy . Our aim was to compare the effect of probiotics vs placebo on hepatic , inflammatory and clinical outcomes following  laparoscopic sleeve gastrectomy ( LSG ) . Methods : This r and omized , double-blind , placebo-controlled , trial of 6-month treatment with probiotics ( Bio-25 ; Supherb ) vs placebo and 6 months of additional follow-up was conducted among 100 morbidly obese nonalcoholic fatty liver disease ( NAFLD ) patients who underwent LSG surgery . The primary outcome was a reduction in liver fat content , measured by abdominal ultrasound , and secondary outcomes were improvement of fibrosis , measured by shear-wave elastography , metabolic and inflammatory parameters , anthropometrics and quality of life ( QOL ) . Fecal sample s were collected and analyzed for microbial composition . Results : One hundred patients ( 60 % women , mean age of 41.9±9.8 years and body mass index of 
    Output:
    
Roux-n-Y gastric bypass caused more alterations in gut microbial composition in comparison with sleeve gastrectomy .