Enterococci are often used in probiotics but can also cause nosocomial infections. As such, enterococcal consumption may have beneficial health effects, but a thorough evaluation of virulence absence and risk of antibiotic resistance spread is needed at the strain level. This article reviewed ten online health product shopping websites in the US. On these websites, 23 probiotic products using enterococci were found across 12 companies. In addition, this article reviewed studies that demonstrated the probiotic potential of enterococcal consumption (e.g., gastrointestinal and respiratory disease, hyperlipidemia alleviation, as well as infection prevention). To investigate the safety aspects of enterococci, the present work examined studies evaluating virulence factors and antibiotic resistance. Furthermore, this article assessed research that explored these virulent factors, specifically in probiotics containing enterococci, as well as the potential transfer mechanism of their antibiotic resistance. Based on reviewed data, enterococcal probiotic consumption has been proven beneficial for conditions or symptoms of multiple diseases without any apparent adverse effects. However, due to the plasmid- or transposon-mediated gene transfer ability of enterococci, surveillance monitoring and further studies regarding enterococcal consumption are warranted. Future studies that identify enterococcal strains safe to use in probiotics without virulence factors and antibiotic resistance are imperative for evidence-based decisions by health organizations and government agencies.

Background: Sleep apnea and insomnia are risk factors for dementia. Slower gait and increased gait variability are also associated with increased risk of MCI, linked to cognitive decline. Wearable digital sensors can serve as vital tools for measuring sleep and motor function. While poor quality of sleep has been correlated with decline in cognitive function, the relationship between sleep quality and gait parameters is less characterized. We hypothesized sleep apnea and lower sleep quality were associated with gait speed, gait variability, and functional mobility.Method: Participants aged 50+ (n=55, female=31) used a finger‐worn sensor with embedded plethysmography [Sleepimage] for at least three consecutive nights over two weeks, quarterly for eight quarters. Five major sleep parameters were evaluated: Sleep Quality Index (SQI), sleep efficiency, Apnea Hypopnea Index (sAHI) at 3% oxygen desaturation threshold, sleep latency, and stable non‐REM sleep percentage. Gait assessments were completed on‐site with inertial sensors [APDM Opals] worn on the wrists, shanks, and waist. It included timed walks with and without cognitive tasks and a Timed Up and Go (TUG) test. Relevant parameters included comfortable gait velocity, dual‐task walking velocity, and lateral step variability. Pearson correlations were used to assess the relationship between sleep and gait parameters. Mean values were compared between participants with and without MCI (MCI=8, Non‐MCI=47) and between slow and fast walkers (above or below 1 meters/second, fast, n=29, slow, n=26) using independent t‐tests.Result: Mean sAHI was significantly greater in slow (22.39) than fast walkers (14.57, t=2.309, p=0.026). sAHI demonstrated a significant negative correlation with gait velocity (r=‐0.288, p=0.047) and a positive correlation with time required to stand from sitting (r=0.367, p=0.01). Better SQI (r=‐0.316, p=0.029), longer sleep latency (r=0.296, p=0.041), and stable non‐REM sleep (r=‐0.316, p=0.029) was significantly associated with increased lateral step variability. Mean lateral step variability was higher in participants with MCI (16.89) than those without (0.68, t=2.485, p=0.036); mean TUG time was longer in participants with MCI (12.21 seconds) than those without (9.85, t=‐2.755, p=0.028).Conclusion: This preliminary analysis suggests associations between sleep disturbances and gait parameters associated with risk of cognitive decline. Constraints of sample size and participant diversity are acknowledged, informing the ongoing enrollment of the cohort.