Are Ancient Durum Wheats Less Toxic to Celiac Patients? A Study of α-Gliadin from Graziella Ra and Kamut

In the present paper, the controversial hypothesis suggesting ancient grains might show lower immunogenic properties and therefore the possibility to introduce them in the diet of wheat-sensitive people, including celiac patients, was investigated. The immunogenic potential of the ancient durum wheats Graziella Ra and Kamut was studied by comparison to the durum accessions Cappelli, Flaminio, Grazia and Svevo. Experiments were carried out with two monoclonal antibodies (mAbs) raised against α-gliadin peptides p31–49 and p56–75 (the latter containing the overlapping DQ2-Glia-α1 and DQ2-Glia-α2 epitopes), toxic for celiac patients. For all accessions, a few α-gliadin alleles were also cloned, sequenced and translated into aminoacid sequences. Several aminoacid substitutions or deletions were detected in p31–49, DQ2-Glia-α1 and DQ2-Glia-α2 epitopes, nevertheless, ELISA constantly showed antibody-antigen positive reactions which led us to suggest that mAbs binding was not apparently affected by polymorphisms. Moreover, a few substitutions were also observed in DQ2-Glia-α3 and DQ8-Glia-α1 epitopes. Although some DQ2-Glia-α1 and DQ2-Glia-α2 variants evidenced herein were previously reported to have a diminished or abolished T cell stimulatory capacity, present results cannot confirm that ancient durum wheats would be less CD-toxic. In conclusion, we strongly advice celiac patients from consuming ancient wheats including Graziella Ra or Kamut

Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study

Background: The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and pulmonary complication rates in patients with perioperative SARS-CoV-2 infection. Methods: This international, multicentre, cohort study at 235 hospitals in 24 countries included all patients undergoing surgery who had SARS-CoV-2 infection confirmed within 7 days before or 30 days after surgery. The primary outcome measure was 30-day postoperative mortality and was assessed in all enrolled patients. The main secondary outcome measure was pulmonary complications, defined as pneumonia, acute respiratory distress syndrome, or unexpected postoperative ventilation. Findings: This analysis includes 1128 patients who had surgery between Jan 1 and March 31, 2020, of whom 835 (74·0%) had emergency surgery and 280 (24·8%) had elective surgery. SARS-CoV-2 infection was confirmed preoperatively in 294 (26·1%) patients. 30-day mortality was 23·8% (268 of 1128). Pulmonary complications occurred in 577 (51·2%) of 1128 patients; 30-day mortality in these patients was 38·0% (219 of 577), accounting for 81·7% (219 of 268) of all deaths. In adjusted analyses, 30-day mortality was associated with male sex (odds ratio 1·75 [95% CI 1·28–2·40], p\textless0·0001), age 70 years or older versus younger than 70 years (2·30 [1·65–3·22], p\textless0·0001), American Society of Anesthesiologists grades 3–5 versus grades 1–2 (2·35 [1·57–3·53], p\textless0·0001), malignant versus benign or obstetric diagnosis (1·55 [1·01–2·39], p=0·046), emergency versus elective surgery (1·67 [1·06–2·63], p=0·026), and major versus minor surgery (1·52 [1·01–2·31], p=0·047). Interpretation: Postoperative pulmonary complications occur in half of patients with perioperative SARS-CoV-2 infection and are associated with high mortality. Thresholds for surgery during the COVID-19 pandemic should be higher than during normal practice, particularly in men aged 70 years and older. Consideration should be given for postponing non-urgent procedures and promoting non-operative treatment to delay or avoid the need for surgery. Funding: National Institute for Health Research (NIHR), Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, NIHR Academy, Sarcoma UK, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research

Molecular analysis of Muticaria syracusana and M. neuteboomi from Southeastern Sicily, Italy (Gastropoda, Pulmonata, Clausiliidae)

The genus Muticaria Lindholm, 1925, is currently distributed either in Southeastern Sicily or in the Malteseislands and comprises the species M. syracusana (Philippi, 1836), M. neuteboomi Beckmann, 1990 and M.macrostoma (Cantraine, 1835). For the first time, we report a molecular study on the topotypicous populationsof M. syracusana and M. neuteboomi carried out on fragments of the ribosomal 16S rDNA subunit and thecytochrome oxydase I (COI) mitochondrial genes by Neighbour Joining, Maximum Likelihood, MaximumParsimony and Bayesian Inference algorithms. Our results revealed the existence of nucleotide-sequencedivergence (Dxy: 5% for 16S rDNA and 12% for COI sequences) between the two taxa

Genetic diversity analysis of the durum wheat Graziella Ra, Triticum turgidum L. subsp. durum (Desf.) Husn. (Poales, Poaceae)

For the first time, the durum wheat Graziella Ra was compared to four Italian durum wheat varieties (Cappelli,Grazia, Flaminio and Svevo) and to Kamut in order to preliminary characterize its genome and to investigategenetic diversity among and within the accessions by Amplified Fragment Length Polymorphisms (AFLPs),Simple Sequence Repeats (SSRs) and α-gliadin gene sequence analysis. The main aim of the study was anattempt to determine the relationship between the historic accession Graziella Ra and Kamut which isconsidered an ancient relative of the durum subspecies. In addition, nutritional factors of Graziella Ra werereported. Obtained results showed that (i) both AFLP and SSR molecular markers detected highly congruentpatterns of genetic diversity among the accessions showing nearly similar efficiency; (ii) for AFLPs,percentage of polymorphic loci within accession ranged from 6.57% to 19.71% (mean 12.77%) and, for SSRs,from 0% to 57.14% (mean 28.57%); (iii) principal component analysis (PCA) of genetic distance amongaccessions showed the first two axes accounting for 58.03% (for AFLPs) and 61.60% (for SSRs) of the totalvariability; (iv) for AFLPs, molecular variance was partitioned into 80% (variance among accessions) and 20%(within accession) and, for SSRs, into 73% (variance among accessions) and 27% (within accession); (v)cluster analysis of AFLP and SSR datasets displayed Graziella Ra and Kamut into the same cluster; and (vi)molecular comparison of α-gliadin gene sequences showed Graziella Ra and Kamut in separate clusters. Allthese findings indicate that Graziella Ra, although being very similar to Kamut, at least in the little part of thegenome herein investigated by molecular markers, may be considered a distinct accession showing appreciablelevels of genetic diversity and medium-high nutritional qualities

Qanat, gebbie and water sources: the last refuge for the malacologican freshwater fauna in Palermo (Sicily, Italy)

The surroundings of Palermo were characterized, over the centuries, by the presence of many natural environments of great ecological and faunal importance. These environments were placed in a context characterized by minimal and sustainable urban development and large agriculture areas, dedicated to the development of tree crops such as citrus and orchards. These crops were supported by an imposing irrigation system that, using natural resources such as watercourses, wells and springs, collected and distributed water in soils through tanks, gebbie, qanat, irrigation channels (saje), etc. Fresh water mollusks, like many other animal and vegetable organisms, spread from the natural freshwater environments in this artificial water system, thus creating a unique and varied ecosystem. The subsequent urban development of the city of Palermo and the destruction of many of those natural environments has further enhanced the ecological role of the artificial freshwater systems as an important refuge for the native fauna and flora. In the present study, we report on freshwater molluscs observed in the territory of Micciulla, a large relict area occupied almost entirely by an old citrus, now located inside the city of Palermo. In this area there are some springs, an extensive array of artificial freshwater to irrigate the crops, and the qanat Savagnone located in the “Camera dello Scirocco”. The results obtained by census of different populations of freshwater mollusks confirm the importance of these environments and the growing role they play as the last refuges for fauna and flora originally linked to natural humid environments

Importance of Baseline Prognostic Factors With Increasing Time Since Initiation of Highly Active Antiretroviral Therapy: Collaborative Analysis of Cohorts of HIV-1-Infected Patients

Background: The extent to which the prognosis for AIDS and death of patients initiating highly active antiretroviral therapy (HAART) continues to be affected by their characteristics at the time of initiation (baseline) is unclear. Methods: We analyzed data on 20,379 treatment-naive HIV-1- infected adults who started HAART in 1 of 12 cohort studies in Europe and North America (61,798 person-years of follow-up, 1844 AIDS events, and 1005 deaths). Results: Although baseline CD4 cell count became less prognostic with time, individuals with a baseline CD4 count 350 cells/μL (hazard ratio for AIDS = 2.3, 95% confidence interval [CI]: 1.0 to 2.3; mortality hazard ratio = 2.5, 95% CI: 1.2 to 5.5, 4 to 6 years after starting HAART). Rates of AIDS were persistently higher in individuals who had experienced an AIDS event before starting HAART. Individuals with presumed transmission by means of injection drug use experienced substantially higher rates of AIDS and death than other individuals throughout follow-up (AIDS hazard ratio = 1.6, 95% CI: 0.8 to 3.0; mortality hazard ratio = 3.5, 95% CI: 2.2 to 5.5, 4 to 6 years after starting HAART). Conclusions: Compared with other patient groups, injection drug users and patients with advanced immunodeficiency at baseline experience substantially increased rates of AIDS and death up to 6 years after starting HAART

Estimating minimum adult HIV prevalence: A cross-sectional study to assess the characteristics of people living with HIV in Italy

In 2012, we conducted a retrospective cross-sectional study to assess the number of people living with HIV linked to care and, among these, the number of people on antiretroviral therapy. The health authority in each of the 20 Italian Regions provided the list of Public Infectious Diseases Clinics providing antiretroviral therapy and monitoring people with HIV infection. We asked every Public Infectious Diseases Clinic to report the number of HIV-positive people diagnosed and linked to care and the number of those on antiretroviral therapy during 2012. In 2012, 94,146 people diagnosed with HIV and linked to care were reported. The majority were males (70.1%), Italians (84.4%), and aged between 25 and 49 years (63.4%); the probable route of transmission was heterosexual contact in 37.5% of cases, injecting drug use in 28.1%, and male-to-male contact in 27.9%. Among people in care, 20.1% had less than 350 CD4 cells/μl, 87.6% received antiretroviral therapy, and among these, 62.4% had a CD4 cell count higher than 350 cells/μl. The overall estimated prevalence of individuals diagnosed and linked to care in 2012 in Italy was 0.16 per 100 residents (all ages). Adding the estimated proportion of undiagnosed people, the estimated HIV prevalence would range between 0.19 and 0.26 per 100 residents. In Italy, the majority of people diagnosed and linked to care receive antiretroviral therapy. A higher prevalence of individuals diagnosed and linked to care was observed in Northern Italy and among males. More information for developing the HIV care continuum is necessary to improve the entire engagement in care, focusing on test-and-treat strategies to substantially reduce the proportion of people still undiagnosed or with a detectable viral load