Allelic diversity of HMW and LMW glutenin subunits and ω-gliadins in Canadian hard red spring bread wheat (Triticum aestivum L.) developed over 150 years

Non-Peer ReviewedWheat (Triticum aestivum L.) is a major cereal crop that is grown around the world. Wheat based products are an important component of human diet as source of calories and proteins. The wheat grain storage proteins are made up of glutenin and gliadin subunits that form gluten in the dough, when wheat flour is mixed with water. The viscoelastic properties of wheat dough lend itself to make diverse food products consumed around the world. During the past few years, wheat gluten has been blamed for increased incidence of some chronic diseases such as obesity and associated cardiovascular ailments and type-2 diabetes. The main objective of this study was to study the diversity in wheat glutenins and gliadins, the two proteins that make up gluten, during 150 years of wheat improvement in Canada. A set of 37 hard red spring wheat cultivars were grown during 2013 and 2014, in a randomized complete block design with four replicates at the Kernen farm, University of Saskatchewan. Cultivars were selected based on the year of release from 1860 to 2007 and subdivided into historical and modern wheats. Historical cultivars included 11 entries released in Canada from 1860 until 1935 and the modern group included 26 cultivars released after 1935 and up to 2007. Gluten protein composition was determined by SDS-PAGE. Most of the genotypes in both groups had the combination Glu-A1b (2*), Glu-B1c (7+9) and Glu-D1d (5+10) for the high molecular weight glutenins (HMW-GS). Another allele that remained stable was the low molecular weight glutenin (LMW-GS) Glu-A3e present in 91% (historical) to 58% (modern) of the cultivars. Most variation was observed in the frequency of appearance of the most common subunits in the LMW-GS Glu-B3 and Glu-D3. For instance, in the historical group, the most common alleles were the Glu-B3b’ (55%) and the Glu-D3a (37%) or Glu-D3b (36%) whereas in modern cultivars Glu-B3h (58%) and the Glu-D3c (58%) were most frequent. Regarding ω-gliadins encoded by the Gli-B1, a relative high proportion of the historical genotypes carried the Gli-B1b subunit whereas in modern cultivars the Gli-B1d (58%) was common. No major alterations in the gluten subunits were observed between the Canadian historical and modern hard red spring wheat cultivars developed over the last century and half. However, subtle differences were found in the HMW-GS and the LMW-GS Glu-A3, and the frequency of appearance in the Glu-D3 and Glu-B3 (LMW-GS) and the Gli-B1 (ω-gliadins). The impact of the alterations on the incidence of Celiac disease is currently being studied

Gender differences within the barriers to smoking cessation and the preferences for interventions in primary care a qualitative study using focus groups in The Hague, The Netherlands

Objectives This research aimed to provide a deeper insight into the gender-specific barriers to smoking cessation and gender-specific preferences for interventions in primary care, in order to contribute to better aligned cessation care for women. Design Qualitative study using focus groups. Setting Regularly smoking female and male adults were recruited from four different general practices in The Hague (The Netherlands). Participants A total of 11 women and nine men participated. Participants included were regular smokers with a minimum age of 18 and sufficient command of the Dutch language, who were willing to talk about smoking cessation. Inclusion ended when saturation was reached for both women and men. Participants were selected by means of purposeful sampling, whereby looking at age, educational level and experience with quitting. Results The main barriers to smoking cessation in women were psychological factors, such as emotion and stress, compared with environmental factors in men. Women indicated they were in need of support and positivity, and both women and men expressed the desire for assistance without judgement. Contrary to men, women were not drawn to restrictions and (dis)incentives. Conclusion When counselling smokers, in women the focus should be on perceived internal problems, as opposed to more external obstacles in men. Contrary to men, female smokers seem to prefer non-coercive interventions, such as a group intervention offering support and positivity. Future research should focus on these gender differences, and how they could improve treatment in primary care.Prevention, Population and Disease management (PrePoD)Public Health and primary car

Tracking development assistance for health and for COVID-19 : a review of development assistance, government, out-of-pocket, and other private spending on health for 204 countries and territories, 1990-2050

Background The rapid spread of COVID-19 renewed the focus on how health systems across the globe are financed, especially during public health emergencies. Development assistance is an important source of health financing in many low-income countries, yet little is known about how much of this funding was disbursed for COVID-19. We aimed to put development assistance for health for COVID-19 in the context of broader trends in global health financing, and to estimate total health spending from 1995 to 2050 and development assistance for COVID-19 in 2020. Methods We estimated domestic health spending and development assistance for health to generate total health-sector spending estimates for 204 countries and territories. We leveraged data from the WHO Global Health Expenditure Database to produce estimates of domestic health spending. To generate estimates for development assistance for health, we relied on project-level disbursement data from the major international development agencies' online databases and annual financial statements and reports for information on income sources. To adjust our estimates for 2020 to include disbursements related to COVID-19, we extracted project data on commitments and disbursements from a broader set of databases (because not all of the data sources used to estimate the historical series extend to 2020), including the UN Office of Humanitarian Assistance Financial Tracking Service and the International Aid Transparency Initiative. We reported all the historic and future spending estimates in inflation-adjusted 2020 US$, 2020 US$ per capita, purchasing-power parity-adjusted US$per capita, and as a proportion of gross domestic product. We used various models to generate future health spending to 2050. Findings In 2019, health spending globally reached$8. 8 trillion (95% uncertainty interval [UI] 8.7-8.8) or $1132 (1119-1143) per person. Spending on health varied within and across income groups and geographical regions. Of this total,$40.4 billion (0.5%, 95% UI 0.5-0.5) was development assistance for health provided to low-income and middle-income countries, which made up 24.6% (UI 24.0-25.1) of total spending in low-income countries. We estimate that $54.8 billion in development assistance for health was disbursed in 2020. Of this,$13.7 billion was targeted toward the COVID-19 health response. $12.3 billion was newly committed and$1.4 billion was repurposed from existing health projects. $3.1 billion (22.4$2.4 billion (17.9%) was for supply chain and logistics. Only $714.4 million (7.7$1519 (1448-1591) per person in 2050, although spending across countries is expected to remain varied. Interpretation Global health spending is expected to continue to grow, but remain unequally distributed between countries. We estimate that development organisations substantially increased the amount of development assistance for health provided in 2020. Continued efforts are needed to raise sufficient resources to mitigate the pandemic for the most vulnerable, and to help curtail the pandemic for all. Copyright (C) 2021 The Author(s). Published by Elsevier Ltd.Peer reviewe

Probiotics and prebiotics in ulcerative colitis

The intestinal microbiota is one of the key players in the etiology of ulcerative colitis. Manipulation of this microflora with probiotics and prebiotics is an attractive strategy in the management of ulcerative colitis. Several intervention studies for both the induction and maintenance of remission in ulcerative colitis patients have been performed. Most of these studies evaluated VSL#3 or E. Coli Nissle 1917 and in general there is evidence for efficacy of these agents for induction and maintenance of remission. However, studies are frequently underpowered, lack a control group, and are very heterogeneous investigating different probiotic strains in different study populations. The absence of well-powered robust randomized placebo-controlled trials impedes the widespread use of probiotics and prebiotics in ulcerative colitis. However, given the promising results that are currently available, probiotics and prebiotics may find their way to the treatment algorithm for ulcerative colitis in the near future

Role of TNFR-related 2 mediated immune responses in dextran sulfate sodium-induced inflammatory bowel disease

Previous work has suggested that the LIGHT-TR2 costimulatory pathway plays a role in the acute and chronic stages of dextran sulfate sodium (DSS)-induced colitis [Steinberg et al. (2008); Wang et al. (2005)]. To clarify the role of TNFR-related 2 (TR2) signaling in the maintenance of intestinal homeostasis, we generated a TR2 knock-out (KO) mouse. Using DSS to induce colitis, we compared the colitic symptoms and pathological changes in wild type (WT) and TR2 KO mice, and the production of cytokines by the diseased colons. We also studied the role of TR2 in suppressing innate and adaptive immunity in the DSS model. TR2 deficient mice were characterized by reduced symptoms of intestinal inflammation compared with wildtype mice, and reduced production of cytokines. We therefore generated a monoclonal antibody against mouse TR2 which was specific to TR2 and capable of blocking TR2 signals. With this antibody, we demonstrated that antagonizing TR2 during the development of DSS-induced colitis reduced the symptoms of inflammation. Our findings suggest that TR2 is an important mediator in colitis, and may serve as a therapeutic target in inflammatory bowel disease

Intraoperative high-dose dexamethasone for cardiac surgery

__Context:__ Prophylactic corticosteroids are often administered during cardiac surgery to attenuate the inflammatory response to cardiopulmonary bypass and surgical trauma; however, evidence that routine corticosteroid use can prevent major adverse events is lacking. __Objective:__ To quantify the effect of intraoperative high-dose dexamethasone on the incidence of major adverse events in patients undergoing cardiac surgery. __Design, Setting, and Participants:__ A multicenter, randomized, double-blind, placebocontrolled trial of 4494 patients aged 18 years or older undergoing cardiac surgery with cardiopulmonary bypass at 8 cardiac surgical centers in the Netherlands enrolled between April 13, 2006, and November 23, 2011. __Intervention:__ Patients were randomly assigned to receive a single intraoperative dose of 1 mg/kg dexamethasone (n=2239) or placebo (n=2255). __Main Outcome Measures:__ A composite of death, myocardial infarction, stroke, renal failure, or respiratory failure, within 30 days of randomization. __Results:__ Of the 4494 patients who underwent randomization, 4482 (99.7%) could be evaluated for the primary outcome. A total of 157 patients (7.0%) in the dexamethasone group and 191 patients (8.5%) in the placebo group reached the primary study end point (relative risk, 0.83; 95% CI, 0.67-1.01; absolute risk reduction, -1.5%; 95% CI, -3.0% to 0.1%; P=.07). Dexamethasone was associated with reductions in postoperative infection, duration of postoperative mechanical ventilation, and lengths of intensive care unit and hospital stays. In contrast, dexamethasone was associated with higher postoperative glucose levels. __Conclusion:__ In our trial of adults undergoing cardiac surgery, the use of intraoperative dexamethasone did not reduce the 30-day incidence of major adverse events compared with placebo