A Gluten-Free Diet, Not an Appropriate Choice without a Medical Diagnosis

In the past, only people diagnosed with celiac disease, approximately 1% of the population, avoided gluten consumption through all their meals. However, popular media often now mistakenly present gluten-free foods as being a healthier choice, and more people have now concluded that gluten is a harmful part of the diet. A review of literature on gluten-free diets, gluten sensitivity, celiac disease, and attitudes toward gluten consumption was undertaken to examine the prevalence and consequences of adopting a gluten-free diet and to provide guidance to healthcare practitioners whose patients are now often adopting this diet without medical input. Aside from celiac disease, nonceliac gluten sensitivity (NCGS) occurs in those persons in which gluten ingestion leads to symptomatic manifestations in the absence of celiac disease or wheat allergy but who report a remission of certain symptoms after removing gluten from their diet. However, it was been shown that a large percentage of people who claim NCGS do not feel those manifestations under a double-blind challenge to gluten. Moreover, some parents, believing that ingesting gluten is detrimental for their health, adopt gluten-free diets for their children. A review of existing data shows that there are detrimental effects to going gluten free, including loss of the dietary fiber, deficiencies in dietary minerals and vitamins, and potential heavy metal exposure. Healthcare practitioners should query patients about their dietary choices, and in cases of questionable adoption of gluten-free diet, patients and parents are educated about the detriments of a gluten-free diet, and in cases where patients continue to insist on gluten-free foods, referrals to nutritional counseling are warranted in order to minimize potential harm

Kinetics of sickle cell biorheology and implications for painful vasoocclusive crisis

We developed a microfluidics-based model to quantify cell-level processes modulating the pathophysiology of sickle cell disease (SCD). This in vitro model enabled quantitative investigations of the kinetics of cell sickling, unsickling, and cell rheology. We created short-term and long-term hypoxic conditions to simulate normal and retarded transit scenarios in microvasculature. Using blood samples from 25 SCD patients with sickle hemoglobin (HbS) levels varying from 64 to 90.1%, we investigated how cell biophysical alterations during blood flow correlated with hematological parameters, HbS level, and hydroxyurea (HU) therapy. From these measurements, we identified two severe cases of SCD that were also independently validated as severe from a genotype-based disease severity classification. These results point to the potential of this method as a diagnostic indicator of disease severity. In addition, we investigated the role of cell density in the kinetics of cell sickling. We observed an effect of HU therapy mainly in relatively dense cell populations, and that the sickled fraction increased with cell density. These results lend support to the possibility that the microfluidic platform developed here offers a unique and quantitative approach to assess the kinetic, rheological, and hematological factors involved in vasoocclusive events associated with SCD and to develop alternative diagnostic tools for disease severity to supplement other methods. Such insights may also lead to a better understanding of the pathogenic basis and mechanism of drug response in SCD.National Institutes of Health (U.S.) (R01HL094270)National Institutes of Health (U.S.) (U01HL114476

A Quantitative Cross-Regional Analysis of the Spanish VET Systems From a Systemic Approach: From a Regional Comparative VET Research Perspective

Purpose: The aim of this paper is to analyse comparatively, at regional level, the current state of a wide range of indicators of Vocational Education and Training (VET) at regional level in Spain. This will make it possible to characterise and better understand the existence of a variety of regional VET systems, including the Initial VET and Continuous VET subsystems within Spain, doing so under a multidimensional approach examining VET supply and demand. Methods: Systemic analysis of Spanish VET indicators leads to a selection of 54 indicators, which are then compared at regional level using k-means clustering. This approach identifies similarities and differences (clusters) across all of Spain's 17 autonomous communities (Spanish regions). The correlation between the variables is then analysed to examine the interaction between the VET system's supply and demand dimensions. Findings: The results show that 19 indicators explain the main differences between autonomous communities, which form two distinct clusters. Both VET supply and VET environment and demand influence cluster formation and inter-cluster differences. In the set of indicators that differentiate the two clusters of autonomous communities, close interaction is detected between certain indicators of VET supply and demand, especially those referring to the STEM occupational group, which confirms the correlation between these dimensions, albeit to a limited extent.  Conclusions: While it is necessary to analyse the differences between clusters in greater depth, the results suggest that Spain’s regions are split into two distinct groups (clusters) in which the respective VET systems are developing and advancing differently. Moreover, there is evidence of a small number of significant interrelations between indicators of VET supply and demand, which point to both the VET system's specialisation and its inclusive nature

Dynamic deformability of Plasmodium falciparum-infected erythrocytes exposed to artesunate in vitro

Artesunate (ART) is widely used for the treatment of malaria, but the mechanisms of its effects on parasitized red blood cells (RBCs) are not fully understood. We investigated ART's influence on the dynamic deformability of ring-stage Plasmodium falciparum infected red blood cells (iRBCs) in order to elucidate its role in cellular mechanobiology. The dynamic deformability of RBCs was measured by passing them through a microfluidic device with repeated bottleneck structures. The quasi-static deformability measurement was performed using micropipette aspiration. After ART treatment, microfluidic experiments showed 50% decrease in iRBC transit velocity whereas only small (~10%) velocity reduction was observed among uninfected RBCs (uRBCs). Micropipette aspiration also revealed ART-induced stiffening in RBC membranes. These results demonstrate, for the first time, that ART reduces the dynamic and quasi-static RBC deformability, which may subsequently influence blood circulation through the microvasculature and spleen cordal meshwork, thus adding a new aspect to artesunate's mechanism of action.Singapore-MIT Alliance for Research and Technology CenterNational Institutes of Health (U.S.) (Grant R01 HL094270-01A1

Electric impedance microflow cytometry for characterization of cell disease states

The electrical properties of biological cells have connections to their pathological states. Here we present an electric impedance microflow cytometry (EIMC) platform for the characterization of disease states of single cells. This platform entails a microfluidic device for a label-free and non-invasive cell-counting assay through electric impedance sensing. We identified a dimensionless offset parameter δ obtained as a linear combination of a normalized phase shift and a normalized magnitude shift in electric impedance to differentiate cells on the basis of their pathological states. This paper discusses a representative case study on red blood cells (RBCs) invaded by the malaria parasite Plasmodium falciparum. Invasion by P. falciparum induces physical and biochemical changes on the host cells throughout a 48-h multi-stage life cycle within the RBC. As a consequence, it also induces progressive changes in electrical properties of the host cells. We demonstrate that the EIMC system in combination with data analysis involving the new offset parameter allows differentiation of P. falciparum infected RBCs from uninfected RBCs as well as among different P. falciparum intraerythrocytic asexual stages including the ring stage. The representative results provided here also point to the potential of the proposed experimental and analysis platform as a valuable tool for non-invasive diagnostics of a wide variety of disease states and for cell separation.Singapore. National Research Foundation (Singapore-MIT Alliance for Research and Technology)Massachusetts Institute of Technology. Center for Integrated Circuits and SystemsNational Institutes of Health (U.S.) (Grant R01 HL094270

Indicators for Sustainable Energy Development. Case: Quintana Roo, México

This paper analyzes the evolution of some sustainable energy development indicators in the State of Quintana Roo, Mexico. The studied period includes from 2006 to 2014. The State of Quintana Roo’s economy is mainly based on tourism, and according to the state energy balance, fossil fuels are the most consumed (59%), and they are employed in transport sector. For this paper, access to electricity, pollutants gasses by the electricity generation, global and sector energy consumption related to inhabitants number, as well as Gross Domestic Product were selected as indicators. The application of these indicators showed as a result a light decrease in sustainable energy development with respect to 2006.En este trabajo se analiza la evolución de algunos indicadores del Desarrollo Energético Sustentable del estado de Quintana Roo, México. El periodo estudiado comprende de 2006 a 2014. Su economía se basa principalmente en el turismo; y con base en el balance energético del estado, los combustibles fósiles son los principales energéticos consumidos (59%) y se emplean principalmente en el sector transporte. Para esta investigación se han seleccionado como principales indicadores el grado de acceso a la electricidad, la emisión de contaminantes por la generación de ésta, así como el consumo de energía global y por sectores en relación con el número de habitantes, y al producto interno bruto. El resultado de la aplicación de los indicadores del desarrollo sustentable ha mostrado un ligero decremento de las condiciones respecto al año base de 2006

Enhancing the quality of international orthopedic medical mission trips using the blue distinction criteria for knee and hip replacement centers

Background: Several organizations seek to address the growing burden of arthritis in developing countries by providing total joint replacements (TJR) to patients with advanced arthritis who otherwise would not have access to these procedures. Because these mission trips operate in resource poor environments, some of the features typically associated with high quality care may be difficult to implement. In the U.S., many hospitals that perform TJRs use the Blue Cross/Shield’s Blue Distinction criteria as benchmarks of high quality care. Although these criteria were designed for use in the U.S., we applied them to Operation Walk (Op-Walk) Boston’s medical mission trip to the Dominican Republic. Evaluating the program using these criteria illustrated that the program provides high quality care and, more importantly, helped the program to find areas of improvement. Methods: We used the Blue Distinction criteria to determine if Op-Walk Boston achieves Blue Distinction. Each criterion was grouped according to the four categories included in the Blue Distinction criteria— “general and administrative”, “structure”, “process”, or “outcomes and volume”. Full points were given for criteria that the program replicates entirely and zero points were given for criteria that are not replicated entirely. Of the non-replicated criteria, Op-Walk Boston’s clinical and administrative teams were asked if they compensate for failure to meet the criterion, and they were also asked to identify barriers that prevent them from meeting the criterion. Results: Out of 100 possible points, the program received 71, exceeding the 60-point threshold needed to qualify as a Blue Distinction center. The program met five out of eight “required” criteria and 11 out of 19 “informational” criteria. It scored 14/27 in the “general” category, 30/36 in the “structure” category, 17/20 in the “process” category, and 10/17 in the “outcomes and volume” category. Conclusion: Op-Walk Boston qualified for Blue Distinction. Our analysis highlights areas of programmatic improvement and identifies targets for future quality improvement initiatives. Additionally, we note that many criteria can only be met by hospitals operating in the U.S. Future work should therefore focus on creating criteria that are applicable to TJR mission trips in the context of developing countries

Habitat use of Peale’s dolphin Lagenorhynchus australis in the Beagle Channel, Tierra del Fuego, Argentina

El delfín austral es uno de los cetáceos más comunes de Tierra del Fuego, Argentina. Sin embargo,ciertos aspectos de su población aún se desconocen. Con el objetivo de caracterizar el uso de hábitat de la especieen la zona, se realizaron observaciones desde costa y se analizaron sus patrones comportamentales en funcióndel estado de la marea y el bosque de macroalgas. Los resultados obtenidos sugieren que ambas variablesinuyen en la frecuencia de los comportamientos. Las actividades más frecuentes fueron búsqueda de alimentoy descanso. Este estudio aporta datos que pueden contribuir a planes de manejo en el ecosistema marino austral.Peale’s dolphin is one of the most common species of cetaceans in Tierra del Fuego, Argentina. However, limited information exists about the local population. In order to characterize the habitat use by Peale’s dolphin, land-based observations were carried out during a summer season. Behavioral patterns were studied in relation to tidal cycles and kelp forest, and the main activities displayed were determined. Foraging and resting were the most frequent behaviors observed. Dolphin’s behavior seems to be related to the tidal cycle and to its position relative to the kelp bed. This study provides data that can contribute to management plans of the austral marine ecosystem.Fil: Ordoñez, Constanza. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Austral de Investigaciones Científicas; Argentina. Universidad de Belgrano. Facultad de Ciencias Exactas y Naturales; ArgentinaFil: Diez, Mariano Javier. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Austral de Investigaciones Científicas; ArgentinaFil: Torres, Monica Analia. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Austral de Investigaciones Científicas; ArgentinaFil: Dellabianca, Natalia Andrea. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Austral de Investigaciones Científicas; Argentin

A combined theoretical and experimental study on the oxidation of fulvic acid by the sulfate radical anion

The kinetics of the reaction of sulfate radicals with the IHSS Waskish peat fulvic acid in water was investigated in the temperature range from 289.2 to 305.2 K. The proposed mechanism considers the reversible binding of the sulfate radicals by the fulvic acid. The kinetic analysis of the data allows the determination of the thermodynamic parameters ΔG° = -10.2 kcal mol-1, ΔH° = -16 kcal mol-1 and ΔS° = -20.3 cal K-1 mol-1 for the reversible association at 298.2 K. Theoretical (DFT) calculations performed with the Buffle model of the fulvic acids support the formation of H-bonded adducts between the inorganic radicals and the humic substances. The experimental enthalpy change compares well with the theoretical values found for some of the investigated adducts.Fil: David Gara, Pedro Maximiliano. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - La Plata. Instituto de Investigaciones Fisicoquímicas Teóricas y Aplicadas. Universidad Nacional de La Plata. Facultad de Ciencias Exactas. Instituto de Investigaciones Fisicoquímicas Teóricas y Aplicadas; ArgentinaFil: Bosio, Gabriela Natalia. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - La Plata. Instituto de Investigaciones Fisicoquímicas Teóricas y Aplicadas. Universidad Nacional de La Plata. Facultad de Ciencias Exactas. Instituto de Investigaciones Fisicoquímicas Teóricas y Aplicadas; ArgentinaFil: Gonzalez, Monica Cristina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - La Plata. Instituto de Investigaciones Fisicoquímicas Teóricas y Aplicadas. Universidad Nacional de La Plata. Facultad de Ciencias Exactas. Instituto de Investigaciones Fisicoquímicas Teóricas y Aplicadas; ArgentinaFil: Russo, Nino. Università della Calabria; ItaliaFil: Del Carmen Michelini, Maria. Università della Calabria; ItaliaFil: Pis Diez, Reinaldo. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - La Plata. Centro de Química Inorgánica "Dr. Pedro J. Aymonino". Universidad Nacional de La Plata. Facultad de Ciencias Exactas. Centro de Química Inorgánica "Dr. Pedro J. Aymonino"; ArgentinaFil: Martire, Daniel Osvaldo. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - La Plata. Instituto de Investigaciones Fisicoquímicas Teóricas y Aplicadas. Universidad Nacional de La Plata. Facultad de Ciencias Exactas. Instituto de Investigaciones Fisicoquímicas Teóricas y Aplicadas; Argentin