Biological Therapy in Primary Sjogren's Syndrome: Effect on Salivary Gland Function and Inflammation

Primary Sjögren's syndrome (pSS) is a chronic, systemic autoimmune disease. It is the second most common rheumatic autoimmune disorder, affecting 0.7% of European Americans and up to 1% of people globally. pSS is characterized by the impaired secretory function of exocrine glands, including salivary and lachrymal glands. A lymphocytic infiltration of these organs leads to the common and debilitating symptoms of oral and ocular dryness, majorly affecting the quality of life of these patients. Currently, no disease-modifying drug has been approved for the treatment of pSS, with therapies largely aimed at relieving symptoms of dry mouth and dry eyes. In particular, management of oral dryness still represents a major unmet clinical need in pSS and a significant burden for patients with this condition. Recently, several randomized clinical trials in pSS with biological therapies targeting specific mechanistic pathways implicated in the disease pathogenesis, including B-cell hyperactivity, T-cell co-stimulation and the aberrant role of cytokines, have been completed with mixed results. In this review, we summarize evidence from recent clinical trials investigating biological therapy in pSS, specifically highlighting efficacy, or lack thereof, in modulating local inflammation and improving salivary gland function

Future Melting Away: Water Stress As A Threat To Human Security In Bangladesh And The Role Of International Community

Bangladesh is considered as one of the frontline states in the global climate change; its policy agendas attempt to respond to the perceived security threats emanating from such changes. Water stress is one of the key problems the country is facing. Yet, links between glaciers in the Hindu Kush Himalaya, Bangladesh’s climate, growing water stress, and its implications for human security have seldom been studied. Drawing on the concepts of climate change, human security and water stress, the thesis examines the causes of Bangladesh’s freshwater crisis and its contribution to the human insecurity. Here in this study, the influence of water stress on human security has been explored. Notably how salinity intrusion and arsenic water contamination turned into a human security threat. Moreover, the study elaborates that indifference to human security threat may cause vulnerability, in this case, freshwater crisis for people in Bangladesh. In the long run, such vulnerability can turn into double vulnerability and here the rural women in Bangladesh are one of the core victims. Additionally, the thesis insists that there is a contradiction between the core values of the UNICEF and its actions in mitigating water stress in Bangladesh

The impact of Social Media Influencer’s (SMI) on the buying decisions of Generation Y

This research aims to analyse how social media influencers on Instagram influence the purchasing decision of Millennial consumers in the luxury watch industry in Swiss Romandie. The first part of this project discusses different elements surrounding influencer marketing and Millennial’s online buying behaviour. The second part investigates Millennials’ presence on social media and their relationship with influencers. The data collected in the analysis show how influencers impact the purchasing decision of Millennial. By combining the findings, the analysis and the literature review, it can be seen that Millennials are aware of the growing trend on influencer marketing on Instagram. Influencers in the fashion and lifestyle category are most followed by millennial consumers. Several key factors of attachment and affinity with influencers were derived from this analysis. For instance, style and physical appearance, aesthetic or similarities are among the drivers that attracts a follower to an influencer besides age and gender. Influencer are also seen as a source of inspiration for Millennials who look up to them for new ideas and inspirations on a daily basis. Safe to say they follow them as role models. Moreover, findings show that most of the Millennials trust influencers. However, this does not always lead to purchase behaviour as Millennials are vigilant and reluctant. Research show that Millennials have real interest in luxury, however not all of them can afford it. There is a fine line between bridging this gap, and it can be deduced that over time luxury brands would realize that a huge potential market is still untapped as some millennials are unable to afford the product even when they follow the influencer on social media. Furthermore, findings show that influencer marketing allow brands to increase their awareness by giving them more visibility and reach a vast audience. Research suggests that a blockbuster influencer would preferably be used for awareness while a microinfluencer for conversion. Choosing the right type of influencers for the right target audience will help luxury watch brands to boost their awareness and visibility and eventually increase their sales. However, in order to fully support these findings and hypotheses a deeper quantitative and qualitative study in necessary

A Comparison of Semi-Parametric and Nonparametric Methods for Estimating Mean Time to Event for Randomly Left Censored Data

The aim of this study was to make a comparison among existing estimation methods (Kaplan-Meier, Nelson-Aalen and Regression on Ordered Statistics (ROS)) for randomly left censored time to event data under selected distributions and for different level of censoring and sample sizes in order to determine the strength of these methods based on simulated data. Comparisons among the methods are made on the basis of unbiasedness and Monte Carlo Standard Error of the summary statistics (mean time to event) obtained by those methods under different conditions

The role of maternal echocardiography and uterine artery Doppler at 11-14 weeks in the prediction of pre-eclampsia in nulliparous women

Background: Pre-eclampsia (PE) complicates 2% of pregnancies and may have serious effects on mother and child, which makes it an important threat to public health in both developed and developing countries. Once high-risk women are identified, they can be targeted for more intense prenatal surveillance and preventative measures. Predicting PE in the first trimester requires the use of maternal echocardiography and the uterine artery pulsatility index (UAPI). Objective of the study was to see whether maternal echocardiography and uterine artery Doppler at 11-14 weeks can predict subsequent development of PE in nulliparous women.Methods: This prospective observational cohort study was carried out in outdoor patients of obstetrics and gynecology of Bangabandhu Sheikh Mujib Medical University (BSMMU), with collaboration with department of cardiology, National Institute of Nuclear Medicine and Allied Sciences (NINMAS), BSMMU, Dhaka, during 01 December 2013 to July 2015. A total of 135 healthy nulliparous women at 11-14 weeks of gestation were included in this study. Data was processed and analyzed by statistical package for the social sciences (SPSS) version 24.0.Results: Among 135 patients, two (1.5%) patients developed preeclampsia during 1st follow-up (20-28 weeks) and four (2.9%) patients developed preeclampsia during (29-36 weeks). Mean total peripheral resistance was found to be 1332.0±75.2 dynes/sec/cm5 in preeclampsia and 1157.0±139.2 dynes/sec/cm5 in non preeclamptic pregnancy. The difference between two groups was statistically significant. MAP and total peripheral resistance were statistically significant (p<0.05) between two groups.Conclusions: In first trimester of pregnancy UAPI is the best predictor for detection of PE

Necessity or Opportunity? Government Size, Tax Policy, Corruption and Implications for Entrepreneurship

Government size, corruption, and tax policy influence individuals' motivation towards necessity or opportunity-driven entrepreneurship. Using a comparative multi-source sample across 52 countries during 2005-2015, we apply a mixed process estimation of the simultaneously unrelated system of equations and unpack these heterogeneous and complex effects. Interestingly, our results show that the influence of tax policy and corruption on necessity and opportunity entrepreneurship depends on government size. Our results hold for numerous robustness analyses

Association of autism spectrum disorder and gestational diabetes mellitus of mothers in Bangladesh

Background: Globally Approximately 1 in 110 children has Autism Spectrum Disorder (ASD) and the cumulative incidence of this disorder seems to be increasing. To date, the etiology of ASD is unknown. Gestational diabetes is a common pregnancy complication whose prevalence is increasing among women of reproductive age and results in both short-and long-term adverse outcomes for the offspring and may contribute to ASD risk.&nbsp;Aims &amp; Objectives:&nbsp;The aim of the study was to determine the association of maternal gestational diabetes mellitus with autism spectrum disorder in children.&nbsp;Material &amp; Methods:&nbsp;A case control study was conducted among the children 5-7 years old diagnosed with an autism spectrum disorder (n=99) in special need primary schools and a similar age control group of children (n= 198) without the disease at randomly selected primary schools. The groups of children were compared with the obstetric information regarding Gestational Diabetes Mellitus (GDM) of mothers during their index pregnancy.&nbsp;Results: Compared with the control subjects, cases had significantly older parents and were more likely to be high socioeconomic status. History of GDM during index pregnancy were higher in cases than controls [OR=2.30, CI= 1.36 – 3.91].Prenatal and perinatal risk factors were more prevalent among case mothers compared with controls. Collectively, these conditions were associated with a higher likelihood of ASD than controls. Among cases family history of DM were more common compared with controls [OR=23, CI= 10.84 – 48.94]. Case mothers had greater frequencies of threatened abortion [OR= 3.23, CI= 1.94- 5.37], bleeding during pregnancy [OR=1.25, CI=0.20–7.61] and more likely to have experienced cesarean section. Male children were more affected by ASD [OR= 2.87, CI= 1.67 – 4.90] compared with controls.&nbsp;Conclusions: Maternal DM in pregnancy is responsible for at least a good proportion of cases of ASD which in turn has been proven as independent risk factors for autism

Regulating entrepreneurship quality and quantity

How does regulation affect entrepreneurship outcomes? We examine the effect of two regulatory policy mechanisms—costs and procedures—on entrepreneurship quality and quantity. Based on the national systems of entrepreneurship perspective, we apply public interest and public choice theories to hypothesize how regulatory costs and regulatory procedures can affect entrepreneurship quality and quantity differently. Using a multi-level approach, we test the direction, size, and shape of these effects with data on 51,330 innovation-oriented entrepreneurs (reflecting quality) and 871,241 entrepreneurs who started new ventures (reflecting quantity) across 76 countries during 2008–2017. We find that regulatory procedures in a country often have an inverted U-shaped relationship with entrepreneurship quality, suggesting that both too few and too many procedures might be detrimental when policymakers target innovation. We find that regulatory costs tend to have negative or inverted U-shaped effects on entrepreneurship quality and quantity. Our findings show that the way regulations are administered—by imposing financial costs or administrative requirements—is a boundary condition for entrepreneurship that affects the overall quantity of entrepreneurship and the innovation-centered quality of entrepreneurship