Health-related quality of life and depression among participants in the Sjögren's International Collaborative Clinical Alliance registry.

ObjectiveTo examine health-related quality of life (HRQoL) and depression among participants in an international Sjögren's syndrome (SS) registry, comparing those with and without SS.MethodsCross-sectional study of participants in the Sjögren's International Collaborative Clinical Alliance (SICCA) registry. The 2016 American College of Rheumatology/European League Against Rheumatism SS classification criteria were used to determine disease status. HRQoL was assessed using the Short Form 12, version 2 Health Survey to derive scores for physical component summary (PCS) and mental component summary (MCS). Depression was assessed using the 9-Item Patient Health Questionnaire. Multivariate linear and logistic regression analyses were performed to identify predictors of HRQoL and depression while controlling for potential confounders.ResultsAmong 2401 SICCA participants who had symptoms of dry eyes and dry mouth, 1051 had SS (44%) and 1350 did not (56%). After controlling for confounders, when compared with non-SS participants, those with SS had better PCS (p<0.001, β=2.43, 95% CI 1.57 to 3.29), MCS (p=0.002, β=1.37, 95% CI 0.50 to 2.23) and lower adjusted odds of depression (p<0.001, OR 0.67, 95% CI 0.55 to 0.81). Other significant predictors of HRQoL and depression included employment, country of residence and use of medication with anticholinergic effect or for management of SS-related signs and symptoms.ConclusionOur results suggest that among symptomatic patients, having a diagnosis of SS may be associated with better emotional and psychological well-being compared with patients without a diagnosis. Having a definitive diagnosis of SS may encourage patients to obtain a better understanding of their disease and have coping mechanisms in place to better manage their symptoms

Legal Rights of Transgender Students in Education

Nearly 150,000 school-aged teenagers in the United States identify as transgender, but the population continues to face harassment, bullying, and discrimination from their peers and educators. The most recent battles for bathroom access based on gender identity has led to significant policy debates nationally and statewide. It is critical for school leaders to promote an all-inclusive and safe school environment to help improve the academic experience for transgender students. The purpose of this paper is to outline the current anti-discrimination federal and state laws that protect against sex and gender identity harassment in school, including Title IX, Equal Access Act, the Family Educational Rights and Privacy Act (FERPA), and the First and Fourteenth Amendments of the U.S. Constitution. Additionally, court cases such as Whitaker v. Kenosha and G.G. v. Gloucester County School Board have helped to set the precedence for equal access to facilities in public schools. This paper will conclude with opportunities for school leaders to cultivate an institution that ensures the success of transgender students

Adjuvants : an essential component of neisseria vaccines

Adjuvants may be classified into delivery systems and immune potentiator or modulator molecules based on their mechanism of action. Neisseria vaccines containing traditional adjuvants such as aluminium salts have existed for long time, but meningitis caused by Neisseria meningitidis serogroups, particularly serogroup B, continues to be a global health problem. Novel strategies have applied in silico and recombinant technologies to develop "universal" antigens (e.g. proteins, peptides and plasmid DNA) for vaccines, but these antigens have been shown to be poorly immunogenic even when alum adjuvanted, implying a need for better vaccine design. In this work we review the use of natural, detoxified, or synthetic molecules in combination with antigens to activate the innate immune system and to modulate the adaptive immune responses. In the main, antigenic and imune potentiator signals are delivered using nano-, micro-particles, alum, or emulsions. The importance of interaction between adjuvants and antigens to activate and target dendritic cells, the bridge between the innate and adaptive immune systems, will be discussed. In addition, nasal vaccine strategies based on the development of mucosal adjuvants and Neisseria derivatives to eliminate the pathogen at the site of infection provide promising adjuvants effective not only against respiratory pathogens, but also against pathogens responsible for enteric and sexually transmitted diseases

Syndecan-1 mediates internalization of apoE-VLDL through a low density lipoprotein receptor-related protein (LRP)-independent, non-clathrin-mediated pathway

BACKGROUND: Triacylglyerol-rich very low density lipoprotein (VLDL) particles are the primary carriers of fatty acids in the circulation and as such serve as a rich energy source for peripheral tissues. Receptor-mediated uptake of these particles is dependent upon prior association with apolipoprotein E (apoE-VLDL) and is brought about by cell surface heparan sulfate proteoglycans (HSPG) in some cell types and by the low density lipoprotein receptor-related protein (LRP) in others. Although LRP's role in apoE-VLDL uptake has been well studied, the identity of the HSPG family member that mediates apoE-VLDL uptake has not been established. We investigated if syndecan-1 (Syn-1), a transmembrane cell surface HSPG, is able to mediate the internalization of apoE-VLDL and examined the relationship between Syn-1 and LRP toward apoE-VLDL uptake. For this study, we used a human fibroblast cell line (GM00701) that expresses large amounts of LRP, but possesses no LDL receptor activity to eliminate its contributions toward apoE-VLDL uptake. RESULTS: Although LRP in these cells is fully active as established by substantial α(2)macroglobulin binding and internalization, uptake of apoE-VLDL is absent. Expression of human Syn-1 cDNA restored apoE-VLDL binding and uptake by these cells. Competition for this uptake with an LRP ligand-binding antagonist had little or no effect, whereas co-incubation with heparin abolished apoE-VLDL internalization. Depleting Syn-1 expressing cells of K(+), to block clathrin-mediated endocytosis, showed no inhibition of Syn-1 internalization of apoE-VLDL. By contrast, treatment of cells with nystatin to inhibit lipid raft function, prevented the uptake of apoE-VLDL by Syn-1. CONCLUSION: These data demonstrate that Syn-1 is able to mediate apoE-VLDL uptake in human fibroblasts with little or no contribution from LRP and that the endocytic path taken by Syn-1 is clathrin-independent and relies upon lipid raft function. These data are consistent with previous studies demonstrating Syn-1 association with lipid raft domains

Chaplygin gas with non-adiabatic pressure perturbations

Perturbations in a Chaplygin gas, characterized by an equation of state $p = -A/\rho$, may acquire non-adiabatic contributions if spatial variations of the parameter $A$ are admitted. This feature is shown to be related to a specific internal structure of the Chaplygin gas. We investigate how perturbations of this type modify the adiabatic sound speed and influence the time dependence of the gravitational potential which gives rise to the Integrated Sachs-Wolfe effect in the anisotropy spectrum of the cosmic microwave background.Comment: 16 pages, comments and references added, accepted for publication in Class.Quantum Gra

A Similarity Measure for GPU Kernel Subgraph Matching

Accelerator architectures specialize in executing SIMD (single instruction, multiple data) in lockstep. Because the majority of CUDA applications are parallelized loops, control flow information can provide an in-depth characterization of a kernel. CUDAflow is a tool that statically separates CUDA binaries into basic block regions and dynamically measures instruction and basic block frequencies. CUDAflow captures this information in a control flow graph (CFG) and performs subgraph matching across various kernel's CFGs to gain insights to an application's resource requirements, based on the shape and traversal of the graph, instruction operations executed and registers allocated, among other information. The utility of CUDAflow is demonstrated with SHOC and Rodinia application case studies on a variety of GPU architectures, revealing novel thread divergence characteristics that facilitates end users, autotuners and compilers in generating high performing code

Exact Histogram Specification Optimized for Structural Similarity

An exact histogram specification (EHS) method modifies its input image to have a specified histogram. Applications of EHS include image (contrast) enhancement (e.g., by histogram equalization) and histogram watermarking. Performing EHS on an image, however, reduces its visual quality. Starting from the output of a generic EHS method, we maximize the structural similarity index (SSIM) between the original image (before EHS) and the result of EHS iteratively. Essential in this process is the computationally simple and accurate formula we derive for SSIM gradient. As it is based on gradient ascent, the proposed EHS always converges. Experimental results confirm that while obtaining the histogram exactly as specified, the proposed method invariably outperforms the existing methods in terms of visual quality of the result. The computational complexity of the proposed method is shown to be of the same order as that of the existing methods. Index terms: histogram modification, histogram equalization, optimization for perceptual visual quality, structural similarity gradient ascent, histogram watermarking, contrast enhancement