Epithelial-immune cell interplay in primary Sjogren syndrome salivary gland pathogenesis

In primary Sjogren syndrome (pSS), the function of the salivary glands is often considerably reduced. Multiple innate immune pathways are likely dysregulated in the salivary gland epithelium in pSS, including the nuclear factor-kappa B pathway, the inflammasome and interferon signalling. The ductal cells of the salivary gland in pSS are characteristically surrounded by a CD4(+) T cell-rich and B cell-rich infiltrate, implying a degree of communication between epithelial cells and immune cells. B cell infiltrates within the ducts can initiate the development of lymphoepithelial lesions, including basal ductal cell hyperplasia. Vice versa, the epithelium provides chronic activation signals to the glandular B cell fraction. This continuous stimulation might ultimately drive the development of mucosa-associated lymphoid tissue lymphoma. This Review discusses changes in the cells of the salivary gland epithelium in pSS (including acinar, ductal and progenitor cells), and the proposed interplay of these cells with environmental stimuli and the immune system. Current therapeutic options are insufficient to address both lymphocytic infiltration and salivary gland dysfunction. Successful rescue of salivary gland function in pSS will probably demand a multimodal therapeutic approach and an appreciation of the complicity of the salivary gland epithelium in the development of pSS. Salivary gland dysfunction is an important characteristic of primary Sjogren syndrome (pSS). In this Review, the authors discuss various epithelial abnormalities in pSS and the mechanisms by which epithelial cell-immune cell interactions contribute to disease development and progression

Centrality dependent particle production at y=0 and y similar to 1 in Au+Au collisions at root s(NN)=200 GeV

52 authors, 8 pages, 12 Figures, 3 Tables, submitted to PRCParticle production of identified charged hadrons, $\pi^{\pm}$, $K^{\pm}$, $p$, and $\bar{p}$ in Au+Au collisions at $\sqrt(snn) =$ 200 GeV has been studied as a function of transverse momentum and collision centrality at $y=0$ and $y\sim1$ by the BRAHMS experiment at RHIC. Significant collective transverse flow at kinetic freeze-out has been observed in the collisions. The magnitude of the flow rises with the collision centrality. Proton and kaon yields relative to the pion production increase strongly as the transverse momentum increases and also increase with centrality. Particle yields per participant nucleon show a weak dependence on the centrality for all particle species. Hadron production remains relatively constant within one unit around midrapidity in Au+Au collisions at $\sqrt(snn) =$ 200 GeV

A well-being support program for patients with severe mental illness: a service evaluation

Background: The risk of cardiovascular disease is increased in patients with severe mental illness (SMI) dramatically reducing life expectancy. Method: A real world pragmatic service evaluation of a Well-Being Support Program (WSP) was conducted. This was a four-session package delivered over a one-year period by mental health practitioners that had received additional training in providing physical health assessment and intervention. Patients' physical health was screened and appropriate one-to-one and group intervention was offered. Results: 212 mental health practitioners were trained in the WSP and 782 patients were enrolled on the program. The majority of our sample was overweight or obese; 66% had a Body Mass Index (BMI) >25. Lifestyle risk factors for cardiovascular disease (CVD) were common and the patients had low self esteem. The average number of formally recorded well-being sessions attended was 2.10. Just under a quarter of those patients enrolled in the program completed. The only cardiovascular risk factor that significantly altered in patients that completed the program was BMI. The qualitative feedback about the program was largely positive. Conclusions: The need to intervene to enhance the physical health of people with SMI is beyond doubt. Maintaining patient engagement in a physical health improvement program is challenging. Regular comprehensive physical health monitoring is necessary to establish the benefit of intervention and increase life expectancy and well-being in this population