Developmental patterns of non-word repetition by monolingual and bilingual school-aged children.

PURPOSE: The present study examines cross-sectional trends in performance on a quasi-universal non-word repetition (NWR) task. It also considers whether NWR performance is dependent on levels of exposure to a language and compares the performance of bilingual children across their two languages. METHOD: A cross-sectional design was employed. The English and French quasi-universal NWR tasks, featuring stimuli from two to five syllables in length, was administered to Canadian school-aged monolinguals and two groups of bilinguals: those who encountered their second language in early childhood and those who encountered their second language at school entry. RESULT: When evaluated in English, the early-exposure bilinguals produced significantly fewer errors than the school-entry exposure bilinguals and the English monolingual groups. When evaluated in French, the early-exposure bilinguals and the French monolinguals produced significantly fewer errors than the school-entry exposure bilinguals. Compared across languages, the French monolinguals produced fewer errors on the French version of the NWR task than the English monolinguals did on the English version of the same task. In both languages and across all analyses, the youngest age group (7-8 years) produced more errors than the two older groups (9-10 years and 11-12 years). CONCLUSION: The quasi-universal NWR task showed sensitivity to improvements from 7 to 11 years of age in English and up to 9 years of age in French. Better performance in French may be due to the relatively greater frequency of multisyllabic words in that language. The development and use of this particular NWR task with monolinguals and bilinguals-in both of their languages-contribute to a deeper understanding of quasi-universal NWR performance in typically developing children.

Development of a Natural Product Rich in Bioavailable Omega-3 DHA from Locally Available Ingredients for Prevention of Nutrition Related Mental Illnesses.

Objectives: Poor mental health remains a serious public concern worldwide. The most vulnerable individuals are children and adolescents in developing countries. Nutritional deficiency of long-chain omega-3 fatty acids, particularly docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA), have long been recognized as a major contributing factor for mental health illnesses. Provision of ready-to-use natural product rich in preformed Omega-3 DHA and EPA could address this problem. However, most commonly used products are expensive and contain less or no preformed Omega-3 DHA and EPA, making them less suitable for prevention of mental illnesses in resource-poor countries. The main objective of this study was to develop a natural product rich in preformed Omega-3 DHA and EPA from locally available ingredients.Methods: Linear programing (LP) was used to formulate a natural product rich in preformed Omega-3 DHA and other essential nutrients using locally available ingredients other than fish and dairy products. Laboratory analysis was then performed to validate the nutritional value of the LP-formulation using standard analytical methods. The relative difference between the LP tool calculated values, and the laboratory-analyzed values were calculated. Sensory testing was also done to evaluate consumer acceptance of the final product.Results: Optimal formulation contained about 220 mg of preformed Omega-3 DHA + EPA, enough to meet the RDI for children aged 2-10 years. The LP analysis further showed that the cost of the developed product is USD 0.15/100 g, which is 50% lower than that of Plumpy'nut. Laboratory analysis revealed similar results as that of LP at P = 0.05.Conclusions: These findings indicate that ready-to-use natural food rich in preformed DHA and EPA can be developed from locally available ingredients.

Proinflammatory high-density lipoprotein as a biomarker for atherosclerosis in patients with systemic lupus erythematosus and rheumatoid arthritis.

OBJECTIVE: Women with systemic lupus erythematosus (SLE) have a 7-50-fold increased risk of coronary artery disease (CAD). In the general population, oxidized low-density lipoprotein (ox-LDL) increases the risk for CAD. Normal high-density lipoproteins (HDLs) protect LDL from oxidation; proinflammatory HDLs do not. This study was undertaken to determine whether patients with SLE, who have chronic inflammation that causes oxidative damage, have more proinflammatory HDL and higher levels of ox-LDL, thus predisposing them to atherosclerosis. METHODS: One hundred fifty-four women with SLE, 48 women with rheumatoid arthritis (RA), and 72 healthy controls were studied. The ability of the patients' HDL to prevent oxidation of normal LDL was measured. Values >1.0 (the value assigned for LDL oxidation in the absence of HDL) after the addition of HDL indicated proinflammatory HDL. Plasma ox-LDL levels were measured as the amount of oxidation produced by the patient's LDL after the removal of HDL. RESULTS: SLE patients had more proinflammatory HDL (mean +/- SD score 1.02 +/- 0.57, versus 0.68 +/- 0.28 in controls [P < 0.0001] and 0.81 +/- 0.22 in RA patients [P = 0.001 versus SLE patients]). A higher proportion of SLE patients had proinflammatory HDL: 44.7% of SLE patients versus 4.1% of controls and 20.1% of RA patients had scores >1.0 (P < 0.006 between all groups). Levels of ox-LDL correlated with levels of proinflammatory HDL (r = 0.37, P < 0.001). SLE patients with CAD had significantly higher proinflammatory HDL scores than patients without CAD (P < 0.001). CONCLUSION: HDLs are proinflammatory in a significant proportion of SLE patients and are associated with elevated levels of ox-LDL. Abnormal HDLs impair the ability to prevent LDL oxidation and may predispose to atherosclerosis.

Systemic sclerosis: hypothesis-driven treatment strategies.

We review data from controlled trials and randomised controlled trials to examine the hypothesis for the pathogenesis of systemic sclerosis. Strategies used to treat the vascular complications in systemic sclerosis have so far shown the biggest successes, especially in the management of renal crisis and pulmonary arterial hypertension. Because these drugs have improved function and quality of life and have increased survival rates, they can truly be classified as disease-modifying compounds. Immunosuppressive therapy with cyclophosphamide in particular has also shown evidence of efficacy, and randomised controlled trials of autologous stem-cell transplantation are underway. So far, strategies to reduce or control fibrosis directly (bosentan, interferon gamma, and relaxin) have been disappointing but new strategies against fibrosis based on advanced understanding of the molecular biology of systemic sclerosis hold promise. Treatments against several cardinal features of the disorder simultaneously have not yet been examined but are being considered for future trials.

Validation of American College of Rheumatology classification criteria for knee osteoarthritis using arthroscopically defined cartilage damage scores.

OBJECTIVE: To validate the ability of the American College of Rheumatology (ACR) clinical classification criteria and the ACR clinical plus radiographic classification criteria for osteoarthritis of the knee to predict articular cartilage damage. METHODS: Ninety subjects with knee osteoarthritis (OA) who were enrolled in a prospective study determining the therapeutic efficacy of arthroscopic irrigation were characterized as to whether they fulfilled the ACR clinical classification criteria or the ACR clinical plus radiographic classification criteria. Ten rheumatoid arthritis (RA) patients were included as controls. Cartilage damage was defined using the ACR/Knee Arthroscopy Osteoarthritis Scale (ACR/KAOS) system, which is a validated outcome instrument for knee OA based on arthroscopic visualization. Mean values of the damage scores in each group were calculated and compared by t-test to determine statistical significance between the 3 groups. RESULTS: The mean ACR/KAOS score for the 10 RA patients was 1.8 [SD 1.22; range 0 to 4]. Of the 90 OA patients who underwent arthroscopy, only 73 patients had sufficient videotape to make an accurate assessment by the blinded assessor. The mean ACR/KAOS score for the 6 OA patients who fulfilled only the ACR clinical classification was 17.4 [SD 11.3; range 5 to 34.3] and the mean ACR/KAOS score for the 67 patients who fulfilled the ACR clinical plus radiographic classification criteria was 42.0 [SD 29.1; range 5.1 to 118.4]. These differences were statistically significant (RA versus OA clinical P=0.02; RA versus OA clinical+radiographic P