Extra-large letter spacing improves reading in dyslexia.

Although the causes of dyslexia are still debated, all researchers agree that the main challenge is to find ways that allow a child with dyslexia to read more words in less time, because reading more is undisputedly the most efficient intervention for dyslexia. Sophisticated training programs exist, but they typically target the component skills of reading, such as phonological awareness. After the component skills have improved, the main challenge remains (that is, reading deficits must be treated by reading more--a vicious circle for a dyslexic child). Here, we show that a simple manipulation of letter spacing substantially improved text reading performance on the fly (without any training) in a large, unselected sample of Italian and French dyslexic children. Extra-large letter spacing helps reading, because dyslexics are abnormally affected by crowding, a perceptual phenomenon with detrimental effects on letter recognition that is modulated by the spacing between letters. Extra-large letter spacing may help to break the vicious circle by rendering the reading material more easily accessible.

Innovative non-targeted screening approach using High-resolution mass spectrometry for the screening of organic chemicals and identification of specific tracers of soil and dust exposure in children.

Environmental contamination through direct contact, ingestion and inhalation are common routes of children's exposure to chemicals, in which through indoor and outdoor activities associated with common hand-to-mouth, touching objects, and behavioral tendencies, children can be susceptible and vulnerable to organic contaminants in the environment. The objectives of this study were the screening and identification of a wide range of organic contaminants in indoor dust, soil, food, drinking water, and urine matrices (N = 439), prioritizing chemicals to assess children's environmental exposure, and selection of unique tracers of soil and dust ingestion in young children by non-targeted analysis (NTA) using Q-Exactive Orbitrap followed data processing by the Compound Discoverer (v3.3, SP2). Chemical features were first prioritized based on their predominant abundance (peak area>500,000), detection frequency (in >50% of the samples), available information on their uses and potential toxicological effects. Specific tracers of soil and dust exposure in children were selected in this study including Tripropyl citrate and 4-Dodecylbenzenesulfonic acid. The criteria for selection of the tracers were based on their higher abundance, detection frequency, unique functional uses, measurable amounts in urine (suitable biomarker), and with information on gastrointestinal absorption, metabolism, and excretion, and were further confirmed by authentic standards. We are proposing for the first time suitable unique tracers for dust ingestion by children.

Predictors of developmental dyslexia in European orthographies with varying complexity.

BACKGROUND: The relationship between phoneme awareness, rapid automatized naming (RAN), verbal short-term/working memory (ST/WM) and diagnostic category is investigated in control and dyslexic children, and the extent to which this depends on orthographic complexity. METHODS: General cognitive, phonological and literacy skills were tested in 1,138 control and 1,114 dyslexic children speaking six different languages spanning a large range of orthographic complexity (Finnish, Hungarian, German, Dutch, French, English). RESULTS: Phoneme deletion and RAN were strong concurrent predictors of developmental dyslexia, while verbal ST/WM and general verbal abilities played a comparatively minor role. In logistic regression models, more participants were classified correctly when orthography was more complex. The impact of phoneme deletion and RAN-digits was stronger in complex than in less complex orthographies. CONCLUSIONS: Findings are largely consistent with the literature on predictors of dyslexia and literacy skills, while uniquely demonstrating how orthographic complexity exacerbates some symptoms of dyslexia.

Calorie Compensation and Self-Regulation of Food Intake in College Students.

OBJECTIVE: To examine self-regulation of food intake among college students. DESIGN: Randomized cross-over study completed between September and November, 2019. SETTING: A large public university, Florida International University in South Florida. PARTICIPANTS: A total of 60 undergraduate college students, mean age of 19.8 ± 1.43 years old, 62% female, 74% Hispanic, 76% White. INTERVENTION(S): Participants attended 2 trials 1 week apart. During each visit, students were offered a preload drink (either 0 or 210 kcal) followed by a buffet-style lunch. Food intake was estimated using weights and pictures of the plates before and after eating and was compared between the 2 sessions. MAIN OUTCOME MEASURE(S): Self-regulation by calculating compensation indices (COMPX) and their correlation with students' body mass index (BMI). ANALYSIS: Intake differences were examined using Welch and t tests. Regression analysis was used to assess correlations. RESULTS: Students exhibited the ability to calorie compensate when intake is manipulated with a mean COMPX of 95.57 ± 71.19. No score was perfect. There was a significant correlation between BMI and COMPX scores (F = 10.71, P < 0.001, r2 = 0.292). Food choices differed between different BMI categories. CONCLUSIONS AND IMPLICATIONS: Participants showed some degree of self-regulation, which suggests opportunities for creating effective interventions to improve health status and promote a more sustainable method to control consumption among college students.

Effectiveness of a 6-Month Nutrition Intervention in People Living with HIV and Prediabetes Progressing through Stages of Change towards Positive Health Behavior.

The prevalence of prediabetes in people living with human immunodeficiency virus (HIV) is two to three times higher than that of the general population. The aim of this study was to assess the effectiveness of an intervention in guiding low-income people living with HIV (PLWH) and prediabetes through the stages of change and promote self-efficacy of positive health behavior. METHODS: A 6- month randomized, controlled intervention was conducted where participants (N = 38) were randomized into the intervention group (n = 20) or the control group (n = 18). The participants' stages of change, nutrition knowledge, and self-efficacy were assessed using questionnaires. Participants were recruited in August 2017-December 2018, were HIV seropositive, had undetectable viral load, were prediabetic, and not currently receiving glucose-altering medications. Participants randomized into the intervention group received medical nutrition therapy/counseling and nutrition education; participants randomized into the control group received educational material related to nutrition, HIV, and prediabetes at baseline. Primary outcome measures were progression through the stages of change as measured by the transtheoretical ("stages of change") model, improvements in nutrition knowledge, and self-efficacy of the participants. RESULTS: Significant improvement in stage of behavioral change was observed in the intervention group for physical activity, fruit/vegetable intake, fiber intake as well as nutrition knowledge and self-efficacy; however, no significant changes were observed in the control group. CONCLUSIONS: A nutrition intervention was effective in promoting positive health behavior by progressing participants through the stages of behavioral change in low-income people living with HIV and prediabetes.

Noise on, voicing off: Speech perception deficits in children with specific language impairment.

Speech perception of four phonetic categories (voicing, place, manner, and nasality) was investigated in children with specific language impairment (SLI) (n=20) and age-matched controls (n=19) in quiet and various noise conditions using an AXB two-alternative forced-choice paradigm. Children with SLI exhibited robust speech perception deficits in silence, stationary noise, and amplitude-modulated noise. Comparable deficits were obtained for fast, intermediate, and slow modulation rates, and this speaks against the various temporal processing accounts of SLI. Children with SLI exhibited normal "masking release" effects (i.e., better performance in fluctuating noise than in stationary noise), again suggesting relatively spared spectral and temporal auditory resolution. In terms of phonetic categories, voicing was more affected than place, manner, or nasality. The specific nature of this voicing deficit is hard to explain with general processing impairments in attention or memory. Finally, speech perception in noise correlated with an oral language component but not with either a memory or IQ component, and it accounted for unique variance beyond IQ and low-level auditory perception. In sum, poor speech perception seems to be one of the primary deficits in children with SLI that might explain poor phonological development, impaired word production, and poor word comprehension.

Physiologically Relevant Fluid-Induced Oscillatory Shear Stress Stimulation of Mesenchymal Stem Cells Enhances the Engineered Valve Matrix Phenotype.

Support of somatic growth is a fundamental requirement of tissue-engineered valves. However, efforts thus far have been unable to maintain this support long term. A key event that will determine the valve's long-term success is the extent to which healthy host tissue remodeling can occur on the valve soon after implantation. The construct's phenotypic-status plays a critical role in accelerating tissue remodeling and engineered valve integration with the host via chemotaxis. In the current study, human bone-marrow-derived mesenchymal stem cells were utilized to seed synthetic, biodegradable scaffolds for a period of 8 days in rotisserie culture. Subsequently, cell-seeded scaffolds were exposed to physiologically relevant oscillatory shear stresses (overall mean, time-averaged shear stress, ~7.9 dynes/cm2; overall mean, oscillatory shear index, ~0.18) for an additional 2 weeks. The constructs were found to exhibit relatively augmented endothelial cell expression (CD31; compared to static controls) but concomitantly served to restrict the level of the activated smooth muscle phenotype (α-SMA) and also produced very low stem cell secretion levels of fibronectin (p < 0.05 compared to static and rotisserie controls). These findings suggest that fluid-induced oscillatory shear stresses alone are important in regulating a healthy valve phenotype of the engineered tissue matrix. Moreover, as solid stresses could lead to increased α-SMA levels, they should be excluded from conditioning during the culture process owing to their associated potential risks with pathological tissue remodeling. In conclusion, engineered valve tissues derived from mesenchymal stem cells revealed both a relatively robust valvular phenotype after exposure to physiologically relevant scales of oscillatory shear stress and may thereby serve to accelerate healthy valve tissue remodeling in the host post-implantation.

Porcine Small Intestinal Submucosa Mitral Valve Material Responses Support Acute Somatic Growth.

Background: Conceptually, a tissue engineered heart valve would be especially appealing in the pediatric setting since small size and somatic growth constraints would be alleviated. In this study, we utilized porcine small intestinal submucosa (PSIS) for valve replacement. Of note, we evaluated the material responses of PSIS and subsequently its acute function and somatic growth potential in the mitral position. Methods and Results: Material and mechanical assessment demonstrated that both fatigued 2ply (∼65 µm) and 4ply (∼110 µm) PSIS specimens exhibited similar failure mechanisms, but at an accelerated rate in the former. Specifically, the fatigued 2ply PSIS samples underwent noticeable fiber pullout and recruitment on the bioscaffold surface, leading to higher yield strength (p < 0.05) and yield strain (p < 0.05) compared to its fatigued 4ply counterparts. Consequently, 2ply PSIS mitral valve constructs were subsequently implanted in juvenile baboons (n = 3). Valve function was longitudinally monitored for 90 days postvalve implantation and was found to be robust in all animals. Histology at 90 days in one of the animals revealed the presence of residual porcine cells, fibrin matrix, and host baboon immune cells but an absence of tissue regeneration. Conclusions: Our findings suggest that the altered structural responses of PSIS, postfatigue, rather than de novo tissue formation, are primarily responsible for the valve's ability to accommodate somatic growth during the acute phase (90 days) following mitral valve replacement. Impact Statement Tissue engineered heart valves (TEHVs) offer the potential of supporting somatic growth. In this study, we investigated a porcine small intestinal submucosa bioscaffold for pediatric mitral heart valve replacement. The novelty of the study lies in identifying material responses under mechanical loading conditions and its effectiveness in being able to function as a TEHV. In addition, the ability of the scaffold valve to support acute somatic growth was evaluated in the Baboon model. The current study contributes toward finding a solution for critical valve diseases in children, whose current prognosis for survival is poor.

Speech-perception-in-noise deficits in dyslexia.

Speech perception deficits in developmental dyslexia were investigated in quiet and various noise conditions. Dyslexics exhibited clear speech perception deficits in noise but not in silence. Place-of-articulation was more affected than voicing or manner-of-articulation. Speech-perception-in-noise deficits persisted when performance of dyslexics was compared to that of much younger children matched on reading age, underscoring the fundamental nature of speech-perception-in-noise deficits. The deficits were not due to poor spectral or temporal resolution because dyslexics exhibited normal 'masking release' effects (i.e. better performance in fluctuating than in stationary noise). Moreover, speech-perception-in-noise predicted significant unique variance in reading even after controlling for low-level auditory, attentional, speech output, short-term memory and phonological awareness processes. Finally, the presence of external noise did not seem to be a necessary condition for speech perception deficits to occur because similar deficits were obtained when speech was degraded by eliminating temporal fine-structure cues without using external noise. In conclusion, the core deficit of dyslexics seems to be a lack of speech robustness in the presence of external or internal noise.

Age and glycemic control among adults with type 2 diabetes in the United States: An assessment from the National Health and Nutrition Examination Survey (NHANES) 2013-2014.

AIM: To assess the age and its association with glycemic control (GC) among adults with type 2-diabetes in the United States. MATERIALS AND MATERIALS: Data were collected from the National Nutrition Examination Survey (NHANES) 2013-2014 (n = 697), cross-sectional national survey adults with Type2 diabetes. Characteristics included retinopathy diagnosis, blood pressure, albumin-creatinine ratio, hemoglobin A1c (HbA1c), BMI, cholesterol, smoking status, pills/insulin, exercise, age, age at diagnosis, education, sex, race, and marital status. Diabetes preventive behaviors were included. Predictors of GC were assessed using logistic regression. RESULTS: The mean age was 61 (SD ±13); the average age at diagnosis 50 (SD ±12.9) and women (51%). Age ≥60, diabetes length >10yrs, taking pills/on insulin, albumin-creatinine ratio ≤30mg/g, optimal BP, no retinopathy diagnosis, optimal cholesterol, seeing a doctor for diabetes, doctors checkup ≥2 times and checking HbA1c annually were significant predictors of GC. The association between GC and age (OR=.97, p<.001; CI: .96-.98) diabetes length >10yrs (OR=1.55, p<.05; CI: 1.02-2.34), creatinine-albumin ratio ≤30mg/g (OR=1.97, p<.001; CI: 1.32-2.94) and checking HbA1c annually (OR=1.86, p<.01; CI: 1.16-3.00) remained significant after adjustment for the effects of all other statistically significant covariates. CONCLUSIONS: GC was prevalent among older individuals; suggestive of intervention programs for young adults with diabetes and continuous HbA1c assessment at least annually.

The relationship of blood neutrophil-to-lymphocyte ratio with nutrition markers and health outcomes in hemodialysis patients.

OBJECTIVE: Adverse outcomes in hemodialysis patients have been attributed, in part, to the pro-inflammatory state prevalent in this population. This study examines the relationship between blood neutrophil-to-lymphocyte ratio (NLR) with nutrition markers and health outcomes in hemodialysis (HD) patients. DESIGN: This is a 12-month prospective cohort study that recruited 77 participants from May to Jun 2017. SETTINGS AND SUBJECTS: Patients receiving maintenance hemodialysis. MAIN OUTCOMES: Hospitalization, transplants and mortality. RESULTS: Of the 77 participants, 63.8% were hospitalized, 10 (13%) died of cardiovascular diseases and 6 (7.8%) had a kidney transplant. Spearman correlations using baseline values showed an inverse significant correlation between the total number of hospitalizations and BMI kg/m2 (BMI rho = - 0.37, P <0.001); a significant inverse correlation between NLR and albumin (rho = - 0.22, P = 0.028); and a significant direct correlation between baseline NLR and BMI kg/m2 (rho = 0.22, P = 0.028). Participants were grouped by their NLR value into quartiles for outcomes analysis: quartile 1 (NLR ≤ 1.75), quartile 2 (NLR 1.76-2.6), quartile 3 (NLR 2.7-3.9) and quartile 4 (NLR ≥ 4). The percentage of patients with the lowest level of inflammation (NLR ≤ 1.75) was greater for not hospitalized patients than for hospitalized (39.3% vs 16.3%, P = 0.025) and not hospitalized participants had higher BMI kg/m2 (mean ± SD) at baseline compared to those hospitalized (29.11 ± 5.4 vs 26.22 ± 5.34, P = 0.026). In a multivariate cox regression analysis, participants in the lowest quartile (NLR ≤ 1.75) were compared to the rest on hospitalization, mortality and transplant. Years in dialysis, BMI kg/m2 and NLR ≤ 1.75 were significant predictors of hospitalization after adjustment (P = 0.021, P = 0.005, P = 0.039; respectively) and we observed an association of low NLR with a hazard ratio (HR 0.44, 95% CI 0.20-0.96, P = 0.039), BMI (HR 0.90, 95% CI 0.85-0.97, P = 0.005) and years in dialysis (HR 0.90, 95% CI 0.83-0.98, P = 0.021) for hospitalization in overall participants. In a further analysis comparing the effect of low NLR in the subgroup of diabetic vs non-diabetics, it was observed that BMI kg/m2 was a significant predictor for hospitalization in the non-diabetic subgroup (P = 0.040) but not significant in the case of diabetics (P = 0.128) after adjustments. Years in dialysis and NLR ≤ 1.75 were significant predictors of hospitalizations in the subgroup of diabetic before and after adjustment (P = 0.049, P = 0.044; respectively). Having a low NLR decreased 73% the risk for hospitalization (HR 0.27 95% CI 0.07-0.96, P = 0.044) in this subgroup. Survival and hospitalization curves were analyzed by comparing all participants and the diabetic subgroup, in the lowest inflammation quartile vs the rest (NLR ≤ 1.75 vs NLR > 1.75). Participants with NLR ≤ 1.75 had 100% survival rate (log-rank test, P = 0.059) and lower hospitalization rate (log-rank test, P = 0.025); participants with diabetes had lower hospitalization rate (log-rank test, P = 0.039). CONCLUSION: NLR at baseline was associated with nutritional markers (albumin, BMI). Low NLR at baseline was a predictor of lower risk for hospitalizations in HD patients with diabetes.

Developmental dyslexia and the dual route model of reading: simulating individual differences and subtypes.

Developmental dyslexia was investigated within a well-understood and fully specified computational model of reading aloud: the dual route cascaded model (DRC [Coltheart, M., Rastle, K., Perry, C., Langdon, R., & Ziegler, J.C. (2001). DRC: A dual route cascaded model of visual word recognition and reading aloud. Psychological Review, 108, 204-256.]). Four tasks were designed to assess each representational level of the DRC: letter level, orthographic lexicon, phonological lexicon, and phoneme system. The data showed no single cause of dyslexia, but rather a complex pattern of phonological, phonemic, and letter processing deficits. Importantly, most dyslexics had deficits in more than one domain. Subtyping analyses also suggested that both the phonological and surface dyslexics almost always had more than a single underlying deficit. To simulate the reading performance for each individual with the DRC, we added noise to the model at a level proportional to the underlying deficit(s) of each individual. The simulations not only accounted fairly well for individual reading patterns but also captured the different dyslexia profiles discussed in the literature (i.e., surface, phonological, mixed, and mild dyslexia). Thus, taking into account the multiplicity of underlying deficits on an individual basis provides a parsimonious and accurate description of developmental dyslexia. The present work highlights the necessity and merits of investigating dyslexia at the level of each individual rather than as a unitary disorder.

HIV-Related Stigma, Quality of Care, and Coping Skills: Exploring Factors Affecting Treatment Adherence Among PLWH in Haiti.

Stigma is a primary barrier to care and support for people living with HIV (PLWH). We explored relationships between HIV-related stigma and treatment adherence and the effects of psychological and structural factors on these relationships. HIV treatment adherence, stigma, and coping strategies were measured with questionnaires. Participants included 285 PLWH in Haiti. Multivariable linear regression was used to estimate predictors of treatment adherence. Structural equation modeling was used to determine whether relationships between stigma and treatment adherence variables were mediated by coping variables. Mean adherence was 93.1%; 72.3% of participants reported ≥ 95% adherence. Perceived stigma and quality-of-care satisfaction scores significantly predicted treatment adherence. Maladaptive coping did not act as a mediator between perceived stigma and treatment adherence, which could be due to stronger effects of perceived stigma on treatment adherence. Our study may help to improve treatment adherence and the care and quality of life for PLWH.

Caffeine Intake and Its Association with Body Composition Measures and Macronutrient Intakes in People Living with HIV in the Miami Adult Studies on HIV Cohort.

Background: Caffeine acts as an anorexic agent, increases energy expenditures, and decreases total body fat mass, and could be detrimental to people living with HIV (PLWH). The objective of this study was to explore the relationship between caffeine consumption, body composition measures (fat mass, body mass index [BMI], and lean body mass [LBM]), nutrient intakes, CD4 counts, and HIV viral load in PLWH. Methods: A convenience sample of 130 PLWH was recruited and followed for 3 months. Caffeine intake, body composition measures, and nutrient intakes were collected using Modified Caffeine Consumption Questionnaire, bioimpedance analyses, and 24-hour dietary recalls. Linear regressions were used to analyze the baseline data for relationships between these variables. Linear mixed models (LMMs) were used to determine the overtime changes. Results: In baseline, linear regression analysis, higher caffeine consumption was associated with lower fat mass (ß = -0.994, p = 0.042). However, BMI and LBM did not show any significant association with caffeine intake. LMM analysis showed that the association between caffeine intake and fat mass strengthened overtime (ß = -1.987, p = 0.035). Baseline linear regression analysis showed that higher caffeine intake was significantly associated with lower caloric intakes from fat (ß = -1.902, p = 0.044) and lower total caloric intake (ß = -1.643, p = 0.042). However, LMM analysis showed that these associations diminished and lost significance overtime. There were no associations between body composition measures, nutrient intakes, CD4 counts, and HIV viral load. Conclusions: Caffeine intake adversely affected dietary intakes of macronutrients and total fat mass. Therefore, caffeine, a known anorectic, should be regulated in PLWH.

Screening for Dyslexia in French-Speaking University Students: An Evaluation of the Detection Accuracy of the Alouette Test.

Developmental dyslexia is a lifelong impairment affecting 5% to 10% of the population. In French-speaking countries, although a number of standardized tests for dyslexia in children are available, tools suitable to screen for dyslexia in adults are lacking. In this study, we administered the Alouette reading test to a normative sample of 164 French university students without dyslexia and a validation sample of 83 students with dyslexia. The Alouette reading test is designed to screen for dyslexia in children, since it taps skills that are typically deficient in dyslexia (i.e., phonological skills). However, the test's psychometric properties have not previously been available, and it is not standardized for adults. The results showed that, on the Alouette test, dyslexic readers were impaired on measures of accuracy, speed, and efficiency (accuracy/reading time). We also found significant correlations between the Alouette reading efficiency and phonological efficiency scores. Finally, in terms of the Alouette test, speed-accuracy trade-offs were found in both groups, and optimal cutoff scores were determined with receiver operator characteristic curves analysis, yielding excellent discriminatory power, with 83.1% sensitivity and 100% specificity for reading efficiency. Thus, this study supports the Alouette test as a sensitive and specific screening tool for adults with dyslexia.

Short-Term Projected Use of Reverse Total Shoulder Arthroplasty in Proximal Humerus Fracture Cases Recorded in Humana's National Private-Payer Database.

Indications for reverse total shoulder arthroplasty (RTSA) have been expanding, and there has been a recent trend in using RTSA to manage proximal humerus fractures. In this study, we used a large private-payer database to analyze this trend over the period 2010 to 2014 and project RTSA use through 2020. Results showed modest quarterly growth in use of RTSA (4.9% compound quarterly growth rate). The number of RTSAs was projected to more than triple by 2020. RTSA is becoming an increasingly popular treatment option for proximal humerus fractures.

Caffeine and Insomnia in People Living With HIV From the Miami Adult Studies on HIV (MASH) Cohort.

We explored the relationship between caffeine consumption, insomnia, and HIV disease progression (CD4+ T cell counts and HIV viral loads). Caffeine intake and insomnia levels were measured using the Modified Caffeine Consumption Questionnaire and the Pittsburgh Insomnia Rating Scale (PIRS) in 130 clinically stable participants who were living with HIV, taking antiretroviral therapy, and recruited from the Miami Adult Studies on HIV cohort. Linear regressions showed that caffeine consumption was significantly and adversely associated with distress score, quality-of-life score, and global PIRS score. Linear regression analyses also showed that global PIRS score was significantly associated with lower CD4+ T cell counts and higher HIV viral loads. Caffeine could have precipitated insomnia in susceptible people living with HIV, which could be detrimental to their disease progression states.

The Relationship Between Caffeine Intake and Immunological and Virological Markers of HIV Disease Progression in Miami Adult Studies on HIV Cohort.

Although there are many studies on adverse health effects of substance use and HIV disease progression, similar studies about caffeine consumption are few. In this study, we investigated the effects of caffeine on immunological and virological markers of HIV disease progression. A convenience sample of 130 clinically stable people living with HIV/AIDS on antiretroviral therapy (65 consuming ≤250 mg/day and 65 consuming >250 mg/day of caffeine) were recruited from the Miami Adult Studies on HIV (MASH) cohort. This study included a baseline and 3-month follow-up visit. Demographics, body composition measures, substance use, Modified Caffeine Consumption Questionnaire (MCCQ), and CD4 count and HIV viral load were obtained for all participants. Multivariable linear regression and Linear Mixed Models (LMMs) were used to understand the effect of caffeine consumption on CD4 count and HIV viral load. The mean age of the cohort was 47.9 ± 6.4 years, 60.8% were men and 75.4% were African Americans. All participants were on ART during both the visits. Mean caffeine intake at baseline was 337.6 ± 305.0 mg/day and did not change significantly at the 3-month follow-up visit. Multivariable linear regressions after adjustment for covariates showed significant association between caffeine consumption and higher CD4 count (ß = 1.532, p = 0.049) and lower HIV viral load (ß = -1.067, p = 0.048). LMM after adjustment for covariates showed that the relationship between caffeine and CD4 count (ß = 1.720, p = 0.042) and HIV viral load (ß = -1.389, p = 0.033) continued over time in a dose-response manner. Higher caffeine consumption was associated with higher CD4 cell counts and lower HIV viral loads indicating beneficial effects on HIV disease progression. Further studies examining biochemical effects of caffeine on CD4 cell counts and viral replication need to be done in the future.

Computerized analysis of tissue density effect on missed cancer detection in digital mammography.

This paper presents a study of the analysis of breast density in missed cancer cases and the effect of tissue density on cancer detection. A total of 100 missed cancer cases were collected. The breast density tissue was segmented with a statistical-based method. A set of tests was then applied to examine: (1) the differences in density between the mammograms at the detected stage and that at missed stage; (2) the density difference between the cancerous mammograms and their contra-lateral normal mammograms in the missed cancer cases; (3) the effect of breast density on CAD cancer detection. The results demonstrate that breast density is an important factor affecting not only radiologist's reading but also CAD performance. In order to improve early detection of breast cancer, a special effort should be directed to the high dense breast cases in CAD system design.

Relationship Between Metabolic Syndrome and Cognitive Abilities in U.S. Adolescents.

BACKGROUND: Metabolic syndrome is increasingly common in U.S. adolescents and has been linked to cognitive dysfunction. Purpose of this study is to explore associations between metabolic syndrome and cognitive impairment in U.S. adolescents using population-based data. STUDY DESIGN: Participants included adolescents aged 12-16 years who participated in the National Health and Nutrition Examination Survey (NHANES) III. The main outcome measures included assessments of cognitive function using Wide Range Achievement Test-Revised (WRAT-R) and Wechsler Intelligence Scale for Children-Revised (WISC-R) tools. The WRAT-R consisted of mathematics and reading tests. The WISC-R consisted of block design test, which measures spatial visualization and motor skills, and digit span test, which measures working memory and attention. Linear regression models were used to examine associations between metabolic syndrome and cognitive function. We used education levels of the family reference person, while controlling for education levels because of missing data. RESULTS: Presence or absence of metabolic syndrome was tested in 1170 of 2216 NHANES III participants aged 12-16 years. Regression models showed that participants with metabolic syndrome scored an average 1.25 [95% confidence interval (CI) = -2.14 to -0.36] points lower in reading examination and an average 0.89 (95% CI = -1.65 to -0.13) points lower in digit span examination, compared to those without metabolic syndrome. In addition, components of metabolic syndrome-elevated systolic blood pressure and increased waist circumference (WC)-were associated with impaired working memory/attention, and higher fasting glucose and increased WC were associated with poorer reading test scores. CONCLUSIONS: Metabolic syndrome was associated with impaired reading, working memory, and attention among adolescents.