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"Tang, Kenny"
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Rapid online assessment of reading ability
An accurate model of the factors that contribute to individual differences in reading ability depends on data collection in large, diverse and representative samples of research participants. However, that is rarely feasible due to the constraints imposed by standardized measures of reading ability which require test administration by trained clinicians or researchers. Here we explore whether a simple, two-alternative forced choice, time limited lexical decision task (LDT), self-delivered through the web-browser, can serve as an accurate and reliable measure of reading ability. We found that performance on the LDT is highly correlated with scores on standardized measures of reading ability such as the Woodcock-Johnson Letter Word Identification test (r = 0.91, disattenuated r = 0.94). Importantly, the LDT reading ability measure is highly reliable (r = 0.97). After optimizing the list of words and pseudowords based on item response theory, we found that a short experiment with 76 trials (2–3 min) provides a reliable (r = 0.95) measure of reading ability. Thus, the self-administered, Rapid Online Assessment of Reading ability (ROAR) developed here overcomes the constraints of resource-intensive, in-person reading assessment, and provides an efficient and automated tool for effective online research into the mechanisms of reading (dis)ability.
Journal Article
The balance between stability and plasticity of the visual word form area in dyslexia
Understanding the balance between plastic and persistent traits in the dyslexic brain is critical for developing effective interventions. This longitudinal intervention study examines the Visual Word Form Area in dyslexic and typical readers, exploring how this key component of the brain’s reading circuitry changes with learning. We find that children with dyslexia show significant differences in Visual Word Form Area presence, size, and tuning properties compared to typical readers. While reading intervention improves reading skills and increases Visual Word Form Area size, disparities persist a year later, suggesting that Visual Word Form Area abnormalities are enduring traits of dyslexia. Our results reveal long-term neural and behavioral changes, while also elucidating stable differences in the functional architecture of the dyslexic brain. This work provides comprehensive insights into the potential and limitations of short-term learning-induced plasticity in human visual cortex.
Children with dyslexia show significant differences in Visual Word Form Area size and specialization compared to typical readers, suggesting enduring neural characteristics exist even after targeted intervention increases reading ability scores.
Journal Article
Severe renal haemosiderosis in a patient with untreated paroxysmal nocturnal haemoglobinuria: a case report
Background
Paroxysmal nocturnal haemoglobinuria (PNH) is a life-threatening disease in which intravascular haemolysis of the red blood cells frequently manifests with chronic haemolysis, anaemia and thrombosis. Renal injury in PNH is associated with chronic haemosiderosis and/or microvascular thrombosis. Herein, we describe a case of haemolytic crisis and severe renal haemosiderosis in a patient who was previously treated for aplastic anaemia (AA) and later developed a symptomatic PNH clone.
Case presentation
A 74-year-old woman with acquired AA treated with immunosuppressive therapy 8 years ago was admitted to our hospital with severe haemolytic anaemia and acute kidney injury in the setting of
Escherichia coli
sepsis. Peripheral blood flow cytometry demonstrated expansion of the small PNH clone detected at diagnosis with clone size now exceeding 80%. Renal biopsy showed extensive brown pigment deposition in most of the proximal tubules and accompanying severe acute tubular injury. The pigment deposits were confirmed to be haemosiderin on Perls’ Prussian blue stain. Based on these biopsy findings and clinical presentation, she was diagnosed with acute tubular injury secondary to
Escherichia coli
sepsis on a background of chronic kidney disease in part due to chronic intravascular haemolysis associated with untreated PNH. During her admission, she was also found to have large vessel vasculitis and was commenced on high-dose steroids. Her acute haemolysis stabilised after treatment of her sepsis and her renal function also improved. A C5 complement inhibitor was commenced following discharge from hospital.
Conclusion
Our case illustrates the potentially severe renal complications of acute on chronic intravascular haemolysis associated with untreated, clinical PNH arising from a history of treated AA. Close monitoring and early intervention of patients with symptomatic PNH is therefore critical.
Journal Article
3+7 Combined Chemotherapy for Acute Myeloid Leukemia: Is It Time to Say Goodbye?
Purpose of ReviewWith the recent approval of multiple new drugs for the treatment of acute myeloid leukemia (AML), the relevance of conventional treatment approaches, such as daunorubicin and cytarabine (“3+7”) induction chemotherapy, has been challenged. We review the AML risk stratification, the efficacy of the newly approved drugs, and the role of “3+7”.Recent FindingsTreatment of AML is becoming more niched with specific subtypes more appropriately treated with gemtuzumab, midostaurin, and CPX-351. Although lower intensity therapies can yield high response rates, they are less efficient at preventing relapses. The only curative potential for poor-risk AML is still an allogeneic stem cell transplant.SummaryThe number of AML subtypes where 3+7 alone is an appropriate therapeutic option is shrinking. However, it remains the backbone for combination therapy with newer agents in patients suitable for intensive chemotherapy.
Journal Article
Retrospective Cohort Study of Non-Traumatic Jejunum and Ileum Perforation: A Multi-center Study
Aim: Non-traumatic jejunum and ileum perforation (NTJIP) is a rare clinical entity. Contrary to infective causes occurring in Eastern countries, immune-mediated pathologies are predominant in the West. The studies on NTJIP in Southeast Asia are lacking. This study is designed to describe the involved patients incidences, etiological patterns, and outcomes. This study analyzed the predictors of mortality in these patients. Method: This retrospective cohort study involved patients with NTJIP who underwent surgery over 4 years from 2016 to 2019. Data were sourced from operative databases of five tertiary public hospitals in Sarawak, Malaysia. Small bowel perforation data were screened, and patients with adhesive obstruction from previous surgeries, trauma, and duodenal perforation were excluded. Patients' socio-demographic characteristics, surgical characteristics, and outcomes were stated in the prepared pro forma. Results: From 2016 to 2019, a total of 42 patients with NTJIP were included in this study. The mean [standard deviation (SD)] age of incidence was 55.7 (19.3) years old. Twenty-nine presented within 3 days of symptoms. Their etiologies were attributed mainly to non-specific causes (29%), followed by radiation-associated perforation (17%). The mean (SD) hospital stay was 10 (3) days, with the post-operative complication rate of ileus at 21%, surgical site infection at 23%, and anastomotic leak at 23%. The mortality rate was 36%, and the Mannheim peritonitis index was a reliable predictor of mortality. Conclusion: This study observed that radiation and vascular etiologies were the most common identifiable causes of NTJIP in the current series. Further research would prove beneficial to analyze inconclusive cases, as the dilemma surrounding etiologies for NTJIP remains.
Journal Article
Small or absent Visual Word Form Area is a trait of dyslexia
Understanding the balance between plastic and persistent traits in the dyslexic brain is critical for developing effective interventions. This longitudinal intervention study examines the Visual Word Form Area (VWFA) in dyslexic and typical readers, exploring how this key component of the brain's reading circuitry changes with learning. We found that dyslexic readers show significant differences in VWFA presence, size, and tuning properties compared to typical readers. While reading intervention improved reading skills and increased VWFA size, disparities persisted, suggesting that VWFA abnormalities are an enduring trait of dyslexia. Notably, we found that even with sufficient intervention to close the reading skill gap, dyslexic readers are still expected to have smaller VWFAs. Our results reveal intervention-driven long-term neural and behavioral changes, while also elucidating stable differences in the functional architecture of the dyslexic brain. This provides new insights into the potential and limitations of learning-induced plasticity in the human visual cortex.
Journal Article
Breakthrough Invasive Fungal Infection After Coadministration of Venetoclax and Voriconazole
Abstract
Venetoclax requires a 75% dose reduction when coadministered with voriconazole. In a 10-year historical cohort of treatment with venetoclax, we did not observe a worse hematologic outcome in patients who received voriconazole prophylaxis versus those who did not. Subtherapeutic voriconazole levels and a triazole exposure history may contribute to breakthrough invasive fungal infection.
Journal Article
Engaging in word recognition elicits highly specific modulations in visual cortex
A person's cognitive state determines how their brain responds to visual stimuli. The most common such effect is a response enhancement when stimuli are task-relevant and attended rather than ignored. In this fMRI study, we report a surprising twist on such attention effects in the visual word form area (VWFA), a region that plays a key role in reading. We presented participants with strings of letters and visually similar shapes which were either relevant for a specific task (lexical decision or gap localization) or ignored (during a fixation dot color task). In the VWFA, the enhancement of responses to attended stimuli occurred only for letter strings, whereas the shapes evoked smaller responses when attended than when ignored. The enhancement of VWFA activity was accompanied by strengthened functional connectivity with higher-level language regions. These task-dependent modulations of response magnitude and functional connectivity were specific to the VWFA and absent in the rest of visual cortex. We suggest that language regions send targeted excitatory feedback into the VWFA only when the observer is trying to read. This feedback enables the discrimination of familiar and nonsense words, and is distinct from generic effects of visual attention.Competing Interest StatementThe authors have declared no competing interest.Footnotes* Several sections updated and clarified, and a new Figure 6 to compare these results to a prior published dataset.* https://doi.org/10.17605/OSF.IO/YU8SW* https://doi.org/10.18112/openneuro.ds004489.v1.0.0
Paper