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Neuropsychological approaches to the study of reading.

This paper describes four syndromes of acquired dyslexia (that is, reading deficits in previously literate adults who have suffered neurological damage); deep dyslexia, surface dyslexia, phonological dyslexia and letter-by-letter reading. The format of the description inquires whether reading performance in each syndrome is (1) sensitive to dimensions of words (such as word length or part of speech), (2) affected by experimental manipulations (such as exposure duration), and (3) relevant to theorectical issues (such as the nature of codes for word recognition in reading). The four patterns of reading impairment seem to relate in an orderly way to these dimensions, manipulations and issues drawn from the literature on normal word recognition and production. Such orderly relationships, it is claimed, favour the position that neuropsychological observations are germane to conceptions of normal reading.

Brain Damage, Chronic↗

Multicenter evaluation of a nonweekend reading schedule for radiometric pyrazinamide susceptibility testing of Mycobacterium tuberculosis.

Pyrazinamide (PZA) is an integral component of the short-course chemotherapy regimen for tuberculosis. The BACTEC 460TB PZA susceptibility test for Mycobacterium tuberculosis with a daily (D) reading schedule has been available for more than 10 years, but weekend laboratory staffing is necessary. A nonweekend (NW) reading schedule has not been validated in a multicenter study. This prospective multicenter study compares the interlaboratory reproducibility of PZA susceptibility results by following both the D and NW schedules. A total of 181 cultures were shared among four laboratories. Isolates were selected based on resistance or borderline resistance to at least one streptomycin-isoniazid-rifampin-ethambutol drug or PZA. One laboratory used a D reading schedule, and three laboratories used a NW schedule. Both reading schedules are based on the standard BACTEC 460TB PZA protocol. With the NW schedule, the growth index (GI) is not available for test interpretation on Saturday, Sunday, and Monday. Of the 181 shared cultures, 154 were found to be susceptible by all laboratories, 19 were found to be resistant, and 8 had discordant results. The overall pairwise interlaboratory agreement was 97.7%. The discrepancies were not associated with the type of reading schedule used. However, the median control GI was significantly higher for the NW schedule (321) than for the D schedule (259) (P < 0.0001) although results were available on average in about 7 days from setup for both schedules. These results show that the NW schedule is a suitable alternative for laboratories that do not read and interpret PZA susceptibility tests on weekends.

Antitubercular Agents↗

Computer-aided detection versus independent double reading of masses on mammograms.

PURPOSE: To evaluate the use of a computer-aided detection (CAD) system (designed for mammographic mass detection) to help improve mass interpretation and to compare CAD results with independent double-reading results. MATERIALS AND METHODS: Screening mammograms from 500 cases were collected; 125 of these cases were screening-detected cancers, and 125 were interval cancers. Previously obtained screening mammograms (ie, prior mammograms) were available in all cases. All mammograms were analyzed by a CAD system, which detected mass regions and assigned a level of (cancer) suspicion to each mass. Ten experienced screening radiologists read the prior mammograms. For independent interpretation with CAD, the suspicion rating assigned to each finding by the radiologist was weighted with the CAD output at the area of the finding. CAD markers on areas that were not reported by the radiologist were not used. Independent double reading was implemented by using a rule to combine the levels of suspicion assigned to findings by two radiologists. Results were evaluated by using localized-response receiver operating characteristic analysis. RESULTS: In a total of 141 cases, there was a visible abnormality at the location of the cancer on the prior mammogram, and 115 of these were classified as mass cases. For prior mammograms that depicted masses, the mean sensitivity of the radiologists, as averaged among the false-positive rates lower than 10%, was 39.4%; this increased by 7.0% with CAD and by 10.5% with double reading. Differences among single, double, and CAD readings were statistically significant (P <.001). CONCLUSION: Although independent double reading yields the best detection performance, the presence and probability of CAD mass markers can improve mammogram interpretation.

Aged↗

Reading protocol for dynamic contrast-enhanced MR images of the breast: sensitivity and specificity analysis.

PURPOSE: To prospectively determine sensitivity and specificity of breast magnetic resonance (MR) imaging in a screening and symptomatic population by using independent double reading, with histologic or cytologic results or a minimum 18-month follow-up as the standard. MATERIALS AND METHODS: Informed consent and ethical approval were obtained. Reader performance was analyzed in 44 radiologists at 18 centers from 1541 examinations, including 1441 screening examinations in 638 high-risk women aged 24-51 years (mean, 40.5 years) and 100 examinations in symptomatic women aged 23-81 years (mean, 49.2 years). A screening protocol of dynamic T1-weighted three-dimensional imaging and 0.2 mmol/kg gadolinium-based intravenous contrast agent was used. Logistic and Poisson regressions were used to analyze reader performance in relation to experience. Correlation between readers was determined with kappa statistics. Sensitivity and specificity were analyzed according to reader, field strength, machine type, and histologic results. RESULTS: The proportion of studies with lesions analyzed reduced significantly with reader experience (odds ratio, 0.84 per 6 months; P < .001), and number of regions per lesion analyzed also diminished (incidence rate ratio, 0.98 per 6 months; P = .047). The two readers for each study agreed 87% of the time, with a moderately good kappa statistic of 0.52 (95% confidence interval [CI]: 0.45, 0.58). By taking the reading with the highest score (most likely to be malignant) from each double-read study, sensitivity was 91% (95% CI: 83%, 96%) and specificity was 81% (95% CI: 79%, 83%). Single readings had 7% lower sensitivity (95% CI: 4%, 11%) and 7% higher specificity (95% CI: 6%, 7%). Sensitivity did not differ between MR imager manufacturers or between 1.0- and 1.5-T field strength, but there were significant differences in specificity for machine type (P = .001) and for field strength adjusted for manufacturer (P = .001). Specificity, but not sensitivity, was higher in women younger than 50 years (P = .02). CONCLUSION: Independent double reading by 44 radiologists blinded to mammography results showed sensitivity and specificity acceptable for screening; sensitivity was higher when two readings were used, at the cost of specificity. Interreader correlation was moderately good, and evidence of learning was seen. Equipment manufacturer, field strength, and age affected specificity but not sensitivity.

Adult↗

Organized breast screening programs in Canada: effect of radiologist reading volumes on outcomes.

PURPOSE: To examine retrospectively the relationship between radiologist screening program reading volumes and interpretation results. MATERIALS AND METHODS: This research project was reviewed by the University of British Columbia Research Ethics Board. Informed patient consent was not required. Data were requested from Canadian provincial screening programs for the period 1988-2000. Cancer detection rates, abnormal interpretation rates, and positive predictive values (PPVs) were calculated for individual radiologists in those programs. Multivariate Poisson mixed regression models were used to examine the effect of patient age, screening examination sequence (first or subsequent screening examination), province, radiologist reading volume, and interradiologist differences on cancer detection rate, abnormal interpretation rate, and PPV. RESULTS: The results of the interpretation of 1406678 screening mammograms by 304 radiologists from seven provincial programs were analyzed. Cancer detection rate, abnormal interpretation rate, and PPV all varied according to age of woman screened and screening sequence and across the sample of radiologists. None of the rates varied by province. Neither the cancer detection rate nor the abnormal interpretation rate varied by reading volume, but the average PPV was increased by 34% for volumes over 2000 mammograms versus volumes of 480-699 mammograms per year. There was no evidence that the magnitude of variability around the average, for radiologists reading the same volume of mammograms, varied across different volume groups for any of the outcome measures. CONCLUSION: Cancer detection did not vary with reading volume. The average PPV for individual radiologists increased as reading volume rose up to 2000 mammograms per year; it stabilized at higher volumes.

Adult↗

Word identification and reading disorders in the Spanish language.

In this study, a reading-level-match design was used to test the hypothesis that children with reading disability (RD) are characterized by poor phonological skills, and that a developmental lag, as opposed to a specific deficit, will be found in transparent orthographies. Spanish has a transparent orthography and thus children with RD should not show severe difficulties in the use of the phonological route, as in the English language. A sample of 118 participants was selected and organized into three different groups: 40 with RD, 38 normal readers matched in age with the former, and 40 younger normal readers at the same reading level as those with RD. Two experiments were conducted to investigate the effects of lexicality, word frequency, word length, and positional frequency of syllables on lexical decision making and word-naming performance. While the participants were performing the naming task, we recorded what they read to subsequently analyze the form as well as the frequency of naming errors. The present study provides evidence for a deficit in phonological processing in a transparent orthography, particularly in nonword reading, because there were differences between the reading-level-matched groups.

Case-Control Studies↗

Intensive remedial instruction for children with severe reading disabilities: immediate and long-term outcomes from two instructional approaches.

Sixty children with severe reading disabilities were randomly assigned to two instructional programs that incorporated principles of effective instruction but differed in depth and extent of instruction in phonemic awareness and phonemic decoding skills. All children received 67.5 hours of one-to-one instruction in two 50-minute sessions per day for 8 weeks. Both instructional programs produced very large improvements in generalized reading skills that were stable over a 2-year follow-up period. When compared to the growth in broad reading ability that the participants made during their previous 16 months in learning disabilities resource rooms, their growth during the intervention produced effect sizes of 4.4 for one of the interventions and 3.9 for the other. Although the children's average scores on reading accuracy and comprehension were in the average range at the end of the follow-up period, measures of reading rate showed continued severe impairment for most of the children. Within 1 year following the intervention, 40% of the children were found to be no longer in need of special education services. The two methods of instruction were not differentially effective for children who entered the study with different levels of phonological ability, and the best overall predictors of long-term growth were resource room teacher ratings of attention/behavior, general verbal ability, and prior levels of component reading skills.

Awareness↗

ADHD and reading disability in male adults: is there a connection?

The present study examined the comorbidity between attention-deficit/hyperactivity disorder (ADHD) and reading disability (RD) in male adults. Participants were 120 men, of whom 24 were classified as having ADHD. The basis for the diagnosis was two self-report scales validated by interviews and background data. An extensive battery was used to assess phonological abilities and various aspects of reading skills. No differences were obtained between adults with and without ADHD on measures of either phonological processing skills or word decoding, indicating a low comorbidity with RD. This finding was valid even when different criteria were used to diagnose RD. However, the two groups differed in reading comprehension, with individuals with ADHD performing poorly in tests of reading comprehension. These results are compatible with the view that reading comprehension involves many of the higher cognitive control functions assumed to be impaired in ADHD. However, these attentional control functions are not critical to word recognition, which is determined by a more encapsulated phonological processing module. The pattern of associations between ADHD and RD observed in the present study is explained with reference to the differential attentional demands of the two aspects of reading.

Adult↗

Early identification and remediation of phonological-processing deficits in first-grade children at risk for reading disabilities.

The present study assessed 486 first-quarter first graders on their reading and phonological-processing skills and intelligence. Based on this assessment, and using the classification data from Hurford et al.'s (1993) study, 99 children were identified as being at risk for reading difficulties: 53 children at risk for reading disabilities (RD) and 46 children at risk for becoming "garden-variety" poor readers (GV). Half of the RD and GV groups received the phonological-processing intervention. Posttraining assessment indicated that the training procedure not only was effective in increasing the phonological-processing skills of the trained participants, but also increased their reading ability. Both of the RD and GV trained groups benefited from the training. Analyses also indicated that the initial screening device was somewhat less accurate in the present study in identifying at-risk children than in our previous studies (85% vs. approximately 98%, respectively). The results of the present study indicate that it is possible to identify children at risk for reading difficulties and to significantly improve their phonological-processing and reading abilities.

Child↗

Research briefs reading grade level and readability of printed cancer education materials.

PURPOSE/OBJECTIVES: To analyze cancer brochures to estimate their reading level and assess their readability. DESIGN: Quantitative. SAMPLE: 10 cancer brochures published by various cancer organizations. METHODS: SMOG was used to estimate reading grade level of the brochures; the Readability Assessment Instrument (RAIN) was used to analyze the brochures in terms of 14 variables that affect comprehension. Interrater reliability was computed for reading grade level and readability level. MAIN RESEARCH VARIABLES: Reading grade level and readability. FINDINGS: Reading grade level of the brochures ranged from 9-15. The RAIN analysis showed that the number of variables incorporated across the 10 brochures ranged from 12-14, and the number of variables reaching readability criteria ranged from 6-8. CONCLUSIONS: Cancer education materials are written at levels that may be too high for the average reader. These materials also may be difficult to understand because of the way they are written. Materials need to be written so that they match the reading levels of patients with cancer and the general public and incorporate more of the variables that affect comprehension so that readers can understand them easily. IMPLICATIONS FOR NURSING: Nurses use written education materials to inform patients about their cancer diagnoses. They can conduct a comprehensive analysis of cancer brochures using SMOG and RAIN and then, if needed, use this information to revise the brochures so that they can be understood easily. If possible, patients who are going to be using the materials should be involved in the revision process.

Comprehension↗

The role of arbitration of discordant reports at double reading of screening mammograms.

OBJECTIVE: To asses the effectiveness of arbitration of discordant double readings in mammography screening. DESIGN: A retrospective study of 1217 consecutive arbitrations. SETTING: A subset of discordant double readings from the Florence screening programme underwent arbitration by a third reader. RESULTS: Positive arbitration of 1217 discordant double readings prompted assessment in 476 cases (39.2%), detecting 30 cancers (6.3%). Of 741 negative arbitrations (60.8%), 311 have been followed up thus far, and two cancers (0.64%) occurred in the site previously suspected at one of the two independent readings. Arbitration had a sensitivity of 86.3% and a negative predictive value of 99.3%. Arbitration reduced the overall referral rates from 3.82% to 2.59% (relative decrease 32.1%). Due to false-negative arbitration, cancers detected per 1000 women screened would decrease from 4.58 to 4.50 (relative decrease 1.7%). For every cancer missed due to false-negative arbitration, 151 unnecessary recalls and 21,248 euro would have been saved, whereas the saved cost per screened woman due to arbitration was 1.72 euro. DISCUSSION: Arbitration of discordant double reading would substantially reduce referral rates with a limited reduction in cancer detection rate, and may be recommended as a routine procedure. Greater benefit from arbitration might be expected in the presence of high referral rates at independent double reading, a common scenario in a newly implemented service screening.

Breast Neoplasms↗

Hierarchical-genetic-algorithm-based design of a large scale Fresnel lens for a reading light system with multiple LED sources.

A conventional Fresnel lens is suitable to be used in the reading light system due to its features of directing and collecting light rays, as well as its properties of being essentially flat, plastic, lightweight, and cost efficient. However, it is not suitable for a reading light system with multiple light sources. To a reading light system with multiple light sources, a Fresnel lens with suitably designed groove angles can be used to improve the performance of that system in both illuminance and uniformity. Nevertheless, suitable groove angles are rather difficult to find if a Fresnel lens consists of a lot of groove angles and each angle covers a wide range of degrees. We develop a hierarchical genetic algorithm (HGA) to search for a set of optimal groove angles to design a Fresnel lens for a reading light system with multiple light sources from an enormous searching space. In addition, the groove angles of the Fresnel lens are directly derived from a conventional Fresnel lens database. The design goal is to maximize the illuminance and simultaneously maintain the uniformity of light rays incident to a specified reading surface. As a result, we can demonstrate that a HGA really works better than a genetic algorithm and the optimally designed Fresnel lens, indeed, offers a better light-guiding performance than a conventional Fresnel lens for a multiple-LED reading light system.

Journal Article↗

kMermaid: Ultrafast metagenomic read assignment to protein clusters by hashing of amino acid k-mer frequencies.

Shotgun metagenomic sequencing can determine both the taxonomic and functional content of microbiomes. However, functional classification for metagenomic reads remains highly challenging as protein mapping tools require substantial computational resources and yield ambiguous classifications when short reads map to homologous proteins originating from different bacteria. Here we introduce kMermaid for the purpose of uniquely mapping bacterial short reads to taxa-agnostic clusters of homologous proteins, which can then be used for downstream analysis tasks such as read quantification and pathway or global functional analysis. Using a nested hash map containing amino acid k-mer profiles as a model for protein assignment, kMermaid achieves the sensitivity of popular existing protein mapping tools while remaining highly resource efficient. We evaluate kMermaid on simulated data and data from human fecal samples as well as demonstrate the utility of kMermaid for classifying reads originating from new, unseen proteins. kMermaid allows for highly accurate, unambiguous and ultrafast metagenomic read assignment into protein clusters, with a fixed memory usage, and can easily be employed on a typical computer.

Metagenomics↗

College students as contingency managers for adolescents in a program to develop reading skills.

Behavior-modification procedures and an individualized tutorial program were used to remediate reading skill deficits in seventh-grade adolescent subjects. Forty-two college students were trained as reading tutors and contingency managers to use reading diagnostic and remedial materials, and to develop contracts and reinforce positive verbal responses toward reading. Significantly greater increases in reading scores of experimental groups, compared to control groups, substantial improvement in target behaviors, and significant changes in verbalizations toward reading were observed after 10 weeks of treatment. Six-month followup studies showed that all groups had consolidated their gains and that grade scores continued to improve. The improvement of the experimental subjects remained significantly ahead of the control subjects.

Adolescent↗

Improving oral reading fluency: a brief experimental analysis of combining an antecedent intervention with consequences.

A brief experimental analysis was used to evaluate the relative effectiveness of combining two consequences (contingent reinforcement or performance feedback) with an antecedent intervention (listening passage preview and repeated readings) on the oral reading fluency of 6 elementary students. The antecedent intervention increased the number of correctly read words per minute for all 6 students. For 4 of the students, pairing the antecedent intervention with either of the consequences resulted in higher reading rates over the antecedent intervention alone. Undifferentiated results were obtained for the remaining 2 participants. These results suggest that combining an antecedent intervention with consequences may enhance the oral reading fluency of students with reading problems. However, individual responsiveness to the different intervention components indicates that brief experimental analyses are warranted to identify the most effective intervention.

Child↗

Physicians' opinions on the delivery of mammographic screening services: immediate interpretation versus double reading.

OBJECTIVE: Mammographic services are delivered in many ways. Emphasis has been placed on providing women with immediate reports of their screening mammograms. We believe that double reading of mammograms is more important than an immediate report. We sought to determine physicians' attitudes toward this issue and if education affects their opinions. MATERIALS AND METHODS: Questionnaires were mailed to 1000 physicians in Massachusetts who were randomly selected from 16,000 members of the state medical society. The questionnaire had four sections, of which two were pertinent to this subject. The first section collected general information on the physician's practice and experience. The second section described two common delivery systems for mammographic screening services and asked physicians to choose the delivery system that would most benefit their patients. RESULTS: Of the 1000 physicians, 294 returned the questionnaire, giving a response rate of 29%. Of these, 16 physicians returned blank surveys, leaving 278 for analysis. Two hundred forty-nine (90%) valued off-site, delayed interpretation of mammographic screening for their patients over on-site reading by a single radiologist if an off-site, delayed reading made double reading possible. CONCLUSION: An off-site, double-reading delivery system for mammographic screening services is preferred by many physicians for their patients once they are educated as to the benefits of double reading.

Adult↗

Word discrimination and chronological age related to sentence-based speech-reading skill.

Twenty-one hearing-impaired subjects participated in the present study designed to investigate two questions. First, whether the ability to discriminate isolated words is related to sentence-based speech-reading. Second, whether older adults (i.e., 52 to 75 years) could, as in listening tasks, benefit relatively more than younger adults (i.e., 31 to 50 years) when extra contextual information is offered in the speech-reading task. The results demonstrated that word discrimination contributes significantly to efficient speech-reading performance. However, the nature of the relationship is dependent on the particular aspect of word discrimination being tested: that is, one aspect of the word-discrimination test (involving a short-term memory component) was tied to one specific speech-reading condition only (i.e., 3-word sentences), whereas another aspect (without a short-term memory component) facilitated performance in all kinds of speech-reading conditions. For both age groups it was found that contextual information had an equally facilitative effect. The results were discussed with respect to the role played by contextual information in visual speech perception compared to other related areas (e.g., listening and reading tasks).

Aging↗

Eye movement patterns and reading performance in poor readers: immediate effects of convex lenses indicated by book retinoscopy.

Eye movement patterns and reading performance were evaluated in 38 4th and 5th grade male students who were at least 1 year behind in their reading levels. Half of the subjects (Group I) demonstrated a need for convex lenses at near by a book retinoscopy criterion. The remaining subjects (Group II) showed no need for convex lenses at near by the same criterion. The subject's eye movements during reading were recorded by a commercial device called Eye-Trac. These recordings were made with 2 lens applications, plano and +0.50 D, respectively. The number of fixations, regressions, rate of reading, and relative efficiency for each condition (plano and +0.50 D) were calculated. In Group I, 3 of 5 measures showed significant improvement with plus lenses. These subjects showed fewer regressions, increased reading speed, and higher relative efficiency with plus than without. In Group II, 3 of 5 measures showed decrement with plus lenses, while 1 (comprehension) showed improvement. These subjects showed more fixations and regressions and lower relative efficiency with plus than without. It is therefore concluded that convex lenses of low power can have considerable immediate effect on children's reading skills, sometimes helpful and sometimes detrimental, and that proper pretesting with both retinoscopy will aid in the prediction of this effect.

Child↗