The role of orthographic and semantic learning in word reading and reading comprehension

We tested the theoretically driven hypotheses that children’s orthographic and semantic learning are associated with their word reading and reading comprehension skills, even when orthographic and semantic knowledge are taken into account. A sample of 139 English-speaking Grade 3 children completed a learning task in which they read stories about new inventions. Then they were tested on their learning of the spelling and meaning of the inventions (i.e., orthographic and semantic learning, respectively). Word reading and reading comprehension were assessed with standardised tasks, and orthographic and semantic knowledge were assessed with choice tasks targeting the spelling and meaning of existing words. The results of our structural equation modeling indicated that orthographic learning predicted word reading directly and reading comprehension indirectly via word reading. We also found that semantic learning predicted reading comprehension directly. These findings support integration of the self-teaching hypothesis and the lexical quality hypothesis

Do children with developmental dyslexia have syntactic awareness problems once phonological processing and memory are controlled?

IntroductionSyntactic awareness is the ability to monitor and manipulate word order within sentences. It is unclear whether children with dyslexia have syntactic awareness problems, as there are mixed results in the literature. Dyslexia is typically classified with very poor word and nonword reading and phonological processing problems are often observed in this population. It is conceivable that a phonological deficit could strain memory when performing oral syntactic awareness tasks. Here we examine if syntactic awareness problems are observed in children with dyslexia once phonological processing and memory skills are controlled.MethodsReal and nonword reading efficiency tests determined reading level. Children with dyslexia (n = 25) were compared to typically developing children (n = 24) matched for age (M = 8;8) and nonverbal abilities. Syntactic awareness was measured with an oral word order correction task (e.g., Is baking Lisa and her son in his room sleeps). Tests of phonological awareness, phonological memory, and verbal working memory were also administered and served as controls.ResultsThe dyslexic group performed worse than typically developing readers on syntactic awareness and this group difference persisted once phonological memory and verbal working memory were controlled. However, after controlling for phonological awareness skills, there were no group differences on the syntactic awareness test.Discussion:The results suggest that phonological awareness problems in particular might be responsible for syntactic awareness difficulties in dyslexia and future studies should control for this. The results are discussed within theoretical frameworks on the nature of oral language deficits in dyslexia

Not all sentences are created equal: Evaluating the relation between children’s understanding of basic and difficult sentences and their reading comprehension

The sentences in texts are far more complex and diverse than those that children commonly encounter in oral language. This raises interesting questions as to whether the understanding of some sentence types might be more important than others in children’s reading comprehension. Accordingly, we examined the relation between children’s reading comprehension and their understanding of two types of sentences: one we label as basic sentences, which are common in both oral and written language, and the other we label as difficult sentences, which are more restricted to written language. One hundred and four English-speaking students (mean age = 10.8 years) completed an experimental measure of oral sentence comprehension capturing these two sentence types, a standardized measure of reading comprehension, as well as control measures for word reading, phonological awareness, vocabulary and working memory. After accounting for the variance explained by the control measures, hierarchical linear regression analyses revealed that comprehension of basic sentences, but not of difficult sentences, was significantly related to children’s reading comprehension. These results demonstrate that, at least in the fifth grade, English-speaking children use their understanding of those sentences for which they have gained a strong foundation through oral language (i.e., basic sentences) to springboard into reading for understanding

The Role of Orthographic and Semantic Learning in Word Reading and Reading Comprehension

We tested the theoretically driven hypotheses that children’s orthographic and semantic learning are associated with their word reading and reading comprehension skills, even when orthographic and semantic knowledge are taken into account. A sample of 139 English-speaking Grade 3 children completed a learning task in which they read stories about new inventions. Then, they were tested on their learning of the spelling and meaning of the inventions (i.e., orthographic and semantic learning, respectively). Word reading and reading comprehension were assessed with standardised tasks, and orthographic and semantic knowledge were assessed with choice tasks targeting the spelling and meaning of existing words. The results of our structural equation modeling indicated that orthographic learning predicted word reading directly and reading comprehension indirectly via word reading. We also found that semantic learning predicted reading comprehension directly. These findings support integration of the self-teaching hypothesis and the lexical quality hypothesis

Effect of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker initiation on organ support-free days in patients hospitalized with COVID-19

IMPORTANCE Overactivation of the renin-angiotensin system (RAS) may contribute to poor clinical outcomes in patients with COVID-19. Objective To determine whether angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) initiation improves outcomes in patients hospitalized for COVID-19. DESIGN, SETTING, AND PARTICIPANTS In an ongoing, adaptive platform randomized clinical trial, 721 critically ill and 58 non–critically ill hospitalized adults were randomized to receive an RAS inhibitor or control between March 16, 2021, and February 25, 2022, at 69 sites in 7 countries (final follow-up on June 1, 2022). INTERVENTIONS Patients were randomized to receive open-label initiation of an ACE inhibitor (n = 257), ARB (n = 248), ARB in combination with DMX-200 (a chemokine receptor-2 inhibitor; n = 10), or no RAS inhibitor (control; n = 264) for up to 10 days. MAIN OUTCOMES AND MEASURES The primary outcome was organ support–free days, a composite of hospital survival and days alive without cardiovascular or respiratory organ support through 21 days. The primary analysis was a bayesian cumulative logistic model. Odds ratios (ORs) greater than 1 represent improved outcomes. RESULTS On February 25, 2022, enrollment was discontinued due to safety concerns. Among 679 critically ill patients with available primary outcome data, the median age was 56 years and 239 participants (35.2%) were women. Median (IQR) organ support–free days among critically ill patients was 10 (–1 to 16) in the ACE inhibitor group (n = 231), 8 (–1 to 17) in the ARB group (n = 217), and 12 (0 to 17) in the control group (n = 231) (median adjusted odds ratios of 0.77 [95% bayesian credible interval, 0.58-1.06] for improvement for ACE inhibitor and 0.76 [95% credible interval, 0.56-1.05] for ARB compared with control). The posterior probabilities that ACE inhibitors and ARBs worsened organ support–free days compared with control were 94.9% and 95.4%, respectively. Hospital survival occurred in 166 of 231 critically ill participants (71.9%) in the ACE inhibitor group, 152 of 217 (70.0%) in the ARB group, and 182 of 231 (78.8%) in the control group (posterior probabilities that ACE inhibitor and ARB worsened hospital survival compared with control were 95.3% and 98.1%, respectively). CONCLUSIONS AND RELEVANCE In this trial, among critically ill adults with COVID-19, initiation of an ACE inhibitor or ARB did not improve, and likely worsened, clinical outcomes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT0273570