'Unexpected' spelling difficulty in a ten-year-old child with good reading skills: An intervention case study

We report a single-case intervention study of Alan, a child aged 10;04, who presented with spelling difficulty but good reading skills. Assessment of the potential cognitive functions underlying the spelling difficulty explored phonological abilities, visual memory and letter report. We also assessed print exposure and verbal memory. Results of analysis of spelling performance revealed an effect of word length on accuracy, and spelling errors involving omission, insertion, substitution and transposition of graphemes. Results of the literacy-related assessments indicated that Alan did not have a phonological or visual memory deficit, but he showed impaired performance in the letter-report task when asked to report all the letters in the five-item test array. On the basis of previous research, we hypothesised that Alan’s unexpectedly poor spelling was due to a graphemic buffer deficit. Two different interventions were employed: a lexical-orthographic programme, followed by one aimed at improving sublexical abilities. The results showed a significant increase in spelling accuracy after the lexical-orthographic intervention for the treated word set, and a small improvement for the untrained words that was significant at delayed post-intervention testing. The improvement was shown to persist over time. No improvement in spelling was observed after the sublexical intervention. The study emphasises the importance of a wide assessment in order to investigate cognitive processes underpinning spelling difficulty

Oncologic outcomes following surgical management of clinical stage II sex cord stromal tumors

Objective To investigate the clinical history of patients with clinical stage II sex cord stromal tumors who underwent RPLND at our institution. Methods Our prospectively maintained testicular cancer database was queried to identify patients who presented with or developed clinical stage II sex cord stromal tumors and underwent RPLND at our institution between 1980 and 2018. Demographic, clinical and pathological characteristics were reviewed. Kaplan-Meier curves were graphed to assess recurrence-free and overall survival. Results Fourteen patients were included in the study with a median age of 44.2 years. Four patients presented with clinical stage II disease and 10 patients developed metastatic disease during follow-up of initial clinical stage I disease with a median time to metastasis of 2.7 years (range: 0.4-19.5 years). Of the 10 patients with orchiectomy pathology data available, all patients had at least 1 risk factor on testis pathology (mean: 2.9 risk factors). Nine patients received treatment prior to referral to our institution. All patients recurred post-RPLND at Indiana University. Median recurrence-free survival was 9.8 months. Twelve patients died of disease with a median overall survival of 14.4 months. Conclusions Metastatic sex cord stromal tumors are rare and are more resistant to standard treatment modalities than metastatic germ cell tumors. Patients presenting with sex cord stromal tumors should consider prophylactic primary RPLND in the setting of one or more pathological predictor of malignancy

New concepts in global wargaming

This report addresses resurgence in wargaming and new techniques used to address complex political-military issues. Relationships between gaming and analysis are examined and benefits, opportunities, and drawbacks of gaming addressed. Requirements for Control Team in modern computer-assisted State and Path games and seminar games are discussed. Authors conclude with the value of modern simulation techniqueshttp://archive.org/details/newconceptsinglo00tritN