Empirical tests of the effectiveness of EnChroma multi-notch filters for enhancing color vision in deuteranomaly.

Manufacturers of notch filter-based aids for color vision claim that their products can enhance color perception for people with anomalous trichromacy, a form of color vision deficiency (CVD). Anecdotal reports imply that people with CVD can have radically enhanced color vision when using the filters. However, existing empirical research largely focussed on the effect of notch filters on performance on diagnostic tests for CVD has not found that they have any substantial effect. Informed by a model of anomalous trichromatic color vision, we selected stimuli predicted to reveal the effects of EnChroma filters. Using these stimuli, we tested the ability of EnChroma filters to enhance color vision for 10 deuteranomalous trichromats in three experiments: 1. asymmetric color matching between test and control filter conditions, 2. color discrimination measured using four alternative forced-choice, and 3. color appearance measured using dissimilarity ratings to reconstruct subjective color spaces using multidimensional scaling. To investigate potential effects of long-term adaptation or perceptual learning, participants completed all three experiments at two time points, on first exposure to the filters, and after a week of regular use. We found a significant effect of the filters on color matches in the direction predicted by the model at both time points, implying that the filters can enhance the anomalous trichromatic color gamut. However, we found minimal effect of the filters on color discrimination at threshold. We found a significant effect of the filters in enhancing the appearance of colors along the red-green axis at the first time point, and a trend in the same direction at the second time point. Our results provide the first quantitative experimental evidence that notch filters can enhance color perception for anomalous trichromats.

Chromatic and spatial image statistics predict infants' visual preferences and adults' aesthetic preferences for art.

Aesthetics has been characterized as a triadic interaction of perceptual, emotional, and conceptual neural systems (e.g., Chatterjee & Vartanian, 2014). There has been much empirical effort to identify the visual features that contribute to the perceptual component of this triad (e.g., Mather, 2020). Here, we measured infants' visual preferences and adults' aesthetic preferences for 40 of van Gogh's landscape paintings and investigated the contribution of the chromatic and spatial image statistics of the art to infants' and adults' responses. We found that infants' and adults' responses were significantly related: infants looked longer at the art that the adults found more pleasant. We also found that our combination of chromatic and spatial image statistics could account for around two thirds of the variance in infant looking and adult pleasantness ratings. The amount of variation in the luminance and saturation of the art's pixels contributed to both infants' visual preferences and adults' aesthetic preferences, potentially identifying two "perceptual primitives" of aesthetics that can be traced back to early sensory biases in infancy. We also identified important differences in the types of image statistics that predict infants' and adults' responses. We discuss the findings in relation to theories of aesthetics, natural scene statistics, and infant vision and perception.

Male pediatric, adolescent, and young adult reproductive survivorship.

As pediatric, adolescent, and young adult cancer survival rates increase, emphasis is placed on reducing late effects, including reproductive complications and potential impact to fertility. Male survivors are at risk of abnormalities in sperm, hormone deficiencies, and sexual dysfunction. This can impact one's progression into puberty and ability to have a biological child and impacts quality of life following treatment. Access to reproductive care is important and requires patient assessment and appropriate referral to reproductive specialists. This review addresses reproductive complications associated with therapy, standard-of-care testing, and therapeutic interventions. The psychologic impact on psychosexual functioning is also addressed.

Colour vision is aligned with natural scene statistics at 4 months of age.

Visual perception in adult humans is thought to be tuned to represent the statistical regularities of natural scenes. For example, in adults, visual sensitivity to different hues shows an asymmetry which coincides with the statistical regularities of colour in the natural world. Infants are sensitive to statistical regularities in social and linguistic stimuli, but whether or not infants' visual systems are tuned to natural scene statistics is currently unclear. We measured colour discrimination in infants to investigate whether or not the visual system can represent chromatic scene statistics in very early life. Our results reveal the earliest association between vision and natural scene statistics that has yet been found: even as young as 4 months of age, colour vision is aligned with the distributions of colours in natural scenes. RESEARCH HIGHLIGHTS: We find infants' colour sensitivity is aligned with the distribution of colours in the natural world, as it is in adults. At just 4 months, infants' visual systems are tailored to extract and represent the statistical regularities of the natural world. This points to a drive for the human brain to represent statistical regularities even at a young age.

Brentuximab vedotin after autologous transplantation in pediatric patients with relapsed/refractory Hodgkin lymphoma.

Outcomes for children and adolescents with relapsed and refractory Hodgkin lymphoma (HL) are poor, with ∼50% of patients experiencing a subsequent relapse. The anti-CD30 antibody-drug conjugate brentuximab vedotin improved progression-free survival (PFS) when used as consolidation after autologous stem cell transplantation (ASCT) in adults with high-risk relapsed/refractory HL. Data on brentuximab vedotin as consolidative therapy after ASCT in pediatric patients with HL are extremely limited, with data of only 11 patients reported in the literature. We performed a retrospective analysis of 67 pediatric patients who received brentuximab vedotin as consolidation therapy after ASCT for the treatment of relapsed/refractory HL to describe the experience of this regimen in the pediatric population. This is the largest cohort reported to date. We found that brentuximab vedotin was well tolerated with a safety profile similar to that of adult patients. With a median follow-up of 37 months, the 3-year PFS was 85%. These data suggest a potential role for the use of brentuximab vedotin as consolidation therapy after ASCT for children with relapsed/refractory HL.

Composite Metric of Glycemic Control Q-Score Is Elevated in Pediatric and Adolescent/Young Adult Hematopoietic Stem Cell Transplant Recipients.

Background: Malglycemia in pediatric, adolescent and young adult (AYA) patients who undergo hematopoietic stem cell transplant (HSCT) is associated with increased infection and mortality rate. Continuous glucose monitoring (CGM) has been safely used in pediatric/AYA HSCT recipients, but there is a need for a composite metric that can easily be used in clinical settings to assess the glycemic control and identify high-risk patients who needs therapeutic intervention. Composite metrics derived from CGM have not been studied in pediatric/AYA HSCT patients. Methods: Patients aged 2-30 years old who are admitted inpatient while undergoing HSCT at Children's Hospital Colorado underwent CGM using the Abbot Freestyle Libre Pro device from up to 7 days before and 60 days after HSCT. A composite metric Q-score, comprising five primary factors of CGM profiles (central tendency, hyperglycemia, hypoglycemia, intradaily variations, and interdaily variations), was calculated for each patient for the duration of CGM wear. Results: Twenty-nine patients received CGM for an average of 25 days per participant. The median Q-score was 10.2 (interquartile range [IQR]: 8.3, 14.3). Sixty-nine percent of patients had Q-scores that would be categorized into the Fair or Poor category. There was no difference in the Q-score by sources of stem cell, types of primary disease, types of preparative regimen, need for PICU admission, presence of documented infections, and total parenteral nutrition use in the peri-HSCT period. Conclusions: Most pediatric/AYA HSCT recipients have Q-scores indicating suboptimal glycemic control in the peri-HSCT period. Future study should focus on developing screening and treatment strategies to improve malglycemia and its associated adverse clinical outcomes. This study was registered at clinicaltrials.gov (NCT03482154).

Therapy Selection for Hodgkin Lymphoma in Sickle Cell Disease: balancing risks and benefits.

Advances in treatment have reduced mortality from Hodgkin lymphoma; therefore, greater attention should be focused on minimizing the late effects. A variety of risk-adapted treatment regimens exist that prioritize disease presentation but not patient-specific comorbidities. Herein, we describe a patient with sickle cell disease diagnosed with Hodgkin lymphoma and the considerations made in treatment planning to minimize therapy-related acute toxicity and late effects that overlap with the patient's preexisting sickle cell disease complications.

Color-biased regions in the ventral visual pathway are food selective.

Color-biased regions have been found between face- and place-selective areas in the ventral visual pathway. To investigate the function of the color-biased regions in a pathway responsible for object recognition, we analyzed the natural scenes dataset (NSD), a large 7T fMRI dataset from 8 participants who each viewed up to 30,000 trials of images of colored natural scenes over more than 30 scanning sessions. In a whole-brain analysis, we correlated the average color saturation of the images with voxel responses, revealing color-biased regions that diverge into two streams, beginning in V4 and extending medially and laterally relative to the fusiform face area in both hemispheres. We drew regions of interest (ROIs) for the two streams and found that the images for each ROI that evoked the largest responses had certain characteristics: they contained food, circular objects, warmer hues, and had higher color saturation. Further analyses showed that food images were the strongest predictor of activity in these regions, implying the existence of medial and lateral ventral food streams (VFSs). We found that color also contributed independently to voxel responses, suggesting that the medial and lateral VFSs use both color and form to represent food. Our findings illustrate how high-resolution datasets such as the NSD can be used to disentangle the multifaceted contributions of many visual features to the neural representations of natural scenes.

The Development of Color Perception and Cognition.

Color is a pervasive feature of our psychological experience, having a role in many aspects of human mind and behavior such as basic vision, scene perception, object recognition, aesthetics, and communication. Understanding how humans encode, perceive, talk about, and use color has been a major interdisciplinary effort. Here, we present the current state of knowledge on how color perception and cognition develop. We cover the development of various aspects of the psychological experience of color, ranging from low-level color vision to perceptual mechanisms such as color constancy to phenomena such as color naming and color preference. We also identify neurodiversity in the development of color perception and cognition and implications for clinical and educational contexts. We discuss the theoretical implications of the research for understanding mature color perception and cognition, for identifying the principles of perceptual and cognitive development, and for fostering a broader debate in the psychological sciences.

Serum lactate is associated with increased illness severity in immunocompromised pediatric hematology oncology patients presenting to the emergency department with fever.

Introduction: Determining which febrile pediatric hematology/oncology (PHO) patients will decompensate from severe infection is a significant challenge. Serum lactate is a well-established marker of illness severity in general adult and pediatric populations, however its utility in PHO patients is unclear given that chemotherapy, organ dysfunction, and cancer itself can alter lactate metabolism. In this retrospective analysis, we studied the association of initial serum lactate in febrile immunosuppressed PHO patients with illness severity, defined by the incidence of clinical deterioration events (CDE) and invasive bacterial infection (IBI) within 48 hours. Methods: Receiver operating characteristic (ROC) curves were reported using initial lactate within two hours of arrival as the sole predictor for CDE and IBI within 48 hours. Using a generalized estimating equations (GEE) approach, the association of lactate with CDE and IBI within 48 hours was tested in univariate and multivariable analyses including covariates based on Quasi-likelihood under Independence Model Criterion (QIC). Additionally, the association of lactate with secondary outcomes (i.e., hospital length of stay (LOS), intensive care unit (PICU) admission, PICU LOS, non-invasive infection) was assessed. Results: Among 897 encounters, 48 encounters had ≥1 CDE (5%), and 96 had ≥1 IBI (11%) within 48 hours. Elevated lactate was associated with increased CDE in univariate (OR 1.77, 95%CI: 1.48-2.12, p<0.001) and multivariable (OR 1.82, 95%CI: 1.43-2.32, p<0.001) analyses, longer hospitalization (OR 1.15, 95%CI: 1.07-1.24, p<0.001), increased PICU admission (OR 1.68, 95%CI: 1.41-2.0, p<0.001), and longer PICU LOS (OR 1.21, 95%CI: 1.04-1.4, p=0.01). Elevated lactate was associated with increased IBI in univariate (OR 1.40, 95%CI: 1.16-1.69, p<0.001) and multivariable (OR 1.49, 95%CI: 1.23-1.79, p<0.001) analyses. Lactate level was not significantly associated with increased odds of non-invasive infection (p=0.09). The QIC of the model was superior with lactate included for both CDE (305 vs. 325) and IBI (563 vs. 579). Conclusions: These data demonstrated an independent association of elevated initial lactate level and increased illness severity in febrile PHO patients, suggesting that serum lactate could be incorporated into future risk stratification strategies for this population.

Infant color perception: Insight into perceptual development.

A remarkable amount of perceptual development occurs in the first year after birth. In this article, we spotlight the case of color perception. We outline how within just 6 months, infants go from very limited detection of color as newborns to a more sophisticated perception of color that enables them to make sense of objects and the world around them. We summarize the evidence that by 6 months, infants can perceive the dimensions of color and categorize it, and have at least rudimentary mechanisms to keep color perceptually constant despite variation in illumination. In addition, infants' sensitivity to color relates to statistical regularities of color in natural scenes. We illustrate the contribution of these findings to understanding the development of perceptual skills such as discrimination, categorization, and constancy. We also discuss the relevance of the findings for broader questions about perceptual development and identify directions for research.

Calibrating Vision: Concepts and Questions.

The idea that visual coding and perception are shaped by experience and adjust to changes in the environment or the observer is universally recognized as a cornerstone of visual processing, yet the functions and processes mediating these calibrations remain in many ways poorly understood. In this article we review a number of facets and issues surrounding the general notion of calibration, with a focus on plasticity within the encoding and representational stages of visual processing. These include how many types of calibrations there are - and how we decide; how plasticity for encoding is intertwined with other principles of sensory coding; how it is instantiated at the level of the dynamic networks mediating vision; how it varies with development or between individuals; and the factors that may limit the form or degree of the adjustments. Our goal is to give a small glimpse of an enormous and fundamental dimension of vision, and to point to some of the unresolved questions in our understanding of how and why ongoing calibrations are a pervasive and essential element of vision.

ColourSpot, a novel gamified tablet-based test for accurate diagnosis of color vision deficiency in young children.

There is a need for a straightforward, accessible and accurate pediatric test for color vision deficiency (CVD). We present and evaluate ColourSpot, a self-administered, gamified and color calibrated tablet-based app, which diagnoses CVD from age 4. Children tap colored targets with saturations that are altered adaptively along the three dichromatic confusion lines. Two cohorts (Total, N = 772; Discovery, N = 236; Validation, N = 536) of 4-7-year-old boys were screened using the Ishihara test for Unlettered Persons and the Neitz Test of Color Vision. ColourSpot was evaluated by testing any child who made an error on the Ishihara Unlettered test alongside a randomly selected control group who made no errors. Psychometric functions were fit to the data and "threshold ratios" were calculated as the ratio of tritan to protan or deutan thresholds. Based on the threshold ratios derived using an optimal fitting procedure that best categorized children in the discovery cohort, ColourSpot showed a sensitivity of 1.00 and a specificity of 0.97 for classifying CVD against the Ishihara Unlettered in the independent validation cohort. ColourSpot was also able to categorize individuals with ambiguous results on the Ishihara Unlettered. Compared to the Ishihara Unlettered, the Neitz Test generated an unacceptably high level of false positives. ColourSpot is an accurate test for CVD, which could be used by anyone to diagnose CVD in children from the start of their education. ColourSpot could also have a wider impact: its interface could be adapted for measuring other aspects of children's visual performance.

A test of the ecological valence theory of color preference, the case of Arabic.

Humans have systematic and reliable color preferences. The dominant account of color preference is that individuals like some colors more than others due to the valence of objects that they associate with colors (Ecological Valence Theory). In support of this theory, Palmer and Schloss show that the average valence of objects associated with a color, when weighted (the WAVE), explains up to 80% of the variation in color preference for adults from the United States (US). Here we investigate whether Ecological Valence Theory can account for the color preferences of female and male adults from Saudi Arabia to test how well the theory generalizes across cultures and how well it accounts for sex differences in color preference. We also extend the investigation of EVT by investigating whether abstract concept associations as well as object associations can account for preference. Saudi adults' color preferences, color object and concept associations, and association valence ratings were collected, and the WAVE was computed and correlated with preference ratings. The WAVE accounted for no more than half of the variance in Saudi color preferences, although there was some degree of sex specificity in the relationship of the WAVE and color preference. Adding abstract concept associations did not account for more variance than object associations alone, but the number of abstract concept associations did account for a significant amount of the variance in color preference for females, but not males. The findings converge with other cross-cultural studies in suggesting that the success of EVT in accounting for color preference varies across cultures and indicates that additional factors other than color associations are likely also at play.

Cardiac Relapse of Acute Lymphoblastic Leukemia Following Hematopoietic Stem Cell Transplantation: A Case Report and Review of Literature.

Isolated extramedullary relapse of acute lymphoblastic leukemia (ALL) occurs in soft tissues and various organs outside the testis and central nervous system. Treatments such as hematopoietic stem cell transplantation and more novel modalities such as immunotherapy have eradicated ALL at extramedullary sites. In some instances, survival times for relapsed ALL at these sites are longer than those for relapsed disease involving only the bone marrow. Isolated relapse of ALL in the myocardium is rare, especially in children, making diagnosis and treatment of it difficult. More recent treatment options such as chimeric antigen receptor T-cell therapy carry a high risk of cytokine release syndrome and associated risk of worsening cardiac function. Herein we present the case of an 11-year-old boy who presented with relapsed symptomatic B-cell ALL in the myocardium following allogeneic hematopoietic stem cell transplantation. This is an unusual presentation of relapsed ALL and this case demonstrates the associated challenges in its diagnosis and treatment. The case report is followed by a literature review of the advances in treatment of pediatric leukemia and their application to extramedullary relapse of this disease in particular.

Combination brentuximab vedotin and bendamustine for pediatric patients with relapsed/refractory Hodgkin lymphoma.

In patients with relapsed/refractory (R/R) Hodgkin lymphoma (HL), achieving a complete metabolic response (CMR) after salvage therapy is associated with superior outcomes, and optimal treatments must be identified. The combination of brentuximab vedotin and bendamustine (BVB), although highly active in adult patients, has not been extensively evaluated in pediatric patients with R/R HL. We performed a multicenter, retrospective review of pediatric patients <21 years of age with R/R HL treated with BVB from January 2016 through July 2019. Response was assessed by local radiologists according to Lugano classification criteria. Twenty-nine patients (17 relapsed, 12 refractory) with a median age of 16 years (range, 10-20) were treated with BVB and received a median of 3 cycles of therapy (range, 2-7). Patients received an infusion of 1.8 mg/kg of BV on day 1 with bendamustine 90 mg/m2 on days 1 and 2 of 3-week cycles. Nineteen patients (66%) achieved a CMR (95% CI, 46-82). An objective response was observed in 23 patients (objective response rate, 79%; 95% CI, 60-92). The most common grade 3 and 4 toxicities were hematologic, and 3 patients (10%) experienced grade 3 infusion reactions. Seventeen of 18 patients underwent successful mobilization and collection of stem cells. Sixteen patients (13 autologous, 3 allogeneic) received a consolidative transplant after BVB. The 3-year post-BVB event-free and overall survival were 65% (95% CI, 46-85) and 89% (95% CI, 74-100), respectively. For pediatric patients with R/R HL, BVB was well tolerated and compared favorably with currently accepted salvage regimens.

Colour category constancy and the development of colour naming.

In this study, we investigated the processes of coordination, adaptation, and calibration during the development of colour naming and colour constancy, and we tested whether colour term knowledge is related to colour constancy. We measured category membership and prototypes with 163 Munsell chips in preschool children (3- to 4-year-old) under neutral, green, and red illuminations, and compared their results to those of adults. We introduced an index of colour term maturity based on the similarity of children's colour term use to adults, and a colour category constancy index that quantifies the variation in colour categorisation that is specific to illumination changes. Results showed that illumination changes affected children's consistency of colour categorisation, but only to a small extent. However, colour term maturity and illumination-specific effects on consistency strongly varied in this age range. Correlations between colour term maturity and illumination-specific consistency indicated that colour constancy increases with colour term acquisition; but those results depended on the type of illumination changes (between neutral, green, and red). Together, our findings suggest that children progressively fine-tune and recalibrate the meaning of colour terms through processes of coordination and adaptation that are also involved in the calibration of colour constancy.