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BACKGROUND: The aim of our study was to compare the Age 65; International normalized ratio; Mental status; Shock (AIMS65) score with the Modifi ed Early Warning Score (MEWS), quick Sepsis Related Organ Failure Assessment (qSOFA) score, Glasgow-Blatchford score (GBS), and the complete Rockall score (CRS) in predicting clinical outcomes in cirrhotic patients with upper gastrointestinal bleeding (UGIB). METHODS: A total of 442 consecutive cirrhotic patients admitted with UGIB during a 17-month period were retrospectively investigated. The primary outcome was in-hospital mortality. The secondary outcomes were rebleeding, intensive care unit (ICU) admission and development of infection. The area under receiver operating characteristic curve (AUC) for each system was analyzed. RESULTS: For prediction of mortality, the AUC of the AIMS65 score was greater than that of other scoring systems without statistical signifi cance. For the prediction of rebleeding, the AIMS65 score was superior to qSOFA (0.65 vs. 0.56, p = 0.020). For the prediction of ICU admission, the AIMS65 score was superior to the GBS and CRS (0.77 vs. 0.63, p = 0.005 and 0.77 vs. 0.63, p = 0.007, respectively). For the prediction of the development of infection, the AIMS65 score was superior to CRS (0.73 vs. 0.60, p = 0.010). CONCLUSIONS: In predicting in-hospital mortality among cirrhotic patients with UGIB, the AIMS65 score showed a trend of better performance than the MEWS, qSOFA score, GBS, and CRS. The AUCs of the AIMS65 score were greater than other four systems in predicting rebleeding, ICU admission and the development of infection.

BACKGROUND: The role of scoring systems in detecting outcomes of non-variceal upper gastrointestinal bleeding in Taiwanese population remains uncertain. AIMS: The aim of our study was to compare Glasgow-Blatchford score with pre-endoscopic Rockall score in their utilities in predicting clinical outcomes in Taiwanese population. METHODS: We designed a prospective study to compare the performance of the Glasgow-Blatchford score and pre-endoscopic Rockall score in predicting endoscopic therapy, rebleeding and 30-day mortality in non-variceal upper gastrointestinal bleeding patients. The area under receiver operating characteristic curve was analyzed. 234 consecutive patients admitted during a 8-month period were enrolled. RESULTS: For prediction of therapeutic endoscopy, area under receiver operating characteristic curve was obtained for Glasgow-Blatchford score (0.629), and pre-endoscopic Rockall score (0.599). For prediction of rebleeding, area under receiver operating characteristic curve was obtained for Glasgow-Blatchford score (0.687), and pre-endoscopic Rockall score (0.581). For prediction of mortality, area under receiver operating characteristic curve was obtained for Glasgow-Blatchford score (0.505), and pre-endoscopic Rockall score (0.734). CONCLUSIONS: In detecting low risk patients requiring endoscopy therapy, the AUC for GBS shows that it is a poor stratification tool, and the AUC for PRS reveals that it is a worthless stratification test. In detecting rebleeding, Glasgow-Blatchford score has a better performance than pre-endoscopic Rockall score. In contrast, pre-endoscopic Rockall score has a better performance in predicting 30-day mortality than Glasgow-Blatchford score.

Ming-Szu Hung,1– 3 Yi-Chuan Chen,2,4 Tsung-Yu Huang,5– 7 Dong-Ru Ho,6,8,9 Chuan-Pin Lee,10 Pau-Chung Chen,11,12 Yao-Hsu Yang10,13,14 1Department of Pulmonary and Critical Care Medicine, Chang Gung Memorial Hospital, Chiayi Branch, Chiayi, Taiwan; 2Department of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan; 3Department of Respiratory Care, Chang Gung University of Science and Technology, Chiayi, Taiwan; 4Department of Emergency Medicine, Chang Gung Memorial Hospital, Chiayi Branch, Chiayi, Taiwan; 5Division of Infectious Diseases, Department of Internal Medicine, Chang Gung Memorial Hospital, Chiayi Branch, Chiayi, Taiwan; 6Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan; 7Shu-Zen Junior College of Medicine and Management, Kaohsiung, Taiwan; 8Division of Urology, Department of Surgery, Chang Gung Memorial Hospital, Chiayi Branch, Chiayi, Taiwan; 9Department of Nursing, Chang Gung University of Science and Technology, Chiayi, Taiwan; 10Health Information and Epidemiology Laboratory, Chang Gung Memorial Hospital, Chiayi, Taiwan; 11Institute of Occupational Medicine and Industrial Hygiene, National Taiwan University College of Public Health, Taipei, Taiwan; 12Department of Environmental and Occupational Medicine, National Taiwan University Hospital and National Taiwan University, College of Medicine, Taipei, Taiwan; 13Department of Traditional Chinese Medicine, Chang Gung Memorial Hospital, Chiayi Branch, Chiayi, Taiwan; 14School of Traditional Chinese Medicine, College of Medicine, Chang Gung University, Taoyuan, TaiwanCorrespondence: Yao-Hsu Yang Email r95841012@ntu.edu.twBackground: Sexual problems are common in male lung cancer survivors. However, the development of erectile dysfunction (ED) in lung cancer patients after surgery has been rarely explored. In this study, we aimed to explore the incidence and risk factors of ED after lung cancer surgery.Methods: From 2000 to 2012, 6025 and 24,100 male patients were included in each matched cohort of lung cancer and non-lung cancer patients, respectively. Poisson regression analysis was used to calculate the incidence rate ratio (IRR) and 95% confidence interval (CI).Results: The incidence of ED was higher in the lung cancer cohort compared to the non-lung cancer cohort (38.47 vs 28.28 per 10,000 person-years) with an adjusted IRR (aIRR) of 1.34 (95% CI: 1.06– 1.70, p=0.014) after the confounders were adjusted for. An increased incidence of ED was observed in the lung cancer cohort aged 40– 54 years (aIRR: 5.44, 95% CI: 2.25– 13.15, p< 0.001), 55– 64 years (aIRR: 3.62, 95% CI: 1.61– 8.17, p=0.002) years, and anxiety (aIRR: 2.99, 95% CI: 1.81– 4.94, p< 0.001). In addition, a higher incidence of emergency room (ER) visits (aIRR: 2.19, 95% CI: 1.98– 2.42, p< 0.001) was observed in lung cancer patients with ED compared to those without ED.Conclusion: Our study results suggested that early surveillance and intervention of ED should be advocated in lung cancer patients after surgery.Keywords: lung cancer, surgery, erectile dysfunction

There has been longstanding interest from both experimental psychologists and cognitive neuroscientists in the potential modulatory role of various top-down factors on multisensory integration/perception in humans. One such top-down influence, often referred to in the literature as the ‘unity assumption’, is thought to occur in those situations in which an observer considers that various of the unisensory stimuli that they have been presented with belong to one and the same object or event (Welch & Warren, 1980). Here, we review the possible factors that may lead to the emergence of the unity assumption. We then critically evaluate the evidence concerning the consequences of the unity assumption from studies of the spatial and temporal ventriloquism effects, from the McGurk effect, and from the Colavita visual dominance paradigm. The research that has been published to date using these tasks provides support for the claim that the unity assumption influences multisensory perception under at least a subset of experimental conditions. We then consider whether the notion has been superseded in recent years by the introduction of priors in Bayesian causal inference models of human multisensory perception. We suggest that the prior of common cause (that is, the prior concerning whether the multisensory signals originated from the same source or not) offers the most useful way to quantify the unity assumption as a continuous cognitive variable.