ABSTRACT
BACKGROUND: Surgical resection (SR) is the main treatment for small bowel adenocarcinoma (SBA), but it increases metabolic demand, systemic inflammation, and digestive dysfunction, resulting in major impacts on the postoperative outcomes of patients. This study, we aimed to investigate the role of the postoperative prognostic nutritional index (PNI), a surrogate marker of inflammation and nutrition, in patients with SBA after resection. METHODS: From June 2014 to March 2022, 44 consecutive patients who underwent SR for SBA in Taipei Veterans General Hospital were retrospectively reviewed. Factors associated with survival including PNI were analyzed. RESULTS: PNI decreased in patients after SR for SBA (median change: -1.82), particularly in those who underwent Whipple operation or developed postoperative pancreatic fistula. Postoperative PNI < 45.2 best predicted overall survival (OS) (AUROC: 0.826, p = 0.001). Patients with lower postoperative PNI had significantly worse OS compared to those higher postoperative values (median OS: 19.3 months vs. not reached, p < 0.001). Low postoperative PNI (hazard ratio [HR]: 11.404, p = 0.002), tumoral lymphovascular invasion (HR: 8.023, p = 0.012), and adjuvant chemotherapy (HR: 0.055, p = 0.002) were independent risk factors for OS. Postoperative PNI also significantly predicted recurrence-free survival independent of lymphovascular invasion and adjuvant chemotherapy (HR: 6.705, p = 0.001). CONCLUSION: PNI commonly decreases in patients with SBA who undergo Whipple surgery or develop postoperative pancreatic fistula. Postoperative PNI independently predicts survival and may serve as a clinical marker to optimize patient outcomes.
ABSTRACT
How compound words are processed remains a central question in research on Chinese reading. The Chinese reading model assumes that all possible words sharing characters are activated during word processing and these activated words compete for a winner (Li & Pollatsek, 2020). The present studies aimed to examine whether embedded component words compete with whole compound words in Chinese reading. In Study 1, we analyzed two existing lexical decision databases and revealed inhibitory effects of component-word frequency and facilitative effects of character frequency on the first components. In Study 2, we conducted two factorial experiments to further examine the effects of first component-word frequency, with character frequencies controlled. The results consistently indicated significant inhibitory effects of component-word frequency. Collectively, these findings support the theoretical proposition that both component words and compound words are activated and engage in competition during word processing. This provides a new approach to compound word processing in Chinese reading and a possible solution to mixed results of character frequency effects reported in the literature. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
Subject(s)
Pattern Recognition, Visual , Word Processing , Humans , China , ReadingABSTRACT
BACKGROUND: CDK4/6 inhibitors (CDK4/6i) have shown great efficacy in prolonging progression-free survival and is the current standard of care for hormone positive (HR(+)) metastatic breast cancer (mBC). Despite well tolerability and ease of use, the most common side effect of CDK4/6i is myelosuppression, with neutropenia the most prevalent adverse effect. Studies show that the prevalence and severity of neutropenia are more marked in Asian patients, although details remain obscure. METHODS: In this study, we retrospectively analyzed 105 Taiwanese patients who received palbociclib for HR(+) HER2(-) mBC at the Taipei Veterans General Hospital. To investigate a possible genetic association for high prevalence of neutropenia, we queried the Taiwan Biobank with publicly available germline databases (ALFA, gnomAD, ExAC, 1000 Genomes project, HapMap), for the allele frequencies of 4 neutropenia-related SNPs (ABCB1_rs1045642, ABCB1_rs1128503, ERCC1_rs3212986, ERCC1_rs11615) and compared between different ethnicities. In addition, one of the patients was a long-term patient with peritoneal dialysis. We quantified the levels of palbociclib in her serum and peritoneal fluid by liquid chromatography-mass spectrometry (LC-MS). RESULTS: Interestingly, in our cohort, early neutropenia nadir (occurred within 56 days of start) was associated with worse treatment outcome, while occurrence of grade 3/4 neutropenia was associated with better outcome. We observed an extremely high incidence of neutropenia (96.2% any grade, 70.4% grade 3/4). In the analyzed germline databases, we discovered a higher SNP frequency of the T allele in ABCB1_rs1128503, a lower frequency of T allele in ABCB1_rs1045642, and a higher SNP frequency of G allele in ERCC1_rs11615. We observed that palbociclib levels in peritoneal dialysate ranged from around 20-50 ppb, and serum levels reached 100-110 ppb during drug administration and decreased to <10 ppb during discontinuation. CONCLUSION: Our retrospective analysis of real world palbociclib use reveals an association with grade 3/4 neutropenia with better outcome and early neutropenia nadir with worse outcome. Our findings of Asian specific SNPs support a predisposition toward profound and prevalent neutropenia in Asian patients under CDK4/6i. We also report the first pharmacokinetics analysis on a patient with peritoneal dialysis receiving CDK4/6i. In summary, our study provides novel clinical and genotypic insights into CDK4/6i associated neutropenia.
Subject(s)
Breast Neoplasms , Neutropenia , Piperazines , Pyridines , Female , Humans , Retrospective Studies , Prevalence , Receptor, ErbB-2/genetics , Breast Neoplasms/drug therapy , Breast Neoplasms/genetics , Breast Neoplasms/pathology , Neutropenia/chemically induced , Neutropenia/epidemiology , Neutropenia/genetics , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Cyclin-Dependent Kinase 4ABSTRACT
Readers sometimes fail to notice word transposition errors, reporting a sentence with two transposed words to be grammatical (the transposed-word effect). It has been suggested that this effect implicates parallel word processing during sentence reading. The current study directly assessed the role of parallel word processing in failure to notice word transposition errors, by comparing error detection under normal sentence presentation conditions and when words are presented serially at 250 ms/word. Extending recent results obtained with serial presentation of Chinese sentences (Liu, Li, Cutter, Paterson, & Wang, Cognition 218: 104922, 2022), in Experiment 1 we found a transposed-word effect with serial presentation of English sentences. In Experiment 2, we replicated this finding with task instructions that allowed responding at any time during the presentation of the sentence; this result indicates that the transposed-word effect that appears with serial word presentation is not due to a late process of reconstruction of short-term memory. Thus, parallel word processing is not necessary for a transposed-word effect in English. Like Liu et al. (2022), we did find that the transposed-word effect was statistically larger with parallel presentation than with serial presentation; we consider several explanations as to why this is so.
Subject(s)
Language , Word Processing , Humans , Cognition , Memory, Short-Term , ReadingABSTRACT
Previous research (Mirault, Snell, & Grainger, 2018) has demonstrated that subjects sometimes incorrectly judge an ungrammatical sentence as grammatical when it is created by the transposition of two words in a grammatical sentence (e.g., The white was cat big). Here we present two eye-tracking experiments designed to assess the prevalence of this phenomenon in a more natural reading task, and to explore theoretical explanations. Readers failed to notice transpositions at about the same rate as in Mirault et al. (2018). Failure to notice the transposition was more common when both words were short, and when readers' eyes skipped, rather than directly fixated, one of the two words. The status of the transposed words as open- or closed-class did not have a reliable effect. The transposed words caused disruption in the eye movement record only on trials when participants ultimately judged the sentence to be ungrammatical, not when they judged the sentence to be grammatical. We argue that the results are not entirely consistent with the account offered by Mirault et al. (2018), which attributes failure to notice transpositions to parallel processing of adjacent words, or with a late, post-perceptual rational inference account (Gibson, Bergen, & Piantadosi, 2013). We propose that word recognition is serial, but post-lexical integration of each word into its context may not be perfectly incremental.
Subject(s)
Eye-Tracking Technology , Reading , Eye Movements , Humans , LanguageABSTRACT
BACKGROUND: Peripheral neuropathy (PN) is a common symptom in colorectal cancer (CRC) survivors and patients with diabetes. However, the differences in PN symptoms between CRC survivors and patients with diabetes are not clear. OBJECTIVES: The purpose of this study was to examine the differences in PN between CRC survivors and patients with diabetes. METHODS: Secondary data were analyzed from two cross-sectional studies consisting of 81 CRC survivors and 86 patients with diabetes from two hospitals in northern and central Taiwan. Data were analyzed using descriptive statistics, analysis of covariance, and multiple logistic regression. FINDINGS: Significant differences in severity and prevalence of PN and neuropathic pain between CRC survivors and patients with diabetes were found. Patients with diabetes had significantly more severe PN and sensory PN compared to CRC survivors. In addition, the prevalence of PN and neuropathic pain was significantly higher in CRC survivors compared to patients with diabetes after control of covariates.
Subject(s)
Colorectal Neoplasms , Diabetes Mellitus , Peripheral Nervous System Diseases , Colorectal Neoplasms/complications , Colorectal Neoplasms/epidemiology , Cross-Sectional Studies , Humans , Peripheral Nervous System Diseases/epidemiology , SurvivorsABSTRACT
PURPOSE: The incidence of deep cervical space infections has decreased after the introduction of antibiotics and improvement of oral hygiene, but they still may be lethal especially when life-threatening complications occur. In this article, we try to find out whether there are predisposing factors related to complicated deep cervical space infections and prolonged hospitalization. MATERIALS AND METHODS: We conducted a retrospective analysis of medical records of 196 patients with deep neck infections during the period from March 1996 to February 2002. Among the 196 patients, 15 patients developed lethal complications. As for data analysis, multiple regression and logistic regression with dummy variable were used. RESULTS: In multiple regressions, patients with older age or with neck swelling, trismus, underlying diseases, complications, and C-reactive protein more than 100 microg/mL stayed longer in the hospital, and the P value reached statistical significance (P <.05). In logistic regression, male patients and patients with neck pain had negative correlation, and the P value reached statistical significance (P <.05). Patients with neck swelling and patients with respiratory difficulty had positive correlation, and the P value reached statistical significance (P <.05). That means female patients, patients with neck swelling, and patients with respiratory difficulty were more likely to have complicated deep neck infections. CONCLUSION: Complicated deep neck infections remain potentially fatal, but the morbidity and mortality can be reduced. Doctors should pay more attention to those high-risk patients; they are female patients, patients with neck swelling, and patients with respiratory difficulty.
Subject(s)
Peritonsillar Abscess/microbiology , Peritonsillar Abscess/therapy , Retropharyngeal Abscess/microbiology , Retropharyngeal Abscess/therapy , Adolescent , Adult , Aged , Aged, 80 and over , Anti-Bacterial Agents , Child , Child, Preschool , Combined Modality Therapy , Critical Illness , Drainage/methods , Drug Therapy, Combination/administration & dosage , Female , Humans , Logistic Models , Male , Middle Aged , Neck , Peritonsillar Abscess/mortality , Probability , Prognosis , Regression Analysis , Retropharyngeal Abscess/mortality , Retrospective Studies , Risk Assessment , Severity of Illness Index , Soft Tissue Infections/microbiology , Soft Tissue Infections/mortality , Soft Tissue Infections/therapy , Survival Analysis , Treatment OutcomeABSTRACT
Natural killer (NK)/T-cell lymphoma is the most common malignant lymphoma among sinonasal lymphomas. Diagnosis is difficult and prognosis is poor. Herein, we report the case of a 22-year-old male patient with sinonasal NK/T-cell lymphoma who first presented with nasal obstruction and left facial swelling. There was a mushroom-like mass over the hard palate, diffuse mucosal swelling in the left nasal cavity, and left orbital cellulitis. The patient underwent a Caldwell-Luc operation, functional endoscopic sinus surgery, and wide excision of the palate tumor. Pathologic examination of the maxillary sinus, nasal cavity, and palate tumor showed an NK/T-cell lymphoma. Two days after the operation, the patient suddenly had bloody stool and suffered hematemesis. A series of examinations revealed a small intestinal hemorrhage. Emergent exploratory laparotomy showed an ulcerative tumor mass with bleeding over the jejunum. Pathologic examination of the mass showed that it was the same as the sinonasal mass, an NK/T-cell lymphoma. We reviewed previous studies on nasal NK/T-cell lymphoma and found no report discussing patients with NK/T-cell lymphoma of both nasal and non-nasal origins. From this case, we learned that in patients with sinonasal NK/T-cell lymphoma, other sites may be involved.
Subject(s)
Jejunal Neoplasms/pathology , Killer Cells, Natural/pathology , Lymphoma, T-Cell/pathology , Nose Neoplasms/pathology , Adult , Humans , MaleABSTRACT
Deep neck infection may be lethal, especially when life-threatening complications occur. We conducted a retrospective analysis of 184 patients with deep neck infection who were treated at Kaohsiung Medical University Hospital during the past 6 years. Factors such as age, sex, hospitalization days, clinical presentations, involved spaces, imaging studies, microbiology, and treatment method were analyzed. There were 122 men and 62 women with a mean age of 41.7 years. The average hospitalization was 8.4 days. The involved spaces, determined by physical examination and radiologic findings, were the peritonsillar space (59 patients), parapharyngeal space (77 patients), submandibular space (55 patients), and retropharyngeal space (20 patients). Of the 49 patients for whom the origin of infection was identified, 29 were infected via the upper respiratory tract and 13 had infection of odontogenic origin. The most common isolated organism was Klebsiella pneumoniae. One hundred and thirty-seven patients (74.5%) underwent surgery, including repeated needle aspiration (87 patients) and surgical drainage (50 patients). The remaining 47 patients recovered uneventfully with antibiotic therapy alone. Eighteen patients developed life-threatening complications, such as descending mediastinitis, sepsis, airway obstruction, and jugular vein thrombosis. Two patients died of septic shock. The combination of accurate diagnosis, effective antibiotic therapy, airway maintenance, and intensive surgical debridement for those who fail to respond to conservative treatment will lead to a good prognosis.