Effectiveness of influenza vaccination in patients with end-stage renal disease receiving hemodialysis: a population-based study.

BackgroundLittle is known on the effectiveness of influenza vaccine in ESRD patients. This study compared the incidence of hospitalization, morbidity, and mortality in end-stage renal disease (ESRD) patients undergoing hemodialysis (HD) between cohorts with and without influenza vaccination.MethodsWe used the insurance claims data from 1998 to 2009 in Taiwan to determine the incidence of these events within one year after influenza vaccination in the vaccine (N = 831) and the non-vaccine (N = 3187) cohorts. The vaccine cohort to the non-vaccine cohort incidence rate ratio and hazard ratio (HR) of morbidities and mortality were measured.ResultsThe age-specific analysis showed that the elderly in the vaccine cohort had lower hospitalization rate (100.8 vs. 133.9 per 100 person-years), contributing to an overall HR of 0.81 (95% confidence interval (CI) 0.72-0.90). The vaccine cohort also had an adjusted HR of 0.85 [95% CI 0.75-0.96] for heart disease. The corresponding incidence of pneumonia and influenza was 22.4 versus 17.2 per 100 person-years, but with an adjusted HR of 0.80 (95% CI 0.64-1.02). The vaccine cohort had lowered risks than the non-vaccine cohort for intensive care unit (ICU) admission (adjusted HR 0.20, 95% CI 0.12-0.33) and mortality (adjusted HR 0.50, 95% CI 0.41-0.60). The time-dependent Cox model revealed an overall adjusted HR for mortality of 0.30 (95% CI 0.26-0.35) after counting vaccination for multi-years.ConclusionsESRD patients with HD receiving the influenza vaccination could have reduced risks of pneumonia/influenza and other morbidities, ICU stay, hospitalization and death, particularly for the elderly

A Study of Learning Pressure, Learning Attitudes, and Achievement among Macau Undergraduates

The purpose of this study was to examine the relationships among learning pressure, learning attitudes, and academic achievement of university students; specifically, Chinese undergraduates from three universities in Macau. Convenience sampling was used in the current study, and a total of 135 questionnaires were retrieved. We found a significant, moderate, and positive correlation between learning pressure and learning attitudes. We also found a negative correlation between learning pressure and academic achievement. The last correlation we found, between learning attitude and academic achievement, was positive and significant. When we regressed learning pressure and learning attitudes on academic achievement, the results showed that both variables were effective predictors of achievement

Serum leptin is associated with cardiometabolic risk and predicts metabolic syndrome in Taiwanese adults

<p>Abstract</p> <p>Background</p> <p>Leptin is associated with cardiovascular disease (CVD); however, few studies have assessed its relationship with metabolic syndrome, especially in an Asian population. Therefore, the aim of the present study was to assess leptin levels and evaluate its association with CVD and metabolic syndrome.</p> <p>Methods</p> <p>In 2009, 957 subjects, who underwent a routine physical examination and choose leptin examination, were selected to participate. Participants (269 females and 688 males) were stratified according to leptin level quartiles. Metabolic syndrome was defined by NCEP ATP III using waist circumference cutoffs modified for Asian populations, and CVD risk was determined using the Framingham Heart Study profile.</p> <p>Results</p> <p>Leptin levels were correlated with CVD risk in men and women. With the exception of fasting plasma glucose, increased leptin levels were observed as factors associated with metabolic syndrome increased in both males and females. After adjusting for age, an association between leptin levels and metabolic syndrome was observed. After adjusting for age alone or with tobacco use, subjects in the highest leptin quartile had a higher risk of having metabolic syndrome than those in the lowest quartile (OR = 6.14 and 2.94 for men and women, respectively). After further adjustment for BMI, metabolic syndrome risk remained significantly increased with increasing leptin quartiles in men. Finally, increased leptin levels were a predictor of metabolic syndrome in men and women.</p> <p>Conclusions</p> <p>Serum leptin levels are correlated with CVD risk and metabolic syndrome. Analysis of leptin as part of routine physical examinations may prove beneficial for early diagnosis of metabolic syndrome.</p

Relationship Quality, Relationship Value, Purchasing Intention: An Empirical Study in the Retail Industry in the USA, Japan and Taiwan

[[abstract]]Due to the increasing globalization of the marketplace, understanding consumer culture has become a most critical issue. The purpose of this study is to review the past literature and propose a model of “quality-value-purchasing intention.” This study examines this model by focusing on 7-Eleven convenience stores in Japan, Taiwan and the USA. A total of 156 college students from Waseda University in Japan, Cheng Kung University in Taiwan and the University of California, Los Angeles (UCLA) in the USA were recruited as participants. The results indicate that the USA’s consumers relate quality and relational value as well as retail trade purchasing intention with forward influence relations. Moreover, relational value takes on an intermediary role in Japan, but not in Taiwan

A Giant Protocluster of Galaxies at Redshift 5.7

Galaxy clusters trace the largest structures of the Universe and provide ideal laboratories for studying galaxy evolution and cosmology. Clusters with extended X-ray emission have been discovered at redshifts up to z ~ 2.5. Meanwhile, there has been growing interest in hunting for protoclusters, the progenitors of clusters, at higher redshifts. It is, however, very challenging to find the largest protoclusters at early times when they start to assemble. Here we report a giant protocluster of galaxies at redshift z = 5.7, when the Universe was only one billion years old. This protocluster occupies a volume of about 35x35x35 cubic co-moving megaparsecs. It is embedded in an even larger overdense region with at least 41 spectroscopically confirmed, luminous Lyman-alpha emitting galaxies (Lyman-alpha Emitters, or LAEs), including several previously reported LAEs. Its LAE density is 6.6 times the average density at z ~ 5.7. It is the only one of its kind in an LAE survey in four square degrees on the sky. Such a large structure is also rarely seen in current cosmological simulations. This protocluster will collapse into a galaxy cluster with a mass of (3.6+/-0.9) x 10^{15} solar masses, comparable to those of the most massive clusters or protoclusters known to date.Comment: Published in Nature Astronomy on Oct 15, 2018 (DOI: 10.1038/s41550-018-0587-9

Early utilization of hypertonic peritoneal dialysate and subsequent risks of non-traumatic amputation among peritoneal dialysis patients: a nationwide retrospective longitudinal study

BACKGROUND: The hemodialysis (HD) population has a particularly high incidence of amputation, which is likely associated with decreased tissue oxygenation during HD. However, information about the risk factors leading to amputation in peritoneal dialysis (PD) patients is limited. Here, we have investigated the association between the use of hypertonic peritoneal dialysate (HPD) and subsequent amputation in PD patients. METHODS: Based on the data from the Taiwan National Health Insurance research database, this observational cohort study enrolled 203 PD patients who had received HPD early during treatment and had not undergone amputation and 296 PD controls who had not undergone amputation. Subjects were followed through until the end of 2009 and the event rates of new non-traumatic amputation were compared between groups. RESULTS: The incidence of amputation was 3 times higher for the HPD cohort than for the comparison cohort (23.68 vs. 8.01 per 1000 person-years). The hazard ratio (HR) for this group, estimated using a multivariable Cox model, was 2.48 (95% confidence interval [CI] = 1.06–5.79). The HR for patients with both diabetes and early adoption of HPD increased to 44.34 (95% CI = 5.51-357.03), compared to non-HPD non-diabetic PD controls. CONCLUSION: Early utilization of HPD in PD patients is associated with increasing risk of amputation; this risk considerably increases for those with concomitant diabetes

2010-2011 Masterworks of Chamber Music

This project has been made possible by the National Endowment for the Arts as part of American Masterpieces: Three Centuries of Artistic Genius.https://spiral.lynn.edu/conservatory_otherseasonalconcerts/1026/thumbnail.jp

Incidence Rate and Predictors of Globus Pallidus Necrosis after Charcoal Burning Suicide

Objective: This study examined predictors of globus pallidus necrosis as there was a paucity of literature of globus pallidus necrosis resulted from carbon monoxide poisoning after charcoal burning suicide. Methods: A total of 67 patients who had attempted charcoal burning suicide were recruited and stratified into two subgroups based on either presence (n = 40) or absence (n = 27) of globus pallidus necrosis. Demographic, clinical, laboratory, and radiographic data were obtained for cross-sectional analysis. All patients were followed to investigate the risks for mortality. Results: The patients aged 36.8 ± 11.1 years (67.2%) were male. Patients with globus pallidus necrosis were younger (p = 0.044) and had less hypertension (p = 0.015) than patients without globus pallidus necrosis. Furthermore, patients with globus pallidus necrosis suffered from severer medical complications, i.e., fever (p = 0.008), acute myocardial injury (p = 0.022), acute rhabdomyolysis (p = 0.022), and neuropsychiatric symptoms (p < 0.001) than patients without globus pallidus necrosis. Moreover, patients with globus pallidus necrosis received less hyperbaric oxygen therapy than without necrosis (p = 0.024). Two patients (3.0%) died on arrival. In a multivariable regression model, it was revealed that acute myocardial injury (odds ratio 4.6, confidence interval 1.1-18.9, p = 0.034) and neuropsychiatric symptoms (odds ratio 8.0, confidence interval 2.0-31.4, p = 0.003), decreased blood bicarbonate level (odds ratio 0.8, confidence interval 0.7-1.0, p = 0.032), and younger age (odds ratio 0.9, confidence interval 0.9-1.0, p = 0.038) were significant predictors for globus pallidus necrosis. Conclusion: Although patients who had attempted charcoal burning suicide had a low mortality rate (3.0%), globus pallidus necrosis was not uncommon (59.7%) in this population. Further studies are warranted.Chang Gung Memorial Hospital, Linkou, TaiwanChang Gung Memorial Hospital [CLRPG3D0016, CORPG5G0051]Open access journalThis item from the UA Faculty Publications collection is made available by the University of Arizona with support from the University of Arizona Libraries. If you have questions, please contact us at [email protected]

Nel positively regulates the genesis of retinal ganglion cells by promoting their differentiation and survival during development

Peer reviewedPublisher PD

Advanced age affects the outcome-predictive power of RIFLE classification in geriatric patients with acute kidney injury

The RIFLE (risk, injury, failure, loss, and end-stage) classification is widely used to gauge the severity of acute kidney injury, but its efficacy has not been formally tested in geriatric patients. To correct this we conducted a prospective observational study in a multicenter cohort of 3931 elderly patients (65 years of age or older) who developed acute kidney injury in accordance with the RIFLE creatinine criteria after major surgery. We studied the predictive power of the RIFLE classification for in-hospital mortality and investigated the potential interaction between age and RIFLE classification. In general, the survivors were significantly younger than the nonsurvivors and more likely to have hypertension. In patients 76 years of age and younger, RIFLE-R, -I, or -F classifications were significantly associated with increased hospital mortality in a stepwise manner. There was no significant difference, however, in hospital mortality in those over 76 years of age between patients with RIFLE-R and RIFLE-I, although RIFLE-F patients had significantly higher mortality than both groups. Thus, the less severe categorizations of acute kidney injury per RIFLE classification may not truly reflect the adverse impact on elderly patients