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Objective The objective of this study is to determine whether vaccination against influenza is associated with a reduced risk of acute kidney injury (AKI) in a nationwide cohort of adults aged ≥65 years. Methods We investigated a total of 13,270 patients aged ≥65 years who were hospitalized for AKI between 2000 and 2013 from Taiwan's National Health Insurance Research Database. Each AKI case was matched with one control subject according to duration of follow-up, age, sex, monthly income, urbanization level, and baseline comorbidities. Odds ratios (ORs) for AKI associated with exposure to the influenza vaccine in the previous year were calculated in a nested case-control analysis. Results Influenza vaccination in the previous year was associated with a lower risk of AKI (adjusted OR 0.67, 95% confidence interval [CI] 0.63–0.72). Compared with a reference group of unvaccinated individuals with no influenza infection, vaccination with no influenza infection was associated with a lower risk of AKI (adjusted OR 0.68, 95% CI 0.64–0.73). Lack of vaccination and presence of influenza infection was associated with a higher risk of AKI (adjusted OR 1.78, 95% CI 1.57–2.01), whereas the risk of AKI was insignificant in vaccinated patients who developed influenza (adjusted OR 1.01, 95% CI 0.69–1.18). Conclusions The risk of AKI was 37% lower among older people who received vaccination against influenza in a real-world setting. Further work is required to clarify causality.

The objective of this study was to evaluate the risks of acute cholecystitis among end-stage renal disease patients and compare the incidence between two dialysis modality.In this retrospective cohort study, records of fifty thousand end-stage renal disease patients older than 20 years of age from 1998 to 2007 and an age, gender, Charlson's score, diabetes, and dyslipidemia matched control cohort were retrieved from Taiwan National Health Insurance Research Database. Hospitalizations for acute cholecystitis were retrieved using ICD-9-CM diagnosis codes and ICD-9-CM operation codes from in-patient claims.The incidence rates were 5.8 per 1000 patient-years in the end-stage renal disease patients and 0.92 per 1000 patient-years in the control group. End-stage renal disease was an independent risk factor for acute cholecystitis. In the end-stage renal disease patients, independent risk factors were old age, higher Charlson's score, diabetes, severe liver disease, atrial fibrillation, and haemodialysis (all p0.05). However, the peritoneal dialysis patients had a higher mortality rate after developing acute cholecystitis.Acute cholecystitis is not uncommon in end-stage renal disease patients. The independent risk factors were older age, higher Charlson's score, atrial fibrillation, severe liver disease, diabetes, and dialysis modality. Haemodialysis patients had a higher risk of acute cholecystitis than PD patients.

To evaluate the association between daily morphine requirement and the intravenous patient-controlled analgesia (IVPCA) setting in patients undergoing spinal surgery.We conducted a retrospective analysis of 179 patients of American Society of Anesthesiologists physical status class I-III who underwent elective posterior lumbar spinal surgery and consented to IVPCA for postoperative pain control. The regi-mental solution contained morphine 1 mg/mL. The IVPCA program was set to deliver a priming dose of 1.5-4 mL, a basal infusion rate of 0-1.2 mL/hr, and a 0.5-1.5 mL bolus on demand with a 5-minute lockout interval. Demographic data, surgical procedures, analgesia program setting variables, 4-hour cumulative morphine dose and 11-point numeric rating scale for pain on postoperative days 1 and 2 were collected for comparison.The IVPCA requirement decreased gradually over time (p0.001). The number of vertebrae involved significantly influenced the daily morphine requirements (p = 0.01). None of the IVPCA settings, including continuous infusion, affected daily morphine requirements. On average, the analgesic requirement on postoperative day 2 was 18% less than that on postoperative day 1.The number of vertebrae involved was significantly associated with the daily IVPCA requirement. The IVPCA settings, including priming dose, basal infusion rate and bolus dose, did not affect the daily morphine requirements.

This study examines the effect of relationship activities and information technology adoption on the effectiveness of interorganizational change, and the moderating effect of partner characteristics and information sharing. The model was empirically tested using a survey instrument given to 131 manufacturers. The results show that relationship activities and information technology adoption are related positively to the effectiveness of interorganizational change. Further, partner characteristics and information sharing have a significant moderating effect. The authors also discuss the theoretical and practical implications of their findings.

Fluorescence of 2-aminopurine (2AP) substituted A site and acrylamide quenching were used to study the interactions of paromomycin and neamine with the decoding region of 16S rRNA. The results reveal that paromomycin binding to the A-site RNA leads to increased exposure of residue A1492. In contrast, neamine has little effect on the solvent accessibility of A1492. Electrospray ionization mass spectrometry was used to compare the affinity of paromomycin with the A-site and 2-AP-substituted A-site RNAs.