1,815 research outputs found

    Cyclophosphamide-induced intractable hemorrhagic cystitis treated with hyperbaric oxygenation and intravesical sodium hyaluronate

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    AbstractCyclophosphamide is a well-known cause of hemorrhagic cystitis. However, the best treatment for hemorrhagic cystitis is still unknown. Herein, we present a patient with cyclophosphamide-induced hemorrhagic cystitis. The patient had a history of myasthenia gravis and had received cyclophosphamide therapy for 14 years. He was admitted due to gross hematuria, which was initially treated by cystoscopic fulguration, followed by continuous bladder irrigation. Due to refractory hemorrhaging, fulguration was repeated and percutaneous suprapubic cystostomy was performed. The bladder hemorrhage eventually subsided after hyperbaric oxygen therapy and intravesical sodium hyaluronate instillation. The combination of hyperbaric oxygen therapy and intravesical sodium hyaluronate instillation may be useful in severe hemorrhagic cystitis caused by cyclophosphamide

    Spatial patterns of largeā€scale land transactions and their potential socioā€environmental outcomes in Cambodia, Ethiopia, Liberia, and Peru

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    Recent largeā€scale land transactions, often framed as ā€™land grabbing,ā€™ are historically unprecedented. Millions of hectares of land have changed hands for agricultureā€driven development over the past decade, and their implementation generates substantial risk of land degradation. This paper investigates land transaction patterns and evaluate their potential socioā€environmental impacts in Cambodia, Ethiopia, Liberia, and Peru. We undertake a novel spatially explicit approach to quantify land transactions and conduct scenarioā€based analyses to explore their implementation consequences on people, land, and carbon emission. Our results demonstrate that existing global datasets on land transactions substantially underestimate their incidence but can either exaggerate or underreport transacted areas. Although confirming that land transactions are more likely to occur in sparsely populated, poorer, and more forested areas, our scenarioā€based analyses reveal that if fully implemented for agricultural development, land transactions in the four countries will affect more than one million people, yield over 2 Gt of carbon emissions, and disrupt vast swathes of forests. Our findings refute the ā€™empty landā€™ discourse in government policy and highlight the consequences of land degradation that can occur at an unexpected scale in the ā€™global land rush.ā€™ Future policymaking needs to anticipate the risk of land degradation in terms of deforestation and carbon emission while pursuing agricultureā€driven development through land transactions.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/155946/1/ldr3544.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/155946/2/ldr3544_am.pd

    Racial and Ethnic Differences in Diabetes Care and Health Care Use and Costs

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    INTRODUCTION: Previous studies have shown racial and ethnic differences in diabetes complication rates and diabetes control. The objective of this study was to examine racial and ethnic differences in diabetes care and health care use and costs for adults with diabetes using a nationally representative sample of the U.S. noninstitutionalized civilian population. METHODS: We performed a cross-sectional analysis of the 2000 Medical Expenditure Panel Survey (MEPS) and its related Diabetes Care Survey. The respondents were adults (aged 18 years and older) with diabetes, including non-Hispanic whites, non-Hispanic African Americans, and Hispanics. Racial and ethnic differences were examined in diabetes process of care and health care use and costs using logistic regression, negative binomial regression, and ordinary least squares regression with log cost. RESULTS: Most of the outcomes in diabetes care management, treatment, and complications were not significantly different among race groups. After adjusting for socioeconomic and demographic characteristics, Hispanics were more likely to have eye problems than whites (odds ratio, 1.56; 95% confidence interval, 1.03ā€“2.56). African Americans and Hispanics had lower total health care costs, lower ambulatory care costs, and lower prescription drug costs than whites (P < .01 for all). CONCLUSION: We found differences in ambulatory care and prescription drug fills among white, African American, and Hispanic adults with diabetes. However, most of the diabetes care measures were not significantly different among the three racial and ethnic groups. Understanding the reason outcomes do not differ when health care use and costs differ significantly should be a focus of future studies

    Exploring the Influence of Ethical Norms on Organizaional Knowledge Management: An Ethical Climate Perspective

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    Since 1990, knowledge management has been developed and adopted as an essential strategy to foster the creation as well as utilization of organizational intellectual resources. Organizational intellectual capital is derived both individually and collectively from the process to create, store, share, acquire and apply the personal and organizational knowledge. Numerous studies have proposed that organizational culture is essential to support organizational knowledge management activities and effectiveness. However, many organizations put much emphasis on the individualsā€™ knowledge contribution and subsequent performance, neglecting the importance of brainstorming or contribution of knowledge sharing with others. In addition, some organizations only focus on the development of public goods, despite the concerns of individualsā€™ self-interest or possible risk. The only single aspect of individual or collective approach toward knowledge management will inevitably lead to the ethical conflicts in the organization. The purpose of this study intends to examine the ethical norms within an organization and its possible influence on the membersā€™ evaluation, satisfaction, engagement, and job performance about the organizational knowledge management process. The research constructs are identified and measuring items will be developed on the basis of literature review. The method to carry out this study will utilize survey methodology. Meanwhile, statistical analysis will also be conducted to test our hypothesized relationships between constructs

    The Solution Distribution of Influence Maximization: A High-level Experimental Study on Three Algorithmic Approaches

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    Influence maximization is among the most fundamental algorithmic problems in social influence analysis. Over the last decade, a great effort has been devoted to developing efficient algorithms for influence maximization, so that identifying the ``best'' algorithm has become a demanding task. In SIGMOD'17, Arora, Galhotra, and Ranu reported benchmark results on eleven existing algorithms and demonstrated that there is no single state-of-the-art offering the best trade-off between computational efficiency and solution quality. In this paper, we report a high-level experimental study on three well-established algorithmic approaches for influence maximization, referred to as Oneshot, Snapshot, and Reverse Influence Sampling (RIS). Different from Arora et al., our experimental methodology is so designed that we examine the distribution of random solutions, characterize the relation between the sample number and the actual solution quality, and avoid implementation dependencies. Our main findings are as follows: 1. For a sufficiently large sample number, we obtain a unique solution regardless of algorithms. 2. The average solution quality of Oneshot, Snapshot, and RIS improves at the same rate up to scaling of sample number. 3. Oneshot requires more samples than Snapshot, and Snapshot requires fewer but larger samples than RIS. We discuss the time efficiency when conditioning Oneshot, Snapshot, and RIS to be of identical accuracy. Our conclusion is that Oneshot is suitable only if the size of available memory is limited, and RIS is more efficient than Snapshot for large networks; Snapshot is preferable for small, low-probability networks.Comment: To appear in SIGMOD 202

    Structural insights into the gating of DNA passage by the topoisomerase II DNA-gate.

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    Type IIA topoisomerases (Top2s) manipulate the handedness of DNA crossovers by introducing a transient and protein-linked double-strand break in one DNA duplex, termed the DNA-gate, whose opening allows another DNA segment to be transported through to change the DNA topology. Despite the central importance of this gate-opening event to Top2 function, the DNA-gate in all reported structures of Top2-DNA complexes is in the closed state. Here we present the crystal structure of a human Top2 DNA-gate in an open conformation, which not only reveals structural characteristics of its DNA-conducting path, but also uncovers unexpected yet functionally significant conformational changes associated with gate-opening. This structure further implicates Top2's preference for a left-handed DNA braid and allows the construction of a model representing the initial entry of another DNA duplex into the DNA-gate. Steered molecular dynamics calculations suggests the Top2-catalyzed DNA passage may be achieved by a rocker-switch-type movement of the DNA-gate
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