Search

To compare the risk of hospitalisation and associated costs in patients after treatment for prostate cancer.We identified 29 571 patients aged 66-75 years without significant comorbidity from the Surveillance, Epidemiology, and End Results (SEER)-Medicare linked database who were diagnosed with localised prostate cancer between 2004 and 2009. We compared the rates of all-cause and treatment-related hospitalisation that occurred within 365 days of the initiation of definitive therapy. We used multivariable logistic regression analysis to identify determinants associated with hospitalisation.Men who underwent radical prostatectomy (RP) rather than radiotherapy (RT) had lower odds of being hospitalised for any cause after therapy [odds ratio (OR) 0.80, 95% confidence interval (CI): 0.74-0.87]. Patients who underwent RP rather than RT had higher odds of being hospitalised for treatment-related complications (OR 1.15, 95% CI: 1.03-1.29). However, men who underwent external beam RT (EBRT)/intensity modulated RT (IMRT) (OR 0.84, 95% CI: 0.72-0.99) had a 16% lower odds of hospitalisation from treatment-related complications than patients undergoing RP. Using propensity score-weighted analyses there was no significant difference in the odds of hospitalisation from treatment-related complications for men who underwent RP vs RT (OR 1.06, 95% CI: 0.92-1.21). Patients hospitalised for treatment-related complications after RT were costlier than patients who underwent RP (Mean $18 381 vs $13 203, P0.001).With the exception of men who underwent EBRT/IMRT, there was no statistically significant difference in the odds of hospitalisation from treatment-related complications. Costs from hospitalisation after treatment were significantly higher for men undergoing RT than RP. Our findings are relevant in the context of penalties linked to hospital readmissions and bundled payment models.

Refined products pipeline system is one of the most economic and effective transportation modes. Many scholars have conducted some research on the oil batch scheduling optimization of refined products pipeline. However, solving the model of a large refined products pipeline scheduling problem usually costs a long time. It also does not involve in automatic scheduling plan developing. In this paper, considering the batch tracking, flow rate constraints, hydraulic constraints and taking the minimum volume deviation between demand volume of each station and the actual unloading volume as the objective function, a mixed integer nonlinear programming (MINLP) model has been established for a large single-source refined products pipeline with multiple output stations. A heuristic algorithm is used to solve this model. The real-world pipeline from Mao Ming to Da Li, part of the Southwest China pipeline network, is taken as the study case. A long term scheduling model for this pipeline is established and solved in this paper. A complete detailed scheduling plan in the whole time horizon is given automatically. The average computing time of the model is 31.70s and the results are in accordance with the process and situation in field. The research achievement is significant and helpful to develop scheduling plan for a large single-source pipeline with multiple output stations.

In this paper, we present a shadow generation method based on our previous tricolor linear attention shadow model. Compared with shadow generation methods in Graphics or based on matting and compositing shadow generation, our method does not need complex calculations or any matting operation, but only to calculate the pixel values of generated shadow on the basis of original image pixel information and tricolor values linear attenuation of shadow. This physically-based shadow generation method enhances the visual effects of shadow generation. A series of experimental results validate this method.

Pancreatic islet beta-cell dysfunction is a signature feature of Type 2 diabetes pathogenesis. Consequently, knowledge of signals that regulate beta-cell function is of immense clinical relevance. Transforming growth factor (TGF)-beta signaling plays a critical role in pancreatic development although the role of this pathway in the adult pancreas is obscure. Here, we define an important role of the TGF-beta pathway in regulation of insulin gene transcription and beta-cell function. We identify insulin as a TGF-beta target gene and show that the TGF-beta signaling effector Smad3 occupies the insulin gene promoter and represses insulin gene transcription. In contrast, Smad3 small interfering RNAs relieve insulin transcriptional repression and enhance insulin levels. Transduction of adenoviral Smad3 into primary human and non-human primate islets suppresses insulin content, whereas, dominant-negative Smad3 enhances insulin levels. Consistent with this, Smad3-deficient mice exhibit moderate hyperinsulinemia and mild hypoglycemia. Moreover, Smad3 deficiency results in improved glucose tolerance and enhanced glucose-stimulated insulin secretion in vivo. In ex vivo perifusion assays, Smad3-deficient islets exhibit improved glucose-stimulated insulin release. Interestingly, Smad3-deficient islets harbor an activated insulin-receptor signaling pathway and TGF-beta signaling regulates expression of genes involved in beta-cell function. Together, these studies emphasize TGF-beta/Smad3 signaling as an important regulator of insulin gene transcription and beta-cell function and suggest that components of the TGF-beta signaling pathway may be dysregulated in diabetes.

A novel n-channel flash memory cell, which uses source induced band-to-band hot electron injection (SIBE) to perform programming, is proposed in this paper. With the proposed programming method, the drain voltage and the control gate voltage can be reduced to as low as -3.6 V and 10 V with the assistance of the source voltage, and the programming speed can increase up to 10 µs. Moreover, the programming current is reduced to approximately 3.0 µA, and a large read current of 64 µA is also realized. The simulation and the testing results show that the proposed flash cell features low programming voltage, low power, high programming efficiency, high read current, low bit-line leakage current, and good reliability.

SummaryImbalances in glucose and energy homeostasis are at the core of the worldwide epidemic of obesity and diabetes. Here, we illustrate an important role of the TGF-β/Smad3 signaling pathway in regulating glucose and energy homeostasis. Smad3-deficient mice are protected from diet-induced obesity and diabetes. Interestingly, the metabolic protection is accompanied by Smad3−/− white adipose tissue acquiring the bioenergetic and gene expression profile of brown fat/skeletal muscle. Smad3−/− adipocytes demonstrate a marked increase in mitochondrial biogenesis, with a corresponding increase in basal respiration, and Smad3 acts as a repressor of PGC-1α expression. We observe significant correlation between TGF-β1 levels and adiposity in rodents and humans. Further, systemic blockade of TGF-β signaling protects mice from obesity, diabetes, and hepatic steatosis. Together, these results demonstrate that TGF-β signaling regulates glucose tolerance and energy homeostasis and suggest that modulation of TGF-β activity might be an effective treatment strategy for obesity and diabetes.

In this paper, an embedded 3.3 V 2 Mb SIBE-based flash memory is introduced. Some novel circuit technologies, such as the DINOR memory array architecture, the row decoder with high performance negative voltage switch and the sector decoder, are described in detail. By introducing a negative logic level circuit in the sector decoder, the maximum high voltage stress is reduced to 8 V. The simulated and tested results show that the SIBE-based Flash memory has low program power, high access speed and high performance.