The eVALuate study: two parallel randomised trials, one comparing laparoscopic with abdominal hysterectomy, the other comparing laparoscopic with vaginal hysterectomy

OBJECTIVE: To compare the effects of laparoscopic hysterectomy and abdominal hysterectomy in the abdominal trial, and laparoscopic hysterectomy and vaginal hysterectomy in the vaginal trial. DESIGN: Two parallel, multicentre, randomised trials. Setting 28 UK centres and two South African centres. Participants 1380 women were recruited; 1346 had surgery; 937 were followed up at one year. PRIMARY OUTCOME: outcome Rate of major complications. RESULTS: In the abdominal trial laparoscopic hysterectomy was associated with a higher rate of major complications than abdominal hysterectomy (11.1% v 6.2%, P = 0.02; difference 4.9%, 95% confidence interval 0.9% to 9.1%) and the number needed to treat to harm was 20. Laparoscopic hysterectomy also took longer to perform (84 minutes v 50 minutes) but was less painful (visual analogue scale 3.51 v 3.88, P = 0.01) and resulted in a shorter stay in hospital after the operation (3 days v 4 days). Six weeks after the operation, laparoscopic hysterectomy was associated with less pain and better quality of life than abdominal hysterectomy (SF-12, body image scale, and sexual activity questionnaires). In the vaginal trial we found no evidence of a difference in major complication rates between laparoscopic hysterectomy and vaginal hysterectomy (9.8% v 9.5%, P = 0.92; difference 0.3%, − 5.2% to 5.8%), and the number needed to treat to harm was 333.We found no evidence of other differences between laparoscopic hysterectomy and vaginal hysterectomy except that laparoscopic hysterectomy took longer to perform (72 minutes v 39 minutes) and was associated with a higher rate of detecting unexpected pathology (16.4% v 4.8%, P = < 0.01). However, this trial was underpowered. CONCLUSIONS: Laparoscopic hysterectomy was associated with a significantly higher rate of major complications than abdominal hysterectomy. It also took longer to perform but was associated with less pain, quicker recovery, and better short term quality of life. The trial comparing vaginal hysterectomy with laparoscopic hysterectomy was underpowered and is inconclusive on the rate of major complications; however, vaginal hysterectomy took less time

Under-ice observations of water column temperature, salinity and spring phytoplankton dynamics: Eastern Bering Sea shelf

The inundation of two moored platforms by sea ice in late winter and early spring of 1995 provided unique time series of water column temperature, salinity, estimated chlorophyll-a, and phytoplankton fluorescence under advancing and retreating sea ice. One platform was located at 72 m in the weakly advective middle shelf regime. Here, chlorophyll-a concentrations began increasing shortly after the arrival of the ice (arch) during the period of weak stratification and continued to increase while wind actively mixed the water column to \u3e60 m. Changes in water column structure and properties resulted from an event of strong advection rather than vertical fluxes. During winter, such advective events can replenish the nutrients required to support the rich blooms that occur over the middle shelf during spring. The advancing ice was associated with the coldest waters and a deep (\u3e50 m ) mixed layer. The ice melt enhanced the two-layer system previously established by advection. A second mooring was located at the 120 misobath on the more advective outer shelf. The ice reached this site on April 6, and chlorophyll-a concentrations increased as the sea ice melted. At the third mooring, located on the shelf farther south beyond the range of ice, the spring bloom began on ~ May 9

Targeting of the P2X7 receptor in pancreatic cancer and stellate cells

The ATP‐gated receptor P2X7 (P2X7R) is involved in regulation of cell survival and has been of interest in cancer field. Pancreatic ductal adenocarcinoma (PDAC) is a deadly cancer and new markers and therapeutic targets are needed. PDAC is characterized by a complex tumour microenvironment, which includes cancer and pancreatic stellate cells (PSCs), and potentially high nucleotide/side turnover. Our aim was to determine P2X7R expression and function in human pancreatic cancer cells in vitro as well as to perform in vivo efficacy study applying P2X7R inhibitor in an orthotopic xenograft mouse model of PDAC. In the in vitro studies we show that human PDAC cells with luciferase gene (PancTu‐1 Luc cells) express high levels of P2X7R protein. Allosteric P2X7R antagonist AZ10606120 inhibited cell proliferation in basal conditions, indicating that P2X7R was tonically active. Extracellular ATP and BzATP, to which the P2X7R is more sensitive, further affected cell survival and confirmed complex functionality of P2X7R. PancTu‐1 Luc migration and invasion was reduced by AZ10606120, and it was stimulated by PSCs, but not by PSCs from P2X7(‐/‐) animals. PancTu‐1 Luc cells were orthotopically transplanted into nude mice and tumour growth was followed noninvasively by bioluminescence imaging. AZ10606120‐treated mice showed reduced bioluminescence compared to saline‐treated mice. Immunohistochemical analysis confirmed P2X7R expression in cancer and PSC cells, and in metaplastic/neoplastic acinar and duct structures. PSCs number/activity and collagen deposition was reduced in AZ10606120‐treated tumours

Reducing the effects of fouling on chlorophyll estimates derived from long-term deployments of optical instruments

Two methods to alleviate the problem of fouling of moored flow tube optical instruments are presented. A chemical method diffuses a concentrated solution of bromine into the flow tube between sampling periods, creating a toxic environment for microorganisms. An optical method removes a baseline value from the red peak of chlorophyll a. Three spectral absorption meters equipped with the chemical system were deployed in the south eastern Bering Sea from March to September 1993. For a 40-, instrument the system prevented biofouling for the entire deployment, while an 11-m instrument was free of contamination for approximately 3.5 months. Reasonable estimates of in situ chlorophyll a were obtained from all three instruments by the subtraction of the baseline

Periodic state-space representations of periodic convolutional codes

In this paper we study the representation of periodically time-varying convolutional codes by means of periodic input-state-output models. In particular, we focus on period two and investigate under which conditions a given two-periodic convolutional code (obtained by alternating two time-invariant encoders) can be represented by a periodic input-state-output system. We first show that one cannot expect, in general, to obtain a periodic input-state-output representation of a periodic convolutional code by means of the individual realizations of each of the associated time-invariant codes. We, however, provide sufficient conditions for this to hold in terms of the column degrees of the associated column reduced generator matrices. Moreover, we derive a sufficient condition to obtain a periodic state-space realization that is minimal. Finally, examples to illustrate the results are presented.publishe

Induction of leaf senescence in Arabidopsis thaliana by long days through a light-dosage effect

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/74662/1/j.1399-3054.1996.tb00463.x.pd

Decoding of 2D convolutional codes over an erasure channel

In this paper we address the problem of decoding 2D convolutional codes over an erasure channel. To this end we introduce the notion of neighbors around a set of erasures which can be considered an analogue of the notion of sliding window in the context of 1D convolutional codes. The main idea is to reduce the decoding problem of 2D convolutional codes to a problem of decoding a set of associated 1D convolutional codes. We first show how to recover sets of erasures that are distributed on vertical, horizontal and diagonal lines. Finally we outline some ideas to treat any set of erasures distributed randomly on the 2D plane. © 2016 AIMS

Importance of Glycosylation on Function of a Potassium Channel in Neuroblastoma Cells

The Kv3.1 glycoprotein, a voltage-gated potassium channel, is expressed throughout the central nervous system. The role of N-glycans attached to the Kv3.1 glycoprotein on conducting and non-conducting functions of the Kv3.1 channel are quite limiting. Glycosylated (wild type), partially glycosylated (N220Q and N229Q), and unglycosylated (N220Q/N229Q) Kv3.1 proteins were expressed and characterized in a cultured neuronal-derived cell model, B35 neuroblastoma cells. Western blots, whole cell current recordings, and wound healing assays were employed to provide evidence that the conducting and non-conducting properties of the Kv3.1 channel were modified by N-glycans of the Kv3.1 glycoprotein. Electrophoretic migration of the various Kv3.1 proteins treated with PNGase F and neuraminidase verified that the glycosylation sites were occupied and that the N-glycans could be sialylated, respectively. The unglycosylated channel favored a different whole cell current pattern than the glycoform. Further the outward ionic currents of the unglycosylated channel had slower activation and deactivation rates than those of the glycosylated Kv3.1 channel. These kinetic parameters of the partially glycosylated Kv3.1 channels were also slowed. B35 cells expressing glycosylated Kv3.1 protein migrated faster than those expressing partially glycosylated and much faster than those expressing the unglycosylated Kv3.1 protein. These results have demonstrated that N-glycans of the Kv3.1 glycoprotein enhance outward ionic current kinetics, and neuronal migration. It is speculated that physiological changes which lead to a reduction in N-glycan attachment to proteins will alter the functions of the Kv3.1 channel

Localization and Characterization of STRO-1+ Cells in the Deer Pedicle and Regenerating Antler

The annual regeneration of deer antlers is a unique developmental event in mammals, which as a rule possess only a very limited capacity to regenerate lost appendages. Studying antler regeneration can therefore provide a deeper insight into the mechanisms that prevent limb regeneration in humans and other mammals, and, with regard to medical treatments, may possibly even show ways how to overcome these limitations. Traditionally, antler regeneration has been characterized as a process involving the formation of a blastema from de-differentiated cells. More recently it has, however, been hypothesized that antler regeneration is a stem cell-based process. Thus far, direct evidence for the presence of stem cells in primary or regenerating antlers was lacking. Here we demonstrate the presence of cells positive for the mesenchymal stem cell marker STRO-1 in the chondrogenic growth zone and the perivascular tissue of the cartilaginous zone in primary and regenerating antlers as well as in the pedicle of fallow deer (Dama dama). In addition, cells positive for the stem cell/progenitor cell markers STRO-1, CD133 and CD271 (LNGFR) were isolated from the growth zones of regenerating fallow deer antlers as well as the pedicle periosteum and cultivated for extended periods of time. We found evidence that STRO-1+ cells isolated from the different locations are able to differentiate in vitro along the osteogenic and adipogenic lineages. Our results support the view that the annual process of antler regeneration might depend on the periodic activation of mesenchymal progenitor cells located in the pedicle periosteum. The findings of the present study indicate that not only limited tissue regeneration, but also extensive appendage regeneration in a postnatal mammal can occur as a stem cell-based process