Randomised trial comparing hysterectomy with endometrial ablation for dysfunctional uterine bleeding: psychiatric and psychosocial aspects

OBJECTIVE: To compare in psychiatric and psychosocial terms the outcome of hysterectomy and endometrial ablation for the treatment of dysfunctional uterine bleeding. DESIGN: Prospective randomised controlled trial. SETTING--Obstetrics and gynaecology department of a large teaching hospital. SUBJECTS: 204 women with dysfunctional bleeding for whom hysterectomy would have been the preferred treatment were recruited over 24 months and randomly allocated to hysterectomy (99 women) or to hysteroscopic surgery (transcervical resection (52 women) or laser ablation (53 women). MAIN OUTCOME MEASURES: Mental state, martial relationship, psychosocial and sexual adjustment in assessments conducted before the operation and one month, six months, and 12 months later. RESULTS: Both treatments significantly reduced the anxiety and depression present before the operation, and there were no differences in mental health between the groups at 12 months. Hysterectomy did not lead to postoperative psychiatric illness. Sexual interest after the operation did not vary with treatment. Overall, 46 out of 185 (25%) women reported a loss sexual interest and 50 out of 185 (27%) reported increased sexual interest. Marital relationships were unaffected by surgery. Personality and duration of dysfunctional uterine bleeding played no significant part in determining outcome. CONCLUSIONS: Hysteroscopic surgery and hysterectomy have a similar effect on psychiatric and psychosocial outcomes. There is no evidence that hysterectomy leads to postoperative psychiatric illness.     

Large scale identification of genes involved in cell surface biosynthesis and architecture in Saccharomyces cerevisiae

The sequenced yeast genome offers a unique resource for the analysis of eukaryotic cell function and enables genome-wide screens for genes involved in cellular processes. We have identified genes involved in cell surface assembly by screening transposon-mutagenized cells for altered sensitivity to calcofluor white, followed by supplementary screens to further characterize mutant phenotypes. The mutated genes were directly retrieved from genomic DNA and then matched uniquely to a gene in the yeast genome database. Eighty-two genes with apparent perturbation of the cell surface were identified, with mutations in 65 of them displaying at least one further cell surface phenotype in addition to their modified sensitivity to calcofluor. Fifty of these genes were previously known, 17 encoded proteins whose function could be anticipated through sequence homology or previously recognized phenotypes and 15 genes had no previously known phenotype.     

Recombinant scrapie-like prion protein of 106 amino acids is soluble

The N terminus of the scrapie isoform of prion protein (PrPSc) can be truncated without loss of scrapie infectivity and, correspondingly, the truncation of the N terminus of the cellular isoform, PrPC, still permits conversion into PrPSc. To assess whether additional segments of the PrP molecule can be deleted, we previously removed regions of putative secondary structure in PrPC; in the present study we found that deletion of each of the four predicted helices prevented PrPSc formation, as did deletion of the stop transfer effector region and the C178A mutation. Removal of a 36-residue loop between helices 2 and 3 did not prevent formation of protease-resistant PrP; the resulting scrapie-like protein, designated PrPSc106, contained 106 residues after cleavage of an N-terminal signal peptide and a C-terminal sequence for glycolipid anchor addition. Addition of the detergent Sarkosyl to cell lysates solubilized PrPSc106, which retained resistance to digestion by proteinase K. These results suggest that all the regions of proposed secondary structure in PrP are required for PrPSc formation, as is the disulfide bond stabilizing helices 3 and 4. The discovery of PrPSc106 should facilitate structural studies of PrPSc, investigations of the mechanism of PrPSc formation, and the production of PrPSc-specific antibodies.     

Structural characterization of a new galactofuranose-containing glycolipid antigen of Paracoccidioides brasiliensis

An acidic glycolipid (Band 1), purified from P. brasiliensis by a combination of ion exchange chromatography, HPLC, and HPTLC, was found to be reactive with sera of all patients with paracoccidioidomycosis (PCM). Monosaccharide analysis of Band 1 yielded mannose and galactose in a 2:1 ratio, while mild acid hydrolysis and mild periodate oxidation/NaB3H4 reduction indicated the presence of a terminal galactofuranose. Preliminary analysis of 1H-NMR and MS data suggests that the structure of the glycan is Galf beta 1-->6(Manp alpha 1-->3)Manp beta 1-->2Ins (Ins = myo-inositol). Removal of the galacto-furanose decreased by 60-80% the reactivity of sera from PCM patients with Band 1, suggesting that this residue is immunodominant. With the presumed absence of galactofuranose in mammalian hosts, compounds containing this residue may be useful targets for therapy of several parasitic and fungal diseases.     

MISR in-flight camera geometric model calibration and georectification performance

In order to facilitate a unique georectification approach implemented for Multi-angle Imaging SpectroRadiometer (MISR) data, specific calibration datasets need to be derived during flight. In the case of the spaceborne MISR instrument, with its unique configuration of nine fixed pushbroom cameras, continuous and autonomous coregistration and geolocation of image data are required prior to the application of scientific retrieval algorithms. In-flight-generated calibration datasets are required to (a) assure accuracy, (b) reduce processing load, and (c) support autonomous aspects of the processing algorithm. This paper describes the in-flight geometric calibration approach with the focus on the first year of activities and the georectification performance achieved.     

Interdisciplinary collaboration and discharge planning communication for elders

The effects of personal characteristics and perceptions of interdisciplinary collaboration on discharge planning communication were examined for nurses, physicians, and social workers in two hospitals. The model for the study explained 61.7% of the variance in discharge planning communication for nurses. For all 142 health professionals, communication openness with social workers, problem solving between nurses and physicians, and collaboration with social workers were important to discharge planning communication. For nurses, communication satisfaction with patients and families also was important.     

Mobility Tracking in Cellular Networks Using Particle Filtering

Mobility tracking based on data from wireless cellular networks is a key challenge that has been recently investigated both from a theoretical and practical point of view. This paper proposes Monte Carlo techniques for mobility tracking in wireless communication networks by means of received signal strength indications. These techniques allow for accurate estimation of mobile station's (MS) position and speed. The command process of the MS is represented by a first-order Markov model which can take values from a finite set of acceleration levels. The wide range of acceleration changes is covered by a set of preliminary determined acceleration values. A particle filter and a Rao-Blackwellised particle filter are proposed and their performance is evaluated both over synthetic and real data. A comparison with an extended Kalman filter (EKF) is performed with respect to accuracy and computational complexity. With a small number of particles the RBPF gives more accurate results than the PF and the EKF. A posterior Cramer Rao lower bound (PCRLB) is calculated and it is compared with the filters' root- mean-square error performance.     

Sequential Monte Carlo methods for contour tracking of contaminant clouds

This paper addresses the problem of contour tracking for airborne emission of contaminant clouds. This is of particular relevance in the context of anti-terrorism and military applications. This problem is solved by estimating the contour boundary positions using a set of particle filters. The use of sequential Monte Carlo techniques enables the tracking to be performed when the measurements are noisy. The tracking results also include the estimation uncertainty. The proposed technique is illustrated for both SCIPUFF and model generated emission scenarios and simulation experiments demonstrate successful tracking throughout the tracking period for both simple and complex environments.