The association between hysterectomy and ovarian cancer risk: A population-based record-linkage study

Background: Recent studies have called into question the long-held belief that hysterectomy without oophorectomy protects against ovarian cancer. This population-based longitudinal record-linkage study aimed to explore this relationship, overall and by age at hysterectomy, time period, surgery type, and indication for hysterectomy. Methods: We followed the female adult Western Australian population (837 942 women) across a 27-year period using linked electoral, hospital, births, deaths, and cancer records. Surgery dates were determined from hospital records, and ovarian cancer diagnoses (n¼1640) were ascertained from cancer registry records.We used Cox regression to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for the association between hysterectomy and ovarian cancer incidence. Results: Hysterectomy without oophorectomy (n¼78 594) was not associated with risk of invasive ovarian cancer overall (HR ¼ 0.98, 95% CI ¼ 0.85 to 1.11) or with the most common serous subtype (HR ¼ 1.05, 95% CI ¼ 0.89 to 1.23). Estimates did not vary statistically significantly by age at procedure, time period, or surgical approach. However, among women with endometriosis (5.8%) or with fibroids (5.7%), hysterectomy was associated with substantially decreased ovarian cancer risk overall (HR ¼ 0.17, 95% CI ¼ 0.12 to 0.24, and HR ¼ 0.27, 95% CI ¼ 0.20 to 0.36, respectively) and across all subtypes. Conclusions: Our results suggest that for most women, having a hysterectomy with ovarian conservation is not likely to substantially alter their risk of developing ovarian cancer. However, our results, if confirmed, suggest that ovarian cancer risk reduction could be considered as a possible benefit of hysterectomy when making decisions about surgical management of endometriosis or fibroids

Epidemiology of epithelial ovarian cancer

Globally, ovarian cancer is the seventh most common cancer in women and the eighth most common cause of cancer death, with five-year survival rates below 45%. Although age-standardised rates are stable or falling in most high-income countries, they are rising in many low and middle income countries. Furthermore, with increasing life-expectancy, the number of cases diagnosed each year is increasing. To control ovarian cancer we need to understand the causes. This will allow better prediction of those at greatest risk for whom screening might be appropriate, while identification of potentially modifable causes provides an opportunity for intervention to reduce rates. In this paper we will summarise the current state of knowledge regarding the known and possible causes of epithelial ovarian cancer and discuss some of the main theories of ovarian carcinogenesis. We will also briefly review the relationship between lifestyle and survival after a diagnosis of ovarian cancer

Debris-flow release processes investigated through the analysis of multi-temporal LiDAR datasets in north-western Iceland

Debris flows are fast‐moving gravity flows of poorly sorted rock and soil, mixed and saturated with water. Debris‐flow initiation has been studied using empirical and experimental modelling, but the geomorphic changes, indicative of different triggering processes, are difficult to constrain with field observations only. We identify signatures to distinguish two different debris‐flow release styles by integrating high‐resolution multi‐temporal remote sensing datasets and morphometric analysis. We analyse debris flows sourced above the town of Ísafjörður (Iceland). Two debris‐flow triggering processes were previously hypothesized for this site: (i) slope failure, characterised by landslides evolving into debris flows, and (ii) the fire‐hose effect, in which debris accumulated in pre‐existing, steep‐sided bedrock passages is transported by a surge of water. It is unknown which process dominates and determines the local risk. To investigate this question, we compare airborne LiDAR elevation models and aerial photographs collected in 2007 with similar data from 2013. We find that two new debris‐flow tracks were created by slope failures. These are characterised by steep sliding surfaces and lateral leveed channels. Slope failure also occurred in two large, recently active tracks, creating the preparatory conditions for the fire‐hose effect to mobilise existing debris. These tracks show alternating zones of fill and scour along their length, and debris stored below the source‐area at rest angles >35°. Our approach allows us to identify and quantify the morphological changes produced by slope failure release process, which generated the preparatory conditions for the fire‐hose effect. As debris flows are rarely observed in action and morphological changes induced by them are difficult to detect and monitor, the same approach could be applied to other landscapes to understand debris‐flow initiation in absence of other monitoring information, and can improve the identification of zones at risk in inhabited areas near hillslopes with potential for debris flows

Debris-flow release processes investigated through the analysis of multi-temporal LiDAR datasets in north-western Iceland

Debris flows are fast-moving gravity flows of poorly sorted rock and soil, mixed and saturated with water. Debris-flow initiation has been studied using empirical and experimental modelling, but the geomorphic changes, indicative of different triggering processes, are difficult to constrain with field observations only. We identify signatures to distinguish two different debris-flow release styles by integrating high-resolution multi temporal remote sensing datasets and morphometric analysis. We analyse debris flows sourced above the town of Ísafjörður (Iceland). Two debris-flow triggering processes were previously hypothesized for this site: (i) slope failure, characterised by landslides evolving into debris flows, and (ii) the fire-hose effect, in which debris accumulated in pre-existing, steep-sided bedrock passages is transported by a surge of water. It is unknown which process dominates and determines the local risk. To investigate this question, we compare airborne LiDAR elevation models and aerial photographs collected in 2007 with similar data from 2013. We find that two new debris-flow tracks were created by slope failures. These are characterised by steep sliding surfaces and lateral leveed channels. Slope failure also occurred in two large, recently active tracks, creating the preparatory conditions for the fire-hose effect to mobilise existing debris. These tracks show alternating zones of fill and scour along their length, and debris stored below the source-area at rest angles >35°. Our approach allows us to identify and quantify the morphological changes produced by slope failure release process, which generated the preparatory conditions for the fire-hose effect. As debris flows are rarely observed in action and morphological changes induced by them are difficult to detect and monitor, the same approach could be applied to other landscapes to understand debris-flow initiation in absence of other monitoring information, and can improve the identification of zones at risk in inhabited areas near hillslopes with potential for debris flows

Adverse Impact of a History of Violence for Women with Breast, Cervical, Endometrial, or Overian Cancer

The experience of physical and sexual violence (victimization) is common among U.S. women and is associated with adverse health consequences. The study objectives were to estimate the prevalence of victimization in women with cancer and to examine associations with demographics, cancer screening, and cancer stage. METHODS: From 2004 to 2005, 101 women with breast, cervical, endometrial, or ovarian cancer were interviewed to collect demographics, cancer screening history, health care access/use, and violence history. Chisquare and Fisher exact tests were used test risk-factor associations. A multinomial logistic regression model was used for multivariable analysis. RESULTS: The prevalence of a history of violence was 48.5% (49/101 women), and within that group, 46.9% (23/49) had a positive childhood violence screen, 75.5% (37/49) had a positive adult screen, and 55% (27/49) reported sexual violence at any age. Women with a positive violence screen differed significantly from women with a negative screen in that they were younger (P .031), more often divorced (P.012), more likely to smoke (P.010), more often lacked commercial insurance (P.036), and had more advanced stage of disease (P.013), but they did not differ with regard to race, cancer type, education level, alcohol or drug use, or cancer screening compliance. Multivariable analysis revealed that only stage remained significant; women with a history of violence had a 2.6-fold increased chance of diagnosis in later stages (odds ratio 2.61, 95% confidence interval 1.03– 6.59). CONCLUSION: A history of violence in breast, ovarian, endometrial, and ovarian cancer patients was extremely common and correlated with advanced stage at diagnosis

Molards as an indicator of permafrost degradation and landslide processes

Molards have been defined in the past as conical mounds of debris that can form part of a landslide's deposits. We present the first conclusive evidence that molards in permafrost terrains are cones of loose debris that result from thawing of frozen blocks of ice-rich sediments mobilised by a landslide, and hence propose a rigorous definition of this landform in permafrost environments. We show that molards can be used as an indicator of permafrost degradation, and that their morphometry and spatial distribution give valuable insights into landslide dynamics in permafrost environments. We demonstrate that molards are readily recognisable not only in the field, but also in remote sensing data; surveys of historic aerial imagery allow the recognition of relict molards, which can be used as an indicator of current and past permafrost conditions. The triggering of landslides as a result of permafrost degradation will arguably occur more often as global atmospheric temperatures increase, so molards should be added to our armoury for tracking climate change, as well as helping us to understand landslide-related hazards. Finally, we have also identified candidate molards on Mars, so molards can inform about landscape evolution on Earth and other planetary bodies

A Novel Keratocan Mutation Causing Autosomal Recessive Cornea Plana

PURPOSE: Mutations in keratocan (KERA), a small leucine-rich proteoglycan, have recently been shown to be responsible for cases of autosomal recessive cornea plana (CNA2). A consanguineous pedigree in which cornea plana cosegregated with microphthalmia was investigated by linkage analysis and direct sequencing. METHODS: Linkage was sought to polymorphic microsatellite markers distributed around the CNA2 and microphthalmia loci (arCMIC, adCMIC, NNO1, and CHX10) using PCR and nondenaturing polyacrylamide gel electrophoresis before KERA was directly sequenced for mutations. RESULTS: Positive lod scores were obtained with markers encompassing the CNA2 locus, the maximum two-point lod scores of 2.18 at recombination fraction theta = 0 was obtained with markers D12S95 and D12S327. Mutation screening of KERA revealed a novel single-nucleotide substitution at codon 215, which results in the substitution of lysine for threonine at the start of a highly conserved leucine-rich repeat motif. Structural modeling predicts that the motifs are stacked into an arched beta-sheet array and that the effect of the mutation is to alter the length and position of one of these motifs. CONCLUSIONS: This report describes a novel mutation in KERA that alters a highly conserved motif and is predicted to affect the tertiary structure of the molecule. Normal corneal function is dependent on the regular spacing of collagen fibrils, and the predicted alteration of the tertiary structure of KERA is the probable mechanism of the cornea plana phenotype

Variant R94C in TNNT2‐encoded troponin T predisposes to pediatric restrictive dardiomyopathy and sudden death through impaired thin filament relaxation resulting in myocardial diastolic dysfunction

Background Pediatric-onset restrictive cardiomyopathy (RCM) is associated with high mortality, but underlying mechanisms of disease are under investigated. RCM-associated diastolic dysfunction secondary to variants i