ABSTRACT: Purpose The purpose of this meta-analysis was to determine the strength of the association between gynecologic surgeries, tubal ligation and hysterectomy, and ovarian cancer. METHODS: We searched the PubMed, Web of Science, and Embase databases for all English-language articles dated between 1969 through March 2011 using the keywords "ovarian cancer" and "tubal ligation" or "tubal sterilization" or "hysterectomy." We identified 30 studies on tubal ligation and 24 studies on hysterectomy that provided relative risks for ovarian cancer and a p-value or 95% confidence interval (CI) to include in the meta-analysis. Summary RRs and 95% CIs were calculated using a random-effects model. RESULTS: The summary RR for women with vs. without tubal ligation was 0.70 (95%CI: 0.64, 0.75). Similarly, the summary RR for women with vs. without hysterectomy was 0.74 (95%CI: 0.65, 0.84). Simple hysterectomy and hysterectomy with unilateral oophorectomy were associated with a similar decrease in risk (summery RR = 0.62, 95%CI: 0.49-0.79 and 0.60, 95%CI: 0.47-0.78, respectively). In secondary analyses, the association between tubal ligation and ovarian cancer risk was stronger for endometrioid tumors (summary RR = 0.45, 95%CI: 0.33, 0.61) compared to serous tumors. CONCLUSION: Observational epidemiologic evidence strongly supports that tubal ligation and hysterectomy are associated with a decrease in the risk of ovarian cancer, by approximately 26-30%. Additional research is needed to determine whether the association between tubal ligation and hysterectomy on ovarian cancer risk differs by individual, surgical, and tumor characteristics.

The rover Opportunity has investigated the rim of Endeavour Crater, a large ancient impact crater on Mars. Basaltic breccias produced by the impact form the rim deposits, with stratigraphy similar to that observed at similar-sized craters on Earth. Highly localized zinc enrichments in some breccia materials suggest hydrothermal alteration of rim deposits. Gypsum-rich veins cut sedimentary rocks adjacent to the crater rim. The gypsum was precipitated from low-temperature aqueous fluids flowing upward from the ancient materials of the rim, leading temporarily to potentially habitable conditions and providing some of the waters involved in formation of the ubiquitous sulfate-rich sandstones of the Meridiani region.

ABSTRACT: INTRODUCTION: Previous research in the Nurses' Health Study (NHS) and NHSII observed that, among women diagnosed with benign breast disease (BBD), those with predominant type 1/no type 3 lobules (a marker of complete involution) versus other lobule types were at lower risk of subsequent breast cancer. Studies in animal models suggest that insulin-like growth factor-1 (IGF-1) may inhibit involution of lobules in the breast; however, this has not been studied in humans. METHODS: We conducted a cross-sectional study among 472 women in the NHSII who were diagnosed with biopsy-confirmed proliferative BBD between 1991 and 2002 and provided blood samples between 1996 and 1999. A pathologist, blinded to exposure status, classified lobule type in normal adjacent tissue on available biopsy slides according to the number of acini per lobule. For each participant, the pathologist determined the predominant lobule type (i.e., type 1, 2, or 3) and whether any type 1 or any type 3 lobules were present. Lobule type then was classified as: 1) predominant type 1/no type 3 lobules, which is suggestive of complete involution or 2) other lobule types. Multivariate logistic models were used to assess the associations between plasma IGF-1, IGF binding protein-3 (IGFBP-3), and the ratio of IGF-1-to-IGFBP-3 levels with lobule type. RESULTS: In univariate analyses, greater age, higher body mass index, postmenopausal status, nulliparity, and lower IGF-1 levels were associated with predominant type1/no type 3 lobules (P<0.05). In multivariate models adjusting for age and assay batch, higher IGF-1 levels were associated with decreased odds of predominant type 1/no type 3 lobules (OR quartile 4 vs. quartile 1=0.37, 95%CI: 0.15 to 0.89). Greater ratios of IGF-1-to-IGFBP-3 levels also were associated with decreased odds of predominant type1/no type 3 lobules (OR quartile 4 vs. quartile 1=0.26, 95%CI: 0.11 to 0.64). These results were slightly attenuated after adjustment for other potential predictors of lobule type. CONCLUSIONS: Higher IGF-1 levels and a greater IGF-1-to-IGFBP-3 ratio were associated with decreased odds of having predominant type 1 lobules/no type 3 lobules among women with proliferative BBD in the NHSII. This study provides further evidence for the role of insulin-like growth factors in the structure of breast lobules and lobular involution.

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OBJECTIVE: We investigated motor control and muscle activation when reaching for and grasping objects with a reacher compared with the unaided hand. METHOD: In a repeated-measures counterbalanced design, 41 healthy participants with no previous experience using a reacher were randomly assigned to a sequence of four conditions. Movements of the wrist and fingers were recorded using a three-dimensional Qualisys camera system for assessing reach and grasp. Muscle activations from finger and arm flexors and extensors were recorded by surface electromyography. RESULTS: Participants exhibited a smaller grasp aperture, longer reaching time, and more muscle activity when they used a reacher. CONCLUSION: Efficient motor control, which requires both time and practice, is needed to successfully use a reacher. Clients presented with reachers without sufficient time to develop motor skills unique to reacher use may be more likely to abandon this assistive device and fail to benefit from its function.

This study investigated the differences in required push, pull and rotating forces for moving fully loaded, floor-based and overhead-mounted full body patient lifting devices with simulated patients of varying weight on a floor of optimal design (i.e. level vinyl tile over concrete). A single person operated the lifting devices for all of the tests. Eighteen male and female volunteer participants, ranging in weight from 51 to 146 kg, acted as patients during the lifting tests. For each test, the simulated patients were pushed and pulled for 3.7 linear metres and were rotated while sitting in the lift slings. Force measurements were acquired using two single axis dynamometers affixed to the lifting devices. Results revealed that, in general, operator input force and torque increased with patient weight category and floor-based lifts required greater force and torque compared to the overhead-mounted lift. Comparison of the required forces with published force limits reveals that the required push and pull force from the various patient lift systems, across all weight categories, were generally acceptable to 90% of the female population. The required forces for these patient transfer tasks, however, could exceed maximum acceptable force limits if the floor surfaces were less than ideal, such as floors composed of carpet, wood, or inclined surfaces. Additional research is needed to assess these conditions.

The present study investigated whether knowledge of results, in the form of visual and audible feedback, would increase the accuracy of time-telling in an individual with an intellectual disability. A 19-year-old male with mild intellectual disability participated in this A1-B1-A2-B2 single-subject study design. The task involved correctly identifying the time given on a computer. Data, based on the Wilcoxon signed-rank test, showed that the participant demonstrated a greater number of correct responses during the intervention phases. Incorporating knowledge of results into a learning strategy for this individual with intellectual disability resulted in an increased ability to accurately identify the correct time on an analogue clock. There is a need to replicate the study design to increase the external validity and generalization of results. The strategies described in the present study may also be useful for occupational therapists who teach individuals with intellectual disability to gain skills in their everyday activities of daily living (ADLs). Copyright (c) 2007 John Wiley & Sons, Ltd.

Content: Intrauterine exposure to maternal diabetes and large size at birth are known risk factors for the subsequent development of insulin resistance and metabolic syndrome (MSX). Although Hispanic youth have been shown to have a high prevalence of MSX, it is unknown whether metabolic abnormalities and a predisposition for glucose intolerance are present at birth. Objective: To determine if abnormalities in insulin sensitivity (SI) exist at or soon after birth in large for gestational age (LGA) neonates born to Hispanic women with and without gestational diabetes. Design/Patients/Setting: Forty-two term Hispanic neonates were enrolled for cross-sectional studies at 24-48h after birth and included: 9 LGA neonates delivered of women with gestational diabetes (LGA-IDM), 12 LGA but not IDM neonates, 11 poorly grown (at 5-10(th)%) and 10 appropriate for gestational age (AGA) neonates. Insulin sensitivity and secretion were measured by shortened fasting intravenous glucose tolerance test. Main Outcome Measure: Insulin Sensitivity Index (SI) within 48h of birth. Results: Neonates were studied at 36+/-11h postnatal, and all groups were euglycemic at the time of study. However, the SI was significantly lower (P<0.05, ANOVA) in LGA-IDM (3.0+/-0.7[SEM] mU/L.min) and LGA-nonIDM (2.2+/-0.4 mU/L.min) cohorts in comparison to poorly grown (5.0+/-0.7 mU/L.min) and AGA controls (5.4+/-0.8 mU/L.min). Insulin secretion did not differ between groups. Conclusions: Reduced SI is present soon after birth in Hispanic LGA neonates born to mothers with and without gestational diabetes, demonstrating the onset of insulin resistance before birth and evidence of altered fetal programming.

OBJECTIVE: To investigate whether the performance of a multisegment motor task is influenced by reading a segment-specific action word. METHOD: Twenty-four participants performed tasks that involved reaching for a bottle, grasping it, lifting and placing it on a shelf, and returning their hand to the starting position. At the initiation of each task, participants read either aloud or silently five randomly provided, task-related words (reach, grasp, lift, place, and return). RESULTS: Reading task-related words significantly affected the reach and lift/place segments in the direction of the hypothesis (p < 0.05) but not the return segments. Grasp times were shorter and grasp velocities were higher when participants read aloud or silently the words grasp and place for the grasp segment (p < 0.05). CONCLUSIONS: The results suggest that in young adults, motor performance may be influenced by precuing or priming the brain with performance-related words. A meaning of a motor performance can be manipulated by contextually relevant language, which can facilitate performance.

OBJECTIVE: A common practice in occupational therapy is to have clients choose an object that they prefer to be used during treatment. This practice assumes that a preference for chosen items will hold greater meaning and result in higher quality of movement. Little research has been conducted that specifically addresses the effect that preference has on quality of movement. Therefore, the purpose of this study was to contribute to the knowledge by determining whether preference affects quality of movement. METHOD: Forty-three healthy right-hand-dominant adult women between the ages of 18 and 60 years in Northwest Ohio engaged in this study. Each participant rank-ordered 15 magazines from most preferred to least preferred. The participant then reached for her most preferred, neutrally preferred, and least preferred magazines. RESULTS: When participants reached for the neutrally preferred magazines, movement time was significantly slower and movement units were significantly greater (less smooth) than when they reached for a magazine perceived as being the least preferred (p <.017). No differences were found between the three conditions in terms of displacement, peak velocity, or percentage of time to peak velocity, nor between the most preferred and the other two preferences. CONCLUSION: This study has shown that preference may not be an influential factor when performing simple reaches for magazines. Although there was a difference between the neutrally preferred and least preferred conditions, the goal when reaching during the neutrally preferred condition may have been different (i.e., to glean more information from the magazine cover) than when reaching in the least preferred condition (e.g., to reach for and discard the magazine as quickly as possible). These results reflect the complexity involved in the formation of meaning, of which preference is a part. Further exploration of individual preferences as well as personal goal formation and their impact on success in occupations of daily living is needed.