International Military Peacekeepers and Sex Offenses Committed in the Central African Republic

AbstractStudies have been conducted on the sexual offending of the local population by peacekeepers, but few have been conducted on the lived experience of professionals providing support and assistance to these victims. This qualitative phenomenological study was conducted to explore the lived experiences of experts providing support and assistance to victims of sex offenses committed in the Central African Republic by international military peacekeepers. The classical deterrence and retributive justice theories guided the study. Participants were recruited through snowball sampling and data collected through face-to- face interviews and analyzed using the Modified Van Kaam method. Two research questions were used to explore the professionals’ lived experiences in supporting sex victims and the essence they make of those experiences. The study findings were analyzed and interpreted with some findings aligning with the study theoretical framework and existing literature while others were new and helped in advancing and strengthening the existing literature. The findings of the study revolved around the vulnerability and powerlessness of the victim and the desire for increase justice, and education aimed at empowering them. The study may help various peacekeeping stakeholders in effecting positive social change through reformulating peacekeeping policies that would address sexual offending by peacekeepers as well as protective measures for the vulnerable local population

Variable selection with FDR control for noisy data -- an application to screening metabolites that are associated with breast and colorectal cancer

The rapidly expanding field of metabolomics presents an invaluable resource for understanding the associations between metabolites and various diseases. However, the high dimensionality, presence of missing values, and measurement errors associated with metabolomics data can present challenges in developing reliable and reproducible methodologies for disease association studies. Therefore, there is a compelling need to develop robust statistical methods that can navigate these complexities to achieve reliable and reproducible disease association studies. In this paper, we focus on developing such a methodology with an emphasis on controlling the False Discovery Rate during the screening of mutual metabolomic signals for multiple disease outcomes. We illustrate the versatility and performance of this procedure in a variety of scenarios, dealing with missing data and measurement errors. As a specific application of this novel methodology, we target two of the most prevalent cancers among US women: breast cancer and colorectal cancer. By applying our method to the Wome's Health Initiative data, we successfully identify metabolites that are associated with either or both of these cancers, demonstrating the practical utility and potential of our method in identifying consistent risk factors and understanding shared mechanisms between diseases

Gynecological cancer profile in the Yaounde population, Cameroon

This population-based retrospective study was carried out in the Yaounde Population Cancer Registry (YPCR) at the General Hospital Yaounde, Cameroon. The aim was to find out the socio-economic, epidemiologic, anatomic and pathologic profile of patients with gynecological cancers in the Yaounde population. The database of the registry was reviewed between January 1, 2004 and June 30 2005 (18 months). All cases of microscopically confirmed gynecological cancers registered within this period were recruited. Defined as gynecological cancers are cancers of the breast (in women), ovary, uterine corpus, vulva, vagina, and cervix. The results showed that gynecological cancers have a monthly incidence of 30 cases. Whereas cancers of the placenta, vagina, breast, and ovary affect younger adults, endometrial, vulval and cervical cancers predominate in the elderly. 58% of the women were aged between 34-54 years. Most patients are from the West (30.55%), Centre (28.90%) and Littoral (10.00%) provinces respectively. The commonest cancers are the breast (48.12%), cervix (40.18%), and ovary (5.82%) at respective average ages of 42.80 years (19-76 years range), 53.08 years (24-78 years range) and 44.22 years (9-75 years range). Cancers of the uterine corpus are rare. Most patients were illiterate, of low to average socio-economic status, presenting at advanced stage of disease. Cancer of the breast is common in the upper social class; while malignancies of the cervix, endometrium, and vagina predominate in the low and middle classes. Only 17.5% of our patients had been previously screened for any form of cancer prior to present disease. We had no data on family history of cancer. We recommend intensive public health education and sensitization of women on primary and secondary prevention especially for cervical and breast cancers. Gynaecological services should be vulgarized and existing ones improved with defined referral and counter referral systems. Further in-depth studies to document trends on cancer survival are recommended. Clinics in Mother and Child Health Vol. 3(1) 2006: 437-44

Changes in the inflammatory potential of diet over time and risk of colorectal cancer in postmenopausal women

We examined the associations between changes in dietary inflammatory potential and risk of colorectal cancer (CRC) in 87,042 postmenopausal women recruited from 1993-1998 into the Women\u27s Health Initiative. Food frequency questionnaire data were used to compute patterns of change in dietary inflammatory index (DII) scores and cumulative average DII scores over 3 years. Cox regression models were used to estimate hazard ratios for CRC risk. After a median 16.2 years follow-up, 1,038 CRC cases were diagnosed. DII changes were not substantially associated with overall CRC, but proximal colon cancer risk was higher in the pro-inflammatory change DII compared to the anti-inflammatory stable DII groups (hazard ratio = 1.32; 95% confidence interval: 1.01, 1.74). Among non-users of nonsteroidal anti-inflammatory drugs (NSAID) (Pinteraction = 0.055) the pro-inflammatory stable DII group was at increased risk of overall CRC and proximal colon cancer. Also among non-users of NSAID, risks of overall CRC, colon cancer, and proximal colon cancer were higher in the highest quintile compared to the lowest cumulative average DII quintile (65%, 61%, and 91% increased risk, respectively). Dietary changes towards, or a history of, pro-inflammatory diets are associated with an elevated risk of colon cancer, particularly for proximal colon cancer and among non-users of NSAID

Identifying Metabolomic Profiles of Insulinemic Dietary Patterns

The food-based empirical dietary index for hyperinsulinemia (EDIH) score assesses the insulinemic potential of diet. This cross-sectional study evaluated associations between EDIH scores from food frequency questionnaires with c-peptide concentrations and with 448 metabolites, from fasting plasma samples, in multivariable linear regression analyses. Metabolites were measured with liquid chromatography tandem mass spectroscopy. Using a robust two-stage study design, discovery of metabolite associations was conducted among 1109 Women’s Health Initiative (WHI) Hormone Therapy (HT) trial participants and results replicated in an independent dataset of 810 WHI Observational Study (OS) participants. In both discovery and replication datasets, statistical significance was based on the false-discovery rate adjusted P \u3c 0.05. In the multivariable-adjusted analyses, EDIH was significantly associated with c-peptide concentrations among 919 women (HT & OS) with c-peptide data. On average, c-peptide concentrations were 18% higher (95% CI, 6%, 32%; P-trend \u3c 0.0001) in EDIH quintile 5 compared to quintile 1. Twenty-six metabolites were significantly associated with EDIH in the discovery dataset, and 19 of these were replicated in the validation dataset. Nine metabolites were found to decrease in abundance with increasing EDIH scores and included: C14:0 CE, C16:1 CE, C18:1 CE, C18:3 CE, C20:3 CE, C20:5 CE, C36:1 PS plasmalogen, trigonelline, and eicosapentanoate, whereas the 10 metabolites observed to increase with increasing EDIH scores were: C18:2 SM, C36:3 DAG, C36:4 DAG-A, C51:3 TAG, C52:3 TAG, C52:4, TAG, C54:3 TAG, C54:4 TAG, C54:6 TAG, and C10:2 carnitine. Cholesteryl esters, phospholipids, acylglycerols, and acylcarnitines may constitute circulating metabolites that are associated with insulinemic dietary patterns

Association between dietary inflammatory potential and breast cancer incidence and death: results from the Women\u27s Health Initiative

BACKGROUND: Diet modulates inflammation and inflammatory markers have been associated with cancer outcomes. In the Women\u27s Health Initiative, we investigated associations between a dietary inflammatory index (DII) and invasive breast cancer incidence and death. METHODS: The DII was calculated from a baseline food frequency questionnaire in 122 788 postmenopausal women, enrolled from 1993 to 1998 with no prior cancer, and followed until 29 August 2014. With median follow-up of 16.02 years, there were 7495 breast cancer cases and 667 breast cancer deaths. We used Cox regression to estimate multivariable-adjusted hazards ratios (HRs) and 95% confidence intervals (95% CIs) by DII quintiles (Q) for incidence of overall breast cancer, breast cancer subtypes, and deaths from breast cancer. The lowest quintile (representing the most anti-inflammatory diet) was the reference. RESULTS: The DII was not associated with incidence of overall breast cancer (HRQ5vsQ1, 0.99; 95% CI, 0.91-1.07; Ptrend=0.83 for overall breast cancer). In a full cohort analysis, a higher risk of death from breast cancer was associated with consumption of more pro-inflammatory diets at baseline, after controlling for multiple potential confounders (HRQ5vsQ1, 1.33; 95% CI, 1.01-1.76; Ptrend=0.03). CONCLUSIONS: Future studies are needed to examine the inflammatory potential of post-diagnosis diet given the suggestion from the current study that dietary inflammatory potential before diagnosis is related to breast cancer death

A systematic review and meta-analysis of the 2007 WCRF/AICR score in relation to cancer-related health outcomes

Background: We conducted a systematic literature review and meta-analysis of observational studies investigating adherence to the 2007 World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) lifestyle recommendations for cancer prevention and health outcomes. Patients and methods: We searched PubMed and the in-house database of the WCRF Continuous Update Project for publications up to June 2019. Cross-sectional studies were only narratively reviewed given their heterogeneity while findings of cohort/case-control studies were synthesized in umbrella reviews and meta-analyses. Summary relative risks (RRs) and 95% confidence intervals (CI) were estimated using a random-effects model when at least two studies reported results on a specific outcome. Results: Thirty-eight articles (17 prospective, 8 case-control, and 13 cross-sectional studies) were included. The summary RR per each point increment in the 2007 WCRF/AICR score was 0.90 (95% CI: 0.87e0.93, n 1⁄4 11) for breast cancer, regardless of hormone receptor and menopausal status, 0.86 (95% CI: 0.82e0.89, n 1⁄4 10) for colorectal cancer, and 0.93 (95% CI: 0.89e0.96, n 1⁄4 2) for lung cancer risk. No statistically significant associations were reported for prostate (n 1⁄4 6) and pancreatic cancers (n 1⁄4 2). Adherence to the recommendations was associated with lower overall mortality (RR 1⁄4 0.90, 95% CI 0.84e0.96, n 1⁄4 3) and cancer-specific mortality (RR 1⁄4 0.91, 95% CI 0.89e0.92; n 1⁄4 3) in healthy populations, as well as with higher survival in cancer patients (n 1⁄4 2). In cross-sectional studies, a healthier plasma marker profile and lower cancer risk factors in the general population and a better health status and quality of life in cancer patients/survivors were reported. Conclusions: Adhering to the 2007 WCRF/AICR recommendations is associated with lower risks of cancer incidence, namely breast and colorectal cancers, and mortality. Primary prevention of cancer should emphasize modification of multiple lifestyle factors. Upcoming studies examining the recently updated 2018 guidelines will further clarify such associations

Serum Calcium Concentrations, Chronic Inflammation and Glucose Metabolism: A Cross-Sectional Analysis in the Andhra Pradesh Children and Parents Study (APCaPS).

BACKGROUND: Evidence suggests a role for elevated serum calcium in dysregulated glucose metabolism, linked through low-level chronic inflammation. OBJECTIVES: We investigated the association of elevated serum calcium concentrations (corrected for albumin) with markers of dysregulated glucose metabolism and type II diabetes and tested if these associations were accounted for by chronic inflammation in a rural Indian population. METHODS: A cross-sectional analysis of participants aged 40-84 y from the Andhra Pradesh Children and Parents Study (APCaPS; n = 2699, 52.2% women) was conducted. Comprehensive information on household, sociodemographic, and lifestyle factors; medical and family history; physical measurements; blood measurements including fasting plasma glucose (FPG), fasting insulin (FI), serum calcium, albumin, phosphorous, vitamin D (in a subset), and creatinine were analyzed. Additionally, in a random sample of healthy participants (n = 1000), inflammatory biomarkers (interleukins 6 and 18, soluble intercellular adhesion molecule 1, adiponectin, and high-sensitivity C-reactive protein) were measured and an inflammatory score (IScore) calculated. RESULTS: After adjustments for sociodemographics, lifestyle factors, and anthropometry the highest calcium quartile (Q4 compared with Q1) was associated with FI (β = 1.4 µU/ml; 95% CI: 1.2, 1.5 µU/ml; P-trend < 0.001), the homeostasis model assessment for insulin resistance (HOMA-IR) (β = 1.4; 95% CI: 1.2, 1.5; P-trend < 0.001), and was modestly associated with FPG (β = 2.1 mg/dL; 95% CI: -0.9, 5.2 mg/dL; P-trend = 0.058) and prevalent type II diabetes (OR = 1.6; 95% CI: 1.0, 2.6; P-trend= 0.020). In the healthy subgroup, the association of the highest calcium quartile was similar for FI and HOMA-IR. Additional adjustment with IScore did not alter the associations. Further, in a subset, all these associations were independent of endogenous regulators of calcium metabolism (serum vitamin D, phosphorus, and creatinine). Independently, after accounting for potential confounders, the highest IScore quartile (Q4 compared with Q1) was positively associated with FPG, FI, HOMA-IR, and prevalent prediabetes, and also with serum calcium concentrations in men. CONCLUSIONS: Elevated serum calcium was positively associated with markers of dysregulated glucose metabolism and prevalent type II diabetes in a rural Indian population. Chronic inflammation did not mediate this association but was independently associated with markers of dysregulated glucose metabolism. Inflammation might be responsible for elevated serum calcium concentrations in men