Promoting Land-Based Food Practices in the not so Rural Idyll of Northern Lebanon: Dietary Solutions from Urban Perspectives

This article is the result of two months of ethnographic fieldwork conducted in rural Lebanon, studying local food harvesting, preparation and consumption practices. The study revealed the complexities of maintaining land-based lifestyles in contemporary Lebanon. It also exposed the paradoxical constructions of rural existence. In this paper, we deconstruct the mythical constructions of the rural idyll in the Lebanese village of Arsal and describe the multiple facets of local food production. If proponents of local food production are advocating for the preservation of local practices, it is critical to understand what is taking place in the communities and the environmental and economic factors they face engaging in the new global economy. Keywords: rural, rural idyll, Lebanon, land-based food practices, agriculture, health ------------------------------------------------------ Promouvoir les Pratiques Alimentaires basées sur les Ressources Naturelles dans une non-idylle rurale du Nord du Liban: Solutions Diététiques selon des perspectives urbaines Résumé Cet article est le résultat de deux mois de travail ethnographique de terrain conduit en milieu rural du Liban, pour étudier la récolte de nourriture locale, les habitudes de préparation et de consommation. L'étude a révélé la complexité de maintenir un mode de vie basé sur les ressources naturelles, dans un Liban contemporain. Elle a exposé les structures paradoxales de l'existence rurale. Dans cet article, nous déconstruisons les structures mythiques de l'idylle rurale dans le village libanais d'Arsal et nous décrivons les multiples facettes de la production de nourriture locale. Si les partisans de la production de nourriture locale soutiennent la conservation des pratiques locales, il est critique de comprendre ce qui se passe dans les communautés ainsi que les facteurs environnementaux et économiques auxquels ils font face en s'engageant dans la nouvelle économie globale

Hoop House Gardening in the Wapekeka First Nation as an Extension of Land-Based Food Practices

Rural Indigenous communities in Canada’s North face many challenges getting regular access to nutritious foods, primarily because of the high cost of market food, restricted availability of nutritious foods, and lack of government support for nutritious food programs. The consequences of food insecurity in this context are expressed in high rates of diabetes, heart disease, and childhood obesity. Many Indigenous communities are responding to issues related to healthy food access by attempting to rebuild local food capacity in their specific regions. Important first steps have been taken in developing local food initiatives, yet whether these initiatives are improving northern food security remains to be seen. We explore this question by working with the Oji-Cree First Nation in the community of Wapekeka, northern Ontario, to construct a hoop house and develop a school-based community gardening program. Using a community-based participatory approach, we determined that hoop house and gardening initiatives in rural, northern settings have the potential to build up local food production, develop the skills and knowledge of community members, engage youth in growing local food, and align with land-based food teachings. We show that despite widespread and multidimensional community hardships, there was considerable community buy-in and support for the project, which gives hope for future development and provides important insight for those seeking to initiate similar gardening, hoop house, or greenhouse initiatives in northern Indigenous communities.Les collectivités autochtones du Canada en milieu rural nordique ont de nombreux défis à relever pour avoir régulièrement accès à de la nourriture nutritive, principalement en raison du coût élevé des denrées alimentaires du marché, de la disponibilité restreinte d’aliments nutritifs et du manque de soutien gouvernemental pour l’adoption de programmes de provisions alimentaires nutritives. Dans ce contexte, les conséquences de l’insécurité alimentaire s’expriment par des taux élevés de diabète, de maladies du coeur et d’obésité infantile. De nombreuses collectivités autochtones relèvent les défis d’accès à des denrées saines en tentant de renforcer la capacité alimentaire locale de leurs propres régions. Ils ont déjà pris d’importantes mesures pour aboutir à des initiatives alimentaires locales, mais il reste à voir si ces initiatives permettent d’améliorer la sécurité alimentaire dans le Nord. Nous nous penchons sur cette question de concert avec la Première Nation oji-cri dans la collectivité de Wapekeka, dans le nord de l’Ontario, en construisant plus précisément une serre à arceaux et en aménageant un programme de jardinage scolaire. Grâce à notre approche participative et communautaire, nous avons déterminé que la serre à arceaux et les initiatives de jardinage en milieu rural nordique ont la possibilité de se traduire par l’accumulation d’aliments produits à l’échelle locale, de favoriser l’acquisition de compétences et de connaissances, d’inciter les jeunes à cultiver des aliments localement et de mettre en valeur les enseignements relatifs à la nourriture provenant de la terre. Nous montrons que malgré les difficultés multidimensionnelles répandues dans la collectivité, ce projet a suscité un appui considérable de la part des gens, ce qui donne de l’espoir en vue de développements futurs et permet aux personnes désirant mettre en oeuvre des initiatives semblables de jardinage, de serres à arceaux et de serres ordinaires dans les collectivités autochtones nordiques d’acquérir d’importantes connaissances

HER2 and ESR1 mRNA expression levels and response to neoadjuvant trastuzumab plus chemotherapy in patients with primary breast cancer

Introduction: Recent data suggest that benefit from trastuzumab and chemotherapy might be related to expression of HER2 and estrogen receptor (ESR1). Therefore, we investigated HER2 and ESR1 mRNA levels in core biopsies of HER2-positive breast carcinomas from patients treated within the neoadjuvant GeparQuattro trial. Methods: HER2 levels were centrally analyzed by immunohistochemistry (IHC), silver in-situ hybridization (SISH) and qRT-PCR in 217 pretherapeutic formalin-fixed, paraffin-embedded (FFPE) core biopsies. All tumors had been HER2-positive by local pathology and had been treated with neoadjuvant trastuzumab/ chemotherapy in GeparQuattro. Results: Only 73% of the tumors (158 of 217) were centrally HER2-positive (cHER2-positive) by IHC/SISH, with cHER2-positive tumors showing a significantly higher pCR rate (46.8% vs. 20.3%, p<0.0005). HER2 status by qRT-PCR showed a concordance of 88.5% with the central IHC/SISH status, with a low pCR rate in those tumors that were HER2-negative by mRNA analysis (21.1% vs. 49.6%, p<0.0005). The level of HER2 mRNA expression was linked to response rate in ESR1-positive tumors, but not in ESR1-negative tumors. HER2 mRNA expression was significantly associated with pCR in the HER2-positive/ESR1-positive tumors (p=0.004), but not in HER2-positive/ESR1-negative tumors. Conclusions: Only patients with cHER2-positive tumors - irrespective of the method used - have an increased pCR rate with trastuzumab plus chemotherapy. In patients with cHER2-negative tumors the pCR rate is comparable to the pCR rate in the non-trastuzumab treated HER-negative population. Response to trastuzumab is correlated to HER2 mRNA levels only in ESR1-positive tumors. This study adds further evidence to the different biology of both subsets within the HER2-positive group

Obesity and Type 2 Diabetes Prevalence in Adults from Two Remote First Nations Communities in Northwestern Ontario, Canada

Objective. To assess the prevalence rates of obesity and type 2 diabetes in adults from two First Nations communities in northwestern Ontario, Canada. Methods. Body weight, height, and waist circumference as well as fasting and postprandial glucose levels following an oral glucose tolerance test were measured in 31 men and 41 women. Results. The mean age of the sample was 43 ± 13 y. The prevalence of obesity was 65.3% and was comparable between men and women. 90.3% of the individuals presented waist circumference levels greater than the thresholds associated with an increased risk of developing health problems. 26 of the 72 individuals (36.1%) were found to be type 2 diabetic. The prevalence of diabetes was not different between men and women. Conclusion. Using objective measurements, this study confirms that First Nations adults from remote communities of Canada continue to experience a disproportionately higher prevalence of obesity and type 2 diabetes than nonaboriginal Canadians

Fine-Scale Mapping of the 4q24 Locus Identifies Two Independent Loci Associated with Breast Cancer Risk

Background: A recent association study identified a common variant (rs9790517) at 4q24 to be associated with breast cancer risk. Independent association signals and potential functional variants in this locus have not been explored. Methods: We conducted a fine-mapping analysis in 55,540 breast cancer cases and 51,168 controls from the Breast Cancer Association Consortium. Results: Conditional analyses identified two independent association signals among women of European ancestry, represented by rs9790517 [conditional P = 2.51 × 10−4; OR, 1.04; 95% confidence interval (CI), 1.02–1.07] and rs77928427 (P = 1.86 × 10−4; OR, 1.04; 95% CI, 1.02–1.07). Functional annotation using data from the Encyclopedia of DNA Elements (ENCODE) project revealed two putative functional variants, rs62331150 and rs73838678 in linkage disequilibrium (LD) with rs9790517 (r2 ≥ 0.90) residing in the active promoter or enhancer, respectively, of the nearest gene, TET2. Both variants are located in DNase I hypersensitivity and transcription factor–binding sites. Using data from both The Cancer Genome Atlas (TCGA) and Molecular Taxonomy of Breast Cancer International Consortium (METABRIC), we showed that rs62331150 was associated with level of expression of TET2 in breast normal and tumor tissue. Conclusion: Our study identified two independent association signals at 4q24 in relation to breast cancer risk and suggested that observed association in this locus may be mediated through the regulation of TET2. Impact: Fine-mapping study with large sample size warranted for identification of independent loci for breast cancer risk

Role of β-adrenergic receptors in the oral activity of zinc-α2-glycoprotein (ZAG)

Zinc-a2-glycoprotein (ZAG) is an adipokine with the potential as a therapeutic agent in the treatment of obesity and type 2 diabetes. In this study we show that human ZAG, which is a 41-kDa protein, when administered to ob/ob mice at 50 µg/d-1 orally in the drinking water produced a progressive loss of body weight (5 g after 8 d treatment), together with a 0.5 C increase in rectal temperature and a 40% reduction in urinary excretion of glucose. There was also a 33% reduction in the area under the curve during an oral glucose tolerance test and an increased sensitivity to insulin. These results were similar to those after iv administration of ZAG. However, tryptic digestion was shown to inactivate ZAG. There was no evidence of human ZAG in the serum but a 2-fold elevation of murine ZAG, which was also observed in target tissues such as white adipose tissue. To determine whether the effect was due to interaction of the human ZAG with the ß-adrenergic (ß-AR) in the gastrointestinal tract before digestion, ZAG was coadministered to ob/ob mice together with propanolol (40 mg/kg-1), a nonspecific ß-AR antagonist. The effect of ZAG on body weight, rectal temperature, urinary glucose excretion, improvement in glucose disposal, and increased insulin sensitivity were attenuated by propanolol, as was the increase in murine ZAG in the serum. These results suggest that oral administration of ZAG increases serum levels through interaction with a ß-AR in the upper gastrointestinal tract, and gene expression studies showed this to be in the esophagus

Dysregulation of Cytokine Response in Canadian First Nations Communities: Is There an Association with Persistent Organic Pollutant Levels?

In vitro and animal studies report that some persistent organic pollutants (POPs) trigger the secretion of proinflammatory cytokines. Whether POP exposure is associated with a dysregulation of cytokine response remains to be investigated in humans. We studied the strength of association between plasma POP levels and circulating cytokines as immune activation markers. Plasma levels of fourteen POPs and thirteen cytokines were measured in 39 Caucasians from a comparator sample in Québec City (Canada) and 72 First Nations individuals from two northern communities of Ontario (Canada). Caucasians showed significantly higher levels of organochlorine insecticides (β-HCH, p,p′-DDE and HCB) compared to First Nations. Conversely, First Nations showed higher levels of Mirex, Aroclor 1260, PCB 153, PCB 170, PCB 180 and PCB 187 compared to Caucasians. While there was no difference in cytokine levels of IL-4, IL-6, IL-10 and IL-22 between groups, First Nations had significantly greater average levels of IFNγ, IL-1β, IL-2, IL-5, IL-8, IL-12p70, IL-17A, TNFα and TNFβ levels compared to Caucasians. Among candidate predictor variables (age, body mass index, insulin resistance and POP levels), high levels of PCBs were the only predictor accounting for a small but significant effect of observed variance (∼7%) in cytokine levels. Overall, a weak but significant association is detected between persistent organochlorine pollutant exposure and elevated cytokine levels. This finding augments the already existing information that environmental pollution is related to inflammation, a common feature of several metabolic disorders that are known to be especially prevalent in Canada's remote First Nations communities

Current and future role of neoadjuvant therapy for breast cancer

Neoadjuvant systemic chemotherapy is a possible therapeutic approach for the treatment of locally advanced operable, primarily non-operable or inflammatory breast cancer. Neoadjuvant systemic chemotherapy is an option for breast cancer patients who would require adjuvant chemotherapy otherwise based on clinical and histological examination and imaging. The use of neoadjuvant systemic therapy in operable breast cancer is currently increasing because of its advantages that include higher rates of breast conserving surgery and the possibility of measuring early in-vivo response to systemic treatment. The timing of axillary sentinel lymph node diagnosis (i.e. before or after neoadjuvant chemotherapy) is critical in that it may influence the likelihood of axillary preservation. It is not yet clear if neoadjuvant therapy might improve outcomes in certain subgroups of breast cancer patients. Neoadjuvant treatment modalities require a close collaboration between oncology professionals, including surgeons, gynecologists, medical oncologists, radiation oncologists, radiologists and pathologists. The most important parameter for treatment success and improved overall survival is the achievement of a pathologic complete response (pCR), although the role of pCR in patients with luminal A like tumours might be less informative. Identification of patient subgroups with high pCR rates may allow less invasive surgical or radiological interventions. Patients not achieving a pCR may be candidates for postoperative clinical trials exploring novel systemic treatments