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Santurtún A, Medín P, Riancho JA, Santiago-Setién M, Ortiz F, López de Munain A, Almendra R, Riancho J. Temporo-spatial analysis of amyotrophic lateral sclerosis in Spain: Altitude and land use as new determinants of the disease. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 957:177796. [PMID: 39616922 DOI: 10.1016/j.scitotenv.2024.177796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/16/2024] [Revised: 11/23/2024] [Accepted: 11/26/2024] [Indexed: 12/21/2024]
Abstract
INTRODUCTION Amyotrophic lateral sclerosis (ALS) is the most common neurodegenerative disease affecting motor neurons. Currently, ALS is conceived as the result of the interaction between genetics, environmental factors, and aging. This study analyzed the spatial and temporal patterns of ALS in Spain, delving into the potential relationships between altitude, land cover, and this disease. METHODOLOGY ALS death data were collected over a 19-year period, including information on sex, age and municipality of residence. The standardized mortality rate was calculated for each municipality of residencia, and Anselin's local Moran's I statistic was used to identify clusters of high and low incidence. Altitude data were sourced from the Copernicus Land Monitoring Services, while land cover data came from CORINE satellite images and national agricultural statistics. RESULTS The average annual incidence of ALS deaths among adults was 2.5 per 100,000 people. Higher mortality rates were noted in males (2.8) than in females (2.3), with both sexes exhibiting a rising mortality trend in a temporal analysis. Cluster analysis revealed that high mortality areas were mostly located in the North and Northeast of the country. Municipalities in these clusters had significantly lower median altitudes and larger areas of Permanently Irrigated Arable Land and Broad-Leaved Forest. CONCLUSION This study provides new evidence about the increase in ALS cases in European countries during the last decades, reporting for the first time altitude and certain agricultural land uses as potential geographic determinants of the disease.
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Affiliation(s)
- Ana Santurtún
- Unit of Legal Medicine, Department of Physiology and Pharmacology, University of Cantabria, Santander, Spain; Valdecilla Research Institute (IDIVAL), Santander, Spain.
| | - Pablo Medín
- Unit of Legal Medicine, Department of Physiology and Pharmacology, University of Cantabria, Santander, Spain
| | - José Antonio Riancho
- Valdecilla Research Institute (IDIVAL), Santander, Spain; Department of Medicine and Psychiatry, University of Cantabria, Santander, Spain; Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER, ISCIII), Madrid, Spain; Hospital U. M. Valdecilla, University of Cantabria, Santander, Spain
| | | | - Fernando Ortiz
- Hospital U. M. Valdecilla, University of Cantabria, Santander, Spain
| | - Adolfo López de Munain
- Neurology Department, Donostia University Hospital, Spain; University of the Basque Country-Osakidetza, Spain; CIBERNED, Barcelona, Spain; Biodonostia, 20014 Donostia-San Sebastián, Spain
| | - Ricardo Almendra
- Centre of Studies on Geography and Spatial Planning (CEGOT), Coimbra, Portugal; Department of Geography and Tourism, Faculty of Arts and Humanities, Colégio de São Jerónimo, University of Coimbra, Coimbra, Portugal
| | - Javier Riancho
- Valdecilla Research Institute (IDIVAL), Santander, Spain; Department of Medicine and Psychiatry, University of Cantabria, Santander, Spain; CIBERNED, Barcelona, Spain; Hospital Sierrallana, Torrelavega, Spain.
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Moraes JS, Ballesteros ML, Hued AC, Bonifacio AF, Azambuja TG, Vaz BDS, Martins CDMG. Glyphosate and its formulated product Roundup Transorb R® affect locomotor activity and reproductive and developmental parameters in Jenynsia lineata fish: An intergenerational study. CHEMOSPHERE 2024; 362:142541. [PMID: 38851497 DOI: 10.1016/j.chemosphere.2024.142541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Revised: 05/31/2024] [Accepted: 06/03/2024] [Indexed: 06/10/2024]
Abstract
Glyphosate is the most widely utilized herbicide worldwide due to its effectiveness in controlling agricultural weeds. However, its persistence in aquatic ecosystems has raised concerns about the well-being of non-target organisms such as fish. This study aimed to evaluate the effects of chronic exposure (21 days) to glyphosate or its formulated product Roundup Transorb R®, at an environmentally relevant concentration permitted by regulations in certain countries (65 μg/L of glyphosate), on the locomotor activity and reproductive success of the fish Jenynsia lineata, as well as on the morphology/development and locomotor activity of its offspring, as intergenerational effects. Neither the pure nor formulated herbicide altered the distance traveled and velocity of adult fish exposed to the herbicide (F0), but they negatively affected reproductive success, decreasing the percentage of positive response to the presence of the female, reducing the number of gravid females, causing abortions, and lowering offspring survival (F1). In the F1 generation, a decrease in weight and length was noted along with developmental abnormalities in both treatment groups (pure or formulated glyphosate), with the formulation causing more harm. Observed developmental abnormalities included muscle atrophy, ascites, pigmentary disorders, vertebral agenesis, spinal deviation, and exophthalmia. Furthermore, parental exposure to pure glyphosate led to an increase in the distance traveled and velocity of F1 (hyperlocomotion), whereas exposure to the formulated product resulted in a decrease in these behaviors (hypolocomotion) of F1. These findings highlight the toxic effects of glyphosate at very low concentrations, although varying between pure and formulated, and demonstrate the intergenerational consequences of herbicide exposure, underscoring the risk to the survival of fish offspring in glyphosate-contaminated environments.
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Affiliation(s)
- Jenifer Silveira Moraes
- Programa de Pós-Graduação em Ciências Fisiológicas, Instituto de Ciências Biológicas, Universidade Federal do Rio Grande, Av. Itália km 8, 96203-900, Rio Grande, RS, Brazil.
| | - María Laura Ballesteros
- Instituto de Diversidad y Ecología Animal (IDEA), CONICET (Consejo Nacional de Investigaciones Científicas Y Técnicas), Córdoba, 5000, Argentina; Facultad de Ciencias Exactas, Físicas y Naturales, Cátedra de Diversidad Biológica IV, Universidad Nacional de Córdoba, Córdoba, 5000, Argentina.
| | - Andrea Cecilia Hued
- Instituto de Diversidad y Ecología Animal (IDEA), CONICET (Consejo Nacional de Investigaciones Científicas Y Técnicas), Córdoba, 5000, Argentina; Facultad de Ciencias Exactas, Físicas y Naturales, Cátedra de Diversidad Biológica IV, Universidad Nacional de Córdoba, Córdoba, 5000, Argentina.
| | - Alejo Fabian Bonifacio
- Instituto de Diversidad y Ecología Animal (IDEA), CONICET (Consejo Nacional de Investigaciones Científicas Y Técnicas), Córdoba, 5000, Argentina; Facultad de Ciencias Exactas, Físicas y Naturales, Cátedra de Diversidad Biológica IV, Universidad Nacional de Córdoba, Córdoba, 5000, Argentina.
| | - Thaíz Gonçalves Azambuja
- Instituto Federal de Educação, Ciência e Tecnologia Sul-rio-grandense, Campus Pelotas. Praça 20 de Setembro, 455, 96015360, Pelotas, RS, Brazil.
| | - Bernardo Dos Santos Vaz
- Instituto Federal de Educação, Ciência e Tecnologia Sul-rio-grandense, Campus Pelotas. Praça 20 de Setembro, 455, 96015360, Pelotas, RS, Brazil.
| | - Camila de Martinez Gaspar Martins
- Programa de Pós-Graduação em Ciências Fisiológicas, Instituto de Ciências Biológicas, Universidade Federal do Rio Grande, Av. Itália km 8, 96203-900, Rio Grande, RS, Brazil.
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Fang YW, Wang C, Lin CY. Association between urinary glyphosate levels and hand grip strength in a representative sample of US adults: NHANES 2013-2014. Front Public Health 2024; 12:1352570. [PMID: 38450138 PMCID: PMC10915012 DOI: 10.3389/fpubh.2024.1352570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Accepted: 02/01/2024] [Indexed: 03/08/2024] Open
Abstract
Introduction Glyphosate, a widely utilized herbicide globally, has been linked to various health issues, including cancer, birth abnormalities, and reproductive issues. Additionally, there is growing experimental support indicating potential harm to skeletal muscles. Despite this, the impact of glyphosate on human muscle health remains unclear. Methods We examined information gathered from the 2013-2014 National Health and Nutrition Examination Survey (NHANES), which included 1466 adults aged 18 or older. Our primary aim was to investigate the relationship between glyphosate exposure and hand grip strength, as well as its influence on lean muscle mass. Results and discussion Our investigation uncovered a detrimental correlation between glyphosate exposure and all measures of grip strength, except for the second test of the first hand. Specifically, we observed a statistically significant adverse association between glyphosate exposure and combined grip strength, which is calculated as the sum of the highest readings from both hands (ß coefficient of -2.000, S.E. = 0.891, p = 0.040). We did not observe a significant correlation between glyphosate levels, lean muscle mass, and the likelihood of reaching maximum grip strength meeting sarcopenia criteria. Additionally, we observed an interaction between age and glyphosate, as well as between body mass index (BMI) and glyphosate, concerning the association with combined grip strength. In this comprehensive analysis of NHANES data, our study reveals a potential association between glyphosate exposure and hand grip strength in the adult population. Our findings suggest the need for deeper exploration into the health effects of glyphosate exposure and its impact on muscle strength, shedding light on possible public health concerns.
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Affiliation(s)
- Yu-Wei Fang
- Division of Nephrology, Department of Internal Medicine, Shin-Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan
- School of Medicine, College of Medicine, Fu Jen Catholic University, New Taipei, Taiwan
| | - ChiKang Wang
- Department of Environmental Engineering and Health, Yuanpei University of Medical Technology, Hsinchu, Taiwan
| | - Chien-Yu Lin
- School of Medicine, College of Medicine, Fu Jen Catholic University, New Taipei, Taiwan
- Department of Environmental Engineering and Health, Yuanpei University of Medical Technology, Hsinchu, Taiwan
- Department of Internal Medicine, En Chu Kong Hospital, New Taipei City, Taiwan
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Buchenauer L, Haange SB, Bauer M, Rolle-Kampczyk UE, Wagner M, Stucke J, Elter E, Fink B, Vass M, von Bergen M, Schulz A, Zenclussen AC, Junge KM, Stangl GI, Polte T. Maternal exposure of mice to glyphosate induces depression- and anxiety-like behavior in the offspring via alterations of the gut-brain axis. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 905:167034. [PMID: 37709081 DOI: 10.1016/j.scitotenv.2023.167034] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 08/24/2023] [Accepted: 09/11/2023] [Indexed: 09/16/2023]
Abstract
The past decade has been characterized by increased awareness and de-stigmatization of mental health issues, in particular the most common neuropsychiatric disorders depression and anxiety. Further, with growing understanding of neurodevelopmental disorders such as attention deficit and hyperactivity disorder and autism spectrum disorder, the number of diagnosed patients has increased. The pathogenesis of these behavioral disorders is multifactorial and early-life exposure to environmental chemicals has been proposed to be a relevant risk factor that might mediate these effects by disturbances on the gut-brain-axis. However, for glyphosate, the most widely used pesticide worldwide, there are only limited and inconsistent findings that link chronic low-dose exposure in particular during early life to neurobehavioral disorders. Here, we explored the impact of maternal oral glyphosate exposure (0.5 and 50 mg/kg body weight/day) during pregnancy and the lactational period on offspring's behavior, brain gene expression and gut microbiota using a cross-generational mouse model. Behavioral analyses revealed a depression- and anxiety-like behavior as well as social deficits most notably in adult female offspring of glyphosate-exposed dams. Furthermore, the expression of tryptophan hydroxylase 2, an enzyme discussed to be linked to behavioral problems, was reduced in the hippocampus of female offspring and correlated to a glyphosate-induced DNA hypermethylation of the gene. Moreover, maternal glyphosate exposure significantly altered the gut microbiota in the female offspring including a decreased abundance of Akkermansia and increased abundance of Alistipes and Blautia, bacteria involved in tryptophan metabolism and associated with depression- and anxiety-like disorders. Our results suggest that glyphosate might influence the gut-brain axis crosstalk following in-utero and lactational exposure. This study underlines the importance of understanding the impact of exposure to pesticides on the gut-brain axis and further emphasizes the need for microbiome analyses to be compulsorily included in health risk assessments of pesticides.
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Affiliation(s)
- Lisa Buchenauer
- Helmholtz Centre for Environmental Research - UFZ, Department of Environmental Immunology, Leipzig, Germany; University of Leipzig, Leipzig University Medical Center, Department of Dermatology, Venerology and Allergology, Leipzig, Germany
| | - Sven-Bastiaan Haange
- Helmholtz Centre for Environmental Research - UFZ, Department of Molecular Systems Biology, Leipzig, Germany
| | - Mario Bauer
- Helmholtz Centre for Environmental Research - UFZ, Department of Environmental Immunology, Leipzig, Germany
| | - Ulrike E Rolle-Kampczyk
- Helmholtz Centre for Environmental Research - UFZ, Department of Molecular Systems Biology, Leipzig, Germany
| | - Marita Wagner
- Helmholtz Centre for Environmental Research - UFZ, Department of Environmental Immunology, Leipzig, Germany; University of Leipzig, Leipzig University Medical Center, Department of Dermatology, Venerology and Allergology, Leipzig, Germany
| | - Johanna Stucke
- Helmholtz Centre for Environmental Research - UFZ, Department of Environmental Immunology, Leipzig, Germany; University of Leipzig, Leipzig University Medical Center, Department of Dermatology, Venerology and Allergology, Leipzig, Germany
| | - Elena Elter
- Helmholtz Centre for Environmental Research - UFZ, Department of Environmental Immunology, Leipzig, Germany; University of Leipzig, Leipzig University Medical Center, Department of Dermatology, Venerology and Allergology, Leipzig, Germany
| | - Beate Fink
- Helmholtz Centre for Environmental Research - UFZ, Department of Environmental Immunology, Leipzig, Germany
| | - Maren Vass
- University of Leipzig, Leipzig University Medical Center, Department of Dermatology, Venerology and Allergology, Leipzig, Germany
| | - Martin von Bergen
- Helmholtz Centre for Environmental Research - UFZ, Department of Molecular Systems Biology, Leipzig, Germany; University of Leipzig, Faculty of Life Sciences, Institute of Biochemistry, Leipzig, Germany; German Centre for Integrative Biodiversity Research (iDiv) Halle-Jena-Leipzig, Leipzig, Germany
| | - Angela Schulz
- University of Leipzig, Medical Faculty, Rudolf Schönheimer Institute of Biochemistry, Leipzig, Germany
| | - Ana C Zenclussen
- Helmholtz Centre for Environmental Research - UFZ, Department of Environmental Immunology, Leipzig, Germany; Perinatal Immunology, Saxonian Incubator for Clinical Translation (SIKT), Medical Faculty, University Leipzig, 04103 Leipzig, Germany
| | - Kristin M Junge
- Helmholtz Centre for Environmental Research - UFZ, Department of Environmental Immunology, Leipzig, Germany; AKAD University Stuttgart, School of Health and Social Sciences, Stuttgart, Germany
| | - Gabriele I Stangl
- Institute of Agricultural and Nutritional Sciences, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - Tobias Polte
- Helmholtz Centre for Environmental Research - UFZ, Department of Environmental Immunology, Leipzig, Germany; University of Leipzig, Leipzig University Medical Center, Department of Dermatology, Venerology and Allergology, Leipzig, Germany.
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Liu R, Sheng J, Huang H. Research progress on the effects of adverse exposure during pregnancy on skeletal muscle function in the offspring. Zhejiang Da Xue Xue Bao Yi Xue Ban 2023; 53:271-279. [PMID: 37986679 PMCID: PMC11348699 DOI: 10.3724/zdxbyxb-2023-0218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 09/05/2023] [Indexed: 11/22/2023]
Abstract
Skeletal muscle plays a crucial role in maintaining metabolism, energy homeostasis, movement, as well as endocrine function. The gestation period is a critical stage for myogenesis and development of the skeletal muscle. Adverse environmental exposures during pregnancy may impose various effects on the skeletal muscle health of the offspring. Maternal obesity during pregnancy can mediate lipid deposition in the skeletal muscle of the offspring by affecting fetal skeletal muscle metabolism and inflammation-related pathways. Poor dietary habits during pregnancy, such as high sugar and high fat intake, can affect autophagy of skeletal muscle mitochondria and reduce the quality of the offspring skeletal muscle. Nutritional deficiencies during pregnancy can affect the development of the offspring skeletal muscle through epigenetic modifications. Gestational diabetes may affect the function of the offspring skeletal muscle by upregulating the levels of miR-15a and miR-15b in the offspring. Exposure to environmental endocrine disruptors during pregnancy may impair skeletal muscle function by interfering with insulin receptor-related signaling pathways. This article reviews the research progress on effects and possible mechanisms of adverse maternal exposures during pregnancy on the offspring skeletal muscle function based on clinical and animal studies, aiming to provide scientific evidence for the prevention and treatment strategies of birth defects in the skeletal muscle.
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Affiliation(s)
- Rui Liu
- Center for Reproductive Medicine, the Fourth Affiliated Hospital of School of Medicine, International School of Medicine, International Institutes of Medicine, Zhejiang University, Yiwu 322000, Zhejiang Province, China.
- Ministry of Education Key Laboratory of Reproductive Genetics, Department of Reproductive Endocrinology, Zhejiang University School of Medicine, Hangzhou 310006, China.
| | - Jianzhong Sheng
- Center for Reproductive Medicine, the Fourth Affiliated Hospital of School of Medicine, International School of Medicine, International Institutes of Medicine, Zhejiang University, Yiwu 322000, Zhejiang Province, China
- Ministry of Education Key Laboratory of Reproductive Genetics, Department of Reproductive Endocrinology, Zhejiang University School of Medicine, Hangzhou 310006, China
| | - Hefeng Huang
- Center for Reproductive Medicine, the Fourth Affiliated Hospital of School of Medicine, International School of Medicine, International Institutes of Medicine, Zhejiang University, Yiwu 322000, Zhejiang Province, China.
- Ministry of Education Key Laboratory of Reproductive Genetics, Department of Reproductive Endocrinology, Zhejiang University School of Medicine, Hangzhou 310006, China.
- Shanghai Key Laboratory of Embryo Original Diseases, Research Units of Embryo Original Diseases, Chinese Academy of Medical Sciences, Shanghai 200030, China.
- Institute of Reproduction and Development, Obstetrics and Gynecology Hospital, Fudan University, Shanghai 200030, China.
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Ganesan S, Keating AF. Maternal impacts of pre-conceptional glyphosate exposure. Toxicol Appl Pharmacol 2023; 478:116692. [PMID: 37708915 DOI: 10.1016/j.taap.2023.116692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 09/05/2023] [Accepted: 09/11/2023] [Indexed: 09/16/2023]
Abstract
Maternal glyphosate (GLY) impacts remain unclear despite associations between urinary GLY and birth outcomes. Whether maternal pre-conceptional GLY exposure would have phenotypic and molecular impacts in the dam and offspring was tested. Female C57BL6 mice (6 wk) were exposed to saline (CT; n = 20) or GLY (2 mg/kg; n = 20) per os five d per week for 20 wk. Females were housed with males and on gestation day (GD) 14, divided into: CT non-pregnant (CNP), CT pregnant (CP), GLY non-pregnant (GNP), GLY pregnant (GP). Another cohort (CT; n = 10 or GLY; n = 10) completed three pregnancy rounds and pregnancy index (PI), number of pups per litter and pups surviving to postnatal day (PND) 5 calculated. The PI in GLY mice was higher in breeding rounds 1 and 2, but lower in round 3. Pregnancy increased (P ≤ 0.1) GD14 liver and ovary weight. Spleen weight was increased (P < 0.05) in GP relative to GNP mice. No offspring phenotypic impacts were observed. Approximately six months after cessation of exposure, secondary follicle number was reduced (P < 0.05) by pre-conceptional GLY exposure. The ovarian proteome analyzed by LC-MS/MS was altered (P < 0.05) by pregnancy (49 increased, 43 decreased) and GLY exposure (non-pregnant: 75 increased, 22 decreased, pregnant: 27 increased, 29 decreased; aged dams: 60 increased, 98 decreased) with several histone proteins being altered. These findings support ovarian transient and persistent impacts of GLY exposure and identify pathways as potential modes of action.
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Affiliation(s)
- Shanthi Ganesan
- Department of Animal Science, Iowa State University, Ames, IA 50011, USA.
| | - Aileen F Keating
- Department of Animal Science, Iowa State University, Ames, IA 50011, USA.
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Anderson G. Amyotrophic Lateral Sclerosis Pathoetiology and Pathophysiology: Roles of Astrocytes, Gut Microbiome, and Muscle Interactions via the Mitochondrial Melatonergic Pathway, with Disruption by Glyphosate-Based Herbicides. Int J Mol Sci 2022; 24:ijms24010587. [PMID: 36614029 PMCID: PMC9820185 DOI: 10.3390/ijms24010587] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 12/23/2022] [Accepted: 12/28/2022] [Indexed: 12/31/2022] Open
Abstract
The pathoetiology and pathophysiology of motor neuron loss in amyotrophic lateral sclerosis (ALS) are still to be determined, with only a small percentage of ALS patients having a known genetic risk factor. The article looks to integrate wider bodies of data on the biological underpinnings of ALS, highlighting the integrative role of alterations in the mitochondrial melatonergic pathways and systemic factors regulating this pathway across a number of crucial hubs in ALS pathophysiology, namely glia, gut, and the muscle/neuromuscular junction. It is proposed that suppression of the mitochondrial melatonergic pathway underpins changes in muscle brain-derived neurotrophic factor, and its melatonergic pathway mimic, N-acetylserotonin, leading to a lack of metabolic trophic support at the neuromuscular junction. The attenuation of the melatonergic pathway in astrocytes prevents activation of toll-like receptor agonists-induced pro-inflammatory transcription factors, NF-kB, and yin yang 1, from having a built-in limitation on inflammatory induction that arises from their synchronized induction of melatonin release. Such maintained astrocyte activation, coupled with heightened microglia reactivity, is an important driver of motor neuron susceptibility in ALS. Two important systemic factors, gut dysbiosis/permeability and pineal melatonin mediate many of their beneficial effects via their capacity to upregulate the mitochondrial melatonergic pathway in central and systemic cells. The mitochondrial melatonergic pathway may be seen as a core aspect of cellular function, with its suppression increasing reactive oxygen species (ROS), leading to ROS-induced microRNAs, thereby altering the patterning of genes induced. It is proposed that the increased occupational risk of ALS in farmers, gardeners, and sportsmen and women is intimately linked to exposure, whilst being physically active, to the widely used glyphosate-based herbicides. This has numerous research and treatment implications.
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Affiliation(s)
- George Anderson
- CRC Scotland & London, Eccleston Square, London SW1V 1PG, UK
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