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Bartholomew V, Hundley V, Clark CJ, Parris BA. The RETHINK Study: Could pain catastrophising explain why some women are more likely to attend hospital during the latent phase of labour. Sex Reprod Healthc 2024; 39:100941. [PMID: 38104503 DOI: 10.1016/j.srhc.2023.100941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 12/01/2023] [Accepted: 12/04/2023] [Indexed: 12/19/2023]
Abstract
OBJECTIVE To examine the prevalence of pain catastrophising and identify whether it impacts on the timing of hospital admission when in labour. METHODS A longitudinal cohort study. Nulliparous women, experiencing an uncomplicated pregnancy in England, were recruited between 25 and 33 weeks gestation. Participants completed two online questionnaires, (1) on recruitment, including the Pain Catastrophizing Scale (PCS) and the Wijma Delivery Expectancy Questionnaire (WDEQ-A) (2) at three weeks postnatal. RESULTS A total of 389 eligible participants entered the study. The percentage of women who were pain catastrophisers (PCS ≥ 20) was 28.1 %, while 7.6 % had a high pain catastrophising score (PCS ≥ 30). There was no association between pain catastrophising and the timing of hospital admission. The percentage of women reporting fear of childbirth (WDEQ-A score of ≥ 85) was 10.6 %. Fear of childbirth was highly associated with PCS scores (p <.001) at both the lower (≥20) and higher (≥30) thresholds. CONCLUSION Although not statistically significant, there was a tendency for women who pain catastrophise to present to hospital in the latent phase. The highly significant association between PCS and WDEQ-A scores has implications for the identification of these women and suggests that the PCS can be used as a screening tool to identify those women who have heightened fear around pain and who may also go on to develop clinically relevant fear of childbirth. Further studies are needed to confirm the acceptability of the PCS as a screening tool with women.
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Affiliation(s)
- V Bartholomew
- Centre for Midwifery & Women's Health, Bournemouth University, Faculty of Health and Social Sciences, Bournemouth Gateway Building, St Paul's Lane, Bournemouth BH8 8GP, United Kingdom.
| | - V Hundley
- Centre for Midwifery & Women's Health, Bournemouth University, Faculty of Health and Social Sciences, Bournemouth Gateway Building, St Paul's Lane, Bournemouth BH8 8GP, United Kingdom
| | - C J Clark
- Centre for Midwifery & Women's Health, Bournemouth University, Faculty of Health and Social Sciences, Bournemouth Gateway Building, St Paul's Lane, Bournemouth BH8 8GP, United Kingdom
| | - B A Parris
- Department of Psychology, Bournemouth University, Poole House P331, Talbot Campus, Fern Barrow, Poole BH12 5BB, United Kingdom
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Clark CJ, Kerr M, Barr ED, Bhattacharyya B, Breton RP, Bruel P, Camilo F, Chen W, Cognard I, Cromartie HT, Deneva J, Dhillon VS, Guillemot L, Kennedy MR, Kramer M, Lyne AG, Sánchez DM, Nieder L, Phillips C, Ransom SM, Ray PS, Roberts MSE, Roy J, Smith DA, Spiewak R, Stappers BW, Tabassum S, Theureau G, Voisin G. Neutron star mass estimates from gamma-ray eclipses in spider millisecond pulsar binaries. Nat Astron 2023; 7:451-462. [PMID: 37096051 PMCID: PMC10119022 DOI: 10.1038/s41550-022-01874-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 12/01/2022] [Indexed: 05/03/2023]
Abstract
Reliable neutron star mass measurements are key to determining the equation of state of cold nuclear matter, but such measurements are rare. Black widows and redbacks are compact binaries consisting of millisecond pulsars and semi-degenerate companion stars. Spectroscopy of the optically bright companions can determine their radial velocities, providing inclination-dependent pulsar mass estimates. Although inclinations can be inferred from subtle features in optical light curves, such estimates may be systematically biased due to incomplete heating models and poorly understood variability. Using data from the Fermi Large Area Telescope, we have searched for gamma-ray eclipses from 49 spider systems, discovering significant eclipses in 7 systems, including the prototypical black widow PSR B1957+20. Gamma-ray eclipses require direct occultation of the pulsar by the companion, and so the detection, or significant exclusion, of a gamma-ray eclipse strictly limits the binary inclination angle, providing new robust, model-independent pulsar mass constraints. For PSR B1957+20, the eclipse implies a much lighter pulsar (1.81 ± 0.07 solar masses) than inferred from optical light curve modelling.
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Affiliation(s)
- C. J. Clark
- Max Planck Institute for Gravitational Physics (Albert Einstein Institute), Hannover, Germany
- Leibniz Universität Hannover, Hannover, Germany
- Jodrell Bank Centre for Astrophysics, Department of Physics and Astronomy, The University of Manchester, Manchester, UK
| | - M. Kerr
- Space Science Division, Naval Research Laboratory, Washington, DC USA
| | - E. D. Barr
- Max-Planck-Institut für Radioastronomie, Bonn, Germany
| | - B. Bhattacharyya
- National Centre for Radio Astrophysics, Tata Institute of Fundamental Research, Pune, India
| | - R. P. Breton
- Jodrell Bank Centre for Astrophysics, Department of Physics and Astronomy, The University of Manchester, Manchester, UK
| | - P. Bruel
- Laboratoire Leprince-Ringuet, École Polytechnique, CNRS/IN2P3, Palaiseau, France
| | - F. Camilo
- South African Radio Astronomy Observatory, Cape Town, South Africa
| | - W. Chen
- Max-Planck-Institut für Radioastronomie, Bonn, Germany
| | - I. Cognard
- Laboratoire de Physique et Chimie de l’Environnement et de l’Espace–Université d’Orléans, CNRS, Orléans, France
- Observatoire Radioastronomique de Nançay, Observatoire de Paris, Université PSL, Université d’Orléans, CNRS, Nançay, France
| | - H. T. Cromartie
- Cornell Center for Astrophysics and Planetary Science and Department of Astronomy, Cornell University, Ithaca, NY USA
| | - J. Deneva
- Space Science Division, Naval Research Laboratory, Washington, DC USA
- College of Science, George Mason University, Fairfax, VA USA
| | - V. S. Dhillon
- Department of Physics and Astronomy, University of Sheffield, Sheffield, UK
- Instituto de Astrofísica de Canarias, La Laguna, Spain
| | - L. Guillemot
- Laboratoire de Physique et Chimie de l’Environnement et de l’Espace–Université d’Orléans, CNRS, Orléans, France
- Observatoire Radioastronomique de Nançay, Observatoire de Paris, Université PSL, Université d’Orléans, CNRS, Nançay, France
| | - M. R. Kennedy
- Jodrell Bank Centre for Astrophysics, Department of Physics and Astronomy, The University of Manchester, Manchester, UK
- Department of Physics, University College Cork, Cork, Ireland
| | - M. Kramer
- Jodrell Bank Centre for Astrophysics, Department of Physics and Astronomy, The University of Manchester, Manchester, UK
- Max-Planck-Institut für Radioastronomie, Bonn, Germany
| | - A. G. Lyne
- Jodrell Bank Centre for Astrophysics, Department of Physics and Astronomy, The University of Manchester, Manchester, UK
| | - D. Mata Sánchez
- Jodrell Bank Centre for Astrophysics, Department of Physics and Astronomy, The University of Manchester, Manchester, UK
- Instituto de Astrofísica de Canarias, La Laguna, Spain
- Departamento de Astrofísica, Universidad de La Laguna, La Laguna, Spain
| | - L. Nieder
- Max Planck Institute for Gravitational Physics (Albert Einstein Institute), Hannover, Germany
- Leibniz Universität Hannover, Hannover, Germany
| | - C. Phillips
- University of Virginia, Charlottesville, VA USA
| | - S. M. Ransom
- National Radio Astronomy Observatory, Socorro, NM USA
| | - P. S. Ray
- Space Science Division, Naval Research Laboratory, Washington, DC USA
| | | | - J. Roy
- National Centre for Radio Astrophysics, Tata Institute of Fundamental Research, Pune, India
| | - D. A. Smith
- Laboratoire d’Astrophysique de Bordeaux, Université de Bordeaux, CNRS, Pessac, France
| | - R. Spiewak
- Jodrell Bank Centre for Astrophysics, Department of Physics and Astronomy, The University of Manchester, Manchester, UK
- ARC Centre of Excellence for Gravitational Wave Discovery (OzGrav), Centre for Astrophysics and Supercomputing, Swinburne University of Technology, Hawthorn, Victoria Australia
- Centre for Astrophysics and Supercomputing, Swinburne University of Technology, Hawthorn, Victoria Australia
| | - B. W. Stappers
- Jodrell Bank Centre for Astrophysics, Department of Physics and Astronomy, The University of Manchester, Manchester, UK
| | - S. Tabassum
- New York University Abu Dhabi, Abu Dhabi, United Arab Emirates
- Department of Physics and Astronomy, West Virginia University, Morgantown, WV USA
| | - G. Theureau
- Laboratoire de Physique et Chimie de l’Environnement et de l’Espace–Université d’Orléans, CNRS, Orléans, France
- Observatoire Radioastronomique de Nançay, Observatoire de Paris, Université PSL, Université d’Orléans, CNRS, Nançay, France
- Laboratoire Univers et Théories, Observatoire de Paris, Université PSL, CNRS, Université de Paris, Meudon, France
| | - G. Voisin
- Jodrell Bank Centre for Astrophysics, Department of Physics and Astronomy, The University of Manchester, Manchester, UK
- Laboratoire Univers et Théories, Observatoire de Paris, Université PSL, CNRS, Université de Paris, Meudon, France
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Siegel HG, Soriano MA, Clark CJ, Johnson NP, Wulsin HG, Deziel NC, Plata DL, Darrah TH, Saiers JE. Natural and Anthropogenic Processes Affecting Domestic Groundwater Quality within the Northwestern Appalachian Basin. Environ Sci Technol 2022; 56:13761-13773. [PMID: 36129683 PMCID: PMC9536308 DOI: 10.1021/acs.est.2c04011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Revised: 08/29/2022] [Accepted: 09/08/2022] [Indexed: 06/15/2023]
Abstract
Domestic wells serve as the primary drinking-water source for rural residents in the northern Appalachian Basin (NAB), despite a limited understanding of contaminant distributions in groundwater sources. We employ a newly collected dataset of 216 water samples from domestic wells in Ohio and West Virginia and an integrated contaminant-source attribution method to describe water quality in the western NAB and characterize key agents influencing contaminant distributions. Our results reveal arsenic and nitrate concentrations above federal maximum contaminant levels (MCLs) in 6.8 and 1.3% of samples and manganese concentrations above health advisory in 7.3% of samples. Recently recharged groundwaters beneath upland regions appear vulnerable to surface-related impacts, including nitrate pollution from agricultural activities and salinization from road salting and domestic sewage sources. Valley regions serve as terminal discharge points for long-residence-time groundwaters, where mixing with basin brines is possible. Arsenic impairments occurred in alkaline groundwaters with major-ion compositions altered by ion exchange and in low-oxygen metal-rich groundwaters. Mixing with as much as 4-10% of mine discharge-like waters was observed near coal mining operations. Our study provides new insights into key agents of groundwater impairment in an understudied region of the NAB and presents an integrated approach for contaminant-source attribution applicable to other regions of intensive resource extraction.
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Affiliation(s)
- H. G. Siegel
- School
of the Environment, Yale University, New Haven, Connecticut 06411, United States
| | - M. A. Soriano
- School
of the Environment, Yale University, New Haven, Connecticut 06411, United States
| | - C. J. Clark
- School
of Public Health, Yale University, New Haven, Connecticut 06511, United States
| | - N. P. Johnson
- School
of Public Health, Yale University, New Haven, Connecticut 06511, United States
| | - H. G. Wulsin
- School
of Earth Sciences, Ohio State University, Columbus, Ohio 43210, United States
| | - N. C. Deziel
- School
of Public Health, Yale University, New Haven, Connecticut 06511, United States
| | - D. L. Plata
- Department
of Civil and Environmental Engineering, Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, United States
| | - T. H. Darrah
- School
of Earth Sciences, Ohio State University, Columbus, Ohio 43210, United States
- Ohio
State University Global Water Institute, Ohio State University, Columbus, Ohio 43210, United States
| | - J. E. Saiers
- School
of the Environment, Yale University, New Haven, Connecticut 06411, United States
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Clark CJ, Clark S, Dorey C, Williams J. Correlation of the functional difficulties questionnaire (FDQ-9) with dynamic balance using the SMART instrumented wobbleboard. Phys Ther Sport 2016; 21:68-74. [PMID: 27458997 DOI: 10.1016/j.ptsp.2016.06.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2014] [Revised: 06/16/2016] [Accepted: 06/21/2016] [Indexed: 10/21/2022]
Abstract
OBJECTIVES To investigate concurrent validity of the Functional Difficulties Questionnaire (FDQ-9) using balance tasks on the SMARTwobbleboard. Poor balance is associated with reduced physical activity which may impact on quality of life. There is a requirement to use simple tests to assess balance so that suitable interventions can be employed to ameliorate poor balance and enhance uptake of physical activity. DESIGN Observational study employing 30 healthy volunteers who completed the FDQ-9 and undertook three balance tasks on the SMARTwobbleboard: double leg stance eyes open (DLSEO); double leg stance eyes closed (DLSEC) and single leg stance eyes open (SLSEO). RESULTS There were moderate significant correlations between the FDQ-9 and DLSEO and SLSEO. There were significant between group differences in dynamic balance for participants with FDQ-9 ≤ 18 (indicative of no functional difficulties) and FDQ-9 ≥ 19 (indicative of one or more functional difficulties) for DLSEO and SLSEO. CONCLUSIONS Significant moderate correlations were recorded between the FDQ-9 and the SMARTwobbleboard in healthy adults indicating a relationship between dynamic balance and questionnaire scores (DLSEO and SLSEO). Initial findings contribute to the concurrent validity of the FDQ-9 which could also be used as a simple tool for assessing balance.
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Affiliation(s)
- C J Clark
- Bournemouth University, Faculty of Health and Social Sciences, Bournemouth, United Kingdom.
| | - S Clark
- Bournemouth University, Faculty of Health and Social Sciences, Bournemouth, United Kingdom
| | - C Dorey
- Bournemouth University, Faculty of Health and Social Sciences, Bournemouth, United Kingdom
| | - J Williams
- Bournemouth University, Faculty of Health and Social Sciences, Bournemouth, United Kingdom
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Clark CJ, Pletsch HJ, Wu J, Guillemot L, Ackermann M, Allen B, Angelis AD, Aulbert C, Baldini L, Ballet J, Barbiellini G, Bastieri D, Bellazzini R, Bissaldi E, Bock O, Bonino R, Bottacini E, Brandt TJ, Bregeon J, Bruel P, Buson S, Caliandro GA, Cameron RA, Caragiulo M, Caraveo PA, Cecchi C, Champion DJ, Charles E, Chekhtman A, Chiang J, Chiaro G, Ciprini S, Claus R, Cohen-Tanugi J, Cuéllar A, Cutini S, D’Ammando F, Desiante R, Drell PS, Eggenstein HB, Favuzzi C, Fehrmann H, Ferrara EC, Focke WB, Franckowiak A, Fusco P, Gargano F, Gasparrini D, Giglietto N, Giordano F, Glanzman T, Godfrey G, Grenier IA, Grove JE, Guiriec S, Harding AK, Hays E, Hewitt JW, Hill AB, Horan D, Hou X, Jogler T, Johnson AS, Jóhannesson G, Kramer M, Krauss F, Kuss M, Laffon H, Larsson S, Latronico L, Li J, Li L, Longo F, Loparco F, Lovellette MN, Lubrano P, Machenschalk B, Manfreda A, Marelli M, Mayer M, Mazziotta MN, Michelson PF, Mizuno T, Monzani ME, Morselli A, Moskalenko IV, Murgia S, Nuss E, Ohsugi T, Orienti M, Orlando E, Palma FD, Paneque D, Pesce-Rollins M, Piron F, Pivato G, Rainò S, Rando R, Razzano M, Reimer A, Parkinson PMS, Schaal M, Schulz A, Sgrò C, Siskind EJ, Spada F, Spandre G, Spinelli P, Suson DJ, Takahashi H, Thayer JB, Tibaldo L, Torne P, Torres DF, Tosti G, Troja E, Vianello G, Wood KS, Wood M, Yassine M. PSR J1906+0722: AN ELUSIVE GAMMA-RAY PULSAR. ACTA ACUST UNITED AC 2015. [DOI: 10.1088/2041-8205/809/1/l2] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Abstract
In tropical forests, resource-based niches and density-dependent mortality are mutually compatible mechanisms that can act simultaneously to limit seedling populations. Differences in the strengths of these mechanisms will determine their roles in maintaining species coexistence. In the first assessment of these mechanisms in a Congo Basin forest, we quantified their relative strengths and tested the extent to which density-dependent mortality is driven by the distance-dependent behavior of seed and seedling predators predicted by the Janzen-Connell hypothesis. We conducted a large-scale seed addition experiment for five randomly selected tropical tree species, caging a subset of seed addition quadrats against vertebrate predators. We then developed models to assess the mechanisms that determine seedling emergence (three months after seed addition) and survival (two years after seed addition). As predicted, both niche differentiation and density-dependent mortality limited seedling recruitment, but predation had the strongest effects on seedling emergence and survival. Seedling species responded differently to naturally occurring environmental variation among sites, including variation in light levels and soil characteristics, supporting predictions of niche-based theories of tropical tree species coexistence. The addition of higher densities of seeds into quadrats initially led to greater seedling emergence, but survival to two years decreased with seed density. Seed and seedling predation reduced recruitment below levels maintained by density-dependent mortality, an indication that predators largely determine the population size of tree seedlings. Seedling recruitment was unrelated to the distance to or density of conspecific adult trees, suggesting that recruitment patterns are generated by generalist vertebrate herbivores rather than the specialized predators predicted by the Janzen-Connell hypothesis. If the role of seed and seedling predation in limiting seedling recruitment is a general phenomenon, then the relative abundances of tree species might largely depend on species-specific adaptations to avoid, survive, and recover from damage induced by vertebrate herbivores. Likewise, population declines of herbivorous vertebrate species (many of which are large and hunted) may trigger shifts in species composition of tropical forests.
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Affiliation(s)
- C J Clark
- Nicholas School of the Environment, Duke University, P.O. Box 90328, Durham, North Carolina 27708, USA.
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Clark CJ, Phillips RS. Cerebral malaria protection in mice by species-specific Plasmodium coinfection is associated with reduced CC chemokine levels in the brain. Parasite Immunol 2012; 33:637-41. [PMID: 21851365 DOI: 10.1111/j.1365-3024.2011.01329.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Cerebral malaria is a major pathological complication of Plasmodium falciparum infection in humans. Epidemiological observations have suggested that the clinical evolution of P. falciparum infections may be influenced by the concurrent presence of another Plasmodium species. Infection of susceptible mouse strains with P. berghei ANKA (PbA) provides an experimental model of cerebral malaria which has been extensively used to identify different components of the immune system involved in cerebral malaria. This model has also been employed to investigate the influence of experimental mixed-Plasmodium-species infections on the expression of cerebral malaria; PbA-induced cerebral malaria is completely inhibited by the simultaneous presence of P. yoelii yoelii 17 X clone 1.1 parasites, and accumulation of CD8(+) T cells in the brain vasculature is abolished. We investigated whether brain levels of CD8(+) -T-cell-chemoattractant chemokines CCL3, CCL4 and CCL5 are reduced in these protected coinfected mice compared with PbA-infected mice. Coinfected mice were found to exhibit significantly reduced levels of all three chemokines on day 6 post-infection. This finding may contribute to the abolition of the accumulation of CD8(+) T cells in the brain vasculature and the prevention of the development of cerebral malaria in coinfected mice.
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Affiliation(s)
- C J Clark
- Infection & Immunity, Faculty of Biomedical & Life Sciences, University of Glasgow, Glasgow, Scotland, UK
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Abstract
In tropical forests, hunting nearly always accompanies logging. The entangled nature of these disturbances complicates our ability to resolve applied questions, such as whether secondary and degraded forest can sustain populations of tropical animals. With the expansion of logging in central Africa, conservation depends on knowledge of the individual and combined impacts of logging and hunting on animal populations. Our goals were (1) to decouple the effects of selective logging and hunting on densities of animal guilds, including apes, duikers, monkeys, elephant, pigs, squirrels, and large frugivorous and insectivorous birds and (2) to compare the relative importance of these disturbances to the effects of local-scale variation in forest structure and fruit abundance. In northern Republic of Congo, we surveyed animals along 30 transects positioned in forest disturbed by logging and hunting, logging alone, and neither logging nor hunting. While sampling transects twice per month for two years, we observed 47 179 animals of 19 species and eight guilds in 1154 passages (2861 km). Species densities varied by as much as 480% among forest areas perturbed by logging and/or hunting, demonstrating the strong effects of these disturbances on populations of some species. Densities of animal guilds varied more strongly with disturbance type than with variation in forest structure, canopy cover, and fruit abundance. Independently, logging and hunting decreased density of some guilds and increased density of others: densities varied from 44% lower (pigs) to 90% higher (insectivorous birds) between logged and unlogged forest and from 61% lower (apes) to 77% higher (frugivorous birds) between hunted and unhunted forest. Their combined impacts exacerbated decreases in populations of some guilds (ape, duiker, monkey, and pig), but counteracted one another for others (squirrels, insectivorous and frugivorous birds). Together, logging and hunting shifted the relative abundance of the animal community away from large mammals toward squirrels and birds. Logged forest, even in the absence of hunting, does not maintain similar densities as unlogged forest for most animal guilds. To balance conservation with the need for economic development and wild meat in tropical countries, landscapes should be spatially managed to include protected areas, community hunting zones, and production forest.
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Affiliation(s)
- J R Poulsen
- Department of Biology, P.O. Box 11852, University of Florida, Gainesville, Florida 32611-8525, USA.
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Wright RJ, Fay ME, Suglia SF, Clark CJ, Evans JS, Dockery DW, Behbehani J. War-related stressors are associated with asthma risk among older Kuwaitis following the 1990 Iraqi invasion and occupation. J Epidemiol Community Health 2010; 64:630-5. [PMID: 20231738 DOI: 10.1136/jech.2009.090795] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND Contemporary warfare involving civilian populations is a growing public health concern. In addition to the psychological impact, war-related trauma may result in physiological alterations and even broader health effects. Associations were examined between war-related stressors and incident asthma in elderly Kuwaiti civilians following the Iraqi invasion. METHODS A random sample of all Kuwaiti nationals aged 50-69 years on the day prior to the invasion were identified. Among the 7873 meeting eligibility criteria, 5567 (71%) agreed to participate and 5028 completed the questionnaire (91% of those eligible). Of these, 3759 were in Kuwait during the invasion, of whom 2294 were alive at follow-up. After exclusions for prevalent asthma or missingness on covariates, 2066 were available for analysis. War-related experiences were summarised into a continuous score using Rasch modelling. Relative Cox proportional hazard rates (HR) were calculated for asthma adjusting for covariates. RESULTS Over 13 years of follow-up, physician-diagnosed asthma was reported by 66/996 (6.6%) men and 104/1070 (9.7%) women. In models adjusted for gender, socioeconomic status, smoking, BMI, and air pollution related to burning oil fires, those reporting highest stress exposure were more than twice as likely to report asthma (HR 2.3, 95% CI 1.3, 3.9) compared to civilians reporting no stressors. Experiences were more salient when anchored to fear for loss of life. CONCLUSIONS War-related trauma is associated with increased asthma risk in these elderly civilians. Although prior research has documented the significant and persistent psychological toll of war, these findings implicate even broader health effects.
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Affiliation(s)
- R J Wright
- Channing Laboratory 181 Longwood Avenue, Boston, MA 02115, USA.
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Abstract
Unsustainable hunting of wildlife for food empties tropical forests of many species critical to forest maintenance and livelihoods of forest people. Extractive industries, including logging, can accelerate exploitation of wildlife by opening forests to hunters and creating markets for bushmeat. We monitored human demographics, bushmeat supply in markets, and household bushmeat consumption in five logging towns in the northern Republic of Congo. Over 6 years we recorded 29,570 animals in town markets and collected 48,920 household meal records. Development of industrial logging operations led to a 69% increase in the population of logging towns and a 64% increase in bushmeat supply. The immigration of workers, jobseekers, and their families altered hunting patterns and was associated with increased use of wire snares and increased diversity in the species hunted and consumed. Immigrants hunted 72% of all bushmeat, which suggests the short-term benefits of hunting accrue disproportionately to "outsiders" to the detriment of indigenous peoples who have prior, legitimate claims to wildlife resources. Our results suggest that the greatest threat of logging to biodiversity may be the permanent urbanization of frontier forests. Although enforcement of hunting laws and promotion of alternative sources of protein may help curb the pressure on wildlife, the best strategy for biodiversity conservation may be to keep saw mills and the towns that develop around them out of forests.
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Affiliation(s)
- J R Poulsen
- Department of Biology, P.O. Box 11852, University of Florida, Gainesville, FL 32611-8525, USA.
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Abstract
The management of tropical forest in timber concessions has been proposed as a solution to prevent further biodiversity loss. The effectiveness of this strategy will likely depend on species-specific, population-level responses to logging. We conducted a survey (749 line transects over 3450 km) in logging concessions (1.2 million ha) in the northern Republic of Congo to examine the impact of logging on large mammal populations, including endangered species such as the elephant (Loxodonta africana), gorilla (Gorilla gorilla), chimpanzee (Pan troglodytes), and bongo (Tragelaphus eurycerus). When we estimated species abundance without consideration of transect characteristics, species abundances in logged and unlogged forests were not different for most species. When we modeled the data with a hurdle model approach, however, analyzing species presence and conditional abundance separately with generalized additive models and then combining them to calculate the mean species abundance, species abundance varied strongly depending on transect characteristics. The mean species abundance was often related to the distance to unlogged forest, which suggests that intact forest serves as source habitat for several species. The mean species abundance responded nonlinearly to logging history, changing over 30 years as the forest recovered from logging. Finally the distance away from roads, natural forest clearings, and villages also determined the abundance of mammals. Our results suggest that logged forest can extend the conservation estate for many of Central Africa's most threatened species if managed appropriately. In addition to limiting hunting, logging concessions must be large, contain patches of unlogged forest, and include forest with different logging histories.
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Affiliation(s)
- C J Clark
- Department of Zoology, University of Florida, P.O. Box 11852, Gainesville, FL 32611-8525, USA.
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Clark CJ, Bloom DE, Hill AG, Silverman JG. Prevalence estimate of intimate partner violence in Jordan. East Mediterr Health J 2009; 15:880-889. [PMID: 20187539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
This study examined the prevalence of intimate partner violence in Jordan among a sample of 517 reproductive health clinic attendees. Intimate partner violence was measured using the World Health Organization's domestic violence questionnaire which was modified by the results of focus group discussions conducted in Amman. The percentages of women experiencing at least 1 form of control or violence since marriage were: control, 97.2%; psychological violence, 73.4%; physical violence, 31.2%; and sexual violence, 18.8%. Modifications of the WHO questionnaire were needed to measure control and psychological violence in Jordan. Similar modifications might be required when conducting research in the Region.
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Affiliation(s)
- C J Clark
- Department of Global Health and Population, Harvard School of Public Health, Boston, Massachusetts, USA.
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Clark CJ, McDade DM, O'Shaughnessy CT, Morris BJ. Contrasting roles of neuronal Msk1 and Rsk2 in Bad phosphorylation and feedback regulation of Erk signalling. J Neurochem 2007; 102:1024-34. [PMID: 17663748 DOI: 10.1111/j.1471-4159.2007.04601.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Activated extracellular-signal-regulated kinase (Erk) phosphorylates and activates downstream kinases including ribosomal S6 kinase 2 (Rsk2/RPS6KA3) and mitogen- and stress-activated kinase 1 (Msk1, RPS6KA5). Rsk2 plays an important role in neuronal plasticity, as patients with Coffin-Lowry syndrome, where Rsk2 is dysfunctional, have impaired cognitive function. However, the relative role of neuronal Rsk2 and Msk1 in activating proteins downstream of Erk is unclear. In PC12 cells and in cortical neurones, the calcium ionophore A23187-induced phosphorylation of Erk, Msk1, Rsk2 and also the Bcl-2-associated death protein (Bad), which protects against neurotoxicity. Specific knockdown of Msk1 with small interfering RNA reduced the ability of A23187 to induce Bad phosphorylation in both PC12 cells and cortical neurones. Conversely, specific knockdown of Rsk2 potentiated Bad phosphorylation following A23187 treatment, and also elevated Erk phosphorylation in both cell types. This indicates that Msk1 rather than Rsk2 mediates neuronal Bad phosphorylation following Ca(2+) influx and implicates Rsk2 in a negative-feedback regulation of Erk activity.
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Affiliation(s)
- C J Clark
- Division of Neuroscience and Biomedical Systems, Institute of Biomedical and Life Sciences, West Medical Building, University of Glasgow, Glasgow, UK
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Clark CJ, Poulsen JR, Levey DJ, Osenberg CW. Are Plant Populations Seed Limited? A Critique and Meta‐Analysis of Seed Addition Experiments. Am Nat 2007; 170:128-42. [PMID: 17853997 DOI: 10.1086/518565] [Citation(s) in RCA: 363] [Impact Index Per Article: 21.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2006] [Accepted: 02/08/2007] [Indexed: 11/04/2022]
Abstract
We examine the relative importance of processes that underlie plant population abundance and distribution. Two opposing views dominate the field. One posits that the ability to establish at a site is determined by the availability of suitable microsites (establishment limitation), while the second asserts that recruitment is limited by the availability of seeds (seed limitation). An underlying problem is that establishment and seed limitation are typically viewed as mutually exclusive. We conducted a meta-analysis of seed addition experiments to assess the relative strength of establishment and seed limitation to seedling recruitment. We asked (1) To what degree are populations seed and establishment limited? (2) Under what conditions (e.g., habitats and life-history traits) are species more or less limited by each? (3) How can seed addition studies be better designed to enhance our understanding of plant recruitment? We found that, in keeping with previous studies, most species are seed limited. However, the effects of seed addition are typically small, and most added seeds fail to recruit to the seedling stage. As a result, establishment limitation is stronger than seed limitation. Seed limitation was greater for large-seeded species, species in disturbed microsites, and species with relatively short-lived seed banks. Most seed addition experiments cannot assess the relationship between number of seeds added and number of subsequent recruits. This shortcoming can be overcome by increasing the number and range of seed addition treatments.
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Affiliation(s)
- C J Clark
- School of Natural Resources and the Environment, University of Florida, Gainesville, Florida 32611, USA.
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Poulsen JR, Osenberg CW, Clark CJ, Levey DJ, Bolker BM. Plants as reef fish: fitting the functional form of seedling recruitment. Am Nat 2007; 170:167-83. [PMID: 17874368 DOI: 10.1086/518945] [Citation(s) in RCA: 65] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2006] [Accepted: 02/08/2007] [Indexed: 11/03/2022]
Abstract
The life histories of many species depend first on dispersal to local sites and then on establishment. After dispersal, density-independent and density-dependent mortalities modify propagule supply, determining the number of individuals that establish. Because multiple factors influence recruitment, the dichotomy of propagule versus establishment limitation is best viewed as a continuum along which the strength of propagule or establishment limitation changes with propagule input. To evaluate the relative importance of seed and establishment limitation for plants, we (1) describe the shape of the recruitment function and (2) use limitation and elasticity analyses to quantify the sensitivity of recruitment to perturbations in seed limitation and density-independent and density-dependent mortality. Using 36 seed augmentation studies for 18 species, we tested four recruitment functions against one another. Although the linear model (accounting for seed limitation and density-independent mortality) fitted the largest number of studies, the nonlinear Beverton-Holt model (accounting for density-dependent mortality) performed better at high densities of seed augmentation. For the 18 species, seed limitation constrained population size more than other sources of limitation at ambient conditions. Seedling density reached saturation with increasing seed density in many studies, but at such high densities that seedling density was primarily limited by seed availability rather than microsite availability or density dependence.
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Affiliation(s)
- J R Poulsen
- Department of Zoology, University of Florida, P.O. Box 11852, Gainesville, Florida 32611, USA.
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Rakhit S, Clark CJ, O'shaughnessy CT, Morris BJ. N-Methyl-D-aspartate and Brain-Derived Neurotrophic Factor Induce Distinct Profiles of Extracellular Signal-Regulated Kinase, Mitogen- and Stress-Activated Kinase, and Ribosomal S6 Kinase Phosphorylation in Cortical Neurons. Mol Pharmacol 2004; 67:1158-65. [PMID: 15625280 DOI: 10.1124/mol.104.005447] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Stimulation of N-methyl-D-aspartate (NMDA) receptors is believed to underlie long-term memory formation, and excessive NMDA receptor activation has been linked to several neuropathological conditions. Phosphorylation and activation of p42/44 mitogen-activated protein kinase (ERK) is believed to mediate many of these effects, but the downstream targets of ERK in response to NMDA activation have not been determined. In primary cultures of rat cortical neurons, we found that NMDA was able to elevate phosphorylation of mitogen- and stress-activated kinase 1 (MSK1) as well as ERK. Likewise, brain-derived neurotrophic factor (BDNF) treatment increased phosphorylation of MSK1 and ERKs. The NMDA-induced MSK1 phosphorylation was sensitive to the MEK inhibitor 2'-amino-3'-methoxyflavone (PD98059) and the p38 inhibitor 4-(4-fluorophenyl)-2-(4-methylsulfinylphenyl)-5-(4-pyridyl)1H-imidazole (SB203580). MSK1 activation by NMDA was transient, although ERK remained phosphorylated within the neuronal cytoplasm for several hours. Although BDNF increased ribosomal S6 kinase (RSK) phosphorylation, NMDA had no discernable effect on the phosphorylation of RSKs. Thus, phosphorylation and activation of MSK1 but not RSK could be an important step in the pathway linking NMDA-induced ERK phosphorylation to the activation of transcription factors required for the formation of long-term memory.
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Affiliation(s)
- S Rakhit
- Institute of Biomedical and Life Sciences, West Medical Building, University of Glasgow, Glasgow G12 8QQ, Scotland, UK
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Clark CJ, Phillips RS, McMillan RB, Montgomery IO, Stone TW. Differences in the neurochemical characteristics of the cortex and striatum of mice with cerebral malaria. Parasitology 2004; 130:23-9. [PMID: 15700754 DOI: 10.1017/s0031182004006237] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Fatal murine cerebral malaria is an encephalitis and not simply a local manifestation in the brain of a systemic process. Histopathologically, murine cerebral malaria has been characterized by monocyte adherence to the endothelium of the microvasculature, activation of microglial cells, swelling of endothelial cell nuclei, microvasculature damage, and breakdown of the blood-brain barrier with cerebral oedema. Brain parenchymal cells have been proposed to be actively involved in the pathogenesis of murine cerebral malaria. We, therefore, compared the neurochemical characteristics ofPlasmodium bergheiANKA-infected mice with controls to determine whether cerebral malarial infection significantly impairs specific neuronal populations. Between 6 and 7 days after infection, we found a significant loss of neurones containing substance P, with preservation of cells containing somatostatin, neuropeptide Y and calbindin in the striatum of infected mice compared with controls. In the cortex of infected mice, we found a significant reduction in the number of cells containing substance P, somatostatin and neuropeptide Y. The number of calbindin-containing neurones was unchanged. This study found significant changes in the neurochemical characteristics of the cortex and striatum of mice infected withP. bergheiANKA, which may contribute to their cerebral symptoms.
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Affiliation(s)
- C J Clark
- Institute of Biomedical and Life Sciences, University of Glasgow, Glasgow G12 8QQ, UK.
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Clark CJ, Poulsen JR, Connor EF, Parker VT. Fruiting trees as dispersal foci in a semi-deciduous tropical forest. Oecologia 2004; 139:66-75. [PMID: 14745649 DOI: 10.1007/s00442-003-1483-1] [Citation(s) in RCA: 52] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2003] [Accepted: 12/08/2003] [Indexed: 10/26/2022]
Abstract
Quantification of seed rain patterns is an initial step toward explaining variation in plant recruitment, and consequently, organization of forest communities. Spatially contagious patterns of seed deposition, where seeds are patchily dispersed with some sites receiving relatively high densities and others receiving low densities of seeds, may be a common phenomenon for which we have very little knowledge. For example, prior feeding events by frugivores (monkeys and birds) combined with transport and dispersal of seeds to other fruiting trees may result in the contagious deposition of non-conspecific seeds below them. Here, we examined whether fruiting trees act as dispersal foci in the semi-deciduous tropical rainforest of the Dja Reserve, Cameroon. Seed rain was sampled below the canopies of nine tree species: three typically dispersed by large, frugivorous birds, three dispersed by monkeys, and three dispersed by wind. We found no evidence that monkeys generate spatially contagious patterns of seed rain under fruiting trees at which they feed. However, we found that rates of deposition of non-conspecific seeds and species richness of seeds delivered by birds (hornbills and turacos) were significantly greater during fruiting than non-fruiting periods, and significantly greater under fruiting individuals of bird-dispersed tree species than under fruiting individuals of monkey- or wind-dispersed tree species. Additionally, during fruiting periods, the composition of non-conspecific seed rain under bird-dispersed tree species was more similar to other bird-dispersed trees than to monkey- or wind-dispersed tree species. The contagious dispersal of non-conspecific seeds to fruiting, bird-dispersed trees leads to higher seed densities under fruiting trees than those caused by local seed production. Non-conspecific seeds deposited in high densities may experience increased seed mortality even far from parent trees if predators are generalists. Alternatively, in the absence of complete density-dependent mortality, contagious seed dispersal could result in associations among species dispersed by the same dispersal agent.
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Affiliation(s)
- C J Clark
- School of Natural Resources and Environment and Department of Zoology, University of Florida, 223 Bartram Hall, Gainesville, FL 32611-8525, USA.
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Crilly A, Hamilton J, Clark CJ, Jardine A, Madhok R. Analysis of the 5' flanking region of the interleukin 10 gene in patients with systemic sclerosis. Rheumatology (Oxford) 2003; 42:1295-8. [PMID: 12867583 DOI: 10.1093/rheumatology/keg420] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES Fibrosis, a feature of systemic sclerosis (SSc), is more severe in the diffuse compared with the limited disease variant. Interleukin 10 (IL-10) is an anti-inflammatory cytokine which reduces type 1 collagen mRNA levels in human fibroblasts. The 5' flanking region of the IL-10 gene is highly polymorphic, with three single base pair substitutions at position -1082(G/A), -819(C/T) and -592(C/A), which results in differential IL-10 production. The GCC/GCC genotype is associated with high IL-10 production while the ATA/ATA genotype with low production. We postulated that there would be a difference in IL-10 polymorphisms in patients with limited (lSSc) and diffuse (dSSc) disease. METHODS Patients with limited (lSSc, n = 89) or diffuse (dSSc, n = 51) disease plus controls (n = 94) were recruited. DNA was isolated from peripheral blood and polymorphisms analysed using amplification refractory mutation system (ARMS) polymerase chain reaction (PCR). RESULTS dSSc patients were less likely to carry the genotype indicative of high IL-10 production when compared with controls (controls vs dSSc; 29 vs 4%, chi2 = 15.7, 5 df, P = 0.005) and lSSc patients (lSSc vs dSSc; 21 vs 4%, chi2 = 17.5, 5 df, P = 0.002). There was no difference between control and lSSc patients. While there was no difference between controls and lSSc haplotypes, the GCC haplotype distribution did differ significantly between controls and dSSc patients (controls vs dSSc; 54 vs 36%, chi2 = 11.2, 2 df, P = 0.001). A significant difference was also observed between lSSc and dSSc haplotype distribution (lSSc vs dSSc; 48 vs 36%, chi2 = 13.5, 2 df, P < 0.001). CONCLUSION We demonstrate that IL-10 genotypes associated with high IL-10 production are under-represented in dSSc. This may have implications in the disease pathology.
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Affiliation(s)
- A Crilly
- Department of Medicine, Glasgow Royal Infirmary, Glasgow, UK
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MacKenzie SM, Lai M, Clark CJ, Fraser R, Gómez-Sánchez CE, Seckl JR, Connell JMC, Davies E. 11beta-hydroxylase and aldosterone synthase expression in fetal rat hippocampal neurons. J Mol Endocrinol 2002; 29:319-25. [PMID: 12459034 DOI: 10.1677/jme.0.0290319] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
The central nervous system produces many of the enzymes responsible for corticosteroid synthesis. A model system to study the regulation of this local system would be valuable. Previously, we have shown that primary cultures of hippocampal neurons isolated from the fetal rat can perform the biochemical reactions associated with the enzymes 11beta-hydroxylase and aldosterone synthase. Here, we demonstrate directly that these enzymes are present within primary cultures of fetal rat hippocampal neurons.
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Affiliation(s)
- S M MacKenzie
- Department of Medicine and Therapeutics, Western Infirmary, Church Street, Glasgow G11 6NT, UK.
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Crilly A, Hamilton J, Clark CJ, Jardine A, Madhok R. Analysis of transforming growth factor beta1 gene polymorphisms in patients with systemic sclerosis. Ann Rheum Dis 2002; 61:678-81. [PMID: 12117671 PMCID: PMC1754186 DOI: 10.1136/ard.61.8.678] [Citation(s) in RCA: 69] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVES To determine the distribution of transforming growth factor beta1 (TGFbeta1) genotypes at codon 10 (+869 polymorphism) and codon 25 (+915 polymorphism) in patients with scleroderma (SSc). Differences between diffuse and limited SSc (dSSc and lSSc) were also investigated. METHODS Patients with lSSc (n=89) and dSSc (n=63) were compared with 147 controls. DNA was isolated from peripheral blood and polymorphisms at codons 10 (C/T) and 25 (G/C) of the TGFbeta1 gene analysed by polymerase chain reaction and sequence specific oligonucleotide probing. RESULTS Significantly more patients with SSc than controls carried allele C at codon 10 (controls v SSc, 38% v 48%, chi(2)=8.2, 1df, p=0.004), OR=1.95 (95% CI 1.16 to 3.27). The difference remained when patients with SSc were split into those with limited or diffuse disease, (controls v dSSc, chi(2)=5, 1df, p=0.02 and controls v lSSc, chi(2)=6, 1df, p=0.013). The patients with SSc had significantly more subjects heterozygous at codon 10 (controls v SSc, chi(2)=45, 1df, p<0.0001). Possession of allele C at codon 10 gave an OR=4.8 (95% CI 2.8 to 8.4). No difference in allele frequency was seen between patients with SSc and controls at codon 25. More patients with SSc than controls carried the GG genotype (controls v SSc, 80% v 88%, chi(2)=7, 2df, p=0.027). Possession of allele G gave an OR=1.7 (95% CI 0.5 to 5.9). There was no difference between diffuse and limited disease at either codon. CONCLUSIONS These results suggest that patients with SSc are genetically predisposed to high TGFbeta1 production. These polymorphisms do not, however, explain the difference in the clinical phenotypes of limited and diffuse SSc.
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Affiliation(s)
- A Crilly
- Department of Medicine, 10 Alexandra Parade, Glasgow Royal Infirmary, UK
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Neder JA, Sword D, Ward SA, Mackay E, Cochrane LM, Clark CJ. Home based neuromuscular electrical stimulation as a new rehabilitative strategy for severely disabled patients with chronic obstructive pulmonary disease (COPD). Thorax 2002; 57:333-7. [PMID: 11923552 PMCID: PMC1746295 DOI: 10.1136/thorax.57.4.333] [Citation(s) in RCA: 215] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND Passive training of specific locomotor muscle groups by means of neuromuscular electrical stimulation (NMES) might be better tolerated than whole body exercise in patients with severe chronic obstructive pulmonary disease (COPD). It was hypothesised that this novel strategy would be particularly effective in improving functional impairment and the consequent disability which characterises patients with end stage COPD. METHODS Fifteen patients with advanced COPD (nine men) were randomly assigned to either a home based 6 week quadriceps femoris NMES training programme (group 1, n=9, FEV(1)=38.0 (9.6)% of predicted) or a 6 week control period before receiving NMES (group 2, n=6, FEV(1)=39.5 (13.3)% of predicted). Knee extensor strength and endurance, whole body exercise capacity, and health related quality of life (Chronic Respiratory Disease Questionnaire, CRDQ) were assessed. RESULTS All patients were able to complete the NMES training programme successfully, even in the presence of exacerbations (n=4). Training was associated with significant improvements in muscle function, maximal and endurance exercise tolerance, and the dyspnoea domain of the CRDQ (p<0.05). Improvements in muscle performance and exercise capacity after NMES correlated well with a reduction in perception of leg effort corrected for exercise intensity (p<0.01). CONCLUSIONS For severely disabled COPD patients with incapacitating dyspnoea, short term electrical stimulation of selected lower limb muscles involved in ambulation can improve muscle strength and endurance, whole body exercise tolerance, and breathlessness during activities of daily living.
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Affiliation(s)
- J A Neder
- Department of Respiratory Medicine, Hairmyres Hospital, East Kilbride and Centre for Exercise Science and Medicine, Institute of Biomedical and Life Sciences (IBLS), University of Glasgow, Glasgow, UK
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Chester JD, Clark CJ, Gouldesbrough DR, Bogle SM, Bradley CJ, Parker D. Management of lymphoma patients in a cancer unit: an audit of 15 years' experience in a district general hospital. Clin Oncol (R Coll Radiol) 2002; 13:243-50. [PMID: 11554620 DOI: 10.1053/clon.2001.9263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The objectives were to analyse data obtained in a district general hospital medical oncology unit over a 15-year period, and to provide a comparator for standards of care for lymphoma patients in new cancer units. Prospectively collected data were analysed on 208 consecutive patients presenting with lymphoma, on an 'all-comers' basis, between 1981 and 1996. Treatment was with radiotherapy and/or chemotherapy, according to local protocols. The outcome measure was survival from the date of diagnosis. The 5-year actuarial survival was 72.7% for Hodgkin's disease and 55.7% for non-Hodgkin's lymphoma. Age and stage of disease were the only predictors of survival in a multivariate analysis. Histological classification was not a useful predictor of survival in this analysis. Survival figures comparable with those obtained nationally and across Europe are attainable in a cancer unit. Multiple pathways of referral of lymphoma patients operate in our region.
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Abstract
Seasonal fluctuations in resource abundance often cause primates to change their feeding behavior and ecology. The objective of this study was to examine the response of a largely frugivorous monkey, the grey-cheeked mangabey (Lophocebus albigena), to seasonal variations in fruit abundance. We used 15-min scan sampling to quantify feeding, activity, and habitat use by monkeys between February and December 1998 in the Dja Reserve, Cameroon. L. albigena were found to have omnivorous feeding habits, consuming the fruits, seeds, leaves, and flowers of 132 plant species. Although monkeys fed from many plant species, only five plant species accounted for 45% of all feeding records. The number of feeding observations on a plant species was significantly correlated with its fruit production. L. albigena responded to fruit-lean periods by shifting from a diet dominated by fruit to one dominated by seeds, flowers, and young leaves. This diet shift coincided with greater use of swamp habitat and higher dietary diversity. L. albigena spent the greatest percentage of scan samples feeding and traveling, but activities varied significantly over the day. Individuals spent a significantly higher percentage of scan samples feeding during the fruit-rich season than in the fruit-lean season. Comparing our results to those of studies in Gabon and Uganda, we found that L. albigena differ across regions in the number of plant species they consume and time spent feeding. These differences may be a result of variations in tree diversity or the strength of seasonal fluctuations in resource abundance among sites.
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Affiliation(s)
- J R Poulsen
- Department of Biology and Center for Tropical Research, San Francisco State University, San Francisco, California, USA.
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Clark CJ, Poulsen JR, Parker VT. The Role of Arboreal Seed Dispersal Groups on the Seed Rain of a Lowland Tropical Forest1. Biotropica 2001. [DOI: 10.1646/0006-3606(2001)033[0606:troasd]2.0.co;2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Clark CJ, Davies E, Anderson NH, Farmer R, Friel EC, Fraser R, Connell JM. alpha-adducin and angiotensin I-converting enzyme polymorphisms in essential hypertension. Hypertension 2000; 36:990-4. [PMID: 11116113 DOI: 10.1161/01.hyp.36.6.990] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This study focused on two genes that have previously been implicated in hypertension and may influence renal sodium handling, adducin, and angiotensin I-converting enzyme (ACE). We compared their polymorphic frequencies and interaction in patients with essential hypertension (n=128) and individually age- and gender-matched normotensive control subjects. The alpha-adducin G460W polymorphism was genotyped by DNA amplification and restriction digestion. The ACE I/D polymorphism was assayed by a triple-primer method, with a "nested" polymerase chain reaction primer situated completely within the insertion sequence of the I: allele. The distributions of genotypes and alleles for the two polymorphisms were not significantly different between the case and control populations, and the cross-classification of cases by alpha-adducin and ACE genotype gave a distribution similar to that of control subjects. We have previously reported that the distributions of genotypes for two linked polymorphisms in the aldosterone synthase gene (one in the steroidogenic factor-1 [SF-1] binding site and the other an intronic conversion [IC]) were significantly different between this cohort of essential hypertensives and matched control subjects. The cross-classification of cases by alpha-adducin and SF-1, alpha-adducin and IC, ACE and SF-1, and ACE and IC genotype gave a distribution similar to that of control subjects. Hence, no evidence was found to suggest an association between either the alpha-adducin G460W or the ACE I/D polymorphism and hypertension in a careful case-control study. Furthermore, the alpha-adducin G460W, ACE I/D, and aldosterone synthase SF-1 and IC polymorphisms do not appear to interact in our hypertensive population.
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Affiliation(s)
- C J Clark
- MRC Blood Pressure Group, Department of Medicine and Therapeutics, Western Infirmary, Glasgow, Scotland
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Robinson A, Clark CJ, Clemens J. Using (1)H magnetic resonance imaging and complementary analytical techniques to characterize developmental changes in the Zantedeschia Spreng. tuber. J Exp Bot 2000; 51:2009-20. [PMID: 11141175 DOI: 10.1093/jexbot/51.353.2009] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
Nuclear magnetic resonance imaging (MRI) and complementary analytical techniques were used to examine tissue structure and developmental changes occurring during active growth in the root tuber of ZANTEDESCHIA: Spreng. cv. Chianti, a commercially significant cut flower. Plants were observed during the period of leaf senescence and tuberization at the end of the first growth cycle of micropropagated plantlets and, following cool storage to break endodormancy, during development occurring after the replanting of ecodormant tubers. MRI distinguished two distinct regions within the tuber, and the differences in the binding state of water in the two regions were reflected in differences in tissue morphology and function. An abundance of free water was observed in tissue comprised of large parenchyma cells, at the base of the tuber. This tissue appeared to be involved in maintaining the viability of the plant during the period of dormancy, a function indicated primarily by increased metabolic activity in this tissue during dormancy, and reduced metabolic activity during periods of active growth. In contrast, water was more tightly bound in tissue comprised of small parenchyma cells. This tissue appeared to operate as a region for dynamic carbohydrate storage. The initial increase in the free water content of this tissue during the growth phase was linked to the mobilization of starch during canopy development. The subsequent decrease in free water in the remainder of the growth period was linked to the reaccumulation of starch while the tuber functioned as a sink for photosynthate prior to canopy senescence.
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Affiliation(s)
- A Robinson
- Institute of Molecular BioSciences, Massey University, Private Bag 11 222, Palmerston North, New Zealand
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Abstract
11beta-hydroxylase and aldosterone synthase catalyse the final stages of corticosterone and aldosterone synthesis respectively. Previously, we established that they are expressed in the rat brain, particularly the cerebellum and the hippocampus. Primary cultures of fetal rat neurons were studied. RT-PCR and immunohistochemistry established that neurons express 11beta-hydroxylase and aldosterone synthase mRNAs and protein. After incubating the cells with 10microM DOC for 24 hours, medium was analysed for aldosterone and corticosterone. Median % conversion of DOC to corticosterone was 7.6% compared to 0.4% in controls. Median % conversion of DOC to aldosterone was 6.2% compared to 0.06% in controls. Corticosteroids mediate a number of functions of mammalian brain, including blood pressure homeostasis, salt appetite and neuronal excitability. Local production of these steroids could have significant effects on these processes.
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Affiliation(s)
- S M MacKenzie
- MRC Blood Pressure Group, Western Infirmary, Glasgow, UK
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Abstract
The terminal stages of cortisol and aldosterone production in the human adrenal gland are catalysed by the enzymes 11beta-hydroxylase and aldosterone synthase, which are encoded by the CYP11B1 and CYP11B2 genes respectively. Recent studies have suggested that aldosterone and cortisol are also made in other tissues such as the brain, heart and vascular system and may play a role in cardiovascular homeostasis. The aim of this study was to confirm the presence of these enzymes and localise them precisely in the rat brain. Reverse transcription-polymerase chain reaction (RT-PCR)/Southern blotting confirmed transcription of CYP11B1 and CYP11B2 in whole brain and hypothalamus minces from Wistar-Kyoto rats. 11beta-Hydroxylase and aldosterone synthase were immunolocalised in paraffin-embedded rat adrenal and brain sections using mouse monoclonal antibodies. Negative controls utilised a mouse monoclonal antibody raised against a non-mammalian epitope. In the brain, 11beta-hydroxylase and aldosterone synthase were detected in the cerebellum, especially the Purkinje cells, as well as the hippocampus. The specificities of the 11beta-hydroxylase and aldosterone synthase antibodies were confirmed by positive immunostaining of the relevant regions of the adrenal cortex. This is the first direct evidence that steroid hydroxylases involved in the final stages of corticosteroid biosynthesis are present in specific regions of the central nervous system.
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Affiliation(s)
- S M MacKenzie
- MRC Blood Pressure Group, Department of Medicine and Therapeutics, Western Infirmary, Glasgow G11 6NT, UK.
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Abstract
This study poses two questions: 1) is there an abnormality in isokinetic skeletal muscle strength and endurance in mild chronic obstructive pulmonary disease (COPD)? and 2) what is the effect of a randomized, controlled, 12 week hospital outpatient weight training programme in terms of skeletal muscle function and exercise tolerance? Upper and lower limb isokinetic maximum and sustained muscle function were compared in 43 COPD patients (age 49+/-11 yrs), mean forced expiratory volume in one second (FEV1) 77+/-23% pred and 52 healthy, sedentary subjects (age 51 (10) yrs), mean FEV1 109+/-16% pred. The 43 COPD patients were randomly allocated into training (n=26) and control (n=17) groups. Isokinetic and isotonic muscle function, whole body endurance, maximal exercise capacity and lung function were measured. The COPD patients had reduced isokinetic muscle function (with the exception of sustained upper limb strength) as compared with healthy sedentary subjects. Muscle function improved after weight training in the COPD patients. Whole body endurance during treadmill walking also improved with no change in maximal oxygen consumption. A deficit in skeletal muscle function can be identified in patients with mild chronic obstructive pulmonary disease which cannot be explained by factors such as hypoxaemia and malnutrition. Intervention with weight training is effective in countering this deficit which the authors conclude is probably due to muscle deconditioning.
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Affiliation(s)
- C J Clark
- Dept of Respiratory Medicine, Hairmyres Hospital, East Kilbride, Glasgow, UK
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Hanlon CA, Olson JG, Clark CJ. Article I: Prevention and education regarding rabies in human beings. National Working Group on Rabies Prevention and Control. J Am Vet Med Assoc 1999; 215:1276-80. [PMID: 10553437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
Abstract
Substantial changes in the epizootic characteristics of rabies have transpired in the United States during the past 50 years. Traditional veterinary practices and public health recommendations have effectively controlled rabies in dogs and prevented associated human fatalities; however, they have been unable to adequately address the problem of rabies in wildlife. Attributable in part to a renewed focus on emerging infectious diseases, a conference was held at the Centers for Disease Control and Prevention in 1993 to begin discussion focused on the reemergence of rabies and to formulate new suggestions for prevention and control of rabies in the United States. Three major working groups were formed from a national committee of professionals representing a broad array of biomedical disciplines. These groups concentrated on prevention of rabies in human beings, education, laboratory diagnosis of rabies, and rabies control in animals. The groups described the perceived minimum requirements to promote prevention and control of rabies in the United States into the next century. The following article describes the needs and recommendations identified by the prevention and education working group. Two other articles, scheduled for the Nov 15 and Dec 1, 1999 issues of JAVMA, will relay the needs and recommendations of the working groups on laboratory diagnosis of rabies and rabies in wildlife.
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Affiliation(s)
- C A Hanlon
- Centers for Disease Control and Prevention, Atlanta, GA 30333, USA
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35
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Abstract
The relationship between asthma and exercise and the resultant disability (ie, the impact on activities of daily living, including physical activity) shows wide interpatient and intrapatient variability, being influenced not only by the disease but additional psychosocial variables. There are a variety of helpful pharmacologic and nonpharmacologic measures in dealing with simple exercise-induced asthma, and new therapeutic options are being developed. The cardiorespiratory performance characteristics of asthmatic patients are very frequently suboptimal, either because of symptom-limited exercise tolerance or secondary deconditioning consequent upon inactivity. Medically supervised physical training can produce significant beneficial change. Recommendations for rehabilitation of asthmatic patients would include individualized exercise prescription and advice based on objective criteria of exercise capability, with flexibility in the programs offered, in order to cater to the broadest spectrum of patient disability.
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Affiliation(s)
- C J Clark
- Hairmyres Hospital, Glasgow, Scotland, UK
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36
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Clark CJ, Boswell F, Greer IA, Lyall F. Treatment of endothelial cells with serum from women with preeclampsia: effect on neutrophil adhesion. J Soc Gynecol Investig 1997; 4:27-33. [PMID: 9051631 DOI: 10.1016/s1071-5576(96)00057-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE The purpose of our study was to determine whether the previously reported neutrophil activation that occurs in the maternal circulation of women with preeclampsia is due to a factor (or factors) in serum that increases neutrophil adhesion to endothelial cells. METHODS The extent of neutrophil adhesion to endothelial cells incubated with serum from women with preeclampsia (n = 12) was compared with serum from normal, pregnant women matched for maternal age and gestational age at blood sampling (n = 12). Preeclampsia was defined as persistent diastolic blood pressure above 90 mmHg, with proteinuria greater than 0.3 g per 24 hours, in patients who were normotensive before 20 weeks' gestation. The ability of serum (with and without heat inactivation of the complement system) from both groups of patients to stimulate neutrophil adhesion to endothelial monolayers was tested in a 15-minute quantitative assay using fluorescence-labeled neutrophils. The extent of neutrophil adhesion was quantified indirectly from fluorescence counts. RESULTS No significant differences were found regarding neutrophil-endothelial cell adhesion in response to media alone, serum from women with preeclampsia, and serum from normal, pregnant women. This was also the case when the serum was heat inactivated to destroy the complement system. However, heat inactivated serum produced a significantly greater extent of adhesion compared with serum containing an intact complement system, regardless of whether the patient had preeclampsia. CONCLUSION This study found no evidence of a factor in serum from women with preeclampsia that could alter neutrophil-endothelial cell adhesion via a direct effect on the endothelium. However, our data suggest that adhesion may be regulated in an inhibitory manner by the complement system.
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Affiliation(s)
- C J Clark
- Department of Obstetrics and Gynaecology, Glasgow Royal Infirmary, Scotland
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37
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Abstract
This randomized, controlled study investigated the physiological effects of a specially designed 12 week programme of isolated conditioning of peripheral skeletal muscle groups. The programme required minimal infrastructure in order to allow continued rehabilitation at home after familiarization within hospital. Forty eight patients, aged 40-72 yrs with chronic obstructive pulmonary disease (COPD) (mean (SD) forced expiratory volume in one second (FEV1) 61 (27)% of predicted normal) were randomly allocated into training (n = 32) and control (n = 16) groups. Physiological assessments were performed before and after the 12 week study period, and included peripheral muscle endurance and strength, whole body endurance, maximal exercise capacity (maximum oxygen consumption (V'O2,max)) and lung function. The training group showed significant improvement in a variety of measures of upper and lower peripheral muscle performance, with no additional breathlessness. Whole body endurance measured by free arm treadmill walking increased by 6,372 (3,932-8,812) 3 (p < 0.001). Symptom-limited maximal V'O2 was unchanged. However, the training group showed a reduction in ventilatory equivalents for oxygen and carbon dioxide, both at peak exercise and at equivalent work rate (Wmax). In summary, low intensity isolated peripheral muscle conditioning is well-tolerated, simple and easy to perform at home. The various physiological benefits should enable patients across the range of severity of chronic obstructive pulmonary disease to improve daily functioning.
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Affiliation(s)
- C J Clark
- Dept of Respiratory Medicine, Hairmyres Hospital, Glasgow, Scotland
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38
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Affiliation(s)
- C J Clark
- Department of Respiratory Medicine, Hairmyres Hospital, Glasgow, UK
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39
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Anderson K, McSharry CP, Clark C, Clark CJ, Barclay GR, Morris GP. Sump bay fever: inhalational fever associated with a biologically contaminated water aerosol. Occup Environ Med 1996; 53:106-11. [PMID: 8777446 PMCID: PMC1128422 DOI: 10.1136/oem.53.2.106] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To investigate the clinical, serological, and environmental features of a work related inhalational fever associated with exposure to an aerosol generated from a biologically contaminated 130,000 gallon water pool in a building used for testing scientific equipment. METHOD Cross sectional survey of all exposed subjects (n = 83) by symptom questionnaire, clinical examination, spirometry, and serology for antibody to Pseudomonads, pool water extract, and endotoxin. In symptomatic patients diffusion capacity was measured, and chest radiology was performed if this was abnormal. Serial peak flow was recorded in those subjects with wheeze. Bacterial and fungal air sampling was performed before and during operation of the water pool pump mechanism. Endotoxin was measured in the trapped waters and in the pumps. Serum cotinine was measured as an objective indicator of smoking. RESULTS Of the 20 symptomatic subjects, fever was most common in those with the highest exposure (chi 2 42.7, P < 0.001) in the sump bay when the water was (torrentially) recirculated by the water pumps. Symptoms occurred late in the working day only on days when the water pumps were used, and were independent of the serum cotinine. Pulmonary function was normal in most subjects (spirometry was normal in 79/83, diffusion capacity was low in five subjects, chest radiology was normal). Peak flow recording did not suggest a work relation. The bacterial content of the aerosol rose from 6 to > 10,000 colony forming units per cubic metre (cfu/m3) (predominantly environmental Pseudomonads) when the pumps were operating. High endotoxin concentrations were measured in the waters and oil sumps in the pumps. Low concentrations of antibody to the organisms isolated were detected (apart from two subjects with high antibody) but there was no relation to exposure or the presence of symptoms and similar antibody was found in the serum samples from a non-exposed population. The fever symptoms settled completely with the simple expedient of changing the water and cleaning the pumps. CONCLUSION Given the results of our study, the development of inhalational fever in this unique environment and clearly restricted cohort was closely related to the degree of exposure to contaminated aerosol and mainly occurred in the absence of distinct serological abnormality and independent of cigarette smoking.
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Affiliation(s)
- K Anderson
- Department of Respiratory Medicine, Western Infirmary, Glasgow
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40
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Mackay E, Clark CJ, Cochrane LM, Bell F. The Effects of a Twelve-week Weight Training Programme on Muscle Endurance in Patients with Chronic Obstructive Pulmonary Disease. Physiotherapy 1995. [DOI: 10.1016/s0031-9406(05)66590-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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41
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Abstract
We studied the efficiency of two common sampling strategies used to assemble cohorts to study the long-term problems of preterm infants: infants with birthweights of 500-1499 g, and infants with gestational ages (GA) of < 31 weeks. Birthweight, GA and 2-year outcome data from a population based study of infants < 2001 g, the Central New Jersey Brain Hemorrhage Study (NBH), were used to define the birthweight and GA distributions, at enrollment and at the age of 2 years, of overlapping subsets: infants 500-1499 g (n = 599) and infants < 31 weeks of age (n = 522). Using frequencies from the NBH study, we estimated that 1000 infants of 500-1499 g enrolled at birth would produce 712 infants at the age of 2 years, 498 below 31 weeks and 214 above. Enrolling 1000 infants < 31 weeks would produce a cohort of 697 infants at the age of 2, all of whom were < 31 weeks. Neither sampling strategy maximised the statistical power to investigate the pathophysiological determinants of long-term outcomes associated with short GA. Both methods oversampled older GAs. A stratified sampling technique based on GA, designed to produce equal numbers of subjects at each week of GA, would improve statistical power to study long-term outcomes. As we move from descriptive to analytical studies of preterm infants, we need to devise efficient, GA-based, sampling strategies that maximise statistical power to test pathophysiological hypotheses.
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Affiliation(s)
- M L Reuss
- G.H. Sergievsky Center, New York, New York 10032, USA
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42
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Clark CJ. Re: "Menstrual cycle patterns and risk of breast cancer". Am J Epidemiol 1995; 141:1201. [PMID: 7771459 DOI: 10.1093/oxfordjournals.aje.a117394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
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43
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Abstract
NMR imaging experiments have been carried out on a fruit (Actinidia deliciosa) and plant stem (Stachys sylvatica) using a wide range of image contrasts. These included T1, T2, T2*, diffusion, flow and chemical shift selection. In the case of fruit imaging we calculated relaxation time and diffusion maps and established that the imaged parameters varied significantly with fruit ripening. These changes we attribute to changes in water dynamics resulting from elevated sugar concentrations. For the plant stem, water flow has been observed in the xylem vessels with a maximum velocity of 70 microns s-1. The role of image artifacts is considered and, in the case of transverse relaxation, we have demonstrated that it is necessary to use a precursor Carr-Purcell-Meiboom-Gill pulse train if additional diffusive attenuation is to be avoided.
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Affiliation(s)
- P T Callaghan
- Department of Physics and Biophysics, Massey University, Palmerston North, New Zealand
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44
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Clark CJ. The influence of education on morbidity and mortality in asthma (including the use of open access hospital admission for severe attacks). Monaldi Arch Chest Dis 1994; 49:169-72. [PMID: 8049704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
Despite the availability of effective drugs, asthma morbidity and mortality are increasing. Undertreatment is a significant contributory factor providing the rationale for improved concentration on education of asthmatics. A review of asthma education programmes reveals improvements in a variety of outcome measures. However, the types of patients studied in these programmes are very variable and it remains an unproven assumption that previously non-compliant and undertreated patients are amenable to improving asthma through education. The problems of compliance are common both in childhood and adult asthma. Further concentration on strategies to improve the management of this particular sub-group require development. In general, education programmes appear more effective when they consist of specific self-management instructions rather than general education regarding the disease process.
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Affiliation(s)
- C J Clark
- Department of Respiratory Medicine, Hairmyres Hospital, East Kilbridge, Glasgow, UK
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45
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Affiliation(s)
- C J Clark
- Hairmyres Hospital, East Kilbride, Glasgow
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46
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Clark CJ. The place of education in the management of chronic lung disease. Monaldi Arch Chest Dis 1994; 49:68-70. [PMID: 8193624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
Health education, although an interesting logical requirement for management of chronic lung disease, is a complete process. It consists of more than transmission of a message with the expectation of implementation. The core materials can easily be identified, but the patient's response cannot be anticipated. Education of the health care providers, in this context respiratory physicians, regarding the second stage, should help to improve outcome.
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Affiliation(s)
- C J Clark
- University of Glasgow and Hairmyres Hospital, East Kilbride, Scotland
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47
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Clark CJ, Milligan G, Connell JM. Guanine nucleotide regulatory protein alterations in young Milan hypertensive strain rats. Biochim Biophys Acta 1994; 1225:149-57. [PMID: 8280782 DOI: 10.1016/0925-4439(94)90072-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Vascular smooth muscle cell membranes from prehypertensive rats of the Milan hypertensive strain (MHS) were used to examine adenylyl cyclase activity and its regulation by guanine nucleotide regulatory proteins (G-proteins). Basal adenylyl cyclase activity was similar in MHS and Milan normotensive strain (MNS) membranes. Forskolin (10(-4) M) produced a significantly greater stimulatory response in MHS membranes, but this was not observed with NaF (10(-2) M). Isoproterenol (10(-4) M) caused a significantly decreased stimulation of adenylyl cyclase activity in MHS membranes, while prostaglandin E1 (10(-5) M) produced similar responses in the two strains. Gi function and GTP responses, as observed by biphasic effects of GTP on isoproterenol-stimulated membranes, were similar in both strains. The levels of Gi2 alpha and Gq alpha/G11 alpha were similar in the two strains, while the levels of Gs alpha (44 and 42 kDa forms) and the beta-subunit were significantly reduced by approximately 20% in MHS membranes. The alpha-subunit of Gi3 was dramatically reduced by approximately 80% in MHS membranes. The affinities of beta-adrenergic receptors for the antagonist, cyanopindolol, were similar in the two strains; however, the number of beta-adrenoceptors was substantially reduced in MHS membranes. These findings may be of relevance to altered vascular reactivity and transmembrane ion distribution observed in the MHS.
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Affiliation(s)
- C J Clark
- MRC Blood Pressure Unit, Western Infirmary, Glasgow, UK
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48
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Clark CJ, Milligan G, Connell JM. Guanine nucleotide regulatory protein alterations in the Milan hypertensive rat strain. J Hypertens 1993; 11:1161-9. [PMID: 8301096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
OBJECTIVE To examine whether the altered regulation of adenylyl cyclase that has been reported in vascular tissues from spontaneously hypertensive rats is also evident in the Milan hypertensive (MHS) rat strain. DESIGN The plasma membranes of vascular smooth muscle cells derived from thoracic aortae from adult (60-day-old) MHS and Milan normotensive (MNS) strain rats were studied. METHODS Guanine nucleotide regulatory protein (G-protein) function was inferred from adenylyl cyclase activity studies, and levels of G-protein subunits were assessed by immunoblotting. beta-Adrenergic receptor number and affinity were measured from the binding of the antagonist [125I]-cyanopindolol. RESULTS Basal adenylyl cyclase activity was increased significantly in MHS rat cell membranes, and stimulation by 0.1 mmol/l isoproterenol and 0.01 mmol/l prostaglandin E1 was significantly greater in MHS than in MNS rat cell membranes. Forskolin (at 0.1 mmol/l) resulted in a significantly greater stimulatory response in MHS membranes, which was eliminated by 0.01 mol/l NaF. Biphasic effects of GTP on isoproterenol-stimulated membranes demonstrated similar Gi function in MHS and MNS rat cell membranes, although a greater stimulatory GTP response was observed in MHS rat cell membranes. The levels of Gs alpha (both forms), Gi3 alpha and the beta-subunit were reduced in MHS rat cell membranes, whereas the levels of Gi2 alpha and Gq alpha and G11 alpha were unchanged. The number of beta-adrenoceptors was increased significantly in MHS rat cell membranes, whereas receptor affinity for the antagonist was unaltered. CONCLUSIONS There are differences in adenylyl cyclase stimulatory responses in MHS rat vascular smooth muscle cell membranes. We have found evidence of reduced levels of particular G-protein subunits, altered beta-adrenoceptor-Gs coupling and increased beta-adrenoceptor number.
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Affiliation(s)
- C J Clark
- MRC Blood Pressure Unit, Western Infirmary, Glasgow, UK
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49
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Clark CJ. Women's sexual behaviors: only half the picture. Am J Public Health 1993; 83:912. [PMID: 8498638 PMCID: PMC1694731 DOI: 10.2105/ajph.83.6.912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
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50
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Abstract
We compared guanine nucleotide regulatory protein (G protein) levels and function in plasma membranes from resistance vessels (mesenteric arteries) isolated from spontaneously hypertensive (SHR) and normotensive Wistar rats. G protein function was deduced from studies of adenylate cyclase activity. Although the basal level of adenylate cyclase activity (+/- Mn2+ ions) was significantly greater in SHR membranes, addition of agents that function via the stimulatory G protein--i.e., NaF (10(-2) M), (-)-isoproterenol (10(-4) M), and prostaglandin E1 (10(-5) M)--resulted in a significantly lower stimulatory response in SHR membranes. Ligands that function via the inhibitory G protein--i.e., adrenaline (10(-5) M)/propranolol (10(-5) M) (this combination being equivalent to an alpha 2-receptor agonist), carbachol (10(-3) M), and serotonin (10(-5) M)--were responsible for only slight inhibitory responses in both SHR and Wistar rat membranes, which were not significantly different. Western blotting identified the presence of Gs, Gi2, and Gi3 alpha-subunits in rat vascular smooth muscle, but there were no differences in the levels of these G protein alpha-subunits found in SHR and Wistar rat plasma membranes. The levels of the beta-subunit in the two sets of membranes were also similar. In conclusion, there is a reduced response in adenylate cyclase activity to agents that function via the stimulatory G protein in SHR membranes. However, this is not a consequence of altered levels of the different G protein subunits.
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Affiliation(s)
- C J Clark
- MRC Blood Pressure Unit, Western Infirmary, Glasgow, Scotland, UK
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