Psychosocial Change in Members of Clubhouse Paris (France) Over an 18-Month Period: A Longitudinal Mixed Methods Study

Community Mental Health Journal - The community-based mental health organizations known as “Clubhouses” have existed since the 1940s in the United States, and the model has since spread...     

Functional trait space and the latitudinal diversity gradient

The processes causing the latitudinal gradient in species richness remain elusive. Ecological theories for the origin of biodiversity gradients, such as competitive exclusion, neutral dynamics, and environmental filtering, make predictions for how functional diversity should vary at the alpha (within local assemblages), beta (among assemblages), and gamma (regional pool) scales. We test these predictions by quantifying hypervolumes constructed from functional traits representing major axes of plant strategy variation (specific leaf area, plant height, and seed mass) in tree assemblages spanning the temperate and tropical New World. Alpha-scale trait volume decreases with absolute latitude and is often lower than sampling expectation, consistent with environmental filtering theory. Beta-scale overlap decays with geographic distance fastest in the temperate zone, again consistent with environmental filtering theory. In contrast, gamma-scale trait space shows a hump-shaped relationship with absolute latitude, consistent with no theory. Furthermore, the overall temperate trait hypervolume was larger than the overall tropical hypervolume, indicating that the temperate zone permits a wider range of trait combinations or that niche packing is stronger in the tropical zone. Although there are limitations in the data, our analyses suggest that multiple processes have shaped trait diversity in trees, reflecting no consistent support for any one theory.Species richness increases toward the equator (1, 2) in major clades of both extant and extinct species of plants and animals (3, 4). The generality of the pattern hints at a correspondingly general explanation, yet the latitudinal gradient in species richness remains one of ecology’s greatest unsolved puzzles. Long-running debates over the causes of the latitudinal gradient of species richness have focused on ecological, evolutionary, and geographic explanations (5–10). Although there has been some progress (11), it is also increasingly clear that there are numerous obstacles to understanding the primary drivers of the latitudinal gradient, including an ever-increasing number of hypotheses (12, 13), challenges in clearly separating their interdependencies (14, 15), and difficulties in rigorously falsifying their assumptions and predictions (16).More powerful tests of biodiversity theories need to move beyond species richness and instead explicitly focus on the mechanisms generating the gradient, by recasting the theories in terms of other measures of diversity, such as functional diversity (17–19). For example, explanations that assume species richness is limited by resource availability have often focused on the strength of species interactions, life history differences, and environmental constraints on how species pack into niche space (20). Evolutionary hypotheses have focused on differences in diversification rates, as well as the influence of species interactions on diversification rates (9). These interaction-based explanations implicitly refer to the degree of ecological differentiation among species, and therefore to trait dispersion within clades and assemblages, suggesting that patterns of functional diversity may provide a more powerful test of theory than taxonomic richness (21).A particularly important concept that unifies many ecological and evolutionary theories is the concept of the Hutchinsonian multidimensional niche (22). Hutchinsonian niches can be quantified by assessing the functional trait hypervolumes that characterize phenotypic space occupied by a set of species. Quantifying the volume, overlap, and packing of functional trait space at different spatial scales enables inferences about how differing ecological and evolutionary processes structure functional diversity and ecological strategies (23, 24).Here, we recast several contrasting hypotheses for the latitudinal gradient in terms of functional trait space. We focus on the proximate ecological mechanisms that ultimately can influence evolutionary processes. We quantify tree functional trait space across latitude at three spatial scales: (i) within assemblages (alpha), (ii) among assemblages (beta), and (iii) among biomes (gamma). For alpha and beta analyses, we use tree species assemblage data from 620 standardized 0.1-ha forest plots (Fig. 1A); for gamma analyses, we calculated the latitudinal range distributions for 520 New World tree species where we had sufficient data on geographic distribution and functional traits. In total, across all analyses, we used paired geographic occurrence data with trait data for 6,839 tree species.Open in a separate windowFig. 1.(A) Spatial distribution of the 620 0.1-ha forest plots used in this study. Plots are colored by richness. Plots cover most of the New World forested climate space (Fig. S1). (B) Relationship between absolute latitude and alpha hypervolume for tropical (red triangles) and temperate (blue pluses) plots. (C) Alpha hypervolume as a function of effective species richness (number of species with full trait coverage). We compare this hypervolume with a null expectation based on sampling the same number of species from the regional pool (median, dark gray line; 90% quantile range, light gray envelope).We primarily measured hypervolumes for three central traits hypothesized to characterize major axes of ecological strategy variation (25): specific leaf area (SLA), maximum height, and seed mass. SLA represents the tradeoff between leaf longevity and maximum photosynthetic rate (26); height is important for light competition and dispersal (27); and seed mass represents tradeoffs between fecundity, dispersal, and seedling survival (27). Although whole-plant resource strategies can be more fully assessed in higher dimensions (28, 29), we focus on these traits because of data availability (Materials and Methods). We use a hypervolume algorithm for calculating the volume and overlap of trait space (30) (Materials and Methods). All hypervolumes are reported in units of SDs of centered and scaled log-transformed trait values, raised to the power of the number of trait dimensions used.At all scales, our overall results and conclusions are similar (i) with and without gap-filling missing data, (ii) if we use convex hulls instead of hypervolumes to calculate trait spaces, and (iii) if we include additional trait axes. Additional details are given in Figs. S2–S7.     

Epidemiology of hypertensive crisis in the Buea Regional Hospital,Cameroon

Hypertensive crisis (HC) includes hypertensive urgency (HU) and hypertensive emergency (HE). There is scarcity of data on the epidemiology of patients presenting with HC in Cameroon. The aim of this study was to determine the prevalence, clinical characteristics, and outcome of HU and HE. We conducted a cross‐sectional study from June 2018 until June 2019. The criteria to define a hypertensive crisis were systolic and/or diastolic blood pressure ≥180/110 mm Hg. We compared HU vs HE. Out of the 1536 patients admitted, 95(6.2%) had a HC. There were 49(51.6%) men and 56 (58.9%) had a HE. The mean age was 51.1 ± 14.9 years. A history of hypertension was found in 75.3% of the patients but only 24.2% were on treatment. 33.7% consumed alcohol and 24.2% had chronic kidney disease. Headache (34.7%), dyspnea (34.7%), and neurological deficit (23.2%) were the most common symptoms. Patients with HE had higher systolic and diastolic blood pressures though the difference was not significant. The most frequent forms of HE were acute left ventricular failure with pulmonary edema (44.6%), intracerebral hemorrhage (21.4%), and cerebral infarction (16.1%). The most commonly prescribed medication was labetalol (44.2%). Mean length of hospital stay was 8.4 days. Patients with HE had a longer hospital stay (9.8 vs 6.3 days, P < .001). In‐hospital case fatality was 6.3%. Hypertensive crisis accounted for 6.2% of admissions in the medical unit with HE being more common than HU. Acute left ventricular failure with pulmonary edema and stroke were the most frequent target organ lesions in HE.     

Insulin-sensitizing effects on muscle and adipose tissue after dietary fiber intake in men and women with metabolic syndrome

Context: Dietary fibers have been associated with a reduced incidence of type 2 diabetes mellitus in epidemiological studies; however, the precise mechanisms are unknown. Objective: The objective of the study was to evaluate the efficacy and site of action of an insoluble dietary fiber derived from maize (HAM-RS2) in improving insulin resistance in subjects at increased risk of type 2 diabetes mellitus. Design: This study was a randomized, controlled crossover, dietary intervention study. Setting: The study was conducted at the Centre for Diabetes, Endocrinology, and Research, Royal Surrey County Hospital, Guildford, United Kingdom. Participants: Fifteen men and women with insulin resistance participated in the study. Intervention: The intervention included 40 g/d HAM-RS2 compared with a matched placebo for 8 wk. Main Outcome Measures: After each supplement, participants underwent a two-step hyperinsulinemic-euglycemic clamp study with the addition of glucose tracers; a meal tolerance test; arteriovenous sampling across forearm muscle tissue; and a sc adipose tissue biopsy for assessment of gene expression. Results: There was enhanced uptake of glucose into the forearm muscle measured by arteriovenous sampling (65 ± 15% increase after resistant starch; P < 0.001). Adipose tissue function was also affected, with enhanced fatty acid suppression after HAM-RS2 treatment and an increase in gene expression for hormone sensitive lipase (P = 0.005), perilipin (P = 0.011), lipoprotein lipase (P = 0.014), and adipose triglyceride lipase (P = 0.03) in biopsy samples. There was no effect on the insulin sensitivity of hepatic glucose production or plasma lipids after HAM-RS2. Conclusion: HAM-RS2 improved peripheral but not hepatic insulin resistance and requires further study as an intervention in patients with or at risk for type 2 diabetes.     

Low-dose vs. high-dose thalidomide for advanced multiple myeloma: a prospective trial from the Intergroupe Francophone du Myélome

This multicentre prospective randomised trial compared the efficacy and safety of two doses of thalidomide in patients with relapsed or refractory myeloma. The study was designed to test the non-inferior efficacy and to confirm the better tolerability of low-dose thalidomide as compared to a higher dose. Four hundred patients were randomly assigned to receive either 100 or 400 mg/day of thalidomide. Dexamethasone treatment was added in both arms for patients with stable disease or treatment failure at 12 weeks. The primary endpoint was 1-year overall survival (OS). Thalidomide 100 mg/day was better tolerated than 400 mg/day with less high-grade somnolence, constipation, nausea/vomiting and peripheral neuropathy (P < 0.001, P = 0.007, P = 0.03 and P = 0.007, respectively). In the per-protocol population (PP), the estimated 1-year OS rates were of 74.5% (n = 149) and 67.3% (n = 156) in the 400 and 100 groups, respectively. The upper limit of the difference between these rates was of 15.6% higher than the non-inferiority acceptable limit of 12.75%, and the hypothesis of non-inferiority of 100 could not be established (P = 0.14). On the other hand, when intent-to-treat (ITT) population was analysed, the non-inferiority was demonstrated because the 1-year OS rates were of 72.8% (n = 195) and 68.8% (n = 205) in the same groups, leading to an upper limit of the difference of 11.49% lower than the non-inferiority acceptable limit. In addition, in patients alive 12 weeks postrandomisation and those who received thalidomide plus dexamethasone, there were no significant differences in response rates, time to progression, progression-free survival and OS between the two groups. Collectively, low-dose thalidomide 100 mg/day has significant activity in advanced myeloma with an improved safety profile and can be a good salvage therapy in combination with dexamethasone.     

Seroprevalence and incidence of transfusion-transmitted infectious diseases among blood donors from regional blood transfusion centres in Burkina Faso, West Africa

Background and objective The high prevalence of numerous transfusion‐transmitted infectious diseases such as HIV, HBV, HCV and syphilis in sub‐Saharan Africa affects blood safety for transfusion recipients. The aim of this study was to evaluate the prevalence and incidence of transfusion‐transmissible infectious diseases among blood donors in Burkina Faso. Methods A retrospective study of blood donors’ records from January to December 2009 was conducted. Prevalence and incidence of viral infections were calculated among repeat and first‐time blood donors. Results Of the total of 31 405 first‐time volunteer blood donors in 2009, 24.0% were infected with at least one pathogen and 1.8% had serological evidence of multiple infections. The seroprevalence of HIV, HBV, HCV and syphilis in first‐time volunteer donors was 1.8%, 13.4%, 6.3% and 2.1%, respectively. In 3981 repeat donors, the incidence rate was 3270.2, 5874.1 and 6784.6 per 100 000 donations for anti‐HIV‐1, HBsAg and anti‐HCV, respectively. These numbers varied significantly according to populations where blood is collected and blood centres in Burkina Faso. Conclusion The relatively high prevalence of viral markers in first‐time volunteers and remarkably high incidence of infections in repeat donors raise concerns regarding the safety of these donors and suggest that implementation of NAT might significantly improve the situation.     

Identification and characterization of cholest-4-en-3-one, oxime (TRO19622), a novel drug candidate for amyotrophic lateral sclerosis

Amyotrophic lateral sclerosis (ALS) is a fatal neurodegenerative disorder characterized by progressive death of cortical and spinal motor neurons, for which there is no effective treatment. Using a cell-based assay for compounds capable of preventing motor neuron cell death in vitro, a collection of approximately 40,000 low-molecular-weight compounds was screened to identify potential small-molecule therapeutics. We report the identification of cholest-4-en-3-one, oxime (TRO19622) as a potential drug candidate for the treatment of ALS. In vitro, TRO19622 promoted motor neuron survival in the absence of trophic support in a dose-dependent manner. In vivo, TRO19622 rescued motor neurons from axotomy-induced cell death in neonatal rats and promoted nerve regeneration following sciatic nerve crush in mice. In SOD1(G93A) transgenic mice, a model of familial ALS, TRO19622 treatment improved motor performance, delayed the onset of the clinical disease, and extended survival. TRO19622 bound directly to two components of the mitochondrial permeability transition pore: the voltage-dependent anion channel and the translocator protein 18 kDa (or peripheral benzodiazepine receptor), suggesting a potential mechanism for its neuroprotective activity. TRO19622 may have therapeutic potential for ALS and other motor neuron and neurodegenerative diseases.