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Rollins RL, Medeiros MC, Cowie RH. Stressed snails release Angiostrongylus cantonensis (rat lungworm) larvae in their slime. One Health 2023; 17:100658. [PMID: 38116454 PMCID: PMC10728333 DOI: 10.1016/j.onehlt.2023.100658] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Accepted: 11/25/2023] [Indexed: 12/21/2023] Open
Abstract
This study investigated the influence of stress on release of Angiostrongylus cantonensis larvae from a snail host, Parmarion martensi. We subjected 140 infected, wild-caught P. martensi to three stress-inducing treatments (heat, molluscicide, physical disturbance) and an unstressed control treatment for 24 h, after which larval presence and abundance in the slime were quantified by qPCR targeting the ITS1 region of the parasite's DNA, and compared among treatments. The significance of stress and host infection load on larval release was determined by generalized linear mixed models and permutation tests. The results indicated that stress significantly increased the probability of larval presence in slime and the number of larvae released, and highly infected snails were also more likely to release larvae. Among stressed snails, 13.3% released larvae into slime, the number of larvae present in the slime ranging from 45.5 to 4216. Unstressed controls released no larvae. This study offers a partial explanation for conflicting results from prior studies regarding A. cantonensis presence in snail slime and sheds light on the broader One Health implications. Stress-induced larval release highlights the potential role of slime as a medium for pathogen transmission to accidental, paratenic, definitive and other intermediate hosts. These findings emphasize the importance of considering stress-mediated interactions in host-parasite systems and their implications for zoonotic disease emergence. As stressors continue to escalate because of anthropogenic activities and climate change, understanding the role of stress in pathogen shedding and transmission becomes increasingly important for safeguarding human and wildlife health within the One Health framework.
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Affiliation(s)
- Randi L. Rollins
- Pacific Biosciences Research Center, University of Hawaiʻi at Mānoa, 3050 Maile Way, Gilmore 408, Honolulu, HI 96822, USA
- School of Life Sciences, University of Hawaiʻi at Mānoa, 3190 Maile Way, St. John 101, Honolulu, HI 96822, USA
| | - Matthew C.I. Medeiros
- Pacific Biosciences Research Center, University of Hawaiʻi at Mānoa, 1800 East West Road, LSB 316, Honolulu, HI 96822, USA
| | - Robert H. Cowie
- Pacific Biosciences Research Center, University of Hawaiʻi at Mānoa, 3050 Maile Way, Gilmore 408, Honolulu, HI 96822, USA
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Cowie RH, Ansdell V, Panosian Dunavan C, Rollins RL. Neuroangiostrongyliasis: Global Spread of an Emerging Tropical Disease. Am J Trop Med Hyg 2022; 107:1166-1172. [PMID: 36343594 PMCID: PMC9768254 DOI: 10.4269/ajtmh.22-0360] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Accepted: 08/18/2022] [Indexed: 11/09/2022] Open
Abstract
Neuroangiostrongyliasis (NAS) is an emerging parasitic disease caused by the neurotropic nematode Angiostrongylus cantonensis. Since it was first discovered, in rats in southern China in the 1930s, this tropical to subtropical parasite has spread to much of Southeast Asia, the Pacific Islands (including Hawaii), Australia, Japan, South America, the southeastern United States, the Caribbean, Africa, the Canary Islands, and the Balearic Islands. The parasite completes its natural life cycle in snails and slugs (intermediate hosts), and rats (definitive hosts). Humans become accidental hosts after ingesting infective third-stage larvae contained within uncooked or undercooked intermediate or paratenic hosts, an event that sometimes results in NAS, also known as rat lungworm disease. Although A. cantonensis larvae cannot complete their life cycle in humans, their migration into the brain and spinal cord combined with a powerful inflammatory reaction often leads to eosinophilic meningitis and can, in rare instances, lead to coma, paralysis, and death or, in other cases, chronic, disabling neurologic sequelae. Symptoms of NAS are diverse, which often makes it difficult to diagnose. Treatment may include administration of analgesics, corticosteroids, anthelminthics, and repeat lumbar punctures to reduce intracranial pressure. Unfortunately, few medical providers, even in endemic areas, are familiar with A. cantonensis or its epidemiology, diagnosis, and treatment. As the parasite continues to spread and NAS affects more people, medical practitioners, as well as the general public, must become more aware of this emerging zoonosis and the potentially devastating harm it can cause.
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Affiliation(s)
- Robert H. Cowie
- Pacific Biosciences Research Center, University of Hawaii, Honolulu, Hawaii;,Address correspondence to Robert H. Cowie, Pacific Biosciences Research Center, University of Hawaii, 3050 Maile Way, Gilmore 408, Honolulu, HI 96822. E-mail:
| | - Vernon Ansdell
- John A. Burns School of Medicine, University of Hawaii, Honolulu, Hawaii
| | | | - Randi L. Rollins
- Pacific Biosciences Research Center, University of Hawaii, Honolulu, Hawaii;,School of Life Sciences, University of Hawaii, Honolulu, Hawaii
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Medeiros MCI, Seabourn PS, Rollins RL, Yoneishi NM. Mosquito Microbiome Diversity Varies Along a Landscape-Scale Moisture Gradient. Microb Ecol 2022; 84:893-900. [PMID: 34617123 DOI: 10.1007/s00248-021-01865-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [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: 01/27/2021] [Accepted: 09/07/2021] [Indexed: 06/13/2023]
Abstract
Microorganisms live in close association with metazoan hosts and form symbiotic microbiotas that modulate host biology. Although the function of host-associated microbiomes may change with composition, hosts within a population can exhibit high turnover in microbiome composition among individuals. However, environmental drivers of this variation are inadequately described. Here, we test the hypothesis that this diversity among the microbiomes of Aedes albopictus (a mosquito disease vector) is associated with the local climate and land-use patterns on the high Pacific island of O 'ahu, Hawai 'i. Our principal finding demonstrates that the relative abundance of several bacterial symbionts in the Ae. albopictus microbiome varies in response to a landscape-scale moisture gradient, resulting in the turnover of the mosquito microbiome composition across the landscape. However, we find no evidence that mosquito microbiome diversity is tied to an index of urbanization. This result has implications toward understanding the assembly of host-associated microbiomes, especially during an era of rampant global climate change.
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Affiliation(s)
- Matthew C I Medeiros
- Pacific Biosciences Research Center, Life Science Building, University of Hawai'i at Mānoa, 1800 East-West Road, Honolulu, Hawaii, 96822, USA.
- Center of Microbiome Analysis Through Island Knowledge and Investigation, Life Science Building, University of Hawai'i at Mānoa, 1800 East-West Road, Honolulu, Hawaii, 96822, USA.
| | - Priscilla S Seabourn
- Pacific Biosciences Research Center, Life Science Building, University of Hawai'i at Mānoa, 1800 East-West Road, Honolulu, Hawaii, 96822, USA
| | - Randi L Rollins
- Pacific Biosciences Research Center, Gilmore Building, University of Hawai'i at Mānoa, 3050 Maile Way, Honolulu, Hawaii, 96822, USA
| | - Nicole M Yoneishi
- Pacific Biosciences Research Center, Life Science Building, University of Hawai'i at Mānoa, 1800 East-West Road, Honolulu, Hawaii, 96822, USA
- Center of Microbiome Analysis Through Island Knowledge and Investigation, Life Science Building, University of Hawai'i at Mānoa, 1800 East-West Road, Honolulu, Hawaii, 96822, USA
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Rollins RL, Qader M, Gosnell WL, Wang C, Cao S, Cowie RH. A validated high-throughput method for assaying rat lungworm ( Angiostrongylus cantonensis) motility when challenged with potentially anthelmintic natural products from Hawaiian fungi. Parasitology 2022; 149:1-28. [PMID: 35236524 PMCID: PMC9440163 DOI: 10.1017/s0031182022000191] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 02/10/2022] [Accepted: 02/15/2022] [Indexed: 11/06/2022]
Abstract
Parasitic nematodes devastate human and animal health. The limited number of anthelmintics available is concerning, especially because of increasing drug resistance. Anthelmintics are commonly derived from natural products, e.g. fungi and plants. This investigation aimed to develop a high-throughput whole organism screening method based on a motility assay using the wMicroTracker system. Anthelmintic activity of extracts from Hawaiian fungi was screened against third-stage larvae of the parasitic nematode Angiostrongylus cantonensis , categorized according to the degree of motility reduction. Of the 108 crude samples and fractionated products, 48 showed some level of activity, with 13 reducing motility to 0–25% of the maximum exhibited, including two pure compounds, emethacin B and epicoccin E, neither previously known to exhibit anthelmintic properties. The process of bioassay-guided fractionation is illustrated in detail based on analysis of one of the crude extracts, which led to isolation of lamellicolic anhydride, a compound with moderate activity. This study validates the wMicroTracker system as an economical and high-throughput option for testing large suites of natural products against A. cantonensis , adds to the short list of diverse parasites for which it has been validated and highlights the value of A. cantonensis and Hawaiian fungi for discovery of new anthelmintics.
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Affiliation(s)
- Randi L. Rollins
- Pacific Biosciences Research Center, University of Hawaii, Honolulu, HI96822, USA
- School of Life Sciences, University of Hawaii at Manoa, Honolulu, HI96822, USA
| | - Mallique Qader
- Department of Pharmaceutical Sciences, Daniel K. Inouye College of Pharmacy, University of Hawaii at Hilo, Hilo, HI96720, USA
| | - William L. Gosnell
- Department of Tropical Medicine, Medical Microbiology and Pharmacology, John A. Burns School of Medicine, University of Hawaii, Honolulu, HI96813, USA
| | - Cong Wang
- Department of Pharmaceutical Sciences, Daniel K. Inouye College of Pharmacy, University of Hawaii at Hilo, Hilo, HI96720, USA
| | - Shugeng Cao
- Department of Pharmaceutical Sciences, Daniel K. Inouye College of Pharmacy, University of Hawaii at Hilo, Hilo, HI96720, USA
| | - Robert H. Cowie
- Pacific Biosciences Research Center, University of Hawaii, Honolulu, HI96822, USA
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Rollins RL, Cowie RH, Echaluse MV, Medeiros MCI. Host snail species exhibit differential Angiostrongylus cantonensis prevalence and infection intensity across an environmental gradient. Acta Trop 2021; 216:105824. [PMID: 33422544 DOI: 10.1016/j.actatropica.2021.105824] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [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: 11/19/2020] [Revised: 12/30/2020] [Accepted: 12/31/2020] [Indexed: 01/27/2023]
Abstract
Diverse snail species serve as intermediate hosts of the parasitic nematode Angiostrongylus cantonensis, the etiological agent of human neuroangiostrongyliasis. However, levels of A. cantonensis infection prevalence and intensity vary dramatically among these host species. Factors contributing to this variation are largely unknown. Environmental factors, such as precipitation and temperature, have been correlated with overall A. cantonensis infection levels in a locale, but the influence of environment on infection in individual snail species has not been addressed. We identified levels of A. cantonensis prevalence and intensity in 16 species of snails collected from 29 sites along an environmental gradient on the island of Oahu, Hawaii. The relationship between infection levels of individual species and their environment was evaluated using AIC model selection of Generalized Linear Mixed Models incorporating precipitation, temperature, and vegetation cover at each collection site. Our results indicate that different mechanisms drive parasite prevalence and intensity in the intermediate hosts. Overall, snails from rainy, cool, green sites had higher infection levels than snails from dry, hot sites with less green vegetation. Intensity increased at the same rate along the environmental gradient in all species, though at different levels, while the relation between prevalence and environmental variables depended on species. These results have implications for zoonotic transmission, as human infection is a function of infection in the intermediate hosts, ingestion of which is the main pathway of transmission. The probability of human infection is greater in locations with higher rainfall, lower temperature and more vegetation cover because of higher infection prevalence in the gastropod hosts, but this depends on the host species. Moreover, severity of neuroangiostrongyliasis symptoms is likely to be greater in locations with higher rainfall, lower temperature, and more vegetation because of the higher numbers of infectious larvae (infection intensity) in all infected snail species. This study highlights the variation of infection prevalence and intensity in individual gastropod species, the individualistic nature of interactions between host species and their environment, and the implications for human neuroangiostrongyliasis in different environments.
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Affiliation(s)
- Randi L Rollins
- School of Life Sciences, University of Hawaii, 2538 McCarthy Mall, Edmondson 216, Honolulu, Hawaii 96822, USA; Pacific Biosciences Research Center, University of Hawaii, 3050 Maile Way, Gilmore 408, Honolulu, Hawaii 96822, USA.
| | - Robert H Cowie
- Pacific Biosciences Research Center, University of Hawaii, 3050 Maile Way, Gilmore 408, Honolulu, Hawaii 96822, USA
| | - Ma Vida Echaluse
- Pacific Biosciences Research Center, University of Hawaii, 1993 East West Road, Honolulu, Hawaii 96822, USA
| | - Matthew C I Medeiros
- Pacific Biosciences Research Center, University of Hawaii, 1993 East West Road, Honolulu, Hawaii 96822, USA
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Bernard J, Wall CB, Costantini MS, Rollins RL, Atkins ML, Cabrera FP, Cetraro ND, Feliciano CKJ, Greene AL, Kitamura PK, Olmedo-Velarde A, Sirimalwatta VNS, Sung HW, Thompson LPM, Vu HT, Wilhite CJ, Amend AS. Plant part and a steep environmental gradient predict plant microbial composition in a tropical watershed. ISME J 2021; 15:999-1009. [PMID: 33188299 PMCID: PMC8115680 DOI: 10.1038/s41396-020-00826-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Revised: 10/27/2020] [Accepted: 10/30/2020] [Indexed: 01/29/2023]
Abstract
Plant microbiomes are shaped by forces working at different spatial scales. Environmental factors determine a pool of potential symbionts while host physiochemical factors influence how those microbes associate with distinct plant tissues. These scales are seldom considered simultaneously, despite their potential to interact. Here, we analyze epiphytic microbes from nine Hibiscus tiliaceus trees across a steep, but short, environmental gradient within a single Hawaiian watershed. At each location, we sampled eight microhabitats: leaves, petioles, axils, stems, roots, and litter from the plant, as well as surrounding air and soil. The composition of bacterial communities is better explained by microhabitat, while location better predicted compositional variance for fungi. Fungal community compositional dissimilarity increased more rapidly along the gradient than did bacterial composition. Additionally, the rates of fungal community compositional dissimilarity along the gradient differed among plant parts, and these differences influenced the distribution patterns and range size of individual taxa. Within plants, microbes were compositionally nested such that aboveground communities contained a subset of the diversity found belowground. Our findings indicate that both environmental context and microhabitat contribute to microbial compositional variance in our study, but that these contributions are influenced by the domain of microbe and the specific microhabitat in question, suggesting a complicated and potentially interacting dynamic.
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Affiliation(s)
- Jared Bernard
- grid.410445.00000 0001 2188 0957Department of Plant and Environmental Protection Sciences, University of Hawai’i–Mānoa, 3050 Maile Way, Honolulu, HI 96822 USA
| | - Christopher B. Wall
- grid.410445.00000 0001 2188 0957Hawai’i Institute of Marine Biology, University of Hawai’i–Mānoa, 46-007 Lilipuna Road, Kāneʻohe, HI 96744 USA ,grid.410445.00000 0001 2188 0957Pacific Biosciences Research Center, University of Hawai’i–Mānoa, 3050 Maile Way, Honolulu, HI 96822 USA
| | - Maria S. Costantini
- grid.410445.00000 0001 2188 0957Department of Biology, University of Hawai’i–Mānoa, 2538 McCarthy Mall, Honolulu, HI 96822 USA
| | - Randi L. Rollins
- grid.410445.00000 0001 2188 0957Pacific Biosciences Research Center, University of Hawai’i–Mānoa, 3050 Maile Way, Honolulu, HI 96822 USA ,grid.410445.00000 0001 2188 0957Department of Biology, University of Hawai’i–Mānoa, 2538 McCarthy Mall, Honolulu, HI 96822 USA
| | - Melissa L. Atkins
- grid.410445.00000 0001 2188 0957Department of Biology, University of Hawai’i–Mānoa, 2538 McCarthy Mall, Honolulu, HI 96822 USA
| | - Feresa P. Cabrera
- grid.410445.00000 0001 2188 0957Department of Botany, University of Hawai’i–Mānoa, 3190 Maile Way, Honolulu, HI 96822 USA
| | - Nicolas D. Cetraro
- grid.410445.00000 0001 2188 0957Pacific Biosciences Research Center, University of Hawai’i–Mānoa, 3050 Maile Way, Honolulu, HI 96822 USA
| | - Christian K. J. Feliciano
- grid.410445.00000 0001 2188 0957Department of Botany, University of Hawai’i–Mānoa, 3190 Maile Way, Honolulu, HI 96822 USA
| | - Austin L. Greene
- grid.410445.00000 0001 2188 0957Department of Biology, University of Hawai’i–Mānoa, 2538 McCarthy Mall, Honolulu, HI 96822 USA
| | - Philip K. Kitamura
- grid.410445.00000 0001 2188 0957Department of Natural Resources and Environmental Management, University of Hawai’i–Mānoa, 1910 East-West Road, Honolulu, HI 96822 USA
| | - Alejandro Olmedo-Velarde
- grid.410445.00000 0001 2188 0957Department of Plant and Environmental Protection Sciences, University of Hawai’i–Mānoa, 3050 Maile Way, Honolulu, HI 96822 USA
| | - Vithanage N. S. Sirimalwatta
- grid.410445.00000 0001 2188 0957Department of Botany, University of Hawai’i–Mānoa, 3190 Maile Way, Honolulu, HI 96822 USA
| | - Helen W. Sung
- grid.410445.00000 0001 2188 0957Department of Biology, University of Hawai’i–Mānoa, 2538 McCarthy Mall, Honolulu, HI 96822 USA
| | - Leah P. M. Thompson
- grid.410445.00000 0001 2188 0957Department of Botany, University of Hawai’i–Mānoa, 3190 Maile Way, Honolulu, HI 96822 USA
| | - Huong T. Vu
- grid.410445.00000 0001 2188 0957Department of Molecular Biosciences and Bioengineering, University of Hawai’i–Mānoa, 1955 East-West Road, Honolulu, HI 96822 USA
| | - Chad J. Wilhite
- grid.410445.00000 0001 2188 0957Department of Natural Resources and Environmental Management, University of Hawai’i–Mānoa, 1910 East-West Road, Honolulu, HI 96822 USA
| | - Anthony S. Amend
- grid.410445.00000 0001 2188 0957Department of Botany, University of Hawai’i–Mānoa, 3190 Maile Way, Honolulu, HI 96822 USA
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Medeiros MCI, Rollins RL, Echaluse MV, Cowie RH. Species Identity and Size are Associated with Rat Lungworm Infection in Gastropods. Ecohealth 2020; 17:183-193. [PMID: 32676832 DOI: 10.1007/s10393-020-01484-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [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: 07/05/2019] [Revised: 04/20/2020] [Accepted: 04/27/2020] [Indexed: 06/11/2023]
Abstract
Angiostrongylus cantonensis, the rat lungworm, is an emerging zoonotic pathogen that cycles between definitive rat and intermediate gastropod hosts. Zoonotic infection occurs when humans intentionally or accidentally consume infectious larvae in a gastropod host, and may manifest as neuroangiostrongyliasis, characterized by eosinophilic meningitis, severe neurological impairment, and even death. Thus, the risk of A. cantonensis zoonoses may be related to the distribution of A. cantonensis larvae across gastropod hosts. We screened 16 gastropod species from 14 communities on the island of O'ahu, Hawai'i, USA, to characterize the distribution of A. cantonensis among species and across host size. Prevalence (proportion of the population infected) and infection intensity (density of worms in host tissue) varied among gastropod species. Prevalence also varied with gastropod host size, but this relationship differed among host species. Most host species showed a positive increase in the probability of infection with host size, suggesting that within species relatively larger hosts had higher prevalence. The density of worms in an infected snail was unrelated to host size. These results suggest that variation in A. cantonensis infection is associated with demographic structure and composition of gastropod communities, which could underlie heterogeneity in the risk of human angiostrongyliasis across landscapes.
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Affiliation(s)
- Matthew C I Medeiros
- Pacific Biosciences Research Center, University of Hawai'i at Mānoa, 1993 East West Road, Honolulu, HI, 96822, USA.
| | - Randi L Rollins
- Pacific Biosciences Research Center, University of Hawai'i at Mānoa, 3050 Maile Way, Gilmore 408, Honolulu, HI, 96822, USA
- Department of Biology, University of Hawai'i at Mānoa, 2538 McCarthy Mall, Edmondson 216, Honolulu, HI, 96822, USA
| | - Ma Vida Echaluse
- Pacific Biosciences Research Center, University of Hawai'i at Mānoa, 1993 East West Road, Honolulu, HI, 96822, USA
| | - Robert H Cowie
- Pacific Biosciences Research Center, University of Hawai'i at Mānoa, 3050 Maile Way, Gilmore 408, Honolulu, HI, 96822, USA
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Rollins RL, Stratas NE. The geographic unit as a phase in merging hospital and community programs. Hosp Community Psychiatry 1974; 25:378-80. [PMID: 4207642 DOI: 10.1176/ps.25.6.378] [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] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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Rollins RL. Recent developments on the insanity defense. N C Med J 1974; 35:356-7. [PMID: 4527230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
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Edwards KR, Gowitt GT, Rollins RL. State mental hospital referrals: patient abandonment by local medical resources. N C Med J 1974; 35:151-5. [PMID: 4524209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
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Rollins RL, Wolfe A. Eugenic sterilization in North Carolina. N C Med J 1973; 34:944-7. [PMID: 4521042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
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Rollins RL. Suggested revisions of North Carolina's laws on involuntary hospitalization for mental illness. N C Med J 1972; 33:1019-22. [PMID: 4508950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
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Rollins RL. The span of control in state hospitals. Hosp Community Psychiatry 1970; 21:100-1. [PMID: 5413029 DOI: 10.1176/ps.21.3.100] [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] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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Rollins RL, Cefalu SJ. Bromide ingestion in alcoholics. N C Med J 1968; 29:342-3. [PMID: 5244558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
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