A psychological view on the effectiveness of psychosocial interventions on positive airway pressure treatment adherence and sleep quality in patients with obstructive sleep apnea.

Positive airway pressure treatment (CPAP) is the gold standard for obstructive sleep apnea syndrome (OSAS). CPAP is highly effective, but its issue lays in poor adherence rates mainly caused by its invasive nature and related stigma. In accordance with a biopsychosocial model of CPAP adherence, psychosocial interventions have been implemented to alleviate low rates of adherence with promising results. The increase in the number of psychosocial interventions has highlighted the need to systematically evaluate their effectiveness. This review aims to identify psychosocial interventions used to increase CPAP adherence, to compile available data on their effectiveness, and the reasons why they are effective. Moreover, the review evaluates the impact of the interventions on sleep quality. Experimental and quasi-experimental studies testing psychosocial interventions (excluding educational only interventions) that aimed to increase CPAP adherence in adults with obstructive sleep apnea vs. no intervention or control group were included. A literature search in PsycINFO, MEDLINE, COCHRANE, EMBASE, CINAHL, and Web of Science was performed for studies published in English and French between 1980 and January 2020. Risk of bias and methodological quality were assessed using the Joanna Briggs Institute Critical Appraisal Tools. Fourteen studies were included involving 1923 participants, six trials tested a motivational intervention, three trials tested a cognitive behavioral intervention and five others tested one of the following: relaxation, exposition therapy, phone coaching, audiotape or stage-matched intervention. Thirteen studies reported a positive effect of the intervention on CPAP adherence, while one reported no effect. Psychosocial interventions for CPAP adherence appear effective at increasing sleep quality, but more studies are needed to test this hypothesis. Reasons for the effectiveness of the interventions were pooled into five categories: time related, the intervention's adaptability, the patient's characteristics, the intervention's nature and characteristics and the intervention's specifics and target. The current review raises a significant gap between the biomedical and psychosocial domains. In fact, even in a psychosocial intervention study, the interpretation of the results revolves around biomedical models and very little consideration is given to biopsychosocial models. Our findings demonstrate the importance of examining the relationship between psychosocial variables and CPAP adherence to better tailor interventions to increase CPAP adherence.

Osteocalcin affects bone mineral and mechanical properties in female mice.

Osteocalcin is one of the most abundant noncollagenous proteins in bone. Phenotypes of osteocalcin knock-out mice (OC-/-) may vary on different backgrounds and with sex. Previous studies using adult female (OC-/-) mice on a mixed genetic background (129/B6) showed osteocalcin inhibited bone formation leading to weaker bone in wild-type (OC+/+). Yet on a pure (B6) genetic background male mice revealed osteocalcin improved fracture resistance and OC-/- bones were more prone to fracture. Osteocalcin is decreased with age and in some diseases (diabetes) where bone weakness is observed. The effect of osteocalcin in adult female bone from mice on a pure B6 background is unknown. We investigated differences in bone mineral properties and bone strength in female adult (6 months) (OC+/+) and (OC-/-) mice on a pure C57BL/6J background using Fourier Transform Infrared Imaging (FTIRI), micro-computed tomography (uCT), biomechanical measurements, histomorphometry and serum turnover markers (P1NP, CTX). Similar to female age matched mice on the (129/C57) background we found B6 OC-/- mice had a higher bone formation rate, no change in bone resorption, more immature mineral, decreased crystallinity and increased trabecular bone as compared to OC+/+. In contrast, the OC-/- mice on a pure B6 background had a lower bone mineral density, lower mineral to matrix ratio resulting in reduced stiffness and weaker bone strength. Our results demonstrate some properties of the OC-/- phenotype are dependent on genetic background. This may suggest that reduced osteocalcin may contribute to fracture and weaker bone in some groups of elderly and adults with diseases where osteocalcin is low.

An evidence based method to calculate pedestrian crossing speeds in vehicle collisions (PCSC).

Pedestrian accident reconstruction is necessary to establish cause of death, i.e. establishing vehicle collision speed as well as circumstances leading to the pedestrian being impacted and determining culpability of those involved for subsequent court enquiry. Understanding the complexity of the pedestrian attitude during an accident investigation is necessary to ascertain the causes leading to the tragedy. A generic new method, named Pedestrian Crossing Speed Calculator (PCSC), based on vector algebra, is proposed to compute the pedestrian crossing speed at the moment of impact. PCSC uses vehicle damage and pedestrian anthropometric dimensions to establish a combination of head projection angles against the windscreen; this angle is then compared against the combined velocities angle created from the vehicle and the pedestrian crossing speed at the time of impact. This method has been verified using one accident fatality case in which the exact vehicle and pedestrian crossing speeds were known from Police forensic video analysis. PCSC was then applied on two other accident scenarios and correctly corroborated with the witness statements regarding the pedestrians crossing behaviours. The implications of PCSC could be significant once fully validated against further future accident data, as this method is reversible, allowing the computation of vehicle impact velocity from pedestrian crossing speed as well as verifying witness accounts.

Plasmablastic lymphoma: oral presentation in patient suffering from osteradionecrosis of the jaw.

INTRODUCTION: We describe here an unusual presentation of a plasmablastic lymphoma in a patient suffering from an osteoradionecrosis of the jaw. PRESENTATION OF CASE: We report the case of a 64-year-old patient who was followed up on oncology because of an oropharyngeal cancer treated by a combined procedure of both surgery and radio-chemotherapy procedure. This patient developed an osteoradionecrosis of the jaw. In the vicinity of this necrotic area appeared an ulceration which could evoke a new necrotic area. Given the persistence of this ulceration, a biopsy was performed which highlighted a plasmablastic lymphoma oral localization. DISCUSSION: The plasmablastic lymphoma, belonging to the diffuse large B-cell lymphoma family, is a very aggressive and unusual form of cancer with poor prognosis. If it is found mainly in patients with positive HIV, in whom it was first described, it is also found in immunosuppressed patients such as transplanted patients or patients suffering from leukaemia. CONCLUSION: Plasmablastic lymphoma is a rare and an aggressive pathology in immunocompetent patients.

[Malignant rhabdoid tumor of the lung]. / Tumeur pulmonaire maligne de type rhabdoïde.

INTRODUCTION: Rhabdoid tumours usually develop in brain and spinal cord or kidney; they are highly malignant neoplasms that typically arise in infancy and early childhood. However, rare cases of pulmonary localization have been described, particularly among young adults. CASE REPORT: A 26-year-old man, smoker, had a right apical lung mass associated with a Pancoast syndrome leading to haemoptysis. There was also a tumour of the left thigh and scalp. Histological samples taken at these three locations were in favour of an undifferentiated carcinoma. The lack of nuclear integrase interactor 1 expression, and immunohistochemical appearance supported the diagnosis of rhabdoid tumour. Despite treatment, unfavourable progression confirmed this hypothesis, doubling time was less than six weeks with development of multiple metastases resulted in death within only three months after diagnosis. CONCLUSION: The lack of expression of integrase interactor 1 should suggest the diagnosis of rhabdoid tumour, especially when there is quick progression. The prognosis of these tumours remains poor and therapeutic options are limited.

Prevalence of hepatic lesion types defined by T2-weighted and dynamic gadolinium-enhanced MR imaging in patients with metastasized neuroendocrine tumors.

PURPOSE: Identifying liver metastases from neuroendocrine tumors (NETs) is a pretherapeutic challenge in patients who are candidates for liver resection. The aims of our study are to characterize and determine the frequency of different MRI characteristics of liver metastases caused by NETs in a lesion-by-lesion analysis and to determine the frequency of monomorphous and polymorphous metastases in a patient-by-patient analysis. METHODS: This retrospective study involved 47 patients with liver metastases arising from histologically confirmed NETs. In a lesion-by-lesion analysis, we classified these metastases according to their MRI characteristics as follows: hypervascular lesions with homogeneous or peripheral enhancement, hypovascular lesions, pure cystic lesions, and mixed solid/cystic lesions. In the patient-by-patient analysis, we distinguished patients whose metastases had the same MRI characteristics from patients with mixed lesion characteristics. RESULTS: A total of 376 metastases were analyzed. Of these, 84.3% (n = 317) were hypervascular, with 51.9% showing homogeneous enhancement and 32.4% (n = 122) showing peripheral enhancement. Another 7.4% (n = 28) were hypovascular, 5.3% (n = 20) were pure cystic, and 2.9% (n = 11) were mixed solid/cystic. After excluding three patients with solitary lesions, 40.9% of patients (n = 18) had mixed-type lesions, consisting of hypervascular lesions with either homogeneous or peripheral enhancement in 27.3% of cases (n = 12), while 59.1% of patients (n = 26) had identical lesions. CONCLUSION: Approximately 15% of metastases have atypical MRI characteristics and are either hypovascular or cystic. Metastases with different MRI characteristics coexist in 40% of patients.

New resources for genetic studies in Populus nigra: genome-wide SNP discovery and development of a 12k Infinium array.

Whole genome resequencing of 51 Populus nigra (L.) individuals from across Western Europe was performed using Illumina platforms. A total number of 1 878 727 SNPs distributed along the P. nigra reference sequence were identified. The SNP calling accuracy was validated with Sanger sequencing. SNPs were selected within 14 previously identified QTL regions, 2916 expressional candidate genes related to rust resistance, wood properties, water-use efficiency and bud phenology and 1732 genes randomly spread across the genome. Over 10 000 SNPs were selected for the construction of a 12k Infinium Bead-Chip array dedicated to association mapping. The SNP genotyping assay was performed with 888 P. nigra individuals. The genotyping success rate was 91%. Our high success rate was due to the discovery panel design and the stringent parameters applied for SNP calling and selection. In the same set of P. nigra genotypes, linkage disequilibrium throughout the genome decayed on average within 5-7 kb to half of its maximum value. As an application test, ADMIXTURE analysis was performed with a selection of 600 SNPs spread throughout the genome and 706 individuals collected along 12 river basins. The admixture pattern was consistent with genetic diversity revealed by neutral markers and the geographical distribution of the populations. These newly developed SNP resources and genotyping array provide a valuable tool for population genetic studies and identification of QTLs through natural-population based genetic association studies in P. nigra.

Insomnia and sleep misperception.

Sleep misperception is often observed in insomnia individuals (INS). The extent of misperception varies between different types of INS. The following paper comprised sections which will be aimed at studying the sleep EEG and compares it to subjective reports of sleep in individuals suffering from either psychophysiological insomnia or paradoxical insomnia and good sleeper controls. The EEG can be studied without any intervention (thus using the raw data) via either PSG or fine quantitative EEG analyses (power spectral analysis [PSA]), identifying EEG patterns as in the case of cyclic alternating patterns (CAPs) or by decorticating the EEG while scoring the different transient or phasic events (K-Complexes or sleep spindles). One can also act on the on-going EEG by delivering stimuli so to study their impact on cortical measures as in the case of event-related potential studies (ERPs). From the paucity of studies available using these different techniques, a general conclusion can be reached: sleep misperception is not an easy phenomenon to quantify and its clinical value is not well recognized. Still, while none of the techniques or EEG measures defined in the paper is available and/or recommended to diagnose insomnia, ERPs might be the most indicated technique to study hyperarousal and sleep quality in different types of INS. More research shall also be dedicated to EEG patterns and transient phasic events as these EEG scoring techniques can offer a unique insight of sleep misperception.

The relationship between appetite scores and subsequent energy intake: an analysis based on 23 randomized controlled studies.

BACKGROUND/OBJECTIVES: Several studies have assessed relationships of self-reported appetite (eating motivations, mainly by Visual Analogue Scales, VAS) with subsequent energy intake (EI), though usually in small data sets with limited power and variable designs. The objectives were therefore to better quantify the relationships of self-reports (incorporating subject characteristics) to subsequent EI, and to estimate the quantitative differences in VAS corresponding to consistent, significant differences in EI. SUBJECTS/METHODS: Data were derived from an opportunity sample of 23 randomized controlled studies involving 549 subjects, testing the effects of various food ingredients in meal replacers or 100-150 ml mini-drinks. In all studies, scores on several VAS were recorded for 30 min to 5 h post-meal, when EI was assessed by ad libitum meal consumption. The relationships between pre-meal VAS scores and EI were examined using correlation, linear models (including subject characteristics) and a cross-validation procedure. RESULTS: VAS correlations with subsequent EI were statistically significant, but of low magnitude, up to r = 0.26. Hunger, age, gender, body weight and estimated basal metabolic rate explained 25% of the total variance in EI. Without hunger the prediction of EI was modestly but significantly lower (19%, P < 0.001). A change of ≥15-25 mm on a 100 mm VAS was the minimum effect consistently corresponding to a significant change in subsequent EI, depending on the starting VAS level. CONCLUSIONS: Eating motivations add in a small but consistently significant way to other known predictors of acute EI. Differences of about 15 mm on a 100 mm VAS appear to be the minimum effect expected to result in consistent, significant differences in subsequent EI.

[Indolent lymphoma of the ear]. / Lymphome indolent de l'oreille.

INTRODUCTION: In 2007, Petrella et al. identified a new entity: CD8 T-cell indolent lymphoma of the ear. CASE REPORT: A 40-year-old man presented a nodular erythematous and violaceous painless lesion on his right ear that had appeared four months earlier. Excision histology revealed a non-epidermotropic T-cell proliferation infiltrating the entire dermis and subcutis but with sparing of a grenz zone. The monotonous infiltrate was positive for CD8, CD3, CD5 and TIA-1, and negative for CD30, CD4, CD56, ALK and EMA. The Mib1 proliferation index was 20%. Lyme serology and PCR for EBV were negative. Additional examinations showed no extracutaneous involvement. DISCUSSION: CD8+ indolent lymphoma is an entity first described in 2007 and reported in the literature in 15 patients. Lesions are located on the nose or external ear. It comprises a non-epidermotropic proliferation of CD8+ T lymphocytes negative for CD4, CD30, CD56, CD57, granzyme B and perforin. The Mib1 proliferation index is low. This new entity appears neither in the 2005 World Health Organization/European Organization for Research and Treatment of Cancer (WHO/EORTC) classification of cutaneous lymphomas nor in the WHO 2008 Classification of tumours of haematopoietic and lymphoid tissues. Surgical treatment or radiotherapy is sufficient, and unlike aggressive, epidermotropic CD8+ T lymphomas chemotherapy is not required.

Measuring satiety with pictures compared to visual analogue scales. An exploratory study.

Visual analogue scales (VAS) are a standard tool used to measure subjective appetite. To explore a potentially more intuitive and precise alternative, we developed a method based on pictures and assessed its performance characteristics vs. VAS. The objective was to compare the capacity of the two methods to discriminate appetite ratings between interventions. Both methods were applied within a previously published trial in which 16 healthy adults received standardised meals followed by three different ileal infusions in a balanced crossover design. At regular intervals volunteers indicated how many units of individually pictured food portions (for 10 different items) they would like to eat, and also scored six VAS. Methods were compared over different timeframes and assessed for their sensitivity to intervention effects. Pictures were more sensitive than VAS in differentiating intervention effects; however, further refinement and validation would be needed for pictures to become a standardised and accepted alternative to VAS for this type of research.

[An atypical presentation of primary cutaneous diffuse B-cell lymphoma, leg type]. / Une présentation atypique de lymphome cutané B primitif à grandes cellules de type jambe.

BACKGROUND: Primary cutaneous diffuse B-cell lymphoma, leg type, are rare and aggressive tumours frequently affecting elderly patients. We present a case of a 53-year-old woman with an atypical presentation of primary cutaneous diffuse B-cell lymphoma, leg type. CASE REPORT: Eight years after complete excision of a Jessner-Kanof lymphocytic infiltration on the right shoulder, the patient developed a primary cutaneous diffuse B-cell lymphoma, leg type at the same site. The isolated lesion was treated using local radiotherapy. One year later, the patient presented headache associated with a temporal lesion, and biopsy confirmed a relapse. Cerebral CT scan showed an osteolytic temporal lesion while the other investigations revealed no extracutaneous extension. She was treated with R-CHOP chemotherapy and intrathecal methotrexate due to the osteolytic lesion. DISCUSSION: The particularity of this case consists in the age of this woman, who was younger than the average, the two atypical localizations on the shoulder, then the temple, and osteolysis, which is not the most frequent extension. Furthermore, to our knowledge, transformation of a Jessner-Kanof lesion into local aggressive primary cutaneous diffuse B-cell lymphoma, leg type, has not been yet described.

Effect of poplar genotypes on mycorrhizal infection and secreted enzyme activities in mycorrhizal and non-mycorrhizal roots.

The impact of ectomycorrhiza formation on the secretion of exoenzymes by the host plant and the symbiont is unknown. Thirty-eight F(1) individuals from an interspecific Populus deltoides (Bartr.)×Populus trichocarpa (Torr. & A. Gray) controlled cross were inoculated with the ectomycorrhizal fungus Laccaria bicolor. The colonization of poplar roots by L. bicolor dramatically modified their ability to secrete enzymes involved in organic matter breakdown or organic phosphorus mobilization, such as N-acetylglucosaminidase, ß-glucuronidase, cellobiohydrolase, ß-glucosidase, ß-xylosidase, laccase, and acid phosphatase. The expression of genes coding for laccase, N-acetylglucosaminidase, and acid phosphatase was studied in mycorrhizal and non-mycorrhizal root tips. Depending on the genes, their expression was regulated upon symbiosis development. Moreover, it appears that poplar laccases or phosphatases contribute poorly to ectomycorrhiza metabolic activity. Enzymes secreted by poplar roots were added to or substituted by enzymes secreted by L. bicolor. The enzymatic activities expressed in mycorrhizal roots differed significantly between the two parents, while it did not differ in non-mycorrhizal roots. Significant differences were found between poplar genotypes for all enzymatic activities measured on ectomycorrhizas except for laccases activity. In contrast, no significant differences were found between poplar genotypes for enzymatic activities of non-mycorrhizal root tips except for acid phosphatase activity. The level of enzymes secreted by the ectomycorrhizal root tips is under the genetic control of the host. Moreover, poplar heterosis was expressed through the enzymatic activities of the fungal partner.

Behavioural correlates of the P3b event-related potential in school-age children.

The latency and amplitude of the P3b component of event-related potentials (ERPs) have been related to behavioural performance on several attention and memory tasks in adult populations. However, the extent to which these results apply to children is unknown. This study examined the neurobehavioral correlates of the P3b component in a longitudinal sample of school-age children from Arctic Québec. Children (N=110; mean age=11.3years) were assessed on an ERP auditory oddball paradigm and a neurobehavioral evaluation targeting several aspects of cognition, including the Stewart Extended Continuous Performance Test (E-CPT), California Verbal Learning Test (CVLT), Stroop Color-Word Interference Test, and five subtests from the Wechsler Intelligence Scale for Children-Fourth edition (WISC-IV). P3b latency was positively related to reaction time measures and negatively associated with performance on the WISC-IV Digit Span Forward subtest. Amplitude of the P3b was associated with shorter completion time on the Stroop test and better delayed recognition memory performance among children who did not use semantic strategies on the CVLT. Profile analyses revealed no difference in scalp distribution of the P3b according to performance on these tests. The results are consistent with previous studies with older participants and suggest that, despite age-related differences in waveform and scalp distribution, the P3b component relates to similar neurocognitive processes in children and adults.

Productivity, water-use efficiency and tolerance to moderate water deficit correlate in 33 poplar genotypes from a Populus deltoides x Populus trichocarpa F1 progeny.

Genotypic variability for productivity, water-use efficiency and leaf traits in 33 genotypes selected from an F1 progeny of Populus deltoides Bartr. ex Marsh x Populus trichocarpa L. was explored under optimal and moderate water-deficit conditions. Saplings of the 33 genotypes were grown in a two-plot open field at INRA Orléans (France) and coppiced every year. A moderate water deficit was induced during two successive years on one plot by withholding irrigation, while the second one remained irrigated (control). Stem biomass and leaf structure (e.g., specific leaf area and leaf area) were measured in 2004 and 2005 and functional leaf traits (e.g., carbon isotope discrimination, Delta) were measured only in 2004. Tolerance to water deficit was estimated at genotype level as the ability to limit losses in biomass production in water deficit versus control trees. Stem biomass, leaf structure and Delta displayed a significant genotypic variability whatever the irrigation regime. For all traits, genotype ranks remained stable across years for similar irrigation conditions. Carbon isotope discrimination scaled negatively with productivity and leaf nitrogen content in controls. The most productive genotypes were the least tolerant to moderate water deficit. No relationship was evidenced between Delta and the level of tolerance to water deficit. The relationships between traits evidenced in this collection of P. deltoides x P. trichocarpa F1 genotypes contrast with the ones that were previously detected in a collection of P. deltoides x Populus nigra L. cultivars tested in the same field trial.

Genetic architecture of qualitative and quantitative Melampsora larici-populina leaf rust resistance in hybrid poplar: genetic mapping and QTL detection.

In order to elucidate the genetic control of resistance to Melampsora larici-populina leaf rust in hybrid poplars, a Populus deltoides x P. trichocarpa F(1) progeny was analysed for qualitative and quantitative rust resistances. This progeny was evaluated for three components of quantitative resistance (latent period, uredinia number and uredinia size) to seven M. larici-populina strains in controlled conditions, and for one component of field susceptibility (rust colonization on the most infected leaf). One qualitative resistance locus inherited from P. deltoides, R(1), was localized on the genetic map. It segregates 1 : 1 in the F(1) progeny and is effective against four of the studied strains. QTL analysis was performed separately on R(1) and r(1) genotype subsets. An additional detection was conducted on the entire F(1) progeny for the three strains able to overcome R(1) and for MAX2. A total of nine QTLs were detected. Two had large, broad-spectrum effects. One (R(US)) is inherited from the P. trichocarpa parent; the other is inherited from P. deltoides and colocalized with R(1). Seven QTLs had only limited and specific effects. Significant interaction effects were detected mainly between the two major QTLs. Implications of these results for durable resistance breeding strategies, and possible benefits from the Populus genome sequence, are discussed.

Genetic analysis of phenotypic variation for ectomycorrhiza formation in an interspecific F1 poplar full-sib family.

A plant's capability to develop ectomycorrhizal symbiosis is under the control of both genetic and environmental factors. In order to determine the roles played by these different factors, we have performed a quantitative genetic analysis of the ability of poplar trees to form ectomycorrhizas. Quantitative genetics were applied to an interspecific family of poplar for which the two parental genetic maps had already been described, and for which data analyses concerning fungal aggressors were obtained. Quantitative trait loci (QTL) related to ectomycorrhiza formation were identified and located in the genetic maps of the two parents. One QTL was located at a linkage group of the genetic map of Populus trichocarpa showing a high concentration of several QTL involved in the pathogenic interaction with the fungus Melampsora larici-populina, the causal agent of leaf rust.

Characterization of Two Major Genetic Factors Controlling Quantitative Resistance to Melampsora larici-populina Leaf Rust in Hybrid Poplars: Strain Specificity, Field Expression, Combined Effects, and Relationship with a Defeated Qualitative Resistance Gene.

ABSTRACT Two genetic factors explain a significant proportion of the variability for quantitative resistance to Melampsora larici-populina leaf rust in a Populus deltoides x P. trichocarpa F(1) progeny. One is inherited from P. deltoides and is associated with a defeated qualitative resistance gene R(1), and the other, R(US), is inherited from P. trichocarpa. To assess the potential contribution of these two factors for durable resistance breeding, 284 genotypes from this F(1) progeny were studied in laboratory experiments with three M. larici-populina strains and in a field experiment under natural inoculum pressure. Results confirmed that both factors can have strong beneficial effects in the laboratory. These effects were strain specific, thus impairing their chances for durability. However, association of both factors led to synergistic effects in most situations. In accordance with good field-laboratory relationships, especially those involving uredinia-size laboratory measurements, field effects of both resistance factors were significant. R(US) led to a significant reduction of rust colonization on the most infected leaf in the field, and its effect was significant both in the presence and the absence of R(1). In contrast, the presence of R(1) was useful in the field only when R(US) was absent. The nature of the genetic relationship between both factors remains unknown, but benefits from their association should be quantified over a longer period to evaluate potential adaptation of the pathogen.