Diallel analysis of cowpea (Vigna unguiculata (L.) Walp.) genotypes under water deficit stress.

Combining ability is referred to as the hybridization value of the parental genotypes involved in the crossing to develop hybrids. The best parents are selected through combining ability methods and subsequently used to produce high yielding and resistant hybrids. Thus, the objectives of this study were to (i) understand the nature and action of genes controlling water deficit tolerance, and (ii) identify superior genotypes from the genetic breadth provided by hybridization in cowpea. Twenty-four genotypes were subjected to normal irrigation and water deficit condition to examine combining ability, genotypic and phenotypic correlations for traits directly related to water deficit (proline and chlorophylls), grain yield and yield components. The results showed the presence of the action of additive and non-additive genes under both water regime conditions. However, there was the predominance of the action of additive genes for most of the traits studied under both conditions. The parents KVX61-1, IT06K242-3, IT07K-211-1-8, Kpodjiguèguè, IT99K-573-1-1, Tawa and IT97K-206-1-1 were observed to be good general combiners for proline content, chlorophyll content and traits associated with yield, while KVX61-1 × KVX396-18, IT06K242-3 × KVX396-18, IT07K-211-1-1 × KVX396-18, Kpodjiguèguè x KVX396-18, KVX61 -1 × IT97K-206-1-1, IT06K242-3 × IT97K-206-1-1, IT07K-211-1-1 × IT97K-206-1-1 and Kpodjiguèguè x IT97K-206-1-1 were proven to be the best specific combiners for traits directly related to water deficit tolerance and yield. It should be noted that number of days to pod maturity, pod length, number of pods per plant and weight of hundred seeds were highly heritable traits in this study.

Method for quantifying arousal and consciousness in healthy states and severe brain injury via EEG-based measures of corticothalamic physiology.

BACKGROUND: Characterization of normal arousal states has been achieved by fitting predictions of corticothalamic neural field theory (NFT) to electroencephalographic (EEG) spectra to yield relevant physiological parameters. NEW METHOD: A prior fitting method is extended to distinguish conscious and unconscious states in healthy and brain injured subjects by identifying additional parameters and clusters in parameter space. RESULTS: Fits of NFT predictions to EEG spectra are used to estimate neurophysiological parameters in healthy and brain injured subjects. Spectra are used from healthy subjects in wake and sleep and from patients with unresponsive wakefulness syndrome, in a minimally conscious state (MCS), and emerged from MCS. Subjects cluster into three groups in parameter space: conscious healthy (wake and REM), sleep, and brain injured. These are distinguished by the difference X-Y between corticocortical (X) and corticothalamic (Y) feedbacks, and by mean neural response rates α and ß to incoming spikes. X-Y tracks consciousness in healthy individuals, with smaller values in wake/REM than sleep, but cannot distinguish between brain injuries. Parameters α and ß differentiate deep sleep from wake/REM and brain injury. COMPARISON WITH EXISTING METHODS: Other methods typically rely on laborious clinical assessment, manual EEG scoring, or evaluation of measures like Φ from integrated information theory, for which no efficient method exists. In contrast, the present method can be automated on a personal computer. CONCLUSION: The method provides a means to quantify consciousness and arousal in healthy and brain injured subjects, but does not distinguish subtypes of brain injury.

[Traumatic subcutaneous emphysema of the face: the hazard of holding a sneeze]. / L'image du mois. Emphysème sous-cutané traumatique de la face : le danger de retenir un éternuement.

In this period of pandemic, protective measures and social distancing, sneezing might not be well received and trying to suppress a sneeze is tempting. It's not always a good idea. We here report the case of a patient suffering from minor facial trauma. The next day after the accident, while trying to hold back a sneeze, the patient caused sudden swelling of the right cheek, associated with subcutaneous emphysema and disturbances in sensitivity, revealing an unrecognized fracture of the right maxillary sinus. Post-traumatic subcutaneous emphysema of the face, caused by suppressed sneezing, is rarely described.

En cette période de pandémie, de gestes barrières et de distanciation sociale, éternuer peut être mal perçu et chercher à réprimer un éternuement est tentant. Ce n'est pas toujours une bonne idée. Nous rapportons ici le cas d'un patient victime d'un traumatisme facial mineur. Le lendemain de l'accident, en essayant de retenir un éternuement, le patient provoqua un brusque gonflement de la joue droite, associé à un emphysème sous-cutané et à des troubles de la sensibilité, révélant ainsi une fracture méconnue du sinus maxillaire droit. L'emphysème sous-cutané post-traumatique de la face, provoqué par un éternuement réprimé, est rarement décrit.

[Psychological and cognitive interventions in end-of-life support of patients with amyotrophic lateral sclerosis. A review.] / Prise en charge psychologique et cognitive au cours de l'accompagnement de fin de vie de patients atteints de sclérose latérale amyotrophique. Une revue systématique.

Amyotrophic lateral sclerosis (ALS) is an incurable disease characterized by muscle atrophy leading to complete paralysis. Once diagnosed, the average life expectancy is three to five years. In this context, palliative and end-of-life care are essential, as well as the development of cognitive and/or psychological therapies to improve the quality of life of patients. In this context, we conducted a review of the pertinent literature about psychological and cognitive interventions in end-of-life support for ALS patients. We identified 504 references out of which only four studies met our inclusion criteria. Two studies focused on dignity therapy, one study on the delay between the diagnosis and the start of psychological care in a specialized centre, and one case-report on psychological therapy combined with a computer-assisted communication system. The results of these studies, although very limited, suggest that psychological interventions may improve the management and quality of life of end-of-life ALS patients. Further studies should investigate the impact of psychological support adapted to ALS, using, for example, computer-assisted communication allowing to implement these interventions in a larger number of patients and over the long term.

La sclérose latérale amyotrophique (SLA) est une maladie neurogénérative qui se caractérise notamment par une amyotrophie progressive évoluant jusqu'à la paralysie complète du patient dont l'espérance de vie est, en moyenne, de trois à cinq ans. Les soins palliatifs et le développement de thérapies pour améliorer la qualité de vie des patients sont essentiels. Dans ce cadre, nous avons réalisé une revue de la littérature portant sur les interventions psychologiques et cognitives dans la prise en charge des patients atteins de SLA en fin de vie. Nous avons identifié 504 références dont quatre rapportant des études qui répondaient aux critères d'inclusion. Deux études portaient sur la thérapie de la dignité, une sur la rapidité d'une prise en charge psychologique dans un centre spécialisé et un rapport de cas concernait une prise en charge psychologique combinée à un système de communication assistée par ordinateur. Les résultats de ces quatre études, bien que limités, suggèrent que les interventions psychologiques pourraient améliorer la qualité de vie des patients en fin de vie. De nouvelles recherches devraient être menées pour investiguer l'impact d'une prise en charge psychologique adaptée à la SLA en utilisant, par exemple, une communication assistée afin d'implémenter ces interventions sur un plus grand nombre de patients et sur le long terme.

Clinical and electrophysiological investigation of spastic muscle overactivity in patients with disorders of consciousness following severe brain injury.

OBJECTIVE: The clinical and electrophysiological profile of spastic muscle overactivity (SMO) is poorly documented in patients with disorders of consciousness (DOC) following severe cortical and subcortical injury. We aim at investigating the link between the clinical observations of SMO and the electrophysiological spastic over-reactivity in patients with prolonged DOC. METHODS: We prospectively enrolled adult patients with DOC at least 3 months post traumatic or non-traumatic brain injury. The spastic profile was investigated using the Modified Ashworth Scale and the Hmax/Mmax ratio. T1 MRI data and impact of medication were analyzed as well. RESULTS: 21 patients were included (mean age: 41 ±â€¯11 years; time since injury: 4 ±â€¯5 years; 9 women; 10 traumatic etiologies). Eighteen patients presented signs of SMO and 11 had an increased ratio. Eight patients presented signs of SMO but no increased ratio. We did not find any significant correlation between the ratio and the MAS score for each limb (all ps > 0.05). The presence of medication was not significantly associated with a reduction in MAS scores or Hmax/Mmax ratios. CONCLUSIONS: In this preliminary study, the Hmax/Mmax ratio does not seem to reflect the clinical MAS scores in patients with DOC. This supports the fact they do not only present spasticity but other forms of SMO and contracture. SIGNIFICANCE: Patients with DOC are still in need of optimized tools to evaluate their spastic profile and therapeutic approaches should be adapted accordingly.

Correction to: Actigraphy assessments of circadian sleep-wake cycles in the Vegetative and Minimally Conscious States.

The original article [1] contains an error affecting the actigraphy time-stamps throughout the article, particularly in Table 1.

Non-invasive brain stimulation for fine motor improvement after stroke: a meta-analysis.

The aim of this study was to determine whether non-invasive brain stimulation (NIBS) techniques improve fine motor performance in stroke. We searched PubMed, EMBASE, Web of Science, SciELO and OpenGrey for randomized clinical trials on NIBS for fine motor performance in stroke patients and healthy participants. We computed Hedges' g for active and sham groups, pooled data as random-effects models and performed sensitivity analysis on chronicity, montage, frequency of stimulation and risk of bias. Twenty-nine studies (351 patients and 152 healthy subjects) were reviewed. Effect sizes in stroke populations for transcranial direct current stimulation and repeated transcranial magnetic stimulation were 0.31 [95% confidence interval (CI), 0.08-0.55; P = 0.010; Tau2 , 0.09; I2 , 34%; Q, 18.23; P = 0.110] and 0.46 (95% CI, 0.00-0.92; P = 0.05; Tau2 , 0.38; I2 , 67%; Q, 30.45; P = 0.007). The effect size of non-dominant healthy hemisphere transcranial direct current stimulation on non-dominant hand function was 1.25 (95% CI, 0.09-2.41; P = 0.04; Tau2 , 1.26; I2 , 93%; Q, 40.27; P < 0.001). Our results show that NIBS is associated with gains in fine motor performance in chronic stroke patients and healthy subjects. This supports the effects of NIBS on motor learning and encourages investigation to optimize their effects in clinical and research settings.

Physical therapy in patients with disorders of consciousness: Impact on spasticity and muscle contracture.

BACKGROUND: Spasticity is a frequent complication after severe brain injury, which may prevent the rehabilitation process and worsen the patients' quality of life. OBJECTIVES: In this study, we investigated the correlation between spasticity, muscle contracture, and the frequency of physical therapy (PT) in subacute and chronic patients with disorders of consciousness (DOC). METHODS: 109 patients with subacute and chronic disorders of consciousness (Vegetative state/Unresponsive wakefulness syndrome - VS/UWS; minimally conscious state - MCS and patients who emerged from MCS - EMCS) were included in the study (39 female; mean age: 40±13.5y; 60 with traumatic etiology; 35 VS/UWS, 68 MCS, 6 EMCS; time since insult: 38±42months). The number of PT sessions (i.e., 20 to 30 minutes of conventional stretching of the four limbs) was collected based on patients' medical record and varied between 0 to 6 times per week (low PT = 0-3 and high PT = 4-6 sessions per week). Spasticity was measured with the Modified Ashworth Scale (MAS) on every segment for both upper (UL) and lower limbs (LL). The presence of muscle contracture was assessed in every joint. We tested the relationship between spasticity and muscle contracture with the frequency of PT as well as other potential confounders such as time since injury or anti-spastic medication intake. RESULTS: We identified a negative correlation between the frequency of PT and MAS scores as well as the presence of muscle contracture. We also identified that patients who received less than four sessions per week were more likely to be spastic and suffer from muscle contracture than patients receiving 4 sessions or more. When separating subacute (3 to 12 months post-insult) and chronic (>12months post-insult) patients, these negative correlations were only observed in chronic patients. A logit regression model showed that frequency of PT influenced spasticity, whereas neither time since insult nor medication had a significant impact on the presence of spasticity. On the other hand, PT, time since injury and medication seemed to be associated with the presence of muscle contracture. CONCLUSION: Our results suggest that, in subacute and chronic patients with DOC, PT could have an impact on patients' spasticity and muscles contractures. Beside PT, other factors such as time since onset and medication seem to influence the development of muscle contractures. These findings support the need for frequent PT sessions and regular re-evaluation of the overall spastic treatment for patients with DOC.

Assessing consciousness in coma and related states using transcranial magnetic stimulation combined with electroencephalography.

Thanks to advances in medical care, an increased number of patients recover from coma. However, some remain in vegetative/unresponsive wakefulness syndrome or in a minimally conscious state. Detection of awareness in severely brain-injured patients is challenging because it relies on behavioral assessments, which can be affected by motor, sensory and cognitive impairments of the patients. Other means of evaluation are needed to improve the accuracy of the diagnosis in this challenging population. We will here review the different altered states of consciousness occurring after severe brain damage, and explain the difficulties associated with behavioral assessment of consciousness. We will then describe a non-invasive technique, transcranial magnetic stimulation combined with high-density electroencephalography (TMS-EEG), which has allowed us to detect the presence or absence of consciousness in different physiological, pathological and pharmacological states. Some potential underlying mechanisms of the loss of consciousness will then be discussed. In conclusion, TMS-EEG is highly promising in identifying markers of consciousness at the individual level and might be of great value for clinicians in the assessment of consciousness.

[Transcranial direct current stimulation: a new tool for neurostimulation]. / La stimulation transcrânienne à courant continu: un nouvel outil de neurostimulation.

Transcranial direct current stimulation (tDCS) is a safe method to modulate cortical excitability. Anodal stimulation can improve the stimulated area's functions whereas cathodal stimulation reduces them. Currently, a lot of clinical trials have been conducted to study the effect of tDCS on post-stroke motor and language deficits, in depression, chronic pain, memory impairment and tinnitus in order to decrease symptoms. Results showed that, if an effect is observed with tDCS, it does not persist over time. Current studies suggest that direct current stimulation is a promising technique that helps to improve rehabilitation after stroke, to enhance cognitive deficiencies, to reduce depression and to relieve chronic pain. Moreover, it is a safe, simple and cheap device that could be easily integrated in a rehabilitation program.

Burnout in healthcare workers managing chronic patients with disorders of consciousness.

OBJECTIVES: The aim of this study was to assess the presence of burnout among professional caregivers managing patients with severe brain injury recovering from coma and working in neurorehabilitation centres or nursing homes. METHODS: The Maslach Burnout Inventory was sent to 40 centres involved in the Belgian federal network for the care of vegetative and minimally conscious patients. The following demographic data were also collected: age, gender, profession, expertise in the field, amount of time spent with patients and working place. RESULTS: Out of 1068 questionnaires sent, 568 were collected (53% response rate). Forty-five were excluded due to missing data. From the 523 healthcare workers, 18% (n = 93) presented a burnout, 33% (n = 171) showed emotional exhaustion and 36% (n = 186) had a depersonalization. Profession (i.e. nurse/nursing assistants), working place (i.e. nursing home) and the amount of time spent with patients were associated with burnout. The logistic regression showed that profession was nevertheless the strongest variable linked to burnout. CONCLUSIONS: According to this study, a significant percentage of professional caregivers and particularly nurses taking care of patients in a vegetative state and in a minimally conscious state suffered from burnout. Prevention of burnout symptoms among caregivers is crucial and is expected to promote more efficient medical care of these challenging patients.

Can Flemish women in semi-rural areas be motivated to attend organized breast cancer screening?

BACKGROUND: The implementation of organized breast cancer screening in Flanders was prepared by means of pilot projects within a multicenter study. In the semi-rural district of Kontich (Province of Antwerp, Flanders) a pilot project was performed using a mobile screening unit. Compared to international standards, the attendance rate for this pilot project (i.e. 34%) was low. Non-organized screening, which already exists in Flanders, at least partly explains this low attendance rate for the organized screening. The main purpose of our study was to investigate the experience of the pilot target group with respect to the organized breast cancer screening in the district of Kontich, in order to maximize the conditions for a high attendance rate in the organized breast cancer screening programme throughout Flanders. METHODS: With a random numbers procedure, performed by the computer, 500 women were selected among those who were invited to the first screening round of the breast cancer screening programme in the district of Kontich (n = 6,897). These 500 randomly selected women were asked to cooperate with a face-to-face interview. The questionnaire used dealt with the different aspects of the organized mammographic screening which were expected to influence the decision to attend. RESULTS: There were 348 women who responded to the questionnaire (69.6%): 138 of them were attenders and 210 were non-attenders at the organized breast cancer screening. Attenders and non-attenders at the organized breast cancer screening in the district of Kontich had different views about various aspects of the screening programme. The percentages of those who thought that an item was important or very important to them, were for the 138 attenders and the 210 non-attenders respectively: "to receive a personal invitation letter": 90.6 vs. 48.1% (p < 0.05); "a preliminary visit to the GP": 9.4 vs. 34.3% (p < 0.05); "possibility of examination outside business hours": 15.9 vs. 30.0% (p < 0.05). CONCLUSIONS: Although the putting into action of a mobile unit in the semi-rural area of the district of Kontich was productive, the attendance rate was still too low compared to international standards. To increase the attendance rate, the following interventions should be considered: devising the personal invitation letter in a more attractive way, activating and stimulating the important motivational role of the GP in persuading women to attend the organized screening programme and offering the invited population the possibility to have a mammographic examination performed outside business hours. Appropriate measures are being explored.

Second primary lung cancer in Flanders: frequency, clinical presentation, treatment and prognosis.

Patient and tumour characteristics of 23 patients presenting with a second primary lung cancer were analysed and compared with 534 patients with radically resected stage 1 non-small cell lung cancer (NSCLC). None of these characteristics is associated with a higher occurrence rate for second primary lung cancer. Prognosis in the latter patients is significantly worse than after resection of a 'solitary' NSCLC: the median survival time (MST) after resection of the first tumour is 50 months; after diagnosis of the second tumour only 14 months. Surgically retreated patients have a prognosis that is similar to that after resection of a 'solitary' NSCLC. No separate independent prognostic factors responsible for this survival difference could be isolated. Squamous histology and central location are associated with a longer recurrence free survival time. We conclude that the occurrence of a second primary lung cancer can not be predicted based on patient or tumour characteristics and that only surgical retreatment offers a chance of long survival in these patients.

[Hyperaldosteronism suppressible by glucocorticoids. An unusual cause of familial hypertension]. / L'hyperaldostéronisme freinable par les glucocorticoïdes. Une cause rare d'hypertension familiale.

The glucocorticoid suppressible hyperaldosteronism (GSH) is a rare form of systemic hypertension. We report a family--a father and his two children--with this disease. GSH represents a peculiar form of primary hyperaldosteronism, with usually an absence of increase of aldosterone in response to upright posture, a sustained responsiveness of aldosterone to prolonged ACTH stimulation and high levels of two steroids, the 18-hydroxy- and the 18-oxocortisol. But the two main features of GSH which distinguish it from other causes of hyperaldosteronism are the prompt reversal of the features of mineralocorticoids excess by glucocorticoid therapy and the autosomal dominant mode of inheritance. Recent studies demonstrate that this disorder is caused by an abnormal structure of the aldosterone synthase gene. Treatment by glucocorticoid (usually 0.30 to 0.75 mg dexamethasone daily) can reverse hypertension and hypokaliemia.

Preparation of poly (D,L) lactide microspheres by emulsion-solvent evaporation, and their clinical applications as a convenient embolic material.

The aim of preoperative embolization is to facilitate surgical removal by reducing tumor volume and vascularity, thereby decreasing blood loss during surgery. In a search for a better embolic material, compared to heterogeneous commercial products, we describe here in detail the preparation of poly (D,L) lactide microspheres by an emulsion-solvent evaporation process. The size distribution of the microparticles and their aggregation state--critical parameters in view of such application--have been investigated. Their effectiveness, as an embolic material, has been evaluated by some preliminary experiments undertaken on humans. The results were assessed on clinical and histological grounds.

(D, L) polylactide microspheres as embolic agent. A preliminary study.

Owing to their shape, accurately calibrated microspheres appear to be very suitable material for distal embolization. Moreover, the biocompatible (D, L) polyactide (PLA) microspheres possess two other valuable advantages: easy adjustment of their biodegradation rate, and incorporation of chemotherapeutic agents during their production. The authors describe the preparation of these (D, L) PLA microspheres and their clinical applications as a preliminary step to arterial chemoembolization.