Autologous adult cortical cell transplantation enhances functional recovery following unilateral lesion of motor cortex in primates: a pilot study.

BACKGROUND:: Although cell therapy is a promising approach after cerebral cortex lesion, few studies assess quantitatively its behavioral gain in non-human primates. Furthermore, implantations of fetal grafts of exogenous stem cells are limited by safety and ethical issues. OBJECTIVE:: To test in non-human primates the transplantation of autologous adult neural progenitor cortical cells with assessment of functional outcome. METHODS:: Seven adult macaque monkeys were trained to perform a manual dexterity task, before the hand representation in motor cortex was chemically lesioned unilaterally. Five monkeys were used as control, compared to two monkeys subjected to different autologous cells transplantation protocols performed at different time intervals. RESULTS:: After lesion, there was a complete loss of manual dexterity in the contralesional hand. The five "control" monkeys recovered progressively and spontaneously part of their manual dexterity, reaching a unique and definitive plateau of recovery, ranging from 38% to 98% of pre-lesion score after 10 to 120 days. The two "treated" monkeys reached a first spontaneous recovery plateau at about 25 and 40 days post-lesion, representing 35% and 61% of the pre-lesion performance, respectively. In contrast to the controls, a second recovery plateau took place 2-3 months after cell transplantation, corresponding to an additional enhancement of functional recovery, representing 24 and 37% improvement, respectively. CONCLUSIONS:: These pilot data, derived from two monkeys treated differently, suggest that, in the present experimental conditions, autologous adult brain progenitor cell transplantation in non-human primate is safe and promotes enhancement of functional recovery.

Is it worth treating fever in intensive care unit patients? Preliminary results from a randomized trial of the effect of external cooling.

BACKGROUND: Antipyresis is a common clinical practice in intensive care, although it is unknown if fever is harmful, beneficial, or a negligible adverse effect of infection and inflammation. METHODS: In a randomized study, rectal temperature and discomfort were assessed in 38 surgical intensive care unit patients without neurotrauma or severe hypoxemia and with fever (temperature >/=38.5 degrees C) and systemic inflammatory response syndrome. Eighteen patients received external cooling while 20 received no antipyretic treatment. RESULTS: Temperature and discomfort decreased similarly in both groups after 24 hours. No significant differences in recurrence of fever, incidence of infection, antibiotic therapy, intensive care unit and hospital length of stay, or mortality were noted between the groups. CONCLUSIONS: These results suggest that the systematic suppression of fever may not be useful in patients without severe cranial trauma or significant hypoxemia. Letting fever take its natural course does not seem to harm patients with systemic inflammatory response syndrome or influence the discomfort level and may save costs.

La Suisse des mosquées. Derrière le voile de l'unité musulmane

En Suisse, un peu moins de 5 % de la population se déclarent musulmans. Originaires pour la majeure partie des grandes vagues migratoires de la fin du XXe siècle, les musulmans helvétiques sont le plus souvent identifiés individuellement. Ce livre présente la réalité institutionnelle et peu connue de l'islam en Suisse à partir de plusieurs enquêtes menées sur la manière dont il s'organise. Sa présence est très diversifiée selon les contextes cantonaux différents et les origines culturelles bien contrastées d'un musulman des Balkans, du Maghreb ou de la Turquie. Ces recherches menées par des sociologues et des politologues dessinent une mosaïque qui montre à partir de l'islam pratiquant et confessant qu'il ne peut être réduit aux formes conservatrices et violentes que certains considèrent comme la traduction obligée de toute posture musulmane. Cet ouvrage propose un portrait contrasté de l'islam en Suisse avec, d'une part, des ensembles qui tentent d'organiser légitimement leur culte et de maintenir leur héritage religieux et, d'autre part, des défis déterminants à relever pour l'intégration des fidèles, comme les liens avec le pays d'origine, l'indépendance financière des mosquées ou les questions relatives aux revendications religieuses ou culturelles de l'identité musulmane. A partir de la réalité musulmane, ce livre expose toute l'ambiguïté de nos sociétés « tolérantes » et « ouvertes », mais démunies et contradictoires face à l'émergence récente de la pluralité religieuse.

Brain tissue properties differentiate between motor and limbic basal ganglia circuits.

Despite advances in understanding basic organizational principles of the human basal ganglia, accurate in vivo assessment of their anatomical properties is essential to improve early diagnosis in disorders with corticosubcortical pathology and optimize target planning in deep brain stimulation. Main goal of this study was the detailed topological characterization of limbic, associative, and motor subdivisions of the subthalamic nucleus (STN) in relation to corresponding corticosubcortical circuits. To this aim, we used magnetic resonance imaging and investigated independently anatomical connectivity via white matter tracts next to brain tissue properties. On the basis of probabilistic diffusion tractography we identified STN subregions with predominantly motor, associative, and limbic connectivity. We then computed for each of the nonoverlapping STN subregions the covariance between local brain tissue properties and the rest of the brain using high-resolution maps of magnetization transfer (MT) saturation and longitudinal (R1) and transverse relaxation rate (R2*). The demonstrated spatial distribution pattern of covariance between brain tissue properties linked to myelin (R1 and MT) and iron (R2*) content clearly segregates between motor and limbic basal ganglia circuits. We interpret the demonstrated covariance pattern as evidence for shared tissue properties within a functional circuit, which is closely linked to its function. Our findings open new possibilities for investigation of changes in the established covariance pattern aiming at accurate diagnosis of basal ganglia disorders and prediction of treatment outcome.

Iowa Department of Human Services - Case Management Unit, Independent Auditor's Reports, Basic Financial Statements and Supplementary Information, June 30, 2004

State Agency Audit Report

Kernohan's notch and misdiagnosis of disorders of consciousness.

A 69-year-old man presented with a sudden headache followed by unconsciousness. There was no head injury. The Glasgow Coma Scale (GCS) score was 3/15 and there was a left mydriasis, unreactive to light. The CT-scan showed a left acute subdural haematoma causing a remarkable mass effect. A supratentorial hemispheric craniotomy was performed. Nevertheless, after several weeks at the intensive care unit (ICU), the patient was still unresponsive to external stimuli and did not show any motor activity. A comfort care attitude was decided on with the family and the patient was extubated. However, a few days later, the patient subsequently showed a surprisingly favourable course, with improved wakefulness. Indeed, the GCS score improved, and the treatment plan was modified so that the patient benefited from rehabilitation. The MRI showed a right cerebral peduncle lesion, consistent with a Kernohan-Woltman notch phenomenon (KWNP). Six months later, the patient was able to walk and live quite normally.

Use of a multidimensional assessment tool in a psychiatric adolescent care unit.

AIMS: Adolescent mental health problems require treatment and care that are adapted to their needs. To evaluate this issue, it was decided to implement a multidimensional instrument focused on a global approach to adolescent social and behavioural functioning, combined with the ICD-10 classification. METHODS: The combination of an assessment interview and a classification tool enabled the method to integrate the measurement of several domains of patient-based outcome rather than focus on the measurement of symptoms. A group of 68 adolescents from an inpatient unit were compared with 67 adolescents from the general population. RESULTS: Results suggest that adolescents from the care unit adopt significantly riskier behaviour compared with adolescents from the control group. As expected, the main problems identified refer to the psychological and familial areas. A cluster analysis was performed and provided three different profiles: a group with externalizing disorders and two groups with internalizing disorders. On the basis of a structured interview it was possible to obtain information in a systematic way about the adolescents' trajectory (delinquency, physical and sexual abuse, psychoactive substance use). CONCLUSION: It was shown that treatment and care should not focus exclusively on mental health symptoms, but also upon physical, psychological and social aspects of the adolescent. A global approach helps in the consideration of the multitude of factors which must be taken into account when working with people with serious mental health problems and may help to turn the care unit's activity more specifically towards the needs of these adolescents.

The neuronal basis of attention: rate versus synchronization modulation

Extensive theoretical and experimental work on the neuronal correlates of visual attention raises two hypotheses about the underlying mechanisms. The first hypothesis, named biased competition, originates from experimental single-cell recordings that have shown that attention upmodulates the firing rates of the neurons encoding the attended features and downregulates the firing rates of the neurons encoding the unattended features. Furthermore, attentional modulation of firing rates increases along the visual pathway. The other, newer hypothesis assigns synchronization a crucial role in the attentional process. It stems from experiments that have shown that attention modulates gamma-frequency synchronization. In this paper, we study the coexistence of the two phenomena using a theoretical framework. We find that the two effects can vary independently of each other and across layers. Therefore, the two phenomena are not concomitant. However, we show that there is an advantage in the processing of information if rate modulation is accompanied by gamma modulation, namely that reaction times are shorter, implying behavioral relevance for gamma synchronization.

The role of the Teaching Quality and Innovation Support Unit in the ICT Engineering Studies at Universitat Pompeu Fabra

One of the strategies of Universitat Pompeu Fabra to support Quality Learning has been the creation of Units for the Support of Teaching Quality and Innovation within each faculty. In the seminar we will present the role and activities of the Polytechnic School Unit in charge or coordinating the efforts towards quality learning in the Information and Communication Technologies (ICT) Engineering Studies. We will also discuss how these activities are informed to relevant academic stakeholders.

Introduction d'un questionnaire de dépistage de l'Etat de stress post traumatique (ESPT) : quel impact sur le diagnostic dans une unité d'urgence psychiatrique ambulatoire ?

Contexte: Impression clinique que l'Etat de Stress Post-traumatique (ESPT) est sous-diagnostiqué dans la prise en charge des patients qui sont évalués dans le cadre d'une urgence psychiatrique. Objectifs: (i) identifier la prévalence de l'ESPT dans une unité d'urgence psychiatrique au moyen d'un instrument diagnostic et la comparer avec le diagnostic clinique retenu dans un échantillon historique (ii) évaluer la perception des cliniciens quant à l'utilisation systématique d'un instrument diagnostic Méthodes: la prévalence de l'ESPT a été évaluée chez des patients consécutifs (N = 403) qui ont bénéficié d'une consultation par des psychiatres de l'Unité urgence-crise du Service de Psychiatrie de Liaison (PLI) du CHUV, en utilisant le module J du Mini Mental Neuropsychologic Interview (MINI 5.0.0, version CIM-10). Ce résultat a été comparé avec la prévalence de l'ESPT mentionné comme diagnostic dans les dossiers (N = 350) d'un échantillon historique. La perception des médecins-assistants de psychiatrie quant au dépistage systématique de l'ESPT avec un instrument a été étudiée en se basant sur la conduite d'un focus group d'assistants travaillant dans l'Unité urgence-crise du PLI. Résultats: Parmi les patients (N = 316) évalués à l'aide de l'instrument diagnostic, 20,3% (n = 64) réunissaient les critères de l'ESPT. Cela constitue un taux de prévalence significativement plus élevé que la prévalence d'ESPT documentée dans les dossiers de l'échantillon historique (0,57%). Par ailleurs, la prévalence de l'ESPT est significativement plus élevée parmi les groupes socio- économiques précarisés, tels que réfugiés et sans papiers (50%), patients venant d'un pays à histoire de guerre récente (47,1%), patients avec quatre (44,4%) ou trois comorbidités psychiatriques (35,3%), migrants (29,8%) et patients sans revenus professionnels (25%). Le focus groupe composé de 8 médecins-assistants a révélé que l'utilisation systématique d'un outil- diagnostic ne convenait pas dans le setting d'urgence psychiatrique, notamment parce que l'instrument a été considéré comme non adapté à une première consultation ou jugé avoir un impact négatif sur l'entretien clinique. Toutefois, après la fin de l'étude, les médecins-assistants estimaient qu'il était important de rechercher activement l'ESPT et continuaient à intégrer les éléments principaux du questionnaire dans leur travail clinique. Conclusion et perspectives: cette étude confirme que l'ESPT est largement sous-diagnostiqué dans le contexte des urgences psychiatriques, mais que l'usage systématique d'un outil diagnostic dans ce cadre ne satisfait pas les praticiens concernés. Pour améliorer la situation et au vu du fait qu'un instrument diagnostic est considéré comme non-adapté dans ce setting, il serait peut-être bénéfique d'envisager un dépistage ciblé et/ou de mettre en place une stratégie de formation institutionnelle.

Integració del motor APIS de qüestionaris on-line en una plataforma d'eLearning basada en serveis

El projecte Integració del motor APIS de qüestionaris on-line en una plataformad'eLearning basada en serveis descriu el procés d'anàlisi i implementació del codi necessari per integrar dins de la plataforma d'eLearning SLeD tot el motor d'APIS de manera que SLeD pugui reproduir preguntes o items i exàmens complets o tests dins d'una UOL o unitat d'aprenentatge. Això permetrà dotar a APIS d'un control de sessió d'usuari i permetrà una utilitat que fins ara no tenia, la possibilitat de entrar al món online mitjançant SLeD. Tot aixòs’implementa gràcies a la connexió WebServices amb el mòdul CCSI de CopperCore i SLeD que s'encarrega de donar facilitats al programador de cara a ampliar el ventall d'eines que ofereix aquesta plataforma i fomentar encara més la idea del codi lliure (open source) i la utilitat globalitzadora d'e-Learning.