Déterminants socio-économiques et institutionnels de l'adoption d'innovations techniques concernant la production de maïs à l'ouest du Cameroun

Socio-economic and Institutional Variables that Affect Adoption of Technical Innovations Concerning Maize Production in Western Cameroon. The low productivity of farms in sub-Saharan Africa including Cameroon is due among others to the low adoption rates of innovations developed by agricultural research. This paper is a case study of the adoption of the technical package (improved varieties, fertilizers, pesticides, mono-culture) for maize cultivation in Western Cameroon. Data from a sample of 52 farmers were analyzed using a logit model and it was found that the maize cultivated area, the market orientation of production, contact with extension services, land tenure are factors that determine the likelihood of a farmer to adopt the technical package. However, it was adopted by less than 20% of the farmers surveyed, the others adopted only one, two or three components of the package according to their specific needs and strategies. These results challenge the agricultural research and extension to adapt their proposals to the diverse needs of farmers and to explain the reasons for the non-adoption of the whole package

Analisis Hubungan Stresor Kerja (Kondisi Pekerjaan, Hubungan Interpersonal Dan Tampilan Pekerjaan-rumah) Dengan Kinerja Pada Pegawai Puskesmas Tongkeina Kota Manado

: Problems that often arise in health centers are among others issues of medical and paramedical personnel performance which appear on the quality of work or the quality of service and achievement of the programs implemented at the PHC. Individual performance is related to the working person's behavior. Employee behavior will result in a positive long-term performance and increase the ability of personnel, or vice versa, causing a negative long-term performance and a decrease in the ability of personnel. This study aimed to determine the relationship between working stressors and employee performance at Tongkeina Health Center Manado. This was a descriptive analytical study with a cross sectional design conducted at the health center Tongkeina from August 2013 to November 2013. The results showed that there was a relationship between job condition, interpersonal relationship, and homework presentation with employee performance. Interpersonal relationship was the most dominant variable affected the performance of employees in the health center Tongkeina

Microsurgical removal of posterior petrosal and petroclival meningiomas: A report of 8 cases

Background: Posterior petrosal and petroclival meningiomas are rare, benign tumors, representing difficult tumours to be treated by microsurgery: for often significant space-occupying effect, brain stem compression, frequent tight brain stem adherence, as well as encasement of the basilar artery, its perforators and cranial nerves. Methods: We report our experience referring on 6 cases of posterior petrosal and 2 cases of petroclival meningiomas operated in the last 5 years; retrospectively analyzed, including: the history, clinical data, imaging studies, surgical & histological records, follow-up records. All patients were woman, The main age was 56 years (range 34-72 years). Bony changes at the petrous apex was seen in one case with petroclival meningioma. Results: Gross total resection was achieved in 7 of 8 patients Simson gr.1-2., using a conventional retromastoid, retrosigmoid approach and in one case a petrosal approach. Retromastoid - retrosigmoid approach was preferred approach for removing posterior petrous meningiomas, used also in one case of petroclival meningioma; especially if preoperative hearing is intact. In all cases the establishment of an arachnoid plane was critical for separating the tumor from the cerebellum and brainstem as well as microdissection of the neurovascular structures. Once the tumor was excised, its dural attachment was removed or coagulated and hyperostotic bone was drilled away. Tumor histology was fibrous, meningothelial and psammomatous meningioma. After surgery two patients had a transitory palsy of the third (extrinsec) and the seventh nerve, installed immediately after operation, but one patient with a petroclival meningioma operated using the posterior petrosal approach died after a hemorrhagic infarct in the midbrain. No recurrence or progression of disease occurred one year after. Conclusions: A variety of techniques have been advocated for complete resection of posterior petrosal and petroclival meningiomas, with minimal brain retraction. For each case planning the safest approach should be sustaind on: detailed radiologic studies to define tumor size, location and extensions, the attachment of the tumor to the dura overlying the posterior face of the petrous apex, tumor encasement of the basilar and pontine perforators, venous anatomy delineation (especially the anatomy of the vein of Labbé). the consistency of the tumor, the operative distance to the tumor and neurovascular structures, minimal brain retraction, good visualization and lighting. The posterior petrosal approach is safe for total removal of clival and petroclival tumor, also for selected cases of petroclival meningioma even a retromastoid-retrosigmoid approach can be suitable

Antimicrobial diterpenoids and triterpenoids from the stem bark of Croton macrostachys

Antimicrobial-guided fractionation of the EtOAc extract of the stem bark of Croton macrostachys afforded five known compounds including two lupane triterpenoids, lupeol (1) and betulin (2), and three clerodane diterpenoids, floridolide A (3), hardwickic acid (4) and 12-oxo-hardwickic acid (5). Their structures were elucidated on the basis of spectral studies and comparison with published data. The EtOAc extract and compounds 1, 2, 4 and 5 were evaluated for their antibacterial and antifungal activities by macro-dilutionmethod. The extract displayed significant antibacterial and antifungal activities (MIC = 31.25-1000 μg/ml). Betulin (2) and 12-oxo-hardwickic acid (5) were the most active compounds (MIC = 7.81-500 μg/ml). Themost sensitive microorganisms were Staphylococcus aureus ATCC 25922 for bacteria and two Candida species, Candida albicans ATCC 24433 and Candida krusei ATCC 6258, for fungi. The isolation of these active antibacterial and antifungal principles supports the use of C. macrostachys in traditional medicine for the treatment of microbial infections.Keywords: Croton macrostachys; Euphorbiaceae; triterpenes; diterpenes; antibacterial; antifungal

Prospective comparison of long-term pain relief rates after first-time microvascular decompression and stereotactic radiosurgery for trigeminal neuralgia

OBJECTIVE Common surgical treatments for trigeminal neuralgia (TN) include microvascular decompression (MVD), stereotactic radiosurgery (SRS), and radiofrequency ablation (RFA). Although the efficacy of each procedure has been described, few studies have directly compared these treatment modalities on pain control for TN. Using a large prospective longitudinal database, the authors aimed to 1) directly compare long-term pain control rates for first-time surgical treatments for idiopathic TN, and 2) identify predictors of pain control. METHODS The authors reviewed a prospectively collected database for all patients who underwent treatment for TN between 1997 and 2014 at the University of California, San Francisco. Standardized collection of data on preoperative clinical characteristics, surgical procedure, and postoperative outcomes was performed. Data analyses were limited to those patients who received a first-time procedure for treatment of idiopathic TN with > 1 year of follow-up. RESULTS Of 764 surgical procedures performed at the University of California, San Francisco, for TN (364 SRS, 316 MVD, and 84 RFA), 340 patients underwent first-time treatment for idiopathic TN (164 MVD, 168 SRS, and 8 RFA) and had > 1 year of follow-up. The analysis was restricted to patients who underwent MVD or SRS. Patients who received MVD were younger than those who underwent SRS (median age 63 vs 72 years, respectively; p 5 years of follow-up (60 of 164 and 64 of 168 patients, respectively). Immediate or short-term (< 3 months) postoperative pain-free rates (Barrow Neurological Institute Pain Intensity score of I) were 96% for MVD and 75% for SRS. Percentages of patients with Barrow Neurological Institute Pain Intensity score of I at 1, 5, and 10 years after MVD were 83%, 61%, and 44%, and the corresponding percentages after SRS were 71%, 47%, and 27%, respectively. The median time to pain recurrence was 94 months (25th–75th quartiles: 57–131 months) for MVD and 53 months (25th–75th quartiles: 37–69 months) for SRS (p = 0.006). A subset of patients who had MVD also underwent partial sensory rhizotomy, usually in the setting of insignificant vascular compression. Compared with MVD alone, those who underwent MVD plus partial sensory rhizotomy had shorter pain-free intervals (median 45 months vs no median reached; p = 0.022). Multivariable regression demonstrated that shorter preoperative symptom duration (HR 1.005, 95% CI 1.001–1.008; p = 0.006) was associated with favorable outcome for MVD and that post-SRS sensory changes (HR 0.392, 95% CI 0.213–0.723; p = 0.003) were associated with favorable outcome for SRS. CONCLUSIONS In this longitudinal study, patients who received MVD had longer pain-free intervals compared with those who underwent SRS. For patients who received SRS, postoperative sensory change was predictive of favorable outcome. However, surgical decision making depends upon many factors. This information can help physicians counsel patients with idiopathic TN on treatment selection

Is the time ripe for new diagnostic criteria of cognitive impairment due to cerebrovascular disease? Consensus report of the International Congress on Vascular Dementia working group

Background: Long before Alzheimer's disease was established as the leading cause of dementia in old age, cerebrovascular lesions were known to cause cognitive deterioration and associated disability. Since the middle of the last century, different diagnostic concepts for vascular dementia and related syndromes were put forward, yet no widely accepted diagnostic consensus exists to date. Discussion: Several international efforts, reviewed herein, are ongoing to define cognitive impairment due to cerebrovascular disease in its different stages and subtypes. The role of biomarkers is also being discussed, including cerebrospinal fluid proteins, structural and functional brain imaging, and genetic markers. The influence of risk factors, such as diet, exercise and different comorbidities, is emphasised by population-based research, and lifestyle changes are considered for the treatment and prevention of dementia. Conclusion: To improve the diagnosis and management of vascular cognitive impairment, further progress has to be made in understanding the relevant pathomechanisms, including shared mechanisms with Alzheimer's disease;bringing together fragmented research initiatives in coordinated international programs;testing if known risk factors are modifiable in prospective interventional studies;and defining the pre-dementia and pre-clinical stages in line with the concept of mild cognitive impairment due to Alzheimer's disease