Prevalence of Glu323Lys Mutation of the TIGR/MYOC Gene and Risk Factors amongst Primary Open-angle Glaucoma Patients in Ouagadougou, Burkina Faso

Aim

Glaucoma is a group of degenerative diseases of the optic nerve whose predisposing factors may be genetic. The objective of this study was to estimate the frequency of the Glu323Lys mutation as a genetic risk factor for glaucoma.

Materials and methods

A cross-sectional study over 6 months from October 2020 to March 2021 in Ouagadougou, Burkina Faso. A total of 89 samples of patients with primary open-angle glaucoma (POAG) were collected. The frequency of the Glu323Lys mutation of the myocilin, trabecular meshwork inducible glucocorticoid response (TIGR/MYOC) gene by polymerase chain reaction (PCR)-restriction fragment length polymorphism.

Results

In glaucoma patients, only homozygous nonmutated guanine-guanine (GG) and heterozygous mutated adenine-guanine (AG) genotypes were found in 96.63 and 3.37% of cases, respectively. Around 69.66% of patients had a family history of glaucoma, 28.09% had a history of hypertension, and 7.86% had a history of diabetes.

Conclusion

The frequency of the Glu323Lys mutation of the TIGR/MYOC gene was 3.37% in the glaucoma population in Ouagadougou. A case-control study is necessary to know the contribution of the Glu323Lys mutation as a genetic risk factor for glaucoma in our study population.

Clinical significance

This study constituted the beginning of genetic investigations of glaucoma in our context and showed a low Glu323Lys mutation.

How to cite this article

Traoré L, Sanou J, Bakyono BS, et al. Prevalence of Glu323Lys Mutation of the TIGR/MYOC Gene and Risk Factors amongst Primary Open-angle Glaucoma Patients in Ouagadougou, Burkina Faso. J Curr Glaucoma Pract 2023;17(2):79-84.

[Central corneal thickness in black children examined under general anesthesia at the Yalgado Ouédraogo University Medical Center]

INTRODUCTION

Central corneal thickness measurement permits an evaluation of physiological and pathological corneal changes. It allows for an intra-ocular pressure correction factor. Our purpose was to determine the mean central corneal thickness in children aged 0 to 72 months and to examine factors that might affect it.

PATIENTS AND METHODS

This was a cross-sectional hospital study which took place from February to December 2019 in the ophthalmology service of YO University Medical Center. It included healthy eyes of children 0-72 months of age examined under general anesthesia. Ultrasonic pachymetry was used to measure the central corneal thickness. The studied variables were age, sex, CCT, corneal diameter, intraocular pressure, and cup/disc ratio.

RESULTS

One hundred and twenty-seven healthy eyes of 78 children 0-72 months of age were included. The mean age was 22 months. The overall mean CCT was 554.01±34.21μm. It was 556.58μm for children from 0 to 36 months of age and 536.12μm for subjects over 36 months. The mean CCT was 555.96±32.96μm in boys and 551.80±36.16μm in girls. In patients who underwent bilateral CCT measurement, the mean CCT was 554.74±35.67μm in the right eye and 549.76±24.08μm in the left eye. Lower IOP's were found in patients with thicker corneas (p=0.00).

CONCLUSION

The CCT values for black children over 36 months of age was similar to the CCT in black adults.

[Overview of visual impairment at the Yalgado Ouédraogo University Medical Center: Study of 501 cases]

OBJECTIVE

To determine the main causes of visual impairment according to age in patients admitted to the ophthalmology department.

MATERIALS AND METHODS

This was a retrospective study of 501 cases of visual impairment. Included were patients of both sexes whose best-corrected visual acuity in the better eye was strictly less than 5/10. The parameters studied were age, gender, place of residence, corrected visual acuity in the better eye, and diagnosis. The data were entered and processed with the Epi info 7.2 software.

RESULTS

Subjects over 50 were the most prevalent (48.5%). In patients over 50 years of age, cataracts (54.32%) were the leading cause of visual impairment, followed by glaucoma (24.69%) and non-glaucomatous optic neuropathy (26.19%). Trauma (17.62%) was frequently found in patients aged 16 to 50 years. Tropical endemic limbo-conjunctivitis (25.00%) was the leading cause of visual impairment in subjects aged 5 to 15 years.

CONCLUSION

This study confirms the results of the literature, which have shown that cataracts are the leading cause of visual impairment in developing countries. A major effort to raise awareness, provide information and therapeutic care would reduce the incidence of visual impairment.

[Preliminary selective laser trabeculoplasty (SLT) intraocular pressure results in glaucoma patients in Burkina Faso]

INTRODUCTION

Glaucoma is the leading cause of irreversible blindness in the world. The purpose of our study was to evaluate the tonometric results of SLT treatment in patients with glaucoma.

MATERIALS AND METHODS

This was a prospective study of patients with glaucoma who were seen from October 1, 2017 to July 31, 2018. All patients underwent SLT of the inferior 180°. Intraocular pressure (IOP) was measured before and then at 1, 15, 30, 60, 90 and 120days after treatment.

RESULTS

We studied 35 eyes of 31 patients. The mean age was 59.3 (±8.4years), range 43-77years. The mean IOP prior to SLT was 20.1mmHg (±7mmHg). One day after the laser, this decreased to 17.6mmHg (±8.4), for a percentage of drop of 12.4%. At 30days, it was 15.3mmHg (±5.4mmHg), i.e. a 23.9% decrease. After 60 and 90days, there was a drop of 13.9% and 15.4%, respectively. At 120days, 43.3% of treated eyes had a decrease of at least 20%. The main complication was increased IOP in 14.2% of cases.

CONCLUSION

SLT reduces IOP and the number of glaucoma medications in patients. It appears to be a viable alternative in our countries. These results should be confirmed with a larger cohort and longer follow-up.

[Epidemio-clinical features of retinoblastoma at the Yalgado Ouedraogo University Hospital Center in Burkina Faso: about 32 cases]

Retinoblastoma is the most common intraocular cancer of childhood. Its estimated incidence is 1 case per 15 000 to 18 000 births. The purpose of this study is to highlight the epidemiological and clinical features of this disease as well as its management in Burkina Faso. We conducted a retrospective study over a period of 5 years at the Yalgado Ouedraogo University Hospital Center. The average age of patients was 33 months, with predominance of male sex (68.75%). Exophthalmia was the most frequent reason for consultation (59.37%). The predominant pattern was unilateral (75%) associated with eye protrusion (59.38%). Chemotherapy associated with surgery was the treatment of choice, with a 5-year survival rate of 34.37%. Retinoblastoma is one of the most common cancers in children younger than 5 years. In our low-income country this disease is diagnosed late. Patients´ management is complex and is commonly associated with poor prognosis. Mortality and morbidity from this disease are disproportionate in our country facing a shortage of technical equipment. In our low-income country, patient´s management should be based on early detection of the disease as well as on adequate treatment.

[What do we know about diabetic retinopathy at the Sourô Sanou university medical center in Bobo-Dioulasso (CHUSS)?]

INTRODUCTION

Ocular damage is one of the numerous complications of diabetes. Proliferative diabetic retinopathy can result in blindness. The purpose of our work was to study the aspects of diabetic retinopathy on fundus examination in diabetic patients in Bobo-Dioulasso in a hospital environment.

METHODS

This is a descriptive, cross-sectional, prospective study from March 1st to August 31st 2014 of diabetic patients in the Sourô Sanou university hospital. We used the Francophone Diabetes Society's classification.

RESULTS

We included 246 patients (487 eyes). The frequency of diabetic retinopathy (DR) was 47.1%, and the frequency of diabetic maculopathy 8.9%. Proliferative DR and severe Non-Proliferative DR represented 3.3% of eyes, and blindness occurred in 3%. Among diabetics with DR, the mean age was 55.75 years (standard deviation 11.04 years); the median duration of diabetes was 36 months, and 99.1% of the diabetic patients were categorized as type 2. There was a statistically significant association between diabetic retinopathy and duration of diabetes progression, history of neuropathy, presence of proteinuria on 24hour urines, hypercreatininemia, and also between triglyceride levels and diabetic maculopathy.

CONCLUSION

Diabetic retinopathy affects almost half of diabetic patients at the Sourô Sanou university hospital. An earlier, multidisciplinary management approach might prevent this.

Intermediate tree cover can maximize groundwater recharge in the seasonally dry tropics

Water scarcity contributes to the poverty of around one-third of the world’s people. Despite many benefits, tree planting in dry regions is often discouraged by concerns that trees reduce water availability. Yet relevant studies from the tropics are scarce, and the impacts of intermediate tree cover remain unexplored. We developed and tested an optimum tree cover theory in which groundwater recharge is maximized at an intermediate tree density. Below this optimal tree density the benefits from any additional trees on water percolation exceed their extra water use, leading to increased groundwater recharge, while above the optimum the opposite occurs. Our results, based on groundwater budgets calibrated with measurements of drainage and transpiration in a cultivated woodland in West Africa, demonstrate that groundwater recharge was maximised at intermediate tree densities. In contrast to the prevailing view, we therefore find that moderate tree cover can increase groundwater recharge, and that tree planting and various tree management options can improve groundwater resources. We evaluate the necessary conditions for these results to hold and suggest that they are likely to be common in the seasonally dry tropics, offering potential for widespread tree establishment and increased benefits for hundreds of millions of people.

Malignant melanoma of the nasal septum, a rare tumor, occurring in a 54-year-old patient after hereditary retinoblastoma treatment

The authors report a case of a malignant melanoma of the nasal cavity that is a rare tumor and very aggressive, constituting 1% of all melanomas. It appeared in a patient 54 years after he was treated for a hereditary retinoblastoma. Its symptoms are nonspecific, and often marked by epistaxis. Its diagnosis is histological, supported by immunohistochemistry. Its prognosis is often unfavorable, and characterized by the occurrence of metastases and recurrences. Because of the risk of secondary cancer that exists in any survivor of hereditary retinoblastoma, we must think of possible mucosal melanoma of the nasal sinus in these patients in cases of chronic epistaxis. The prognosis of this tumor depends on its early diagnosis and surgical treatment.

[Interests of the examination of the fundus in general practice: review of 438 cases]

L'examen du fond d’œil fait partie du bilan de nombreuses maladies générales en dehors de l'ophtalmologie. L'objectif de notre travail était d’étudier les aspects cliniques et épidémiologiques des patients adressés pour un fond d’œil afin de montrer l'intérêtde cet examen. Il s'est agi d'une étude rétrospective descriptive des examens du fond d’œil durant la période de janvier 2011 à décembre 2013 dans un cabinet d'ophtalmologie d'une polyclinique à Bobo Dioulasso. Au cours de la période étudiée, 5942 consultations ont été enregistrées, dont 438 pour fond d’œil soit 7,37%. Il y avait 225 hommes et 213 femmes soit un sex ratio de 1,056. La tranche d’âge 40-59 ans représentait 54%. La fréquence des principaux motifs de la demande était l'hypertension artérielle 43,15% (N=189), le diabète 39,04% (N=171), l'association HTA et diabète 10,27% (N=45), et la drépanocytose 7,53% (N=33). Le fond d’œil était anormal chez 175 patients soit 36,23%. La rétinopathie hypertensive était retrouvée dans 42,73% des cas, la rétinopathie diabétique 25,92%, et la rétinopathie drépanocytaire 7,53%. L'examen du fond d’œil en médecine de ville présente un intérêt majeur, et permet de retrouver des anomalies chez plus d'un tiers des patients.

[Ocular manifestations in severe pre-eclampsia or eclampsia in Souro Sanou University Hospital in Bobo Dioulasso]

La pré-éclampsie sévère est un problème de santé publique. L'atteinte oculaire est une de ses nombreuses complications. Le but de notre travail était de décrire les atteintes oculaires chez les patientes présentant une pré-éclampsie et/ou éclampsie afin de contribuer à leur meilleure prise en charge. Il s'est agi d'une étude transversale descriptive à collecte prospective allant du 1^er novembre 2013 au 31 juillet 2014, chez les patientes ayant souffert de pré-éclampsie sévère/éclampsie. Nous avons inclus 127 patientes dans notre étude. La moyenne d’âge des patientes de notre étude était de 26,37 ans (ET= 6,8 ans), avec des extrêmes de 15 et 40 ans. Les tranches d’âge les plus représentées étaient celles de 26 à 30 ans avec 29,1% des cas et celle des 15 à 20 ans avec 25,2%. Le diagnostic de pré-éclampsie sévère a été retenu dans 69,3% des cas. Les primigestes représentaient 40,9% de la population. Les troubles visuels à type de phosphènes ont été observés chez 33,1% des patientes. Nous avons noté un courant granulaire conjonctival dans 41,7%, des lésions du segment postérieur chez 32,3% des patientes. Ces résultats ont été discutés par rapport à la littérature, et nous notons plus de cas d'atteinte rétinienne. Nous n'avons pas trouvé de lien statistiquement significatif entre la tension artérielle à l'admission et le stade de la rétinopathie hypertensive. Les complications oculaires de la pré-éclampsie sévère sont très fréquentes et souvent ignorées. Les atteintes rétiniennes sont fréquentes mais de bon pronostic.

[Functional outcomes of cataract surgery by phacoemulsification with implantation in the posterior chamber: 300 cases in Bobo Dioulasso (Burkina Faso)]

La cataracte est la première cause de cécité curable dans le monde. Son traitement est chirurgical. Le but de notre travail a été d’évaluer les résultats de la phacoalternative ou la chirurgie de la cataracte à petite incision. Il s'est agi d'une étude transversale descriptive à collecte prospective allant du 1er janvier au 31 septembre 2014, chez des patients âgés d'au moins 40 ans. Les données socio-démographiques, l'acuité visuelle, l'astigmatisme et les complications ont été évalués. Nous avons inclus 300 yeux de 286 patients. L’âge moyen était de 66 ans (écart type 9,93) avec une prédominance masculine de 57,7%. Les co-morbidités étaient dominées par l'hypertension artérielle 30,33% des cas. L'acuité visuelle pré-opératoire était de moins de 1/20è dans 70, 7% des cas. En biométrie, la puissance moyenne était de 21,50 dioptries. L'implant posé a été adéquat dans 60%. Les principales complications per-opératoires étaient le chémosis post-anesthésie 4,67% et l'issue de vitrée moins de 2% des cas. Les complications post opératoires précoces ont été dominées par l’œdème de cornée 26,33%, et les complications tardives par la cataracte secondaire. L'astigmatisme induit était de 1, 12 dioptrie en moyenne (écart type 1,26). Sans correction, les résultats visuels étaient mauvais dans moins de 1%, limites dans 31%, et bons 68% suivants les normes de l'Organisation Mondiale de la Santé. La phacoalternative donne des résultats satisfaisants, avec peu de complications. L'amélioration du plateau technique et la disponibilité d'implants adéquats pourraient les améliorer.

[Assessment of knowledge and pain management by traumatological emergencies staff of the teaching hospital of Ouagadougou]

INTRODUCTION

Pain is a frequent reason of consultation in traumatological emergencies. Its management is characterized by oligoanalgesia whose causes are multiple. The purpose of this study is to assess the knowledge and practices of pain management by traumatological emergencies staff of the teaching hospital Yalgado Ouedraogo of Ouagadougou.

MATERIALS AND METHODS

A questionnaire survey of health workers performing in traumatological emergencies has been conducted. Two different questionnaires, one for medical staff and one for the paramedics were administered.

RESULTS

A total of 67 health workers participated in the study with a participation rate of 98% and 100%, respectively, for the medical and paramedical staff. According to their report, 65.3% of medical and 77.7% of paramedical staff had never received training on pain and its management. For 85.7% of physicians, pain should be assessed before treatment, but 79.6% of them didn't know any conventional pain assessment method. All the nurses and 40.8% of physicians felt that pain in the emergency services should not be treated immediately to prevent misdiagnosis. Morphine and regional anesthesia were not used for pain treatment in the emergency room. 10.2% of medical staff and 27.8% of the paramedics said that they systematically search for the analgesicsside effects.

CONCLUSION

The knowledge of health workers about pain and its management is insufficient. The lack of training of health workers on the management of pain is the cause and contributes to explain the oligoanalgesia in this service.

[Creation of emergency care services in developing countries: luxury or necessity?]

Organization of emergency care services prior to hospital admission has progressed at a satisfactory pace in developed countries. A performance model in this field is the French emergency service called service d'aide médicale d'urgence (SAMU). Socioeconomic conditions prevailing in developing countries have pushed authorities to give priority to preventive medicine. However numerous patients especially young people and women during childbirth die as a result of inadequate facilities for transportation from hospitals and dwellings in outlying areas to major medical centers where the best medical equipment and staff are available. As a result, it may be asked if emergency care services is really a luxury. The authors base their conclusion on analysis of the conditions and outcome of emergency patient care in three African countries in which it is essentially a requirement.

[Survey of nosocomial infection prevalence in the surgery department of the Central National Hospital of Ouagadougou]

The objective of this study is to collect preliminary epidemiologic data about nosocomial infections (NI) in the National Hospital of Ouagadougou. A prevalence survey of NI was realized in surgical wards (116 patients). All hospitalized patients were included, excepted those stayed less than 48 hours. Using the definitions of the "Conseil Supérieur d'Hygiène Publique de France", the nosocomial infections studied were surgical wards, pneumonia and urinary tract infection. The result showed that 19 patients (16.4%) had 26 nosocomial infections (prévalence: 22.4%). Six patients had at least 2 nosocomial infections. The infection rate increases with operation, debilated preoperative physical statute, and invasive care. The average increasing of duration of hospital stay for infected patients was 10 days. This data confirm the importance of nosocomial infections and emphasize the need of surveillance and control of nosocomial infections. But deeper epidemiological studies must be undertaken before.

[Anesthesia practice by nurse anesthetists in French speaking Sub-Saharan Africa]

OBJECTIVE

To evaluate the practice of anaesthesia in French-speaking subsaharian countries.

TYPE OF STUDY

Prospective survey.

PERSONS

Two hundred seventeen nurse anaesthetists, from 11 different countries.

METHODS

Anonymous questionnaire.

RESULTS

One third of nurses were practising anaesthesia since less than five years and 1/3 since more than 10. Only 39 (18%) were working in the country side. Thirty seven (17%) had been trained outside subsaharian Africa (in Cuba 6%, France 5%, Morocco 5% and Germany 1% respectively). Two hundred thirteen (98%) were performing general anaesthesia and 169 (78%) regional anaesthesia. Hundred sixty eight (97%) used spinal anaesthesia, 57 (33%) epidural, 31 (18%) intravenous regional anaesthesia, 24 (14%) axillary block, 17 (10%) caudal block and 10 (6%) peripheral block respectively. For regional techniques, disposable devices were available in 50% of cases. For general anaesthesia, thiopental was administered by 193 (89%) and ketamine by 156 (72%) nurse anaesthetists respectively. In 50% of cases, these drugs were used alone. An ECG was available in 40%, a pulse oximeter in 14% and a capnographe in less than 2% of cases. A ventilator was present in 66% of the places, but used only in 30% of them because of the lack of maintenance and training.

CONCLUSIONS

In this study, 50% of nurse anaesthetists were working alone. However, this rate is probably under-estimated, as the questionnaire did not consider anaesthesia practice in the country side.

[Maternal mortality in adolescents at the university hospital of Ouagadougu]

This retrospective study evaluates the adolescent mortality rate at the University Hospital of Ouagadougou in the year 1995. Twenty lethal cases were collected amongst 646 deliveries giving birth to 490 children. The in-hospital adolescent maternal mortality rate come to be 4081 for 100,000 living births (4.08%) and represented 16.3% of all maternal deaths occurring during the study period. The most frequent causes of death were related to clandestine abortion (30%) and chronic anemia due to malnutrition (30%). Pregnancy in an adolescent girl is a high-risk event that requires special care due to a precarious global health status.

[Contraception with levonorgestrel (Norplant) subcutaneous implants. African experience in Burkina Faso]

The subcutaneous implants from the levonorgestrel (Norplant) has been introduced in Burkina Faso in September 1992 within the context of a project assisted by a non-governmental organization (the Population Council). The aim was to reinforce the family planning programme in Burkina Faso by increasing the number of family planning methods available for the clients. 4 years after its introduction, we propose to make a report of our experience in terms of the contraception through subcutaneous implants in order to better set up an IEC campaign on this method. Within 4 years, 1,660 users benefitted from that contraceptive method. They were housewives in 65% of the cases. The age-group of 30-34 years old most used this method with 28.6%. Multipares most benefitted from this method with 64.3%. In 72% of the cases, the insertion was made during the premenstrual period. On the whole, 247 withdrawals have been made before the fourth years for various reasons. Among those reasons are cycle disorders (60 withdrawals), medical reasons (53 withdrawals), personal conveniences (47 withdrawals), weight gaining (14 withdrawals), failures (2 withdrawals). Regarding the side effects, they were mainly represented by the menstrual cycle disorders such as amenorrhoea, spotting, hypermenorrhoea in 51% of the cases. A good information and sensitization campaign should reduce the number of implants withdrawals before the fourth year of use. Moreover, a perfect knowledge of contraindications is indispensable before any prescription.

[Evaluation of cognitive functions after anesthesia with propofol]

OBJECTIVES

To assess the disturbances and delay of recovery of cognitive functions following propofol anaesthesia, and to evaluate a series of simple cognitive recovery tests.

STUDY DESIGN

Prospective comparative non randomized clinical study.

PATIENTS

Two groups of non premedicated patients, of ASA physical class 1 and 2 were studied. The control group (n = 11) included patients undergoing gastric fibroscopy under local anaesthesia. The propofol group (n = 22) consisted of patients scheduled for coloscopy under propofol anaesthesia.

METHODS

The gastric fibroscopy was performed under local anaesthesia with lidocaine and the coloscopy under general anaesthesia with propofol as the sole anaesthetic. Five cognitive tests, designed to assess short-term memory, delayed memory, the ability to plan complex tasks, attention, and language comprehension were conducted the day before, and 1 hour, 3 hours and 6 hours after the endoscopy.

RESULTS

The cognitive functions remained significantly depressed for at least 3 hours after anaesthesia, and recovered fully about 6 hours after the cessation of propofol administration. The capacity for planning was the most heavily affected.

CONCLUSIONS

Complete recovery can be evaluated by simple cognitive tests, which showed that cognitive functions are impaired over a longer period than psychomotor functions. Oral instructions may therefore not be fully understood by the patient within 3 hours after anaesthesia, emphasizing the importance of written instructions and the essential role played by a well-informed accompanying person.

Risk factor for neonatal tetanus in west Burkina Faso: a case control study

A case-control study was carried out to identify risk factors for neonatal tetanus in rural Burkina Faso. Each of the 31 cases identified prospectively were matched with two controls. Risk factors such as the instrument used to cut the umbilical cord and the qualification of the midwives were only identified in the univariate analysis. The multifactorial analysis identified factors commonly believed to be associated with neonatal tetanus: lack of mother's immunization and place of birth other than maternity clinics. However, applying karite nut butter on the umbilical cord was found to be a strong independent factor associated with neonatal tetanus. Immunization of mothers against tetanus should be enforced. Health education must take into consideration sociocultural realities of these populations.

Cognitive sequelae of propofol anaesthesia

As with any substance that interferes with nervous system functioning, anaesthetics are likely to have neural effects the duration of which extend beyond the acute loss of consciousness. Studies of recovery after anaesthesia have shown that physiological effects and psychomotor functions return to pre-anaesthesia levels within at most 90 min of the cessation of propofol administration. To date no report has been published concerning the possible longer term effects of propofol anaesthesia on higher cognitive functions such as learning, language, reasoning and planning. We evaluated a range of cognitive tasks (short and long-term memory, attention, language comprehension and planning) up to 6 h after cessation of Propofol administration, and found that this set of cognitive functions was still depressed after 3 h, but had recovered by 6 h. The results suggest that, for their security, patients should be remain in a supervised environment for at least 3 h after propofol anaesthesia, and that oral information to patients within those 3 h should be avoided.

Evaluation of agronomic traits and analysis of exotic germ plasm polymorphism in adapted x exotic maize crosses

The utilization of exotic germ plasm is difficult due to its non-adaptability. This study investigates the possibility of exotic germ plasm loss during adaptation, and the effect of an additional cross with elite material on the breeding value of exotic x adapted material. The study was conducted on a temperate x highland tropical composite (or pool) developed in order to broaden the genetic variability of maize in north western Europe. The frequency of unique exotic alleles and the isoenzymatic polymorphism at four loci were analysed in the pool itself, in the pool after mild selection, and in the selected pool crossed with elite material. Based on these data, no significant deviation seemed to occur during the mild selection and the cross. The pool and the pool x elite germ plasm cross were evaluated in testcrosses with two complementary testers for both grain and forage production. The pool was later in maturity, more susceptible to lodging, and yielded less than the pool x elite germ plasm crosses for all evaluations. The highest estimates of genetic variance were obtained in the pool for earliness and height traits, and for yield. However, based on the predicted genotypic mean of the selected population, the pool had a lower breeding value than the pool x elite germ plasm cross. The pool x elite germ plasm cross is thus preferred to initiate selection.