NCube/papyrus huggingface dataset:
L’efficacité contestée du recours aux agents de santé communautaires pour la prise en charge du paludisme : évaluation du programme burkinabé dans les districts de
Kaya et de Zorgho

Context. In Burkina Faso, malaria causes approximately 25,000 deaths every year in children under five. In 2010, national health authorities introduced case management of malaria by community health workers (CHWs) as a way to increase prompt access to effective treatments. While this strategy’s efficacy has been demonstrated in controlled studies, very few studies evaluated its effectiveness under real-world and nation-wide conditions of implementation. Objective. The overarching aim of this thesis is to evaluate the effects of the Burkinabè program on treatment-seeking practices in febrile children. The specific objectives are: (1) to examine CHWs’ perceptions and investigate the contextual factors likely to affect their performance; (2) to estimate the use of CHWs in febrile children and its determinants; (3) to evalauate changes in treatment-seeking practices induced by the introduction of a concomitant intervention – the removal of user fees at health centres. Methods. The study was conducted in two similar health districts, Kaya and Zorgho. The evaluation design integrates quantitative and qualitative components. Interviews were carried out with all CHWs in the study area (N=27). Surveys were repeated every year from 2011 to 2013 in 3002 randomly selected households. Treatment-seeking practices of all children with a recent sickness episode (N2011=707; N2012=787; N2013=831) were examined. Results. Results show that the use of CHWs is really low in comparison to previous controlled studies. Feasibility issues in urban areas and barriers to implementation of the community case management of malaria programme were identified. Moreover, its effectiveness in rural areas was challenged by the removal of user fees at health centres. Conclusion. In Burkina Faso, community case management of malaria faces serious challenges of feasibility and implentation. These challenges compromise the programme’s potential to reduce child morbidity and mortality. The lack of integration between the programme and local concomitant interventions can generate unpredicted adverse effects.

Keyphrases: Burkina Faso, Malaria, Evaluation, Community case management, Community health workers, Mixed methods, Treatment-seeking behavior, Artemisinin-combination therapies
Impact de la maladie du greffon contre l’hôte sur la reconstitution immunitaire suite à une transplantation allogénique de cellules souches hématopoïétiques

Hematological cancers are currently treated with allogeneic hematopoietic stem cell transplantation (ASCT). Unfortunately, graft-versus-host disease (GVHD) greatly limits the health benefits of this procedure, as it is the main cause of mortality post-ASCT. GVHD damages various organs and delays the immune reconstitution of T lymphocytes (TL), which increases the risk of infections and relapse. Thus, developing new treatments modulating the immune reconstitution following ASCT would greatly enhance survival of the transplanted patients. TL can be regenerated by two ways: de novo production of TL by thymopoiesis; or homeostatic proliferation (HP), which consists of rapidly expanding mature TL already present in the graft. HP requires two crucial signals: interleukin-7 (IL-7) and self-antigen presentation by dendritic cells (DC) via the major histocompatibility complex (MHC) I for CD8+ TL and MHC II for CD4+ TL. During ASCT however, chemotherapy and GVHD induce damage to the thymus making thymopoiesis inefficient, and thus immune reconstitution relies almost entirely on HP of TL.  The objective of this thesis was to understand how GVHD affects TL reconstitution. Using a mouse model, we demonstrate that CD4+ TL fail to undergo HP when transferred in GVHD hosts due to low levels of IL-7 and reduced numbers of DCs. Moreover, the loss of DCs is mostly caused by reduced levels of Stromal Derived Factor-1 alpha (SDF-1α) and the absence of DC progenitors in the bone marrow of mice suffering from GVHD. Treating GVHD hosts with SDF-1α resulted in increased DC counts and, when administered in combination with IL-7, significantly improved HP of CD4+ TL. Unlike CD4+ TL, administration of IL-7 alone was sufficient to restore HP of CD8+ TL in GVHD mice and this, regardless of the presence of DCs. These differences could be explained by two reasons: 1) MHC I expression is not limited to DCs but is expressed by stromal cells from the recipient, which is sufficient to promote HP in CD8+ TL and 2) CD8+ TL respond to lower doses of systemic IL-7 in comparison to CD4+ TL.  In conclusion, these results can lead to future translational studies on the therapeutic potential of SDF-1α and IL-7 in the immune reconstitution of grafted patients.

Keyphrases: GVHD, lymphocyte T CD4+, lymphocyte T CD8+, SDF-1α, immune reconstitution, CD4+ T lymphocyte, CD8+ T lymphocyte, dendritic cell, homeostatic proliferation, interleukin-7
Rôle de la PKC delta dans la fonction plaquettaire en réponse à la thrombine via le récepteur GPIb alpha

The protein kinase C (PKC) family is essential for platelet function in response to thrombin, which signals and activates platelets via protease-activated receptors (PARs) and GPIbα, the low/medium and high affinity receptors in human platelets, respectively. PKCδ positively and negatively regulates platelet function depending on the nature of the stimulus. However, its importance in platelet function in response to thrombin downstream of GPIbα remains unknown. Here, we aimed to determine the involvement of the thrombin/GPIbα/PKCδ axis in platelet function and investigate the relevance of this axis in regulating thrombosis. In human platelets, pre-treatment with the specific PKCδ inhibitor δ(V1-1)TAT significantly potentiated platelet activation and aggregation in response to a priming concentration of α-thrombin, but not to γ-thrombin or PAR agonists. This potentiation process was associated with enhanced granule secretion, TXA2 generation and PKCδ phosphorylation on Tyr311, all of which were prevented by GPIbα blockade. Moreover, inhibition of p38 MAPK, Erk1/2 and TXA2 reverses this potentiation process. Platelets from PKCδ-/- mice show increased aggregation, whereas PKCδ-/- mice exhibit significantly decreased in vivo tail bleeding times and exacerbated pulmonary thrombo-emboli in response to α-thrombin. Blockade of GPIbα protects PKCδ-/- mice from these effects. This study adds new insights into the role of PKCδ in platelets downstream of GPIbα, where it negatively regulates platelet function in response to thrombin. Thus, the thrombin/GPIbα/PKCδ axis in platelets may represent a critical regulator of platelet function and hemostasis, and dysfunction of this pathway could lead to adverse thrombotic events.

Keyphrases: PKCδ, GPIbα, Platelets, PKCδ, GPIbα, Thrombin, Thrombosis
Identification et regroupement de QTL influençant la pression artérielle en modules épistatiques et analyse de deux gènes candidats chez la souche Dahl Salt-Sensitive

Essential hypertension is a major risk factor for cardiovascular diseases. Understanding the etiology of this pathology is of the outmost importance. Thus, unraveling novel genetic components and mechanisms regulating blood pressure (BP) via QTL identification and QTL-QTL interaction analysis is a promising strategy. Congenic strains establishment is a common and fruitful means for achieving such goal.  A quantitative trait, such as BP, has long been thought to result from the accumulation of infinitesimal effects exerted by multiple QTL. Nevertheless, BP is controlled by an epistasis-based architecture. Pair-wise comparisons of individual QTL based on the existence or lack-of epistatic interaction between them allowed us to establish a modularized organization of BP QTL in the Dahl Salt-sensitive model. Hence, two epistatic modules, namely EM1 and EM2 were constituted. In this fashion, any member of the EM1 is epistatic to all the other members of the same module and is additive to those of EM2. Regulatory hierarchies among BP with paradoxical effects can be revealed within each EM.  The molecular identification of EM1 members, C18QTL4/Hdhd2 and C18QTL3/Tcof1, as well as the revelation of the molecular basis for their epistatic interaction enabled us to suggest a sequential regulation within this EM. Hdhd2 could act upstream of Tcof1 and regulate it by post-transcriptional modification. This interaction is the first experimental evidence derived from the predictive model of QTL modularization.  The elucidation of the molecular mechanisms underlying the genetic architecture of BP, as well as the identification of the causal genes for QTL will lay the grounds for expanding therapeutic targets and for developing more efficient antihypertensive treatments.

Keyphrases: Hypertension, QTL, Hdhd2, Tcof1, Alpk2, epistasis, modularization, epistatic genetics, epistatic module, congenics
Évaluation des effets d’une intervention infirmière sur l'adhésion thérapeutique des personnes diabétiques de type 2 Libanais

In Lebanon, diabetes is estimated at 12%, it is expected to double by the year 2025. In front of this increase, it is relevant to assess the effects of an educational intervention with people with T2DM their sense self-efficacy and self-care capacity to make their most optimal therapeutic adherence. This study use an experimental design: before / after 3 months. Adherence was assessed using the HbA1c <7% and the SDSCA for self-care behaviors of DMSES for self-efficacy. The formed sample: 71 65 GE and GC. GE has improved the level of self-care behaviors, the implementation of recommendations, the feeling of self-efficacy and HbA1c. As a nurse education promotes adhesion among T2DM. This study could contribute to the development of nursing knowledge and renewal of clinical practices.

Keyphrases: HbA1c, Type 2 diabetes, Treatment adherence, Nurse education, Self-efficacy, Self-care
Gérer la ville au Bénin : la mise en œuvre du Registre foncier urbain à Cotonou, Porto-Novo et Bohicon

The management of West African cities is problematic nowadays: uncontrolled urban sprawl, insufficient basic services, and land insecurity. Yet, major reforms had been put in place with the assistance of international aid to enhance the effectiveness of urban management; which seems to have failed. Going beyond this policy failure statement, the present dissertation aims at understanding how “managing the city” takes place in the particular context of West Africa. The implementation of the Urban Land Registry (RFU), a municipal and multi-purpose land information system that has been put in place in Benin through development programmes in the early 1990s, is the lens through which urban management is examined. Urban management is then studied through the actions taken rather than through the discourses. With a socio-anthropological approach, the implementation of the instrument is analysed from the stakeholders’ perspectives and according to a double analysis grid. On the one hand, the analysis aims at understanding the local appropriation of the RFU inside public administrations; and on the other hand, its aims at comprehending the interaction of the RFU with the territory, in particular with the complex dynamics of access to the land and land security. A multiple case study was conducted in three municipalities: Cotonou, Porto-Novo, and Bohicon. This study led to two main conclusions. First, the RFU is recognized as the key instrument of local taxation, but it is minimally implemented. This particular functioning is an optimal adaptation to a context made of: 1) professional rivalries in a compartmentalized administration, 2) political and financial stakes related to different sources of local revenues, and 3) political and institutional tensions provoked by the late decentralisation. Then, the RFU’s impacts in terms of national professional capacities are insufficient to reform urban management from inside municipal administration. Second, a key function of the RFU that is centralizing information on presumed landowners is impeded by the commodification of land information and by the territorialisation of land regulatory modes. This affects the implementation of the RFU as it takes part in this land information market, but with little success; and its impact is differentiated according to the ‘land regulation territory’ it applies. Finally, ‘managing the city’ in Benin is not an automatic task, even with the introduction of management instruments such as the RFU. Administration and politics continue to shape municipal policies, and the pluralistic city is managed in a differentiated manner. To the designers of public action (policies), this dissertation encourages to take into account existing regulation modes in African societies, even if they are multiple and complex, and it recognises the singular process of institution building in Africa.

Keyphrases: Urban management, Land information system, Local taxation, Public administration, Land market, Land security, Urban planning, Public action (policy) analysis, West Africa, Benin
La planification métropolitaine et le transit-oriented development (TOD) : les nouveaux instruments de la gouvernance du Grand Montréal

This dissertation crosses the concepts of planning, governance and transit-oriented development (TOD) through a study of the production, debate and adoption of the Montreal Metropolitan Community (MMC)'s Metropolitan Land Use and Development Plan (MLUDP). It presents the results of four years of qualitative research on the impacts of the MMC's MLUDP episode and TOD strategy on the Greater Montreal Area's metropolitan planning practices and decision-making processes. It reveals that metropolitan planning and the transportation-land use coordination objective in general as well as the MLUDP and the TOD concept in particular are governance instruments for the region. Chapters 2, 3 and 4 present the problem, field of investigation and methodology of this research. Chapter 5 describes the MLUDP episode by analysing its content, the procedures by which the MMC produced, debated and adopted it, the area’s stakeholders' reaction to these issues and how they intend to ensure the monitoring of its implementation. Chapter 6 illustrates how this episode has made the MLUDP a governance instrument for the Greater Montreal Area by scrutinising the role of public participation, the media, stakeholders of the local and regional scales, the elected officials, the MMC and the area's civil society in this process of registry change for planning and governance deploying them on more strategic and collaborative bases. Chapter 7 shows that this episode also made TOD a governance instrument for the Greater Montreal Area by detailing the ins and outs of the process of appropriation, bargaining/merchandising and instrumentalisation of the concept by the political and technical elites for territorial marketing and political capital construction purposes paving the way for the stabilisation of a governance on metropolitan land use and development. It emerges from this dissertation that the profound transformations currently affecting planning and governance exacerbate the symbiotic nature of the relationship that unites them.

Keyphrases: transit-oriented development (TOD), metropolitan planning, metropolitan governance, metropolitan land use and development plan (MLUDP), Montreal Metropolitan Community (MMC)
Le gouvernement du Québec, les relations internationales et
l'environnement économique international (1973-1994)

The objective of this thesis is to lay the foundations of a new narrative of the Quebec government's international relations, one distinct from the traditional account that emerged from the work of political scientists who have described the international activities of Quebec as essentially the product of its unique historical path. By contrast, this thesis aims to show that the history of Quebec's international relations must be understood as being embedded in the larger histories of Canada and North America, and especially in the histories of capitalism and neoliberalism. Since the beginning of its existence as a modern political entity, the Quebec government has nourished links with foreign governments, the intensity of which were determined by the transformations affecting the entire international capitalist order. Towards the end of the 1867-1973 period, the international policy of the Quebec government was institutionalized, both politically and juridically, through the formulation of the Gérin-Lajoie doctrine, which drew upon Canadian constitutional particularities as the basis of Quebec international policy. In the period framed by the 1972-73 and 1981-82 economic crises, Quebec's international relations focused increasingly on economic issues, notably the search for foreign investment and the projection of a positive brand image abroad. Then, in the period extending from the 1981-82 crisis to the conclusion of the North American Free Trade Agreement in 1994, Quebec's international activity was transformed by the neoliberal shift affecting all of the world's capitalist governments. Thus, Quebec's diplomatic apparatus came to be perceived as a tool for the promotion of Quebec business exports and the adaptation to the rise of economic interdependence and free trade, and decreasingly, as a network of political and cultural diplomatic ties. To demonstrate this, this thesis is based upon two main bodies of primary sources: first, government publications such as the annual reports issued by the different ministries that have been associated with Quebec's and Canada's international relations throughout the period, notably the white papers that they published; and secondly, publications produced by the business community, mainly Les Affaires magazine, an excellent barometer of the dominant mentality of the Quebec and French-Canadian business class.

Keyphrases: Canada, ALÉ, Quebec, Canada, International relations, Free trade, Neoliberalism, Capitalism, FTAA
Étude du rôle de l'interleukine-32 dans l'infection à VIH-1

HIV-1 slow progressors constitute a rare population of subjects who remain asymptomatic for many years without antiretroviral therapy. Among this population, some individuals will lose control of their infection after several years of immunological control.  Our laboratory has analyzed the differential expression profile of various proteins and molecular pathways associated with the loss of control of HIV infection.  The pro-inflammatory cytokine interleukin-32 alpha and delta isoforms significantly decreased in slow progressors as they were losing control of their infection.  Furthermore, previous studies have attributed to IL-32 both antiviral property against HIV-1 and immunosuppressive properties that can induce an environment conducive to HIV-1 replication. This project addresses the role of IL-32 in HIV-1 disease progression with a particular emphasis on slow progressors.  We compared the levels of IL-32 in HIV-1 positive versus HIV-1 negative subjects and evaluated the role of this cytokine using longitudinal studies. We observed that levels of IL-32 remains higher in HIV-positive compared to HIV-negative subjects.  Also, HIV-1 infection leads to increased level of IL-32.  In addition, after one year of antiretroviral therapy, IL-32 plasma levels remain significantly higher than those of HIV-negative subjects.  As expected, the levels of IL-32 increased as slow progressors lost control of their infection.  A high plasma concentration of IL-32 predicts:  1) an increase in plasma levels of sCD14 as well as pro-inflammatory cytokine IL-6, 2) a decrease in CD4 cell count and an increase in viral load.  High plasma CCL5 predicted a low concentration of IL-32.  The alpha isoform of IL-32 is elevated in the plasma of HIV negative subjects while IL-32 gamma appears to induce a pro-inflammatory and immunosuppressive environment. We conclude that increased IL-32 levels are associated with progression of HIV-1 disease and could be used as a biomarker for assessing HIV-1 prognosis.

Keyphrases: Cd14-soluble, Interleukine-6, Ccl5, Interleukine-10, Hiv-1, Slow-progressors, Interleukin-32, Soluble-cd14, Interleukin-6, Interleukin-10
Femmes fatales en devenirs : les femmes vampires face à la domination masculine dans "Byzantium" (2012, Neil Jordan)

This master thesis is the opportunity to establish a short genealogy of vampire women on screen, highlighting how the figure of the vampire resonates with that of the femme fatale, since it is both a negative vision of the emancipated woman, while also providing a way to escape the traditional female model. Wondering if vampirism can be a source of emancipatory power for women, I analyze carefully Byzantium (2012, Neil Jordan). Through successive study of the two main characters, Clara and Eleanor, I show how the film resonates with the genealogy of vampire women established previously, as well as some feminist issues. Above all, the emphasis is on how the female characters are challenging male power, through the performance of stereotypes, for Clara, and through the takeover of the narrative, for Eleanor. Finally, I focus on how, through movements of becomings, these characters come out of the fatal cycle of masculinist oppression, which usually leads to the extinction of the female vampire at the end of the story, but here leads to an attempt at reconciliation between the sexes. My work is based on extensive research on the figure of the vampire, and women and gender studies relating to vampiric texts. I also rely on Judith Butler’s work, the deleuzian concept of “becoming”, and considerations on the gift by Derrida.

Keyphrases: Domination masculine, Femme fatale, Women, Male domination, Stereotypes, Becoming
Explanations of the International Community Deadlock in Bosnia and Herzegovina

Bosnia and Herzegovina has been under international supervision since 1995. Key actors in the international community namely the Office of the High Representative (OHR) and the European Union (EU) have expressed a desire to change the focus of this mission from one led by the OHR to one led by the EU. Despite the strong will of the international community to carry out this transition, it seems to have reached a deadlock. In the last few years, the arrangement of the international community has remained unchanged. This thesis focuses on these two main actors in this transition and their responsibility in the deadlock. This thesis tests three frameworks in order to explain this deadlock, specifically rationalism, constructivism, and regime complexity. Drawing on interviews with experts and officials working in the European Union and in the Office of the High Representative, this thesis explores the suitability of these frameworks for explaining these actors’ behaviours.

Keyphrases: relations internationales, Bosnia and Herzegovina, international relations, regime complexity, deadlock, rationalism, constructivism, Office of the High Representative, European Union