NCube/papyrus huggingface dataset:
Intervention éducationnelle infirmière visant la transition des nouveau-nés prématurés 
du gavage vers l’allaitement au sein

Transitioning preterm infants from gavage to direct breastfeeding during their hospitalization in neonatal intensive care units (NICU) is a challenging step. While this vulnerable population could benefit from interventions promoting an evidence-based transition such as non-nutritive sucking and oral stimulation, as well as promotion of direct breastfeeding experience and avoidance of bottles, the implementation of these interventions remains suboptimal in the NICUs. The persistence of restrictive beliefs as well as the lack of specific knowledge related to breastfeeding preterm infants may explain the suboptimal nursing practices related to the transition of preterm infants from gavage to direct breastfeeding in the NICUs. Thereby, an educational intervention supporting an evidence-based transition from gavage to direct breastfeeding was designed, piloted and evaluated with six NICU nurses. Based on the model Iowa Model for Evidence-Based Practice (Titler et al., 2001), the educational intervention, divided into three workshops, aimed an evidence-based transition of preterm infants to direct breastfeeding through a change in nurses’ practice, beliefs and knowledge. A pre and post-intervention questionnaire, as well as an evaluation questionnaire were administered to participant nurses. In addition, a clinical tool encompassing preterm infants’ oral development stages and interventions promoting a transition from gavage to direct breastfeeding was designed and given to participating nurses. After the intervention, participants reported their satisfaction with the educational intervention, as well as an improvement in their practice, knowledge and beliefs related to the transition of preterm infants from gavage to direct breastfeeding.

Keyphrases: Transition, Educational intervention, Direct breastfeeding, Preterm infants, Iowa model
Anticiper l’avenir de la prévention basée sur le risque génétique : analyse qualitative de la perception des participants à l’étude «Dessine-moi un futur!»

In this era of «new public health», professionals are urged to shift their attention away from individuals and to pay greater attention to the social determinants of health. In the field of biomedical sciences, a movement in the opposite direction towards personalised health might allow for preventive and curative care tailored to each individual, according to their genetic risk profile. While scientific advances in the field of genomics have only begun to pave their way into our healthcare system, they carry the potential to change the face of prevention and give rise to important societal debates. This study’s aim is to contribute to a reflection on the future of one of the essential functions of public health by exploring public perceptions of prevention based on genetic risk. This qualitative research project consists of a secondary analysis of the content of exchanges which occurred between members of the public in the context of four deliberative workshops, during which they debated on the desirability of a fictive preventive technology, the «cardiac rectifier». Anthony Giddens’ theory of structuration is used as a conceptual framework to guide the analysis of the exchanges, which led to the following findings: a- the «cardiac rectifier» is far from being interpreted as a preventive intervention by every participant; b- its use is perceived as being legitimate or not on the basis of which group of individuals it would target; c- the proposed intervention cannot be thought of out of context.

Keyphrases: genetic risk, public deliberation, prospective scenarios
Impact d'un traumatisme crânio-cérébral léger sur l’architecture du sommeil et le
transcriptome dans un modèle murin

Mild traumatic brain injury (mTBI) is one of the most common neurological disorders affecting public health. Sleep disorders are common in patients with mTBI. Studies in rodents show that some synaptic plasticity markers decreased after mTBI which could impair brain plasticity. We suggest that sleep loss intensifies the negative effect of mTBI, which may reflect changes of synaptic plasticity markers or changes of different physiological pathway that regulates the sleep process. Using a "closed head injury" model, we have studied the bidirectional relationship between mTBI and sleep by investigating the effects of mTBI on sleep structure, and that of sleep deprivation (SD) on gene expression post-mTBI. First, EEG activity was monitored to investigate if sleep architecture is altered following mTBI. We then tested if SD, following mTBI, induces changes in gene expression of plasticity markers (Arc, Homer1a, Hif1a, Bdnf, Fos, and Ephrins), which have also been linked to sleep regulation. We also investigated the effect of SD post-mTBI on genome wide gene expression in target regions. The main results obtained in this study confirm that mTBI affects wakefulness, and significantly changes spectral activity during wakefulness, rapid eye movement (REM) sleep, and non-REM sleep on the second 24 hours post-TCL. Interestingly, the capacity to sustain long bouts of wakefulness was impaired immediately after mTBI. In addition, delta activity time course was altered by mTBI during wakefulness. In parallel to these alterations, changes in gene expression were observed. Only Arc and EfnA3 showed a mTBI/SD interaction in the hippocampus specifically, whereas expression of all other genes seemed to be affected by SD or mTBI independently. Our results indicate for the first time that the TCL induced the expression of two chemokines (Ccl3 and Cxcl5) in the cerebral cortex and hippocampus 2.5 days post-TCL. Also, we observed that the TCL induces a decrease in the expression of Lgals3 and S100A8 in the cortex, and an increase of Olig2 in the hippocampus.Results of SD effects on genome wide gene expression in the cortex and hippocampus show significant changes in genes involved in various physiological functions, such as circadian rhythms, inflammation, and also glial cell activation. In general, our results precise changes in wakefulness as well as in expression of various genes after mTBI.

Keyphrases: Trauma, EEG, Activation gliale, Sleep/wake process, Synaptic plasticity, EEG, Glial activation
Rôles des facteurs de croissance dans la prolifération de la cellule β-pancréatique en réponse à un excès de nutriments : étude du facteur de croissance HB-EGF et du récepteur à l’EGF

Type 2 diabetes (T2D) results from insulin resistance in peripheral tissues and impaired insulin secretion from the pancreatic β-cell. Over the time, compensation of the β cell islets for insulin resistance fails, and therefore leads to a gradual decline in β-cell function. Several factors may contribute to β-cell compensation. However, the cellular and molecular mechanisms underlying β-cell compensation remain unknown. The purpose of this thesis was to identify what mechanism could lead to β cell compensation in response to nutrients excess and specifically the increase in proliferation and β-cell mass. Thus, with increasing insulin resistance and circulating factors in the 6 month rats infused with glucose + intralipid, the hypothesis was made and confirmed in our study that the growth factor HB-EGF would activate the EGF receptor, and subsequent signaling pathways such as mTOR and FoxM1, both involved in the proliferation of the pancreatic beta-cell. Collectively, these results allow us to understand better the molecular mechanisms involved in the β cell compensation in the insulin resistance state and may serve as a potential new therapeutic approach to prevent or delay T2D development.

Keyphrases: compensation, HB-EGF, mTOR, FoxM1, Diabetes, islets of Langerhans, pancreatic β-cell, proliferation, compensation, nutrients, EGF receptor
Impact de la pression artérielle et influence de l’insuffisance cardiaque systolique sur le contrôle de la fibrillation auriculaire et la survie

Blood pressure may have a major impact on the evolution of AF and heart failure; nonetheless optimal management of blood pressure in these patients remains uncertain. Sinus rhythm maintenance has only moderate efficacy in abrogating AF and the potential role of blood pressure and its impact on risks of arrhythmia recurrence are unknown. Moreover, in patients with heart failure, blood pressure may affect prognosis in a non-linear fashion, where high blood pressure and also low blood pressure may increase mortality. The aim of this research was to evaluate the impact of blood pressure on the efficacy of sinus rhyhtm maintenance and mortality in patients with AF and to assess the potential role of ejection fraction and heart failure on this interaction. We conducted a post hoc combined analysis on pooled data from AFFIRM and AF-CHF trials. Patients were first classified according to LVEF (>40%, ≤40%) and we then assessed the impact of a baseline SBP (<120 mmHg, 120-140 mmHg, >140 mmHg) on outcomes. Firstly, in a total of 2715 patients randomized to rhythm control, 68±8 years and followed for 41±17 months, we assessed time to first AF recurrence according to SBP. Secondly, in all 5436 patients from both source studies, we assessed mortality according to SBP. In patients with LVEF >40%, baseline SBP did not influence any of the outcomes in multivariate Cox regression analyses. In contrast, in patients with LVEF ≤40%, the AF recurrence rate was higher in those with a SBP <120 mmHg and a SBP >140 mmHg compared to SBP 120-140 mmHg [HR 1.15; 95% CI (0.92-1.43)] and [HR, 1.47; 95% CI (1.12-1.93)], respectively. Mortality was also modulated by blood pressure in patients with LVEF ≤40% : SBP <120 mmHg and SBP >140 mmHg were both associated with increased death rate compared to SBP 120-140 mmHg [HR 1.75; 95% CI (1.41 to 2.17)] and [HR 1.40; 95% CI (1.04 to 1.90)], respectively. In conclusion, AF recurrence and mortality are influenced by SBP in patients with AF and depressed ejection fraction but not in patients with normal ejection fraction. A “U-shaped” pattern was identified where lower (<120 mmHg) and higher (>140 mmHg) SBP lead to worse outcomes.

Keyphrases: Hypertension, Heart failure, Blood pressure, Atrial fibrillation, Mortality
Changements dans le fonctionnement des familles ayant un enfant atteint d’un trouble de déficit de l’attention/hyperactivité après un programme d’entraînement aux habiletés parentales

In Quebec, Attention Deficit Hyperactivity Disorder (ADHD) is a disorder that requires more consultation in child psychiatry (50% to 75%). To date, the Multimodal Intervention (pharmacological, parenting skills training program (PSTP) and cognitive behavioral treatment program (CBTP) for children with ADHD) have achieved better long-term results. The present study of PSTP evaluated through the family functioning. The design of this PSTP is based on two approaches: Calgary family systems approach (Wright & Leahey, 2012) and Collaborative & Proactive Solution approach (Greene, 2014). The short version of the Family Assessment Questionnaire Device (FAD; Epstein, Baldwin, et Bishop, 1983) was used to measure the general functioning of the family. Data collection was conducted with two groups (participants and control) at two measurement times (before and after PSTP). The sample contains 28 families in the participant group and 18 families in the control group. Analysis of variance for repeated measures (ANOVA) was conducted to test the effect of the independent variables (Time and Intervention) on the dependent variable (GF). Based on the analysis, the results indicate that parents who participate in a PSTP perceive an improvement on their family general functioning compared to the control group. Interpreting changes in the family environment as a result of PSTP suggest nurse’s intervention to these families as its main goal is to avoid the impact of the disorder on the long-term in family functioning.

Keyphrases: Attention deficit hyperactivity disorder, parenting skills training program, family functioning, family systems approach
Le potentiel des technologies de l’information et des communications pour le renforcement de la résilience organisationnelle lors des opérations d’évacuation : étude de cas de la ville de New York

When the interaction of hurricane with the natural and the built environment occurs, exposed communities often have only one option: to evacuate. Because of the complexity under disaster condition as well as human behaviour, evacuation processes are always confronted to significant uncertainty. Previous experiences have shown that information and communications technologies (ICTs) have the potential to improve the state of the art in evacuation management. Despite this recognition, there is limited empirical research on this topic to date. This research examines how the integration of ICTs into operational planning of New York City organizations with transportation-related responsibilities during hurricane evacuation can improve their response to weather events and can influence the overall success of the emergency system. The analysis is based on information collected through semi- structured interviews with city transportation agencies and departments, emergency response organizations, and experts over a nine-week field research. The results show that ICTs has the potential to improve in-house decision-making capacity. This is partly due to the potential of ICTs to provide organizations with the ability to collect real-time data and to keep an accurate understanding of the rapidly changing disaster environment. Even though it is widely recognized that ICTs are a promising mean for achieving efficient in-house and cross-agency information sharing, these uses face certain technological, organizational, structural and systemic limits. This observation lead to a better understanding of the constraints that may be experienced in the management of urban systems on a daily basis.

Keyphrases: transport, Information and communications technologies, emergency management, transportation, organisational resilience, New York City, evacuation
Impact du stress sur la survie des lymphocytes T CD8+ mémoires dans le contexte des missions spatiales

The immune memory allows the body to remember all pathogens encountered in order to mount a faster and more effective immune response upon reinfection. After the contraction phase of the primary response, memory CD8 T cells survive in the presence of cytokines such as interleukin 15 (IL-15). These cells also allow the immune system to control latent viruses that were not completely removed from the host. Situations of chronic stress affect the immune system, causing the reactivation of these latent viruses. High viral titers of Herpesviridea family viruses were observed in astronauts upon their return, suggesting that hormones released under stress have a negative impact on memory CD8+ lymphocytes. An in vitro murine model of chronic stress has been developed by adding corticosterone to CD8+ memory T cells. It has been shown that the stress hormone had a pro-apoptotic effect on these cells and that this effect was partially inhibited by the addition of IL-15. Molecular targets have also been identified to monitor the memory immune function during spaceflight using the Microflow-1 cytometer, a new portable platform for biomedical diagnosis. The results of laboratory tests and the International Space Station (ISS) showed that it is possible to monitor the memory immune function and stress markers in real time during spaceflight.

Keyphrases: Stress, Vol spatial, CD8+ memory T cells, Flow cytometry, Spaceflight
Remédiation et interaction dans le milieu textuel

A literary text is a milieu in which different intermedial relations can occur. Borrowing on Bolter and Grusin’s notion of remediation and displacing the latter from digital technologies to literature, this article defines three strategies by which a novel can convoke modes that are conventionally related to other forms of mediation. The breaking points and the blanks that result from these intermedial strategies are then discussed from a reader-response perspective, to substantiate the hypothesis that a strong intermedial dynamic in a novel enhances the reader’s activity. Océan mer serves as a ground for an analysis that demonstrates the dynamism of the interactions that characterize such an intermedial object.

Keyphrases: Alessandro Barrico, Barrico, Alessandro
Combinaison d’approches classiques et de génétique inverse en vue d'une meilleure compréhension du tropisme et de l'activité oncolytique du réovirus de mammifères

The mammalian reovirus preferentially replicates and kills cancer cells. It is therefore currently used in clinical trials to treat various types of cancers in humans. The main objective of this study was to get a better understanding of the various components involved in the reovirus replication cycle that could potentially be important for the optimization of its oncolytic properties using a combination of traditional approaches and the newly described reverse genetics technique. Classically, the viral persistence approach is undertaken to identify new reovirus variants. This has led to the selection of uncoating mutants in L929 cells. In this study, adapted viruses were recovered from Vero cells (VeroAV) and unlike other persistence mutants, VeroAV had amino acid substitutions on the mu1 and the sigma1 proteins. The reverse genetics approach demonstrated that VeroAV had a better binding ability onto sialic acids of Vero cells. Substitutions on sigma1 were found to be mainly responsible for this phenotype although mu1 substitutions may affect virus infectivity. In a second study, we noticed that the reverse genetics wild-type virus (T3DK) was more sensitive to interferon when compared with the wild-type virus from our laboratory (T3DS). After complete sequencing of the T3DS, we then constructed a T3DS by reverse genetics. This allowed us to proceed in our studies of a mutant virus previously recovered in our laboratory by chemical mutagenesis (P4L-12). It was previously established that P4L-12 had an enhanced replication in transformed cells while sparing the parental cells and this phenotype was correlated to an increased sensitivity to interferon. In this study, amino acid substitutions on the sigma3, mu1, muNS and lambda2 proteins were identified. By using the reverse genetics approach, we demonstrated that the substitution found on the lambda2 protein was primarily responsible for the increase in sensitivity to interferon of P4L-12. The combination of approaches based on persistence or selection of mutants sensitive to interferon followed by characterization with reverse genetics will certainly be useful to get a better understanding of reovirus in order to improve its oncolytic capacity.

Keyphrases: Reovirus, Reverse Genetics, Viral persistence, Interferon, Binding, Uncoating, Viral oncolysis
Évaluation de la performance du score de propension à hautes dimensions dans le cadre d’études observationnelles québécoises

Propensity scores (PS) are frequently used to adjust for confounders leading to indication bias. However, PS are limited by the fact that they can only adjust for measured and known confounders. High-dimensional propensity scores (hdPS), a specific type of PS, select which variables they adjust for by means of a standardized selection algorithm. Thanks to the use of this selection algorithm, hdPS could potentially adjust for all type of confounders. This thesis aims to evaluate the hdPS’s performance in the adjustment for indication bias in the context of an observational study focussing on the potential diabetogenic effect of statins. The first article’s aim was to identify if the exposure to statins was associated with the risk of diabetes. Results of this article suggest that exposure to statins is associated with an increase in the risk of diabetes and that this association is dose-dependent and reversible in nature. After having identified this association, we examined if the hdPS outperforms the PS in the adjustment for indication bias. Both methods’ performance were compared by means of the obtained adjusted measures of associations and by means of the standardized differences regarding 19 characteristics following the creation of two matched sub-cohorts (each matched on either patients’ PS or patients’ hdPS). Results of this second article identify that the performance of either method could not be differentiated by means of the first approach but that, based on the second approach, the hdPS outperforms the PS in its adjustment for indication bias. The last article aimed to evaluate if the hdPS could adjust for known confounders which were hidden to the selection algorithm. Results of this third article suggest that the hdPS method can adjust for at least some hidden confounders and that it could potentially adjust for some unmeasured confounders. As a whole, this thesis suggests that the hdPS method could be superior to the PS method in its ability to adjust for indication bias and supports its use in future observational studies using medico-administrative databases.

Keyphrases: Score de propension, Propensity scores, High-dimensional propensity scores, Indication bias, Statins, Diabetes
Impacts des réarrangements génomiques chloroplastiques sur l'apparition des phénotypes de variégation chez Arabidopsis thaliana

In contrast to most non-photosynthetic eukaryotes, plants must ensure the stability of an additional genome contained within the plastid organelle. Despite the small size of the plastid genome and its low gene content, this genome is nevertheless absolutely essential for photosynthesis and plant energy metabolism. In spite of this, the main threats this genome encounters and their underlying consequences remain poorly understood. To evaluate the consequences of generalized plastid genome instability, we use the why1why3polIb Arabidopsis thaliana mutant line, which exhibits elevated levels of plastid genome rearrangements, and ciprofloxacin, a compound that induces double strand-breaks within organelle DNA. We demonstrated that high levels of plastid genome rearrangements lead to a decrease in photosynthetic electron transport chain efficiency and to a severe photosynthesis-associated oxidative stress. Surprisingly, these high levels of reactive oxygen species are neither associated to a loss of chloroplast function, nor to cell death. Instead, this redox imbalance seems to initiate a nuclear genetic expression remodelling that allows adaptation to this photosynthetic stress and confers tolerance to subsequent oxidative stresses. Using a novel approach for the analysis of next-generation sequencing data, we have also shown that a poorly characterized type of genomic instability constitutes one of the main threats to organelle genomic integrity, both in Arabidopsis and human. We demonstrate that this particular type of genomic instability, named U-turn-like DNA rearrangement, is most probably associated to errors during the replication process. Also, a genetic approach revealed that the chloroplast-localized proteins WHY1, WHY3 and RECA1 all act to repress this type of genomic instability, probably by stabilizing and stimulating the accurate restart of collapsed replication forks. A strong accumulation of U-turn-like rearrangements is notably associated to severe developmental defects in the why1why3reca1 mutant line. This raises the question of whether this type of genomic instability could be involved in the appearance of several mitochondria-associated pathologies.

Keyphrases: ROS, Whirly, RecA, plant biology, chloroplast, mitochondria, genomic instability, replication, recombination