NCube/papyrus huggingface dataset:
Une étude cadavérique pour réduire les risques des approches chirurgicales et percutanées de l’artère fémorale

In vascular surgery, access to the femoral artery is frequently used either through a surgical incision of the groin or by a percutaneous approach in a wide variety of vascular and endovascular procedures; for multiple bypasses, treatment of arterial occlusions, aneurysms repair and placement of various stents. The general purpose of this study is to facilitate and reduces the risks of both the surgical and the percutaneous approaches of the femoral artery through a better anatomical understanding of the femoral triangle. The methodology was conducted on specifically embalmed cadavers according to the method developed by Walter Thiel. The results presented in this memory allowed us to propose solutions to clinical problems in vascular surgery. First, the study of the cutaneous vascularisation of the femoral triangle led to suggest new surgical approaches in order to reduce lesions of the cutaneous arteries and the potential devascularization of the borders of the wound yielding a better postoperative outcome. Then, we validated the radiographic and ultrasonographic position and identification of the inguinal ligament and the proximal femoral artery to facilitate the identification of a safe arterial puncture site. Moreover, we developed a simple method for ultrasound-guided arterial puncture, suitable for obese patients, to facilitate the percutaneous approach of the femoral artery. The benefits of this research project are multiple for clinicians, the study provides a better tridimensional anatomic understanding of the femoral triangle and the techniques proposed will lead to an improved surgical practice and facilitate the work of doctors. However, our work and propositions still need to be validated clinically.

Keyphrases: Cadavre Thiel, Vascularisation, Femoral artery, Femoral triangle, Inguinal incisions, Arterial puncture, Thiel cadavers, vascularisation, Ultrasound
Traitement du cancer pulmonaire non à petites cellules par radiothérapie stéréotaxique d’ablation

Lung neoplasia remains the leading cause of cancer death accounting for nearly 6,000 deaths per year in Quebec. In recent years, stereotactic ablative radiotherapy (SABR) has emerged as an alternative treatment to anatomical resection for inoperable patients suffering from early stage non-small cell lung cancer. This technique can deliver highly focused doses such as 30-60 Gy in 1-8 fractions in order to target precisely the treatment volume while sparing healthy tissue. In 2009, the Centre Hospitalier de l’Université de Montréal acquired a robotic SABR apparatus, the CyberKnife™ (CK), a linear accelerator mounted on a moving arm producing non-coplanar photon beams of 6 MV with millimetric precision. This thesis presents two scientific peer reviewed articles adressing some clinical and physical challenges with CK. On one hand, a clinical prospective study reporting the advantages of lung SABR, a technic that offers excellent long-term tumor control and helps maintain the quality of life and lung function. On the other hand, a medical physics study exposing the limits of computed tomography scan acquisition in breath-holding for CK treatment planning.

Keyphrases: CyberKnife™, Stereotactic ablative radiotherapy, Non-small cell lung cancer, Quality of life, Pulmonary function, Treatment planning
Décès pendant une simulation médicale : perspectives des apprenants et impacts sur le stress et la performance des réanimateurs

The acceptability of simulated death has been debated by experts, but there is scarce information regarding trainees' perspective. Pediatric trainees were invited to perform medical simulation, including pre and post questionnaires. Participants were exposed to 2 mock codes of neonates born pulseless. In the RESUSC scenario, the manikin responded to adequate resuscitation; in the DEATH scenario, the manikin remained pulseless. Mock codes were evaluated using the Neonatal Resuscitation Program score sheet. Debriefing was analyzed using qualitative methodology. Salivary cortisol was collected from participants (objective stress).  59/62 trainees answered the questionnaire, and 42 performed mock codes.  All trainees found mock codes beneficial and would appreciate being exposed to more.  Scenario or order of scenario did not affect performance. Only one trainee stopped resuscitation after 10 minutes of asystole, as recommended by clinical guidelines of Neonatal Resuscitation Program (NRP), and 31% had not ceased resuscitation efforts by 20 minutes.  Trainees found the DEATH scenario more stressful than RESUSC. Post-simulation salivary cortisol levels were significantly higher (p<0.001) than before simulation (for both scenario). This increase was not scenario dependent (p = 0.06) nor associated with performance scores. Trainees all answered the following question during debriefing: “How did this go for you?” Two themes were identified in their answers: 1. The manikin does not die; 2. Death equals inadequate resuscitation.  The death of the manikin was stressful, but trainees thought this was acceptable and prepared them for their future. Having a mannequin die during simulation does not interfere with their performance.

Keyphrases: Stress, Medical simulation, resuscitation, death, neonatolatogy, pediatrics, palliative care, medical education, stress, salivary cortisol, Neonatal Resuscitation Program (NRP)
Suivi longitudinal de la densité osseuse et du statut en vitamine D chez des enfants prépubères avec une allergie au lait de vache non résolue

Background: Previous studies have shown that most children lose their allergy to cow's milk (CMA) by the age of 3-5 years. However, recent studies have documented increasing persistence of this allergy until later age. Although, dairy products mainly contribute to dietary intake of two key bone nutrients, namely calcium and vitamin D, regular monitoring of bone health is not part of the current management of CMA. A cross-sectional study aimed at characterizing bone health of prepubertal children with persistent CMA found that bone mineral density (BMD) of these children was significantly lower than the control group, made of children with non-dairy food allergies (NCMA). Aims: In light of these findings, the aim of this study was to document and compare the evolution of BMD, vitamin D status, calcium and vitamin D intakes, and supplementation compliance of CMA (n=36) and NCMA (n=19) children recruited in the initial cross-sectional study. Results: The average annualized gain in lumbar spine BMD was similar between cases and controls. Although BMD did not differ significantly between the groups, lumbar spine BMD values of CMA children were lower than those of controls. Moreover, whole body BMD score-Z tended to be lower in cases than in controls.  Serum concentrations of 25OHD as well as the rate of vitamin D insufficiency were similar between CMA and NCMA children. No significant differences were detected for total intakes of calcium and vitamin D between baseline and follow-up for both groups. Compared to baseline, more children with CMA took calcium supplements (42% vs. 49%, p<0.05) but compliance decreased to 4 days/week. Conclusion: An early evaluation of bone density in children with persistent CMA could be recommended to ensure normal bone development during growth. Our study emphasizes the importance of monitoring calcium and vitamin D intakes in these children, to encourage consumption of alternate sources of dietary calcium and vitamin D, to promote routine supplementation and to provide education to improve compliance.

Keyphrases: calcium, bone density, vitamin D, food allergies, allergy to cow's milk
La puissance technique de la médecine : des pistes de réflexion

In his book, Réflexion éthique et pratiques soignantes – Points de repère (Ethical reflection and care practices – Landmarks), Christian Gilioli describes the evolution of medicine and ethics the associated questions of a philosophical, scientific, technological, social, economic and political nature. He proposes further reflections pertaining to the complexity of contemporary ethics in the modern world continuously in search of happiness and health, and in denial of ageing and suffering.

Keyphrases: pratiques soignantes, contemporary ethics, care practices, evolution of medicine, person, technological development
L’effet de l'interleukine-17 sur la survie et la glucocorticorésistance du neutrophile équin

Glucocorticoids are the most potent drugs for the control of the airway obstruction present in heaves and asthma, although the airway neutrophilia persist with these agents. It was previously reported that human and equine’s peripheral blood neutrophils are sensitive to glucocorticoid. Interleukin-17 (IL-17) is a cytokine contributing to glucocorticoid insensitivity airway epithelial cells in human. We therefore hypothesized that IL-17 has a similar effect on neutrophils and contributes to the persistence of these cells in the airways in response to glucocorticoid therapy.  In this study, we evaluated: 1. The expression of both subunits of IL-17 receptor (IL-17RA/ IL-17RC) in highly purified neutrophils. 2. The gene expression of proinflammatory cytokines in neutrophils to assess their activation by IL-17 and their effect in these cells treated with glucocorticoids. 3. The effects of IL-17 on the viability and apoptosis in neutrophils were performed.  Results showed that 1. Equine neutrophils express IL-17RA and IL-17RC at transcriptional at protein level. 2. IL-17 induces a selective activation in neutrophils, which results in an upregulation of IL-8, not attenuated by dexamethasone and finally, 3. IL-17 increases the viability of neutrophils stimulated with LPS by a decrease in apoptosis.  Our results indicate that IL-17 directly activates neutrophils to upregulate IL-8, a potent neutrophils chemoattractant, and that this response is not prevented by glucocorticoids. They also suggest a possible role of IL-17 in the persistence of neutrophils in the asthmatic airways by decreasing apoptosis.

Keyphrases: interleukine-17, Neutrophils, horse, interleukine-17 subunits of receptor, proinflammatory cytokines, survival, apoptosis
Quand la réadaptation blesse? Éducateurs victimes de violence

The aim of this study is to understand violence directed against behaviour technicians in juvenile rehabilitation centres. The findings are based on a survey conducted among 586 educators working in one of ten youth centres across Quebec. In this article we will first assess the occurrence of violent acts. Then, we will examine individual and contextual factors that predict physical aggression. More than half (53.9 %) of the educators surveyed reported to have been physically assaulted at least once in the past year. Regarding individual factors, being affected by the exposure to aggressive behaviours and the frequency of psychological aggression increase the risk of victimization. With respect to situational factors, the age of the clientele and the legal basis for placement (i.e. civil or criminal) influence the occurrence of violent acts towards staff members. Our analyses also show that physical violence not only affects staff members but also the institution. The identification of predictors of violence can guide prevention programs in youth centres. Moreover, they can help target behaviour technicians who are at risk of being assaulted in order to prevent their victimization.

Keyphrases: Institutional violence, Behaviour technician, Victimization, Youth centres
Des classes sociales aux classes cognitives

The author pursues two objectives in this article. First, he attempts to show that, from now on, cognitive competencies will be more important than social class when it comes to landing a prestigious job. Five aspects are examined: social status and cognitive competencies, the Flynn effect, the interaction between heritability and environment-mentality, educational homogamy and globalization. Secondly, the author presents some social consequences of this state of affairs on society and educa- tion, including meritocratic ideology.

Keyphrases: Classes cognitives, Méritocratie, Intelligence, Social classes, Cognitive classes, Merito- cracy, Environment
La psychanalyse ne résiste pas à l'analyse

The text analyzes the foundations, development, and current state of psychoanalysis, and formulates a critical response to its current proponents. The first section of the text stresses the importance of two elements: the analysis of 31 cases documented by Freud, underlining the inefficacy of his approach, and Freud’s own acknowledgment of his literary vocation. The second section demonstrates that the dogmatic character of early psychoanalysis continues to prevail in certain milieus today. After describing how dogmatism ended Piaget’s career as a psychoanalyst, this section argues that submission to authority (a central characteristic of dogmatism) permeates the field of psychoanalysis and that its founding case – that of Anna O. – rests on dogma and fabrication. Drawing on examples from the works of Lacan, Dolto, and Bettelheim, as well as from current practice, the third section formulates a response to arguments that psychoanalysis has evolved, raising doubts about whether such is really the case. Based on the analysis, the fourth and final section concludes that attempts by psychoanalysts to bring the central current of neuropsychology back under their sway are ill-founded.

Keyphrases: Neuropsychanalyse, History of psychoanalysis, Dogmatism, Neuro-psychoanalysis
L’égalité des sexes n’a rien à voir avec la science!

This article is a critique of a recent book that was written with the objective of defending sex equality by denying the existence of differences between women and men. The first part of the article argues that sex equality is a social value independent of the fact that men and women differ in certain ways. When researchers use scientific data to defend personal values and beliefs, it is an abuse of power that affects both their own credibility and that of science itself. The second part demonstrates the importance of developing a better understanding of those sex differences, both large and small, even if men and women have more points in common than differences. Researchers rarely take context into account when they measure different traits and compare scores instead of comparing the developmental processes involved in women and men’s adaptation to their environment. The interaction between environment and biological predispositions is inherent in the developmental processes requiring further investigation.

Keyphrases: Hormone, Gender equality, Sexism, Sex differences, Brain, Hormones, Gene environment interaction
La synergologie, une lecture pseudoscientifique du langage corporel

The objective of this paper is to assess whether synergology is part of science or whether it is merely a nonverbal behavior decoding pseudoscience. The text consists of five sections. In the first section, we describe important elements of the scientific approach. In the second and third sections, we briefly present synergology and we examine if it meets scientific criteria. The fourth section reports a demand letter addressed to Patrick Lagacé and La Presse for a series of texts which presented a very critical view of this approach. Finally, the use of irrelevant arguments from a scientific point of view, an unwarranted attempt to give credibility to synergology by a demand letter and an unjustified use of the ethical argument lead us to conclude that synergology is a nonverbal behavior decoding pseudoscience.

Keyphrases: Pseudoscience, Synergology, Nonverbal behavior
Mechanical simulation of the endovascular repair of abdominal aortic aneurysms

This thesis work is concerned with the simulation of the deployment of stent-graft (SG)  vascular prostheses in abdominal aortic aneurysms (AAA) during endovascular repair  (EVAR). This study is composed of three main parts: (i) mechanical tests in bending and  compression of frequently used SG (body and leg from Cook) as well as the numerical  simulation of these tests, (ii) development of a numerical AAA model, (iii) strategy of  simulation of SG deployment.  The finite element method is used. In a first step, a verification of the finite element  model (FEM) of SG is performed by comparison of the different load cases with their  experimental counterparts. Subsequently, the vascular FEM is also verified in terms of  maximal principal constraints in the wall against values available in the literature. Finally,  the deployment is investigated while taking the catheters into account.  The mechanical tests performed on the SG were simulated with a maximal difference  of 5.93%, while accounting for the pre-load in stents. The FEM of the vascular structure  showed maximal principal stresses that were 4.41% far from the ones found in the literature  for a similar model. Regarding the simulation of SG deployment, a complete set of SG  could be deployed with a good control of the relative and global position into a specific and  pre-deformed AAA, however, no intra-luminal thrombus (ILT) was included. The AAA  wall was modeled with an isotropic hyperelastic constitutive law.  In the clinical setting, the maximum tolerated difference between reality and simulation  is 5%, therefore, our approach seems acceptable, and could give rise to further developments.  However, the small amount of tested SG justifies a wide campaign of additional mechanical tests and simulations for the sake of validation.

Keyphrases: Stent-graft, Simulation, Aneurysm, Aorta, Abdominal, Stent-graft, Deployment
Ultrafast Echocardiography

Because of its low cost, versatility and safety, echocardiography has become the most common imaging technique to assess the cardiac function. The recent success of ultrafast ultrasound plane wave imaging has prompted the implementation of similar approaches to enhance the echocardiography temporal resolution. The ability to enhance the echocardiography frame rate beyond conventional values (~60 to 80 fps) would positively impact other echocardiography features, e.g. broaden the color Doppler unambiguous velocity range. We investigated the ultrafast echocardiography imaging approach using ultrasound diverging waves. The high frame rate offered by the diverging wave method was used to enhance the capabilities of both B-mode and color Doppler echocardiography. The B-mode temporal resolution was increased to 633 fps whilst the image quality was kept almost unchanged with reference to the conventional echocardiography technique. The color Doppler Nyquist velocity range was extended to up to 6 times the conventional limit using a weather radar imaging approach; such an approach could not have been implemented without using the ultrafast diverging wave imaging technique. The advantageous performance of the ultrafast diverging wave echocardiography approach is supported by multiple in vitro and in vivo results included in this manuscript.

Keyphrases: Onde divergente, Onde plane, Ultrafast ultrasound, Ultrafast echocardiography, Diverging wave, Plane wave, Staggered multiple-PRF, Ultrafast color Doppler, Nyquist velocity extension
L’exploration du modèle des vies saines auprès de détenus dans un milieu de réinsertion sociale encadré par un modèle de gestion du risque

The social reintegration of offenders is a focus point in modern criminology and different ideologies concerning its effectiveness exist. Considering this aspect, the present study based on the Good lives model, which is a relatively new social reinsertion model that has been minimally utilized by the Correctional service of Canada (CSC). We are exploring the possible application of the Good lives model principles in the actual correctional context. More specifically, we wish to study the compatibility of the Good lives model with offenders in halfway house inside a context of risk management that is using the Risk-Need-Responsivity model. To do so, we use a qualitative methodology based on case studies, using observations, interviews and file information to illustrate the aspects of the two models. This type of methodology allowed us to conclude that it is possible to apply certain aspects of the Good lives model proposed by Ward within a social reinsertion context. On the other hand, the principles and the frame of the actual context of risk management challenges the principles of the Good lives model, which do not allow an entire application of it. Based on our results, a few hypotheses are proposed tin order to make the actual framework used in different correctional settings of Correctional service of Canada more flexible.

Keyphrases: Good lives model, Risk-need-responsivity, Social reintegration, Case study, Risk Management, Offenders
L’imagination et la pensée chez Aristote : le traité De l'âme et les Seconds Analytiques II, 19

The treaty On the Soul (DA) and the connex treaties (Parva Naturalia) expose a theory of phantasia, often translated as « imagination » or « representation ». In the DA, Aristotle maintains that it is impossible to think without phantasia, yet this text offers little precision on the exact signification of his affirmation. An elucidation may however be found in another text, the Posterior Analytics II, 19, which focuses on the acquisition of knowledge, that is, the first universals implanted by perception and the first intelligible principles. This text, as we will firstly demonstrate, has to be read in the frame of the theory of phantasia, which will show that the acquisition of klowledge depends on phantasia. Thus and secondly, it will be clearer what it means that it is impossible for the intellect to think without phantasia.

Keyphrases: imagination, phantasia, phantasma, induction, intellection, Aristotle, imagination, phantasia, sense-image, phantasma, On the Soul, appearance, induction, epagoge, intellection, Posterior Analytics 2, 19
Prier à la campagne : art et dévotion dans les chapelles de villas romaines de la Contre-Réforme

The taste for countryside palaces among the Princes of the Church was already well established when the Council of Trent (1545-1563) moved to counter the protestant Reformation. This council asserted catholic dogmas and significantly reformed clerical mores. In this context, villas are seen as the perfect stage to realize spiritual ambitions. This thesis thus studies extra-urban devotional practices by examining three chapels in countryside palaces around Rome decorated after the Council of Trent: Cardinal Alessandro Farnese’s (1520-1589) chapel in his villa at Caprarola; the Villa d’Este chapel at Tivoli built for Cardinal Ippolito II d’Este (1509-1572); and the Villa Mondragone chapel at Frascati, ordered by Cardinal Marco Sittico Altemps (1533-1595) for Pope Gregory XIII (1502-1585). We seek to examine the influence of contemporary devotional practices on the iconographic cycles in the private sphere. The public’s perception and spiritual response to the frescoes will be probed through an anthropological approach to images.

Keyphrases: Rome, Counter-Reformation, Religious art, Domestic devotion, Villa chapels