NCube/papyrus huggingface dataset:
À quel moment enseigner la forme dans le cadre d’un enseignement basé sur la tâche?

Task-Based Language Teaching is an increasingly popular approach used in a variety of second-language learning environments. There is debate, however, on the incorporation of form-focused instruction and, more specifically, regarding when precisely it should be integrated in the execution of a task. Beyond determining whether a form should be taught proactively or reactively (Ellis, 2017, Long, 2015), the lack of consensus as to whether form-focused instruction should occur at the beginning of a task (Dekeyser, 1997, 2007), during a task (Lightbown, 2008; Long, 2015), or after a task (Willis et Willis, 2007) drives language instructors to question whether they should integrate form-focused instruction at all and creates uncertainty as to when it is most beneficial to do so (East, 2017). The present quasi experimental study seeks to better understand the effects of the timing of form-focused instruction in the task-based teaching framework while controlling for moderating variables such as the degree of learner knowledge and learners’ language aptitude.    Eight groups, six experimental and two comparison, of French as a second language students (four groups of B1 level and four groups of B2 level) and their respective teachers participated in the study. The experimental intervention consisted of two tasks, one hierarchical task and one decision-making task.  Six groups received explicit instruction on the subjunctive at the beginning, during, or after a task while two groups completed the tasks without explicit instruction. The participants (N = 165) completed a pre-test, an immediate post-test and a delayed post-test assessing both implicit knowledge (Elicited Imitation Test) and explicit knowledge (Grammaticality Judgment Test). Participants also completed a language aptitude assessment test (LLAMA). Learners’ degree of knowledge was determined based on their pre-test performance. Participants whose mean scores were below or above the median were assigned to the low or advanced knowledge groups respectively.   Repeated-measures ANOVAs show that lower-level learners benefit from instruction during a task while more advanced learners benefit from instruction at the start of a task. Consequently, learner readiness is a factor to consider when planning and executing focus on form instruction. Additionally, multiple regression results demonstrate that language aptitude plays a more significant role when form-focused instruction is given before or during a task and that different components are drawn upon at different acquisitional stages. The study concludes by offering theories and practical recommendations regarding the inclusion of focus on form instruction that considers the level and aptitude of learners.

Keyphrases: Task-based language teaching, Form-focused instruction, Timing of instruction, Language aptitude, Developmental readiness, French as a second language
Étude des pratiques et des rôles de gestion favorisant l’engagement des patients dans les soins et l’amélioration de la qualité des services de santé

Background: In OECD countries, most health organizations have implemented approaches to increase patient engagement in direct care and quality improvement. In Canada, the province of Quebec stands out by an innovative context in terms of patient engagement in healthcare organizations. While patient engagement approaches are becoming widespread in many organizations, little is known about their implementation in different clinical and organizational contexts. The patient engagement literature primarily identifies facilitating and impeding factors, without understanding the key roles and practices of managers at different levels of healthcare organizations.  Objective: This thesis aims at analyzing the roles and practices of managers, at different levels of health care organizations, in integrating patient engagement in care and quality improvement.   Methods: The thesis is based on multiple case studies (articles 1 and 3) and one cross-sectional study (article 2) using both qualitative and quantitative data and methods. In the two first studies, qualitative data have been used to explore managerial roles and practices that aims at enhancing patient engagement in quality improvement. In the last study, a mixed-methods approach has been used to understand managers’ practices that contribute to improve patient engagement in their care. In total, 74 interviews were conducted with managers at different levels of management (top-level n=26, mid-level n=28 and front-line level n=20) and 11 focus groups have been realized with health care professionals (n=7) and patients in oncology and mental health (n=4). In addition, surveys have been administered to patients in mental health.   Findings: This thesis highlights six main results. 1-Management practices are an important lever for integrating the patient perspective into care and quality improvement efforts. 2-The implementation of patient engagement approaches requires enhanced cooperation between managers at different levels of management. 3-Managers’ leadership is situated at different levels of management, depending on the level of patients’ integration (organizational or clinical). 4-Managers’ roles and practices are supported by a set of contextual factors which foster patient engagement. 5-The integration of patient participation creates innovative management practices within healthcare organizations. Finally, 6-The implementation of patient engagement generates challenges and paradoxes that managers have to face.  Scientific contribution: Our findings contribute to the development of knowledge in the field of patient engagement and can pave the way for a new research area on the management of patient engagement.

Keyphrases: Patient engagement, Partnership in care and services, Managerial roles and practices, Clinical governance, Complaints handling, Healthcare organizations, Quality improvement
La distraction par la réalité virtuelle pour le soulagement de la douleur de jeunes enfants ayant subi des brûlures

Burns in children cause severe pain especially during wound care procedures. Pain management is a primary role of nurses involved in burn care. In addition to administration and monitoring of the medication, the nurse can initiate non-pharmacological interventions since the medication does not provide total relief with this population of patients and has many side effects. Virtual reality (VR) distraction is a non-pharmacological intervention that helps divert the child's attention away from painful stimuli. Several studies have shown a promising effect of this technology for the relief of procedural pain. However, no studies have explored its effect on pain in young children. The purpose of this thesis was two-fold: First to evaluate the feasibility and acceptability, and secondly the preliminary effect on pain of a new VR prototype (projector-based hybrid VR) developed specifically for burned children between 6 months and 7 years of age during hydrotherapy sessions. For this purpose, two studies were conducted. The first study was a single group pilot study. Participants were 15 children aged 2.2 +/- 2.1 years with a mean body surface area of 5% +/- 4%. They all received distraction by the projector-based hybrid VR combined with standard pharmacological treatment. Results showed that the VR projector was a feasible intervention adapted to the treatment room. It did not interfere with the procedure and was found useful for pain management by most care providers. Measurements of pain, comfort, and sedation were feasible, but not the measurement of anxiety given the participants’ age-group. The second study, based on the first one, was an efficacy crossover clinical trial of 38 children aged 1.8 ± 1.3 years. Each participant received, during the same hydrotherapy session, the pharmacological treatment alone (control intervention) as well as the pharmacological treatment combined with the distraction by the projector-based hybrid VR (experimental intervention) in a randomized order. The experimental intervention had a statistically significant beneficial effect compared to the control intervention for all participants combined for pain levels measured by the FLACC (Face, Legs, Activity, Cry, Consolability Scale) (p = 0.026) and comfort levels measured by OCCEB-BECCO (Behavioral Observational Scale of Comfort Level for Child Burn Victims) (p = 0.002). However, according to the analysis by randomization sequences, the difference was only significant for the group for which the sequence started with the experimental intervention suggesting that it is more difficult to distract a child once the painful procedures are started. No side effects were observed. Results of this thesis highlight the beneficial effect of a hybrid VR distraction device with young burned children. This tool could be implemented in daily nursing practice to provide better pain care to young children with no side effects.

Keyphrases: Distraction, Burns, Children, Hydrotherapy, Nursing, Procedural pain, Virtual reality
Prevention of atherosclerosis by modulating PCSK9 expression and function

Autosomal dominant hypercholesterolemia (ADH) is a genetic disorder characterized by high plasma low-density lipoprotein (LDL) cholesterol levels. Elevated plasma LDL level is known to contribute to the development of atherosclerosis, a leading cause of heart attack and stroke. Liver LDL receptor (LDLR) acts as a primary pathway for endocytosis and clearance of LDL particles. In contrast, PCSK9, a liver-secreted glycoprotein, binds to LDLR and enhances its lysosomal degradation, resulting in increased plasma LDL concentrations and a higher risk of cardiovascular disease. Genetic defects in LDLR, PCSK9, and apolipoprotein B (apoB), the ligand of LDLR, can cause ADH, but in some ADH-families no mutations can be found in these genes, suggesting that other gene defects may also be involved in ADH. Furthermore, loss-of-function mutations in PCSK9 can greatly reduce plasma LDL levels and lower risk of coronary heart disease by up to ~88%. All these findings have made PCSK9 an attractive target for the treatment of hypercholesterolemia. In the present thesis, which is based on two studies (articles), we investigated protein interactors of PCSK9 (first article, chapter 2) and the effect of PCSK9 on atherosclerosis (Second article, chapter 3). In our first study, mass spectrometry analysis of PCSK9 interacting proteins revealed that Golgi glycoprotein 1 (GLG1) is a novel PCSK9 interactor. Co-immunoprecipitation, Western blotting, and colocalization by confocal immunofluorescence microscopy confirmed that GLG1 is an endogenous PCSK9 binding partner. We also demonstrated that LDLR and apoB interact with GLG1. Using a mouse model, we found lower levels of circulating PCSK9, cholesterol, and triglycerides in Glg1 knockdown mice. Moreover, GLG1 deficiency reduced microsomal triglyceride transfer protein (MTP) activity and induced perinuclear aggregation of apoB, thereby, reducing apoB secretion. In our second study, we developed a mouse model of atherosclerosis to investigate the effect of PCSK9 modulation on the regression of atherosclerotic plaques. We showed that overexpression of a PCSK9 gain-of-function in mouse liver accelerated the development of atherosclerotic lesions in the aortic root, which were then reduced by inducing PCSK9 downregulation using a Tet-on system.  In conclusion, we have contributed to the identification of a novel PCSK9 interacting protein, GLG1, which regulates plasma level of cholesterol and represents a potential target for hypercholesterolemia treatment. We also demonstrated that PCSK9 gene modulation directly regulates the level of atherosclerotic plaques in the aortic root. We showed in our study that the wild-type mice, overexpressing PCSK9-D377Y in an inducible manner, is a useful mouse model for understanding the molecular role of PCSK9 on atherosclerotic plaques development. These studies will help to develop effective therapies to reduce hypercholesterolemia and the risk of cardiovascular disease.

Keyphrases: Atherosclerosis, Cholesterol, PCSK9, GLG1, LDLR
Biceps brachii synergy and its contribution to target reaching tasks within a virtual cube

In recent years, important work has been done in the development of prosthetic control to help upper limb amputees improve their quality of life on a daily basis. Some modern commercially available upper limb myoelectric prostheses have many degrees of freedom and require many control signals to perform several tasks commonly used in everyday life. To obtain several control signals, many muscles are required, but for people with upper limb amputation, the number of muscles available is more or less reduced, depending on the level of amputation. To increase the number of control signals, we were interested in the biceps brachii, since it is anatomically composed of 2 heads and the presence of compartments was observed on its internal face. Physiologically, it has been found that the motor units of the biceps are activated at different places of the muscle during production of various functional tasks. In addition, it appears that the central nervous system can use muscle synergy to easily produce multiple movements. In this research, muscle synergy was first identified to be present in the biceps of normal subjects, and it was shown that the characteristics of this synergy allowed the identification of static posture of the hand when the biceps signals had been recorded. In a second investigation, we demonstrated that it was possible in a virtual cube presented on a screen to control online the position of a sphere to reach various targets by using muscle synergy of the biceps. Classification techniques have been used to improve the classification of muscular synergy features, and these classification techniques can be integrated with control algorithm that produces dynamic movement of myoelectric prostheses to facilitate the training of prosthetic control.

Keyphrases: upper limb, myoelectric prostheses, biceps brachii, virtual cube, muscle synergy, electromyography, targets
Implication de la résolvine D1 dans la régulation des processus inflammatoires et cataboliques au niveau ostéoarticulaire

The recognition of the proactive character of the resolution phase of inflammation has revealed alternative therapeutic paradigms for inflammatory conditions, based on the use of active mediators capable of promoting the resolution of inflammation. In other words, these mediators regulate the inflammatory response, initiate tissue repair and promote the return to homeostasis. Among them, resolvin D1 (RvD1) has remarkable anti-inflammatory and proresolutive properties. Although the effects of RvD1 have been well studied, its potential role in the osteoarticular tissues remains poorly documented. In this study, we expand our understanding of the potential of RvD1 in protecting and preserving joint integrity by studying its ability to regulate the major factors involved in the articular pathophysiology. First, we demonstrated that RvD1 is produced in the articular environment and that its levels are higher in the synovial fluid of osteoarthritic knees compared to healthy knees. The knees were obtained from an osteoarthritic dog model performed in a previous study. Therefore, we studied RvD1 actions on the cellular components of the joint. In human osteoarthritic chondrocytes, we demonstrated that RvD1 inhibits IL-1β-induced inflammatory and catabolic mediators, namely COX-2, PGE2, iNOS, NO, and MMP-13. This led to the study of signaling pathways, which revealed that RvD1 counter-regulates IL-1β-induced activation of NF-κB / p65, p38 / MAPK and JNK1 / 2. In addition, RvD1 confers a protection against cellular apoptosis and oxidative stress induced by HNE, as revealed by caspases inactivation, LDH inhibition, as well as increased levels of Bcl-2, AKT, and GSH. In addition to chondrocytes, RvD1 showed remarkable effects on osteoclasts. Indeed, it inhibits osteoclast differentiation and activation, as demonstrated by the inhibition of TRAP and cathepsin K expression. Moreover, it reduces LPSinduced TNF-α, IL-1β, IFN-γ, PGE2 as well as RANKL and concurrently increases IL-10 expression. Furthermore, it inhibits RANKL and M-CSF-induced hydroxyapatite matrix degradation and bone matrix erosion, ex vivo. Finally, the study of the properties of RvD1 in a mouse model of arthritis, revealed that it alleviates the clinical score, paw inflammation, as well as bone and joint destruction. Furthermore, it reduces the inflammatory mediators and significantly decreases serum markers of bone and cartilage remodeling. Our results are very promising and confirm the high potential of RvD1 in resolving inflammation and preserving joint integrity. They highlight its clinical relevance as a therapeutic agent for the management of osteoarticular diseases.

Keyphrases: Inflammation, Resolution of inflammation, Resolvin D1, Joint, Catabolism, Bone resorption, Osteoarthritis, Arthritis
Critical roles of dendritic cells and macrophages in cardiovascular disease

Cardiovascular disease is a major cause of mortality in the world, and is rapidly increasing. To understand the inflammatory response of various diseases, we have made tremendous advances in molecular and cellular research to show clear evidence that macrophages and dendritic cells play central roles in cardiovascular diseases, such as atherosclerosis and myocardial infarction.  We have identified the two conventional DCs subsets (cDC1 and cDC2) in heart of healthy mouse. As expected, we found that the IRF8-expressing cDC1, but not the IRF4-expressing cDC2, was dependent on Flt3 for its development. Myocardial infarction significantly increased the infiltration of CD45+ leukocytes in the infarcted heart, including macrophages, neutrophils and DCs. Among cDC, the most significantly increased subset was the cDC2. The diphtheria toxin receptor (DTR) mediated depletion of Zbtb46-expressing DCs in myocardial infarcted mice led to a significant decrease of IL-1β expression together with an increased recruitment of leukocytes. This dramatically reduced the infarcted size and improved cardiac function, suggesting that cardiac DCs play an important role in immune cell infiltration following myocardial infarction. In another study, we developed, for the first time, a lipid probe-based flow cytometry method to analyze foam cells in atherosclerotic aorta. Our method enables to isolate foamy and non-foamy macrophages in order to perform the transcriptomic analysis of these cells. In addition, this technique allows to assess the severity of atherosclerosis and the characteristics of foam cells. RNA-seq analysis showed that lipid-laden foamy macrophages in atherosclerotic lesions clearly expressed different transcripts compared to non-foamy macrophages. Surprisingly, we found that non-foamy macrophages showed a pro-inflammatory signature reflected by the up-regulation of cytokines, such as Il1β, Tnf and Nlrp3. However, foamy macrophages up-regulated genes related to the transport and uptake of lipids (cholesterol and fatty acid).  Collectively, we specifically identified the function of dendritic cells and macrophages in the pathogenesis of cardiovascular diseases. Understanding the precise role of these cells will help to develop appropriate immune-therapeutic strategy to attenuate cardiovascular disease.

Keyphrases: Conventional DCs, Macrophages, Foam Cells, Atherosclerosis, Myocardial Infarction, RNA-seq
Revues systématiques et méta-analyses en chirurgie cardiaque : défis et solutions

Objective: To explore, adapt and develop new methodologies for performing systematic reviews and meta-analyses in cardiac surgery. Methods: Text mining and citation chasing were used to optimize the efficiency and sensitivity of search process. We participated in the evaluation of new tools (Risk of Bias 2.0 and Risk of bias in non-randomized studies of interventions) for quality assessment of randomized and nonrandomized studies and we have adopted them for our future projects. A new graphic methodology has been developped for the performance of meta-analyses of time-to-event data. Results: These approaches have been used to answer various research questions touching different aspects of cardiac surgery: 1) writing the first guidelines of enhanced recovery after cardiac surgery, 2) a systematic review of the results of valvular surgery and aortic in cardiac transplantation, demonstrating good results of these procedures in a high-risk population and the emergence of trans-catheter techniques in the management of these pathologies, 3) a meta-analysis of supra-ventricular arrhythmias in patients who had a Fontan intervention, finding a beneficial effects of the extracardiac conduct technique and 4) a meta-analysis of aortic insufficiency in patients with left ventricular assist device, showing an under-estimated incidence of this clinical entity with a significant impact on the survival of this population of patients. Conclusion: This thesis addresses some of the short comings of the heart surgery literature such as the sensitivity of the systematic search and time-to-event data meta-anlysis and proposed novel solutions. Other issues such as the need to summarize a comprehensive and coherent set of comparisons remain. Future researchs focused on new approaches such as the network meta-analysis or the Bayesian approach can solve these issues.

Keyphrases: Systématic review, Meta-analysis, Methodology, Time-to-event data, Cardiac surgery