NCube/papyrus huggingface dataset:
Le soutien du leadership transformationnel des infirmières gestionnaires dans un contexte de changement organisationnel : la perspective des infirmières gestionnaires

Introduction: In the context of organizational change, nurse managers should favour the use of transformational leadership. Nurse managers have identified a need for support to use transformational leadership. Purpose: To explore, in the context of organizational change, the ways nurse managers can be supported in their use of transformational leadership. Methodology: A qualitative descriptive study was undertaken from date debut to date de fin. Semi-structured interviews were completed with nurse managers (n=12). Content analysis and descriptive statistics were used. Results: Four themes emerged and included the magnitude of the change, implementing transformational leadership, strategies and time. These four themes included 21 sub-themes with emotional and behavioural aspects and strategies to support the use of transformational leadership by nurse managers in the context of organizational change. Nurse managers need for support to use transformational leadership fluctuates according to their experience and their vision of leadership, and that may affect their choice of strategies. Discussion: Models of support for the development of transformational leadership and strategies leading to organizational performance are put forward. Recommendations are made for nurse manager practice, nursing management training and research in nursing. Conclusion: Theses results can support nurse managers to use their leadership and positively influence their managing practices.

Keyphrases: Administration des services infirmiers, Qualitative descriptive study, Nursing administration, Nursing manager, Organizational change, Transformational leadership
Intervention de stimulation olfactive avec du lait maternel pour diminuer la réponse à la douleur procédurale des nouveau-nés prématurés : une étude pilote

Preterm neonates experience many painful procedures during their hospitalisation in the Neonatal Intensive Care Unit (NICU) where heel prick is the most frequent painful intervention. Repeated and untreated pain has long term consequences for preterm neonates. The use of pharmacological and non-pharmacological pain management interventions is limited for preterm neonates. Therefore, it is essential to investigate new pain management interventions such as breast milk odor. This pilot study aimed to evaluate the feasibility and acceptability of an olfactive stimulation intervention to manage procedural pain of preterm neonates, born between 28 and 34 weeks of gestation, during heel prick. A pilot study was conducted with 12 preterm neonates, 11 mothers and 20 nurses in a level III NICU. The study group was familiarised with breast milk odor for nine hours preceding blood sampling. Breast milk odor was combined with standard care during heel prick and pain was measured by the Premature Infant Pain Profile-Revised.  Self-reported questionnaires administered to mothers (n = 11) and nurses (n = 20) confirmed the feasibility and acceptability of the intervention, with a proportion of over 80% for both of these items. Observed effect indicated that the closer the compress with the breast milk odor was to the preterm neonates’ nose (n=12), the shorter time to return to baseline after the painful procedure was and the lower the pain score was on the PIPP-R.   Breast milk odor is a non-pharmacological pain management intervention which is non-expensive and feasible for mothers and nurses. Findings of this pilot study guide the methodology of a randomized controlled trial.

Keyphrases: pain, non-pharmacologic intervention, preterm neonate, odor, breast milk, pilot study, neonatal intensive care unit, heel prick
The expression of netrin-1 in the intact and injured adult mice retina

Netrin-1 plays a highly-conserved role as a guidance cue directing axonal growth during the early stages of central nervous system development. Recent data has shown that netrin-1 is continued to be expressed in the adult forebrain where it regulates synaptic function and plasticity in cortical neurons. However, the contribution of netrin-1 in the adult retina remains unknown. The purpose of this study was to characterize the expression of netrin-1 in the intact and injured adult mouse retina.   The retinal expression of netrin-1 and its receptor, deleted in colorectal cancer (DCC), was examined at postnatal day 0 (P0), P14, and adult mice using western blots. Double labeling of netrin-1 with an antibody against RBPMS, a selective marker for retinal ganglion cells (RGCs), was used to determine its location on retinal cross-sections. Netrin-1 levels were also quantified at 3 and 7 days after optic nerve axotomy.  We demonstrate that netrin-1 and DCC are abundantly and widely expressed in the retina at P0, but although the expression level of netrin-1 remains relatively stable during development, the expression level of DCC is markedly downregulated in adulthood. Adult RGC soma were shown to be endowed with robust netrin-1 expression. DCC receptors were also found to be expressed around the cell body. Importantly, we show that netrin-1 and DCC levels are further downregulated at 3 and 7 days after optic nerve axotomy. However, the over-expression of netrin-1 protein failed to exert any significant effect on RGC survival in comparison to vehicle-injected controls. Our data support that: 1) netrin-1 is abundantly expressed in the neonatal retina and undergoes marked downregulation in adulthood, 2) netrin-1 and DCC are present in RGCs, 3) netrin-1 expression decreases rapidly after axonal injury. Together, these results suggest a role for netrin-1 in the mature visual system.

Keyphrases: DCC, Retina, Adult, Netrin-1, Axotomy
Radiosynthesis of hexadecyl-4-[18F]fluorobenzoate for labeling exosomes and chitosan hydrogels

Positron emission tomography (PET) is a powerful nuclear imaging modality allowing for non-invasive functional measures in cells, animals and humans with high sensitivity. Exosomes are 30-120 nm extracellular vesicles that can transfer their cytoplasmic contents between cells, however, understanding where exosomes traffic in the body remains a challenge. Chitosan-based thermosensitive hydrogels have been developed and are currently under optimization for various applications such as blood vessel embolization, drug delivery, lymphocyte delivery systems, and cartilage and intervertebral disc repair. There is an urgent need for in vivo, short term follow-up of such procedures to assess the retention of hydrogels and exosomes at the site of injection. Hexadecyl-4-[18F]fluorobenzoate ([18F]HFB) is a long chain lipophilic radiotracer that has been reported to be retained within cell membranes or biomaterials. The aim of this work was to automate the radiosynthesis of [18F]HFB for labeling exosomes and chitosan-based hydrogels. The radiosynthesis and purification of [18F]HFB was done using the commercial IBA Synthera® chemistry synthesiser with the R&D IFP-cassette and HPLC module. As previously reported, [18F]HFB was prepared by [18F]F- substitution of the trimethyl ammonium triflate precursor in DMSO. After removal of unreacted [18F]F- and DMSO via a C18 light cartridge, [18F]HFB was eluted with acetonitrile and purified by semi-prep C18 HPLC. [18F]HFB was then reformulated in DMSO (10%) solution after removal of the HPLC solvent from the radioactive product peak under nitrogen, filtered, and diluted in sterile saline. [18F]HFB was obtained in radiochemical yield (isolated after HPLC and evaporation) ranging from 15 – 45% (decay-corrected), high radiochemical and chemical purities, and within a total synthesis time of 60 mins. Exosomes were not successfully labeled. However, high labeling efficiency was observed with the chitosan hydrogels displaying a stability >90%, even after 8 hours incubation in saline. PET imaging with [18F]HFB of exosomes and biomaterials presents a novel approach to determining their in vivo distribution.

Keyphrases: F-18, Fluor-18, exosome, hydrogels, chitosan, Fluorine-18, automated, Radiosynthesis, nanovesicle, biomaterials, radiolabeling, Positron emission tomography, PET
Étude des réponses humorales chez la femme enceinte infectée par le virus de l’hépatite C : cytotoxicité dépendante des anticorps (ADCC) et réponses neutralisantes

Almost 185 million people worldwide are infected with hepatitis C virus (HCV) and are at risk of developing cirrhosis and hepatocellular carcinoma. In developed countries, the major cause of infection in children is mother-to-child transmission (MTCT), which occurs in <10% of cases during pregnancy or at delivery. For reasons that remain poorly understood, HCV viral load increases in the third trimester of gestation and decreases following delivery. This situation is often followed by elevated serum markers of liver inflammation and by an exacerbation of hepatic pathology in an important fraction of infected women. The development of in vitro culture models enabled the recognition of the implication of humoral immune responses in the clinical evolution of hepatitis C. Nonetheless, the impact of neutralizing antibodies (AB) and non-neutralizing AB in the pathology of hepatitis C in pregnancy has been under-investigated. In this study, we report evidence that the selective pressure exerted by the neutralizing responses against HCV is responsible for the diversification of HCV quasispecies in HCV mono-infected women and women co-infected with HCV and HIV. This diversification was associated with a reduced frequence of MTCT and with reduced hepatic inflammation in mono-infected patients only. In co-infected patients, quasispecies diversification and the presence of neutralizing antibodies are not sufficient to reduce the risk of MTCT. We also propose a role for non-neutralizing AB in the exacerbation of hepatic inflammation in women without neutralizing activity against HCV. The elevated hepatic inflammation could be linked to the antibody dependent cellular cytotoxicity (ADCC), the role of which has yet to be defined in the control of HCV viremia. In the aim of elaborating a quantitative assay to measure ADCC specific for HCV, different approaches have been tested and will be presented in this monograph. This study has contributed to a better understanding of the role of neutralizing humoral responses and the likely implication of ADCC in the pathogenesis of hepatitis C in pregnancy.

Keyphrases: ADCC, HCV, Humoral responses, Neutralization, Pregnancy
La différentiation in vitro des cellules dendritiques plasmacyto des   partir de cellules CD34+ de sang de cordon, un outil thérapeutique pour augmenter l'activité́ antitumorale des cellules NK

NK cells immunotherapy is a promising treatment for different human cancers. An effective approach to stimulate NK cells has been the use of activated plasmacytoid dendritic cells (pDC). NK cell activated by pDC develops a strong cytotoxic response against pre-B acute lymphoblastic leukemia (ALL) cell lines in vitro and in vivo. However, the use of pDC in the clinic has limitations because of its low frequency. One suitable strategy is the differentiation of CD34+ progenitors using different cytokines and chemokines. Recently, it has been demonstrated that antagonists of aryl hydroxyl receptor (AhR) increase the number of pDC obtained after culture of CD34+ cells. Nevertheless, the ability of these in vitro differentiated pDC to induce NK cells activation has not been well documented. In this study, it was showed that activated in vitro differentiated pDC present different characteristics than adult pDC, like a lower expression of activation markers and IFNalpha secretion, but their capacity to stimulate NK cells was similar to that observed in adult pDC. In addition, NK cells activated by in vitro differentiated pDC showed a strong cytotoxicity against the pre-B ALL cell line REH suggesting its effectiveness to treat ALL patients.

Keyphrases: Immunotherapy, NK cells, plasmacytoid dendritic cells, in vitro expansion and differentiation of hematopoietic cells, AHR antagonists
Analyse de l'équilibre à la marche face à des perturbations imprédictibles chez des sujets en santé

When repeated postural perturbations are induced while walking on the floor or on a treadmill, reactive and proactive postural adjustments improve progressively. The objective of the study was to analyse proactive postural and balance adjustments between varied perturbations with unpredictable onsets with and without a previous period of habituation. Two studies have been conducted in which 24 young healthy subjects (mean ± standard deviation: 25.3 ± 2.3 years) participated. Participants walked on a slip-belt treadmill at comfortable speed under different conditions: without perturbations (studies 1 and 2), with repeated perturbations (study2), and with random perturbations (studies 1 and 2). Perturbations consisted in an accelerations or a decelerations of various magnitude, of one of the belt of the treadmill during right or left single support stance every 8 to 20 steps. Three dimensional whole-body kinematic and kinetic data were recorded. The difficulty to maintain balance increased at the end of trials with random perturbations compared to the beginning with (study 2) and without (study 1) habituation to the perturbations. Balance difficulty also increased at the end of the trials with repeated deceleration perturbations (Study 2). No change were observed during repeated acceleration perturbation trials. The increase of the difficulty to maintain balance was mainly due to a decrease between the center of pressure and the base of support. No change were observed during repeated acceleration perturbation trials. Changes observed during random trials may be a non-specific strategy adopted by the participants to respond to perturbations, particularly when they were unpredictable.

Keyphrases: Adapation, Random Perturbations, Balance
Implication de HMGB1 dans la différentiation des trophoblastes

The placenta plays a crucial role during pregnancy and trophoblast differentiation is fundamental to its proper functioning. The absence of inflammation is also essential for the success of gestation, the presence of uncontrolled inflammation is associated with several pregnancy complications, such as preeclampsia (PE) and preterm delivery. High Mobility Group Box 1 (HMGB1), a nuclear protein that acts as a pro-inflammatory mediator when secreted into the extracellular media, is one of the endogenous inflammatory mediators increased during pathological pregnancies. However, the actions of HMGB1 at the materno-fetal interface are still unknown. The aim of this work was to evaluate the concentration, subcellular localization and secretion of HMGB1 during trophoblast differentiation and to evaluate the distribution of HMGB1 in the placenta from pregnancies complicated with PE. In my studies I have shown an increase of HMGB1’s nuclear concentration during the spontaneous differentiation of trophoblasts. Moreover, the use of a histone deacetylase inhibitor (i.e. NaB) leads to an accumulation of HMGB1 in the cytoplasm and promotes differentiation, while the use of a nuclear export inhibitor (i.e. leptomycin) leads to a decrease in differentiation. Concerning pregnancies complicated with PE, there is a redistribution of HMGB1 with cytoplasmic accumulation. In conclusion, this work demonstrates the association between the modulation of HMGB1 localisation with trophoblasts differentiation, although the causal link remains to be determined.

Keyphrases: HMGB1, Placenta, Differentiation, Preeclampsia, Pregnancy, Trophoblasts
Breast Reconstruction Post-Mastectomy : an Assessment of Rates, Limiting Factors and Attitudes at a Tertiary Care Center in Quebec

Breast reconstruction post-mastectomy has been shown to improve psychosocial wellbeing, and body image. However, accessibility and acceptance of breast reconstruction is limited, with patients being unequally privileged based a number of limiting factors. To date, no evaluation on the rates of reconstruction and the factors that influence patient access has been  performed in the province of Quebec.  The objective of the research was two-fold with the first component being to identify the rates of breast reconstruction at a tertiary care center in Montreal and the factors influencing the rates of reconstruction through a retrospective chart review. The second component was to directly evaluate in the same cohort of breast cancer patients; their interest in a consultation  with plastic surgery through a telephone questionnaire.  There was a total rate of PMBR of 21%, where 14% of patients had an immediate reconstruction and 8% of eligible patients underwent a delayed reconstruction. Patients that received a PMBR were younger, more likely to have bilateral mastectomies, had non-invasive breast cancer and resided further then 10km from the hospital. Approximately half of patients with a mastectomy were interested in consulting a plastic surgeon but only 38% of all patients underwent a reconstruction. The offer and awareness of reconstruction increased the chance of opting to have a reconstruction.  There are barriers outside of the patient’s own desires that impede their access to breast reconstruction.

Keyphrases: Quebec, Canada, Breast reconstruction, Rate of reconstruction, Teaching hospital, Autologous breast reconstruction, Prosthetic breast reconstruction, Immediate reconstruction, Delayed reconstruction, Montreal, Breast cancer, Desire for reconstruction, Interest in consultation, Chart review, Telephone questionnaire, Access to reconstruction, Reconstruction tardive
Impact de la colchicine sur l'inflammation vasculaire

Background : Recent studies suggest that colchicine reduces cardiovascular risk.  The COLPET Study evaluated the impact of colchicine on vascular inflammation, as measured by PET/CT, in patients with stable CAD.  Methods: In this randomized, double-blind, placebo-controlled, phase II clinical trial, patients were treated for 24 weeks with a daily tablet of colchicine 0.6 mg or placebo.  Vascular inflammation was assessed by uptake of 18F-FDG in the ascending aorta and carotid arteries on PET/CT at baseline and at the end of study drug therapy.  The primary outcome was the change in the mean of maximal target-to-background ratio of the image slices of the ascending aorta (Mean MAX TBR).  Secondary outcomes included various PET/CT parameters, as well as serial measures of inflammatory biomarkers, such as hs-CRP.  Results: A total of 111 patients were randomized, with 56 in the placebo group and 55 in the colchicine group.  Colchicine had no significant impact on the primary outcome (change in mean: 0.051; IC95% : -0.016 à 0.117; p=0.1346) or any of the PET/CT secondary outcomes.  In contrast, patients treated with colchicine presented a decrease of 28% in hs-CRP levels (p=0.0026).  Conclusion: Colchicine therapy for 24 weeks had no significant impact on vascular uptake of 18F-FDG in the ascending aorta or carotid arteries.  However, a reduction of 28% in hs-CRP was observed in the colchicine group.  The Colchicine Cardiovascular Outcomes Trial (COLCOT) is a multicenter randomized phase III trial, currently under way, evaluating the long-term cardiovascular benefits of therapy with colchicine (0.5 mg daily) when begun less than thirty days following acute myocardial infarction.

Keyphrases: Colchicine, Atherosclerosis, Vascular inflammation, Cardiovascular disease, Positron emission tomography, C-reactive protein, Biomarkers
Association entre l'élastographie vasculaire non invasive et l'indice de masse corporelle chez les enfants

Knowing that cardiovascular disease risk factors are present in asymptomatic children, this study explores the association between non-invasive vascular elastography (NIVE) as a subclinical marker of atherosclerosis and obesity in children. In the absence of a gold standard, we also compare B-mode and Radiofrequency (RF) based ultrasound measurements of intima-media thickness (IMT) in children with normal and increased body mass index (BMI). This is a prospective study between 2005 and 2011. NIVE parameters and IMT of the common carotid artery were compared between 60 children with normal BMI and 60 children with increased BMI enrolled in the QUebec Adipose and Lifestyle Investigation in Youth cohort (QUALITY). NIVE parameters included cumulated axial strain (CAS) (%) and cumulated axial translation (CAT) in mm. The three methods of IMT measurements included M’ath Std (B-mode), RF echotracking system and RF probability distribution using NIVE platform. ANOVA analysis and Pearson correlation were calculated using SAS version 9.3. Intra-class correlation coefficient (ICC) and regression analysis was done on MedCalc software version 17.2. The mean age was 11.4 years for the normal BMI group and 12 years for the increased BMI group. Fifty-eight percent were boys in the normal BMI group and 63% in the increased BMI group. The two groups were significantly different with respect to age, Tanner stage, systolic and diastolic blood pressure and were similar with respect to sex. After controlling for confounders, the results show no difference in CAS between the two groups and a significantly lower CAT in the normal BMI group (CAT=0.51+/-0.17 mm for the normal BMI group and 0.67+/-0.24 mm for the increased BMI group (p<0.001)). There is a weak correlation among the three techniques. ICC=0.34 (95% confidence interval (CI): 0.27-0.39). There is however significantly increased IMT in children with increased BMI according to all three techniques. The results were as follow: for B-mode IMT (0.55 mm (normal BMI group) vs. 0.57 mm (increased BMI group); p=0.02); for RF echotracking IMT (0.45 mm (normal BMI group) vs. 0.48 mm (increased BMI group); p=0.03) and for RF probability distribution IMT (0.32 mm (normal BMI group) vs. 0.35 mm (increased BMI group); p=0.010).NIVE is a one-step technique for IMT and CAT measurement in children at risk. Significant IMT measurement variation is observed between the three techniques. However, children with increased BMI tend to have higher IMT values regardless of the technique. Both subclinical markers can be used for optimal stratification of children with cardiovascular disease risk factors. The same technique should be used throughout.

Keyphrases: Non invasive vascular elastography, Body mass index, Intima media thickness, Children, Ultrasound