NCube/papyrus huggingface dataset:
Comparaison populationnelle des résultats périopératoires entre la néphro-urétérectomie ouverte et laparoscopique aux États-Unis

Background: Nephroureterectomy represents the primary management for patients with non-metastatic upper tract urothelial carcinoma (UTUC). Either an open (ONU) or laparoscopic (LNU) nephroureterectomy may be considered. Despite the presence of several reports comparing perioperative and cancer control outcomes between the two approaches, no reports relied on a population-based cohort. Objectives: To examine intraoperative and postoperative morbidity of ONU and LNU in a population-based cohort. Design, setting, and participants: We relied on the Nationwide Inpatient Sample (NIS) to identify patients with non-metastatic UTUC treated with ONU or LNU between years 1998 and 2009. Overall, 7401 (90.8%) and 754 (9.2%) patients underwent ONU and LNU, respectively. To adjust for potential baseline differences between the two groups, propensity-based matching was performed. This resulted in 3016 (80%) ONU patients matched to 754 (20%) LNU patients. Intervention: All patients underwent NU. Measurements: The rates of intraoperative and postoperative complications, blood transfusions, prolonged length of stay (pLOS), and in-hospital mortality were assessed for both procedures. Multivariable logistic regression analyses were performed within the post propensity-matched cohort. Results and limitations: For ONU vs. LNU respectively, the following rates were recorded: blood transfusions: 15 vs. 10% (P<0.001); intraoperative complications: 4.7 vs. 2.1% (P=0.002); postoperative complications: 17 vs. 15% (P=0.24); pLOS (≥5 days): 47 vs. 28% (P<0.001); in-hospital mortality: 1.3 vs. 0.7% (P=0.12). In multivariable logistic regression analyses, LNU patients were less likely to receive a blood transfusion (odds ratio [OR]: 0.6, P<0.001), to experience any intraoperative complications (OR: 0.4, P=0.002), and to have a pLOS (OR: 0.4, P<0.001). Overall postoperative complications were equivalent. However, LNU patients had fewer respiratory complications (OR: 0.4, P=0.007). This study is limited by its retrospective nature. Conclusions: After adjustment for potential selection biases, LNU is associated with fewer adverse intraoperative and perioperative outcomes than ONU.

Keyphrases: Nephroureterectomy, laparoscopy, upper urinary tract carcinoma, urothelial carcinoma
L’évaluation des déterminants des paramètres hémodynamiques centraux à l’aide de la cohorte populationnelle CARTaGENE

Cardiovascular diseases have a large impact on Canadian’s lives, and throughout the years, several risk factors associated with this condition have been identified. Hypertension represents an important of the modifiable risk factors. While high blood pressure is usually defined using peripheral blood pressure measurements, it has recently been shown that measurements of the central blood pressure and its components are more precise predictors of incident cardiovascular events. The thesis aims at better characterising mainly two determinants of central blood pressure: beta-blocker use for the treatment of hypertension and early chronic kidney disease. Using data from the CARTaGENE populational cohort and propensity score matching techniques, it was shown that beta-blockers use in the treatment of hypertension are associated with an unfavorable central hemodynamic profile. Hence, individuals receiving these agents had higher central blood pressures and arterial amplification than individuals of the matched control group, despite identical peripheral blood pressures. This effect was mostly, but not only, explained by the associated reduction of the heart rate. It was also shown that stage 3 chronic kidney disease (estimated glomerular filtration rate between 30 and 60 mL/min/1.73m2) was not associated with an increase in central hemodynamic parameters, unlike what was previously shown in individuals with more advanced chronic kidney disease. Furthermore, albuminuria was not associated with detrimental changes in the central hemodynamic profile in a subset of CARTaGENE.

Keyphrases: Hypertension, CARTaGENE, Central blood pressure, Central hemodynamic parameters, Central pulse pressure, Beta-blocker, Chronic kidney disease
Le mode de ventilation neurally adjusted ventilatory assist (NAVA) est faisable, bien toléré, et permet la synchronie entre le patient et le ventilateur pendant la ventilation non invasive aux soins intensifs pédiatriques : étude physiologique croisée

Introduction: The need for intubation after noninvasive ventilation (NIV) failure is frequent in the pediatric intensive care unit (PICU). One reason is patient-ventilator asynchrony during NIV. Neurally adjusted ventilatory assist (NAVA) is a mode of ventilation controlled by the patient’s neural respiratory drive. The aim of this study was to assess the feasibility and tolerance of NIV-NAVA in children and to evaluate its impact on synchrony and respiratory effort.  Methods: This prospective, physiologic, crossover study included 13 patients requiring NIV in the PICU of Sainte-Justine’s Hospital from October 2011 to May 2013. Patients were successively ventilated in conventional NIV as prescribed by the physician in charge (30 minutes), in NIV-NAVA (60 minutes), and again in conventional NIV (30 minutes). Electrical activity of the diaphragm (EAdi) and airway pressure were simultaneously recorded to assess patient-ventilator synchrony.  Results: NIV-NAVA was feasible and well tolerated in all patients. One patient asked to stop the study early because of anxiety related to the leak-free facial mask. Inspiratory trigger dys-synchrony and cycling-off dys-synchrony were significantly shorter in NIV-NAVA versus initial and final conventional NIV periods (both p< 0.05). Wasted efforts were also decreased in NIV-NAVA (all values expressed as median and interquartile values): 0 (0 - 0) in NIV-NAVA versus 12% (4 - 20) and 6% (2 - 22) in initial and final conventional NIV, respectively (p< 0.01). As a whole, total time spent in asynchrony was reduced to 8% (6 - 10) in NIV-NAVA, versus 27% (19 - 56) and 32% (21 - 38) in initial and final conventional NIV, respectively (p= 0.05). No difference in term of respiratory effort was noted. Conclusion: NIV-NAVA is feasible and well tolerated in PICU patients and allows improved patient-ventilator synchronization. Larger controlled studies are warranted to evaluate the clinical impact of these findings.

Keyphrases: pediatric intensive care unit (PICU), respiratory physiology, noninvasive ventilation (NIV), positive pressure ventilation, patient-ventilator synchrony, electrical activity of the diaphragm (EAdi), Neurally Adjusted Ventilatory Assist (NAVA)
Analyse de l'effet d'âge et du sexe sur l'utilisation des symboles graphiques

Augmentative and alternative communication (AAC) is used by people who cannot communicate through speech to transmit information to their environment and interact functionally with it. AAC has seen significant advances in recent years, especially with the advent of new technologies. Nevertheless, a more thorough understanding of the mechanisms underlying the use of AAC remains crucial. In addition, the relationships between the use of oral language and graphic symbols are little explored to date. This study is part of a larger project aiming to explore the nature of skills underlying the optimal use of graphic symbols in AAC. Accordingly, and in order to better understand this relationship between spoken language and the use of graphic symbols both in production and in comprehension, as well as to explore the effect of age and gender on this relationship, we recruited 79 children   (37 girls and 42 boys) aged between 4:1 and 9:11 years, with typical language development. The study of typical development allows us to explore certain skills that can be difficult to evaluate in children with severe deficits. Participants were divided into 3 groups according to age: 4-5 years (n = 26), 6-7 years (n = 35) and 8-9 years (n = 18). Several tasks were created; these included comprehension and production tasks, using graphic symbols, objects or words, in utterances consisting of three, four, six or eight elements. First, the results showed two distinct profiles: in young children, the main distinction fell on the interpretation-production axis, regardless of the task. However, this difference is less obvious for the older age groups, with the distinction falling on the oral-graphic symbols axis. In addition, and in accordance with observations made for oral language development, the performance of girls was higher than the performance of boys in all tasks, and this difference seemed to become less significant with age. Finally, our results showed that oral language is better mastered than graphic symbols with age, whereas the difference between the interpretation and production tends to disappear. Our study supports results reported in the literature, and widens our knowledge on the relationship between oral and symbolic production and interpretation according to age and gender.

Keyphrases: production, augmentative communication, sequences of graphic symbols, production, comprehension, gender differences
Fonctionnalité in vivo d’un endothélium cornéen reconstitué par injection de cellules endothéliales cornéennes dans la chambre antérieure d’un modèle félin

Introduction : Despite their growth arrest in vivo, corneal endothelial cells (CEC) can be amplified in vitro. Their subsequent transplantation by cell-injection therapy could overcome the tissue scarcity associated with traditional allo-transplantation, which is the only currently available treatment for irreversible corneal endothelial failure.   Objective : To evaluate the functionality of a corneal endothelium reconstituted by cell- injection therapy in the feline.   Methods: The right eyes of 16 animals underwent surgery. Eight underwent central endothelial scraping and injection with 2x10e5 (n=4) or 1x10e6 (n=4) feline CEC supplemented with Y-27632 and labeled with SP-DiOC18(3). After total scraping, two eyes were injected with 1x10e6 labeled CEC and Y-27632. The central (n=3) or entire (n=3) endothelium was scraped in six controls followed by Y-27632 injection without CEC. Outcomes included clinical performance, anatomical integrity, functional phenotype and SP-DiOC18(3) expression of the new endothelium.   Results: Corneas grafted with 2x10e5 CEC and centrally scraped controls performed the best clinically. Entirely scraped controls remained hazy and thick. Histopathology revealed a confluent, functional endothelial monolayer in corneas grafted with 2x10e5 CEC and centrally scraped controls, a non-uniform, non-functional endothelial multilayer in centrally scraped corneas grafted with 1x10e6 CEC, and a non-functional fibrotic endothelium in entirely scraped grafts and controls. SP-DiOC18(3) was scarce in grafts and absent in controls.   Conclusion : Cell-injection therapy reconstituted an incompletely functional endothelium, to which injected CEC contributed little. Y-27632 injection without CEC reconstituted the healthiest endothelium. Further studies investigating the therapeutic effect of Y-27632 alone are warranted.

Keyphrases: corneal endothelial cells, cell-injection therapy, endothelial keratoplasty, corneal transplantation, Y-27632, transplantation cornéenne
Validation de la reproductibilité d’outils de mesure de la fraction d’éjection du ventricule gauche en médecine nucléaire

Left ventricular ejection fraction is an excellent indicator of cardiac function. Many invasive and non-invasive techniques can be used for its assessment: angiography, echocardiography, cardiac MRI, computed tomography of the heart, multigated radionuclide angiography and myocardial perfusion imaging. More than 40 years of scientific publication praise the multigated radionuclide angiography for its execution speed, its availability, its low cost and intrarater and interrater reproducibility. The left ventricular ejection fraction was calculated twice for 47 patients, using two raw data acquisitions, two technologists and three software platforms: one fully manual, one semi-automatic and one fully automatic. In general, the automatic and semi-automatic methods showed greater reproducibility, a smaller standard error of measurement and minimal detectable change than the manual method, whereas the manual method systematically gave a significantly lower quality of result. It was the only technique that showed significant intrarater difference, and its standard error of measurement and minimal detectable change were 40% to 50% higher than those of automatic and semi-automatic methods. Even though all three techniques are all excellent and reliable options, reliability coefficient estimations were superior using automatic and semi-automatic methods as compared to the manual method.

Keyphrases: Insuffisance cardiaque, ANOVA, Left ventricular ejection fraction, Multigated Radionuclide Angiography, Heart failure, Cardiotoxcity, Generalizability theory, Reliability
Le traitement nutritionnel des épisodes d'hypoglycémie dans le diabète de type 1

Patients with type 1 diabetes mellitus (TIDM) seem to be overtreating their hypoglycemia, compared to the Canadian Clinical practice guidelines in diabetes. Objectives: 1) Describe T1DM patients’ habits of nutritional treatment of hypoglycaemia and observe the impact on cardio-metabolic risk profile, and 2) explore glycemic excursions following hypoglycemic treatment performed according to guidelines. Methods (secondary analysis): Objective 1: 121 T1DM patients completed a 48-hour food and glycemic record. Metabolic variables were measured and a self-administered questionnaire on fear of hypoglycemia was completed. Objective 2: 57 T1DM patients completed the control arm from our artificial pancreas program (standardized hypoglycemia treatment). Glycemia levels at a 5-minute interval were available. Results: Project 1: The daily mean of hypoglycemia events was 1.45/day, and 73% of patients over-treated with a mean carbohydrate daily intake of 32 ± 24 g. Overtreatment was associated with a younger age and a higher fear of hypoglycemia, but not with a worsen cardio-metabolic risk profile. Project 2: Rising glycemia to ≥ 4,0 mmol/L within 15 minutes using a treatment of 15g of carbohydrates was efficient in only 20% of the cases. Mean time of hypoglycemia recuperation was 24 ± 12 minutes. Basal insulin, elapsed time since the last meal, and physical activity seemed to have the most impact on hypoglycemia treatment efficiency. Conclusion: Education on treatment of hypoglycemia needs to be increased. Further studies validating recommendations are warranted.

Keyphrases: hypoglycemia, type 1 diabetes, treatment
Modulation de l’homéostasie lipidique intestinale suite à une intervention en médecine traditionnelle Cri chez un modèle animal d’obésité et de pré-diabète

Introduction : Obesity and type 2 diabetes as well as their complications are present at higher rates in aboriginal communities than in the general population. One reason for this situation is the cultural resistance of Aboriginals to contemporary health care due to the cultural inadequacy of modern treatments for obesity and type 2 diabetes. In order to address this issue, the Canadian Institutes of Health Research Team in Aboriginal Antidiabetic Medicines (CIHR-TAAM) looked at 17 plants of the traditional pharmacopeia of the Cree Nations of Eastern James Bay in Canada, among which was balsam poplar, Populus balsamifera. Objective : The purpose of the present study is to examine the effect of P. balsamifera on the intestinal content of various lipid species and key protein components involved in lipid metabolism. Material and methods: Mice were exposed for eight weeks to a standard diet (CHOW), a high fat diet (HFD) or HFD containing 125 mg/kg of Populus balsamifera. Samples of jejunum were collected, homogenized and their lipid content extracted. Results: The results showed that jejunal total cholesterol, phospholipids and triglycerides were not affected by the absence or the presence of P. balsamifera extract. In contrast, the jejunal content in fatty acids was significantly increased by the DIO treatment as compared to Chow controls. P. balsamifera treatment significantly reduced intestinal fatty acid content back toward values observed in Chow controls. A non-significant change was noted in the expression of the FAS protein, CPT-1, ACC-P. Conclusion : This further strengthens the potential of balsam poplar extracts to be useful in the context of the high prevalence of obesity in Indigenous populations.

Keyphrases: Anti-obesity, Antidiabetic, C57BL/6 mice, Balsam poplar, Fatty acid absorption, Aboriginal traditional medicine
Utilisation de cartes conceptuelles par des formatrices en nutrition à la petite enfance

Introduction : Extenso, the nutrition reference center of the Université de Montréal, created the Croqu’Plaisir trainings for the childcare workforce of the province of Quebec. Those training were administered by selected registered-dietitians. Considering the volume of knowledge that had to be assimilated by the dietitians, the use of a thought organising tool became relevant. This study’s main objective was to describe the use of concept maps by Quebec dietitian trainers in early childhood. Method : The dietitians received a training on the use of concept maps that enabled them to create one on a subject of their choosing with the software program CmapTools. Afterwards, their perceptions were collected during an individual and structured interview. Results : 8 dietitians with 2 to 15 years of experience and having given 0 to 32 Croqu’Plaisir trainings participated to the study. The participants were independent enough to basically use CmapTools, but they had some difficulties while creating their concept map.  Conclusion : Participant’s comments revealed barriers, such as time, change resistance and organisational barriers. For the place of concept maps to develop in nutrition, it needs a proper context to encourage its use, as much on a personal or organisational level than in an academic or professional environment.

Keyphrases: nutrition, innovation, Concept map, nutrition, childcare, early childhood, innovation
Impact d’une supplémentation protéino-énergétique sur les performances physiques en réadaptation chez la personne âgée traumatisée crânienne : un projet pilote

Elderly often lose functional capacities while being hospitalized. Traumatic brain injury (TBI) is a medical condition associated with high inflammatory stress and hypercatabolism that adds to their fragility. Moreover, studies tend to show that actual protein intake recommendations (0.8 g/kg, Dietary Reference Intake (DRI)) are not preventing sarcopenia to occur. The objective of this study was to determine the efficacy of a protein-energy supplementation in physical performance in older individuals with TBI. Twenty-four older patients with TBI going through rehabilitation (age range 65- 94 y, 14 men) agreed to participate to this doubled-blind randomized study in Montreal. The experimental intervention consisted of ingesting a protein-energy supplement (230 kcal, 15 g protein, 25 g carbohydrate) while the control group received a placebo supplement. Both groups ingested the supplement (or placebo) immediately following their regular physical therapy intervention (45-60 min, 4-5 times per week). Significant improvement on the Time Up and Go (TUG) test was found in the protein-energy supplement group.  To our knowledge, this is the first clinical trial in Quebec evaluating the effect of protein supplementation in older individuals going through rehabilitation immediately after a TBI. Even though our results showed modest improvement in physical performance, nutritional supplementation was easy to introduce into the clinical setting. Therefore, any intervention that aims to improve nutritional status and protein intake could be beneficial to elderly traumatic brain injured persons and optimize functional mobility.

Keyphrases: nutrition, performance physique, nutritional supplementation, elderly, rehabilitation, walking capacity, traumatic brain injury
Identification de protéines impliquées dans la localisation des ARNm au niveau de l'appareil mitotique

The localization of mRNA to microtubules and centrosomes has led to the suggestion that the centrosome and mitotic spindle are in fact ribonucleoprotein complexes. However, the mechanism of mRNA localization to those structures and its functional contribution in mitosis regulation remain poorly characterized. The objectives here were to identify RNA Binding Proteins (RBPs) involved in mitotic mRNA localization in Drosophila and to assess the conservation of the function of these RBPs in human cells. RNAi-mediated RBP depletion in Drosophila mutants leads to distinct phenotypes of abnormal localization of the centrosomal cen mRNA, and to different mitotic defects depending on the targeted RBP, suggesting different functions for these RBPs. Moreover, in young embryos, Bru-2 and Mask RBPs seem to be functionally important for mitosis through cen mRNA regulation, giving insight into a possible RBP mitotic function in regulating a centrosomal mRNA. In addition, data from an immunofluorescence screen on HeLa cells at metaphase suggests that HNRNPUL1 colocalizes to the spindle and centrosomes. HNRNPUL1 may be involved in the regulation of CDR2 mRNA (cen ortholog) because depletion of the HNRNPUL1 ortholog in flies, CG30122, disrupted cen mRNA localization.

Keyphrases: cen, Drosophila melanogaster, mRNA localization, cen, Centrosomal mRNA, mitotic RBPs
Rôle de l’urée dans la dysfonction de la cellule bêta-pancréatique au cours de l’insuffisance rénale chronique

Chronic kidney disease (CKD) is defined as a glomerular filtration defect and is associated with many disorders. Impaired glucose homeostasis is one of them. Glucose homeostasis is maintained in part by insulin, which is the hormone secreted by the pancreatic beta cells from the islets of Langerhans in response to glucose. The preservation of beta cell function is essential to maintain glucose homeostasis. It has been demonstrated that insulin secretion is altered during CKD; however, the underlying mechanisms remain unknown. In CKD, chronic accumulation of uremic toxins could contribute to beta cell dysfunction. Urea is a major uremic toxin and its toxicity has been recently reported in many tissues. The purpose of this master project was to ascertain the role of urea in pancreatic beta cell dysfunction during CKD. We have demonstrated that exposure of mouse islets to pathological concentrations of urea leads to diminution of insulin secretion via an increase in oxidative stress and O-glycosylation. This defect is due to disturbed intracellular glucose metabolism. Among others, we have observed a reduction in glycolysis associated with a decrease in the activity of phosphofructokinase-1. These results demonstrate a direct toxic effect of urea on insulin secretion and contribute to a better understanding of mechanisms of pancreatic beta cell dysfunction during CKD.

Keyphrases: Chronic kidney disease, Glucose homeostasis, Pancreatic beta cell, Insulin, Glucose metabolism