NCube/papyrus huggingface dataset:
Contribution à la validation d’un outil informatique pour l’évaluation des surfaces corporelles brûlées

PURPOSE Total body surface area burned assessment is currently based on the transpositon of burns seen on paper charts representing standard models. The purpose of this project is to contribute to the validation of a tool for TBSA assessment. A handheld 3D scanner and anthropometrical measurements have been proposed. METHODS Four commercial mannequins with different body shapes were selected. Each model was scanned 10 times with a handhed, white light scanner and once with a gold standard scanner. The images were transferred to a modelling software allowing to assess the total body surface. Total body surfaces were calculated and compared. Secondly, 14 volunteers estimated the total burned surface using paper charts and drawing on 3D virtual models. RESULTS Values of the total body surface obtained with the handheld scanner are 0.812; 1.581; 1.711 and 1.916 m2 for the child, female I, female II and male mannequins. The results of the gold standard scanner are 0.815 ; 1.588 ; 1.716 and 1.918 m2. Burn extent ratios correspond to 23.33 ; 22.67 ; 32.63 and 26.07 % for the same mannequins. Estimated burned surfaces obtained with paper diagrams are the following : 29.9 ; 32.5 ; 40.4 and 35.7 %. Results obtained with the software are 23.5 ; 22.6 ; 32.1 and 25.1 %. CONCLUSION The handheld scanner is a precise and accurate tool for the assessment of the total surface. Use of anthropometric data for the calculation of the body burned surface is a more accurate tool and less variable than the conventional paper charts.

Keyphrases: Validation outil, Anthropometric measurements, Handheld 3D scanner, Total burned surface, Total body surface, Tool validation
Mécanismes cérébraux sous-tendant le binding en mémoire chez les personnes autistes

Individuals with autism spectrum disorder (ASD) demonstrate alteration of various cognitive functions, including working memory (WM). WM is defined as a limited-capacity system devoted to temporary storage and short-term handling of information. Within the different components of working memory, the ability to combine various information, referred to as binding, is crucial for episodic memory and learning processes. There are two types of binding: the automatic form, for which associations between pieces of information are made unconsciously (information being presented already bound together), and the controlled form, for which these associations require a conscious effort. These two forms of binding are based on separate neural substrates: automatic binding is based on the functioning of the hippocampus, while controlled binding is based on the communication between the hippocampus and prefrontal cortex. Some studies have suggested preserved automatic binding capabilities in autistic individuals, while other studies have shown difficulties in intentional organization of information, suggesting that controlled binding is also affected. The objective of the present study was to investigate the cognitive and brain mechanisms underlying both automatic and controlled forms of binding in individuals with ASD, in comparison with neurotypical (NT). Seventeen ASD and sixteen NT participants performed a working memory experiment in an MRI scanner. The tasks consisted in the presentation of words and ellipses (indicating a spatial position) of different colors, to memorize. In the automatic condition, words were presented directly inside ellipses. In the controlled condition, words were presented in the center of the screen, separated from ellipses. Participants had to associate words and ellipses of the same color. The results suggest that ASD individuals have preserved controlled and automatic binding capabilities. At the brain level, for the controlled binding, ASD participants presented comparable levels of activation to those of NT participants in various brain regions, but showed activations in additional regions, including the hippocampus and frontal cortex. Differences in brain activation found between groups suggest a difference in activity modulation, associated with the level of difficulty of the task and the executive load.

Keyphrases: Binding, Autism spectrum disorder, Working memory, fMRI
Environmental tobacco smoke exposure and risk for Crohn’s disease in children

positively associated with the disease. In children, there is interest in understanding whether passive exposure to environmental tobacco smoke (ETS) could confer similar risks. However, current studies have provided inconsistent results. The major objective of our study was thus to comprehensively ascertain whether ETS exposure during pregnancy and childhood was associated with the risk of developing CD in children. Methods: We carried out a case-control study based on Caucasian children diagnosed with CD (n=132) prior to age 20 at a pediatric gastroenterology clinic in Montreal (CHU-Sainte-Justine). Controls (n=131) were children having visited the orthopedic or gastroenterology clinics, who did not have a past/current history of IBD, were diagnosed within ± 3 months of case diagnosis and resided in the same geographic area (based on the first 3 digits of the postal code) as the cases. Information on ETS during and post-pregnancy and other potential risk factors for CD was acquired using a structured questionnaire. Associations between ETS and CD were analyzed using unconditional logistic regression. Odds ratios (OR) and corresponding 95% confidence intervals (95% CI) were estimated. Results: The mean age (±SD) of the cases 12.7 (±4.0) was slightly higher than the controls (11.4±4.7) (p-value=0.01). Gender was equally distributed between the groups. Family history was positively associated with CD (p-value=0.01). Multivariate logistic regression did not reveal any association with CD when mothers who smoked during pregnancy were compared to those who neither smoked during pregnancy nor post-pregnancy (OR=1.55, 95% CI=0.84-2.86). Paternal smoking during pregnancy was also not associated with risk of CD (OR=0.95, 95% CI=0.33-2.75). Exposure of ETS to the child during childhood via maternal smoking appeared to increase risk (OR=3.54, 95% CI=0.71-17.57) but the risks were not iv significant. Paternal smoking during childhood also appeared to enhance risk of CD, in particular when the parents also smoked during pregnancy (OR=2.52, 95% CI=1.11-5.72). Conclusions: ETS exposure per se during pregnancy does not seem to confer risks of CD in children. However, ETS exposure during childhood either from maternal or paternal smoking appears to contribute to risk of CD in the child. Further studies are required to validate these associations.

Keyphrases: Crohn’s disease, tobacco smoking, children, environmental risk factors
The relevance of preoperative ultrasound cervical mapping in thyroid cancer

Over the last 30 years, the incidence rate of thyroid cancer has drastically increased in both genders all over the world. However, due to a more dramatic pattern in females, it is estimated that by 2019 it will become the third most prevalent cancer in women of all ages. Overall, there are no clear reasons behind the worldwide increase in thyroid cancer incidence and it is hypothesized that this upsurge has a multifactorial etiology. Despite the fact that recent advances in imaging modalities such as ultrasound can lead to thyroid cancer overdiagnosis by improving the detection rate for subclinical disease, there is strong evidence indicating a true increase in the occurrence of thyroid cancer as well.   Preoperative ultrasound cervical mapping, an important tool in the diagnostic algorithm of thyroid cancer, helps to identify metastatic spread in cervical lymph nodes and guides the surgeon for subsequent surgical dissection. Compartment oriented neck dissection directed by ultrasound mapping decreases locoregional tumor recurrence and lowers the risk of postsurgical complications. We conducted a qualitative and quantitative analysis of ultrasound mapping to evaluate this test’s diagnostic reliability. Our results demonstrated that the positive predictive value of this diagnostic modality was sufficiently high and that there was a strong quantitative association between ultrasound mapping and histopathology results. We therefore recommend that ultrasound mapping be used to target patients with a higher risk of persistent or recurrent thyroid cancer.

Keyphrases: Thyroid cancer, Ultrasound cervical mapping, Positive predictive value, Qualitative and quantitative analysis
Étude de l'effet de l'antibiothérapie et de l'anticoagulothérapie sur le développement de la sclérodermie expérimentale chez la souris

Systemic sclerosis (SSc) is an incurable and chronic autoimmune disease characterized by a complex and heterogeneous clinical presentation. Our laboratory has developed a mouse model of lung and skin fibrosis that shares many features with human SSc, and is induced by repeated immunization with dendritic cells loaded with peptides of topoisomerase I. First, the long term persistence (objective 1) and progressive nature (objective 2) of this experimental disease model was characterized. A dysregulated coagulation cascade is implicated in the development of fibrosis in SSc. Thrombin, a key mediator of coagulation, appears to contribute to this process. Next, the efficacy of dabigatran, a thrombin inhibitor, to ameliorate lung and skin fibrosis was studied in this model (objective 3). Intestinal microbiota appears to play a key role in several diseases including autoimmune diseases. Finally, the effect of manipulating gut microbiota by administration of streptomycin on disease pathogenesis was evaluated in this model (objective 4). Immunized mice developed persistent fibrosis that was preceded by an inflammatory phase. Dabigatran aggravated pulmonary and skin fibrosis when administered during the inflammatory period and was not protective when given during the fibrotic phase. Manipulation of intestinal microbiota by streptomycin aggravated lung fibrosis when it was given early in life and exacerbated skin disease when administered in adulthood. Our model of experimental SSc with progressive and persistent disease represents an important tool to evaluate different therapeutic approaches for SSc. Furthermore, our results caution against the use of dabigatran as a therapeutic option to treat fibrosis in patients with SSc. Exposure to streptomycin for certain periods of life differentially affects the development and clinical manifestations of experimental SSc.

Keyphrases: inflammation, dabigatran, systemic sclerosis, murine model, topoisomerase I, dendritic cells, fibrosis, thrombin, microbiota, streptomycin
Identification de biomarqueurs génétiques pour la détection précoce des séquelles métaboliques chez les survivants de la leucémie pédiatrique

Background. While cure rates for childhood acute lymphoblastic leukemia (cALL) now exceed 80%, over 60% of survivors will face treatment-related long-term sequelae, including cardiometabolic complications such as obesity, insulin resistance, dyslipidemia and hypertension. Although genetic susceptibility contributes to the development of these problems, there are very few studies that have so far addressed this issue in a cALL survivorship context. In this study, we aimed at evaluating the associations between common and rare genetic variants and long-term cardiometabolic complications in survivors of cALL. Method. We examined the cardiometabolic profile and performed whole-exome sequencing in 209 cALL survivors from the PETALE cohort. Variants associated with cardiometabolic outcomes were identified using PLINK (common) or SKAT (common and rare) and a logistic regression was used to evaluate their impact in multivariate models. Results. Our results showed that rare and common variants in the BAD and FCRL3 genes were associated (p<0.05) with an extreme cardiometabolic phenotype (3 or more cardiometabolic risk factors). Common variants in OGFOD3 and APOB as well as rare and common BAD variants were significantly (p<0.05) associated with dyslipidemia. Common BAD and SERPINA6 variants were associated (p<0.05) with obesity and insulin resistance, respectively. Conclusion. In summary, we identified genetic susceptibility loci as contributing factors to the development of late treatment-related cardiometabolic complications in cALL survivors. These biomarkers could be used as early detection strategies to identify susceptible individuals and implement appropriate measures and follow-up to prevent the development of risk factors in this high-risk population.

Keyphrases: Hypertension, Acute lymphoblastic leukemia, Cancer survivors, Genetics, Cardiometabolic, Association study, Obesity, Dyslipidemia, Insulin resistance, Hypertension, Extreme phenotype
Les nouveau-nés : des personnes pas comme les autres

Neonates are different. Contrary to older patients, professional guidelines specifically addressing the resuscitation or the non-resuscitation of neonates have been established and are being used by healthcare institutions worldwide. These guidelines are mostly built around gestational age criteria. Unfortunately, gestational age is imprecise and is not a good predictor of survival or long-term prognosis. This may not be the typical perspective when dealing with older patients. Not only are neonates resuscitated differently, their modes of death are also not the same. Unlike older patients who mostly die while receiving acute care, many neonates die following a decision to withdraw or withhold care, and the majority of these die in a condition of relative physiologic stability because of concerns for their future quality of life. When investigated or surveyed, even though a majority of health care providers believe resuscitating a fragile neonate is in the baby’s best interest, a similar majority is also willing to redefine this best interest according to family wishes and to accept comfort care. This is not the case with older patients. This devaluation is explained by the fact that neonates are perceived as being morally different. The reasons explaining this difference in moral status are many but include the historical and socio-cultural context, the absence of long standing pre-existing social relationships, an attachment to neonates that is perceived as being inferior, and the influence of professional and personal biases, values, and experiences that are unfavorable to neonates. We believe this difference in conferred moral status needs to be recognized and acknowledged, and should further professional and social reflections about its desirability and consequences.

Keyphrases: Neonatology, Prematurity, Palliative care, Moral status, Death, Clinical ethics, Devaluation, Best interest
Évaluation de l'activité anti-leucémique des cellules T traitées par photodéplétion au TH9402

Allogeneic hematopoietic stem cell transplantation (HSCT) represents the only efficient therapeutic avenue in a number of patients with chemotherapy resistant or relapsed leukemia. This treatment aims at enabling the engraftment of donor stem cells into an immunocompromised patient. However, it isn’t always possible to find a fully HLA compatible donor. Over the last decade, a new form of allograft has been developed for those remaining patients: haploidentical stem cell transplantation. This treatment enables transplantation to be performed with donor cells that demonstrate up to 50% HLA mismatch with those of the patient. Thus, this approach enables patients without a suitably matched donor to benefit from an HSCT. The potential advantage of using mismatched cells is the increase of the graft-versus-leukemia effect (GVL). The latter is induced by alloreactive cells. Nonetheless, the disparity of HLA can also drive alloreactive cells to cause graft-versus-host disease, which is one of the major causes of death following allogeneic HSCT. In our laboratory, we have developed a T cell photodepletion (PD) approach based on the use of a photosensitizer activated with visible light. It consists of 4,5-dibromorhodamine-123 (TH9402), a photosensitive molecule that selectively eliminates alloreactive (GVHD causing) cells. Following treatment, the sample is enriched in naive and regulatory T cells (Treg). We previously demonstrated that PD preserves CD4+ T cells displaying a regulatory effect, thus potentially controlling the severity of GVHD. On the other hand, preliminary results showed that PD can preserve cells with the functional capacity to react against a viral peptide pool (Epstein-Barr, cytomegalovirus, and influenza). This prompted us to assess the anti-leukemia reactivity of these cells. Therefore, we first studied the ability of these cells to become activated après PD. We also tested the capacity of those restimulated cells to eliminate a monocytic leukemia cell line (THP-1). We determined that it is possible to generate after PD cells that have the capacity to become activated when cocultured with antigens from a given donor. In addition, we demonstrated that these cells have the potential to recognize WT1 antigen viii peptides and to develop a cytotoxic response. Thus, this work demonstrated the anti-GVHD/GVL plasticity of T cells photodepleted using TH9402.

Keyphrases: Lymphocytes T CD4+, Lymphocyte T CD8+, WT1, Leukemia, allogeneic stem cell transplantation (alloSCT), graft-versus-host disease (GVHD), graft versus leukemia (GVL), CD4+ T lymphocytes, CD8+ T lymphocytes, WT1
Devenir obstétrical des patientes atteintes de cardiopathies congénitales

Background: The aim of the study was to describe cardiac maternal outcomes as long as perinatal and obstetrical morbidities of pregnant women with congenital heart disease. Secondary outcome was to validate predictive cardiovascular events risk scores (ZAHARA 1 score and modified World Health Organization classification) in our population.  Methods: We conducted a case series study including 408 pregnancies of 283 women with congenital heart disease, who delivered at Sainte-Justine Hospital in Montreal (Canada) from 1992 to 2013. Data were collected from chart review. Perinatal issues were described. Comparison of cardiac risk scores was analysed using Chi square test.  Results: Our low-risk cohort was composed of 405 pregnancies (99.3%) with New York Heart Association functional classes I or II. Obstetrical complications rates among women with congenital heart disease was 49.0% (200 pregnancies), such as intensive care admission for close monitoring (16.9%), gestational diabetes (12.7%) and post-partum haemorrhage (11.3%) which are higher than the general obstetrical population. Furthermore, offspring complications occurred in 148 pregnancies (36.3%); the rates of small for gestational age (16.6%) and preterm delivery (14.9%) were significantly higher than general population. Only 4.7% pregnancies (19 pregnancies) were complicated by a cardiac event. The modified World Health Organization classification gave the best overview of cardiac prognostic during the pregnancy, except for the highest risk class (IV).  Conclusions: Compared to Canadian obstetrical population, pregnant women with congenital heart disease had higher rates of assisted vaginal delivery, post-partum haemorrhage, preterm delivery and birth weight lower than the 10th percentile. The modified World Health Organization classification risk seemed better to predict cardiovascular events, while ZAHARA 1 score is complementary in the evaluation of prognosis of pregnancy.

Keyphrases: Congenital heart disease, Pregnancy, Perinatal and obstetrical outcomes
Statut vitaminique K et fonctions cérébrales chez le rat : études comportementales et mécanistiques

There is growing evidence that vitamin K (VK) plays a role in cognition. Some in vitro studies have shown how VK affects different molecular pathways in brain cells, but few in vivo studies have been conducted. Recently, a study from Tamadon- Nejad showed that a treatment of 14mg/kg/d of warfarine, a VK antagonist, given simultaneously with subcutaneous injections of 85mg/kg/d lead to a significant decrease in MK-4 concentration in brain, resulting in a significant decrease of VK status in brain, and perturbation in cognition, exploratory behaviour and locomotion [1]. In the present study, we modified the treatment used in Tamadon-Nejad and increased the phylloquinone doses to 120mg/kg/d which maintained the significant decrease in MK-4 concentration in brain, but lead to an overcompensation of phylloquinone that resulted in an increase of VK status in brain. This status was associated with an intact recognition memory and correlated with an improvement in spatial memory of WVK rats. The treatment was also associated with a significant increase in anxiety and recovery of exploratory behavior and locomotion compared to rats in the Tamadon-Nejad study [1]. In WVK rat hippocampi, cognition improvement and increased VK status were not associated with significant variation in VK dependant proteins (VKDP) Gas6 and Protein S activation, but were associated with an increase in the MAPK activation pathway, an inhibition of apoptosis and, an increased presence of microglia. In summary, this study confirms the modulatory role of VK in brain in cognition and cell survival.

Keyphrases: Phylloquinone, MK-4, Cognition, Rat, Gas6, MAPK, Caspase, Vitamin K, Warfarin, Brain, Hippocampus, Protein S, Microglia
Manger : ma réalité, mon idéal, mes défis, mes propositions de solutions : un portrait des jeunes adultes du projet Hochelaga'Table

CONTEXT: Over the past 10 years, food insecurity has increased in Quebec, jeopardizing both the nutritional intakes and health potential of its citizens. An initiative launched in Hochelaga-Maisonneuve aimed at raising young adult’s awareness of the impact of their food choices on the local supply by harnessing the participant’s creativity and commitment. OBJECTIVES: To explore young adult’s eating patterns and habits, their perception of “eating well”, their challenges, and their visions of solutions to food insecurity in the neighbourhood. METHODOLOGY: During summer and fall of 2014, 46 adults aged 18 to 30 years old took part in a series of three creative and empowering workshops designed to reflect on the solutions they value to enhance the food security in Hochelaga-Maisonneuve, Montreal. Using a combination of innovative technics such as dot democracy and citizen participation oriented focus groups, the non-for-profit organisation Alternatives, dedicated to reducing social inequalities in the Province of Quebec, collected qualitative data on their food consumption, perception of “eating well”, barriers to overcome, and proposed solutions. Data analysis followed both deductive and inductive methods. RESULTS: The qualitative data collected highlights the resemblance between the participant’s food patterns and those observed in food insecure populations. Processed and ultra-processed foods, as defined by NOVA, appeared the most frequently in their diet. Quality of food, pleasure and commensality are central to the participant’s definition of “eating well”. Financial and individual challenges (lack of motivation, time, knowledge) are identified as barriers to “eating well”. The solutions they envision to alleviate food insecurity locally highlight notions of solidarity, variety of foods from different origins, and dignity. CONCLUSION: Tapping into the rich experiential knowledge of young adults in Hochelaga- Maisonneuve, solutions to food insecurity, tailored to their specific needs, emerged.

Keyphrases: Faim, Hochelaga-Maisonneuve, Perception, Solutions, Food insecurity, Hunger, young adults, Hochelaga-Maisonneuve, Underprivileged, Qualitative, Nutritional intakes, Food habits, Perception, Healthy eating, Barriers, Solutions, Quebec