NCube/papyrus huggingface dataset:
Évaluation de la plateforme de formation en ligne MOTIV@CŒUR sur les interventions motivationnelles brèves auprès d’infirmières en soins aigus cardiovasculaires

Nursing interventions that target motivation to adopt healthy behaviors, such as brief motivational interviewing (MI), can help reduce cardiovascular risk factors. While face-to-face MI training lacks accessibility, e-learning use for MI training is promising because of the flexibility it offers.  The objective was to assess the feasibility, acceptability and preliminary effect of a web-based e-learning platform for brief MI (MOTIV@CŒUR) on cardiovascular nurses’ clinical use  and perceived skill in brief MI. A single group pre-post pilot study was conducted to evaluate MOTIV@CŒUR with nurses working in a coronary care unit. The web-based e-learning platform consists of two sessions with a total duration of 50 minutes based on videos of nurse-patient interactions. In each session, a theoretical introduction of brief MI is followed by role playing based on real life clinical situations in which a nurse practitioner evaluates patients’ motivation to change, and intervenes according to the principles of brief MI. The clinical situations target smoking, medication adherence, physical activity and diet. Nurses were asked to complete both training sessions online within 20 days. Data on feasibility, acceptability and preliminary effects (perceived skills in brief MI and self-reported clinical use of conviction and confidence interventions) were collected at 30 days (± 5 days) following the first session.  We enrolled 27 women and 4 men (mean age 37 ± 9) in March 2016. Twenty-four out of 31 participants (77%) completed both sessions in less than 20 days, and at one month, 28 had completed at least one session. The training was found highly acceptable, with information quality, perceived ease of use, and system quality scoring the highest. The score of self-reported clinical use of confidence interventions was higher after the two sessions than before the sessions (P = .032). While all scores increased from baseline, other results were not statistically significant.  In conclusion, the implementation of a web-based e-learning platform for brief MI is both feasible and acceptable among cardiovascular care nurses. Moreover, it can have a positive effect on self-reported clinical use of confidence interventions towards health behaviour change.

Keyphrases: E-learning, Web-based learning, Nurses, Motivational interviewing, Secondary prevention, Cardiovascular risk factors
Favoriser le développement de compétences en contexte pédiatrique au 1er cycle de la formation infirmière

Pediatric patients in critical care have many specific needs highlighting the complexity of the nurse’s role in accompanying these children and their families. Clinical evaluation, although central to the work of the nurse with this patient group, is only briefly discussed in the first degree nursing program at University of Montreal. The writings suggest the use of Active learning strategy based on social constructivism in the teaching of pediatric critical care. This internship report is a reflective look on the development and testing of a peer assisted learning (PAL) activity, contributing to the development of pediatric critical care competencies among students in the Bachelor of Nursing Science. Lasnier’s competency education model (2014) was the framework for the planning of this project. The benefits of this intervention strategy enabled the implantation of the workshop in the SOI 2609 unit – situation critique de santé and gave more prominence to pediatrics content in the undergraduate nursing program.

Keyphrases: Formation initiale, Nursing students, Undergraduate teaching, Competency-based approach, Peer assisted learning, Pediatric critical care
La collaboration intra professionnelle lors de l'intégration des candidates à l'exercice de la profession infirmière : expériences d'infirmières

When integrating newly graduated nurses, titled candidates for the profession of nursing (CPN), beginners frequently rely on the experience of their colleagues to guide them in providing care (Ballem and McIntosh, 2014 ; Benner, 1982; Fink, Krugman, Casey, and Goode, 2008).  The establishment of such professional collaboration allows knowledge transfer (D’Amour, 2002 ; Lavoie-Tremblay, Wright, Desforges, and Drevniok, 2008) and increases the quality of care (Pfaff, Baxter, and Ploeg, 2013). However, the establishment of such collaboration may be difficult to initiate in some wards (Thrysoe, Hounsgaard, Dohn, and Wagner, 2012). The available literature focusing mainly on the experience that has novice nurses, nurses' experience of this phenomenon is still unknown. This exploratory qualitative study inspired by a grounded theory approach was aimed to explore nurses' experience of intra professional collaboration during the integration of CPN in medicine and surgery hospital wards. Semi-structured interviews with eight nurses were analyzed using grounded theory approach.  The results of this research led to the mapping of the nurses' experiences of collaboration during CPN integration. This mapping emphasizes the importance of collaboration during the various periods of the CPN integration and the complementary of nursing roles in the health care team, including assistant head nurse, preceptor and staff nurse. The result of this collaboration is the autonomy in task for the CPN and entering the team. Next to this mapping, recommendations were made for research, training, management and practice.

Keyphrases: Intra professional collaboration, Integration, Nurses, Candidates for the profession of nursing, Hospital, Qualitative study
Effets des variations dans l’implantation d’un programme sur le risque cardiométabolique dans six CSSS de Montréal sur les résultats chez les patients

In 2011, the Agence de la santé et des services sociaux de Montréal (ASSSM), in partnership with the Health and social service centres (CSSS) of the region, coordinated implementation of an integrated and interdisciplinary program for prevention and management of cardiometabolic risk. The program, based on the Chronic Care Model and designed for patients with diabetes and hypertension, consists of a two-year sequence of individual follow-ups with a nurse and a nutritionist, group classes and physical activity sessions. The objective of this master’s thesis is to assess the impact of variations in implementation of some aspects of the program in the six CSSS participating in this study on patients’ health outcomes. Five aspects of implementation have been selected: resources, conformity to the clinical process proposed in the regional program, maturity of the program, internal coordination within the CSSS team and external coordination with primary care physicians. Analysis of difference in differences, including propensity scores that make the groups comparable, have been calculated to assess the impact of those aspects on four health outcomes: glycated hemoglobin, reaching the blood pressure level target and reaching two targets of lifestyle habits regarding the distribution of dietary carbohydrates and the practice of physical activity. The results show that the program yielded expected effects in regard to patients’ selected health outcomes, regardless of implementation variations among the studied CSSS. Indeed, few analysis revealed a significant impact of the implementation variables on those outcomes. Results suggest that beneficial effects of this program depend more on services provided to patients than on specific organisational aspects of its implementation.

Keyphrases: Chronic Care Model, Implementation, Chronic Diseases, Diabetes, Hypertension, Primary care
Les interactions vestibulo-corticales qui sous-tendent le contrôle de la posture chez les sujets sains

The vestibular system and the motor cortex are involved in the control of posture but the nature of their interactions is poorly documented. To characterize vestibulo-cortical interactions underlying the control of balance during quiet standing, the electromyographic activity (EMG) of the soleus (SOL), tibialis anterior (TA) and peroneus longus (PERL) of the right leg was recorded in 14 healthy subjects. Bipolar galvanic vestibular stimulation (GVS) was applied with the cathode behind the right or left ear at various inter-stimulus intervals (ISI) before and after transcranial magnetic stimulation eliciting motor evoked potentials (MEP) in the muscles recorded. When the cathode was on the right, MEP in the SOL were inhibited at 40 and 130 ms while MEP were facilitated in TA at 110 ms. When the cathode was on the left, MEP were facilitated in the SOL at 50 ms, in TA at -10 ms and in PERL at 0 ms. The localization of these interactions along the neural axis was estimated according to the ISI and by comparing the effect of the GVS on the MEP to its effect on the background EMG and on the SOL H-reflex. Based on these analyses, the observed modulations of MEP observed could have occurred at spinal or supraspinal level. These results suggest that the corticospinal output may be modulated by the vestibular system at different levels of the neural axis.

Keyphrases: Posture, Balance, Posture, Motor cortex, Corticospinal tract, Vestibular system, Vestibulospinal tract
Étude des voies de signalisation activées par la prostaglandine F2α dans les cellules de cancer colorectal

Colorectal cancer is the third most common form of cancer in Canada. Despite recent developments, no curative treatment is available for patients diagnosed at an advanced stage of the disease. Several evidences support an important role of prostaglandins in this disease. Indeed, overexpression of EP-like and FP receptors is noticed. These and intracellular signaling molecules that are activated following receptor stimulation, represent new targets for treating cancer. We and others have demonstrated that monomeric G proteins are important molecular switches coordinating intracellular signaling cascades initiated by receptors in normal cells but that disruption thereof is associated with cancer. The main objective of this research project aims to identify the signaling pathways by which the FP receptor contributes to the invasive capacity of tumor cells of colorectal origin. Our hypothesis is that the proteins ARF6, one of the 6 ARF isoforms, and RhoA protein, act to coordinate the activation of signaling pathways associated with cell migration and invasion. Our results show that stimulation of HEK293 cells that stably express the FP receptor (HA-FP) and SW480 cells, a lineage of invasive colorectal cancer that endogenously express FP receptor, by PGF2α, increased the level of activation of ARF6, but also that of RhoA. In addition, other mediators and intermediates associated with cytoskeleton reorganization such as cofilin and the myosin light chain (MLC) were found highly phosphorylated following stimulation by prostaglandin PGF2α. These observations are associated with an increase of stress fibers in cells. Finally, we have examinated whether inhibition of ARF6 and RhoA, affected the ability of PGF2α to activate these effectors and some biological effects. Thus, our results will contribute to identify new potential therapeutic targets for the treatment of colorectal cancer.

Keyphrases: RhoA, ARF6, MLC, Remodeling of the actin cytoskeleton, G protein coupled receptor, FP receptor, RhoA, ARF6, MLC, Cofilin
Régulation de la prolifération des cellules musculaires lisses vasculaires par l’activation in vivo du récepteur natriurétique de type C

Vascular remodeling due to hyper-proliferation of vascular smooth muscle cells (VSMCs) from spontaneously hypertensive rats (SHR) is associated with hypertension. We previously showed that in vivo treatment of SHR with natriuretic peptide receptor type C (NPR-C) specific agonist C-ANP4-23 attenuates the hyper-proliferation of VSMC. We undertook the present study to investigate if the anti-proliferative effect of C-ANP4-23 treatment is mediated through the inhibition of the over-expression of cell cycle proteins and explore the signaling molecules contributing to this effect. For this study, two-week-old SHR and age-matched Wistar Kyoto rats (WKY) rats were injected intraperitoneally with C-ANP4-23 twice per week for 6 weeks and sacrificed at the end of the 9th week. Blood pressure measurements were done by tail cuff method, proliferation of VSMC was determined by thymidine incorporation and MTT assay, and Western blotting was used to measure the levels of proteins. VSMC from SHR exhibited enhanced proliferation as compared to WKY and C-ANP4-23 treatment attenuated the hyper-proliferation to control levels. In addition the overexpression of cyclin D1, cyclin A, cyclin E, cyclin dependent kinase 2 and 4 (cdk2, cdk4), phosphorylated retinoblastoma protein (pRb) and Giα proteins exhibited by VSMC from SHR was attenuated to control levels. Furthermore, the enhanced phosphorylation of ERK1/2, AKT, EGF-R, PDGF-R, IGF-R and c-Src was significantly decreased by C-ANP4-23 treatment. Moreover, the enhanced levels of superoxide anion (O2−), NADPH oxydase activity, and the enhanced expression of NOX4 and P47phox in SHRs were attenuated by C-ANP4–23. These results indicate that in vivo NPR-C activation attenuates the over-expression of cell cycle proteins through the inhibition of the enhanced oxidative stress, c-Src and EGF-R, PDGF-R, IGF-R activation, MAPK signaling and over-expression of Giα proteins resulting in the inhibition of the hyper-proliferation of VSMC from SHR. Thus, it can be suggested that C-ANP4-23 may be used as a therapeutic agent for the treatment of vascular complications associated with hypertension and atherosclerosis.

Keyphrases: hypertension, NPR-C, c-Src, AKT, MAPK, PI3-K, SHR, cell cycle proteins, oxidative stress, NO, growth factor receptors, Gαi proteins
Impact of genetic polymorphisms determining leukocyte/neutrophil count 
on chemotherapy toxicity

We investigated the relationship between single nucleotide polymorphisms (SNPs) in 3 candidate genes/chromosomal loci: DARC, CXCL2 and ORMDL3-GSDMA-CSF3 locus on chromosome 17q21, and neutropenic and infectious complications during chemotherapy in pediatric acute lymphoblastic leukemia (ALL) patients. These loci encode the components of immune system altering chemokine concentration and distribution (DARC), stimulating neutrophil release from bone marrow and migration (CXCL2) and regulating granulocyte proliferation and survival (G-CSF). It is possible that polymorphisms of these loci when associated with chemotherapy may put susceptible individuals at higher risk of chemotherapy complications. Selected tag SNPs in these genes are genotyped in children treated at the CHU Sainte-Justine for (ALL) between 1989 and 2005. After correction for multiple testing, DARC polymorphism rs3027012 in 5’UTR was associated with low absolute phagocyte count (APC<500 and <1000 cells/µL, p=0.001 and p=0.0005, respectively) and hospitalisation due to febrile neutropenia (p=0.007) or due to infection and/or febrile neutropenia (p=0.007). A protective effect was instead noted for missense Gly42Asp variant rs12075 (p=0.006). The polymorphisms on chromosome 17q2 were associated with hospitalisation due to infection (rs3859192, p= 0.004) and neutropenia (rs17609240, p=0.006). Infection was also modulated by CXCL2 (rs16850408, p=0.008) This study identifies for the first time that the loci modulating white blood cell and neutrophil count may play a role in the onset of chemotherapy complications and may thus serve as markers for adjustment or follow-up of the treatment.

Keyphrases: Infection, Genetic Polymorphisms, Neutropenia, Acute Lymphoblastic Leukemia
Phosphodiesterase 6 generates intracellular cGMP microdomains in the native endothelium

Endothelial cells (EC) are essential regulator of vascular homeostasis through the generation and release of various bioactive agents, including nitric oxide (NO). NO modulates several vascular functions such as vascular tone and permeability, through the stimulation of soluble guanylate cyclase (sGC) leading to the production of cGMP. Conversely, phosphodiesterases (PDEs) are enzymes metabolizing cyclic nucleotides (cGMP and cAMP) and are therefore major regulatory players for cGMP and cAMP signalling pathways. Although ECs are the main source of NO, little is known on the endothelial NO-cGMP signalling pathway and cellular outcomes. It was then hypothesized that a specific population of cGMP-phosphodiesterases allows ECs to stabilize cGMP levels despite the elevated production of NO. Expression of cGMP-phosphodiesterases was initially studied in resistance mesenteric arteries from mice. PDE5 and PDE6 were both found at mRNA and protein levels in native arteries but PDE6 is not found in cultured ECs. Interestingly, subcellular distributions of both enzymes were distinct. PDE5 appeared to be homogeneously distributed whilst PDE6 catalytic subunits (PDE6 and PDE6) showed a preferential staining in the perinuclear region. These results suggest that PDE6 might be involved in the regulation of cGMP microdomains. Based on these findings, a mathematical model was developed. Simulations of dynamic cGMP levels in ECs support the notion of cGMP microdomains dependent on PDE6 expression and localization. In the absence of PDE6, application of NO either as a single bolus or repetitive pulses led to a homogeneous increase in cGMP levels in ECs despite PDE5 homogeneous distribution. However, PDE6 subcellular targeting to the perinuclear membrane generated a cGMP-depleted perinuclear space. The findings from this study provide the first evidence of the expression and specific intracellular distribution of PDE6 in native endothelial cells that strongly support their involvement in the generation of cGMP microdomains

Keyphrases: cGMP, PDE5, PDE6, mathematical model, microdomains
Étude du niveau de B Lymphocyte Stimulator (BLyS) et de son impact sur les lymphocytes B en relation avec l’infection et la résistance au virus d’immunodéficience humaine (VIH) chez des travailleuses du sexe au Bénin

HIV infection leads to B cell dysregulations that disrupt efficient immune responses. Detected early after infection, these dysregulations are lasting, are not totally resolved by therapy and often lead to auto-immune defects. We have shown that excess BLyS in plasma and on the surface of blood dendritic cells (DC) of HIV-infected progressors coincides with B cell dysregulation and increased frequency of “precursor” innate marginal zone (MZ)-like B cells. In contrast, BLyS levels were normal in elite-controllers and frequency of precursor MZ-like B cells was unaltered. Instead, percentages of MZ-like B-cells presenting a more “mature” profile were decreased in the blood of these individuals, suggesting peripheral recruitment of these cells could be beneficial to the control of disease progression. Based on this, we hypothesize that control of BLyS status and innate B cells could be relevant to the understanding of natural immunity to HIV.   We previously established an ongoing cohort of heavily HIV-exposed female commercial sex workers (CSWs) in Cotonou (Benin) and identified individuals who remain HIV-uninfected after several years of active prostitution. Herein, we have measured BLyS levels in the blood and cervico-vaginal lavages (CVLs) of HIV-uninfected CSWs and have compared them to those of HIV-infected CSWs and control uninfected non-CSWs. We found that BLyS levels in the blood and CVLs of HIV-uninfected CSWs were lower when compared to HIV-infected CSWs and even to controls. BLyS surface expression on T-cells, monocytes, and DC of HIV-uninfected CSWs was increased, but to a significantly lower extent than those measured in HIV-infected CSWs, albeit higher than controls. In HIV-infected CSWs, high BLyS levels were concomitant with a dysregulated blood B-cell compartment, characterized by hyperglobulinemia, increased frequency of populations presenting immature and/or innate profiles and a higher proportion of IgG+ than IgA+ plasmablasts. In contrast, contained BLyS levels in the blood of HIV-uninfected CSWs coincided with a rather preserved B-cell compartment, which reveals that “mature” MZ-like B-cells could be involved in natural immunity against HIV. These results highlight the importance of a better understanding of B cell populations and BLyS in the context of HIV resistance.

Keyphrases: Lymphocyte B, BLyS, HIV, B cell, Marginal zone, Commercial sex worker, natural immunity
Anomalies immunitaires chez les enfants exposés au VIH mais non infectés

Antiretroviral therapy prevents mother to child transmission of HIV in 98% of cases when administered during pregnancy, labor and to the newborn. The availability of antiretroviral therapy for nearly 70% of the 1.5 million HIV+ pregnancies in the world leads to the birth of more than one million HIV-exposed uninfected children yearly. The number of HIV-exposed uninfected children is on the rise along with concerns about their health. Indeed, several groups reported an increase in morbidity and mortality in HIV-exposed uninfected children. Preliminary analysis of retrospective data of 705 HIV-exposed uninfected children from the Centre maternel et infantile sur le SIDA (CMIS) Mother-Child Cohort (CHU Sainte-Justine) revealed that at 2 months of age, children born to mothers with viral load greater than 1,000 RNA copies / ml had a significantly higher frequency of B cells compared to HIV-exposed uninfected children born to mothers with an undetectable viral load. The objective of this study is to characterize these anomalies.  Lymphocytes from the umbilical cord blood and venous blood obtained at 6 and 12 months of age, were phenotyped by flow cytometry using markers CD3 / CD10 / CD14 / CD16 / CD19 / CD20 / CD21 / CD27 / IgM for B cells and CD4 / CD8 / CD3 / CCR7 / CD45RA for T cells. Moreover, to study the functional capabilities of CD19+ B-cell, antigen-specific response to the tetanus vaccine was measured by flow cytometry with fluorescent tetramers of tetanus toxoid C fragment.  Our work has demonstrated statistically significant differences between ENI born to mothers with detectable viral load compared with those born to mothers with an undetectable viral load. At birth, they had significantly fewer total B cells, more classical memory B cells, activated memory B cells, plasmablasts and central memory CD8+ T cells. At 6 months of age, they had significantly more naive B cells and significantly fewer effector memory CD8+ T cells. At 12 months of age, they had significantly more total B cell and CD8+ T cells, fewer total CD4+ T cells and those T cells showed an activated profile (more memory cells). The analysis of antigen-specific response revealed a higher frequency of IgM+ memory B cells suggesting that children born to mothers with detectable viremia have a harder time establishing an effective immune memory against the tetanus vaccine.  Our data suggest that there is exposure during the first trimester of pregnancy to maternal viremia and that this exposure affects the developing immune system of the foetus. The underlying mechanisms causing these abnormalities have yet to be elucidated and exhaustion of the T compartment at birth and six months remains to be investigated. In industrialized countries where access to care is facilitated, these anomalies have moderate consequences, but in low- and middle-income countries, the consequences can be much more tragic.

Keyphrases: HIV, HIV-exposed uninfected children, Immunological anomalies, CD4 T cells, CD8 T cells, CD19 B cells