NCube/papyrus huggingface dataset:
L’effet du ligand du CD36 MPE-001 dans la protection de l’épithélium pigmentaire rétinien contre le stress oxydatif

Age-related macular degeneration (AMD) is a leading cause of irreversible blindness in the elderly population. The retinal pigment epithelium (RPE) is a monolayer of epithelial cells that are critical in maintaining retinal neurons. Oxidative stress, inflammation and defects in lipid clearance are thought to cause damages to the RPE and the eventual loss of photoreceptors in the dry form of AMD. CD36 is a scavenger receptor that plays an important role in inflammation and lipid homeostasis. We have previously shown that stimulation of CD36 by a selective ligand preserves photoreceptor function in high fat high cholesterol diet-fed Apoe-/- mice, a mouse model of AMD. The effect of CD36 ligands on RPE cells protection from oxidative insults, however, had yet to be investigated. In this study, we aimed to study the cytoprotective effect of the CD36 ligand MPE-001 in RPE cells exposed to oxidative stress.  Oxidative stress was induced in the human RPE cell line hTERT RPE-1 using NaIO3. MPE-001 was observed to decrease NaIO3-induced mitochondrial superoxide production and apoptosis, with no transcriptional effect on antioxidant enzymes. Immunoblotting and immunostaining showed that NaIO3 disrupts autophagic flux while MPE-001 co-treatment restores it. The protective effect of MPE-001 was completely abolished by the autophagy inhibitors wortmannin and bafilomycin A1. In conclusion, we report for the first time that a CD36 ligand confers protection to RPE cells under oxidative stress through the improvement of autophagic process. We therefore propose modulation of oxidative stress by CD36 ligands as a potential strategy to treat dry AMD.

Keyphrases: CD36, age-related macular degeneration, retinal pigment epithelium, oxidative stress, autophagy
Évaluation économique de l'ajustement des antihypertenseurs par le pharmacien en milieu communautaire

OBJECTIVE: Hypertension is a chronic disease for which only 68% of treated patients were controlled in Canada in 2013. Pharmacists in the province of Québec recently received legislative authority to adjust the dosage of antihypertensive drugs if there is an agreement with the prescriber of the therapeutic target. This research aims to estimate the incremental cost- utility ratio (ICUR) of this new model of care in Québec. METHODS: A Markov model was developed to extrapolate the impact of this pharmacy practice on strokes, myocardial infarctions and mortality. Framingham Risk Equations were used to derive the impact of blood pressure control on strokes and myocardial infarctions. The efficacy of the intervention was derived from the RxAction clinical trial, conducted in Alberta. Efficacy was expressed as the proportion of patients with controlled blood pressure. The model used the payer perspective and direct costs only. The main clinical outcome was expressed as the number of quality-adjusted life years (QALYs) gained. Both QALYS and costs were discounted at a 1.5% annual rate. A cohort of 1000 patients entered the model at 65 years old. The model used a 20 years time horizon, with a 1-year cycle length. RESULTS: The model yielded 0.051 QALYs per patient in the intervention group for an incremental expense of $268 per patient. The ICUR was 5,223 $/QALY. At a willingness-to- pay threshold of $50,000/QALY, the intervention is cost-effective. The results were sensitive to the comparative efficacy of the pharmacist intervention against usual care and to the utility of hypertension. CONCLUSION: Providing pharmacists the ability to adjust the dosage of antihypertensive drugs within the actual fee-for-service rational appears to be cost-effective. Obtaining data on the efficacy of this pharmacy practice from a trial conducted in Québec would provide better data to inform this economic evaluation.

Keyphrases: Hypertension, Pharmacist, Adjustment, Antihypertensive, Cost-utility, Framingham, Markov model, Pharmacoeconomics, Health economics
Facteurs qui influencent l'intention de quitter d'infirmières praticiennes spécialisées en première ligne travaillant dans le réseau public de santé

Problematic: In recent years, several studies have outlined the obstacles faced by nurse practitioners (NP) in primary care in their daily practice. The lack of autonomy, the limited scope of practice and the lack of collaboration in care teams are factors that are highlighted in the studies as challenges faced by these nurses. Nurse practitioners in primary care in Quebec are no exception and their deployment has also been difficult for some. These obstacles can give to the NP the intention to leave their work and knowing the factors influencing this intention could therefore help to maintain these indispensable professionals in the health care system. Aim: Identify the factors that influence the intention to leave of NP in primary care working in the Quebec public health care system. Methods: This study is a secondary analysis of data collected between March and April 2017 using a self-administered questionnaire that lasts approximately 45 minutes. The sample for this study is composed of the 222 NP in primary care who participated. The factors influencing the intention to leave measured are: work rewards, condition of work environment, relationship and support from manager, organizational support and practices, relationships with co-workers, nurse characteristics and external factors. Descriptive, bivariate and multiple regression analyzes were used to meet the aim of the study. Findings: 23% of NP in primary care plan to leave their current establishment within the next three years (n=199), 2% thinks about leaving their profession (n=198) and 10% are thinking about leaving the public health care system in favor of a private organization (n=196). These results are comparable to those obtained by a study published in 2011 where 27.2% of nurse practitioners were thinking about leaving their jobs and 5.5% of them were thinking about leaving the nursing profession (n=254). The factors associated with the intent to leave of the NP in primary care are: the decrease of their salary compared to the net salary before being NP and the lack of flexibility in the work schedules compared to the possibility of having flexibles schedules. Also, the decrease of collaboration with others health professionals and doctors is associated with an increase in the intention to leave. Conclusion: These new informations could assist managers in the development of retention strategies to maintain primary care NP in workplace.

Keyphrases: Collaboration, Nurse practitioners in primary care, Intention to leave, Retention, Multiple regression analyze, Work rewards, Condition of work environment, Relationship and support from manager, Organizational support, Relationships with co-workers, Nurses practitioners characteristics, Working region
The relationship between retinal nerve fiber layer, visual function and vision-specific quality of life in multiple sclerosis

Multiple sclerosis (MS) is the most common neurological condition causing disability in working-age adults. The hallmark of MS related disability is axonal loss. Through new technologies, such as optical coherence tomography (OCT), the retinal nerve fibre layer (RNFL), composed of ganglion cell axons, can be visualized and studied non-invasively in cross-section. Furthermore, recent OCT advances allow precise retinal layer segmentation and macular imaging of the ganglion cell layer. In this thesis, these different OCT parameters were measured to see which layers would be most affected in MS patients without previous optic neuritis. Results show that macular ganglion cell layer thickness is the only OCT parameter that can differentiate this sub-group of patients from healthy controls. Visual function was then assessed using a newly available, easy to use contrast sensitivity chart that can be self-administered by patients. Results show that this chart is also capable of differentiating MS patients without optic neuritis from controls, but usually gives better contrast sensitivity scores than the Mars chart. Lastly, vision-specific quality of life was assessed and proved to be reduced in MS patients with prior optic neuritis, despite supposed favorable recovery and good visual acuity in patients with this diagnosis. In sum, the use of OCT imaging, as well as sensitive visual function and quality of life measures, could help detect subtle, yet important structural or functional visual changes in patients with MS. This could ultimately help better screen, manage and counsel this subset of patients.

Keyphrases: OCT (optical coherence tomography), Retinal nerve fiber layer, Retinal ganglion cell layer, Optic neuritis, Retinal imaging, Vision-related quality of life, Multiple sclerosis
Le rôle des vésicules extracellulaires dans la dysfonction lymphatique liée à l’athérosclérose

All cell types release extracellular vesicles (EVs) that carry different types of cellular cargo, such as proteins, lipids and nucleic acids. These small vesicles are found in all biological fluids including blood and lymph and can interact with neighboring cells. The lymphatic system is a preferred route for the mobilization of cholesterol from the arterial wall. We have demonstrated in a mouse model that lymphatic dysfunction precedes the development of atherosclerosis and that that this dysfunction affects the contraction capacity of the collecting vessels. Based on these observations, we hypothesized that EVs contribute to atherosclerosis-associated lymphatic dysfunction. Therefore, we have initiated a translational study involving two groups of healthy subjects that differ in their risk of cardiovascular disease (CVD). We quantified several subtypes of circulating EVs on platelet-free plasma by ultraspecialized flow cytometry in the detection of small particles (> 100 nm) combined to other state-of-the art complementary techniques. Next, we assessed the lymphatic function using near-infrared imaging and injection of indocyanine green (ICG). Our preliminary results are promising for the role of EVs and lymphatic dysfunction in the development of atherosclerosis and corroborate with our observations made in mice. Individuals at high risk of CVD have signs of lymphatic dysfunction even before the onset of subclinical atherosclerosis. The mechano-sensitive response of their collecting vessels appears to be defective and is observable in concert with a profile of EVs that presume lymphatic damage. These results remain to be confirmed with the recruitment of additional subjects and the assessment of the correlation with the polygenic risk score of developing a CVD, in the hope of making these specific EV subsets and lymphatic function new biomarkers in the early detection of CVD.

Keyphrases: extracellular vesicles, Lymphatic system, Atherosclerosis, Flow cytometry, Cardiovascular diseases, Infrared imaging
Barrières et facilitateurs au dépistage du cancer du sein et à la mammographie auprès de femmes immigrantes

Breast cancer is the most common malignant disease among women. Since the introduction of breast cancer screening programs in the early 2000s, the mortality rate of women with breast cancer in Canada decreased significantly. Despite this decrease, recent immigrant women (who arrived in the host country less than 10 years ago) in Canada have been found to use breast cancer screening programs less frequently. The purpose of this thesis is to shed some light on the state of knowledge related to breast cancer screening among immigrant women, with emphasis on the challenges they face when accessing or using breast screening programs. We first conducted a literature review to describe the current barriers and benefits of using breast cancer screening among immigrant women. Using Lévesque’s patient-centered access to healthcare framework, the data was organized into five major categories: (1) “perception of needs and desire for screening”, (2) “breast cancer screening seeking”, (3) “breast cancer screening reaching”, (4) “breast cancer screening utilisation”, and (5) “breast cancer screening consequences”. The second study was a cross-sectional analysis of the Canadian Community Health Survey (CCHS, 2013/2014) to update the data regarding the use of mammography services among women aged 50 to 69 years. Several socioeconomic factors were significantly related to the low use of mammography services, including: age, marital status (divorced, widowed, or single), lower income, lower level of education, status of immigration (being an immigrant), lack of access to a family doctor, body mass index (obese class 3), and smoking status (being a smoker), etc. Finally, we present the findings of a qualitative study which was conducted to investigate the barriers and facilitators to mammography screening use among recent immigrant women from Northwest Africa (Tunisia, Algeria, and Morocco) currently residing in Montreal. As in the narrative review, again based on the Lévesque et al. conceptual framework, the participants identified common barriers and facilitators to accessing screening: “perception of needs and 8 desire for screening”, “breast cancer screening seeking”, “breast cancer screening reaching”, “breast cancer screening utilisation”, and “breast cancer screening consequences”. The results of this thesis indicated that there were various barriers (e.g. sociocultural, socioeconomic, etc.) to accessing breast cancer screening and /or mammography among immigrant women. It is important to implement new interventional tools adapted to the common barriers and diverse needs of immigrant women in order to promote preventive culture and enable them to make informed choices regarding screening mammography.

Keyphrases: Breast cancer, Screening, Mammography, Access, Immigrant women, Recent immigrant women, Knowledge, Practices, Barriers, Reasons
L’évolution à long terme, le fonctionnement de l’intestin et la qualité de vie des patients affectés par la maladie de Hirschsprung : étude prospective cas-témoins

Introduction Multimorbidity and bowel dysfunction are affecting patients with Hirschsprung disease (HSCR) on long-term follow-up, having an important impact on quality of life (QoL). The primary aim of this study is to evaluate the disease-specific QoL with determination of its predictive factors in a French-Canadian cohort of HSCR patients. Methods Prospective cohort and case-control study. The questionnaires ‘HAQL’ (disease-specific QoL questionnaire), 'PedsQL’ (global health related QoL), ‘Stressful life events’, a questionnaire about the socio-economic state and a stool diary were requested to fill in. Hair cortisol concentration (HCC) (measure of chronic stress) was measured using an enzyme-linked immunosorbent assay kit (ELISA).  Results 72 patients (72% males) and 117 controls (65% males) were analyzed. Median [IQR1, IQR3] age at study inclusion was 12.1 years [8,17.5] in patients and 12.6 years [10.2,15.1] in controls. General health related QoL was comparable between patients and controls. In the patient’s group, children 8 to 11 years reported lower disease-specific QoL than adolescents (12 to 16 years) (mean scores 539.3±66.5/700 vs. 622.6±54.6/700; p=0.002). The dimension ‘Fecal continence during daytime’ was the most affected one in children (mean score 52.6± 25.3/100) and the dimension ‘Physical functioning’ was the most affected one in adolescents. Prevalence of fecal incontinence/soiling in the patient’s group was 85% in children, 40% in adolescents and 12% in adults. Younger age was associated with a higher prevalence of fecal incontinence (p=<0,0001). No association was seen between presence of fecal soiling/incontinence and chronic stress (HCC, Stressful live events) or social situation.  Conclusion Disease-specific QoL investigation is mandatory in HSCR patients, to encounter and evaluate adequately psychosocial problems related to long term bowel dysfunction.

Keyphrases: HAQL, Hirschsprung disease, HSCR, Quality of life, Fecal incontinence, Hair cortisol concentration, Chronic stress
Évaluation de l’association entre l’exposition postnatale aux p,p’-DDT et p,p’-DDE et l’indice de masse corporelle chez les enfants japonais

Children are exposed to p,p’-dichlorodiphenyltrichloroethane (p,p’-DDT) and p,p’-dichlorodiphenyldichloroethylene (p,p’-DDE) through placental and lactational transfer. Studies have revealed that these exposures could lead to increased body mass index (BMI) during childhood. Our aim was to assess whether exposure through breast milk is associated with BMI in Japanese children at 42 months of age. We used data from a pilot study (n=290) of the Japanese Environment and Children Study (JECS). p,p’-DDT and p,p’-DDE levels were measured in breast milk, and levels in children were estimated using a toxicokinetic model for three exposure periods (0-6 months, 6-12 months, 12-24 months). Associations with BMI at 42 months of age were assessed using multivariate linear regression models. Our study revealed no significant association with levels of p,p’-DDT measured in breast milk or estimated in children. Positive associations with p,p’-DDE were found in girls during all exposure periods. For each log increase in the estimated p,p’-DDE levels, BMI z-score increased by 0.23 (C.I. 95%: 0.01, 0.45) for the 0-6 months exposure period, 0.26 (C.I. 95%: 0.06, 0.47) for the 6-12 months exposure period and 0.24 (C.I. 95%: 0.05, 0.43) for the 12-24 months exposure period. Our results in girls were similar to those found in a previous meta-analysis that included boys and girls (BMI z-score increase of 0.13 by log increase in prenatal p,p’-DDE levels), supporting that early-life exposure to p,p’-DDE may be associated with increased BMI during childhood.

Keyphrases: dichlorodiphenyltrichloroethane, dichlorodiphenyldichloroethylene, persistent organic pollutants, body mass index, postnatal exposure, breast milk, toxicokinetic modeling
Littérature et réalité : une étude sur la zoophilie et la bestialité

Although sexual contacts between humans and animals (bestiality and zoophilia) seem to have existed since the very beginning of human history, the scientific literature on this subject remains scarce. Over time, this phenomenon has been illustrated in arts, mythology, religious texts, morals’ trials, animal rights’ trials, and in many other fields acknowledging the existence and public interest for the phenomenon. It is only in recent decades that researchers have attempted to describe and understand zoophilia and bestiality, and to date, these studies have remained largely descriptive.  The researchers' understanding of zoophilia and bestiality is still fragmented, and the present study attempts to add a new piece to this mosaic of knowledge by comparing different variables of people who have or have had sexual contacts with animals to people who have not had such contacts. In order to do this, we took an interest in recent and older writings, and sought to verify some of the information provided in these writings. More precisely, we attempted to differentiate between these two groups.   Using computerized questionnaires, we surveyed 440 people from 27 countries (219 zoophiles and 221 non-zoophiles). All participants were recruited via the internet and their participation to the study was entirely anonymous. The data collected were then analyzed using descriptive statistics (mean, standard deviation, percentage), and comparative and exploratory analyzes (ANONVA 2x2, T-test, Chi-square, Discriminant Function Analysis).   Several statistically significant differences were observed in demographic characteristics, psychosocial variables and sexuality. The main findings were that in our community sample, zoophiles were less anxious and had better self-esteem than participants from the control group. They were also less educated, not as wealthy, felt lonelier, and lived more in rural or mixed environments than participants from the control group.   This study aimed to contrast the data of zoophiles with those of non-zoophiles on variables put forward in previous studies in order to put them into perspective. Since studies on zoophilia have never, to our knowledge, used a control group, this thesis offers a unique point of view on the characteristics of the zoophiles who participated in the study. Finally, this thesis was also intended to provide some ideas for future research on the subject.

Keyphrases: solitude, zoophilia, zoophilic disorder, bestiality, community sample, anxiety, self-esteem, loneliness, sexuality
Validité convergente entre l’Entrevue de l’attachement adulte et le Projectif de l’attachement adulte auprès de mères de familles d’accueil

Parents’ attachment state of mind is known to influence their child’s development in various domains as well as the attachment relationship. Indeed, the attachment type that children develop is significantly associated to their parent’s attachment state of mind, including among foster families. Adults’ attachment representations can be assessed using the Adult Attachment Interview (AAI) and the Adult Attachment Projective (AAP) that categorize adults in corresponding attachment categories with very different classification systems. Studies have examined convergent validity between the both measures among different populations, but none among foster mothers. Moreover, studies revealed significant convergence between attachment categories, but none has examined the convergence between dimensional scales of both measures. Some authors have proposed that differences according to attachment may be better explained continuously rather than with categories. Thus, this study aims to investigate the convergent validity between the overall classifications as well as dimensional scales of the AAI and the AAP and their association to the global score of depression obtained at Beck’s Depression Inventory (BDI). The sample consists of 54 foster mothers (mean age: 39) from Quebec (Canada). Results show acceptable convergence when participants a separated in autonomous and non-autonomous categories but not for the four-way classification and the resolved and unresolved division. Some dimensional scales of the AAI and the AAP were significantly associated and one scale of the AAP was associated to the global score of depression as assessed by the BDI. In sum, the two measures categorized adults in similar manners, but some discrepancies are observed in the insecure states of mind.

Keyphrases: Adult attachment representations, Attachment states of mind, Convergent validity, Foster mothers, Depressive symptoms
Intégrabilité et superintégrabilité de deuxième ordre dans l'espace Euclidien tridimensionel

The article "A systematic search for nonrelativistic systems with dynamical symetries, Part I" published about 50 years ago started the classification of what is now called superintegrable systems. It was devoted to systems in Euclidean space with more integrals of motion than degrees of freedom. The integrals were all assumed to be second order polynomials in the particle momentum. Here we present some further results on second order superintegrability that are relevant for studies of higher order superintegrability and for superintegrability for systems with vector potentials or for particles with spin.

Keyphrases: Classification, Hamiltonian, Integrability, Conserved quantity, Integrals of motion, Scalar potential, Classical, Quantum, Euclidean space, Separation of variables, Poisson bracket, Symmetry