NCube/papyrus huggingface dataset:
Essai clinique randomisé comparant la méthadone et la morphine pour la prévention du syndrome de sevrage aux opiacés en pédiatrie

Background : The prolonged use of opioids has been associated with opioid tolerance and weaning is necessary to prevent opioid withdrawal symptoms (OWS). Little research exist for an ideal effective opioid taper to reduce the prevalence of OWS. This study aim to compare the effectiveness of two opioid taper strategies, enteral’s methadone and morphine, in preventing the occurrence of OWS among pediatric intensive care patients. Design: Double-blinded randomized controlled trial in mechanically ventilated children (MVCs) hospitalized in 2 pediatric intensive care units (PICU). Methods: Eligible patients were MVCs at moderate risk of OWS admitted in PICU of the Centre Hospitalier Universitaire Sainte-Justine or the Centre Mère-Enfant Soleil de Québec between November 1, 2003 and May 31, 2009. We assessed the total weaning duration, the OWS’s incidence and the OWS’s severity in a methadone’s and a morphine’s taper schedule. Results: Forty-eight patients were included, 22 in the methadone group and 26 in the morphine group and 30 patients completed the weaning protocol (16 methadone and 14 morphine). The median duration of weaning was 5.4 days among methadone’s patients as opposed to 5.8 days among morphine’s group (p=0.49). There was no statistical difference between groups for OWS’s incidence (62.5% vs 42.9%; p=0.46), nor for its severity (12.5% vs 14.3% of severe OWS; p=0.62). Conclusion: The use of a standardized opioid weaning protocol with enteral methadone was as effective as the enteral morphine one’s to prevent OWS. Further studies are needed to determine an ideal opioid taper to reduce OWS.

Keyphrases: Morphine, Opioids, Tolerance, Physical dependence, Opioid withdrawal, Methadone, Morphine, Pediatric intensive care unit, Protocol
L’implication des répresseurs traductionnels 4E-BP1 et 4E-BP2 dans la régulation du sommeil

Albeit it is known that sleep and sleep loss are impacting protein synthesis in the brain, several unknowns persist about the contribution of the mechanisms of translational control to wakefulness and sleep regulation. In this master project, we studied the role of two suppressors of protein synthesis, the eukaryotic initiation factor 4E-binding protein 1 and 2 (4E-BP1 and 4E-BP2) in sleep architecture and electroencephalographic (EEG) activity as well as in the EEG and molecular responses to acute sleep loss. These two proteins normally repress cap-dependent translation initiation by binding eIF4E. When activated by extracellular and intracellular signaling, mTORC1 phosphorylates 4E-BPs leading to their dissociation from eIF4E, thus allowing the translation initiation. 4E-BP1 is highly expressed in the suprachiasmatic nucleus and implicated in circadian rhythms. 4E-BP2, widely expressed in the brain, is critical for memory and plasticity. Yet, there is no data on their implication in sleep regulation. Mutant mice for the genes encoding 4EBP1 or 4E-BP2 (Eif4ebp1-/- and Eif4ebp2-/- mice) were implanted with EEG and electromyographic (EMG) electrodes and recorded under undisturbed conditions and following a 6-h sleep deprivation (SD). The effect of SD on the expression of genes known to respond to SD was also assessed in the prefrontal cortex of Eif4ebp1-/- and Eif4ebp2-/- mice. Mice lacking Eif4ebp1 differed from wildtype mice regarding the quantity and quality of their sleep and wakefulness, and more subtly in the gene expression response to SD. Moreover, Eif4ebp2-/- mice differed from wild-type mice only for wakefulness and sleep quality, changes in EEG spectral activity generally revealed during and after SD. The results of my master project point towards an implication of the translation machinery in the regulation of wakefulness and sleep and of synchronized cortical activity and suggest different roles of effectors of translational control.

Keyphrases: Protein synthesis, Electroencephalography, Spectral analysis, Sleep deprivation, Gene expression
Effets de la thérapie cognitivo-comportementale pour l’insomnie sur le sommeil au cours d’un sevrage de benzodiazépines chez la personne âgée

Background: Chronic insomnia affects a significant number of the elderly population, with approximately 34% of older adults complaining of persistent difficulty falling asleep. Many of these older adults choose to use hypnotics to treat their insomnia. To be more specific, they tend to use a certain class of hypnotics called benzodiazepines (BZD). However, benzodiazepine use is correlated with several negative health impacts in the elderly (hip fracture, increased risk of mortality, cancer and cognitive decline). In addition, Cognitive behavioral therapy for insomnia (CBTI) is considered the gold standard and the first-line treatment for primary insomnia disorder. In addition, CBTI improves several sleep variables (sleep latency, total sleep time, waking duration and sleep efficiency). Objective: The objective of this pilot study is to evaluate the effect of CBTI on sleep during a structured benzodiazepine withdrawal in participants who are 60 years of age and older. Methods: Thirty-six (36) participants, twenty-four (24) of whom are female and twelve (12) of whom are male with a mean age of 69.5 years (60-90 years) with chronic insomnia and taking BZDs over an average time of 15 years (1-44 years) completed a comprehensive sleep assessment through sleep diaries, actigraphy, and polysomnographic recordings, before being randomly divided into two groups: the therapy group (n = 19) with a 16-week weaning program associated with eight CBTI sessions, and a control group (n = 17) with a weaning program associated with providing an explanatory brochure of the steps of structured weaning. The same sleep assessments were repeated after weaning of both groups. Repeated measures ANCOVAs and Pearson’s χ2 tests evaluated the effect of therapeutic intervention on sleep variables and withdrawal success. 6 Results and conclusion: 65% of all participants reached a complete cessation of their BZDs (73.68% of participants in the therapy group and 56.25% of the control group). According to the values obtained from sleep diaries, the therapy group improved more than the control group in terms of a reduction in the sleep onset latency (F = 6.15, df = 1, p = 0.02), wake after sleep onset (WASO) (F = 10.96, df = 1, p < 0.001) and an increase in the sleep efficiency (F = 4.84, df = 1, p = 0.03). In addition, the therapy group shows a trend toward improvement in sleep quality, as reported by the questionnaire of PSQI2 (F = 3.46, df = 1, p = 0.06). These preliminary results suggest a beneficial effect of CBTI on sleep as part of a program of structured withdrawal from benzodiazepines.

Keyphrases: Elderly, Seniors, Benzodiazepines, Insomnia, CBTI
Le rôle de l’expression de nétrine-1 par les cellules présentatrices d’antigènes dans la régulation immunitaire et la sclérose en plaques

Multiple Sclerosis (MS) is an autoimmune disorder of the central nervous system (CNS) characterized by leukocytic infiltration and axonal demyelination. Antigen presenting cells (APCs) play a crucial role in this process by activating myelin-reactive lymphocytes in the periphery. Activated lymphocytes subsequently cross the blood-brain barrier (BBB) and infiltrate the CNS. These lymphocytes are reactivated in the perivascular space by APCs, following which they contribute to demyelination and axonal damage. Netrin-1 (N1) is an axonal guidance protein with considerable anti-inflammatory properties. The relevance of N1 in maintaining BBB function has been thoroughly established, but its involvement in antigen presentation and T cell activation has yet to be studied. This project investigates the hypothesis that N1 is produced by APCs to regulate neuroinflammation and aims to characterize N1 production by APCs, delineate the impact of N1 on T cell activation and clarify the role of APC-derived N1 in neuroinflammation. The results presented in this thesis demonstrate that N1 is produced by mature dendritic cells and M1 macrophages. Furthermore, N1 is shown to increase T cell proliferation, decrease TH17 cell cytokine production and decrease CD8+ T cell perforin expression. N1 does not alter T cell expression of adhesion molecules. Finally, N1 is not expressed by the CNS dendritic cells, macrophages or microglial cells of mice undergoing experimental autoimmune encephalomyelitis, an animal model for MS. In summary, these results suggest that N1 is produced by APCs to modulate T cell function.

Keyphrases: Macrophages, Lymphocytes T CD4+, Netrin-1, Antigen presenting cells, Dendritic cells, CD4+ T cells, CD8+ T cells, Multiple sclerosis, Experimental autoimmune encephalomyelitis
L’interdisciplinarité au pays des protocoles : ethnographie du travail d’équipe dans une unité d’hémato-oncologie pédiatrique

This Master's thesis examines how interdisciplinarity can be expressed in the daily practice of a healthcare team, in this case the Hematology-Oncology Unit at CHU Ste-Justine. I looked at the daily practice within the unit through an ethnographic lens sustained by observing, shadowing and interviewing various professionals. In an attempt to further understand which type of interdisciplinarity is found in the unit, I tried to escape the doctor-nurse dyad's gravitational field to look at the most "marginal" professions instead – psychosocial workers and healthcare assistants. I sought to better understand which type of interdisciplinarity is practiced in the unit. My work highlights the importance of everyday life and of a logic of care. It is when caregivers are trying and guessing, when they are looking for solutions from a perspective where "life goes on" rather than one that follows the "protocol", that they seem to be the most at ease working as a team. In this context, nurses find themselves playing a key role, being the main interlocutors of both the medical and psychosocial worlds. At the same time, healthcare assistants show us the persistence of hierarchy in the unit, despite a discourse promoting more egalitarian collaboration.

Keyphrases: care, Anthropology of health, Hospital ethnography, Interdisciplinarity, Interprofessional relations, Teamwork
Les Matsuri : l’identité japonaise en festival

The role of Shinto has changed through the last thirty years in Japan. Since the end of World War II and the adoption of the new Constitution, Shinto has been limited to private and religious space. The Aum crisis changed the perception of religion in Japanese society, and Shinto priesthood had to adapt. More present in public space, Shinto leaders want to present Shinto beliefs as central to Japanese traditions and culture. The conception of religion in Japan is different than the one in Western countries. The word religion, shūkyō (宗教), has an interesting history affecting the way Japanese perceive all religions and Shinto in particular. In this context, it is important to analyse the connection between Shinto practices and identity. The main objective of this research is to analyze the links between Shinto and identity at two levels, local and national, with a focus on youth. To do so, this paper will focus on one type of Shinto activities: matsuri. From an anthropological point of view, the interest about these developments comes from their popularity, their intergenerational dynamics, and the place they occupy in the public domain.  The data were gathered during ethnographic research that spanned for three months in the Sapporo area. Multiple festivals were observed during this period. The focus of the observation was on social space, behavior, gender and intergenerational relations, clothing, activities, and rituals. Those elements help us understand the place of matsuri in contemporary Japanese culture, and ultimately, give information about the conception of Shinto. Shrine festivals also provide information about Japanese identity. Both local and national identity elements can be observed and analysed though these events. This paper points out those elements and puts them in relation to the actual religious context.

Keyphrases: Religion, Shinto, Matsuri, Secularism, Identity, Japan, Nationalism
L’exploitation de la faune par les Iroquoiens : l’alimentation carnée des habitants du site McDonald (BgFo-18)

This thesis explores patterns of faunal exploitation habits at the McDonald site, in the Saint-Anicet area during the Late Woodland period. The main goal is to determine the importance of wild game in the Iroquoian economical system which is based on the balance of fishing, hunting and horticulture. The result of the faunal analysis shows that White-Tailed Deer, North American Black Bear and North American Beaver are the most important taxa contributing to the subsistence economy of the inhabitants of the site. This was determined by standard zooarchaeological methods, including calculation of the number of identified specimens (NISP), the minimum number of individuals (MNI), meat weight (MW) and ethnohistorical data. This thesis also discusses the spatial distribution of animal skeletal remains, comparing meat consumption patterns within each family unity inside the longhouses and within and between each longhouse. This comparison shows that faunal remains are mostly located in the central alignment of longhouses and are homogeneously distributed. The taxa distributed within the longhouses suggest relatively equalitarian access to animal resources. Analysis of the bone concentrations shows a collaborative tendency between family units within the community. Furthermore, the faunal assemblage tends to show an annual occupation of the site. Sedentary occupation of the site is also supported by ceramic analysis and cultigen analysis. Finally, we compare the mammal NISP and MNI of the McDonald's site with seven other contemporaneous archaeological sites from the region. This comparison shows that mammalian resources declined in importance in the Iroquoian diet between the beginning of the 14th century and the first part of the 16th century, probably due to the adoption of horticulture.

Keyphrases: Saint-Anicet, Zooarchaeology, Faunal analysis, Late Woodland, St. Lawrence Iroquoians, Mammalofauna, White-Tailed Deer, North American Black Bear, North American Beaver
Justice pénale internationale : la lutte contre l’impunité en tant qu’impératif moral

The fight against impunity as conducted by the International Criminal Court is criticized and controversial. The actions of the international criminal institution are perceived by its critics as renewing forms of racism, ethnocentrism, imperialism, neocolonialism, authoritarianism that fundamentally corrupt the aspiration to justice. Paradoxically, the need for international criminal justice is understood as an imperative of peace and justice. This research examines the justifications for such a moral imperative. It starts from the assumption that it is categorical and comes from an ethical approach to ethics. The justifications for such an assumption rest analysis of the different historical contexts that have seen the affirmation or re-affirmation of a categorical rejection of crimes of inhumanity (Article 5 of the Rome Statute of the International Criminal Court: the crime of genocide, crimes against humanity, war crimes, crimes of aggression). These condemnations laid the foundations for an ethic of universal significance and recognized humanity as a universal moral community. Thus, despite moral and ethical particularisms, the philosophical foundations of the fight against impunity is based on a moral universalism and the regulating idea of an ethical contract linking the community of states and peoples. It is about being and making humanity. Therefore, in spite of; realistic theories of international relations suggesting both the amorality of inter-state relations, prudential motivations and instrumental rationality (morality of interest), despite the culturalist perspectives that testify to moral and ethical pluralism, we want to show that the fight against impunity is above all an universalizable moral duty (based on the principle of dignity) of a deontological nature (even if this struggle also implies consequentialist considerations). Given the complexity of this issue, our research will be transdisciplinary; and our approach combines inductivism and deductivism.

Keyphrases: Morale des relations internationales, International criminal justice, Fight against impunity, International criminal court, Rome statute, Moral imperative, Kantianism, International relations, Liberal institutionalism, Ethics in international relations, Moral of international relations.
Poétique, thèmes et contexte des lamentations dans la tragédie grecque

Unlike ritual laments, tragic laments take place in a wide range of situations. Some are made over troubles other than an actual death, over events that have not happened yet, or over the mourner himself. This seems to be why we find such a huge diversity of both forms and contents of laments within the tragic corpus. How do the tragic poets modify the traditional form of the lament? Do these changes depend on specific contextual elements? In order to answer these questions, I will examine three laments: Cassandra’s in Aeschylus’ Agamemnon, Creon’s in Sophocles’ Antigone and Polymestor’s in Euripides’ Hecuba. These three passages show major contextual discrepancies, especially when it comes to the identity of the mourner (gender, age, social status, ethnicity) and their relationship to the Chorus. Moreover, they were composed by different authors at different times, which accounts for the evolution of the literary form during the 5th century B.C. These contextual differences allow us to identify specific ties between the context and the lament itself. The form of the actor’s part depends mostly on the mourner’s ethnicity and gender, while the Chorus’ part suits its relationship with the mourner. The stylistics of the lament may also result from the author’s personal preferences or from the date of composition. As for the content, it is heavily determined by the position and the function of the passage within the play. As the functions of a tragic lament differ from those of a ritual lament, the model given by ritual lament cannot serve as the only basis for the analysis of a tragic lament’s content.

Keyphrases: kommos, Agamemnon (Eschyle), Antigone (Sophocle), Greek tragedy, lament, characters, poetics, language, Agamemnon (Aeschylus), Antigone (Sophocles), Hecuba (Euripides)
Caractériser et évaluer la capacité d'adaptation des communautés face aux risques naturels : le cas de Saint-Raymond

Global climate change is increasingly impacting the well-being, development and vulnerability of communities across the world, whom must further mitigate disaster risk. In Québec, disaster risk management presents a “return to normal” philosophy that focuses primarily on intervention and short-term recovery. However, with the many uncertainties brought forth by global climate change, it is imperative that local communities in the province have the capacities to improve their resilience to natural hazards, which are becoming more devastating. Hence, the capacity to adapt must find itself at the heart of disaster risk management and sustainable development. That said, there are few tools that exist that enable decision-makers to assess adaptive capacity in Québec, which is understood as the dynamic resources that are available and accessible that increase resilience and reduce vulnerability by positively transforming a community and its environment. The present research seeks then to develop a method to evaluate the local citizens’ and their community’s adaptive capacity to flood risk with the help of GIS tools, using Saint-Raymond de Portneuf as a case study. This research founds itself on vulnerability, resilience et adaptation literature to elaborate indicators that could characterize and assess local capacities to mobilize the proper resources to not only cope with a flood event but also to better prevent and prepare for them in the long-term. Socio-economic et planning data are notably used as well as data taken from a survey conducted in 2014 following a major flood event by the CAPSA, the watershed organization in the Portneuf region, in collaboration with the Comité Rivière in the city of Saint-Raymond

Keyphrases: Indice, Québec, Adaptive capacity, Vulnerability, Resilience, Disaster risk management, Index, Quebec, Global climate change
Parcours exploratoire et virtualités : une théorie des mondes possibles vidéoludiques

This master’s thesis mobilizes the possible worlds theoretical framework in order to develop the core notions of a videoludic possible worlds theory which would account for the medium’s artifactuality, interactivity and ludicity. The first chapter offers an overview of possible worlds theory both in the philosophical and literary traditions, thus defining the notions of alternative (or historical) worlds and fictional worlds. The second chapter is centered around the notion of videogame worlds: we will both define videoludic worlds and examine the mechanisms through which the player can interact with it. The third chapter is dedicated to these ontological states in which the main components of the videogame worlds exist, as well as on their impact on the relationship between the player and the system. We end this third chapter by defining the notion of a player’s “exploratory journey”, that is, all of the necessary, possible and virtual elements as they have manifested themselves throughout her gaming experience. The player’s exploratory journey, thus, represents a state of the videoludic world as it was actualized by a specific player.

Keyphrases: possible worlds, video games, virtuality, philosophy of video games, agency, experience, game studies
Les violoneux du Saguenay-Lac-St-Jean : style et répertoire des derniers de leur lignée

The Saguenay-Lac-St-Jean region is an enclave, and this fact contributed, through the years, to the isolation of the populations established there. This isolation is a factor that would have contributed to the presence of cultural distinctiveness amongst the inhabitants of the region. This cultural specificity has been observed in many fields of research, such as genetics, linguistics, culinary traditions, history and music. This thesis documents the musical element of culture in the region of Saguenay-Lac-St-Jean, through the analysis of style and repertoire of four fiddle players from the region. The classification of repertoire and the identification of different playing techniques, highlight both common and individual elements featured in the music of these four fiddlers. The research also contains a historical overview of the people who lived in or crossed the region, from the period of fur trading to industrialisation, and how they could have influenced the music in this region. Additionally, this research contains a census of over 100 fiddle players who have inhabited or passed through the region since colonisation, as well as a lexic explaining over 70 terms and expressions used by the fiddle players of Saguenay-Lac-St-Jean.

Keyphrases: Saguenay-Lac-St-Jean, style, folklore, variation, traditional music, repertoire, fiddle, fiddler, fiddling, ornamentation, bowing, Quebec