NCube/papyrus huggingface dataset:
Critique du modèle neurophysiologique de la desphinothérapie. Sonophorèse et écholocation

A number of researchers (Birch, 1996 ; Cole, 1995, 1996 ; De Bergerac, 1998), claim a neurophysiological model in order to support therapeutic benefits of dolphin assisted therapy in treating various DSM-IV cognitive and emotional disorders in children and youth. The model is based on analogies with mechanisms of sonophoresis, echolocation and neurohormonal transmission during therapy. In order to demystify pseudo scientific elements in view of a nonspecialized readership, the present article discusses the postulates and implications for each mechanism and concludes to the absence of reliable and valid support for this model.

Keyphrases: Dolphin assisted therapy, Sonophoresis, Echolocation, Autism, Learning disorders, Cognitive disorders, Developmental disorders
Le rôle de la méthylation de l’ADN dans les fonctions cérébrales fronto-limbiques et la réactivité au stress quotidien

Serotonin (5-HT)  plays  a  crucial  role in mental  disorders  etiology  such as major depression,   conduct   disorders   and   anxiety   disorders.   Studies   have   shown   that   early alterations in the 5-HT system can potentially influence frontal-limbic brain development and functioning,  with  consequences  for  emotional  regulation.  There is also  evidence  that  early stress can affect DNA methylation resulting in an alteration in gene expression; however the link  between DNA methylation and behavioural  reactivity to current  daily life  stressors is not known.  DNA methylation in the 5-HT transporter (SLC6A4) is of particular interest, given the role of SLC6A4 in brain development, mental disorders and stress regulation. The aim of the present thesis is to study the association between (1) peripheral levels of DNA methylation inthe  SLC6A4  gene  and  the  neural  responses to emotional  stimuli in  the  frontal-limbic  brain circuitry (2) peripheral SLC6A4 methylation and behavioural reactivity to daily life stress. We also explore the association between frontal-limbic neural responses to emotional stimuli and behavioural  reactivity to daily  life  stress  (3). To  this  end,  twenty-two  individuals  (11 females) with  mean  age of  34.0  years  old  (SD:  1.5)  with  various  levels of SLC6A4  methylation  gene were  recruited  from  two  longitudinal  studies.  Participants  underwent an  fMRI  scan  that included an emotional processing  task.  An online  questionnaire on daily  life  stress  reactivity was  performed  during  5  consecutive  days.  Correlations and  regressions  analyses  were performed to  investigate  the  associations  among  the  primary  variables.  Results of  this  pilot study  showed  that DNA  methylation is  associated  with  the  significant  deactivation of the precentral  gyrus  and  fusiform  gyrus  when  respectively  facing  fearful  and  sad  stimuli. No significant association was observed between levels of methylation and amygdala activation. Also, obtained  scores todaily  life  stress  variables  such as  chronic distress  were  associated with  the  deactivation of  the  precuneus and  posterior  cingulate  cortex  when  facing  sadness. Those  results  suggest  the  potential  implication of  epigenetic  processes in specific  brain activation and daily life stress sensitivity.

Keyphrases: Stress, Serotonin, Methylation, Brain, fMRI, Psychopathology
Applying scanning electron microscopy for the ultrastructural and clinical analysis of periprosthetic capsules in implant-based breast reconstruction

Two-stage implant-based (expander to implant) breast reconstruction is the most frequently applied technique following total mastectomy. While the periprosthetic capsule is a normal physiologic response to any foreign body, pathological capsule formation often leads complications and suboptimal aesthetic results. The scanning electron microscope (SEM) is a powerful tool that offers unparalleled assessment of capsule ultrastructural topography.  The first research aim was to compare conventional high-vacuum (Hi-Vac) SEM with newer environmental scanning electron microscopy (ESEM) technology to determine whether the latter offers superior assessment of breast capsular tissue. The second aim was to apply the most optimal SEM mode to study periprosthetic capsule ultrastructural modifications in women undergoing differing expansion protocols during the first stage of implant-based reconstruction. Ten patients were prospectively included in the first study and 48 prospectively included into the second. Conventional Hi-Vac mode was deemed superior for the comprehensive analysis of breast capsular tissue. Using Hi-Vac mode within the established study protocol, a more pronounced capsular 3-D relief was observed around BIOCELL® expanders when the first postoperative saline inflation took place at 6 weeks following expander insertion (delayed approach). No significant changes were observed with SILTEX® expander capsules in both early (2 weeks) and delayed approach groups.

Keyphrases: Scanning electron microscopy (SEM), Environmental scanning electron microscopy (ESEM), Breast cancer, Implant-based breast reconstruction, Breast expander implants, Breast implants, Tissue expansion, Periprosthetic capsule, Capsular contracture
Caractérisation des unités de soins aigus chirurgicaux au sein des départements de chirurgie générale au Canada

Introduction : The acute care surgery (ACS) units are dedicated to the prompt management of surgical emergencies. It is a systemic way of organizing on-call services to diminish conflict between urgent care and elective obligations. The aim of this study was to define the characteristics of an ACS unit and to find common criteria in units with reported good functioning.   Methods : As of July 1st 2014, 22 Canadian hospitals reported having an ACS unit. A survey with questions about the organization of the ACS units, the population it serves, the number of emergencies and trauma cases treated per year, and the satisfaction about the implementation of this ACS unit was sent to those hospitals.  Results : The survey’s response rate was 73%. The majority of hospitals were tertiary or quaternary centers, served a population of more than 200 000 and had their ACS unit for more than three years. The median number of surgeons participating in an  ACS unit was 8.5 and the majority were doing seven day rotations. The median number of operating room days was 2.5 per week. Most ACS units (85%) had an estimated annual volume of more than 2500 emergency consultations (including both trauma and non-trauma) and 80% operated over 1000 cases per year. Nearly all the respondents (94%) were satisfied with the implementation of the ACS unit in their hospital.   Conclusion : Most surgeons felt that the implementation of an ACS unit resulted in positive outcomes. However, there should be a sizeable catchment population and number of surgical emergencies to justify the resulting financial and human resources.

Keyphrases: Canada, Satisfaction, Acute care surgery unit, Efficiency, General surgery, Operating rooms, Administration, Surgical emergencies, Traumatology
Réadaptation et performance visuelle chez la personne hémianopsique : une étude de cas portant sur les saccades oculaires et le blindsight

Purpose: The unilateral loss of the posterior visual cortex leads to a contralateral cortical blindness, called homonymous hemianopia (HH). HH is known to be accompanied by visual exploration problems in the blind hemifield due to defective saccadic strategies, which have been the target of rehabilitation therapies. Moreover, this blindness may be accompanied by an unconscious visual perception, called blindsight. Our hypothesis proposes that blindsight is mediated by a retino-collicular extrastriate pathway, recruiting the superior colliculus (SC), which is a multisensory structure. Our program aims to assess the impact of a multisensory training (audio-visual) on the unconscious visual performance and ocular strategies of hemianopic patients. Thus, we try to attest the implication of the SC in blindsight and the relevance of multisensory compensation therapies for rehabilitation. Method: ML, a right HH patient, performed an audio-visual training for a period of 10 days. We evaluated the visual localisation and detection performances, as well as ocular strategies in three main comparisons (1) between the normal and the blind hemifield; (2) between the visual and the audio-visual conditions; (3) between the pre-training, post-training and 3 months post-training sessions. Results: We demonstrated that (1) saccadic and fixation characteristics are defective in the blind field compared to the normal field; (2) saccadic strategies differ depending on eccentricities and conditions; (3) long-term adaptation of saccadic accuracy is possible in the blind field; (4) improvement of saccadic eye movements is linked with enhancement of action-blindsight. Conclusion: Compensatory multisensory trainings lead to improvement of visual performances for unseen targets, which is possibly induced by development of oculomotor performances, and thus seem to act more than just a compensation therapy.

Keyphrases: Blindsight, Hemianopia, Rehabilitation, Multisensory integration, Audio-visual, Superior colliculus, Eye strategies
Réduction des artéfacts de tuteur coronarien au moyen d’un algorithme de reconstruction avec renforcement des bords  : étude prospective transversale en tomodensitométrie 256 coupes

Metallic artifacts can result in an artificial thickening of the coronary stent wall which can significantly impair computed tomography (CT) imaging in patients with coronary stents.  The purpose of this study is to assess the in vivo visualization of coronary stent wall and lumen with an edge-enhancing CT reconstruction kernel, as compared to a standard kernel.    This is a prospective cross-sectional study of 24 consecutive patients with 71 coronary stents, using a repeated measure design and blinded observers, approved by the Local Institutional Review Board. 256-slice CT angiography was used, as well as standard and edge-enhancing reconstruction kernels. Stent wall thickness was measured with orthogonal and circumference methods, averaging wall thickness from stent diameter and circumference measurements, respectively. Stent image quality was assessed on an ordinal scale. Statistical analysis used linear and proportional odds models.    Stent wall thickness was inferior using the edge-enhancing kernel compared to the standard kernel, either with the orthogonal (0.97±0.02 versus 1.09±0.03 mm, respectively; p<0.001) or circumference method (1.13±0.02 versus 1.21±0.02 mm, respectively; p<0.001). The edge-enhancing kernel generated less overestimation from nominal thickness compared to the standard kernel, both with orthogonal (0.89±0.19 versus 1.00±0.26 mm, respectively; p<0.001) and circumference (1.06±0.26 versus 1.13±0.31 mm, respectively; p=0.005) methods.  The average decrease in stent wall thickness overestimation with an edge-enhancing kernel was 6%.  Image quality scores were higher with the edge-enhancing kernel (odds ratio 3.71, 95% CI 2.33–5.92; p<0.001).      In conclusion, the edge-enhancing CT reconstruction kernel generated thinner stent walls, less overestimation from nominal thickness, and better image quality scores than the standard kernel.

Keyphrases: Stent, Coronary artery disease, Computed tomography, Angiography, Artifact, Stenosis, Reconstruction kernel, Cardiac imaging, Atherosclerosis
Biomarqueurs pronostiques dans le cancer de la prostate : mieux prédire pour mieux traiter

Prostate cancer (PC) is the most frequently diagnosed cancer in North America and is ranked third in terms of mortality. After first line treatments, 20-30% of patients with localized disease will develop biochemical recurrence. Androgen-deprivation therapy is often used as a second line treatment, but some patients unfortunately progress to the castrate-resistant state, for which no curative treatment exists, and which is associated with high morbidity (bone metastasis) and a mean survival of less than two years. PC has a heterogeneous evolution among patients and to date no prognostic markers exist to identify those with a higher risk of biochemical recurrence, bone metastasis or castrate-resistant disease.  Many studies have shown that the inflammatory cytokines IL-6 and IL-8 are implicated in PC progression and the development of castration-resistance. In addition, high serum levels of these markers are associated with a worse outcome. Previous work has shown that the kinase IKKε is associated with higher levels of IL-6 and IL-8 in vitro, and that its expression is higher in tissue samples of more advanced disease.  The first objective was to assess the association between IKKε, IL-6 and IL-8 tissular expression levels and clinical parameters. Our results suggest that IKKε has prognostic properties in terms of biochemical recurrence and the development of bone metastasis. No association between IL-6/IL-8 and the clinical parameters was identified. The second objective was to evaluate the coexpression of these molecules within the PC epithelium. Our results confirm previous in vitro observations showing a strong correlation between IKKε, IL-6 and IL-8 expression levels. The third objective was to compare within the same patients the expression levels of IL-6 and IL-8 in the serum and PC tissue samples. No relation was identified suggesting that serum levels of these cytokines are not only of prostatic origin.  In conclusion, the research project presented highlights the potential of IKKε as a prognostic biomarker in tissue samples and validated for the first time its correlation with IL-6 and IL-8, both well-established cytokines implicated in the pathogenesis of PC. Further studies can further investigate the IKKε signaling pathways implicated in the stimulation of IL-6 and IL-8 production and by which mechanisms IKKε could contribute to the transition into castration-resistance.

Keyphrases: Prostate cancer, IKKe, IL-6, IL-8, immunofluorescence, biochemical recurrence, bone metastasis, prognostic
Les mères avec un trouble de personnalité limite en protection de la jeunesse : un paradoxe entre les difficultés et les services

A significant proportion of mothers who have children in the care of the Youth Protection Services have borderline personality disorder (BPD). However, there is very little information on the needs and difficulties of these mothers in this special context.   This qualitative study was conducted among 30 mothers who have BPD and who have at least one child followed by Centre jeunesse de Montréal-Institut universitaire, a Youth Protection Service. The study provided a description of the difficulties those mothers have associated with their personality disorder, their children and their couple relationship. Their experiences of services offered by Youth Protection suggested that the follow up received were unstable and not suitable for their difficulties and their needs. Mothers have addressed the importance of interpersonal skills of caseworkers to develop better collaboration and the importance of putting in place specifically dedicated services to parents. It would appear pertinent to adapt Youth Protection Services in order to include interventions that target the specific difficulties of parents with BPD, notably regarding parenting skills.

Keyphrases: Services, Intervenants DPJ, Recherche qualitative, Mothers, Borderline personality disorder, Youth protection, Needs, Services, Youth protection workers, Qualitative research, Parenting skills
Les effets du dalcetrapib, un inhibiteur de la protéine de transfert des esters de cholestérol (CETP), sur la structure et la fonction des lipoprotéines de haute densité (HDL) dans l’étude dal-PLAQUE2

Introduction: Dalcetrapib, an inhibitor of the hydrophobic cholesteryl ester transfert protein (CETP), was studied within the framework of the phase II clinical essay dal-PLAQUEII (DP2). The main goal is to study the effect of dalcetrapib after 1 year of treatment on the structure and function of the HDL particles in a subpopulation of the DP2 cohort.   Method: DP2 subjects having a series of measurements of cIMT and samples of plasma and serum at baseline and after 1 year of treatment were selected (379 samples: 193 in the placebo arm (PCB) and 186 in the dalcetrapib arm (DAL)). Predetermined biochemical data, profile of size and subclass concentrations of HDL and LDL by nuclear magnetic resonance (NMR) and 2 different serum cholesterol efflux capacity (CEC) measures were explored. Statistical data were obtained comparing change at 1 year from baseline with ANOVA or ANCOVA. The standardized protocol of efflux essay allowed to calculate the 3H-cholesterol fractional efflux (in %) of BHK-ABCA1 (fibroblasts) and J774 (macrophages, ABCA1 pathway) and HepG2 (hepatocytes, SR-BI pathway) cell lines, to human sera samples from the DP2 cohort.   Results: Regarding the plasmatic biochemistry, a combined effect in CETP activity changes in both arms caused a reduction of 30% in the DAL arm. After 1 year in the DAL arm, HDL-C rate was increased by 35.5% (p < 0.001) and apoA-I value increased by 14.0% (p < 0.001). In the NMR lipoprofile in the DAL arm after 1 year, size of HDL particles by 5.2% (p < 0.001), large HDL particles by 68.7% (p < 0.001) and large LDL particles by 37.5% (p < 0.01). Small HDL particles were decreased by 9.1% (p < 0.001). Regarding cIMT index, there is no significant difference between the 2 arms. On the level of the CEC, we noted a significant increase of the efflux through the SR-BI pathway and a increase via the ABCA1 pathway in the DAL arm after 1 year of treatment.   Conclusion: After one year of treatment with dalcetrapib, one can note a rise of HDL-C, rather neutral results on the level of the NMR lipoprofile and a modest increased efflux capacity but too low to affect the value of cIMT in the tested samples.

Keyphrases: Cholesterol, Atherosclerosis, Dalcetrapib, Cholesterol efflux capacity, ABCA1, SR, HDL, cIMT
Metabolomics analysis in rats with thiamine deficiency identifies key metabolites in vulnerable brain regions and suggests neural stem progenitor cells play a role in ameliorating metabolic dysfunction

Endogenous neural-stem progenitor cells (NSPC) have been documented to be found in the subventricular and subgranular zones, the dentate gyrus, and suggestions of the possibility of these cells being found in the spinal cord and neocortex in adult mammalian brain have been postulated.  Thiamine deficiency (TD) is the major cause of Wernicke's Encephalopathy, a reversible neurological disorder that results in cerebral dysfunction and impairment. Recent evidence suggests factors involved in neural NSPC proliferation and differentiation are involved during TD.  By means of a current approach for profiling metabolic changes occurring in focal areas of the TD rat brain, specifically the thalamus and the inferior colliculus (IC), it was hypothesized that new metabolites that might offer a better understanding into the sequel and/or mechanism of TD could be identified. It was also considered that the use of NSPC transplantation could offer new information into the involvement of NSPC and potential therapeutic benefit in TD.  Non-targeted metabolomics analysis, fluorescences microscopy, and scanning election microscopy (SEM) analysis visualization was performed on samples of the focal areas (thalamus and IC) of pyrithiamine induced TD rats (PTD), pair-fed controls (PFC) rats, and NSPC transplanted TD and PFC rats. Various key metabolites were identified in rats with TD, including previous undocumented metabolites such as bile acids, kynurenic acid, and 1,9-dimethyluric acid in the thalamus and taurine and carnosine in the IC. The study also demonstrated a possible involvement of endogenous NSPC in focal areas of the thalamus and IC identifying key metabolites targeting NSPC and showed tissue amelioration (observed through SEM) following NSPC transplantation. The findings suggested that NSPC could offer a therapeutic alternative to alleviate some of symptomatic degeneration of TD.

Keyphrases: Non-targeted Metabolomics, Neurochemistry, Thiamine Deficiency, Wernicke's Encephalopathy, Neural Stem-Progenitor Cells, Transplantation
Cost-effectiveness of Transcatheter Mitral Valve Leaflet Repair for the Treatment of Mitral Regurgitation 
in Heart Failure

Background:  Mitral regurgitation (MR) is a common valvular heart disorder requiring intervention once it becomes severe. Transcatheter mitral valve leaflet repair with the MitraClip device is a safe and effective therapy for selected patients denied surgery.  We sought to evaluate the clinical outcomes and economic impact of this therapy compared to medical management in heart failure patients with symptomatic MR.  Methods:  The study was comprised of two phases; an observational study of patients with heart failure and MR treated with either medical therapy or the MitraClip, and an economic model. Results of the observational study were used to estimate parameters for the decision model, which estimated costs, and benefits in a hypothetical cohort of patients with heart failure and moderate to severe MR treated with either standard medical therapy or MitraClip.   Results:  The cohort of patients treated with the MitraClip was propensity matched to a population of heart failure patients, and their outcomes compared. At a mean follow up of 22 months, all-cause mortality was 21% in the MitraClip cohort and 42% in the medical management cohort (p=0.007).  The decision model demonstrated that MitraClip increased life expectancy from 1.87 to 3.60 years and quality-adjusted life years (QALY) from 1.13 to 2.76 years. The incremental cost was $52,500 Canadian dollars, corresponding to an incremental cost-effectiveness ratio (ICER) of $32,300.00 per QALY gained.  Results were sensitive to the survival benefit.  Conclusion: In this cohort of heart failure patients with symptomatic moderate-severe MR, therapy with the MitraClip was associated with superior survival and is cost-effective compared to medical therapy.

Keyphrases: mitral regurgitation, heart failure, transcatheter mitral valve repair, cost-effectiveness
Étude des motivations de consommation alimentaire d’adolescents québécois de 12 à 14 ans par l’utilisation de la photographie

Introduction : Adolescence is a pivotal period when healthy eating habits are developed and strengthened into adulthood. Food choices are inevitably influenced by multiple factors, both individual and environmental. Moreover, amongst teenagers, such factors are often biased by a quest for identity.  Study Aims : Investigate and contrast the principal determinants pertaining to the decision-making process of food choices among Quebec teenagers as well as evaluate the qualitative research method used.  Method : This study is based on the project « Les dimensions socioculturelles des pratiques alimentaires et d'activité physique des jeunes : une enquête qualitative auprès d'adolescents québécois de 12 à 14 ans ». Thirty semi-directed interviews were analyzed using a framework of food photo-elicitation.  Results : Both key individual and social factors were found to be significant. Taste and sensory perception, personal meaning of food and nutritional knowledge were found to be key individual motivators. Conversely, for social factors, family, friends, activities and location pertaining to food consumption had an important impact. In the setting of an interview, the use of photography is a very interesting and useful tool to further collect key, complementary data.  Conclusion : This study confirms the importance of key individual and social determinants of eating behaviours among Quebec teenagers. The knowledge acquired will be useful for both the improvement and development of governmental programs that will be well-suited to promote healthy behaviours among Quebec teenagers.  Keywords : adolescence, teenagers, adolescents, photo-elicitation, food choices,

Keyphrases: Jeunes, Adolescents, Adolescence, Teenagers, Photo-elicitation, Food choices