Comment évaluer la théorie de l’esprit? Revue systématique des outils d’évaluation destinés aux enfants d’âge préscolaire

Essai doctoral présenté en vue de l’obtention du grade de doctorat en psychologie, option neuropsychologie clinique (D.Psy.)La Théorie de l’Esprit (TDE), soit l’habileté à inférer des états mentaux à soi-même et à autrui, est un domaine de recherche ralliant plusieurs disciplines, incluant la psychologie sociale et développementale, la neuropsychologie, les neurosciences sociales et l’orthophonie. Les habiletés de la TDE ont été maintes fois reliées à plusieurs marqueurs d’adaptation sociale, telles des compétences relationnelles et communicationnelles de meilleure qualité. Par ailleurs, la TDE est altérée dans le contexte de nombreuses conditions cliniques. Malgré l’énorme quantité d’études dédiées à la TDE, identifier des outils de mesures appropriés destinés aux enfants d’âge préscolaire demeure un défi. Cet essai a pour but de faciliter l’identification d’outils de mesures de la TDE pour les enfants de 0-5 ans en créant un inventaire de ceux-ci et de leurs caractéristiques. Une introduction positionne l’importance de la TDE à titre d’habileté sociocognitive, la définit et la distingue de construits socio-cognitifs apparentés, survole sa trajectoire développementale et soulève les défis reliés à son évaluation. Une revue systématique de la littérature, sous forme d’article scientifique, présente ensuite la méthodologie utilisée et l’inventaire des outils de mesures réalisé, et permet de souligner la grande variété d’outils évaluant la TDE, mais également de nombreux écueils méthodologiques et psychométriques associés à la création et au choix d’outils appropriés, incluant le nombre limité de sous-habiletés visées, le manque de standardisation et la pauvreté des informations psychométriques disponibles. Une discussion générale est ensuite fournie et relève les apports théoriques, méthodologiques et cliniques de cette recherche pour le domaine de la TDE.Theory of mind (TOM), the ability to infer mental states to self and others, has been a pervasive research theme across many disciplines including developmental, neuro-, and social psychology, social neuroscience and speech therapy. TOM abilities have been consistently linked to markers of social adaptation, such as better communication skills and quality social relationships, and are affected in a broad range of clinical conditions. Despite the wealth and breadth of research dedicated to TOM, identifying appropriate assessment tools for the preschool population remains challenging. This work aims to facilitate the choice and use of adequate measures for children aged 0 to 5 years by generating a comprehensive inventory of TOM measures and listing their characteristics. The introduction highlights the importance of TOM as a social-cognitive ability, defines TOM and distinguishes it from related yet distinct sociocognitive constructs, provides information on its developmental trajectory and raises challenges associated with TOM assessment. A systematic review of the literature is then presented in the form of an article and provides details on the methods used and the inventory of TOM measures generated. The remarkable variety of measures that have been created to assess TOM is highlighted, but also the numerous methodological and psychometric challenges associated with developing and choosing appropriate measures, including issues related to the limited range of sub-abilities targeted, lack of standardisation across studies and paucity of psychometric information provided. Finally, a general conclusion provides the opportunity to discuss the theoretical, methodological and clinical contributions of this project

How do social interactions with a significant other affect PTSD symptoms? An empirical investigation with a clinical sample

Social support and coping are both related to posttraumatic stress disorder (PTSD) symptoms, but the mechanisms underlying their relationships remain unclear. This study explores these relationships by examining the perceived frequency of supportive and countersupportive interactions with a significant other in PTSD patients. Ninety-six participants with PTSD were recruited and completed questionnaires assessing social interactions, ways of coping, and PTSD symptoms. Associations of social interactions (r2 = 4.1%–7.9%, p < .05) and coping (r2 = 15.9%– 16.5%, p < .001) with symptoms were independent, and suggested a direct association between social interactions and PTSD. Countersupportive interactions were more associated to symptoms than supportive interactions. Our findings suggest the development of psychotherapies that integrate social support interventions

Postconcussive Symptoms After Early Childhood Concussion

IMPORTANCE: Research on postconcussive symptoms (PCS) following early childhood concussion has been hindered by a lack of measures suitable for this age group, resulting in a limited understanding of their evolution in young children. OBJECTIVE: To document PCS in the first 3 months after early childhood concussion using a developmentally appropriate measure. DESIGN, SETTING, AND PARTICIPANTS: This cohort study used data collected at 3 Canadian and 1 US urban pediatric emergency departments (EDs) and 8 Canadian daycares from December 2018 to December 2022 as part of the Kids\u27 Outcomes and Long-Term Abilities (KOALA) project, a prospective, multicenter, longitudinal cohort study. Participants included children aged 6 to 72 months with early childhood concussion or orthopedic injury (OI) or uninjured children from the community to serve as controls. Data were analyzed from March 2023 to January 2024. EXPOSURE: Concussion sustained between ages 6 and 72 months. MAIN OUTCOMES AND MEASURES: Primary outcomes were cognitive, physical, behavioral and total PCS assessed prior to injury (retrospectively), acutely (within 48 hours), and at 10 days, 1 month, and 3 months after injury or recruitment through caregiver observations using the Report of Early Childhood Traumatic Injury Observations & Symptoms inventory. Group comparisons were analyzed using ordinal regression models. RESULTS: The study included 303 children (mean [SD] age, 35.8 [20.2] months; 152 [50.2%] male). Of these, 174 children had a concussion (mean [SD] age,  33.3 [19.9] months), 60 children had an OI (mean [SD] age, 38.4 [19.8] months) and 69 children were uninjured controls (mean [SD] age, 39.7 [20.8] months). No meaningful differences were found between the concussion and comparison groups in retrospective preinjury PCS. Significant group differences were found for total PCS at the initial ED visit (concussion vs OI: odds ratio [OR], 4.33 [95% CI, 2.44-7.69]; concussion vs control: OR, 7.28 [95% CI, 3.80-13.93]), 10 days (concussion vs OI: OR, 4.44 [95% CI, 2.17-9.06]; concussion vs control: OR, 5.94 [95% CI, 3.22-10.94]), 1 month (concussion vs OI: OR, 2.70 [95% CI, 1.56-4.68]; concussion vs control: OR, 4.32 [95% CI, 2.36-7.92]), and 3 months (concussion vs OI: OR, 2.61 [95% CI, 1.30-5.25]; concussion vs control: OR, 2.40 [95% CI, 1.36-4.24]). Significant group differences were also found for domain-level scores (cognitive, physical, behavioral) at various time points. CONCLUSIONS AND RELEVANCE: In this early childhood cohort study, concussion was associated with more PCS than OIs or typical development up to 3 months after injury. Given the limited verbal and cognitive abilities typical of early childhood, using developmentally appropriate manifestations and behaviors is a valuable way of tracking PCS and could aid in concussion diagnosis in young children

Effect of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker initiation on organ support-free days in patients hospitalized with COVID-19

IMPORTANCE Overactivation of the renin-angiotensin system (RAS) may contribute to poor clinical outcomes in patients with COVID-19. Objective To determine whether angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) initiation improves outcomes in patients hospitalized for COVID-19. DESIGN, SETTING, AND PARTICIPANTS In an ongoing, adaptive platform randomized clinical trial, 721 critically ill and 58 non–critically ill hospitalized adults were randomized to receive an RAS inhibitor or control between March 16, 2021, and February 25, 2022, at 69 sites in 7 countries (final follow-up on June 1, 2022). INTERVENTIONS Patients were randomized to receive open-label initiation of an ACE inhibitor (n = 257), ARB (n = 248), ARB in combination with DMX-200 (a chemokine receptor-2 inhibitor; n = 10), or no RAS inhibitor (control; n = 264) for up to 10 days. MAIN OUTCOMES AND MEASURES The primary outcome was organ support–free days, a composite of hospital survival and days alive without cardiovascular or respiratory organ support through 21 days. The primary analysis was a bayesian cumulative logistic model. Odds ratios (ORs) greater than 1 represent improved outcomes. RESULTS On February 25, 2022, enrollment was discontinued due to safety concerns. Among 679 critically ill patients with available primary outcome data, the median age was 56 years and 239 participants (35.2%) were women. Median (IQR) organ support–free days among critically ill patients was 10 (–1 to 16) in the ACE inhibitor group (n = 231), 8 (–1 to 17) in the ARB group (n = 217), and 12 (0 to 17) in the control group (n = 231) (median adjusted odds ratios of 0.77 [95% bayesian credible interval, 0.58-1.06] for improvement for ACE inhibitor and 0.76 [95% credible interval, 0.56-1.05] for ARB compared with control). The posterior probabilities that ACE inhibitors and ARBs worsened organ support–free days compared with control were 94.9% and 95.4%, respectively. Hospital survival occurred in 166 of 231 critically ill participants (71.9%) in the ACE inhibitor group, 152 of 217 (70.0%) in the ARB group, and 182 of 231 (78.8%) in the control group (posterior probabilities that ACE inhibitor and ARB worsened hospital survival compared with control were 95.3% and 98.1%, respectively). CONCLUSIONS AND RELEVANCE In this trial, among critically ill adults with COVID-19, initiation of an ACE inhibitor or ARB did not improve, and likely worsened, clinical outcomes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT0273570

The 26S proteasome system degrades the ERM transcription factor and regulates its transcription-enhancing activity

ERM is a member of the ETS transcription factor family. High levels of the corresponding mRNA are detected in a variety of human breast cancer cell lines, as well as in aggressive human breast tumors. As ERM protein is almost undetectable in these cells, high degradation of this transcription factor has been postulated. Here we have investigated whether ERM degradation might depend on the proteasome pathway. We show that endogenous and ectopically expressed ERM protein is short-lived protein and undergoes proteasome-dependent degradation. Deletion mutagenesis studies indicate that the 61 C-terminal amino acids of ERM are critical for its proteolysis and serve as a degradation signal. Although ERM conjugates with ubiquitin, this post-translational modification does not depend on the C-terminal domain. We have used an Ets-responsive ICAM-1 reporter plasmid to show that the ubiquitin-proteasome pathway can affect transcriptional function of ERM. Thus, ERM is subject to degradation via the 26S proteasome pathway, and this pathway probably plays an important role in regulating ERM transcriptional activity. © 2007 Nature Publishing Group. All rights reserved.SCOPUS: ar.jinfo:eu-repo/semantics/publishe

Traduction de l'Occupational Balance Questionnaire en français et sa validation

Background: Questionnaires measuring occupational balance have been created in recent years, but those available in French are limited. Purpose. This study aimed to translate and transculturally adapt the Occupational Balance Questionnaire and to examine the internal consistency, test–retest reliability and convergent validity of the French version. Methodology: A cross-cultural validation was conducted with adults in Quebec (n =69) and in French-speaking Switzerland (n=47). Results: Internal consistency was good in both regions (α > 0.85). Test–retest reliability was satisfactory in Quebec (ICC =0.629; p < 0.001), but a significant difference was found between the two measurement times in French-speaking Switzerland. Significant associations were found between the results of the Occupational Balance Questionnaire and those of the Life Balance Inventory (Quebec, r =0.47; French-speaking Switzerland, r =0.52). Implications: These initial results support the use of the OBQ-French in the general population of two French-speaking regions.Description: Des questionnaires visant à mesurer l’équilibre occupationnel ont été créés ces dernières années, mais ceux disponibles en français sont limités. But. Cette étude visait à traduire et adapter transculturellement l’Occupational Balance Questionnaire et à examiner la cohérence interne, la fidélité test-retest et la validité convergente de la version en français. Méthodologie: Une validation a été effectuée auprès de personnes adultes au Québec (n=69) et en Suisse romande (n=47). Résultats: La cohérence interne est bonne dans les deux régions (α > 0,85). La fidélité test-retest est satisfaisante au Québec (ICC=0,629 ; p < 0,001), mais une différence significative est relevée entre deux passations en Suisse romande. Une relation significative est démontrée entre l’équilibre occupationnel et l’équilibre de vie (Québec r=0,47 ; Suisse romande r=0,52). Conséquences: Ces premiers résultats soutiennent l’utilisation de l’OBQ-français auprès de la population générale de deux régions francophones

SUMO modification of the Ets-related transcription factor ERM inhibits its transcriptional activity

A variety of transcription factors are post-translationally modified by SUMO, a 97-residue ubiquitin-like protein bound covalently to the targeted lysine. Here we describe SUMO modification of the Ets family member ERM at positions 89, 263, 293, and 350. To investigate how SUMO modification affects the function of ERM, Ets-responsive intercellular adhesion molecule 1 (ICAM-1) and E74 reporter plasmids were employed to demonstrate that SUMO modification causes inhibition of ERM-dependent transcription without affecting the subcellular localization, stability, or DNA-binding capacity of the protein. When the adenoviral protein Gam1 or the SUMO protease SENP1 was used to inhibit the SUMO modification pathway, ERM-dependent transcription was de-repressed. These results demonstrate that ERM is subject to SUMO modification and that this post-translational modification causes inhibition of transcription-enhancing activity. © 2005 by The American Society for Biochemistry and Molecular Biology, Inc.SCOPUS: ar.jinfo:eu-repo/semantics/publishe

In vivo evaluation and imaging of a bilayered self-assembled skin substitute using a decellularized dermal matrix grafted on mice

As time to final coverage is the essence for better survival outcome in severely burned patients, we have continuously strived to reduce the duration for the preparation of our bilayered self-assembled skin substitutes (SASS). These SASS produced in vitro by the self-assembly approach have a structure and functionality very similar to native skin. Recently, we have shown that a decellularized dermal matrix preproduced by the self-assembly approach could be used as a template to further obtain self-assembled skin substitute using a decellularized dermal template (SASS-DM) in vitro. Thus, the production period with patient cells was then reduced to about 1 month. Herein, preclinical animal experiments have been performed to confirm the integration and evolution of such a graft and compare the maturation of SASS and SASS-DM in vivo. Both tissues, reconstructed from adult or newborn cells, were grafted on athymic mice. Green fluorescent protein-transfected keratinocytes were also used to follow grafted tissues weekly for 6 weeks using an in vivo imaging system (IVIS). Cell architecture and differentiation were studied with histological and immunofluorescence analyses at each time point. Graft integration, macroscopic evolution, histological analyses, and expression of skin differentiation markers were similar between both skin substitutes reconstructed from either newborn or adult cells, and IVIS observations confirmed the efficient engraftment of SASS-DM. In conclusion, our in vivo graft experiments on a mouse model demonstrated that the SASS-DM had equivalent macroscopic, histological, and differentiation evolution over a 6-week period, when compared with the SASS. The tissue-engineered SASS-DM could improve clinical availability and advantageously shorten the time necessary for the definitive wound coverage of severely burned patients