Cerebrospinal fluid biomarkers of central nervous system dysfunction in HIV-infected patients

Background :¦In addition to opportunistic infections of the central nervous system (CNS), which are due to immunosuppression related to HIV, the latter virus, itself, can cause neuropathological abnormalities which are located mainly in the basal ganglia and are characterized by microglial giant cells, reactive astrocytosis and perivascular monocytes. This HIV encephalopathy is characterized, clinically, by psycho-motor slowing, memory loss, difficulties in complex tasks requiring executive functions, as well as motor disorders .These cognitive deficits are grouped under the acronym of HIV-associated neurocognitive disorders (HAND). In fact, HANDs are subdivided in three groups in accordance with the severity of the cognitive impairment: Asymptomatic Neurocognitive Impairment (ANI), Mild/moderate Neurocognitive Disorders (MND) and HIV Associated Dementia (HAD).¦While the incidence of HAD has significantly decreased in the era of combined antiretrobiral therapy (cART), the prevalence of milder forms of HIV-associated neurocognitive disorders HAND seem to have increased. There are many potential reasons to explain this state of facts.¦An important question is to understand how soon the brain may be affected by HIV. Since performing a biopsy in these patients is not an issue, the study of the CSF represents the best available way to look at putative biomarkers of inflammation/neurodegeneration in the CNS. Here, we wanted to examined the putative usefulness of different biomarkers as early indicators of anti-retroviral failure at the level of the CNS. We chose to study the CSF levels of:¦Amyloid-β 1-42 (Aβ42), Tau total (tTau), phosphorylated Tau (pTau), Neopterin and S100-β.¦Indeed, these molecules are representative biomarkers of the major cells of the CNS, i.e. neurons,¦macrophages/microglia and astrocytes.¦To examine how sensitive were these CSF biomarkers to indicate CNS insults caused by HIV, we proposed to take advantage of the MOST (Monotherapy Switzerland/Thailand study) study, recently published in AIDS. Thus, we collaborated with Prof. Pietro Vernazza in St-Gall. In MOST study, monotherapy (MT) consisting in ritonavir-boosted lopinavir (LPV/r) was compared to continuous conventional antiretroviral therapy including several molecules, hereafter referred as CT¦Methods :We tested 61 cerebrospinal fluid (CSF) samples from 52 patients enrolled in MOST, including 34 CSF samples of CT and 27 of MT (mean duration on MT: 47+20 weeks) in patients who maintained full VL suppression in blood (<50cps/ml). Using enzyme-linked immunosorbent assay (ELISA), we determined the CSF concentration of S100-beta (astrocytosis), neopterin (microglia, inflammation), total Tau (tTau), phosphorylated Tau (pTau), and amyloid-beta 1-42 (Abeta), the latter three markers indicating neuronal damages. The CSF samples of 37 HIV-negative patients with Alzheimer dementia (AD) served as controls. Results are expressed in pg/ml and reported as median ± interquartile range. Mann Whitney-U test was used to compare the results of a given biomarker between two groups and the Fisher test to compare frequencies.¦Results: We found a higher concentration of S100-beta (570±1132) and neopterin (2.5±2.9) in the CSF of MT versus CT (0±532, p=0.002 and 1.2±2.5, p=0.058, respectively). A cutoff of 940 pg/ml for S100-beta allowed to discriminate MT (11 above versus 16 below) from CT (1 vs 33, p=0.0003). At a lesser extent, a cutoff of 11 pg/ml for neopterin separated MT (4 above versus 23) from CT (0 vs 34, p=0.034) (Figure).¦In AD, tTau was higher (270±414) and Abeta lower (234±328) than in CT (150±153, p=0.0078, and 466±489, p=0.007, respectively). Such as for CT, Abeta was lower in AD than in MT (390±412, p=0.01). However, contrasting with CT, the levels of tTau were not different between AD and MT (199±177, p=0.11). S100b (173±214; p=0.0006) and neopterin (1.1±0.9; p=0.0014) were lower in AD than MT.¦Conclusions: Despite full VL-suppression in blood, HIV monotherapy is sufficient to trigger inflammation and, especially, astrocytosis. CSF markers of patients on CT have the same profile as reported for healthy subjects, suggesting that CT permits a good control of HIV in the brain. Finally, the levels of tTau, which are relatively similar between AD and MT patients, suggest that neurons are damaged during monotherapy

School culture and social inequalities in school-based health promoting interventions in Québec elementary schools

Contexte : Les interventions de promotion de la santé (IPS) en milieu scolaire visent à soutenir le développement des jeunes et promouvoir l'adoption de modes de vie sains. Une culture scolaire promotrice de santé a été identifiée comme un facteur facilitant l’adoption, la mise en œuvre et l’efficacité des interventions. Toutefois, la culture scolaire peut varier d'une école à l'autre, particulièrement dans celles accueillant des élèves issus de milieux défavorisés, et des inégalités dans l’offre d’IPS risqueraient d’exacerber les inégalités de santé existantes. Un écart de connaissances persiste sur les inégalités sociales dans la culture scolaire et l’offre d’IPS dans les écoles desservant des élèves de statut socio-économique différent. Objectifs : L'objectif était d'étudier les associations entre le niveau de défavorisation de l’école, la culture scolaire et la disponibilité d’IPS. Nous avons cherché à: (1) quantifier l'association entre la défavorisation de l’école, l'importance de problématiques de santé et la disponibilité d’IPS; (2) quantifier l'association entre la défavorisation de l’école et la culture scolaire promotrice de santé. Les résultats de l'objectif 1 ayant montré un gradient social dans la disponibilité d’IPS en matière de santé mentale, nous avons approfondi pour: (3) quantifier l'association entre des variables du contexte scolaire et la présence d’IPS de santé mentale; (4) les caractériser par rapport aux meilleures pratiques (ex. approche globale, optimisation de la culture scolaire). Méthodes : Les données sont tirées de PromeSS, une étude transversale comprenant 171 écoles primaires du Québec, Canada (2017-2019). Quatre mesures d'une culture scolaire promotrice de santé ont été développées à partir du modèle théorique «Health Promoting Schools». Des modèles de régression logistique, ANOVA unidirectionnelle et tests de Tukey ont servi à estimer les associations entre les variables d’intérêt. Des données approfondies sur un échantillon de 25 IPS de santé mentale ont été analysées dans le cadre d'une analyse de cas croisés. Résultats : Les écoles défavorisées ont signalé plus de problématiques de santé que les écoles favorisées. Les proportions d’IPS disponibles étaient similaires, sauf pour les IPS de santé mentale offertes en plus grande proportion dans les écoles favorisées. Les écoles favorisées avaient une culture scolaire plus promotrice de la santé que les écoles défavorisées, principalement en termes d'engagement avec les familles et la communauté. Les écoles plus susceptibles de mettre en œuvre des IPS de santé mentale étaient les écoles favorisées, ayant une culture scolaire plus promotrice de santé et où les problématiques de santé mentale étaient considérées comme importantes. Bien que généralement bien adaptées à leur contexte, peu d’IPS de santé mentale étaient alignées avec les meilleures pratiques. Conclusions : Cette thèse illustre l’importance du contexte dans lequel les IPS sont mis en œuvre, incluant la culture scolaire comme caractéristique essentielle pour des IPS efficaces et les conditions socioéconomiques des élèves. La capacité des écoles à établir une culture scolaire promotrice de santé et à mettre en œuvre des interventions fondées sur les données probantes devrait être renforcée, en particulier pour les écoles défavorisées, afin d'améliorer la santé des élèves et de réduire les inégalités.Background: School-based health-promoting interventions (HPIs) are key components of public health strategies that aim to support youth development and promote the adoption of healthy lifestyles. A health-promoting school culture, which represents the school’s context for HPI implementation, has been identified as a facilitator of HPI adoption, implementation, and effectiveness. However, school culture may vary across schools and in particular, schools serving students from disadvantaged backgrounds which face known challenges for HPI implementation. Inequalities in school culture and HPI programming may exacerbate existing health inequalities across disadvantaged versus advantaged settings. Yet little is known about social inequalities in school culture or HPI availability across schools serving student populations of varying socio- economic status. Objectives: The aim of this dissertation was to investigate the associations among school deprivation, school culture and HPI availability. Specifically we aimed: (1) to quantify the association between school deprivation and each of perceived importance of health issues and HPI availability; (2) to quantify the association between school deprivation and health-promoting school culture. Because results from objective 1 showed a social gradient in the availability of mental health HPIs, we delved deeper: (3) to quantify the association between school context variables and the availability of mental health HPIs; and (4) to characterize them according to their alignment with best practices for effective school-based mental health promotion. Methods: Data were drawn from the PromeSS study, a cross-sectional survey of school principals including 171 elementary schools across Québec, Canada (2017-2019). Four measures of a health- promoting school culture were developed drawing from the Health Promoting Schools theoretical model. Logistic regression models, one-way ANOVA and post-hoc Tukey tests were used to estimate associations between school deprivation, health-promoting school culture, importance of health issues, and HPI availability. In-depth data on a sample of 25 mental health HPIs implemented in study schools were analyzed in cross-case analysis. Results: The three articles that comprise this thesis show that: (1) disadvantaged schools reported more health issues as important than advantaged schools, but similar proportions of HPIs, except for mental health HPIs (a higher proportion of advantaged schools reported offering one in the past year); (2) advantaged schools had a more health-promoting school culture than disadvantaged schools, primarily in terms of engagement with families and the wider school community; (3) in the case of mental health promotion, advantaged schools, schools with a more health-promoting school culture, and schools where mental health issues were seen as important were more likely to implement mental health HPIs; and (4) although schools generally implemented interventions that were highly tailored to their context, few mental health HPIs were aligned with best practices for effective mental health promotion (e.g., whole-school approach, optimization of school culture). Conclusion: This thesis suggests that the context in which school-based HPIs are implemented matters, including student socioeconomic conditions. It strengthens empirical support for health- promoting school culture as a crucial feature for effective HPIs. School capacity for establishing a health-promoting school culture and implementing evidence-based interventions should be reinforced, especially for disadvantaged schools to improve student health and reduce inequalities.estimate associations between school deprivation, health-promoting school culture, importance of health issues, and HPI availability. In-depth data on a sample of 25 mental health HPIs implemented in study schools were analyzed in cross-case analysis. Results: The three articles that comprise this thesis show that: (1) disadvantaged schools reported more health issues as important than advantaged schools, but similar proportions of HPIs, except for mental health HPIs (a higher proportion of advantaged schools reported offering one in the past year); (2) advantaged schools had a more health-promoting school culture than disadvantaged schools, primarily in terms of engagement with families and the wider school community; (3) in the case of mental health promotion, advantaged schools, schools with a more health-promoting school culture, and schools where mental health issues were seen as important were more likely to implement mental health HPIs; and (4) although schools generally implemented interventions that were highly tailored to their context, few mental health HPIs were aligned with best practices for effective mental health promotion (e.g., whole-school approach, optimization of school culture). Conclusion: This thesis suggests that the context in which school-based HPIs are implemented matters, including student socioeconomic conditions. It strengthens empirical support for health- promoting school culture as a crucial feature for effective HPIs. School capacity for establishing a health-promoting school culture and implementing evidence-based interventions should be reinforced, especially for disadvantaged schools to improve student health and reduce inequalities

Alliance entre enseignants et parents d’élèves présentant des difficultés d’attention : une analyse sémiotique des perceptions du diagnostic

La collaboration entre parents et enseignants apparaît comme un processus au sein duquel ces acteurs s’approprient des stratégies qui les aident à actualiser leurs compétences et à offrir un meilleur soutien à l’élève en difficulté. Or plusieurs études démontrent que parents et enseignants s’entendent peu et craignent respectivement d’être perçus comme incompétents. Dans le cadre d’une recherche visant les pratiques d’intervention auprès des élèves ayant des difficultés d’attention, deux groupes de réflexion ont été formés. L’analyse des données issues de ces rencontres fait émerger quelques enjeux majeurs, dont l’incertitude amenée par le diagnostic de difficultés d’attention en milieu scolaire. Elle permet aussi de questionner les conditions et stratégies d’alliances entre parents et enseignants comme partenaires dans la réussite scolaire.Collaboration between parents and teachers seems to be a process in which these actors appropriate strategies that can help them to actualize their competences and to give better support to attention-disorder students. However, many studies have shown that parents and teachers understand each other poorly, and that they both fear being perceived as incompetent. Within the framework of research on intervention practices with attention-disorder students, two focus groups have been formed. Among the major concerns that emerge from the data analysis was the uncertainty associated with the diagnosis of attention difficulties in the school environment. The analysis also bring into question the conditions and alliance strategies between parents and teachers as partners in school success.La colaboración entre padres y docentes aparece como un proceso dentro del cual estos actores se apropian estrategias que les ayudan a actualizar sus competencias y a proporcionar un mejor apoyo al alumno en dificultades. Ahora bien, varios estudios muestran que padres y docentes no se llevan mucho y temen ser percibidos respectivamente como incompetentes. En el marco de una investigación sobre las prácticas de intervención con alumnos que presentan dificultades de atención, se formaron dos grupos de reflexión. El análisis de los datos colectados de estos encuentros permite destacar algunos desafíos mayores, entre ellos, la incertidumbre que conlleva el diagnóstico de dificultades de atención en el ámbito escolar. Asimismo el análisis permite cuestionar las condiciones y estrategias de alianzas entre padres y docentes como socios en el éxito escolar

Network Data Security for the Detection System in the Internet of Things with Deep Learning Approach

We thought to set up a system of interconnection which allows sharing the communication network of data without the intervention of a human being. The Internet of Things system allows many devices to be connected for a long time without human intervention, data storage is low and the level of data processing is reduced, which was not the case with older solutions proposed to secure the data for example: cyber-attack and other systems. But other theories like for example: artificial intelligence, machine learning and deep learning have a lot to show their ability and the real values of heterogeneous data processing of different sizes and many researchers had to work on it.In the case of our work, we have used deep learning theories, to achieve a light data interconnection security solution; we also have TCP/IP protocol for data transmission control, algorithm drillers for classifications. In order to arrive at a good solution; First, we thought of a model for anomalies detection in Internet of Things and we think about the improvement of architectures of the Internet of the existing objects already proposed a system with a light solution and especially multilayer for an IoT network. Second, we analyzed existing applications of machine learning, deep learning to IoT, and cybersecurity. The recent hack of 2014 Jeep Cherokee, iStan pacemaker, and a German steel plant are a few notable security breaches. Finally, from the evaluated metrics, we have proposed the best neural network design suitable for the IoT Intrusion Detection System. With an accuracy of 98.91% and False Alarm Rate of 0.76 %, this research outperformed the performance results of existing methods over the KDD Cup '99 dataset. For this first time in the IoT research, the concepts of Gated Recurrent Neural Networks are applied for the IoT security

La collaboration école-famille en contexte d’inclusion : entre obstacles, risques et facteurs de réussite

Cet article porte sur la collaboration école-famille en contexte d’inclusion scolaire. Depuis plusieurs années, des travaux montrent que parents et enseignants auraient intérêt à participer de manière concertée à la réussite des élèves. Ce constat tend à devenir une exigence majeure en ce qui concerne le soutien aux élèves présentant des difficultés, car les rôles joués par les uns et les autres déterminent l’orientation des pratiques sur le terrain, particulièrement en milieu scolaire. En partant des résultats des travaux recensés, le présent article met en lumière des facteurs de réussite, des facilitateurs et des obstacles identifiés qui influencent le type de collaboration ainsi que la qualité des services offerts.This article is about school-family collaboration in a school inclusion context. It has been known for some years that parents and teachers have an interest in participating in a collaborative way in a student’s success at school. This is especially of concern with respect to the support of students having difficulty, because the roles played by each determine the orientation of common practices especially in the school environment. Using the results from the documentation analysis, the present article highlights some of the success factors, facilitators and obstacles identified that influence the type of collaboration, as well as the quality of services offered.El presente artículo trata de la colaboración escuela-familia en contexto de inclusión escolar. Desde hace varios años, los estudios demuestran que padres y docentes tendrían interés en participar de manera concertada al éxito de los alumnos. Esta constatación tiende a convertirse en una exigencia mayor en lo referente al apoyo a los alumnos con dificultades, dado que los papeles desempeñados por unos y otros determinan la orientación de las prácticas sobre el terreno, en particular en el ámbito escolar. Partiendo de los resultados de los trabajos analizados, el presente artículo destaca algunos factores de éxito, facilitadores y obstáculos identificados que influyen en el tipo de colaboración así como en la calidad de los servicios proporcionados

A case of chronic disseminated candidiasis in metamizole-induced neutropaenia

Chronic disseminated candidiasis (CDC) is a severe complication of a disseminated yeast infection mainly seen after prolonged chemotherapy-induced neutropaenia in the context of haematological malignancy. We present a case of CDC in a patient with metamizole-induced neutropaenia. To the best of our knowledge, this is the first case described in this context. Furthermore, we highlight the role of steroids in the management of this disease

Comparative molecular analyses between red maple (Acer rubrum) and trembling aspen (Populus tremuloides) exposed to soil metal contamination: metal translocation, gene expression, and DNA methylation.

he main objectives of the present study were to 1) compare the physiological responses and gene expression in red maple (Acer rubrum) and trembling aspen (Populus tremuloides) exposed to metal contamination, 2) determine if epigenetic events are associated with metal resistance in A. rubrum, and 3) assess global gene expression in A. rubrum exposed to different doses of nickel. Metal analyses of soil and plant tissues revealed that P. tremuloides is an accumulator of Mg, Zn, and Ni while A. rubrum does not accumulate these metals in the leaves as it shows avoidance as the main mechanism of coping with soil metal accumulation. Comparative analysis of gene expression revealed that the four genes tested (Nramps4, Nas3, At2G, and MRP4) were more upregulated in P. tremuloides compared to A. rubrum in a field study. AT2G and MRP4 genes were significantly down regulated in A. rubrum from the targeted metal contaminated sites compared to those from uncontaminated areas but environmental factors driving this differential gene expression couldn’t be established. The growth chamber experiment, showed differential gene expression based on p values when the effects of nickel doses were compared. There were more upregulated than down regulated genes in resistant genotypes compared to susceptible genotypes. Most of these genes are associated with coping with abiotic stressors and involves tolerance and detoxification mechanisms. There was a significant variation in the level of cytosine methylation among the metal-contaminated sites, with significant negative correlations between bioavailable nickel / copper content and cytosine methylation being observed. In Conclusion, the present study reveals that A. rubrum exhibits the avoidance strategy as the main mechanism of coping with soil metal accumulation. However, a more informative and indepth analysis of this mechanism would be very beneficial in deciding whether it is strictly physiological or genetic. The role of epigenetics can be further understood by determining the distribution of DNA methylation in both A. rubrum and P. tremuloides.Doctor (Ph.D) in Biomolecular Science

L’effet-tuteur dans l’accompagnement des élèves présentant un trouble neurodéveloppemental

Plusieurs travaux portant sur la réussite scolaire ont mis l’accent sur les facteurs d’impact et les gestes favorisant une mobilisation adéquate des approches d’enseignement. Les communautés éducatives à travers le monde exposent d’innombrables ressources en vue d’ajuster les pratiques enseignantes sur le terrain. Elles aident aussi à trouver des moyens pour rendre visibles les apprentissages des élèves. Leurs préoccupations convergent aussi autour des rôles déterminants joués par les enseignants. Ces derniers assurent aussi la mission de connecter les systèmes éducatifs aux technologies nouvelles. Le processus de médiation symbolique relié aux fonctions de tuteurs produit des effets transformateurs relevant de quelques facteurs de protection. Le contexte d’utilisation de la technologie est variable, à l’école, à la maison comme dans la communauté. Une recherche exploratoire a été menée concernant l’encadrement des élèves présentant un trouble neurodéveloppemental. Associant la recension des travaux scientifiques à des entrevues semi-dirigées (élève, parent, enseignant), ce texte met en évidence les atouts de l’effet-tuteur, considéré comme une force dans l’accompagnement des élèves