Le test de concordance de scripts : un outil pour évaluer le raisonnement clinique des résidents en radio-oncologie

Mémoire numérisé par la Direction des bibliothèques de l'Université de Montréal

L’émergence des appellations d’origine au Québec. Naissance d’une nouvelle convention de qualité

Les produits de terroir, leur reconnaissance et leur protection publique par Appellation d’origine contrôlée (AOC) ou Indication géographique protégée (IGP) peuvent-ils se développer en dehors de l’Europe et en particulier en Amérique du Nord ? C’est la question à laquelle cet article tente d’apporter des éléments de réponse à partir de l’analyse de la situation québécoise. Pour cela l’étude s’inscrit dans le postulat que le transfert du cadre législatif européen et de ses outils peut être analysé comme une innovation radicale au Québec. Après avoir étudié les différentes phases qui ont accompagné ce transfert, l’article met en perspective la construction d’une nouvelle convention de qualité.Is there any development prospect for traditional products - their recognition, public protection by AOC (controlled Label of origin) or PGI (Protected Geographical indication) outside Europe and in particular in North America? It is the question this article brings replies to based on the analysis of the Quebec situation. We then establish that the introduction of the European legislative framework in Quebec would represent radical innovation. Once analysed the different transfer stages the article deal with the construction of a new convention of quality

Ancrage territorial et formes de valorisation des productions localisées au Québec

Depuis une dizaine d’années au Québec, le nombre des productions localisées est en constante augmentation, pour autant celles-ci font preuve de liens au lieu très hétérogènes. L’objet de cet article est d’interroger la construction et la revendication de ces liens au lieu, d’une part dans les sphères productives et d’autre part dans les sphères marchandes. Il s’agit ici d’identifier les formes de médiation entre ces deux sphères et la communication faite au consommateur autour de l’ancrage de ces produits.In Quebec, the number of local products has been steadily increasing over these last ten years. However the link developed with the place of production are extremely heterogeneous. The aim of this article is to question how this links have been constructed and promoted both in the sphere of production and marketing. We identify the forms of mediation employed between these two spheres and how through communication the consumer is made aware of the links

Isotropic-Resolution Tomographic Diffractive Microscopy

International audienceMicroscopy techniques based on recording of the optical field diffracted by the specimen, in amplitude and phase, like Digital Holographic Microscopy (DHM) have been a growing research topic in recent years. Tomographic acquisitions are possible if one is able to record information, while controlling variations of the specimen illumination. Classical approaches consider either illumination variation, simple to implement, but suffering fro the classical "missing cone" problem, or sample rotation, delivering images with quasi-isotropic, but lower resolution. We have developed an original-, combined tomographic diffractive microscope setup, making use of specimen rotation as well as illumination rotation, which is able to deliver images with an almost isotropic resolution better than 200 nm

Work-related stress of companies' directors during the first lockdown due to the COVID-19

BACKGROUND: The COVID-19 pandemic and the first lockdown were particularly stressful with a major economic impact, but the impact on stress of company directors was not known. Therefore, this study aimed to assess that impact and the characteristics of companies the most at risk. METHOD: A online questionnaire was sent to 13,114 company. It assessed stress at work, number of employees, sector of activity, business activity rate and geographical location. It studied the mean stress levels, the percentage of stress > 8/10 and carried out an analysis of the characteristics of the most at-risk companies. RESULTS: A total of 807 company directors responded. Their stress levels increased by 25.9% during lockdown and 28.7% of them had a stress > 8/10. Sectors which had the biggest increase in stress levels during lockdown were retail trade, wholesale trade, and nursing homes. Sectors the most at risk of stress >8/10 during lockdown tended to be nursing homes, pharmacies, and IT activities. Biggest companies had the highest increase in stress levels. CONCLUSION: The first lockdown of the COVID-19 pandemic had a major impact on the stress of company directors. Directors of large companies were the most exposed to stress as well as medical and IT activities

From ‘the people’ to ‘the citizen’ : the emergence of the Edwardian municipal park in Manchester, 1902 - 1912

This paper argues that the Edwardian municipal park represents a significant transition from the highly regulated and formal space of the Victorian park. It takes as a case study Heaton Park in Manchester purchased in late 1901 and suggests that this park represented a transition from a Victorian people’s park to an Edwardian citizen’s park in which each visitor accessed facilities and amenities appropriate to their individual or group leisure interests. It addresses the comparative neglect of the Edwardian park by urban historians and suggests the importance of the emerging concepts of citizenship and social responsibility

One-stage versus two-stage piezocision-assisted orthodontic tooth movement: A preclinical study based on Nano-CT and RT-PCR analyses.

peer reviewed[en] OBJECTIVE: To evaluate the effect of a second-stage piezocision on the biological response. MATERIALS AND METHODS: 60 rats were randomly allocated to 6 experimental groups of 10 rats. Rats undergoing a one-stage piezocision were sacrified on day 7, 28 and 42 (groups 1-3) while rats undergoing a two-satge piezocision were sacrified on day 42, 63 and 90 (groups 4-6), respectively. The biological response was investigated in 3D at the tissue level using Nano-computed tomography (Nano-CT) and, at the molecular level using the qRT-PCR technique. Bone Volume Fraction (BVF) loss was the primary endpoint. RESULTS: Similar loss of BVF were observed both after the first and second piezocisions. The change in BVF loss between 7 and 28 days after each piezocision were 25.1 ± 13.0 (SE)% and 11.2 ± 11.6 (SE)% respectively and did not differ from each other (p = 0.43). Changes in BVF loss from 7 to 42 days were also comparable in one-stage and two-stage piezocision (4.9 ± 12.3 (SE) vs. -19.9 ± 13.4 (SE), p = 0.19). At the molecular level, all parameters except Translating Ribosome Affinity Purification (TRAP) protein had identical patterns. CONCLUSION: Within the limits of the present study, a second piezocision allowed to re-induce the Regional Acceleratory Phenomenon (RAP) effect. Nevertheless, the relevance of the findings to the clinical effect has not been tested

Evidence for new targets and synergistic effect of metronomic celecoxib/fluvastatin combination in pilocytic astrocytoma.

RIGHTS : This article is licensed under the BioMed Central licence at http://www.biomedcentral.com/about/license which is similar to the 'Creative Commons Attribution Licence'. In brief you may : copy, distribute, and display the work; make derivative works; or make commercial use of the work - under the following conditions: the original author must be given credit; for any reuse or distribution, it must be made clear to others what the license terms of this work are.BACKGROUND: Pilocytic astrocytomas occur predominantly in childhood. In contrast to the posterior fossa location, hypothalamo-chiasmatic pilocytic astrocytomas display a worse prognosis often leading to multiple surgical procedures and/or several lines of chemotherapy and radiotherapy to achieve long-term control. Hypothalamo-chiasmatic pilocytic astrocytomas and cerebellar pilocytic astrocytomas have a distinctive gene signature and several differential expressed genes (ICAM1, CRK, CD36, and IQGAP1) are targets for available drugs: fluvastatin and/or celecoxib. RESULTS: Quantification by RT-Q-PCR of the expression of these genes was performed in a series of 51 pilocytic astrocytomas and 10 glioblastomas: they were all significantly overexpressed in hypothalamo-chiasmatic pilocytic astrocytomas relative to cerebellar pilocytic astrocytomas, and CRK and ICAM1 were significantly overexpressed in pilocytic astrocytomas versus glioblastomas.We used two commercially available glioblastoma cell lines and three pilocytic astrocytoma explant cultures to investigate the effect of celecoxib/fluvastatin alone or in combination. Glioblastoma cell lines were sensitive to both drugs and a combination of 100 μM celecoxib and 240 μM fluvastatin was the most synergistic. This synergistic combination was used on the explant cultures and led to massive cell death of pilocytic astrocytoma cells.As a proof of concept, a patient with a refractory multifocal pilocytic astrocytoma was successfully treated with the fluvastatin/celecoxib combination used for 18 months. It was well tolerated and led to a partial tumor response. CONCLUSION: This study reports evidence for new targets and synergistic effect of celecoxib/fluvastatin combination in pilocytic astrocytoma. Because it is non-toxic, this new strategy offers hope for the treatment of patients with refractory pilocytic astrocytoma

Toxicity report of once weekly radiation therapy for low-risk prostate adenocarcinoma: preliminary results of a phase I/II trial

<p>Abstract</p> <p>Background</p> <p>Increasing clinical data supports a low α/β ratio for prostate adenocarcinoma, potentially lower than that of surrounding normal tissues. A hypofractionated, weekly radiation therapy (RT) schedule should result in improved tumour control, reduced acute toxicity, and similar or decreased late effects. We report the toxicity profile of such treatment.</p> <p>Materials and Methods</p> <p>We conducted a multi-institution phase I/II trial of three-dimensional conformal radiation therapy (3D-CRT) for favourable-risk prostate cancer (T1a-T2a, Gleason ≤ 6 and PSA < 10 ng/ml). RT consisted of 45 Gy in nine 5 Gy fractions, once weekly. Primary end-points were feasibility and late gastrointestinal (GI) toxicity (RTOG scale), while secondary end-points included acute GI toxicity, acute and late genitourinary (GU) toxicity, biochemical control, and survival.</p> <p>Results</p> <p>Between 2006 and 2008, 80 patients were treated. No treatment interruptions occurred. The median follow-up is 33 months (range: 20-51). Maximal grade 1, 2, and 3 acute (< 3 months) GU toxicity was 29%, 31% and 5% respectively (no grade 4). Acute GI grade 1 toxicity was reported in 30% while grade 2 occurred in 14% (no grade 3 or 4). Crude late grade ≥ 3 toxicity rates at 31 months were 2% for both GU and GI toxicity. Cumulative late grade ≥ 3 GI toxicity at 3 years was 11%. Two patients had PSA failure according to the Phoenix definition. The three-year actuarial biochemical control rate is 97%.</p> <p>Conclusions</p> <p>Weekly RT with 45 Gy in 9 fractions is feasible and results in comparable toxicity. Long term tumour control and survival remain to be assessed.</p