Le service sanitaire de la Compagnie du canal de Suez (1860-1914) : médecine coloniale ou medical encounter?

Mémoire numérisé par la Division de la gestion de documents et des archives de l'Université de Montréal

Arrays of high aspect ratio magnetic microstructures for large trapping throughput in lab-on-chip systems

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Effectiveness of serious games and impact of design elements on engagement and educational outcomes in healthcare professionals and students : a systematic review and meta-analysis protocol

Introduction Serious games (SGs) are interactive and entertaining digital software with an educational purpose. They engage the learner by proposing challenges and through various design elements (DEs; eg, points, difficulty adaptation, story). Recent reviews suggest the effectiveness of SGs in healthcare professionals’ and students’ education is mixed. This could be explained by the variability in their DEs, which has been shown to be highly variable across studies. The aim of this systematic review is to identify, appraise and synthesise the best available evidence regarding the effectiveness of SGs and the impact of DEs on engagement and educational outcomes of healthcare professionals and students. Methods and analysis A systematic search of the literature will be conducted using a combination of medical subject headings terms and keywords in Cumulative Index of Nursing and Allied Health, Embase, Education Resources Information Center, PsycInFO, PubMed and Web of Science. Studies assessing SGs on engagement and educational outcomes will be included. Two independent reviewers will conduct the screening as well as the data extraction process. The risk of bias of included studies will also be assessed by two reviewers using the Effective Practice and Organisation of Care criteria. Data regarding DEs in SGs will first be synthesised qualitatively. A meta-analysis will then be performed, if the data allow it. Finally, the quality of the evidence regarding the effectiveness of SGs on each outcome will be assessed using the Grading of Recommendations Assessment, Development and Evaluation approach. Ethics and dissemination As this systematic review only uses already collected data, no Institutional Review Board approval is required. Its results will be submitted in a peerreviewed journal by the end of 2018

Efficacy of adaptive e-learning for health professionals and students : a systematic review and meta-analysis

Objective Although adaptive e-learning environments (AEEs) can provide personalised instruction to health professional and students, their efficacy remains unclear. Therefore, this review aimed to identify, appraise and synthesise the evidence regarding the efficacy of AEEs in improving knowledge, skills and clinical behaviour in health professionals and students. Design Systematic review and meta-analysis. Data sources CINAHL, EMBASE, ERIC, PsycINFO, PubMed and Web of Science from the first year of records to February 2019. Eligibility criteria Controlled studies that evaluated the effect of an AEE on knowledge, skills or clinical behaviour in health professionals or students. Screening, data extraction and synthesis Two authors screened studies, extracted data, assessed risk of bias and coded quality of evidence independently. AEEs were reviewed with regard to their topic, theoretical framework and adaptivity process. Studies were included in the meta-analysis if they had a non-adaptive e-learning environment control group and had no missing data. Effect sizes (ES) were pooled using a random effects model. Results From a pool of 10 569 articles, we included 21 eligible studies enrolling 3684 health professionals and students. Clinical topics were mostly related to diagnostic testing, theoretical frameworks were varied and the adaptivity process was characterised by five subdomains: method, goals, timing, factors and types. The pooled ES was 0.70 for knowledge (95% CI −0.08 to 1.49; p.08) and 1.19 for skills (95% CI 0.59 to 1.79; p<0.00001). Risk of bias was generally high. Heterogeneity was large in all analyses. Conclusions AEEs appear particularly effective in improving skills in health professionals and students. The adaptivity process within AEEs may be more beneficial for learning skills rather than factual knowledge, which generates less cognitive load. Future research should report more clearly on the design and adaptivity process of AEEs, and target higher-level outcomes, such as clinical behaviour

Bottom-up strategies for the assembling of magnetic systems using nanoclusters

International audienceIn the frame of the 20th Anniversary of the Journal of Nanoparticle Research (JNR), our aim is to start from the historical context twenty, years ago and to give some recent results and perspectives concerning nanomagnets prepared from clusters preformed in the gas phase using the Low Energy Cluster Beam Deposition (LECBD) technique. In this paper, we focus our attention on the typical case of Co clusters embedded in various matrices to study interface magnetic anisotropy and magnetic interactions as a function of volume concentrations, and on still current and perspectives through two examples of binary metallic 3d-5d TM (namely CoPt and FeAu) clusters assemblies to illustrate size-related and nanoalloy phenomena on magnetic properties in well-defined mass-selected clusters. The structural and magnetic properties of these cluster assemblies were investigated using various experimental techniques that include High Resolution Transmission Electron Microscopy (HRTEM), Superconducting Quantum Interference Device (SQUID) magnetometry, as well as synchrotron techniques such as Extended X-Ray Absorption Fine Structure (EXAFS) and X-Ray Magnetic Circular Dichroism (XMCD). Depending on the chemical nature of both NPs and matrix, we observe different magnetic responses compared to their bulk counterparts. In particular, we show how finite size effects (size reduction) enhance their magnetic moment and how specific relaxation in nanoalloys can impact their magnetic anisotropy

Could conservative iron chelation lead to neuroprotection in amyotrophic lateral sclerosis?

Iron accumulation has been observed in mouse models and both sporadic and familial forms of Amyotrophic lateral sclerosis. Iron chelation could reduce iron accumulation and the related excess of oxidative stress in the motor pathways. However, classical iron chelation would induce systemic iron depletion. We assess the safety and efficacy of conservative iron chelation (i.e. chelation with low risk of iron depletion) in a murine preclinical model and pilot clinical trial. In Sod1G86R mice, deferiprone increased the mean life span as compared with placebo. The safety was good, without anemia after 12 months of deferiprone in the 23 ALS patients enrolled in the clinical trial. The decreases in the ALS Functional Rating Scale and the body mass index (BMI) were significantly smaller for the first 3 months of deferiprone treatment (30 mg/kg/day) than for the first treatment-free period. Iron levels in the cervical spinal cord, medulla oblongata and motor cortex (according to MRI), as well as cerebrospinal fluid levels of oxidative stress and neurofilament light chains were lower after deferiprone treatment. Our observation leads to the hypothesis that moderate iron chelation regimen that avoids changes in systemic iron levels may constitute a novel therapeutic modality of neuroprotection for ALS

In Vivo Methods for the Assessment of Topical Drug Bioavailability

This paper reviews some current methods for the in vivo assessment of local cutaneous bioavailability in humans after topical drug application. After an introduction discussing the importance of local drug bioavailability assessment and the limitations of model-based predictions, the focus turns to the relevance of experimental studies. The available techniques are then reviewed in detail, with particular emphasis on the tape stripping and microdialysis methodologies. Other less developed techniques, including the skin biopsy, suction blister, follicle removal and confocal Raman spectroscopy techniques are also described