Showing papers by "Université de Sherbrooke published in 2023"

Effects of Transcendental Meditation on Academic Physician Burnout and Depression: A Mixed Methods Randomized Controlled Trial

Abstract: Introduction: Burnout is pervasive among physicians and has widespread implications for individuals and institutions. This research study examines, for the first time, the effects of the Transcendental Meditation (TM) technique on academic physician burnout and depression. Methods: A mixed methods randomized controlled trial was conducted with 40 academic physicians representing 15 specialties at a medical school and affiliated VA hospital using the TM technique as the active intervention. Physicians were measured at baseline, 1 month, and 4 months using the Maslach Burnout Inventory, Beck Depression Inventory, Insomnia Severity Index, Perceived Stress Scale, and Brief Resilience Scale. Repeated measures analysis of covariance was used to assess adjusted mean change scores for the 1- and 4-months posttests. Qualitative interviews were conducted at baseline and 4 months and compared with the quantitative measurements. Results: Significant improvements were found for the TM group compared with controls at 4 months in total burnout (p = .020) including the Maslach Burnout Inventory dimensions of emotional exhaustion (p = .042) and personal accomplishment (p = .018) and depression (p = .016). Qualitative interviews supported quantitative outcomes. Physicians reported classic burnout and depression symptoms in baseline interviews. Those regularly practicing the TM technique reported relief from those symptoms. The control group did not state similar changes. Discussion: Mixed methods findings suggest the TM technique is a viable and effective intervention to decrease burnout and depression for academic physicians. Larger longitudinal studies with a wider range of health care providers are needed to validate these findings for extrapolation to the greater medical community.

Spinal sensorimotor circuits play a prominent role in hindlimb locomotor recovery after staggered thoracic lateral hemisections but cannot restore posture and interlimb coordination during quadrupedal locomotion in adult cats

Abstract: Spinal sensorimotor circuits interact with supraspinal and peripheral inputs to generate quadrupedal locomotion. Ascending and descending spinal pathways ensure coordination between the fore-and hindlimbs. Spinal cord injury disrupts these pathways. To investigate the control of interlimb coordination and hindlimb locomotor recovery, we performed two lateral thoracic hemisections placed on opposite sides of the cord (right T5-T6 and left T10-T11) at an interval of approximately two months in eight adult cats. In three cats, we then made a complete spinal transection caudal to the second hemisection at T12-T13. We collected electromyography and kinematic data during quadrupedal and hindlimb-only locomotion before and after spinal lesions. We show that 1) cats spontaneously recover quadrupedal locomotion following staggered hemisections but require balance assistance after the second one, 2) coordination between the fore-and hindlimbs displays 2:1 patterns and becomes weaker and more variable after both hemisections, 3) left-right asymmetries in hindlimb stance and swing durations appear after the first hemisection and reverse after the second, and 4) support periods reorganize after staggered hemisections to favor support involving both forelimbs and diagonal limbs. Cats expressed hindlimb locomotion the day following spinal transection, indicating that lumbar sensorimotor circuits play a prominent role in hindlimb locomotor recovery after staggered hemisections. These results reflect a series of changes in spinal sensorimotor circuits that allow cats to maintain and recover some level of quadrupedal locomotor functionality with diminished motor commands from the brain and cervical cord, although the control of posture and interlimb coordination remains impaired.Coordinating the limbs during locomotion depends on pathways in the spinal cord. We used a spinal cord injury model that disrupts communication between the brain and spinal cord by sectioning half of the spinal cord on one side and then about two months later, half the spinal cord on the other side at different levels of the thoracic cord in cats. We show that despite a strong contribution from neural circuits located below the second spinal cord injury in the recovery of hindlimb locomotion, the coordination between the forelimbs and hindlimbs weakens and postural control is impaired. We can use our model to test approaches to restore the control of interlimb coordination and posture during locomotion after spinal cord injury.

Cost-effectiveness of transdiagnostic group cognitive behavioural therapy for anxiety disorders <i>v.</i> treatment as usual: economic evaluation of a pragmatic randomized controlled trial over an 8-month time horizon using self-reported data

Abstract: This economic evaluation supplements a pragmatic randomized controlled trial conducted in community care settings, which showed superior improvement in the symptoms of adults with anxiety disorders who received 12 sessions of transdiagnostic cognitive-behavioural group therapy in addition to treatment as usual (tCBT + TAU) compared to TAU alone.This study evaluates the cost-utility and cost-effectiveness of tCBT + TAU over an 8-month time horizon. For the reference case, quality-adjusted life years (QALYs) obtained using the EQ-5D-5L, and the health system perspective were chosen. Alternatively, anxiety-free days (AFDs), derived from the Beck Anxiety Inventory, and the limited societal perspective were considered. Unadjusted incremental cost-effectiveness/utility ratios were calculated. Net-benefit regressions were done for a willingness-to-pay (WTP) thresholds range to build cost-effectiveness acceptability curves (CEAC). Sensitivity analyses were included.Compared to TAU (n = 114), tCBT + TAU (n = 117) generated additional QALYs, AFDs, and higher mental health care costs from the health system perspective. From the health system and the limited societal perspectives, at a WTP of Can$ 50 000/QALY, the CEACs showed that the probability of tCBT + TAU v. TAU being cost-effective was 97 and 89%. Promising cost-effectiveness results using AFDs are also presented. The participation of therapists from the public health sector could increase cost-effectiveness.From the limited societal and health system perspectives, this first economic evaluation of tCBT shows favourable cost-effectiveness results at a WTP threshold of Can$ 50 000/QALY. Future research is needed to replicate findings in longer follow-up studies and different health system contexts to better inform decision-makers for a full-scale implementation.

Sleeping sickness: time for dreaming

Abstract: For a long time, the treatment of human African trypanosomiasis (HAT) represented for clinicians a journey through time, to the sources of colonial tropical medicine. Until 2018, the drugs available (apart from eflornithine), were commercialised during the first half of the 20th century. 1 Pépin J Milord F The treatment of human African trypanosomiasis. Adv Parasitol. 1994; 33: 1-47 Crossref PubMed Scopus (279) Google Scholar The pharmaceutical industry had no financial motivation to seek new products for a disease with a market representing a few tens of thousands of cases per year, living in rural and impoverished regions of sub-Saharan Africa. Eflornithine was developed as a potential anti-cancer drug, which surprisingly also proved effective against Trypanosoma brucei gambiense. Efficacy and safety of acoziborole in patients with human African trypanosomiasis caused by Trypanosoma brucei gambiense: a multicentre, open-label, single-arm, phase 2/3 trialGiven the high efficacy and favourable safety profile, acoziborole holds promise in the efforts to reach the WHO goal of interrupting HAT transmission by 2030. Full-Text PDF Open Access

Decentralized architectures for supervisory control of discrete event systems

Abstract: A discrete event system (DES) is a system whose execution is described by a sequence of discrete events. Supervisory control of DES is a rigorous approach for designing DESs, which proceeds basically as follows: Given a plant and a specification described as DES, the objective is to design a supervisor which interacts with the plant so that it conforms to the specification. We will first introduce the basic theory of supervisory control of DES which assumes a centralized control architecture, that is, control is realized using a single supervisor. Such centralized and monolithic control has disadvantages when the DES under design is complex and large. In such a case, a suitable approach is to use a decentralized control architecture, where several local supervisors cooperate to achieve the control objective. We then present several decentralized controls among the most important that have been developed. Those decentralized controls are: conjunctive and permissive (C&P) control, disjunctive and anti-permissive (D&A) control, conditional control, inference-based control, arborescent control, and multi-decision control.

La 27e Conférence des Parties de la Convention-cadre des Nations unies sur les changements climatiques : un bilan critique

Abstract: Les changements climatiques occupent une place centrale en gouvernance mondiale de l'environnement. Vu l'envergure des défis à résoudre, la plus récente Conférence des Parties (CdP) de la Convention-cadre des Nations Unies sur les changements climatiques (CCNUCC), la CdP-27, faisait face à de grandes attentes. Ce court article offre un bilan critique de la CdP-27. L'article présente une synthèse des résultats de cette CdP en étudiant quatre volets principaux, soit l'atténuation des émissions de gaz à effet de serre (GES), l'augmentation du financement climatique, l'adaptation aux changements climatiques et les pertes et préjudices. Il dresse ainsi un portait des résultats de la CdP-27 au regard des attentes qui avaient été établies au préalable par les parties prenantes. L'article se conclut par une analyse prospective des principaux enjeux à suivre d'ici la CdP-28 et au-delà. Il permet ainsi de faire le point sur les plus récents développements, d’éclairer les avancées à venir et de contribuer aux discussions sur la gouvernance mondiale du climat.

Reply on RC1

Abstract: In the ablation zone of land-terminating areas of the Greenland Ice Sheet, water pressures at the bed control seasonal and daily ice motion variability. During the melt season, large amounts of surface meltwater access the bed through moulins, which sustain an efficient channelized subglacial system. Water pressure within these subglacial channels can be inferred by measuring the hydraulic head within moulins. However, moulin head data are rare, and subglacial hydrology models that simulate water pressure fluctuations require water storage in moulins or subglacial channels. Neither the volume nor the location of such water storage is currently well constrained. Here, we use the Moulin Shape (MouSh) model, which quantifies time-evolving englacial storage, coupled with a subglacial channel model to simulate head measurements from a moulin in the Pâkitosq region in Greenland. We force the model with surface meltwater input calculated using field-acquired weather data. Our first-order simulations of moulin hydraulic head either over-predict the diurnal range of oscillation of the moulin head or require an unrealistically large moulin size to produce realistic head oscillation ranges. We find that to accurately match field observations of moulin head, additional subglacial water must be added to the system. We hypothesize that this additional `baseflow' represents strong subglacial network connectivity throughout the channelized system and is ultimately sourced from basal melt and non-local surface water inputs upstream.

Scaling migrations to communities: An empirical case of migration network in the Arctic

Abstract: Seasonal migrants transport energy, nutrients, contaminants, parasites and diseases, while also connecting distant food webs between communities and ecosystems, which contributes to structuring meta-communities and meta-ecosystems. However, we currently lack a framework to characterize the structure of the spatial connections maintained by all migratory species reproducing or wintering in a given community. Here, we use a network approach to represent and characterize migratory pathways at the community level and provide an empirical description of this pattern from a High-Arctic terrestrial community. We define community migration networks as multipartite networks representing different biogeographic regions connected with a focal community through the seasonal movements of its migratory species. We focus on the Bylot Island High-Arctic terrestrial community, a summer breeding ground for several migratory species. We define the non-breeding range of each species using tracking devices, or range maps refined by flyways and habitat types. We show that the migratory species breeding on Bylot Island are found across hundreds of ecoregions on several continents during the non-breeding period and present a low spatial overlap. The migratory species are divided into groups associated with different sets of ecoregions. The non-random structure observed in our empirical community migration network suggests evolutionary and geographic constraints as well as ecological factors act to shape migrations at the community level. Overall, our study provides a simple and generalizable framework as a starting point to better integrate migrations at the community level. Our framework is a far-reaching tool that could be adapted to address the seasonal transport of energy, contaminants, parasites and diseases in ecosystems, as well as trophic interactions in communities with migratory species.

Faces of the Enemy, New Battlefields

Abstract: In the past two decades, the allegorical conflict pitting young veiled Muslims against emancipatory, liberating republican valuesChristianityvalues inherited from the EnlightenmentEnlightenment has continued to set down rootsRoots in law. There can now be no denying that the legal system has been enlisted since the turn of the millennium in efforts to refurbish the iconography of deviance from the republican ideal. Such deviance is increasingly embodied in figures whose behaviour is regarded as hostile to the Republic—most notably, Muslim women who wear the veil. Otherness, that is, has come to be largely (with the exception of radicalized Muslim youths who have turned to terrorism) embodied by feminine representations of Islam. Many in society are increasingly intolerant of the veil; meanwhile, women who wear fuller religiousReligious garments have come to be treated as the quintessence of communitarianismCommunitarianism, an ideal said to be encroaching ever more aggressively on French society and its valuesChristianityvalues. Some of the most virulent debates of the 2010s have dealt with these garments: first the full-face veil, then the burkini. A parallel development has seen secularism moving onto new terrain from which it was formerly excluded, particularly in the private sector. Domestic and European courts alike have increasingly legitimized an obligation of visible neutralityNeutrality falling on businesses, furthering eroding the individual rights that they are supposed to protect.

Impedance of porous electrodes in the presence of electroactive species

Abstract: Behavior of model porous electrodes in the presence of electroactive species and absence of the potential gradient is presented. The presence of dc current forces the concentration gradient in pores. In typical electrochemical applications, the concentration gradient is much more important than the potential gradient. In the absence of potential gradient analytical solutions for the concentration, current, and impedance are obtained. Two cases are considered: a) with only one electroactive species in the bulk of the solution and b) with the redox couple in the bulk of the solution. In these cases, two semicircles form on the complex plane plots. The influence of the porosity, concentration, and potential on current, faradaic and total impedances, and resistances of both semicircles are presented and discussed.

Experimental evidence for spin–triplet states in Titanium implanted AlN film: An electron spin resonance study

Abstract: Spin carrying defects in wide-bandgap semiconductors are promising candidates for the development of quantum information and quantum sensing technology. Here we report experimental evidence for the formation of paramagnetic defects in AlN films, subjected to high-energy hydrogen and titanium ion implantation. X-ray diffraction and Raman spectroscopy show that ion species and implantation process could alter the amount of local strain in AlN films. Electron spin resonance spectroscopy reveals resonance peaks with g-value higher than the one of a free electron (2.0023) for both H-implanted and Ti-implanted AlN films. The origin of these peaks is identified and attributed to different types of point defects. For the Ti-implanted film, in addition to the central peak, a half-field resonance peak has been detected and assigned to spin–triplet (S=1). These results provide new insight into the electronic spin state of point defects in AlN, which opens up interesting perspectives for applications to quantum devices.

Conclusion: The Roots and the Sap

Abstract: In contemporary debate and policy, there is an observable nationalization of secularism that is being deployed within what may seem, at first sight, like a paradoxical dialectic between two poles. This new secularism is, in the first place, of the republican nationalist variety. It draws on Enlightenment rationalism and conveys numerous age-old values—humanism, liberty, emancipation, progress— inherent in the construction of the French Republic. In making membership in the polity conditional upon prior suspension of particular allegiances, at the risk of infringing certain freedoms—particularly the expression of religious rights—this secularism invokes the universality of French citizenship. It is profoundly assimilationist. Contemporary French secularism is also civilizationist-nationalist in character. It reinserts religion within a French national imaginary and anchors citizenship within a Christian identity said to have been handed down to and shared by all. The numerous speeches given by presidential candidates during the 2022 electoral campaign have given ample evidence of this. This secularism would thus appear to run counter to the universalist republican ideal, since it tends to particularize the French national identity. It is profoundly differentialist.

Unveiling Marianne: Religious Symbols at School and the New Secular Grammar

Abstract: Although the controversies surrounding the wearing of religious symbols in schools emerged in the late 1980s, it was not until 2004 that Parliament stepped in to clarify the applicable policies. Public debate on French secularism has taken a new turn since then, bearing almost exclusively on the visibility of religious symbols in the public sphere. I shall revisit this debate here, along with the legal framework concerning the wearing of religious symbols by public school students since 1989. This will serve to uncover the reasoning—upstream of the passage of the Act of 15 March 2004, but also downstream—that gave rise to the emergence of a “new French secularism”.

The Reliability of the AO Spine Upper Cervical Classification System in Children: Results of a Multi-Center Study

Abstract: Background: There is no uniform classification system for traumatic upper cervical spine injuries in children. This study assesses the reliability and reproducibility of the AO Upper Cervical Spine Classification System (UCCS), which was developed and validated in adults, to children. Methods: Twenty-six patients under 18 years old with operative and nonoperative upper cervical injuries, defined as from the occipital condyle to the C2–C3 joint, were identified from 2000 to 2018. Inclusion criteria included the availability of computed tomography and magnetic resonance imaging at the time of injury. Patients with significant comorbidities were excluded. Each case was reviewed by a single senior surgeon to determine eligibility. Educational videos, schematics describing the UCCS, and imaging from 26 cases were sent to 9 pediatric orthopaedic surgeons. The surgeons classified each case into 3 categories: A, B, and C. Inter-rater reliability was assessed for the initial reading across all 9 raters by Fleiss’s kappa coefficient (kF) along with 95% confidence intervals. One month later, the surgeons repeated the classification, and intra-rater reliability was calculated. All images were de-identified and randomized for each read independently. Intra-rater reproducibility across both reads was assessed using Fleiss’s kappa. Interpretations for reliability estimates were based on Landis and Koch (1977): 0 to 0.2, slight; 0.2 to 0.4, fair; 0.4 to 0.6, moderate; 0.6 to 0.8, substantial; and >0.8, almost perfect agreement. Results: Twenty-six cases were read by 9 raters twice. Sub-classification agreement was moderate to substantial with ακ estimates from 0.55 for the first read and 0.70 for the second read. Inter-rater agreement was moderate (kF 0.56 to 0.58) with respect to fracture location and fair (kF 0.24 to 0.3) with respect to primary classification (A, B, and C). Krippendorff’s alpha for intra-rater reliability overall sub-classifications ranged from 0.41 to 0.88, with 0.75 overall raters. Conclusion: Traumatic upper cervical injuries are rare in the pediatric population. A uniform classification system can be vital to guide diagnosis and treatment. This study is the first to evaluate the use of the UCCS in the pediatric population. While moderate to substantial agreement was found, limitations to applying the UCCS to the pediatric population exist, and thus the UCCS can be considered a starting point for developing a pediatric classification. Level of Evidence: Level III.

“Praying Together”: A Secular Challenge?

Abstract: The previous chapter discussed the legal framework implemented by the French government in 1905 and its implications for the collective expression of beliefs. As mentioned, it revolved around recognition of associations of worship but also included a specific legal regime applicable to places of worship. This regime, which placed the Catholic, Protestant, and Jewish religions on an equal footing, has aged poorly; over time, it has resulted in inequalities between the “old religions” and newly arrived religious groups. The situation finds echo, moreover, in the organization of chaplaincy services in certain public institutions (hospitals, prisons, the army, etc.), where minority religious groups, some of them less socially accepted, now find themselves at a disadvantage.

Neural Teleportation

Abstract: In this paper, we explore a process called neural teleportation, a mathematical consequence of applying quiver representation theory to neural networks. Neural teleportation teleports a network to a new position in the weight space and preserves its function. This phenomenon comes directly from the definitions of representation theory applied to neural networks and it turns out to be a very simple operation that has remarkable properties. We shed light on the surprising and counter-intuitive consequences neural teleportation has on the loss landscape. In particular, we show that teleportation can be used to explore loss level curves, that it changes the local loss landscape, sharpens global minima and boosts back-propagated gradients at any moment during the learning process.