De Sherbrooke Research Articles

Health disinformation & social media: The crucial role of information hygiene in mitigating conspiracy theory and infodemics.

Social media has been an effective vector for spreading disinformation about medicine and science. Informational hygiene can reduce the severity of falsehoods about health.

Assessing Three Elements of “Canadian” International Relations

AbstractThis research note addresses the ongoing debate over the existence of a “Canadian” International Relations (IR) by interrogating the university setting, the professoriate and important institutions of IR in the Canadian context. We not only contribute an update to the data but also enrol a larger number of Canadian universities and a wider sample of journals and conferences. Our analysis is structured around three existing groupings of institutions: the three most “Americanized” departments (the BMT)—University of British Columbia, McGill University and University of Toronto; the four most “critical” departments (the Four Nodes)—McMaster University, University of Ottawa, University of Victoria and York University; and the four largest French-language institutions (the FLIs)—Université de Montréal, Université du Québec à Montréal, Université Laval and Université de Sherbrooke. The characteristic openness often taken to define IR in Canada is more often found at the Four Nodes, the FLIs or unclassified schools than at the BMT schools, which are not only more Americanized in training but also isolated from other Canadian institutions.

The effect of aspirin, ticagrelor and heparin pre-transfer vs. similar precatherization treatment in STEMI on pre-PCI TIMI flow

Abstract Aims Whether early combined antithrombotic therapy with aspirin, ticagrelor and unfractionated heparin (UFH) in STEMI patients can improve clinical outcomes is unknown. Data regarding the efficacy of UFH in this clinical setting is lacking. The objective of this novel study was to evaluate the effects of early pretreatment with aspirin, ticagrelor and UFH on pre-PCI TIMI flow in the IRA in acute STEMI patients. Methods and results Between January 2015 and June 2018, we retrospectively compared 488 STEMI patients receiving aspirin, ticagrelor and UFH pretreatment in a spoke peripheral hospital before transfer (PHT) versus 233 prehospital triage setting (PTS) STEMI patients receiving in-ambulance aspirin, followed by ticagrelor and UFH pretreatment in the hub catheterization laboratory before PCI. The primary outcome was the presence of a pre-PCI TIMI flow 2–3 in the IRA. The median times from ticagrelor and UFH administration to angiography in the PHT group and in the PTS group were 80 minutes (95% CI: 68.5–93.9) and 10 minutes (95% CI: 5–15.5) respectively (p<0.0001). Inverse probability of treatment weighting was used to minimize differences between groups. Main results are shown in Table 1. Each 10-minute delay between ticagrelor and heparin administration and angiography was associated with a reduced pre-PCI TIMI flow (OR 0.89, 95% CI: 0.85–0.93). Conclusion STEMI patients receiving aspirin, ticagrelor and UFH before peripheral hospital transfer have a significantly greater pre-PCI TIMI flow 2–3 and a lower rate of definite in-hospital stent thrombosis compared to patients receiving in-ambulance aspirin in the prehospital setting followed by ticagrelor and heparin in the catheterization laboratory without greater bleeding risk. While prehospital triage with rapid primary PCI remains the preferred scenario for STEMI patients, a prompt UFH initiation may play a synergistic role with ticagrelor and aspirin in decreasing pre-PCI thrombus burden in the presence of organizational delays. Figure 1. Study Design and Main Results Funding Acknowledgement Type of funding source: Public hospital(s). Main funding source(s): Université de Sherbrooke's Department of Medicine, Division of Cardiology

Methylparaben in Meconium and Risk of Maternal Thyroid Dysfunction, Adverse Birth Outcomes, and Attention-Deficit Hyperactivity Disorder

Background Parabens are detected ubiquitously in human urine samples, but the effects of prenatal exposure are unclear, partially due to inadequate exposure assessment in maternal urine, which may fail to capture fetal exposure. We examined the association of meconium methylparaben detection with preterm birth, gestational age, birthweight, maternal thyroid hormones, and child attention-deficit hyperactivity disorder (ADHD) at 6-7 years. Methods Methylparaben was measured in meconium with ultraperformance liquid chromatography mass spectrometry and dichotomized (detect/non-detect) for 345 children in the Gestation and the Environment cohort in Sherbrooke, Quebec, Canada, Birth outcomes and maternal thyroid hormones (T3, T4, and thyroid stimulating hormone [TSH]) at <20 weeks gestation were measured at the Centre Hospitalier Universitaire de Sherbrooke. ADHD diagnosis at age 6-7 was determined at follow-up or from medical records. Associations were estimated with logistic and linear regressions, and the potential for mediation by birthweight and preterm birth of the effect of methylparaben on ADHD was modeled with causal mediation analysis. Results Meconium methylparaben detection was associated with increased odds of preterm birth (odds ratio [OR]=4.81; 95% CI [2.29, 10.10]), decreased gestational age (beta [β]=-0.61 weeks; 95% CI [-0.93, -0.29]) and decreased birthweight (β=-0.12 kilograms; 95% CI [-0.21, -0.03]). Associations were also found with decreased maternal TSH (relative concentration [RC]=0.76; 95% CI [0.58, 0.99]) and total T3 (RC=0.84; 95% CI [0.75, 0.96]), but increased total T4 (RC=1.10; 95% CI [1.01, 1.19]). Mothers of infants with detectable meconium methylparaben had increased odds of hypothyroxinemia (OR=2.50, 95% CI [1.01, 6.22]), and children were more likely to be diagnosed with ADHD at age 6-7 (OR=2.33, 95% CI [1.45, 3.76]). Preterm birth and birthweight mediated 20% and 13% of the effect of methylparaben on ADHD respectively. Conclusions This adverse association between methylparaben and ADHD, partially mediated by birth outcomes, warrants further research into fetal methylparaben exposure.

Association of Prenatal Acetaminophen Exposure Measured in Meconium With Risk of Attention-Deficit/Hyperactivity Disorder Mediated by Frontoparietal Network Brain Connectivity

Despite evidence of an association between prenatal acetaminophen exposure and attention-deficit/hyperactivity disorder (ADHD) in offspring, the drug is not contraindicated during pregnancy, possibly because prior studies have relied on maternal self-report, failed to quantify acetaminophen dose, and lacked mechanistic insight. To examine the association between prenatal acetaminophen exposure measured in meconium (hereinafter referred to as meconium acetaminophen) and ADHD in children aged 6 to 7 years, along with the potential for mediation by functional brain connectivity. This prospective birth cohort study from the Centre Hospitalier Université de Sherbrooke in Sherbrooke, Québec, Canada, included 394 eligible children, of whom 345 had meconium samples collected at delivery and information on ADHD diagnosis. Mothers were enrolled from September 25, 2007, to September 10, 2009, at their first prenatal care visit or delivery and were followed up when children were aged 6 to 7 years. When children were aged 9 to 11 years, resting-state brain connectivity was assessed with magnetic resonance imaging. Data for the present study were collected from September 25, 2007, to January 18, 2020, and analyzed from January 7, 2019, to January 22, 2020. Acetaminophen levels measured in meconium. Physician diagnosis of ADHD was determined at follow-up when children were aged 6 to 7 years or from medical records. Resting-state brain connectivity was assessed with magnetic resonance imaging; attention problems and hyperactivity were assessed with the Behavioral Assessment System for Children Parent Report Scale. Associations between meconium acetaminophen levels and outcomes were estimated with linear and logistic regressions weighted on the inverse probability of treatment to account for potential confounders. Causal mediation analysis was used to test for mediation of the association between prenatal acetaminophen exposure and hyperactivity by resting-state brain connectivity. Among the 345 children included in the analysis (177 boys [51.3%]; mean [SD] age, 6.58 [0.54] years), acetaminophen was detected in 199 meconium samples (57.7%), and ADHD was diagnosed in 33 children (9.6%). Compared with no acetaminophen, detection of acetaminophen in meconium was associated with increased odds of ADHD (odds ratio [OR], 2.43; 95% CI, 1.41-4.21). A dose-response association was detected; each doubling of exposure increased the odds of ADHD by 10% (OR, 1.10; 95% CI, 1.02-1.19). Children with acetaminophen detected in meconium showed increased negative connectivity between frontoparietal and default mode network nodes to clusters in the sensorimotor cortices, which mediated an indirect effect on increased child hyperactivity (14%; 95% CI, 1%-26%). Together with the multitude of other cohort studies showing adverse neurodevelopment associated with prenatal acetaminophen exposure, this work suggests caution should be used in administering acetaminophen during pregnancy. Research into alternative pain management strategies for pregnant women could be beneficial.

1866-P: Adipocyte Hypertrophy Is Associated with Increased Dietary Fatty Acid Storage in Adipose Tissue and Reduced Postprandial Hepatic Fatty Acid Uptake and Esterification in Humans

Introduction: Excessive exposure of lean tissues to nonesterified fatty acids (NEFA) leads to insulin resistance (IR). Adipocyte hypertrophy is associated with IR and increase in adipose tissue intracellular triglyceride lipolysis and in NEFA levels, that may contribute to hepatic steatosis and IR. The effect of adipocyte hypertrophy on postprandial hepatic NEFA flux and metabolism and dietary fatty acids (DFA) storage in adipose tissues has not been studied, however. Methods: In 28 healthy adult subjects, fat cell size (FCS) was determined via histomorphologic analysis of abdominal subcutaneous fat tissue. Adipose tissue DFA storage was measured using oral administration of 18FTHA with positron emission tomography (PET). Postprandial hepatic NEFA uptake, oxidation, and esterification were determined using intravenous 11C-palmitate with dynamic PET acquisition. Results: As expected, FCS was correlated positively with fasting glycemia (ρ=0.44, P-value=0.029), homeostasis model assessment-estimated insulin resistance (HOMA-IR) (ρ=0.43, P-value=0.049), and hepatic fat content from CT radiodensity (ρ=0.32, P-value=0.10). FCS was correlated positively with DFA storage in intra-abdominal adipose tissues (ρ=0.48, P-value=0.022) and negatively with postprandial hepatic NEFA uptake (ρ=-0.42, P-value=0.027) and esterification (ρ=-0.58, P-value=0.0080). Conclusion: Adipocyte hypertrophy is associated with increased DFA storage in intra-abdominal adipose tissues and reduced postprandial hepatic NEFA uptake and esterification, despite being associated with greater hepatic fat content, fasting glycemia and HOMA-IR. Adipocyte hypertrophy is thus associated with adipose tissue metabolic adaptation that limits the exposure of the liver to fatty acids in the postprandial period. Disclosure R. Ye: None. S. Phoenix: None. C. Noll: None. E. Montastier: None. F. Frisch: None. L. Bouffard: None. M. Amrani: None. E.E. Turcotte: None. A.C. Carpentier: Advisory Panel; Self; HLS Therapeutics, Inc. Funding Canadian Institutes of Health Research (MOP53094); Centre de recherche du CHUS; Centre d’imagerie moléculaire de Sherbrooke; Faculté de médecine et des sciences de la santé de l’Université de Sherbrooke

P057: Impact of a clinical pathway for the treatment of acute asthma in the emergency department

Introduction: In Canada, acute asthma is a common cause of emergency department (ED) attendance and its treatment is affected by ED overcrowding and increasing wait times. Literature suggests that a clinical pathway (CP) for the treatment of acute asthma can increase the use of medical therapy, reduce hospital admission rates and decrease associated costs. However, only few have looked at the effect on ED length of stay (ED LOS) when such a CP is initiated by triage nurse/respiratory therapist among adults. In this optic, an asthma CP was launched on Feb. 2016 at Centre Hospitalier Universitaire de Sherbrooke (QC) and included medical directives allowing triage nurse and respiratory therapist initiation of treatment. Methods: The objectives are to determine the effect of an ED nurse/respiratory therapist-initiated asthma CP on (1) ED LOS, (2) time-to-treatment (beta-agonist, corticosteroids), time-to-MD and other secondary outcomes. This was a retrospective before-after study. Adults presenting to the ED before and after CP implementation with a final diagnosis of asthma or asthma exacerbation were eligible. The groups A (before implementation) and B (after implementation) were compared for ED LOS. Three subgroups of 50 patients were generated and compared for outcomes: A1 (before implementation), B1 (after implementation without CP) and B2 (after implementation with CP). All five groups were controlled for triage level and sex. Results: In total, 1086 patients were included; 543 before implementation (Mar. 2011 – Feb. 2016) and 543 after (Feb. 2016 – Jun. 2019), of whom 14% (N = 77) were treated by CP. The average ED LOS was similar (10.36h vs 10.65h; (p = 0,31)) in group A and in group B. In groups A1, B1 and B2, the median ED LOS were respectively 6.00, 6.84, 4.80; these differences were not statistically significant. The average time-to-treatment for beta-agonist in A1, B1 and B2 was respectively 148, 180 and 50 mins; the differences between B2 and A1 and between B2 and B1 were both statistically significant (p < 0,05). Conclusion: Although this study indicates a low compliance to the CP, it shows that time-to-treatment can be reduced. It didn't demonstrate any statistically significant decrease in ED LOS, most likely due to low number of patients and non-normal distribution, but the 1.2h shorter could be a major advantage if it proves true. Further studies are essential to understand facilitators and alleviate the barriers in anticipation of a multi-centric implementation.

Highlights From the Circulation Family of Journals.

Highlights From the Circulation Family of Journals.

Methylparaben in meconium and risk of maternal thyroid dysfunction, adverse birth outcomes, and Attention-Deficit Hyperactivity Disorder (ADHD)

BackgroundParabens, which are used as a preservative in foods and personal care products, are detected in nearly 100% of human urine samples. Exposure to parabens is associated with DNA damage, male infertility, and endocrine disruption in adults, but the effects of prenatal exposure are unclear. In part, this is due to inadequate assessment of exposure in maternal urine, which may only reflect maternal rather than fetal exposure. To address this gap, we examined the association of prenatal methylparaben measured in meconium with preterm birth, gestational age, birthweight, maternal thyroid hormones, and child Attention-Deficit Hyperactivity Disorder (ADHD) at 6–7 years. DesignData come from the GESTation and the Environment (GESTE) prospective observational pregnancy cohort in Sherbrooke, Quebec, Canada. Participants were 345 children with data on ADHD among 394 eligible pregnancies in women age ≥18 years with no known thyroid disease before pregnancy and meconium collected at delivery. Methylparaben was measured in meconium. Birthweight, gestational age, and maternal thyroid hormones at <20 weeks gestation were measured at the Centre Hospitalier Universitaire de Sherbrooke. Preterm birth was defined as vaginal birth before the 37th week of gestation. Physician diagnosis of ADHD was determined at a scheduled cohort follow-up when children were 6–7 years old or from medical records. Associations between meconium methylparaben and outcomes were estimated with logistic and linear regressions weighted on the inverse probability of exposure to account for potential confounders, including child sex, familial income, maternal education, pre-pregnancy body mass index, age, and smoking and alcohol consumption during pregnancy. ResultsMethylparaben was detected in 65 meconium samples (19%), 33 children were diagnosed with ADHD (10%), and 13 children were born preterm (4%). Meconium methylparaben was associated with preterm birth (odds ratio [OR] = 4.81; 95% CI [2.29, 10.10]), decreased gestational age (beta [β] = −0.61 weeks; 95% CI [−0.93, −0.29]) and birthweight (β = −0.12 kg; 95% CI [−0.21, −0.03]), altered maternal TSH (relative concentration [RC] = 0.76; 95% CI [0.58, 0.99]), total T3 (RC = 0.84; 95% CI [0.75, 0.96]) and total T4 (RC = 1.10; 95% CI [1.01, 1.19]), maternal hypothyroxinemia (OR = 2.50, 95% CI [1.01, 6.22]), and child ADHD at age of 6–7 (OR = 2.33, 95% CI [1.45, 3.76]). The effect of meconium methylparaben on ADHD was partially mediated by preterm birth (20% mediation) and birthweight (13% mediation). ConclusionsMeconium methylparaben was associated with preterm birth, decreased gestational age and birthweight, maternal thyroid hormone dysfunction, and child ADHD. Parabens are a substantial health concern if causally related to these adverse outcomes.

Spatial Abilities, Haptic Perception, Anatomy Knowledge and Technical Skills Performance in Health Care

Spatial ability has been defined as a skill in representing, transforming, generating and recalling symbolic, non‐linguistic information. Two distinct human spatial abilities have been identified: visualization and orientation. A sex difference in spatial abilities favoring male has been documented. A pattern of negative age effects on spatial abilities has also been demonstrated.Haptics has been originally defined as the science of human touch. Spatial abilities assessed by vision‐based tests were positively correlated with a drawing score based on blind haptic perception of objects and negatively correlated with time to perform correct drawings of objects from blind haptic perception. Similarly, vision‐based spatial abilities tests were correlated with pictures of objects recognized from blind haptic perception. Decreasing haptic perception while increasing working memory and cognitive load decreased performance on drawings and picture recognition of objects from blind haptic perception. Spatial abilities were correlated to the effect of working memory on drawings, but not on picture recognition of objects. These findings may be explained by the two‐dimensional (2D) nature of picture recognition and three‐dimensional (3D) nature of making a perspective drawing of an object.The interrelationship between spatial abilities tests based on vision, anatomy knowledge and technical skills performance in health care was conceptually viewed as a triangle (Figure) .Spatial abilities and anatomy knowledgeAn applied anatomy course was chosen by many medical graduates because of training needs rather than innate spatial abilities. In a systematic review, spatial abilities were found to be correlated to anatomy knowledge assessment using practical examination, 3D synthesis from 2D views of structure, drawing of views, and cross‐sections. Evidence was found in a systematic review for improvement of spatial abilities in anatomy education using instruction in anatomy and mental rotations training.Spatial abilities and technical skills in health careA studied sample of medical graduates over a five‐year period was not found to choose their residency programs based on their innate spatial abilities. In a systematic review, spatial abilities were found to be correlated negatively to duration and positively to the quality of technical skills performance in novices and intermediate learners. Spatial abilities test scores were found in a systematic review to be enhanced by courses in abdominal sonography and hands‐on radiology, but were not improved by residency training in General Surgery and first‐year dental curriculum.Anatomy knowledge, technical skills in health care and spatial abilitiesNo studies were identified in a systematic review of the interrelationship between anatomy knowledge, technical skills performance and spatial abilities.Vision‐based spatial abilities tests were correlated to blind haptic perception and were found to be an important skill determinant of individual differences in learning spatial anatomy and technical skills in health care.Support or Funding InformationSeveral research projects were supported by internal grants from the Department of Surgery, Université de Sherbrooke, Sherbrooke, QC, Canada.Figure 1

A75 ON THE TRAIL OF ALTERNATIVE LIGANDS AND SIGNALING PATHWAYS FOR LGR5

Abstract Background Leucine-rich G protein coupled receptor-5 (LGR5) is a GPCR originally identified as a marker for intestinal stem cells but is now associated to stemness in numerous other tissues. R-spondins (RSPO) are the only reported ligands of LGR5, which upon receptor binding, potentiates the canonical Wnt/b-catenin pathway. Surprisingly, despite the presence of classical GPCR features such as conserved DRY and NPXXY motifs RSPO binding to LGR5 does not induce classical GPCR behaviors such as coupling to heterotrimeric G-proteins or engagement of b-arrestins. For this reason, LGR5 is still considered to be an orphan receptor. Aims Aberrant expression of LGR5 is a common feature of many cancers, including gastrointestinal cancers, but it is still unclear why LGR5 is pro-tumorigenic in some cancers, while anti-tumorigenic in others. One potential explanation is that LGR5 does not only signals through the Wnt/b-catenin pathway, but also to alternative pathways. Thus, the goals of this study were 1), to elucidate LGR5 signaling networks and 2), to identify new LGR5 ligands and activity modulators. We suggested that the intestinal lumen content could be a source of bioactive molecules that could act as alternative LGR5 ligands Methods All experiments were performed on HEK293 cells expressing recombinant LGR5 (HEK293/LGR5) and compared to control cells expressing empty vector. Characterization of LGR5 signaling network was initiated with LC MS/MS spectrometric analyses using cells stimulated with Wnt3a and RSPO1. To identify new LGR5 modulators, commercially available bacteria-derived metabolites (BDM) were tested on HEK293/LGR5 cells stimulated with Wnt3a and RSPO1 and assessed using the TOP-Flash luciferase system. Finally, a mouse intestinal lumen extract (ILE) was investigated in whole-cell impedance assay to detect if it contained native BDM or potential host-derived LGR5 ligands. Results Mass spectrometric analyses revealed distinct protein expression and phosphorylation profiles in HEK293/LGR5 cells stimulated with Wnt3a and RSPO1. The TOP/Flash luciferase assays showed that the flavonoid derivative 3,4-dihydroxyphenylacetic acid (DOPAC) and lipopolysaccharide (LPS) acted as negative regulators of LGR5, while butyrate had no effect. Interestingly, stimulation of HEK293/LGR5 with ILE induced a Gαq-like response in the impedance assay, while control cells did not respond. Conclusions Stimulation of LGR5 with Wnt and RSPO triggered a complex signaling network. In agreement with our hypothesis, some BDM such as DOPAC and LPS were indeed activity modulators of LGR5. Moreover, a still unidentified compound present in the ILE triggered a selective GPCR-like response in HEK293/LGR5 cells. Future works aim at identifying this putative LGR5 ligand(s) and establish the LGR5 interactome using proximity labeling and mass spectrometry. Funding Agencies NSERC, Université de Sherbrooke, FRQS

Health education assessment practices used by physical education and health teachers in a collaborative action research

ABSTRACTBackground: The school setting is the ideal environment for encouraging students to adopt health-promoting behaviours (Chong, McCuaig and Rossi, 2018, “Primary Physical Education Specialists and their Perceived Role in the Explicit/Implicit Delivery of Health Education.” Curriculum Studies in Health and Physical Education 9 (2): 189–204. doi: 10.1080/25742981.2018.1452163). Schools are actively supporting the implementation of health education (HE) initiatives, and the potential contribution of physical education (PE) to these initiatives is recognised in a number of countries (Gray, MacIsaac and Jess, 2015, “Teaching ‘Health’ in Physical Education in a ‘Healthy’ Way.” Retos 28 (1): 165–172; Haerens, Kirk, Cardon and De Bourdeaudhuij, 2011, “Toward the Development of a Pedagogical Model for Health-Based Physical Education.” Quest 63 (3): 321–338. doi: 10.1080/00336297.2011.10483684). One of the biggest challenges faced by PE teachers is the assessment of student learning in the area of health (Bezeau, 2019, “L’accompagnement d’enseignantes en éducation physique et à la santé visant l’optimisation de leurs pratiques évaluatives en éducation à la santé.” PhD diss., Université de Sherbrooke; Turcotte, Gaudreau, Otis and Desbiens, 2010, “Les pratiques pédagogiques d’éducateurs physiques du primaire en éducation à la santé.” In Éducation à la santé, edited by Claire Isabelle, Louise Sauvé, and Monique Noël-Gaudreault, 717–738. Montréal: Revue des sciences de l’éducation). These challenges highlight the need for professional development that meets the needs of PE teachers in regard to the health component, in particular in terms of assessment practices (Turcotte, 2010, “Problématisation: l’éducation à la santé et l’éducation physique.” In Faire équipe pour une éducation à la santé en milieu scolaire, edited by Johanne Grenier, Joanne Otis, and Gilles Harvey, 25–48. Québec: Presses de l’Université du Québec). However, teachers report that the professional development provided to better integrate health into PE is ineffective (Alfrey, Cale and Webb, 2012, “Physical Education Teachers’ Continuing Professional Development in Health-Related Exercise: A Figurational Analysis.” European Physical Education Review 18 (3): 361–379. doi: 10.1177/1356336X12450797; Makopoulou and Armour, 2011, “Teachers’ Professional Learning in a European Learning Society: the Case of Physical Education.” Physical Education and Sport Pedagogy 16 (4): 417–433. doi: 10.1080/17408989.2010.548060). In order to optimise assessment practices in HE, the development of training methods that answer the real needs of PE teachers constitutes a potential solution to this problem. In this study, two PE teachers were supported in the operationalisation and appropriation of an innovative problem-solving process aimed at optimising their assessment practices in HE.Objectives: The objectives of this article are to describe: 1) the operationalisation of strategies established by the participants targeting their assessment practices in HE, and 2) the evolution of these practices.Method: A collaborative action research (CAR) approach was taken, and four methods of data collection were used: 1) individual interviews; 2) group interviews; 3) participant observation, and 4) logbooks. The data was collected over a 12-month period, overlapping two school years, and then analyzed through content analysis.Findings: Results suggest that, despite the planning and implementation of strategies considered effective by the participants, their assessment practices in the gymnasium progressed very little, while their practices outside the gymnasium evolved considerably.Conclusion: If we want to optimise assessment practices in HE, or teaching practices in general, we must put aside the question ‘why,’ and focus on ‘how’ to meet the challenges related to the implementation of this type of professional development. Bringing real change to teaching practices is a long process that requires an investment of time and effort from teachers, and starts with the optimisation of practices outside the learning environment.

Welcome

Greetings, and welcome to Daytona Beach, FL and PowerMEMS 2018 – the 18th International Conference on Micro and Nanotechnology for Power Generation and Energy Conversion Applications!The objective of PowerMEMS 2018 is to catalyze innovation in micro- and nano-scale technologies for the energy domain. The scope of the meeting ranges from basic principles, to materials and fabrication, to devices, systems and applications. The topics span the lifecycle of energy from power generation or harvesting to storage, conversion and conditioning, and integrated systems that manage these processes. The applications include micro power generation for wireless sensors and portable devices, as well as microsystems for actuation, pumping and propulsion.Our Conference aims to stimulate the exchange of insights and information, as well as the development of new ideas, in the power MEMS field. Our goal is to allow the attendees to interact and network within our multidisciplinary community that includes professionals from many branches of science and engineering, as well as energy and entrepreneurial specialists interested in the commercialization of power MEMS technologies.Since the first PowerMEMS in Sendai, Japan in 2000, the Conference has grown in size, reputation, impact, and technical breadth. This year’s technical program is highlighted by three plenary talks from prominent experts on wearable energy harvesting systems, magneto-electric generators, and near-zero-power microsystems. Each plenary talk anchors a “Focus Session” in each of these themes. The contributed program received 162 abstract and late news submissions. After careful review by the 35-member Technical Program Committee, a total of 135 papers were selected for presentation, 51 for oral, and 84 posters. There oral presentations are divided into 16 sessions, and the posters divided into two afternoon poster sessions. Nine PowerMEMS-in-Action live demos will be featured during the poster sessions, showcasing mature technologies and novel approaches hands-on. The conference proceedings are made available to attendees via direct download. All authors have the option to “elevate” their conference paper into a fully peer-reviewed journal article in either J. Micromechanics and Microengineering or Smart Materials and Structures. All non-elevated conference papers will be archived online around May 2019 under IoP’s J. of Physics: Conference Series.We hope to maximize interaction among participants and stimulate lively discussion through technical and social events. The PowerMEMS School provides opportunity to learn from leading experts in topics ranging from fundamentals of energy harvesting technologies to applications of PowerMEMS in selected domains. The PowerMEMS-in-Action live demos stimulates researchers to push their power MEMS technologies out of the laboratory and get feedback. Our tabletop exhibitors will help catalyze conversations between our industrial partners and the research community. On Thursday, the conference banquet will be held at the Kennedy Space Center, with dinner served directly below the retired Space Shuttle Atlantis orbiter. This will be a once-in-a-lifetime experience!This meeting is made possible by many generous contributions of time, effort, and financial support. Thanks are due to our co-organizers Florian Herrault (TPC Chair), Shad Roundy (Sponsorship and industry Chair), and Alexandra Garraud (School Chair), Peter Woias (PMiA Chair), to the Technical Program Committee for their intensive efforts in reviewing abstract submissions, and to the International Steering Committee for their advice and support. We are grateful to Preferred Meeting Management Inc. for their many contributions to the management and organization of our Conference. Finally, we gratefully acknowledge the organizational and financial support provided for this meeting by the Transducers Research Foundation, Université de Sherbrooke, University of Florida, University of Utah, HRL Laboratories, and our exhibitors, publication partners, and other supporters.We hope that you find PowerMEMS 2018 enjoyable and fruitful, while enjoying the beautiful scenery and unique attractions of Daytona Beach!Sincerely,

P14.84 Intraarterial chemotherapy and osmotic blood-brain barrier modification in the treatment of primary CNS lymphoma

Abstract BACKGROUND Primary central nervous system lymphomas (PCNSL) are considered a rare and aggressive form of central nervous system (CNS) tumors. High-dose methotrexate has become the backbone of PCNSL treatment, and is recommended by the EANO guidelines. In most recent protocols, investigators tend to postpone or even avoid the use of radiotherapy; indeed, its use has become controversial with findings of associated severe neuro-toxicity, especially in elderly patients. To maximize delivery across the BBB, we use cerebral intra-arterial chemotherapy (CIAC) coupled with osmotic blood-brain barrier disruption (OBBBD). We hereby report our single-center experience over 18 years with the CIAC + BBBD technique using 2 different HD-MTX protocols. MATERIAL AND METHODS This phase II study was conducted at the Centre hospitalier Universitaire de Sherbrooke (CHUS) from November 1999 to May 2018. The protocol was approved by the institutional review board, and informed consent was obtained in accordance to institutional regulation in every patient After enrollment and initial evaluation, patients were treated every four weeks (1 cycle) for 12 cycles, unless progression. After general anesthesia, a transfemoral approach was used to catheterize either the right or left internal carotid artery or the dominant vertebral artery, depending on tumor(s) location. OBBBD was performed by infusing 20% mannitol in the selected vascular distribution for 30 seconds at a rate that fills the vascular distribution so as to maximize the contact of the mannitol with the endothelial cells.Two different chemotherapy regimens were sequentially used in this study. High-dose MTX (5 g IV) was the cornerstone of both regimens: the first regimen (1999 to 2007) also included etoposide phosphate IV (400 mg/m²) and cyclophosphamide IV (660 mg/m²), whereas the 2nd regimen (1998 to 2018) also included carboplatin IA (400 mg/m²). RESULTS The present analysis therefore concerns a cohort of 44 naive patients recruited over 18 years in a single center. Median follow-up was 38 months. Overall, a CR was induced in 34 patients (79%). Themedian time to CR was 7.3 months (IQR: 7.8). Of these 34 patients, 11 (25.6%) are still alive, and 9 of these are disease-free after treatment discontinuation. The actuarial median survival (MS) was 46.5 months (95% CI: 30.9–62.2) for the cohort. Survival was 88%, 64%, 54%, 39% and 18% at 1, 2, 3,5 and 10 years (Figure 1 and Table 2).The progression-free survival was 43.4 months (95% CI: 17.9–68.9). Five occurrences of vascular complications related to the treatment were observed (11.6%). Conclusion: CIAC HD-MTX-based protocols with OBBBD is a safe and well-tolerated procedure for the management of primary CNS lymphoma. Our single center data suggests better PFS and survival outcomes compared to IV protocols with less hematologic toxicity and good tolerability, especially in the elderly.

Marc Labelle

Marc Labelle, 61, died on Jan. 1 in Bedford, New Hampshire. “Marc was a visionary, charismatic, and talented scientist. He was an inspiration, with his unique approach to chemistry, infectious laugh, and strong zest for life. It was Marc’s creative intuition that led to the discovery of the asthma drug Singulair. After leaving Merck & Co. in 2000, he worked at Amgen, ImClone Systems, and Lundbeck Research USA. In 2011, while running a highly successful consulting business, he became an associate professor at the Université de Sherbrooke. Marc received numerous awards, including the American Chemical Society Heroes of Chemistry Award in 2003. Marc was a coauthor of nearly 100 patents and research articles.”—Tim Cushing, friend and colleague Most recent title: Owner, ML Pharma Consulting, and associate professor of chemistry, Université de Sherbrooke Education: BS, chemistry, 1978, and PhD, organic chemistry, 1983, University of Montreal Survivors: Wife, Helene Perrier; daughter, Evelyne

Thirteenth International Conference on Recent Advances in Structural Dynamics (RASD)

RASD2019: Recent Advances in Structural DynamicsPrefaceThis volume contains the papers presented at the Thirteenth International Conference on Recent Advances in Structural Dynamics (RASD). The twelve previous RASD conferences have been held every three years or so since 1980, primarily in Southampton, UK.This conference was devoted to theoretical, numerical and experimental developments in structural dynamics and their application to all types of structures and dynamical systems. The conference reflected the state-of-the-art structural dynamics and dynamical systems in science and engineering practice and it was an opportunity to exchange scientific, technical and experimental ideas.The Conference Proceedings included papers by authors from over twenty four countries, twenty one technical sessions and five plenary presentations. The five invited speakers were Professor Li Cheng (Hong Kong Polytechnic University, Hong Kong) presenting “Structural Wave Manipulation through Acoustic Black Holes”, Dr Alain Berry (Université de Sherbrooke, Canada) presenting “Time-space identification of dynamic transverse loads on plane elastic structures”, Professor Gaetan Kerschen (University of Liège, Belgium,) presenting “Dynamic vibration absorbers: revisiting classical results and introducing new tuning strategies”, Professor Domingos A. Rade (Aeronautics Institute of Technology, Brazil) presenting “Dynamic modeling of advanced composite materials”, and Dr John Macdonald (University of Bristol, UK) presenting “Human-structure interaction: modelling, experiments and full-scale measurements”.I would like to thank members of the Organising Committee for their help, over the last year or so, in shaping the conference and for their invaluable assistance in the paper review process. In particular, I would like to thank the hosting Chairs, Quentin Leclère and Nicolas Totaro from the Laboratory of Vibration and Acoustics of INSA Lyon. I would also like to thank the conference secretary, Harriet Gemmell, without whom there would be no conference. Lastly, I would like to thank all delegates for supporting the conference.Emiliano RustighiLyon, France15-17 April 2019List of Chairs, Organising Committee and Proceedings Editors and Conference Secretariat are available in this PDF.

Unravelling Learning Engagement in the Hybrid Virtual Classroom

Based on current societal transitions and in the context of lifelong learning, both upper secondary education, higher education and vocational training are invited to think about how to enable people, at any stage of their life, to take part in stimulating learning experiences. The expectancy to be present at one core location is getting more and more difficult in this (inter)national society. In addition, the student population is changing and balancing work and family life becomes an important point of priority. Therefore, it is important to make education less dependent on location and time and improve flexibility within the learning trajectory (Lakhal, De Sherbrooke, Bateman, 2017). Next to this, there are growing insights about the need to collaborate.

Comparison of two dose calculation methods of intra-arterial carboplatin in the treatment of recurrent glioblastoma multiforme.

e13503 Background: Glioblastoma is a deadly brain cancer, and as part of the natural evolution, its relapses will mostly occur 32 to 36 weeks after the initial diagnosis. The standard of care for recurrent glioblastomas is not well defined and multiple options exist. Intra-arterial chemotherapy as one option is currently practiced at the Centre hospitalier universitaire de Sherbrooke, the only center doing this procedure in Canada. The aim of this study is to evaluate the impact of using the area under the curve (AUC) or body surface area (BSA) dosing formula to guide intra-arterial carboplatin administration. It was designed to explore the relation of two dose calculation methods on efficacy and toxicity, determined by progression-free survival (PFS) and hematologic toxicity, respectively. Methods: A retrospective observational study was conducted, which includes adult in-patients who received intra-arterial carboplatin for recurrent glioblastoma from June 1st, 2000 to December 31st, 2017. It examined the associations of the method used to calculate the doses, in mg or mg/mL x min-1, with clinical outcomes. Results: One hundred ninety patients were included in the analysis. For the primary endpoint, an exposure greater than 6 of AUC was found potentially harmful in terms of efficacy compared to AUC under 6 (HR 0.529, p = 0.0044). In terms of toxicity, a higher AUC is highlighted to correlate with a slightly higher incidence of thrombocytopenia and neutropenia (OR 1.051 p = 0.0271; OR 1.072 p = 0.049). No significant association between toxicity and dose calculated with BSA could be established. Conclusions: AUC greater than 6 is detrimental in terms of effectiveness according to progression free survival. Moreover, AUC could be used to predict neutropenia and thrombocytopenia. However no significant predictions were found using BSA method. We recommend the use of AUC method in intra-arterial carboplatin instead of BSA method since the latter was not statistically related to toxicity. A prospective trial comparing the two dosage methods would be needed.

Does long-term storage of clay samples influence their mechanical characteristics?

The prime objective of this study is to assess the influence of long-term storage on the physical and mechanical characteristics of clay samples. Samples from two different clays were sealed and stored in a temperature- and humidity-controlled room at the geotechnical laboratory of the Université de Sherbrooke for up to 27 years. The stored clay samples were tested before and after long-term storage and the results compared in this note. The comparison showed that even with long-term storage, the majority of the physical and mechanical characteristics of the samples were preserved.

A Modified Oedometer Setup for Simultaneously Measuring Hydromechanical Stress-Strain Paths for Soils in the Unsaturated State

This article reports a modified setup for an automatic oedometer apparatus that was designed at the Universite de Sherbrooke, Quebec, Canada. The proposed setup can be used to simultaneously measure the superimposed volume change of a soil specimen caused by mechanical loading and suction imposition along with continuous measurement of water exchange. The combined use of air and water volume/pressure controllers allows the operator to use the axis translation technique to impose matric suction. The setup can also be used to carry out the conventional negative water column technique using a single burette or the water volume/pressure controller to apply suction within the range of 0 kPa to 25 kPa under atmospheric air pressure conditions. A modified Tempe cell was designed to ensure the airtightness of the cell and enhance the freedom of the specimens to move vertically during one-dimensional loading and soil-water retention tests, which is particularly of interest for practical cases in which accurate vertical deformation measurement (as low as 0.02 %) is required. Details of the calibration and test procedures are described and discussed. The test results of reconstituted specimens of a fine sand mixture and Ascot Corner silt are also presented to demonstrate the key features of the modified apparatus.