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Élévation des tests hépatiques et maladies stéatosiques du foie : nouveautés 2024
No full textLa découverte d’une élévation des tests hépatiques est courante en médecine de premier recours, sa prévalence est estimée à 8 %. Les maladies hépatiques stéatosiques sont les étiologies les plus fréquemment retrouvées et représentent la principale cause de morbimortalité liée au foie. Cet article aborde les nouveautés concernant ces maladies et plus particulièrement la MASLD ou « Metabolic Dysfunction Associated Steatotic Liver Disease ». Les recommandations préconisent un suivi biologique tous les 1-3 ans en présence de facteurs de risque et l’utilisation du score FIB-4 (fibrosis-4) pour dépister la fibrose en cas de MASLD. La prise en charge thérapeutique vise à améliorer la dysfonction métabolique par des mesures hygiénodiététiques et le traitement des facteurs de risque.Elevated liver enzymes are a common finding in primary care medicine, with an estimated prevalence of 8 %. Steatotic liver diseases are the most frequently encountered etiologies and r-epresent the main cause of liver-related morbidity and mortality. This article looks at the latest developments in these diseases, with a particular focus on MASLD (Metabolic dysfunction associated steatotic liver disease). Recommendations include biological monitoring every 1-3 years in the presence of risk factors, and the use of the FIB-4 score to detect fibrosis in cases of MASLD. Therapeutic management aims to improve metabolic function by treating risk factors and through lifestyle and dietary measures
Gendered opportunities across modes of political participation: a macro–micro analysis of the gender gap
No full textWe examine the role of ‘gendered opportunities’ for political participation by analysing original survey data covering nine European countries alongside relevant macro-level factors. We hypothesize that gender interacts differently with certain features of the broader context – here, government spending on public services – across various modes of participation, leading to ‘gendered opportunities’ for political engagement. By analysing data for three different modes of participation, namely voting, protest and consumerist participation, we show that the political context provides ‘gendered opportunities’ for political participation and that the gender gap is not homogeneously distributed across modes but varies depending on the repertoire. Our findings clearly highlight how the relationship between gender and the broader context for political participation is a complex one, suggesting that further work must consider the macro–micro linkages leading to differential gender inequalities in political participation.</p
Manipulation on Thiolate-Protected Gold Nanoclusters for Electroreduction of CO<sub>2</sub>
No full textThiolate-protected atomically precise gold nanoclusters exhibit molecular properties owing to the quantum confinement effect, originating from the ultra-small size of the nanoclusters. The unique characteristics of gold nanoclusters such as large surface area, optical features, and chirality, enable their applications in catalysis, bioimaging, sensing and so on. Additionally, the core-shell structure of the nanocluster, with the metal kernel enveloped by a monolayer of organic ligands, provides the feasibility to manipulate the metal core and surface ligands, thereby optimizing the physicochemical properties to suit specific objectives.
First, we realized the precise manipulation of ligand chemistry on Au25PET18 nanoclusters. Exactly one monothiol functionalized metal-terpyridine complex (metal= Ru, Co, Ni, Fe) is added or exchanged to neutral Au25PET18 nanoclusters through ligand exchange reactions, forming Au25PET18(metal complex)1 and Au25PET17(metal complex)1, respectively. This phenomenon stands out as unique in contrast to common ligand exchange reactions, in which the number of exchanged ligands is typically uncontrollable and incoming ligands can only substitute the existing surface ligand without addition to the parent nanoclusters. We observed that the selective ligand exchange or ligand addition depends on the oxidation properties of metal complexes and charge state of parent Au25PET18 nanocluster. The photoluminescence quantum yield of Au25PET18(Ru complex)1 is 14 times higher than that of pristine Au25PET18.
In addition, Au25 nanocluster can serve as a photosensitizer due to its discrete energy bands. Photocoupled electrocatalytic CO2 reduction (PECR) was investigated using various metal complexes anchored Au25 nanoclusters, [Au25PET17(metal complex)1, abbreviated as Au25-M]. The anchoring of Ru and Ni complexes on Au25 nanoclusters (Au25−Ru and Au25−Ni) leads to adequate CO2 to CO conversion for photocoupled PECR in terms of high selectivity, with Faradaic efficiency of CO (FECO) exceeding 90 % in a wide potential range, remarkable activity (CO production rate up to two times higher than that for pristine Au25PET18) and extremely large turnover frequencies (TOFs, 63012 h−1 at −0.97 V for Au25−Ru and 69989 h−1 at −1.07 V vs. RHE for Au25−Ni). Moreover, PECR stability test indicates the excellent long-term stability of the modified nanoclusters in contrast with pristine Au nanoclusters. These improvements are attributed to more active sites and an efficient electron transfer pathway provided by the metal complexes. It provides a new strategy for designing active and stable nanoclusters for different photo/electrocatalytic applications.
The self-assembly of gold nanoclusters induced by ligand exchange reaction is often plagued by uncontrollability and instability, leading to the formation of oligomer mixtures. In this thesis, we successfully achieved the precise dimeric assembly of gold nanoclusters linked by dithiol functionalized metal-terpyridine complexes (metal = Ni, Fe), based on our observation of controllable ligand exchange on Au25 nanoclusters. Additionally, we investigated the photophysical properties of these assemblies. This study offers a guide for the precise assembly of metal nanoclusters into dimers.</p
Qu’est-ce qu’un récit de voyage digne de foi dans l’Europe du XVIe siècle ? : réflexions à partir d’épisodes incertains de l’<i>Itinerario</i> de Ludovico de Varthema (1510)
No full text<i>Distressed M&A </i>: qui décide de céder l’entreprise ? Réflexions sur la répartition des compétences au sein d’une société en difficulté
No full textLa question de la répartition des compétences en matière de cession d’actifs par des sociétés anonymes en difficulté. En effet, il arrive fréquemment que l’assainissement d’entreprise passe par la cession de tout ou partie des actifs d’une société en difficulté à un reprenant qui continuera l’exploitation, le cas échéant après l’avoir restructuré. Or, se pose fréquemment la question dans ce contexte de savoir à qui revient la compétence de décider d’aller de l’avant : au conseil d’administration de la société en difficulté ou ses actionnaires décidant en assemblée générale. Comme nous le verrons, cette question ne présente pas seulement un enjeu pratique important, mais peut avoir un impact sur le succès de l’opération
Radiation dosimetry of the 18 kDa translocator protein ligand [<sup>18</sup>F]PBR111 in humans
No full text Purpose: The 18 kDa translocator protein (TSPO) is a mitochondrial protein that becomes overexpressed during neuroinflammatory conditions, such as in Alzheimer's disease or multiple sclerosis. TSPO is of interest because it serves as a marker for microglial and astrocytic activity, measurable via in vivo positron emission tomography (PET) molecular imaging. [18F]PBR111 is a second-generation TSPO PET radioligand with high signal specificity but a sensitivity to TSPO polymorphism, in comparison with first-generation ligands. This study focused on the biodistribution and dosimetry of [18F]PBR111 in healthy humans.
Method: Six volunteers (three males, three females) were administered approximately 200 MBq of [18F]PBR111. Organs such as the lungs and liver showed the highest initial radioactivity level, while the bone marrow and bladder accumulated activity over time, likely reflecting ligand defluorination and elimination.
Results: Dosimetry findings revealed a total effective dose of 16.17 μSv/MBq, equivalent to 3.04 mSv per examination. Compared to animal models, human dosimetry showed lower radiation exposure, highlighting discrepancies in predictive models. Organ-specific dose comparisons with other TSPO ligands ([18F]PBR06, [18F]FEPPA, [18F]FEDAA1106) revealed similar distribution patterns. This study underscores the clinical viability of [18F]PBR111 for TSPO imaging, providing critical data for optimizing its safe use in research and clinical settings.
Conclusion: The findings support its potential for studying neuroinflammatory and systemic diseases. The trial registration number is NCT06398392.</p
Ophtalmologie : ce qui a changé en 2024
No full textL’ophtalmologie se distingue par son dynamisme, notamment grâce à des innovations techniques (lasers, microscopes, outils diagnostiques de pointe) et des progrès thérapeutiques significatifs réalisés chaque année. Cet article expose les principales avancées thérapeutiques récentes et souligne l’importance croissante de l’intelligence artificielle pour le dépistage des maladies oculaires. Un focus est fait sur les atteintes oculaires associées aux virus émergents, mieux décrites désormais en raison de l’augmentation du nombre de patients infectés dans le monde.Ophthalmology is notable for significant technological innovations (e.g laser, microscopy…) that allow for diagnostic and therapeutic advances every year. This article presents the main significant therapeutic progress and highlights the growing use of artificial intelligence in diagnosis of eye disease. We include a focus on emergent virus-mediated ocular conditions that have garnered attention lately, as the number of patients with viral infections is increasing worldwide
Bradyarythmies dans le syndrome coronarien aigu
No full textLe syndrome coronarien aigu (SCA) est compliqué d’arythmies cardiaques jusque dans 30 à 40 % des cas. Celles-ci peuvent être bénignes ou malignes et surviennent principalement durant les premières 24 heures après l’infarctus du myocarde (IDM). Le temps d’ischémie étant le facteur clé, elles sont en baisse depuis la mise en place de stratégies de reperfusion accélérées. Les bradyarythmies, souvent bénignes et spontanément résolutives, sont moins fréquentes que les tachyarythmies mais peuvent parfois nécessiter une prise en charge spécifique. L’objectif de cet article est une mise à jour sur les bradycardies et troubles de la conduction survenant lors d’un SCA ainsi que leurs prises en charge.In up to 30-40% of the cases acute coronary syndrome (ACS) is complicated by cardiac arrhythmias. The latter can be benign or malignant and mainly occur during the first 24 hours after myocardial infarction. Ischemia time being the key factor, arrythmias decreased dramatically since the implementation of accelerated reperfusion strategies. Bradyarrhythmias are often benign and self-limiting and are less frequent than tachyarrhythmias but can sometimes require specific treatment. The objective of this article is to provide an update on bradycardia and conduction system disorders occurring during ACS and their management
Competing influence of the Taiwan orogen and East Asian Summer Monsoon on South China Sea paleoenvironmental proxy records
No full textQuand opérer une rupture du tendon du moyen fessier ?
No full textThe gluteus medius allows hip abduction and stabilization of the pelvis when walking. A rupture of the gluteus medius tendon is associated with lateral hip pain, weakness, a positive Trendelenburg sign, and a limp. Diagnosis is confirmed by ultrasound or MRI. In the case of a degenerative lesion, treatment is based on activity modification, physiotherapy, and injections. If conservative treatment fails, or in the case of a traumatic injury in a young patient, tendon repair surgery may be performed. Open and arthroscopic surgeries give good results with improved pain and strength, improved gait, and a low re-rupture rate. Tendon transfer may be considered in cases of re-rupture or irreparable tendon.Le muscle moyen fessier permet l’abduction de la hanche et le maintien de l’horizontalité du bassin lors de la marche. La rupture du tendon du moyen fessier se manifeste par des douleurs latérales de hanche, une faiblesse à l’abduction, un signe de Trendelenburg positif et une boiterie. Le diagnostic est confirmé par échographie ou IRM. Un traitement par adaptation des activités, physiothérapie et infiltrations est entrepris en cas de rupture dégénérative. En cas d’échec du traitement conservateur ou de rupture traumatique, une chirurgie de réparation du tendon peut être effectuée. La chirurgie ouverte et la chirurgie arthroscopique donnent de bons résultats, avec une amélioration des douleurs et de la force, une diminution de la boiterie et un faible taux de reruptures. Un transfert tendineux peut être envisagé en cas de rerupture ou de tendon irréparable