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Prise de décision partagée dans la maladie de Huntington
Get PDFpeer reviewedConsidérations pratiques à propos du partage de décision relative à la prise en soin, tant avec le patient qu’avec son entourage, dans le contexte de la maladie de Huntington
SisClever process: simultaneous recovery of metals from ore or waste to high purity and high concentration via solvent extraction – experimental validation
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Cicatrisation radiologique des fistules périanales dans la maladie de Crohn : facteurs prédictifs de l'IRM et évolution de la maladie
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Background
Perianal fistulising Crohn’s disease (CD) is a disabling condition affecting up to 30% of patients. Studies suggest that greater fibrosis in the fistula tract is linked to improved clinical outcomes. This study aims to describe the natural history of perianal fistulising CD, including MRI parameters, and to identify clinical and radiological predictors of relapse and radiological healing
Methods
Pelvic MRIs for perianal fistula performed at CHU Liège, Belgium, from 2018 to 2023 were collected. MRI protocols used 1.5T [Siemens Aera/Sola] or 3T [Siemens Vida] machines, with sequences including T2 TSE, T2 TSE FS, and T1 TSE FS before and after gadolinium injection. The MAGNIFI-CD and modified Van Assche (VA) indices were assessed for each patient. Two blinded radiologists evaluated fistula tract fibrosis. For patients with perianal flare, only the first MRI was analysed (MRI 1). For others, the first and last MRI (MRI 2) within the study period were assessed. Perianal flare was defined as abscess drainage or stoma creation for active perianal CD, and radiological healing as ≥80% fistula fibrosis or a MAGNIFI-CD score of 0.
Results
A total of 102 pelvic MRIs from 84 patients were included. The median patient age was 39 years (31–51), with 40% female. The median duration of perianal CD was 52 months (2–144); 26% had a seton at MRI 1, 7% had a stoma, and 41% were on anti-TNF therapy. During follow-up, 22% required abscess drainage. No clinical factors were associated with perianal flare. Univariate analysis identified several MRI 1 radiologic predictors of flare: fibrosis percentage (OR=0.72, p=0.033), VA hyperintensity T2 (OR=3.22, p=0.028), VA rectal involvement (OR=1.75, p=0.040), VA inflammatory mass (OR=1.42, p=0.022), VA T1 post-contrast hyperintensity (OR=3.68, p=0.045), MAGNIFI-CD score (OR=1.13, p=0.022), MAGNIFI T1 post-contrast hyperintensity (OR=1.77, p=0.031), and MAGNIFI inflammatory mass (OR=1.40, p=0.033). In multivariate analysis, only MAGNIFI T1 post-contrast hyperintensity remained significant (OR=1.77, p=0.031). Radiological healing was achieved in 30% at MRI 1 (25/84) and 44% at MRI 2 (8/18). No factors at MRI 1 predicted healing at MRI 2, though T1 post-contrast hyperintensity at MRI 1 showed a trend towards predicting lack of healing (OR=0.11, p=0.071).
Conclusion
One-fifth of patients experienced perianal flare during follow-up. Clinical and therapeutic factors did not predict outcomes; only persistent MRI inflammation and low fistula fibrosis were linked to future abscess drainage. Specific MRI features may serve as therapeutic targets in perianal CD management, pending validation in a prospective cohort
Les jeux vidéo comme outil de médiation du patrimoine, application à la tombe de Sennefer dans la vallée des Nobles, Égypte.
No full textDe nombreux sites patrimoniaux restent inaccessibles en raison de leur état de conservation, leur contexte géopolitique, etc. Les progrès réalisés vis à vis des technologies de documentation numérique offrent la possibilité de préserver des traces de ces monuments et de les rendre plus accessibles. Leur utilisation, dans le but de réaliser des jeux sérieux digitaux, physique ou phygitaux, est apparue comme un moyen efficace de médiation publique du patrimoine tangible et intangible. Cette recherche explore le potentiel du développement de jeux sérieux pour partager des sites patrimoniaux qui seraient autrement inaccessibles. Le cas d’étude choisi est la chapelle de la tombe thébaine de Sennefer (TT96A), un membre de l'élite de la XVIIIe dynastie de l'Égypte antique, située sur la colline de Sheikh Abd el-Qurna, à Louqsor. L'étude s’étend sur le choix du site d'implantation, sur l'orientation et sur la méthode d'excavation de la chapelle
Microscopic and Crystallographic Analysis of Increased Acid Resistance of Melted Dental Enamel Using 445 nm Diode Laser: An Ex-Vivo Study.
Get PDFpeer reviewedBackground/Objectives: This study aimed to evaluate the efficacy of a 445 nm diode laser in enhancing enamel resistance to acid-induced demineralization and to investigate the associated compositional and structural modifications using scanning electron microscopy (SEM), electron spectroscopy for chemical analysis (ESCA), and X-ray diffraction (XRD) crystallographic analysis. Methods: A total of 126 extracted human teeth were used. A total of 135 (n = 135) enamel discs (4 × 4 mm) from 90 teeth were assigned to either a laser-irradiated group or an untreated control group for SEM, ESCA, and XRD analyses. Additionally, 24 mono-rooted teeth were used to measure pulp temperature changes during laser application. Laser irradiation was performed using a 445 nm diode laser with a pulse width of 200 ms, a repetition rate of 1 Hz, power of 1.25 W, an energy density of 800 J/cm2, a power density of 3980 W/cm2, and a 200 µm activated fiber. Following acid etching, SEM was conducted to assess microstructural and ionic alterations. The ESCA was used to evaluate the Ca/P ratio, and XRD analyses were performed on enamel powders to determine changes in phase composition and crystal lattice parameters. Results: The laser protocol demonstrated thermal safety, with minimal pulp chamber temperature elevation (0.05667 ± 0.04131 °C). SEM showed that laser-treated enamel had a smoother surface morphology and reduced acid-induced erosion compared with controls. Results of the ESCA revealed no significant difference in the Ca/P ratio between groups. XRD confirmed the presence of hydroxyapatite structure in laser-treated enamel and detected an additional diffraction peak corresponding to a pyrophosphate phase, potentially enhancing acid resistance. Results of the spectral analysis showed the absence of α-TCP and β-TCP phases and a reduction in the carbonate content in the laser group. Furthermore, a significant decrease in the a-axis lattice parameter suggested lattice compaction in laser-treated enamel. Conclusions: Irradiation with a 445 nm diode laser effectively enhances enamel resistance to acid demineralization. This improvement may be attributed to chemical modifications, particularly pyrophosphate phase formation, and structural changes including prism-less enamel formation, surface fusion, and decreased permeability. These findings provide novel insights into the mechanisms of laser-induced enhancement of acid resistance in enamel
Steel-concrete shear connection in composite structures – a key structural component for composite floor
Get PDFpeer reviewedA composite structural member is a member made of at least two parts with different materials, interconnected by a shear connection which allows to design the member as a single structural member. Composite members combining steel and concrete are the most common solutions met in practice and is the topic of the present paper. As reflected in the above definition, the shear connection plays a key role in the global behaviour of composite members, as the latter should limit the slip between the concrete part and the steel part but also to ensure the transfer of shear forces between the two materials to allow the composite member to act as a monolith structural element. The present paper summarises the general concept behind the design strategies for shear connection in steel-concrete composite beams, the code requirements and recent research out-comes allowing to extend the code requirements to new structural composite solutions such as shallow floors
The Belgian-Dutch civil codification of 1830: a lawmaking process encouraging parliamentary compromises ?
No full textThis communication proposes an analysis of the Belgian-Dutch codification in the light of compromises: rather than follow the classical narrative presenting this codification as the imposition of Belgian claims, I will (1) question the lawmaking process developed in the Parliament during the elaboration of the civil code and (2) show its propensities to conciliate the different views on civil law - or not. To assess the impact of the process, the presentation will conclude (3) by investigating how the drafting commission incorporated these compromises into his drafting of the law
Advancing Neonatal Screening for Pyridoxine-Dependent Epilepsy-ALDH7A1 Through Combined Analysis of 2-OPP, 6-Oxo-Pipecolate and Pipecolate in a Butylated FIA-MS/MS Workflow.
Get PDFpeer reviewedPyridoxine-dependent epilepsy (PDE) represents a group of rare developmental and epileptic encephalopathies. The most common PDE is caused by biallelic pathogenic variants in ALDH7A1 (PDE-ALDH7A1; OMIM #266100), which encodes α-aminoadipate semialdehyde (α-AASA) dehydrogenase, a key enzyme in lysine catabolism. Affected individuals present with seizures unresponsive to conventional anticonvulsant medications but responsive to high-dose of pyridoxine (vitamin B6). Adjunctive lysine restriction and arginine supplementation have also shown potential in improving neurodevelopmental outcomes. Given the significant benefit of early intervention, PDE-ALDH7A1 is a strong candidate for newborn screening (NBS). However, traditional biomarkers are biochemically unstable at room temperature (α-AASA and piperideine-6-carboxylate) or lack sufficient specificity (pipecolate), limiting their utility for biomarker-based NBS. The recent identification of two novel and stable biomarkers, 2S,6S-/2S,6R-oxopropylpiperidine-2-carboxylate (2-OPP) and 6-oxo-pipecolate (oxo-PIP), offers renewed potential for biochemical NBS. We evaluated the feasibility of incorporating 2-OPP, oxo-PIP, and pipecolate into routine butylated FIA-MS/MS workflows used for biochemical NBS. A total of 9402 dried blood spots (DBS), including nine confirmed PDE-ALDH7A1 patients and 9393 anonymized controls were analyzed using a single multiplex assay. 2-OPP emerged as the most sensitive biomarker, identifying all PDE-ALDH7A1 patients with 100% sensitivity and a positive predictive value (PPV) of 18.4% using a threshold above the 99.5th percentile. Combining elevated 2-OPP (above the 99.5th percentile) with either pipecolate or oxo-PIP (above the 85.0th percentile) as secondary marker detected within the same multiplex FIA-MS/MS assay further improved the PPVs to 60% and 45%, respectively, while maintaining compatibility with butanol-derivatized method. Notably, increasing the 2-OPP threshold above the 99.89th percentile, in combination with either pipecolate or oxo-PIP above the 85.0th percentile resulted in both 100% sensitivity and 100% PPV. This study supports the strong potential of 2-OPP-based neonatal screening for PDE-ALDH7A1 within existing NBS infrastructures. The ability to multiplex 2-OPP, pipecolate and oxo-PIP within a single assay offers a robust, practical, high-throughput and cost-effective approach. These results support the inclusion of PDE-ALDH7A1 in existing biochemical NBS panels. Further prospective studies in larger cohorts are needed to refine cutoffs and confirm clinical performance
Un ventre pour deux: Les ajustements psychiques des mères-porteuses dans la GPA relationnelle
No full textGreek Philosophy and Roman Satire Lucilius’ Use of Greek Philosophical Vocabulary. About Three Fragments Attributed to Book 28 (753, 755-756, 784-790 Marx)
No full textThe language of the genre specific to the Latin world that is satire is characterized by varietas, thematic diversity, but also by variatio, namely stylistic variety. Lucilius, who wrote at a time when the purist ideal of urbanitas was being established, in cultivated and philhellenic circles of the 2nd century, around the figure of Scipio Aemilianus, uses varietas as a linguistic strategy. He forges a language that integrates a significant number of Greek words, mostly technical terms. In several places he uses Greek terms relating to philosophical notions. This contribution would like to explore how Lucilius integrates Greek philosophical notions alongside references to specifically Roman habits, laws, culture and linguistic uses