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[en] BlackRock CEO Larry Fink recently announced in his annual letter to clients that the asset manager would seek to align its portfolio with a net zero economy. Policy announcements also included a promise to hold portfolio companies accountable for setting net zero plans and a commitment to increase oversight of companies with 'significant climate-related risk' and support more shareholder climate resolutions. These new measures imply huge changes for BlackRock as they require its investments to quickly become compatible with a 1.5 deg. C world, which is far from being the case. Unfortunately, BlackRock has yet to clearly define what net zero means, or to establish short and medium term benchmarks that would reduce overall emissions in line with climate science. Furthermore, the new measures still provide a way out to major polluters, as BlackRock has still not taken any steps to exclude climate laggards in the short term. There is not enough time left regarding our climate goals for engagement strategies directed at companies in the fossil fuel sector that have no viable net zero transition pathway, such as companies actively expanding fossil fuel exploration and production. Over the next few years, concrete steps will need to be taken by BlackRock as it is highly unlikely that continuing to shrug off responsibilities will really lead to the 'tectonic shift' in investing required in the short term. Embarking on a net zero pathway has immediate implications for BlackRock, as fossil fuel production needs to quickly wind down. The 2020 Production Gap Report, published with the UNEP, shows that, alarmingly, major fossil fuel producing countries are still planning for an average annual fossil fuel production increase of 2%. By 2030, this would result in more than double the fossil fuel production than would be consistent with the 1.5 deg. C limit. It is therefore highly inconsistent for financial actors which have committed to become net zero by 2050 to continue to invest in major fossil fuel developers in 2021, and especially companies involved in unconventional oil and gas development. As outlined by recent research by HSBC, 'it will be difficult for net zero committed institutions to justify holding oil and gas issuers in net-zero portfolios'. It is well past time for BlackRock to exit any company planning to develop new fossil fuel reserves and infrastructure and not complying with a robust fossil fuel phase out plan. The tar sands sector is a key example of a sector that is clearly inconsistent with keeping global warming below 1.5 deg. C, as tar sands reserves are a ticking time bomb regarding climate objectives. Our research reveals that BlackRock is a massive supporter of the tar sands industry, with $75 billion of current holdings in 30 major tar sands production companies planning on developing new reserves. To be consistent with its net zero commitment, BlackRock will need to step up its ambition and stop fueling the tar sands sector and exacerbating the huge negative impacts on climate and human rights linked to its development.
[en] Diffusion-weighted imaging (DWI) is a powerful tool that has recently been applied to evaluate several pediatric musculoskeletal disorders. DWI probes abnormalities of tissue structure by detecting microscopic changes in water mobility that develop when disease alters the organization of normal tissue. DWI provides tissue characterization at a cellular level beyond what is available with other imaging techniques, and can sometimes identify pathology before gross anatomic alterations manifest. These features of early detection and tissue characterization make DWI particularly appealing for probing diseases that affect the musculoskeletal system. This article focuses on the current and future applications of DWI in the musculoskeletal system, with particular attention paid to pediatric disorders. Although most of the applications are experimental, we have emphasized the current state of knowledge and the main research questions that need to be investigated. (orig.)
[en] The sensitivity and specificity of evaluating clubfoot deformity by MR in high-risk fetuses is currently unknown. To correlate fetal MRI with US in the assessment of clubfoot and to identify the MRI features most characteristic of clubfoot. With IRB approval and informed consent, the presence of fetal clubfoot was prospectively evaluated in mothers referred for MRI for a fetus with myelomeningocele. Two radiologists blind to the US results independently reviewed the MRI for the presence of clubfoot. MRI results were compared with US results obtained the same day and birth outcomes. Of 20 patients enrolled, there were 13 clubfeet. Interobserver agreement for the presence of clubfoot was 100%. The sensitivity of the MRI exam was 100% and the specificity 85.2%. A dedicated sagittal imaging plane through the ankle region allowed the most confident diagnosis; medial deviation of the foot relative to the leg was seen in all 13 fetuses with clubfoot. The correlation of fetal MRI with US in the evaluation of clubfoot yields a sensitivity of 100% and specificity of 85.2%. The sagittal plane provided the most useful information. (orig.)
[en] Pulmonary embolism (PE) is an underdiagnosed entity in the pediatric population in part because of the low level of suspicion and awareness in the clinical world. To examine its relative prevalence, associated risk factors and imaging features in our pediatric population. A total of 92 patients age 21 years and younger with a high clinical suspicion of PE and who had available radiographic studies were identified from January 2003 to September 2006. Patients with a positive CT scan or a high probability ventilation/perfusion scan formed the case group; patients with a high clinical suspicion of PE and no radiographic evidence of PE or deep venous thrombosis (DVT), randomly matched in age and sex, became the matched control group. We reviewed the charts of both groups and analyzed the imaging studies. In our hospital, the prevalence of PE in patients with a strong suspicion of PE was 14%. The overall prevalence of thromboembolic disease (PE and/or DVT) was 25%. Recent surgery or orthopedic procedure, blood dyscrasias and contraceptive use were more common in patients with PE. No child died of PE in our study. The youngest child with PE in our study was 13 years. Girls were twice as likely to develop PE as boys. PE is a relatively common diagnosis in our tertiary care pediatric population when the clinical suspicion is high. We suggest increased awareness and index of suspicion in order to initiate prompt diagnostic imaging and treatment. (orig.)
[en] In 2020, Total produced 447 units of fossil fuels for every 1 unit of renewable energy. Nonetheless, despite its desire to rename itself Total Energies, the major continues to invest heavily in the development of new fossil energy projects, such as the highly controversial EACOP oil project such as the highly controversial EACOP oil project in Uganda and Tanzania, or in the Arctic. 90% of its capital expenditure remains oriented towards fossil fuels and the trends in its hydrocarbon production could result in an increase of more than 50% between 2015 and 2030. Thus, the way French financial players are adapting their relationship with Total SE, in a context of climate emergency, is a good indicator of the sincerity of their commitments, and of the challenges related to their success. This briefing takes stock of Total SE's climate promises and of the way financial players have treated such a heavyweight in the energy sector until now. It also sketches out possible courses of action. The first follows a global approach that extends across the entirety of financial actors' portfolios and the companies they support. The second follows a sector-based approach aimed at finding immediate solutions for the most polluting sectors, which also turn out to involve the heaviest ESG and financial risks. For an oil and gas company, these are unconventional hydrocarbons - shale gas and oil, oil sands and drilling in the Arctic and deep waters. While acting on the first axis will only end up having an impact after several years, targeting the most polluting sectors makes it possible to meet the scientific imperative of reducing our greenhouse gas emissions by 7.6% every year until 20301. The actions to be taken on both axes must of course be based on science, which stipulates that oil production must be reduced by 4% and gas production by 3% per year by 2030 in order to meet the 1.5 deg. C objective.
[fr]En 2020, Total a produit 447 unites d'energies fossiles pour 1 d'energies renouvelables. Or malgre sa volonte de se renommer TotalEnergies, la major continue d'investir massivement dans le developpement de nouveaux projets d'energies fossiles, comme le tres controverse projet petrolier d'EACOP entre l'Ouganda et la Tanzanie, ou des projets d'energies fossiles en Arctique. 90% de ses depenses d'investissements demeurent orientees vers les energies fossiles et l'evolution de sa production d'hydrocarbures nous amene vers une augmentation de plus de 50% de cette derniere entre 2015 et 2030. Ainsi, la maniere dont les acteurs financiers francais adaptent leur relation a Total SE dans un contexte d'urgence climatique est un bon indicateur de la sincerite de leurs engagements precites, et des defis lies a leur succes. Ce briefing analyse les promesses climatiques du groupe, ainsi que la maniere dont les acteurs financiers ont jusqu'a present traite un tel poids lourd du secteur energetique. Il presente enfin les pistes d'actions possibles. Le premier suit une approche globale qui couvre l'integralite des portefeuilles des acteurs financiers et des entreprises qu'ils soutiennent. Le deuxieme suit une approche sectorielle visant a trouver des solutions immediates pour les secteurs les plus polluants, lesquels s'averent concentrer aussi les plus lourds risques ESG et financiers. Pour une entreprise gaziere et petroliere, il s'agit des hydrocarbures non conventionnels - gaz et petrole de schiste, sables bitumineux et forages en Arctique et en eaux tres profondes. Alors qu'agir sur le premier axe ne pourra produire des impacts qu'au bout de quelques annees, viser les secteurs les plus polluants permet de repondre a l'imperatif scientifique de baisser tous les ans nos emissions de gaz a effet de serre de 7,6% jusqu'en 20301. Les actions a mener sur les deux axes doivent bien entendu etre fondees sur la science, laquelle stipule qu'il faut baisser de 4% la production petroliere et de 3% la production gaziere par an d'ici 2030 afin de tenir l'objectif de 1,5 deg. C.
[en] Avascular necrosis (AVN) is a common morbidity in children with sickle cell disease (SCD) that leads to pain and joint immobility. However, the diagnosis is often uncertain or delayed. To examine the ability of apparent diffusion coefficient (ADC) measurements on diffusion-weighted imaging to detect AVN in children with SCD. ADC values were calculated at the hips of normal children (n = 19) and children with SCD who were either asymptomatic with no known previous hip disease (n = 13) or presented for the first time with clinical symptoms of hip pathology (n = 12). ADC values were compared for differences among groups with and without AVN using non-parametric statistical methods. The ADC values were elevated in the hips of children with AVN (median ADC = 1.57 x 10-3 mm2/s [95% confidence interval = 0.86-2.10]) and differed significantly in pairwise comparisons (all P < 0.05) from normal children (0.74 [0.46-0.98]), asymptomatic children with SCD (0.55 [0.25-0.85]), and SCD children who had symptoms referable to their hips but did not show findings of hip AVN on conventional MRI or radiographs (0.46 [0.18-0.72]). Children with sickle cell disease have elevated apparent diffusion coefficient values in their affected hips on initial diagnosis of avascular necrosis. (orig.)