Rehabilitation versus surgical reconstruction for non-acute anterior cruciate ligament injury (ACL SNNAP): a pragmatic randomised controlled trial

BackgroundAnterior cruciate ligament (ACL) rupture is a common debilitating injury that can cause instability of the knee. We aimed to investigate the best management strategy between reconstructive surgery and non-surgical treatment for patients with a non-acute ACL injury and persistent symptoms of instability.MethodsWe did a pragmatic, multicentre, superiority, randomised controlled trial in 29 secondary care National Health Service orthopaedic units in the UK. Patients with symptomatic knee problems (instability) consistent with an ACL injury were eligible. We excluded patients with meniscal pathology with characteristics that indicate immediate surgery. Patients were randomly assigned (1:1) by computer to either surgery (reconstruction) or rehabilitation (physiotherapy but with subsequent reconstruction permitted if instability persisted after treatment), stratified by site and baseline Knee Injury and Osteoarthritis Outcome Score—4 domain version (KOOS4). This management design represented normal practice. The primary outcome was KOOS4 at 18 months after randomisation. The principal analyses were intention-to-treat based, with KOOS4 results analysed using linear regression. This trial is registered with ISRCTN, ISRCTN10110685, and ClinicalTrials.gov, NCT02980367.FindingsBetween Feb 1, 2017, and April 12, 2020, we recruited 316 patients. 156 (49%) participants were randomly assigned to the surgical reconstruction group and 160 (51%) to the rehabilitation group. Mean KOOS4 at 18 months was 73·0 (SD 18·3) in the surgical group and 64·6 (21·6) in the rehabilitation group. The adjusted mean difference was 7·9 (95% CI 2·5–13·2; p=0·0053) in favour of surgical management. 65 (41%) of 160 patients allocated to rehabilitation underwent subsequent surgery according to protocol within 18 months. 43 (28%) of 156 patients allocated to surgery did not receive their allocated treatment. We found no differences between groups in the proportion of intervention-related complications.InterpretationSurgical reconstruction as a management strategy for patients with non-acute ACL injury with persistent symptoms of instability was clinically superior and more cost-effective in comparison with rehabilitation management

La spectroscopie Raman pour l’environnement marin

L’analyse des composés chimiques est au coeur de nombreuses applications en sciences marines et environnementales : surveillance dans le cadre de la Directive cadre sur l’eau (Directive 2000/60/CE) et la Directive cadre stratégie milieu marin (2008/56/CE), études d’impact des activités industrielles marines, surveillance de l’état sanitaire des eaux et produits de la mer, études écosystémiques ou biogéochimiques..

Sinking rates, orientation, and behavior of pennate diatoms

Phytoplankton cells are now recognized as dynamic entities rather than as passive and isolated particles because they can actively modulate impacts of selection factors (nutrients, light, turbidity, and mixing) through a wide range of adaptations. Cell shape and/or chain length modulation is one of these processes but has predominantly been studied as an adaptation or an acclimatation to a specific growth limitation (light, nutrients, predation, etc.). In this study we have demonstrated that cell shape and size may have greater roles than previously known in phytoplankton ecology and species adaptation by permitting cell‐to‐cell signaling and more complex ecological processes that result from it. By exploring microscale biophysical interactions that lead to specific cell reorientation processes, we demonstrated that cell geometry not only modulates cell sinking rates but can also provide fast sensor responses to the cells' environment. Although gyrotaxis has been described in detail for motile phytoplankton cells, our findings illustrate that the reorientation process described here can occur even in non‐motile cells within their natural environment. An additional consistent behavior was also recently described for a diatom species (Pseudo‐nitzschia delicatessima), and with this study, we extend this observation to Pseudo‐nitzschia pungens and Pseudo‐nitzschia fraudulenta. Our observations emphasize the generality of this process, which adds a new level of complexity to our understanding of cellular interactions and their network of sensors

Optimisation de l’identification et du dénombrement du microphytoplancton avec le système couplé de numérisation et d’analyse d’images FlowCAM – Zoo/PhytoImage (système innovant). Action 9 – Livrable 3. Evolution du matériel de numérisation : prototype FastCAM et perspectives. Rapport final, février 2016

This deliverable contains all development work of the FastCAM, new tool for fast imaging of the phytoplankton, which took place in 2015. It consists of: One report of the FastCAM and its comparison with the FlowCAM presentation: The FlowCAM enables the digitalization of a sample of phytoplankton with X10 and X 4 magnifications. The first allows a better morphological description and therefore a higher taxonomic resolution but with a longer scan time (16 X). Thus, for routine analyses, only scanning at 4 X is possible. A considerable gain would be able to do an acquisition to the magnification 10 X with a time of analysis more short, comparable to 4 X. A fast flow imaging system has therefore developed in this sense. He was called FastCAM. The system is based on the use of a high resolution (2 Megapixels) and high‐speed camera allowing the acquisition to 340 FPS. In this way, it allows to scan 10 mL of sample with a X 10 magnification within 15 min. Comparison of the images with those obtained with the FlowCAM clearly shows a gain to the use of the FastCAM. The outlook now is the establishment of a set of learning for a coupling with Zoo/Phytoimage and the industrial transfer of the system. A slide show presentation of the system showed during a project meeting (on the 4th of November 2015).Ce livrable contient l’ensemble des travaux de développement du FastCAM, nouvel outil de numérisation rapide du phytoplancton, ayant eu lieu en 2015. Il est constitué de deux documents : Un rapport de présentation du FastCAM et de sa comparaison avec le FlowCAM. Le FlowCAM permet la numérisation d’un échantillon de phytoplancton avec des grandissements X10 et X4. Le premier permet une meilleure description morphologique et donc une meilleure résolution taxonomique mais avec un temps d'acquisition environ 16X plus long. Ainsi, pour des analyses en routine, seule une numérisation au X4 est possible. Un gain considérable serait de pouvoir réaliser une acquisition au grandissement 10X avec un temps d'analyse plus court, comparable au 4X. Un système d’imagerie rapide en flux a donc été développé en ce sens. Il a été nommé FastCAM. Le système repose sur l’utilisation d’une caméra rapide haute résolution (2 Megapixels) permettant l’acquisition à 340 images/s. Grâce à cela, il permet de numériser 10 mL d’échantillon avec un grandissement X10 en moins de 15 min. La comparaison des images à celles obtenues avec le FlowCAM en un temps équivalent au X4 montre clairement un gain à l’utilisation du FastCAM. Les perspectives maintenant sont la constitution d’un set d’apprentissage pour un couplage avec le logiciel Zoo/Phytoimage. Un diaporama de présentation du système, présenté lors d’une réunion de projet (4 novembre 2015

Design, Characterization, and Test of a Versatile Single-Mode Power-Over-Fiber and Communication System for Seafloor Observatories

A power-over-fiber (PoF) and communication system for extending a cabled seafloor observatory is demonstrated in this contribution. The system allows the cabled seafloor observatory to be linked, through a single optical fiber, to a sensor node located 8 km away. The PoF system is based on an optical architecture in which power and data propagate simultaneously on the same single-mode fiber. The Raman scattering effect is exploited to amplify the optical data signals and leads to the minimization of the sensor node power consumption. Versatile low power electronic interfaces have been developed to ensure compatibility with a wide range of marine sensors. A low-consumption field-programmable gate array and an energy-efficient microcontroller are used to develop the electronic interfaces. For an electrical input power of 31 W, up to 190 mW is recovered at the sensor node while a data bitrate of up to 3.6 Mb/s is achieved. The PoF system has been tested and validated for turbidity and acoustic measurement applications. The current study focuses on the electronic development and the validation of the PoF system

Design, Characterization, and Test of a Versatile Single-Mode Power-Over-Fiber and Communication System for Seafloor Observatories

International audienc

Powering a remote board and sensors in an extreme environment — An optical solution

International audienc

KOSMOS: An Open Source Underwater Video Lander for Monitoring Coastal Fishes and Habitats

Background: Monitoring the ecological status of coastal ecosystems is essential to track the consequences of anthropogenic pressures and assess conservation actions. Monitoring requires periodic measurements collected in situ, replicated over large areas and able to capture their spatial distribution over time. This means developing tools and protocols that are cost-effective and provide consistent and high-quality data, which is a major challenge. A new tool and protocol with these capabilities for non-extractively assessing the status of fishes and benthic habitats is presented here: the KOSMOS 3.0 underwater video system. Methods: The KOSMOS 3.0 was conceived based on the pre-existing and successful STAVIRO lander, and developed within a digital fabrication laboratory where collective intelligence was contributed mostly voluntarily within a managed project. Our suite of mechanical, electrical, and software engineering skills were combined with ecological knowledge and field work experience. Results: Pool and aquarium tests of the KOSMOS 3.0 satisfied all the required technical specifications and operational testing. The prototype demonstrated high optical performance and high consistency with image data from the STAVIRO. The project’s outcomes are shared under a Creative Commons Attribution CC-BY-SA license. The low cost of a KOSMOS unit (~1400 €) makes multiple units affordable to modest research or monitoring budgets