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Saint-Denis, France

Ballas R.,University of Reunion Island | Beguin L.,Mutualiste Clinic
Journal of Shoulder and Elbow Surgery | Year: 2013

Hypothesis: A stemless reverse shoulder prosthesis with humeral cup was developed to allow stemless press-fit fixation, to preserve bone stock. Our hypothesis was that a stemless reverse shoulder arthroplasty could produce the same functional results without compromising humeral fixation. Methods: This is a continuous, prospective, single-surgeon series including prostheses implanted from 2004 to 2009. Patients received pre- and postoperative clinical evaluation with measurement of joint mobility, the Oxford Shoulder score, and the Constant-Murley score by independent evaluators. Standard radiographs and computed tomographic arthrography were performed. Results: Fifty-six implants were reviewed at a mean of 58 months (38-95). The Constant-Murley score improved from 29 to 62 points and the Oxford Shoulder score from 46 to 17 points. Active elevation in forward flexion improved from 79° to 140°. One intraoperative complication was recorded: a metaphyseal-diaphyseal humeral bone crack without consequence. One revision surgery due to early instability was performed using a conventional implant. No humeral loosening was observed. Five cases of scapular notching were reported. Conclusion: This is the first study reporting results with mid-term follow-up for a stemless reverse shoulder arthroplasty. The clinical results are comparable to conventional prostheses with stem. The absence of a humeral stem preserves bone stock for possible later revisions. © 2013 Journal of Shoulder and Elbow Surgery Board of Trustees.


Plu M.,University of Reunion Island
Monthly Weather Review | Year: 2011

The inherent predictability of tropical cyclone tracks has received much attention since the 1980s. It is still an issue because of the recent improvement of track forecasts by numerical models. The aim of this study is to assess this predictability limit globally using an approach devised by Lorenz on several up-to-date numerical models. The differences between forecasts valid at the same instant are considered to be error values; the doubling time of these small errors leads to an estimated upper bound on predictability. This method is here applied on cyclone position forecasts obtained from three different global operational models (from ECMWF, Météo-France, and the Met Office) over the main tropical cyclone basins in the world and during three recent cyclone seasons (2006-09). The resulting estimates of predictability largely exceed the values that are commonly accepted in the literature. The doubling time of small errors is found between 30 and 50 h. An important consequence is that cyclone track forecasts have not reached their predictability limit yet. It is argued that the previous methods for computing the predictability of tropical cyclone tracks did not constrain the environment and the structure of the cyclones initially. But the Lorenz method could still underestimate the inherent predictability of tropical cyclone tracks. The sensitivity of the predictability estimates to the model characteristics is discussed. In particular, the use of wind bogus is suggested to avoid serial correlations between successive forecasts and to accelerate error growth. © 2011 American Meteorological Society.


Suhrbier A.,Queensland Institute of Medical Research | Jaffar-Bandjee M.-C.,University of Reunion Island | Gasque P.,Laboratoire dHemato microbiologie
Nature Reviews Rheumatology | Year: 2012

Mosquito-transmitted alphaviruses causing human rheumatic disease are globally distributed and include chikungunya virus, Ross River virus, Barmah Forest virus, Sindbis virus, o'nyong-nyong virus and Mayaro virus. These viruses cause endemic disease and, occasionally, large epidemics; for instance, the 2004-2011 chikungunya epidemic resulted in 1.4-6.5 million cases, with imported cases reported in nearly 40 countries. The disease is usually self-limiting and characterized by acute and chronic symmetrical peripheral polyarthralgia- polyarthritis, with acute disease usually including fever, myalgia and/or rash. Arthropathy can be debilitating, usually lasts weeks to months and can be protracted; although adequate attention to differential diagnoses is recommended. The latest chikungunya virus epidemic was also associated with some severe disease manifestations and mortality, primarily in elderly patients with comorbidities and the young. Chronic alphaviral rheumatic disease probably arises from inflammatory responses stimulated by the virus persisting in joint tissues, despite robust antiviral immune responses. Serodiagnosis by ELISA is the standard; although international standardization is often lacking. Treatment usually involves simple analgesics and/or NSAIDs, which can provide relief, but better drug treatments are clearly needed. However, the small market size and/or the unpredictable and rapid nature of epidemics present major hurdles for development and deployment of new alphavirus-specific interventions. © 2012 Macmillan Publishers Limited. All rights reserved.


Neal J.W.,University of Cardiff | Gasque P.,University of Reunion Island
Journal of Neuropathology and Experimental Neurology | Year: 2013

The most devastating CNS bacterial infection, bacterial meningitis, has both acute and long-term neurologic consequences. The CNS defends itself against bacterial invasion through a combination of physical barriers (i.e. blood-brain barrier, meninges, and ependyma), which contain macrophages that express a range of pattern-recognition receptors that detect pathogens before they gain access to the CNS and cerebrospinal fluid. This activates an antipathogen response consisting of inflammatory cytokines, complement, and chemoattractants. Regulation of the antipathogen inflammatory response is essential for preventing irreversible brain injury and protecting stem cell populations in the ventricle wall. The severity of brain inflammation is regulated by the clearance of apoptotic inflammatory cells and neurons. Death signaling pathways are expressed by glia to stimulate apoptosis of neutrophils, lymphocytes, and damaged neurons and to regulate in flammation and remove necrotic cells. The emerging group of neuroimmunoregulatory molecules adjusts the balance of the anti-inflammatory and proinflammatory response to provide optimal conditions for effective clearance of pathogens and apoptotic cells but reduce the severity of the inflammatory response to prevent injury to brain cells, including stem cell populations. The neuroimmunoregulatory molecules and other CNS anti-inflammatory pathways represent potential therapeutic targets capable of reducing brain injury caused by bacterial infection. Copyright © 2013 by the American Association of Neuropathologists, Inc. Unauthorized reproduction of this article is prohibited.


Grant
Agency: Cordis | Branch: H2020 | Program: RIA | Phase: INFRADEV-1-2014 | Award Amount: 3.24M | Year: 2015

It has been robustly demonstrated that variations in the circulation of the middle atmosphere influence weather and climate throughout the troposphere all the way to the Earths surface. A key part of the coupling between the troposphere and stratosphere occurs through the propagation and breaking of planetary-scale Rossby waves and gravity waves. Limited observation of the middle atmosphere and these waves in particular limits the ability to faithfully reproduce the dynamics of the middle atmosphere in numerical weather prediction and climate models. ARISE2 capitalizes upon the work of the EU-funded first ARISE project combining for the first time international networks with complementary technologies such as infrasound, lidar and airglow. This joint network provided advanced data products that started to be used as benchmarks for weather forecast models. The ARISE network also allows enhanced and detailed monitoring of other extreme events in the Earth system such as erupting volcanoes, magnetic storms, tornadoes and tropical thunderstorms. In order to improve the ability of the network to monitor atmospheric dynamics, ARISE2 proposes to extend i) the existing network coverage in Africa and the high latitudes, ii) the altitude range in the stratosphere and mesosphere, iii) the observation duration using routine observation modes, and to use complementary existing infrastructures and innovative instrumentations. Data will be collected over the long term to improve weather forecasting to monthly or seasonal timescales, to monitor atmospheric extreme events and climate change. Compared to the first ARISE project, ARISE2 focuses on the link between models and observations for future assimilation of data by operational weather forecasting models. Among the applications, ARISE2 proposes infrasound remote volcano monitoring to provide notifications to civil aviation. The data portal will provide high-quality data and advanced data products to a wide scientific community.

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