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Background: Recent systematic reviews on the outcomes of sulcus-deepening trochleoplasty with adjuvant medial patellofemoral ligament (MPFL) reconstruction at a follow-up of 2 to 6 years have found that the procedure grants good clinical outcomes with low redislocation rates. However, there is a lack of evidence in the literature regarding mid- and long-term follow-ups. Purpose: To evaluate the radiographic and clinical outcomes of thick-flap sulcus-deepening trochleoplasty with MPFL reconstruction at a minimum follow-up of 10 years to assess the signs of patellofemoral arthritis, incidence of recurrent dislocation, and grade of patient satisfaction. Study Design: Case series; Level of evidence, 4. Methods: The authors evaluated a retrospective series of 43 patients (48 knees) who underwent sulcus-deepening trochleoplasty between 2003 and 2013. All patients underwent thick-flap sulcus-deepening trochleoplasty with additional MPFL reconstruction. All patients were assessed at a minimum follow-up of 10 years by an independent clinician who noted any patellar redislocation or reoperations in the operated knee and collected the International Knee Documentation Committee (IKDC), Kujala, and satisfaction scores. Furthermore, a radiographic examination was performed to assess patellar height using the Caton-Deschamps index and patellofemoral arthritis using the Iwano classification. Results: At a mean follow-up of 14.8 ± 2.1 years (range, 10-20 years), 4 patients (4 knees) were lost to follow-up (8.3%). The satisfaction, Kujala, and IKDC scores were 8.2 ± 1.6, 77.5 ± 14.4, and 65.7 ± 13.5, respectively. Only 1 patient reported a traumatic patellar dislocation (2%). Radiographs at the final follow-up were available for 34 knees, which revealed Iwano grade 1 in 14 knees (41%), Iwano grade 2 in 7 knees (21%), and no patellofemoral arthritis in 13 knees (38%). Conclusion: Sulcus-deepening trochleoplasty with MPFL reconstruction provides satisfactory results and prevents patellar redislocations with no or minimal patellofemoral arthritis. [ABSTRACT FROM AUTHOR]

In the south of France, the so-called climate hiatus from 1998 to 2013 was associated with a late winter cooling which has affected the phenology of several reptiles and amphibian species, delaying their dates of first appearances in spring. This episode has been related to a period of frequently negative values of the North Atlantic Oscillation index (NAOi). The recent increase of this index after this episode marks the end of the "hiatus" and provides an opportunity to verify the impact of the North Atlantic Oscillation (NAO) on the fauna of the North Mediterranean region. Most of the emergence dates of amphibians and reptiles in spring have rapidly advanced from 1983 to 1997 and then receded or stabilized from 1998 to 2010. They began to advance again since 2010. These phenological changes covary with the temperature of February–March in the study area, which is itself related to the variations of the NAO index. These changes confirm the influence of the NAO on the phenology of terrestrial organisms in northern Mediterranean where its influence is sometimes assumed to be attenuated. [ABSTRACT FROM AUTHOR]

Abstract: The reduction of greenhouse gas emission is now firmly established at the top of the public policy agenda, to the extent that it is increasingly often presented as one of the major constraints which will be placed on activities, particularly in the transport sector. This sector creates large amounts of greenhouse gases and is characterized by the highly decentralized nature of its emissions which are the outcome of the travel decisions taken by billions of individuals. The collective problem is therefore created by a multitude of individual behaviors. If travel choices are constrained in an attempt to solve this collective problem, we need an understanding of the economic bases of individual behaviors. With this in view, this paper begins by presenting the macroscopic impacts of a number of sustainable travel scenarios in France in the year 2050. It then shows the changes in trends which accompany the necessary changes in individual travel behaviors. Some of these changes in trends amount to breaks with the past which will be far from easy to implement. [Copyright &y& Elsevier]

This study aimed to analyze the relationship between spirituality, coping strategies and health-related quality of life (HRQL) among a large representative sample of patients two years after cancer diagnosis. Using a cross-sectional design, medical and self-reported data were collected by physicians and a patient telephone interview, respectively. Among 4270 participants, 54.6% reported that spirituality was not a source of comfort at all during the disease, 23.4% stated that it was a source of moderate comfort and 22.5% a source of great comfort. After adjustment for age, gender, educational level and living in a couple, a multivariate analysis showed that a lower mental HRQL score was independently associated with finding moderate comfort in spirituality when compared with finding no comfort at all. After multiple adjustment, a lower score of physical HRQL and a higher score of fighting spirit were independently associated with having found great comfort in spirituality when compared with those who found no comfort at all. This study aimed to understand the dynamics of religious beliefs among cancer patients over the disease duration and to understand how these beliefs could be considered and utilized by patients as a source of comfort and support. The results highlight not only the role spirituality may play in disease management and the extent to which it may be a valuable source of comfort during the follow-up of cancer patients, but also its role in the evaluation of the different dimensions of HRQL. [ABSTRACT FROM AUTHOR]

Spanning 20 years (1979-2007), this study is the longest time series pertaining to the resident shrimp species Palaemon longirostris in a European estuary. Data from monthly faunal surveys undertaken across the middle part of the Gironde estuary from April 1979 along with data from a statistical analysis of the commercial catches throughout the entire estuary and river were considered in order to explore their inter and intra-annual variability and long-term trends. Long-term densities series as well as environmental series (salinity, discharge, temperature and NAO) were decomposed and the effects of environmental variables were also examined using statistical models (GAMs). This revealed important spatio-temporal variability and a significant overall decrease in abundance of this species in the Gironde estuary since the beginning of the 1980s. This long-term decrease in abundance corresponded significantly to long-term decreases in both discharge and the NAO index, as well a long-term increase in temperature and salinity in the middle part of the estuary. However, models showed that environmental factors explained only a small part of the variability. The upstream shift of the population highlighted in this study, probably due to the intrusion of marine waters into the middle section of the estuary, may also have contributed to its decrease in abundance. Inter-annual variability of densities was also significantly linked with inter-annual fecundity fluctuations, and a significant decrease in both mean female size and fecundity was shown for preserved samples from 1992. Moreover, the breeding period has been temporally stretched out and began earlier in more recent years, potentially due to the increase in spring temperature. [ABSTRACT FROM AUTHOR]

This paper presents a new methodology for the development of a probabilistic very long term forecast of the total port throughput in the Le Havre -- Hamburg range up to 2100. The forecast is based on a combination of System Dynamic Modelling, Judgement, and Causal Relations. It is intended to provide infrastructure planners with some guidance on the very long term development of transport demand over the lifetime of the infrastructure. On the basis of the forecast it can be expected that the port throughput in the Le Havre -- Hamburg region will remain growing throughout the first half of the century, but at a reduced pace. Towards the end of the century throughput volumes will stabilize or even decrease. The notion of decreasing and stabilizing throughput volumes will help infrastructure planners to consider the (ultimate) capacity to be provided beyond the current expansion plans as well as the type of expansions that will suit future demand some 20 to 30 years from now. [ABSTRACT FROM AUTHOR]

The study presented here describes a method for defining set-back lines along eroding coasts. The method (a mathematical model) combines the long-term shoreline retreat trend with short-term shoreline erosion (during storms). Simulations are carried out for 2030 and compared with the beach width to determine whether the shoreline is likely to shift onshore. The mathematical model is applied to the Frontignan and Camon beaches (south of France). Both sites possess hard engineering coastal structures and downdrift erosion on the natural beaches. The set-back lines indicate that beaches with groynes are generally wide enough to resist shoreline retreat, while the downdrift "natural" beaches are not. We discuss the possible utilisation of set-back line estimations. [ABSTRACT FROM AUTHOR]

To investigate the impact of integrating ley grassland in crop rotations on soil C changes at depths of 0–30 and 0–60 cm, field data regarding C input, soil C and crop production were collected during 2005–2016 from a long-term experimental site in Lusignan, southwestern France. Root biomass C was sampled annually, and the stable C isotope signature (δ13C) was determined to quantify the amount of C input from the root biomass. The results showed that integrating ley grassland in crop rotations increased the C input in the 0–30 and 0–60 cm soil layers. Carbon stocks also increased in the 0–30 cm soil layer but not always in the 0–60 cm layer. However, during the first full rotation (2005–2013), treatments involving 3-year and 6-year grasslands showed 37.5% and 62.5% losses of their crop production, respectively. In crop rotations, integrating ley grassland together with high-nitrogen (N) or low-N fertilisation did not impact the C input, changes in soil C in either the 0–30 or 0–60 cm soil layer, or even crop production, while grass production decreased by 22.2–66.6% under low-N fertilisation. Compared with cropland, permanent grassland did not show a greater C input, whereas the latter showed a C stock increase of 0.6–1.4 Mg C ha−1 yr−1. The analysis of 2005–2013 crop rotation data suggested that both above- and belowground C inputs should be considered as a single total C input. An estimated baseline C input rate of 1.9 Mg C ha−1 yr−1 was suggested to maintain soil C stocks for some of the crop rotations at the site. Considering the balance of food production and soil C stocks, crop rotation in conjunction with 3 years of high-N-fertilised grassland is recommended. The Lusignan national long-term observatory experiment in the Nouvelle-Aquitaine region of France showing integration of grassland in crop rotations and the target plots in this study in red frames (a) and its experimental design (b) [Display omitted] • Integrating ley grassland into crop rotations increased the C stock only in topsoil. • Nitrogen application rates impacted either C input or soil C changes in ley grassland. • Permanent grassland had similar C inputs as cropland but greater soil C increases. • Above- and belowground C inputs had similar importance to soil C stocks. • A C input of 1.9 Mg C ha−1 yr−1 was proposed to maintain soil C stocks for crop rotations. [ABSTRACT FROM AUTHOR]