De Loire Research Articles

Effect of well drilling on Buruli ulcer incidence in Benin: a case-control, quantitative survey

Buruli ulcer is the third most common mycobacterial disease worldwide. The public health burden of this neglected tropical disease is large, particularly in poor areas of west and central Africa. The development of appropriate preventive strategies is hampered by an incomplete understanding of the epidemiology and transmission of the disease. We investigated the effect of the drilling of wells on Buruli ulcer incidence. In this case-control, quantitative survey, we obtained field data for Buruli ulcer incidence over a 10-year period from a specialised centre that collected data for the Ouémé and Plateau departments in Benin, and data for well drilling from the Ministry of Energy, Water and Mines in Benin. The coordinates of the wells drilled were obtained during site visits. A case-control study was then done to investigate the role of well water use in protecting against Buruli ulcer. We found a strong inverse correlation between the incidence of Buruli ulcer and the number of new wells drilled in the Bonou municipality (r2=0·8818). A case-control study (106 cases and 212 controls) showed that regular use of the water from the wells for washing, bathing, drinking, or cooking was protective against Buruli ulcer (adjusted odds ratio 0·1, 95% CI 0·04-0·44; p=0·0012). This study opens up new possibilities for developing an effective yet affordable policy to fight the disease on a substantial geographical scale. Our study shows that providing access to protected water is an efficient and feasable way to reduce the incidence of Buruli ulcer. Fondation Francaise Raoul Follereau, French National Institute of Health and Medical Research, and Région Pays de Loire.

Invasion Dynamics of A Termite, Reticulitermes flavipes, at Different Spatial Scales in France.

Termites are social insects that can also be major pests. A well-known problem species is the subterranean termite, Reticulitermes flavipes. It is invasive in France and is thought to have arrived from Louisiana during the 18th century. While the putative source of French populations has been identified, little is known about how the termite spread following its establishment. Here, we examined expansion patterns at different spatial scales in urban areas to clarify how R. flavipes spread in France. Based on our analyses of phylogeography and population genetics, results suggest a scenario of successive introductions into the Charente-Maritime region, on the Atlantic Coast. Two major expansion fronts formed: one that spread toward the northeast and the other toward the southeast. At the regional scale, different spatial and genetic distribution patterns were observed: there was heterogeneity in Île-de-France and aggregation in Centre-Val de Loire. At the local scale, we found that our three focal urban sites each formed a single large colony that contained several secondary reproductives. Our findings represent a second step in efforts to reconstruct termite’s invasion dynamics. They also highlight the role that may have been played by the French railway network in transporting termites over long distances.

Management of fetal goiters: 6-year retrospective observational study in three prenatal diagnosis and treatment centers of the Pays De Loire Perinatal Network

Introduction: The incidence of fetal goiters is reported to be around 1 per 40,000 births. The risk of complications is first of all obstetric, directly related to goiter size, but it may also affect longer term fetal and child development, depending on whether the goiter is due to hypo- or hyperthyroidism. Management is multidisciplinary, but not yet consensual and not always optimal by either endocrinologists or obstetricians.Objectives: The principal objective of this retrospective study was to analyze the data that enabled the physicians to assess whether the goiter was hypo- or hyperthyroid and then to analyze the obstetric practices used in the Pays de Loire network to describe in detail the tools used to diagnose and characterize the goiters and the management chosen in these cases. The secondary objectives are to assess, in our small cohort, the effectiveness of the in utero treatments provided, based on the examination of the children at birth and their outcome at 6 months of life, and to suggest a strategy for monitoring these women at risk that takes current guidelines into consideration.Materials and methods: This multicenter retrospective study covers a 6-year period and focused on the prenatal diagnosis centers (CPDPN) of the Pays de Loire perinatal network: in Nantes, Angers, and Le Mans. The network is responsible for around 42,000 births a year, and the study included 17 women, for a prevalence of 1 per 15,000 births.Results: Ten of the 17 fetuses had a hypothyroid goiter, 4 a hyperthyroid goiter, and 3 normal thyroid findings on fetal blood sample (FBS). For four women, these goiters were secondary to fetal dyshormonogenesis, for 9 more to Graves disease with TSH receptor antibodies (TRAb), and for four women to thyrotoxicosis at the start of pregnancy, managed by synthetic antithyroid drugs. Two newborns had severe complications associated with maternal transmission of Graves disease (TRAb positive at birth): one with exophthalmos and one with neonatal tachycardia. The other 14 had normal psychomotor development at 6 months, based on a clinical examination by a pediatric endocrinologist; only one child was lost to follow-up.Conclusion: Together, ultrasound and multidisciplinary expertise (of an endocrinologist and an obstetrician experienced with this disease) remain the best means for avoiding, or otherwise for accurately characterizing fetal goiter. An ultrasound diagnostic score, of the type proposed by Luton et al. in 2009, may make it possible to homogenize practices and thus to defer or delay the – currently too common – performance of invasive FBS procedures, which must remain rare in this management to limit comorbidities. A threshold TRAb value (>5 IU/l) makes it possible to define this group of women as at risk of fetal and neonatal hyperthyroidism and thus requiring close monitoring. The value of prenatal intra-amniotic thyroxine treatment for hypothyroid goiters (including dyshormonogenesis) remains to be demonstrated.

90 Risk of Coxiella burnetii Transmission via Embryo Transfer Using In Vitro Early Caprine Embryos

Previous experiments using in vitro infection have shown that Coxiella burnetii has a strong tendency to adhere to the zona pellucida (ZP) of in vivo-derived goat embryos, and the washing procedure recommended by the International Embryo Technology Society (IETS) for bovine embryos failed to remove it (Alsaleh et al. 2013 Theriogenology 80, 571-575). The aim of this study was, for in vitro-produced caprine embryos infected in vitro, to (1) evaluate the ability of C. burnetii to adhere to intact ZP, (2) test the efficacy of IETS recommended rules for the washing of bovine embryos to eliminate C. burnetii, and (3) determine, by confocal microscopy, the bacteria location. One hundred ZP-intact caprine embryos, produced in vitro, at the 8- to 16-cell stage were randomly allocated into 11 batches of 8 to 9 embryos. Nine batches were incubated for 18 h with 109 Coxiella/mL of CbB1 strain (ISP, INRA, Val de Loire, France). The embryos were then recovered and washed in batches in 10 successive baths following the IETS guidelines. In parallel, 2 batches of embryos were subjected to similar procedures but without exposure to C. burnetii to serve as the control group. One of the 9 batches of infected embryos and 1 of the 2 non-infected control batches were used to perform immunolabelling to localise the bacteria. Coxiella burnetii DNA was detected by conventional PCR in all 8 batches of infected embryos after 10 successive washings. However, bacterial DNA was not detected in the embryos of the control group. The first 5 washing media of the infected groups were consistently positive and Coxiella DNA was detected up to the tenth wash in 2 batches. After immunolabelling, the observation of embryos under confocal microscopy allowed us to localise C. burnetti on the external part of the ZP without deep penetration. The presence of C. burnetii was seen on the surface of the ZP, with bacterial loads differing from one embryo to another in the same batch. This study clearly demonstrates that C. burnetii, after in vitro infection at 109 Coxiella mL−1, stick strongly to the external part of the ZP of in vitro-produced early caprine embryos without profound penetration. The 10-washings protocol recommended by IETS to eliminate the pathogenic agents of bovine embryos is unable to eliminate these bacteria in caprine embryos. Nevertheless, the finding of C. burnetii DNA by conventional PCR does not imply that the bacteria found remain infective. Further studies are required to investigate whether enzymatic or antibiotic treatment of caprine embryos infected by C. burnetii would eliminate or inactivate the bacteria from the ZP of in vitro-produced goat embryos.

Potential spread of the invasive North American termite, Reticulitermes flavipes, and the impact of climate warming

Reticulitermes flavipes is an invasive termite from North America that is found in several European countries, including France from north to south. It feeds on several timber species and can cause major damage when it infests lumber. Termites are urban pests: they are often found in and around towns and their expansion is closely linked to human activity. Although, by law, termite infestations must be reported and treated, R. flavipes continues to spread. To better identify areas that may soon be colonized, it is crucial to understand the mechanisms underlying the termite’s spread at a fine spatial scale. However, the complexity of the species’ dispersal dynamics (i.e., via swarming, budding, or human-mediated transport of infested material) and social organization render this process difficult. The goal of our study was to determine R. flavipes’ potential to expand its current range within a region of France: Centre-Val de Loire. We focused on one administrative department within the region—Indre and Loire—where infestations are common and data on termite presence date back to the 1980s. We developed a spatiotemporal model to study the growth and dispersal of termite colonies within favorable habitat. Habitat favorability was defined based on the density of urbanization and annual mean minimum temperature. First, we modeled temporal population dynamics, using biological parameters describing the transitions between life stages/castes within colonies; we could thus estimate alates production. Then, using this information, we modeled termite dispersal within favorable habitat, and determined the termite’s potential spread. We validated the results by comparing the model’s output with actual data on the termite’s range expansion between 1985 (when the termite was first observed in the region) and 2013. Finally, the model was used to predict the termite’s future spread given climate warming for the period from 2013 to 2030. The results show that an increase in temperature should increase the amount of favorable habitat and, as a consequence, termites could continue to spread within this region. In addition to continuing current control efforts, it will be necessary to enact preventative strategies in newly favorable habitat. In these areas, monitoring efforts should therefore be intensified, as they might be able to slow down the termite’s spread and limit its impact.

When Allotment Gardens Become Urban Green Spaces like Others, Providing Cultural Ecosystem Services

Different kind of nature can be observed in urban settings: forest or semi-natural spaces, ornamental gardens and allotment gardens (community gardens). Our article focuses on the last ones and questions some ecosystem services they offer, in order to know if they are urban green spaces like others. This study comes in the framework of the research program SERVEUR (funded by the French Centre-Val de Loire region), which is interested in the services given by urban green spaces. Here we set out one case-study, the Bergeonnerie allotments in Tours (France). To identify the services these allotments offer, we conducted: - in situ observations and surveys of Bergeonnerie allotments users, - interviews of some municipal stakeholders and decision-makers of several cities of the region Centre-Val de Loire. The in situ study revealed that allotments offered not only provisioning services - according to the MEA [1] ecosystem services list, in this case food. They also provide cultural services, becoming a source of well-being for the gardeners but not only. We could observe that some other people come in these green spaces, like in other ones, to walk. They are places of sociability and education, what the municipal stakeholders and decision-makers confirm. Allotments give more benefits for the population than expected; they are more than places used to cultivate vegetables.

Age and factors associated with access and time to post-operative adjuvant chemotherapy in colon cancer: a French epidemiological study.

Studies have shown the negative prognostic impact of increased time between colectomy and postoperative adjuvant chemotherapy (AC) in colon cancer (CC). Our aim was to investigate the role of age and non-organizational factors on access and time to AC. All adult patients undergoing surgery for stage II or III CC in the "Région Centre-Val de Loire" in 2013, were selected. Time to AC and socio-demographic factors were collected. Logistic regression modeling was used to identify factors associated with access to AC, and a multivariate analysis performed to identify factors associated with time to AC. Among 404 stage II or III patients who underwent colectomy, 182 (45%; sex ratio 1.5; mean age 67.6 years; range 32-90) received AC. AC patients were younger than those without AC (67.6 vs. 77.9 years) and the difference was even greater for stage III patients (69.0 vs. 82.4). The median time to AC was 48 days, exceeding 42 days in 60% of cases. Living alone, postoperative morbidities, and emergency colectomy were independently associated with increased time to AC. Age and other factors were not associated with delayed AC. Emergency colectomy, postoperative morbidities, and living alone are associated with increased time to AC. Organizational measures to reduce the time to AC are therefore unlikely to have an impact. In contrast, age is not associated with increased time to AC, but to access to AC. Reasons for omitting AC in older patients requires further study.

Fine particles at a background site in Central France: Chemical compositions, seasonal variations and pollution events

To expand our knowledge of regional fine particles in Central France (Centre-Val de Loire region), a field observation study of PM2.5 was carried out at Verneuil site (46.81467N, 2.61012E, 180m.a.s.l.) from 2011 to 2014. The mass concentrations of water-soluble inorganic ions (WSIIs), organic carbon (OC), elemental carbon (EC) and biomass burning tracer (Levoglucosan) in PM2.5 were measured. Annual average PM2.5 mass concentrations were 11.8, 9.5, 12.6 and 10.2μg·m−3 in 2011, 2012, 2013 and 2014, respectively, three of four higher than the WHO guideline of 10μg·m−3. Secondary inorganic aerosol (SIA) and organic matter (OM) appeared to be the major components in PM2.5 in Verneuil, contributing 30.1–41.8% and 36.9–46.3%, respectively. Main chemical species were observed in the following order: winter≥spring>autumn>summer. Backward atmospheric trajectories were performed using Hysplit model and suggested that the PM2.5 pollutants caused by atmospheric transport were mainly originated from European inland, mainly east to north-east areas. During the observation period, five pollution events were reported and indicated that not only the polluted air masses from central Europe but also the biomass burning from East Europe significantly influenced the air quality in Verneuil site.

Temporal dynamics of human-excreted pollutants in wastewater treatment plant influents: Toward a better knowledge of mass load fluctuations

The occurrence of 25 drug target residues (illicit drugs or pharmaceutically active compounds) was investigated during 85 consecutive days in the influents of a wastewater treatment plant in the Region Centre-Val de Loire, France. This long tracking period allowed a better understanding of the patterns affecting the occurrence of this type of contaminants. Among them, 2 were never detected (i.e. heroin and amphetamine). Concerning illicit drugs two patterns were found. Cocaine and ecstasy median loads varied considerably between weekdays and weekend days (i.e. 18.3 and 35.9% respectively) whereas cannabis and heroin (based on 6-mono-acetylmorphine loads) loads were within the same order of magnitude with a significant statistical correlation with pharmaceuticals such as acetaminophen or ketoprofen.The consumption of selected drugs was back-calculated from the loads. Among illicit drugs the highest consumption was found for cannabis with a median consumption of 51mg·day−1·inhabitant−1 (inh) whereas the median consumption for cocaine (based on benzoylecgonine loads) and ecstasy was 32 and 6mg·day−1·103·inh−1 respectively.The highest consumption values of pharmaceutically active compounds (PACs) were found for acetaminophen and acetylsalicylic acid with 108.8 and 34.1mg·day−1·inh−1 respectively, in good agreement with national sales data. A statistically significant weekly pattern was found for several PACs such as metoprolol and trimethoprim, but with the opposite pattern to that of illicit drugs. The variations in daily PAC loads could provide information about the mobility of people in the catchment, especially on the basis of daily taken PACs (i.e. to treat chronicle diseases).

Rediscovery of the endangered species Harpalus flavescens (Coleoptera: Carabidae) in the Loire River

Abstract The Loire River is one of the last European large rivers with important sediment dynamics and numerous sandbanks. The extraction of sediment from the riverbed during decades and the construction of levees for flood prevention have strongly affected and shaped the biodiversity of the Loire River. Many species from pioneer riverbanks have been impacted with particular consequences for psammophilous insects. The ground beetle Harpalus (Acardystus) flavescens (Piller & Mitterpacher, 1783), is considered to have disappeared from the Middle Loire River for 40 years and is endangered everywhere in Europe. In 2012 and 2013, we recorded two specimens of H. flavescens in Région Centre‐Val de Loire (France), in the course of a survey dedicated to evaluating the impact of fluvial maintenance operations upon sediment and biodiversity dynamics. The presence of H. flavescens may be linked to the interruption of riverbed extractions and the vegetation removal of sandbanks of the Loire River (ecosystem restoration).

What Ideal Green Spaces for the City of Tomorrow, Providing Ecosystem Services?

The present study comes within the scope of a research program, which was funded by the French Region Centre-Val de Loire and questioned the fallout of urban green spaces (UGS) for city dwellers and municipalities. Here, the purpose is to identify the ideal UGS for a better urban future. We base our proposal on our knowledge of cultural and supporting ecosystem services (ES) provided by these spaces.The six medium cities of the Region Centre-Val de Loire were chosen to study these cultural and supporting ES provided by urban nature. Public UGS, higher than 1ha, were inventoried then classified into five categories. Six of these UGS were selected and subject of a more in-depth study. Their biodiversity (based on the arthropods frequency) and their soils quality (pedology, agronomy and microbiology) were analyzed. In the same time, 321 users and 12 managers of UGS were interviewed.According to the interviewees, UGS contribute to the urban life quality, the well-being of city dwellers and even the city identity. They are thus approved by all. Users come first in these spaces for the quiet and to feel closer to nature. And indeed, these spaces are biodiversity spaces and they have quite good soils indicators. They provide a diversity of ES, especially cultural services.All UGS are approved – except for those where traffics are suspected. The reasons and the time of their frequenting differ according to their facilities and their localization. However, the functions can be more numerous than the assigned ones – example of allotment gardens, which are places to cultivate but also to relax, meet and learn. Belonging to the five identified categories, the UGS are complementary. It is also valid for biodiversity because this one varies according to the land use, to the plant species. The ideal UGS could be a multifunctional UGS.

Wider economic impacts of high-speed rail: example of agglomeration benefits assessment on Bretagne Pays de Loire high speed rail project

Abstract Wider economic impacts are indirect effects of transport infrastructure on the whole economy. That is a major change in rationale from the cost-benefit analysis to a greater range of impacts on labour and intermediary goods and services markets. Wider effects are mainly considered as agglomeration benefits, although there is some research gap on possible losses. This paper examines the possibility of applying the UK agglomeration effects assessment method to the new French Bretagne Pays de Loire (BPL) high speed line to be opened 2017. Besides some theoretical limitation of accounted both users surplus and productivity gains, the methodology is likely to change along with region-specific economic features and initial accessibility levels. Furthermore, data availability and reliability in France might challenge the direct application of the UK method onto French projects. This paper is a preliminary work of a global study on wider economic impacts of high speed rail projects and explores the possibility of assessing agglomeration effects and productivity gains to be drawn from infrastructure schemes.

River Loire levees hazard studies – CARDigues’ model principles and utilization examples on Blois levees

Along the river Loire, in order to have a homogenous method to do specific risk assessment studies, a new model named CARDigues (for Levee Breach Hazard Calculation) was developed in a partnership with DREAL Centre-Val de Loire (owner of levees), Cerema and Irstea. This model enables to approach the probability of failure on every levee sections and to integrate and cross different “stability” parameters such topography and included structures, geology and material geotechnical characteristics, hydraulic loads… and observations of visual inspections or instrumentation results considered as disorders (seepage, burrowing animals, vegetation, pipes, etc.). This model and integrated tool CARDigues enables to check for each levee section, the probability of appearance and rupture of five breaching scenarios initiated by: overflowing, internal erosion, slope instability, external erosion and uplift. It has been recently updated and has been applied on several levee systems by different contractors. The article presents the CARDigues model principles and its recent developments (version V28.00) with examples on river Loire and how it is currently used for a relevant and global levee system diagnosis and assessment. Levee reinforcement or improvement management is also a perspective of applications for this model CARDigues.

Benzodiazepines Consumption: Does Dependence Vary with Age?

We have compared two groups of chronic benzodiazepines (or zolpidem/zopiclone) users: “Seniors,” aged 65 years or more, and “Adults,” aged less than 65 years. The study took place in the Pays de Loire region. The questionnaire assesses dependence based on items from the DSM-IV. The analysis was based on 176 Senior questionnaires and 212 Adult questionnaires. Whereas Senior patients take benzodiazepines routinely with little negative consequences, Adults suffer from underlying psychological trouble, mention a higher consumption than planned, which causes negative consequences. 35.2% of Seniors are dependent on benzodiazepines versus 49.8% of Adults.

Rapport Rein 2011 – Synthèse

Rapport Rein 2011 – Synthèse

Prévalence de l’IRCT en 2011

This chapter describes temporal and geographical variations of ESRD prevalence in France. This indicator assesses health needs of ESRD patients on dialysis or living with functional transplant. It does not include patients on conservative treatment. On December 31, 2011, 70 300 patients were receiving a renal replacement therapy in one of the 25 regions contributing to the registry, 39 200 (56%) on dialysis and 31 100 (44%) living with a functional renal transplant. The overall crude prevalence was 1091pmh. It was 1.6 higher in males. Prevalence was subject to regional variations with 5 regions (3 overseas) above the national rate. Renal transplant share varied from 33% in Nord-Pas-de-Calais to 53% in Pays de Loire, and from 16 to 25% in overseas regions.The overall sex and age standardised prevalence was 40, 567 and 483 pmh respectively for peritoneal dialysis, haemodialysis and transplantation, with marked regional variations. The study of temporal variations for 18 regions contributing to the registry since 2007 demonstrated a +4% increase in standardised prevalence of ESRD patients with a functional transplant vs +2% increase for dialysis, resulting in a decreasing gap between dialysis and transplantation prevalence, due to an increase number of renal transplant and a longer survival of transplanted patients. Such an evolution should prompt the nephrological community and health authorities to anticipate changes in the ESRD healthcare organisation and to adapt them to the regional context.

Can the “Seek, Test, Treat, and Retain” Strategy be Effective in France?

Can the “Seek, Test, Treat, and Retain” Strategy be Effective in France?

Stockless organic farming: strengths and weaknesses evidenced by a multicriteria sustainability assessment model

Agronomists need methodologies to assess the sustainability of cropping systems. Few models such as MASC have been recently developed for evaluation. The effective use of those models is still a challenge, notably for low-input systems. Here a more specific model entitled MASC-OF was developed and applied to study stockless organic cropping systems. The MASC-OF model is original because it is based on agricultural advisers’ needs and expertises. Two groups of advisers supported by agronomic scientists were involved in a nine-step methodology to progress from preliminary meetings to data analysis. The methodology allowed advisers to design a model including their own views on what is a sustainable organic cropping system. Soil fertility and weed and pest control were integrated as a new branch in the original MASC model. We also developed evaluation criteria for each basic attribute, defining aggregation rules and weighting attributes. Tested case studies were based on 44 real cropping systems identified on 19 farms in the Midi-Pyrenees region of France and on 23 cropping system types developed by the advisers from the Centre, Ile-de-France, Pays de Loire, Poitou-Charentes and Rhone-Alpes regions of France. Our results show that a high score of economic sustainability is the most difficult to achieve. This finding is explained by low productivity of cereal crops and high variability of market prices for organic grain. Further, agronomic viability is also difficult to ensure, as a consequence of poor soil-fertility management practices. The ability to achieve social acceptability for the producer, including workload and health risk, is high. By contrast, acceptability for the society has a medium score due to reduced productivity and contribution to local employment. Environmental sustainability is the easiest dimension to achieve, despite nitrogen-loss risks in some situations and high water and energy consumption in irrigated systems. Overall our findings show that the potential for the development of more sustainable organic cropping systems in stockless farms is high.

Landscaped inheritance of the viticulture in the Val de Loire, from Orléans to Tours and its periphery

Les heritages paysagers de la viticulture dans le Val de Loire d’Orleans a Tours et ses abords peripheriques posent d’abord la question de la definition du Val de Loire, puis de la presence et de l’evolution des espaces viticoles dans ce territoire. La demarche consiste a partir d’un modele de paysage dans le Val de Loire (sous forme de bloc-diagramme paysager) et de confronter ce modele a la realite paysagere. Or, ce modele, s’il est largement valide par les faits, ne prend pas assez en compte l’evolution historique sur le long terme tres bien exposee par Roger Dion. Cette derniere permet de comprendre que la vigne s’est maintenue en certains endroits et a quasiment disparu en d’autres. En consequence, les heritages paysagers viticoles dans ce territoire sont parfois tenus, peu fonctionnels, souvent sous forme decorative, la vigne perdurant en des lieux insolites et en des espaces interstitiels. Elle est souvent presentee de maniere symbolique qui est un rappel d’une periode doree qui a vecu. Pour cette thematique, comme pour d’autres, le paysage fonctionne veritablement comme un palimpseste.

The DATEL (diagnosis for territorial action environment and longevity), a territorial diagnosis for a future with our elders

The territorial structure is such that it is necessary to go through a step of diagnosis. Ageing must be apprehended in all its aspects, but the multiplicity of actors involved prevents the local powers from getting a comprehensive vision of the stakes and from implementing the adequate policies. The gerontopôle of "Pays de Loire" has developed an original method of diagnosis consisting in a comprehensive approach so called DATEL (diagnosis for territorial action environment and longevity). It is based on three aspects: an analysis of the geographical areas, a diagnosis shared by citizens and local councilors according to the Vancouver method, and a prospective review of the medico-social and health situation which integrates all services and forces at work and their potential demographic evolution. This DATEL aims to give local politicians the means to take well-informed decisions that will sustain the rapid demographic evolution of the ageing population and will maintain a good quality of life for our elders.