Loire Valley Region Research Articles

Geriatric factors associated with overall survival in older patients with metastatic colorectal cancer

Advanced age in patients with colorectal cancer is a factor of poor prognosis, but little is known about geriatric factors associated with survival and chemotherapy prescription in frail elderly patients. Our research sought to investigate these factors in older patients with metastatic colorectal cancer (mCRC). Patients and methodspatients aged ≥75 years, who were treated for mCRC and have had a Comprehensive Geriatric Assessment (CGA) due to their frailty, were included in this multicenter practice study in the Loire Valley region (France). With initial patient care for mCRC as the starting point, demographic, oncological, geriatric and survival data were collected from the regional cancer database and the medical record of each patient. We analyzed overall survival and chemotherapy prescription, according to the geriatric factors of the CGA. Results108 patients were enrolled (mean age 84.0 +/- 4.5 years; 57.4 % men), among whom 53 (49 %) received at least one line of chemotherapy. The median overall survival [95 %CI] was 8.05 [5.6–12.0] months. In univariate analysis, prescription of chemotherapy was associated with the number of severe co-morbidities, number of co-medications, G8 score, BMI, MMSE score, IADL and ADL scores, Lee index and Balducci criteria. Survival was significantly associated with chemotherapy, ADL and IADL scores, G8 score, repeated falls, number of severe co-morbidities, MMSE score, Lee index and Balducci criteria. In multivariate analysis, only the ADL score (HR [95 %CI]: 0.74 [0.55–0.99], p = 0.04), number of severe co-morbidities (HR [95 %CI]: 1.62 [1.06–2.47], p = 0.03) and repeated falls (HR [95 %CI]: 3.54 [1.70–7.39], p < 0.001) were significantly associated with survival. Conclusionin frail elderly patients with mCRC, dependency, co-morbidities and repeated falls are independent factors associated with survival. As such, there could be merit in taking these into consideration before the choice of oncological treatment is made.

Analysis of cycling network evolution in OpenStreetMap through a data quality prism

Abstract. Cycling practice has been constantly increasing for several years and the COVID crisis has just accelerated the process. Indeed, more and more municipalities have developed new cycle paths to facilitate cycling. Considering this increasing interest for cycling, it makes sense to study how this recent evolution is reflected in the underlying representation of the cycling network in the geographic databases. Main studies analysing the evolution of the road network focus on the motor vehicle network in the major cities of the world. These studies do not seem applicable to cycling network specially to some low population density areas or even to smaller cities. This paper analyses the changes in the cycling network through OSM data from a data freshness perspective. These changes can be either updates from changes in the real-world network or upgrades to the network. To these end, we propose a method using a Monte Carlo simulation (MCS) to analyse the frequency of changes in cycling routes in several areas with different population density, all in the Loire Valley region in France. We also define the cycling network, which is a very complex concept and we explain how it is represented in OSM data and suffers from different data quality issues. Results show that the number of changes across time are similar in areas having a similar population density, while being lower in low population density areas. These phenomena is higher in the cycling network compared to other networks.

Diffusion régionale et intégration urbaine des espaces de coworking. Les spécificités d’une région française faiblement métropolisée

The geography of economic activities is evolving rapidly and the emergence of alternative workplaces—so-called third places—is changing its traditional models. This paper adopts a geographical and urban planning perspective to examine the dynamics of coworking spaces (abbreviated as CWS) by analyzing the links between CWS and space at different scales. As CWS are widespread and quite well studied in metropolitan areas, our focus here is on CWS in intermediate and mid-sized cities. The first section reviews the existing literature in geography and urban planning on coworking and its urban context. Then, we present the qualitative methodology (cartography, observation, and interviews) that was used to study the location patterns of CWS in a non-metropolitan French region. The third section presents the Loire Valley region and the intermediate cities where the spatial diffusion of CWS was analyzed: Tours, Orleans, and Blois. Section four presents our main findings: (i) the location patterns of CWS in intermediate cities varies according to the status of the project’s holder (private, public, not-for-profit); (ii) the transformative effects of CWS at the scale of a neighborhood are not very noticeable in intermediate cities; and (iii) local government can play an important part in creating or anchoring CWS in cities.

Monitoring water transfers in limestone building materials with water retention curve and Ground Penetrating Radar: A comparative study

The rehabilitation of older buildings is necessary to achieve both a reduction in energy consumption and the preservation of cultural heritage. To ensure a successful building rehabilitation project, an efficient diagnosis makes it possible to determine the various existing pathologies and their causes. In this study, we focus on the “Tuffeau”, which is a kind of limestone widely found in older buildings of the Loire Valley region in France. The durability is strongly affected by the water content for such kind of material. However, very few studies can be found in this field. Moisture condition measurements are currently carried out using punctual sensors placed into the walls. These sensors record highly localized measurements through structural alteration (coring). This paper proposes two non-destructive testing (NDT) methods with the application of Ground Penetrating Radar (GPR) in order to compare the ability of the two methods to analyze the water transfer in limestone blocks. A modified water retention curve model is proposed here to characterize the water gradients in limestone blocks: the limestone - water characteristic (LWC) model. The analysis of the results shows good agreement between the two GPR methods, which shows good capability of monitoring water ingress linking to the results of LWC model.

Risk factors for episodic neck pain in workers: a 5-year prospective study of a general working population.

Development of neck pain (NP) in workers has a multifactorial etiology and depends on both individual and workplace factors. The aim of this study was to investigate risk factors for episodic NP in a large diverse sample of active workers. A prospective study based on the surveillance program implemented by the French Public Health Agency in the Loire Valley region. Between 2002 and 2005, 3710 workers were included. Between 2007 and 2010, 2332 workers responded to a follow-up questionnaire which assessed: (1) musculoskeletal symptoms (Nordic questionnaire) and (2) individual and work-related risk factors. Associations between episodic NP in 2007 (i.e., free subjects at baseline and who suffered at least 8days during the preceding 12months) and individual and work-related risk factors at baseline were studied using logistic regression modeling, stratified by sex. Among the 1510 workers (914 men, 596 women) still active at follow-up, 10.4% (8.4-12.4) of men and 14.6% (11.8-17.4) of women declared episodic NP. Among men, work pace dependence of guests or permanent hierarchical controls were risk factors of NP [OR=1.8 (1.1-2.8) and OR=2.1 (1.3-3.3), respectively]. Among women, the combination of sustained/repeated arm abduction with high physical perceived exertion was the strongest risk factor for NP [OR=3.5 (1.7-7.2)]; age and paced work were also predictors for NP in women. NP results from complex relationships between individual and work-related variables. High physical workload, awkward postures, and poor organizational environment together with age differently predicted episodic NP according to the sex.

Functional incapacity related to rotator cuff syndrome in workers

Functional incapacity related to rotator cuff syndrome (RCS) in salaried workers may vary according to their sociodemographic and medical characteristics. A cross-sectional study carried out in 2007 on a sample of workers from the Loire Valley region who had been diagnosed for RCS between 2002 and 2005. In addition to the Disabilities of the Arm, Shoulder and Hand (DASH) and DASH-work questionnaires, subjects were given a self-administered questionnaire relating to sociodemographic data, musculoskeletal symptoms (Nordic) and medical management. The DASH and DASH-work scores were studied according to sociodemographic factors, to the existence of others musculoskeletal disorders (MSDs) and to the RCS seek care during the preceding 12-months. Among the 3710 workers included between 2002 and 2005, 207 who suffered from RCS responded to the questionnaire in 2007. Seventy-eight percent of them were symptomatic from RCS and 80% were still professionally active. The DASH score was significantly higher in women ( P < 0.01), in patients over the age of 50 ( P < 0.005), in case of another upper limb MSD ( P < 0.0001), and in case of RCS seek care ( P < 0.001). The RCS seek care was the only factor influencing the DASH-work score. This study highlights variation of the degree of functional incapacity of the upper limb in workers according to their sociodemographic characteristics and the RCS medical management. The study design also confirms the questionnaire's feasibility by occupational physicians within large populations of workers and its clinical relevance; including in case of multiple upper limb MSDs.

Introduction to the special issue ‘Urban green spaces: insights into cultural ecosystem services’

This thematic issue is based on the research program SERVEUR (Ecosystem Services of Urban Greenspace 2013-2016). It is funded by the Center Loire Valley Region in France and estimates the services rendered by ecosystems. This notion is recent. However, it has long been recognized that nature provides many benefits to human groups. Although little research has been carried out until the end of the 20th century, scientific publications have multiplied since the 1990s. But it was the Millennium ...

84 Risk factors of acute and subacute low back pain in a cohort of French Loire Valley region’s workers

ObjectivesIn recent years, emphasis was placed on the determinants of chronic low back pain (LBP) in a tertiary prevention perspective. However, prevention of acute and subacute LBP should remain a...

Using the free comments method for sensory characterisation of Cabernet Franc wines: Comparison with classical profiling in a professional context

In this study, we adapt the free comments method to a professional wine panel and compare it with the classical profiling method. Indeed, the methods classically used for sensory analysis appear to be poorly suited to a professional wine panel, which is less time available than other panel types.The odour properties of thirty-one Cabernet Franc wines from the Loire Valley region were described by two distinct panels performing, respectively, a classical profiling and a free comments method. Both methods were performed by wine professionals without prior common training. The classical profiling data were analysed using analysis of variance (ANOVA), the Student Newman-Keuls (SNK) test and principal component analysis (PCA). The free comments data were analysed with a global Chi-square, a Chi-square per cell test and a correspondence analysis (CA). The data analysis was followed by a multiple factor analysis (MFA) allowing assessment of the correspondence between the sensory maps obtained using the two methods. As expected, a large number of descriptors were generated via the free comments method, providing rich information on the set of products. In general, the two methods underlined similar main odour characteristics of the Cabernet Franc wines. The free comments method was advantageous for highlighting the specific characteristics of a number of products. This method is less time consuming and allows easy characterisation of wines. In conclusion, the free comments method may represent a convenient alternative to conventional descriptive analysis in a wine professional context or a convenient sensory mapping tool for conducting the preliminary phases of sensory studies, such as the generation of attributes.

Prevalence of multisite musculoskeletal symptoms: a French cross-sectional working population-based study

BackgroundThe musculoskeletal disorders in working population represent one of the most worrying work-related health issues at the present time and although the very great majority of available data on the subject focus on musculoskeletal disorders defined by anatomical site, a growing number of studies indicate the low prevalence of disorders strictly confined to a specific anatomical site. The objective of this study was to describe the prevalence and characteristics of multisite musculoskeletal symptoms (multisite MS) in a large French working population.MethodsThis study was performed on surveillance data of the cross-sectional survey (2002–2005) conducted by a network of occupational physicians in the working population of the Loire Valley region (from 20 to 59 years old). Data concerning MS were collected in the waiting room of the occupational physicians by means of the self-administrated standardized NORDIC questionnaire.ResultsThe study population comprised 3,710 workers (2,162 men (58%) and 1,548 women (42%)) with a mean age of 38.4 years (standard deviation: 10.4 years). The prevalence of MS during the past 12 months was 83.8% with 95% confidence interval of [82.8-85.3] for men and 83.9% [82.0-85.7] for women. The prevalence of subacute MS (lasting at least 30 days) over the past 12 months was 32.8% [30.9-34.8] for men and 37.3% [34.9-39.7] for women. Two-thirds of workers reported MS in more than one anatomical site and about 20% reported MS lasting at least 30 days in more than one anatomical site. The anatomical sites most frequently associated with other MS were the upper back, hip, elbow and neck. The majority of these multisite MS were widespread, involving at least two of the three anatomical regions (upper limb, axial region and lower limb).ConclusionsThe frequency and extent of multisite MS reported by workers are considerable. Further research must be conducted in this field in order to provide a better understanding of the characteristics and determinants of these multisite MS.

Characterization of atmospheric deposition and runoff water in a small suburban catchment

A study has been carried out as part of the mission assigned to IRSTV (Research Institute of Urban Sciences and Techniques), a federative research network supported by the Loire Valley Region, with the objective of characterizing atmospheric deposition, roof runoff and street runoff in a small (31 ha) suburban catchment in Nantes equipped with a separate sewer system. Trace metals, polycyclic aromatic hydrocarbons (PAHs) and pesticides were investigated. The characterization of atmospheric deposition reveals a high variability of trace metal concentrations, which could not be explained by rainfall characteristics. The relative abundance order of the metals was as follows: Zn > Cu > Cr ≈ Ni > Cd. Organic pollutants, i.e. PAHs and pesticides, were only rarely detected in the atmospheric deposition. Zn and Pb appear to be the major contaminants in runoff water, whereas the concentrations of Ni, Cu, Cr, Cd, PAHs and pesticides tend to remain low. On the whole, concentrations were similar to the lowest range reported in the literature. According to statutory thresholds, runoff water quality is poor because of the high Pb and Zn concentrations. Based on scanning electron microscopy observations, atmospheric particles do not apparently differ from runoff particles, with a predominance of pollen, bacteria and particles resulting from soil erosion. Spherical organic particles produced during fuel combustion have also been observed.

Assessment of maturity of Loire Valley wine grapes by mid-infrared spectroscopy

&lt;p style="text-align: justify;"&gt;&lt;strong&gt;Aim&lt;/strong&gt;: The objective of the present study was to assess the ripening of grapes collected at different stages of maturation between the “véraison” and harvest periods from mid-infrared spectroscopy (MIRS) analysis.&lt;/p&gt;&lt;p style="text-align: justify;"&gt;&lt;strong&gt;Methods and results&lt;/strong&gt;: Grape berries of Cabernet Franc collected in two locations of the Loire Valley region (Touraine and Anjou), from 28 vine plots and during two vintages (2005 and 2006) were analysed. With principal component analysis (PCA) of spectral data of grape musts, different levels of ripening were described during the three to four weeks before harvest. A separation according to origin (Touraine or Anjou) was also observed and confirmed by the results of partial least squares (PLS) discriminant analysis (88 % of correct classification). Similar evolutions and geographical discriminations were obtained for specific physicochemical parameters. By PLS regression, good predictions of titratable acidity and sugar concentration from berry spectral data were obtained, with root mean square error of prediction (RMSEP) of 0.53 g/L for titratable acidity (expressed in H&lt;sub&gt;2&lt;/sub&gt;SO&lt;sub&gt;4&lt;/sub&gt;) and 8 g/L for sugar concentration. Moreover, when the data from only one of the regions were considered, the predictions of titratable acidity and sugar concentration were improved and those of real acidity (pH) and maturity index were then satisfactory. The RMSEP values for samples from Touraine and Anjou were reduced, respectively, to 0.05 and 0.02 units for pH, 0.4 and 0.12 g/L for titratable acidity (expressed in H&lt;sub&gt;2&lt;/sub&gt;SO&lt;sub&gt;4&lt;/sub&gt;), 6.6 and 3.2 g/L for sugar concentration, and 5 and 2.2 units for maturity index.&lt;/p&gt;&lt;p style="text-align: justify;"&gt;&lt;strong&gt;Conclusion&lt;/strong&gt;: Spectroscopic and classic chemical analyses of grape berries yielded highly similar results. The evolution of berries from “véraison” to harvest can be characterized according to both time course and region. The samples showed similar PCA results for chemical and IR spectra parameters. PLS regression between chemical and spectral data showed that Fourier transform IR is a good method to predict acidity and sugar concentration throughout ripening. And the results for these parameters, as well as for pH, maturity index and anthocyanin concentration, are improved if the regressions are calculated from sample sets restricted to a single growing region. Consequently, a calibration model is required for each grape geographical origin.&lt;/p&gt;&lt;p style="text-align: justify;"&gt;&lt;strong&gt;Significance and impact of the study&lt;/strong&gt;: The potential of MIRS was demonstrated for the quantification of the main indicators of maturity during berry ripening. Furthermore, these spectra can be used to estimate grape maturity in particular in reference to a spectral database established over several years of study. The association infrared spectroscopy, chemometric methods and database will help to monitor ripening and to determine the optimum harvest date.&lt;/p&gt;

A METHODOLOGY FOR THE ANALYSIS OF SENSORY TYPICALITY JUDGMENTS

ABSTRACT The present paper described a global methodology studying typicality, in several steps (the first step conditioning the following ones), (1) to ensure the existence of an agreement in typicality judgments between the local wine experts; (2) to link typicality with the appellation membership; (3) to determine the relation between typicality and the global image of the product space; and finally, (4) to characterize the specificity of the wines judged as the most representative. This methodology was applied to two different sets of appellations (white wines and red wines sets) from the Central Loire Valley region in France. The results obtained differed according to the product space studied: an agreement between the typicality judgments was only observed for the red wines product space. The appellation and typicality constituted strong elements in the red wine space structure and it was possible to translate typicality of the red wines product space in terms of sensory characteristics. PRACTICAL APPLICATIONSEvaluating the sensory specificities of wines from a given category, such as an appellation, is of strategic interest for the wine industry. The production factors induce a great sensory diversity within the appellations, which leads to a problem of representativeness: the appellation membership is thus not sufficient to determine the sensory specificities of a given appellation and has to be distinguished from typicality. For a full vision, typicality needs to be studied through typicality judgments, global image of the product space and characterization. This paper proposes a global methodology for both the data collection and data treatment, including analysis of variance models, linking and synthesis methods. The example suggests that the existence of sensory typicality needs to be checked in all wine appellations where typicality is considered as a quality criterion. It would be thereafter possible to study sensory typicality and to translate it in terms of sensory characteristics.

Les TMS et le maintien en emploi des salariés de 50 ans et plus : un défi pour la santé au travail et la santé publique

Work-related musculoskeletal disorders of the upper limbs (MSDs) are the first cause of occupational illness in France, as in Europe. A pilot network for epidemiological surveillance system of MSDs has been implemented in France's Loire Valley region to assess the prevalence of MSDs and their risk factors in the working population, namely the ageing workforce. The surveillance was based on a network of occupational physicians and used the recommendations of a group of European experts ('Saltsa Criteria document' consensus). Between 2002 and 2004, 3710 men and women (aged 20-59) representative of the regional workforce were randomly selected. Exposure to risk factors of MSDs was evaluated by the use of a self-administered questionnaire which aimed to assess bio-mechanical and psychosocial risk factors. With at least one of the six primary MSDs of the upper limbs having been clinically diagnosed using a rigorous protocol, the prevalence of clinically-diagnosed MSDs was high: about 11% of male and 15% of female workers suffered from at least one of the MSDs studied. After age fifty, about 19% of male and 27% of female workers suffered from at least one MSD and 4% of male and 6% of female workers from at least two disorders. Blue-collar workers were the most affected, regardless of age or gender, followed by office employees. Exposure to MSD risk factors of remained high after age fifty: 77% of male and 72% of female blue-collar workers were exposed to at least two MSD risk factors. The implications for the prevention of MSDs and job security of workers are discussed. The high prevalence of specific MSDs of the upper limb combined with a high exposure to risk factors of MSDs in ageing workers emphasizes the need to implement comprehensive prevention programs in most sectors to reduce the exposure to risk, the prevalence of MSDs and ensure the capacity to keep employees suffering from MSDs working, or at least to quickly return to work after recovery.

Evolution of vegetation landscapes during the Holocene in the central and downstream Loire basin (Western France)

Nine sites along the downstream and middle section of the Loire river at Cordemais (Loire Atlantique, France) situated in the estuary to Saint-Nicolas-de-Bourgueil (Indre et Loire, France) were investigated. Interdisciplinary studies combined palynology, geography, archaeology, sedimentology and history, thus enabling us to reconstruct the evolution and the long-term response of the Loire valley ecosystem to natural variations and anthropogenic pressure from the Preboreal to the present in an integrated manner. The Atlantic marine transgression (between 7000 and 5000 B.P.) caused the level of brackish water to increase at Oudon between 6740+205/−200 and 5010+115/−100 B.P. This phenomenon, which was the first of its kind to be detected near the central Loire region (approximately 80 km from the current mouth of the Loire river), was accompanied by the development of subhalophile vegetation (Chenopodiaceae) and the appearance of dinoflagellate cysts. A regressive phase occurred during the Subboreal, about 4500 B.P., and led to the erosion of most of the estuarian sediments and to the disappearance of plant species linked to salinity at Oudon: peat deposits built up at most other sites. Human activities had an early effect; moderate deforestation took place at Champtoce about 6600 B.P. as farming was already orientated towards rearing animals. However, possibly cultivated plants were present towards the middle and the end of the Neolithic period (wheat, rye, buckwheat, flax) at about 5600 B.P. and chestnut and walnut were probably exploited in the Loire valley region at about 4600 B.P. The Bronze Age seemed to mark a phase when societies settled down (planting of vineyards) and deforestation peaked from the Gallo-Roman period onwards. The textile industry (flax, hemp), in the context of crop rotation set up during the Iron Age, developed rapidly during the Middle Ages, whereas nowadays the rearing of animals is the dominant activity in the Loire Valley, following the introduction of maize into the region in 1950.

INRA and Apple Disease Research in the Loire Valley Region of France.

The Loire Valley Region France’s Loire Valley region frequently evokes images of châteaux, those grand homes and historic structures encompassing immense medieval fortress-like castles and extravagant renaissance mansions alike. A visitor from abroad can’t help but be impressed with each Loire Valley château: from the imposing castle of Angers, housing its immense medieval tapestry of the apocalypse; the elegant feminine mystique of château de Chenonceaux, built over a river; the sheer enormity of Chambord with its Leonardo da Vinci doublehelix staircase; Chinon, site of the historic meeting between Joan-of-Arc and Charles VII; Sleeping Beauty’s fairy tale castle, Usse; to the geometric or playful gardens found at Villandry or Chaumont sur Loire, and many, many more (Fig. 1). Mon dieu, qu’ils sont magnifiques! Although the Loire Valley is famous for its picturesque and historical châteaux, it is also a region rich in horticulture, often called the “Jardin de la France” (Garden of France). The Loire, France’s longest river, flows roughly east to west through central France past cities such as Roanne, Orleans, Blois, Tours, Angers, and Nantes before discharging into the Atlantic Ocean. Voila une tres belle region! The region is well known for its grapes and wine, pears, apples, strawberries, asparagus, lettuce, artichokes, and field and greenhouse nursery crops and ornamentals. Although apples are also grown elsewhere in France, such as in the Bordeaux region, the Rhone Valley, and Provence, the Loire region is the top producer; France produces about 25% of the apples in the European Union (3) and is a net exporter of apples. During the late 1990s, the American authors (J. R. Hartman and S. Thomson), while on sabbatical leaves, worked in the laboratories of the French authors (L. Parisi and J.-P. Paulin) on apple diseases. In this article, we report on the French apple industry and describe the national institute for agricultural research and its role in understanding apple diseases. We review results of work on apple scab and fire blight in France and provide impressions from the point of view of American plant pathologists working in France.