67 research outputs found

    Patient-perceived progression in multiple system atrophy: natural history of quality of life

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    Health-related quality of life (Hr-QoL) scales provide crucial information on neurodegenerative disease progression, help improving patient care, and constitute a meaningful endpoint for therapeutic research. However, Hr-QoL progression is usually poorly documented, as for multiple system atrophy (MSA), a rare and rapidly progressing alpha-synucleinopathy. This work aimed to describe Hr-QoL progression during the natural course of MSA, explore disparities between patients, and identify informative items using a four-step statistical strategy.We leveraged the data of the French MSA cohort comprising annual assessments with the MSA-QoL questionnaire for more than 500 patients over up to 11 years. The four-step strategy (1) determined the subdimensions of Hr-QoL in MSA; (2) modelled the subdimension trajectories over time, accounting for the risk of death; (3) mapped the sequence of item impairments with disease stages; and (4) identified the most informative items specific to each disease stage.Among the 536 patients included, 50% were women and they were aged on average 65.1 years old at entry. Among them, 63.1% died during the follow-up. Four dimensions were identified. In addition to the original motor, nonmotor, and emotional domains, an oropharyngeal component was highlighted. While the motor and oropharyngeal domains deteriorated rapidly, the nonmotor and emotional aspects were already slightly to moderately impaired at cohort entry and deteriorated slowly over the course of the disease. Impairments were associated with sex, diagnosis subtype, and delay since symptom onset. Except for the emotional domain, each dimension was driven by key identified items.Hr-QoL is a multidimensional concept that deteriorates progressively over the course of MSA and brings essential knowledge for improving patient care. As exemplified with MSA, the thorough description of Hr-QoL using the 4-step original analysis can provide new perspectives on neurodegenerative diseases' management to ultimately deliver better support focused on the patient's perspective

    Retour le projet TRANSYLVE: réévaluation de la chronologie et des variations d'intensité de la métallurgie du fer dans le haut Vicdessos aux époques médiévales et modernes

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    National audienceLes Pyrénées Ariégoises et ses forêts ont été le creuset de l’écologie historique française avec des études pionnières menées dans le cadre du programme interdisciplinaire PIREN Histoire de l’environnement – la forêt charbonnée du CNRS (1988-1991). Ce programme a posé les jalons de la réflexion globale des interactions humains-environnement en milieu de montagne, et plus spécifiquement des interactions entre métallurgie, ici du fer, et dynamiques de la couverture et composition forestières. L’objectif était de tester, au travers d’une approche multidisciplinaire (histoire, anthracologie, palynologie) et multiscalaire, la thèse d’une forge « dévoreuse » de forêt ; postulat construit par l’administration des Eaux et Forêts et des ingénieurs des mines entre le XVIIe et le XIXe siècle. Les travaux universitaires qui en ont découlés ont certes confirmé le rôle de la métallurgie du fer dans le façonnage de ces paysages essentiellement pour l’époque moderne, mais ont également soulevé des questions relatives à la chronologie de ces changements environnementaux, à la spatialisation, aux modes de gestion des ressources forestières mises en place par les communautés et au rôle relatif de la métallurgie au charbon de bois par rapport aux autres activités forestières et agropastorales. Malgré ces questionnements, l’idée d’une déforestation causée par le charbonnage demeure prégnante dans les travaux ultérieurs et l’imaginaire collectif.Les recherches interdisciplinaires réamorcées dans le Vicdessos (Haute-Ariège) dans le cadre des projets FODYNA et TRANSYLVE (Labex DRIIHM, OHM Haut-Vicdessos) et de la thèse de Léonel Fouédjeu (2016-2022), remettent en cause le scénario d’une déforestation globale causée par la métallurgie au charbon de bois. Elles livrent au contraire une vision spatiale et temporelle, fine et renouvelée, des changements environnementaux (composition floristique et structurale) à l’œuvre. Elles mettent en évidence les stratégies développées par les communautés passées (pratiques) et les pouvoirs publics (règlements) pour pérenniser les ressources forestières locales. La comparaison avec les résultats acquis récemment dans d’autres secteurs appelle à appréhender la complexité et la variabilité des processus intra- et inter-valléens et montre le risque d’une généralisation appliquée à l’ensemble d’un massif. Elle invite à développer des recherches micro-historiques innovantes combinées à une archéologie des ressources environnementales

    A long-term tree-ring chronology over 796 years for silver fir (Abies alba Mill.) in Southern France

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    International audienceA 796 years chronology spanning the period 1214–2009 has been built. Data can be used for dating projects, paleoecology studies and climate reconstructions. Datasets access at https://hal.archives-ouvertes.fr/hal-01528324. Associated metadata available at: https://metadata-afs.nancy.inra.fr/geonetwork/srv/fre/catalog.search#/metadata/a74b4869-318c-458c-a5fe-f9ff44a5082c Abstract A 796 years tree-ring master chronology (1214-2009) was compiled for Silver fir (Abies alba Mill.). This data was collected from 515 living trees and archaeological timbers, in 31 sites in Northern Alps (Maurienne) to Southern Pre-Alps (Ventoux). The results are 31 site chronologies with good correlations, even at long distance The master chronology is available and can be accessed through a website database. This information can be used for numerous projects, such as historical dating, paleoecology studies, and climate reconstruction. It is the hope of the authors that this information can be widely utilized and continuously updated to benefit future research

    The European fir-beech forests, the reference state for montane belt forests in Europe: the revisiting of a paradigm in ecology

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    The conservation of old-growth forests has regained international attention because of their crucial role in mitigating climate change and in providing refuge areas for biodiversity. The problem, however, is which forests should be prioritized for preservation and what should be done to ensure that other forests evolve to resemble high-value forests. Many agree here that the reference state should serve as a benchmark and guide management so that the forests furthest from that state come closer to it. For the European montane belt, it is commonly admitted that the reference forest is a mature fir-beech forest (Abies alba Mill., Fagus sylvatica L.) with yew (Taxus baccata L.).Palaeoecological and archaeological records provide a longer temporal perspective to address issues of naturalness, maturity, and ancientness, and thus shed light on the gap between these forests and a near-natural (reference) state. Through the analysis of charcoals from soils and charcoal kiln platforms we have attempted to better characterize the Holocene trajectory and sub-recent dynamics of these forest formations in two mountain areas: the Romanian Carpathian and the French Pyrenees. Our results from 6 stands, 3 in each massif are consistent with post-glacial forest recolonization processes known on a regional scale and species successions that followed the last glacier retreat. The temporal depth provided by our study in two disjointed massifs reveals a common trajectory during the late Holocene where the establishment of the fir-beech mixed forest resulted from a close co-construction between the life history of tree species and the development of pre-industrial societies. Considering the high heritage value of these forests inherited from human-nature interaction, it deserves to be considered in its own right and as a reference to be reached and preserved in the European montane level
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