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Introduction: Audiovisual distraction (AVD) is one of the non-pharmacological means of anxiety prevention. However, few studies have evaluated its perioperative effect in adults., Aim: To evaluate the contribution of audio-visual distraction in the prevention of perioperative anxiety in adult patients proposed for surgery under spinal anesthesia., Methods: This was a prospective randomized controlled study lasting three months from July 1, 2021. We included ASA I to III over 18 years patients, proposed for visceral or orthopedic surgery under spinal anesthesia. We didn't include patients operated in lateral or prone positions or with a history of anxiety disorders or communication difficulties. 90 patients were randomized into two groups: a control group T and a group A who had an AVD throughout the operation. The primary outcome was anxiety as assessed by the visual analogue scale (VAS)., Results: Demographic characteristics, Amsterdam preoperative anxiety and information scale (APAIS) and pain levels were comparable between the two groups. During the surgery, 22 (48.9 %) patients in group T versus 3 (6.7 %) in group A required Midazolam (p < 0.001). Anxiety assessed by VAS at the end of the act was lower in group A (p < 0.001). The pain levels also were lower in patients who received AVD (p = 0.004). A patient satisfaction score (Iowa Satisfaction with Anesthesia Scale French version) ≥ 5.4 was more frequently observed in group A (p < 0.001)., Conclusion: AVD reduced perioperative anxiety and decreased the use of midazolam during surgery performed under spinal anesthesia.

Introduction: Many prognostic indices have been developed to assess clinical status and predict the probability of death in the intensive care unit (ICU) but none have perfect sensitivity or specificity., Aim: To evaluate the prognostic value of admission lactate in patients admitted to ICU., Methods: A cohort, observational, prospective study was carried out in the intensive care unit (ICU) of Mongi Slim Hospital, la Marsa, over 12 months period. Arterial blood lactate (ABL) was measured in ICU admission (H0), then 6 hours (H6), 12 hours (H12), 24 hours (H24) and 48hours (H48) after admission. Prognostic scores were calculated 24 hours after the admission. We also recorded biological data, hemodynamic parameters, and the evolution during the stay in intensive care. Primary endpoint was ICU mortality., Results: We included 135 patients. The average age was 47.22 ± 16.88 years with a sex-ratio of 1.75. ICU mortality was 48%. The mean ABL at admission was 3.05 ± 2.63 mmol/l, higher in the dead group with a statistically significant difference. Prognostic value of lactate at admission was less powerful than severity indices in this study but remains excellent with an AUC >0, 7 defining « cut-off » values with a good sensitivity and specificity. In multivariate analysis, initial lactate > 2 mmol/l was found to be an independent predictive factor of ICU mortality with an Odd Ratio [IC 95%] =1.16 [1.07 - 3.6]; p=0.04., Conclusions: Monitoring lactatemia in ICU could allow better identification of patients at high risk of death and the reassessment of therapeutic efficacy.

Our objective is to solve the time-fractional Vasicek model for European options with a new stabled relaxation method. This new approach is based on the splitting method. Some numerical tests are presented to show the stability and the reliability of our approach with the theory of options., Competing Interests: Conflict of interestThis work does not have any conflicts of interest., (© The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2022.)

In this paper, we investigate the existence and uniqueness of fractional differential equations (FDEs) by using the fixed-point theory (FPT). We discuss also the Ulam-Hyers-Rassias (UHR) stability of some generalized FDEs according to some classical mathematical techniques and the FPT. Finally, two illustrative examples are presented to show the validity of our results., Competing Interests: Competing interestsThe authors declare no competing interests., (© The Author(s) 2023.)

The application of Cu and CuO nanofertilizers in horticulture has been a promising strategy to promote plants' growth. In our study, increasing concentrations (10, 25, 50, 100, 250, 500, 1000, 2000 mg/L) were assessed for their inhibitory or stimulatory effects on barley (Hordeum vulgare L.) seedlings. Our results showed an enhancement of seed germination parameters (FGP, t50, cumulative germination rate, AUC), and seedling growth parameters (roots and shoots' lengths, fresh biomasses and dry biomasses) by the low concentrations of Cu NPs and CuO NPs, while concentrations above 500 mg/L displayed inhibiting effects. CuO NPs treatment showed a significant similitude with CuSO 4 , which confirms that CuO NPs act mainly via released Cu ions. However, Cu NPs exhibited a different behavior since the nanosized particles contribute together with Cu ions in barley response to Cu NPs. This provides an overall picture of the way these nanoparticles may behave in plant systems., (© 2021. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

This work deals with the existence and uniqueness of global solution and finite time stability of fractional partial hyperbolic differential systems (FPHDSs). Using the fixed-point approach, the existence and uniqueness of global solution is studied and an estimation of solution is given. Moreover, some sufficient conditions for the finite time stability of FPHDSs are established. Numerical experiments illustrate the Stability result., (© Korean Society for Informatics and Computational Applied Mathematics 2021.)

Granulomatosis with polyangiitis (GPA) is a rare vasculitis among adolescents. Its pulmonary manifestations may mimic tuberculosis. We report the case of a 16-years-old female patient with multiple excavated lung nodules revealed by a chronic cough, hemoptysis, epistaxis and weight loss. The diagnosis of GPA was achieved due to systemic pulmonary, ENT and renal involvement, the positivity of anti-neutrophil cytoplasmic antibody directed against proteinase 3 (C-ANCA) and bronchial and nasal biopsies showing granulomatous inflammation with a dense perivascular infiltrate destroying the vessel wall. Bolus of glucocorticoids and immunosuppressants reversed her symptoms. Although GPA is a rare disease in teenagers, it should be considered as one of the differential diagnosis in adolescents presenting with excavated pulmonary nodules., Competing Interests: The authors declare no competing interests., (Copyright: Hajar Arfaoui et al.)

Background: Adverse events related to vitamin K antagonists (VKA) represent a major public health problem. Informative tools and educative program contributes to the reduction of iatrogenic risk. The purpose of our study is to assess representations and information needs of patients under VKA therapy in order to develop a suitable therapeutic education program., Methods: Individual semi-structured interviews were conducted among both long term VKA therapy patient and patients initiating VKA. The thematic analysis allowed us to explore patient's speech qualitatively and semi-quantitatively., Results: The main needs in information concerned the modalities of treatment (27.6%), side effects (24.1%), precautions and management of VKA treatment (24.1%). Origin of the disease (P=0.022) and drug mechanism of action (0.012) were specially asked about by patients initiating their treatment., Conclusion: Patients under VKA therapy reported needs for information on both their pathology and their anticoagulant therapy. The therapeutic education approach will enable us to adapt the educational tools and messages to the needs of patients under VKA therapy., (Copyright © 2017. Published by Elsevier Masson SAS.)