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International audience; Biological methanation is an emerging Power-to-Gas technology that provides a flexible, efficient, and long-term storage system to address the renewable energy intermittency issue. However, scaling-up a biological methanation plant requires overcoming the bottleneck of H2 gas–liquid mass transfer. The current work demonstrates analytically, experimentally and numerically the importance of H2 mass transfer on CH4 purity and productivity. The influence of sparger design was investigated in a pilot-scale bubble column bioreactor. An increase of 265 % in kLa and subsequently 81 % in CH4 purity is obtained when a uniform porous plate is used over a 4-points porous sparger. Numerical simulation of the bioreactor was performed using a multiscale modeling approach coupling 1D and CFD models. The numerical simulations were validated satisfactorily by the experimental data. Parametric studies were also performed using the 1D model to reveal the impact of operating conditions on the bioprocess. An analytical solution for the productivity of biomethanation reactors at steady-state is proposed based on mass balances and provides new insights into biological methanation. It is found that any modification of operating parameters that improve H2 mass transfer, such as higher gas recirculation rate and smaller bubble size, leads to a better bioreactor performance.

The capture of four abnormal specimens of the Striped panray, Zanobatus schoenleiniii was reported from shallow coastal waters surrounding the touristic area of Dakar, Republic of Senegal, and among them, some specimens displaying morphological deformities. A specimen exhibited a pectoral non-adherent to the head, a second was tailless, and two specimens displayed scoliosis at level of trunchal vertebrae and tail. The abnormalities are described and their causes and consequences herein considered.

In this article, we study the polarity detection problem using linear supervised classifiers. We show the interest of penalizing the document frequencies in the regularization process to increase the accuracy. We propose a systematic comparison of different loss and regularization functions on this particular task using the Amazon dataset. Then, we evaluate our models according to three criteria: accuracy, sparsity and subjectivity. The subjectivity is measured by projecting our dictionary and optimized weight vector on the SentiWordNet lexicon. This original approach highlights a bias in the selection of the relevant terms during the regularization procedure: frequent terms are overweighted compared to their intrinsic subjectivities.We show that this bias appears whatever the chosen loss or regularization and on all datasets: it is closely link to the gradient descent technique. Penalizing the document frequency during the learning step enables us to improve significantly our performances. A lot of sentimental markers appear rarely and thus, are unappreciated by statistical learning algorithms. Explicitly boosting their influences leads to increasing the accuracy in the sentiment classification task.

Résumé Introduction : La broncho-pneumopathie chronique obstructive (BPCO) est une pathologie pulmonaire chronique dont le retentissement est multi-systémique, pouvant se compliquer de troubles psycho-affectifs. Objectif : Estimer la fréquence de l’anxiété et de la dépression chez les patients suivis pour BPCO à l’état stable dans un CHU à Tunis et de déterminer les facteurs prédictifs de leur apparition. Méthodes : Il s'agissait d'une étude transversale à visée analytique réalisée auprès de patients suivis pour une BPCO à l’état stable aux consultations externes du service de pneumologie du CHU Mongi Slim La Marsa. Les symptômes de la BPCO ont été évalués par le Chronic obstructive pulmonary disease Assessment Test (CAT),sa sévérité par la classification du GOLD 2020 et le dépistage des troubles psycho-affectifs par l’échelle HAD. Résultats : Cent trois patients ont été colligés, d’âge moyen de 64 ans. La prévalence de l’anxiété était de 44,7% et celle de la dépression de 33,9% avec 26,2% des patients ayant un épisode dépressif majeur. En analyse multivariée par régression logistique binaire, les valeurs les plus élevées du CAT étaient associées à l’anxiété, à la dépression et l’apparition d’un épisode dépressif majeur. Les autres facteurs associés à l’anxiétéet à l’apparition d’un épisode dépressif majeur étaient les troubles du rythme cardiaques associés et les valeurs les plus basses de l’IMC. De plus, le sexe féminin était associé à l’apparition d’un épisode dépressif majeur. Conclusion : L’anxiété et la dépression sont fréquentes chez les patients Tunisiens souffrant de BPCO, d’où tout l’intérêt de leur dépistage systématique.

Zinc (Zn) deficiency is a common condition and could contribute to poor outcomes in hemodialysis (HD) patients. The aim of this study was to evaluate the effects of Zn supplementation on serum copper (Cu) to Zn and C-reactive protein (CRP) to albumin ratios (CAR) in HD patients.Seventy-seven HD patients were enrolled in a multicentre simple-blind randomized clinical trial. Only 37 HD patients completed the study; they were randomly divided into two groups and supplemented with zinc sulphate (n=17) or placebo (n=20) for two months. Serum Zn and Cu were measured by atomic absorption spectrophotometry. Serum albumin and hypersensitive-CRP were assessed by colorimetric and immunoturbidimetric method, respectively. Determinations were performed before and after supplementation.After two months of supplementation, serum Zn significantly increased, and Cu to Zn ratio decreased in Zn supplemented group, but remained unchanged in the placebo group. In parallel, serum albumin concentrations significantly increased, and CAR decreased in Zn supplemented group only.Zn supplementation reduces Cu to Zn and CRP to albumin ratios in HD patients. These changes point towards an improvement in nutritional, oxidative and inflammatory status. The study findings suggest that correcting Zn deficiency reduces poor outcomes in HD patients.Manjak cinka (Zn) je uobičajeno stanje i može doprineti lošim ishodima kod pacijenata na hemodijalizi (HD). Cilj ove studije je bio da proceni efekte suplementacije Zn na odnos serumskog bakra (Cu) i Zn i odnos C-reaktivnog proteina (CRP) i albumina (CAR) kod pacijenata na hemodijalizi.Sedamdeset i sedam pacijenata na hemodijalizi je uključeno u jednostruko - slepo i randomizovano kliničko ispitivanje u više centara. Samo 37 pacijenata na hemodijalizi je završilo studiju. U nasumično podeljene dve grupe počelo se sa suplementacijom u ishrani cink sulfatom (n=17) ili placebom (n=20) tokom dva meseca. Serum Zn i Cu su mereni atomskom apsorpcionom spektrofotometrijom. Albuminski serum i hipersenzitivni CRP procenjeni su kolorimetrijskim i imunoturbidimetrijskim metodom, svaki posebno. Merenja su vršena i pre i posle suplementacije.Nakon dva meseca suplementacije Zn u serumu se značajno povećao, a odnos Cu i Zn smanjio u grupi gde je sprovođena suplemenacija Zn, ali je ostao nepromenjen u grupi sa placebom. Paralelno sa tim, koncentracije albumina u serumu značajno su porasle, a CAR se smanjio samo u grupi sa suplementacijom Zn.Suplementacija Zn smanjuje odnos Cu u odnosu na Zn, i CRP u odnosu na albumin kod pacijenata na hemodijalizi. Ove promene ukazuju na poboljšanje statusa u vezi sa ishranom, oksidacijom i zapaljenjima. Nalazi studije sugerišu da smanjenje deficita Zn umanjuje šanse za loše ishode kod pacijenata na hemodijalizi.

A specimen of Physiculus dalwigki Kaup, 1758 measuring 218 mm in total length, 190 mm in standard length, and weighing 90 g was caught off the northern Tunisian coast. This capture constitutes the first record of this fish from the Tunisian coast. The specimen is described including morphological measurements, meristic counts, and color. Due to a lack of records, the real status of the species in the Tunisian waters still remains questionable. Physiculus dalwigki occurs only off northern Spain and south to the Strait of Gibraltar in the waters surrounding Madera and the Azores Islands, and in the Mediterranean Sea from Nice (southern France) to the Tunisian coast. Therefore, it appears that P. dalwigki is displaying a disjoint distribution with the exclusion of a large western region of the Mediterranean Sea.

The recent overmedication of childbirth process ignores mothers wishes. In Tunisia, women are not involved in decision-making during childbirth.To analyze the opinion of a sample of Tunisian women regarding the possibility of making their own informed choices during childbirth and to determine the factors that may influence the requested mode of delivery.This was a 5-month descriptive cross-sectional survey. Were included: Tunisian women who were consultants or practitioners at a university obstetrics and gynaecology department in Tunis; female medicine students or members of women dedicated social network groups. The questionnaire was applied during direct interviews or posted online. The main judgment criteria was: participants' opinion regarding access to autonomous choice of delivery mode. Participants were initially enrolled into 2 groups: • group of women requesting access to autonomous choice. • group of women who do not request access to autonomous choice. The participants were then divided into 2 other groups according to the requested mode of delivery: • Group : Cesarean section • Group: Vaginal delivery. A multivariate logistic regression was used to identify risk factors that may have influenced the responses.The total number of participants was 197. Access to autonomous choice was requested by 63.45% of the participants. These were mainly: consultants: OR=7.76 95% CI [0.56-106.16] or practitioners: OR=3.93 95% CI [0.01-829.03], with a high level of education OR=1.22 95% CI [0-1174.40], with a past positive birth experience: OR=1.24 95% CI [0.27-5.74]. The women who did not claim access to autonomous choices were mainly: doctors OR=-0.31 95% CI [0-32.58], midwives: OR=-0.08, 95% CI [0-18.12] or even housewives OR=-0.42 95% CI [0-68.88]. The women who preferred to give birth by Caesarean section were mainly: practitioners: OR=2.03 95% CI [0.53-7.81], nulliparous OR=2.51 95% CI [0.243-25.98], pregnant OR= 4.44 95% CI [1.03-19.13], with a history of cesarean delivery: OR=5.68 95% CI [0.64- 50.43] or even a history of negative childbirth experience: OR=1.87 95% CI [0.22-15.85].The request for an Autonomous choice during childbirth most often expresses a certain number of beliefs and fears. Obstetricians should take time to listen and explain, in order to understand the mother's anxieties and enable her to resolve them. Based on the principles of justice, the access to autonomous choices during childbirth process should be universally recognized by legislations and thus fairly respected for all.

Chronic obstructive pulmonary disease (COPD) is a chronic lung disease with a multi-systemic impact that can be complicated by psycho-affective disorders.To determinethe frequency of anxiety and depression in patients followed for stable COPD in a university hospital-center in Tunisand to determine the predictors of their onset.This was an analytical cross-sectional studyof patients followed for stable COPD at the pulmonology department of the Mongi Slim La Marsa Hospital. The symptoms of COPD were assessed by the Chronic obstructive pulmonary disease Assessment Test (CAT), its severity by the GOLD 2020 classification and the screening of psycho-affective disorders by the HAD scale.One hundred and three patients were enrolled, with an average age of 64 years. The prevalence of anxiety was 44.7% and that of depression was 33.9%with 26.2% of patients with a major depressive episode. In multivariate analysis by binary logistic regression, the highest values of CAT score were associated with anxiety, depression, and the onset of a major depressive episode. Other factors associated with anxiety and the onset of a major depressive episode were associated heart rhythm disorders and the lowest BMI values. In addition, the female gender was associated with the onset of a major depressive episode.Anxiety and depression are common in Tunisian patients with COPD, hence the interest of their systematic screening.

The involvement of immunity in the pathogenesis of schizophrenia and related psychoses was suspected a century ago but was shadowed by the dopaminergic hypothesis after the discovery of antipsychotics. We currently know that this latter theory has many limits and cannot account for the wide variety of psychotic conditions. The immune-inflammatory theory is now one of the most promising axes of research in terms of pathogenesis of several mental health conditions. Immunity and inflammation play a role at least in a subgroup of patients with psychosis. The immune system is complex with a variety of components and mediators that can all have effects on the brain and thus mediate psychiatric symptoms. In this chapter we will explore the scientific evidence of the role of immune system in pathophysiology of psychosis. The sections of this chapter will discuss the role of innate system components (cytokines, microglia, inflammation.), the role of adaptive system (lymphocytes and antibodies) with a section focusing on auto-immunity and particularly antineuronal antibodies. Finally we will discuss how this research can impact patients management and elaborate recommendations for future research.

Aim: Little is known about the cardiovascular effects of oral water intake in shock patients. This study was designed to assess the effect of oral water on stroke volume and blood pressure during a 1-h time period.Method and Results: This open-label, randomized clinical trial included patients admitted to intensive care with acute circulatory failure. Three ICU units at the anesthesia and critical care department of the Dijon Bourgogne University Hospital. Patients were randomized 1:1 to an intervention or standard care group. The intervention group received 500 ml of oral water while the standard care group received intravenous administration of 500 ml of physiological saline solution. Baseline SV did not differ between the two groups (36 ml [28;51] vs. 38 ml [30;51], p = 0.952). The number of patients who were fluid responders did not differ between the two groups [n = 19 (76%) vs. n = 18 (72%), p = 1]. The median change in stroke volume during the three time points did not differ between the two groups (p < 0.05). In the intervention group, blood pressure increased up to 60 min. In the control group, blood pressure quickly increased at the end of fluid expansion, then returned close to baseline value at 60 min.Conclusion: Shock patients who were administered oral water experienced improvements in blood pressure and blood flow up to 60 min when compared with patients who received intravenous saline solution. Further studies are warranted to confirm these effects.Clinical Trial Registration:www.clinicaltrials.gov, identifier: NCT03951519.

Background: Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) is the rescue treatment proposed to patients with refractory cardiogenic shock. The VA-ECMO implantation promotes inflammation and ischemia-reperfusion injuries through the VA-ECMO flow, causing digestive mucosa barrier disrupture and inducing translocation of bacterial wall components—Lipopolysaccharides (LPS) with further inflammation and circulatory impairment. LPS is a well-studied surrogate indicator of bacterial translocation. Oxiris membrane is a promising and well-tolerated device that can specifically remove LPS. The main study aim is to compare the LPS elimination capacity of Oxiris membrane vs. a non-absorbant classical renal replacement (RRT) membrane in patients with cardiogenic shock requiring VA-ECMO.Methods: ECMORIX is a randomized, prospective, single-center, single-blind, parallel-group, controlled study. It compares the treatment with Oxiris membrane vs. the standard continuous renal replacement therapy care in patients with cardiogenic shock support by peripheral VA-ECMO. Forty patients will be enrolled in both treatment groups. The primary endpoint is the value of LPS serum levels after 24 h of treatment. LPS serum levels will be monitored during the first 72 h of treatment, as clinical and cardiac ultrasound parameters, biological markers of inflammation and 30-day mortality.Discussion: Oxiris membrane appears to be beneficial in controlling the VA-ECMO-induced ischemia-reperfusion inflammation by LPS removal. ECMORIX results will be of major importance in the management of severe cases requiring VA-ECMO and will bring pathophysiological insights about the LPS role in this context.Clinical Trial Registration:www.ClinicalTrials.gov, identifier: NCT04886180.

The present study aimed to evaluate the hypoglycemic and hypolipidemic activities of Aloe vera mucilage in alloxaninduced diabetic rats. Adult male Wistar rats were assigned into 4 groups (6 rats/group), as follows: the first group (C) served as the controls. The second group of rats (AL) received a single subcutaneous dose of alloxan at 120 mg kg-1bw. These groups received 1 mL of NaCl 9%. The third group (AL+Av) represented diabetic rats treated with 1 mL of mucilage extracted from Aloe vera leaves. The fourth group (C+Av) corresponded to control rats administered with 1 mL of Aloe vera mucilage. NaCl or Aloe vera mucilage were intraperitoneally injected to the rats. Diabetic rats exhibited significant hyperglycemia accompanied by glycosuria. We also observed a significant reduction in the liver weight and glycogen content of the specimen. A reduced level of serum insulin was also observed among diabetic rats. However, the levels of serum triglycerides and total cholesterol increased in alloxaninduced diabetic rats. Aloe vera mucilage administration to diabetic rats partially and totally corrected glycaemia and liver glycogen content and serum insulin level, respectively. The rats’ lipid status has also been improved. Medicinal plants, including Aloe vera, are expected to correct hyperglycemia and hyperlipidemia in diabetic patients to prevent the adverse effects of synthetic drugs.

General lockdown was declared in Tunisia in March 2020 due to the COVID-19 pandemic. It had a negative psychological and social impact on the Tunisian population and health professionals. Mental healthcare was crucial during this period but health services access was difficult because of movement restrictions. Mongi Slim Hospital contains three special COVID-19 units and there was an urgent need for a psychological intervention with increasing demands at the mental health department in this hospital. A psychological support unit (PSU) was implemented with a free helpline for both patients, families and hospital staff. The objective of this paper was to describe the design, implementation and activities of this unit. This PSU had preventive and management activities for both patients and health professionals. Recommendations drawn from this experience are to promote mental health care and to encourage implementation of such units in order to respond to the local need of patients and staff. This pilot experience should be generalized to other hospitals in Tunisia and worldwide.

The current international context considers birth experiences as a focal point for women's health. However, this subject is rarely discussed in Tunisian literature.Analyze birth experience of a sample of Tunisian women.Transverse descriptive study. All women who gave birth in the study unit during August 2018 were included. A direct interview was conducted during the first postpartum day. The questionnaire used was developed by a multidisciplinary team and included 55 questions, divided into 4 items. We compared the group of women who described their delivery as physically or psychologically traumatic to the group of women who reported a serene birth experience. A multivariate analysis of variance was used to identify the variables that can influence childbirth experience.During the study period, 170 women were included with a response rate of 81%. Severe anxiety about delivery was reported by 74.5% (n = 127) of women. Delivery was experienced as a trauma in 48.2% (n = 82) of cases. In the group of women who expressed a negative experience, we found a significant association with the use of media and internet as a source of information (p=0.001) and repeated vaginal examinations (p=0.001). Pain significantly impacted women's experience (p = 0.02). Finally, main risk factors of a negative childbirth experience were: uterine revision: OR=7.04 95%CI [0.27-177.68]; Emergency caesarean section: OR=3.04 95%CI [0.94-9.85] and vaginal delivery: OR=2.13 95%CI [0.45-10.14].We can intervene on modifiable factors with the introduction of a specific program preparing women for their childbirth and the improvement of the professional practices. However, the issue will benefit from being discussed and addressed at the national, cultural and societal levels.

Highlights • Ballistic tramatology in the upper humerus extremity region presents challenging management difficulties. • Resurfacing shoulder hemi arthroplasty in ballistic injuries is not commonly reported. • The indication of resurfacing shoulder hemi arthroplasty was appropriate regarding good functional outcome., Introduction Ballistic traumatology of the shoulder joint is uncommon. Usually, it is associated to comminuted fractures of the upper humerus. Total shoulder arthroplasty has been proposed to restore a good function. The indication of resurfacing hemi arthroplasty still controversial and is not commonly reported after ballistic traumatology. Presentation of case We report the case of a 26-year-old soldier victim of a gunshot of the left shoulder entailing a comminuted complex fracture of the upper extremity of the humerus. After shoulder immobilization of 3 months joint mobility was very limited. Radiographs showed bone malunion with a total loss of the hemispherical form of the humeral head. Patient has undergone a resurfacing hemi arthroplasty. Surgery outcome was good. At five years of follow-up, there were no major functional complaints. Clinical and radiological result was satisfactory with a good shoulder mobility. Discussion Shoulder arthroplasty provided good functional outcome in case of post fracture sequelae. Difficulty was to choose between total arthroplasty and hemi arthroplasty. In young and active patients, authors disapproved total arthroplasty in post traumatic gleno-humeral arthrosis to prevent revision difficulties especially after glenoid erosion. Conclusion Although follow-up still be limited, the indication of shoulder hemi arthroplasty was appropriate regarding functional outcome and patient satisfaction. Further clinical and radiological supervision still necessary to detect glenoid erosion.