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This paper examines the extent to which the intercultural speaker is promoted through intercultural contacts in five Tunisian EFL textbooks produced in five different periods in the history of English language teaching in Tunisia. Using content analysis, the study evaluated the textbooks' representation of intercultural contacts in texts and activities. The results revealed that intercultural contacts were limited in frequency and variety in both contents and activities, and that textbooks were mainly meant to teach language forms and language skills. Despite being designed in different periods and using different teaching methods, textbooks did not differ in their representation of contacts and their potential to develop the intercultural speaker's competencies in learners. It is suggested that more importance should be given to intercultural contacts in the current textbook series to make them more responsive to learners' increasing needs for intercultural communication skills.

The severity of diabetic ketoacidosis (DKA) at diagnosis increased during the global COVID-19 pandemic. This study aimed to analyze the impact of the pandemic on the clinical and biological severity of DKA in patients with new-onset diabetes mellitus (DM) in Tunisia. The study included patients hospitalized for new-onset DKA 2 years prior and 2 years during the COVID-19 pandemic. Data was collected retrospectively, and DKA severity was classified based on biological parameters like potential of hydrogen (pH) and HCO3-. The results showed that DKA was more severe during COVID-19, as evidenced by lower potential of hydrogen (pH) (p = 0.006), and serum bicarbonate (HCO3-) levels (p = 0,005). Despite the higher severity of DKA was higher during COVID-19, intensive care unit hospitalizations remained equivalent (p = 0.359). The prevalence of hyponatremia was also higher during COVID-19 (p = 0.024). The findings suggest that delayed diagnosis and COVID-19 May contribute to the increased severity of DKA and electrolyte imbalance during the pandemic. Further research is needed to better understand the underlying mechanisms and develop appropriate strategies to address this issue. [ABSTRACT FROM AUTHOR]

Ectotherms are largely impacted by extreme climate events, essentially heatwaves. In Tunisia, the pine processionary moth (PPM), Thaumetopoea pityocampa, is a defoliator typically laying eggs in summer. Its geographical range is expanding northwards in Europe while retracting from southern Tunisia where summer temperatures can reach extreme heats. We explored the effects of climate change over the last 30 years on PPM at its southern range edge. We investigated variations of fecundity and causes of egg mortality over time using historical and contemporary collections of egg masses. Due to incomplete historical series, a clustering method was used to group climatically homologous sampling sites and perform allochronic analyses on clusters instead of individual localities. Our results suggest negative effects of summer heat on egg survival, down to 0% hatching rate in one site during a major heatwave. Such high hatching failures resulted partly from high egg sterility and aborted embryos, with little effects of parasitism rate, suggesting heat susceptibility during embryonic development, but our results do not allow distinguishing impeded mating success from failed egg maturation or early embryo death. Decreasing female fecundity was observed in regions where allochronic comparisons were possible, associated with a decrease in parasitism rate, while climatic variability increased. Previous studies have confirmed experimentally the thermal sensitivity of PPM early instars to temperatures observed in the present work, including one population from southern Tunisia. However, further work is required to evaluate the relative importance of warming summers among populations, since the risk of heat stress depends on the phenology of sensitive instars, and populations from the warmest areas may not necessarily be the most vulnerable to climate change if they already evolved phenological heat avoidance. In addition to heat‐induced mortality, the ultimate fitness of heat survivors should also be explored to determine potential carry‐over effects on subsequent life stages. [ABSTRACT FROM AUTHOR]

This paper evaluates the potential of intercultural contacts portrayed in the content and tasks of a Tunisian EFL textbook for third-year secondary school students to develop the model of the intercultural speaker. The quantitative and qualitative analyses of the elements of intercultural contacts reveal that this portrayal is imbalanced in terms of frequency and variety and that their potential to help participants become good intercultural speakers is low. To compete with other sources of intercultural contacts, the textbook should include more frequent and varied contact situations where culturally different characters can interact and apply intercultural skills.

The JN.1 sub-variant is a new variant of the SARS-CoV-2 Omicron strain, derived from the BA.2.86 sub-variant. It was first detected in late 2023 and has quickly spread to many countries, becoming the most prevalent variant in some regions. JN.1 exhibits a unique mutation (L455S) in the spike protein compared to the BA.2.86 lineage, which may affect its transmissibility and immune evasion capabilities. JN.1 has been designated as a "variant of interest" by the World Health Organization due to its rapidly increasing spread and is being closely monitored for its impact on the COVID-19 pandemic. This study describes the emergence of SARS-CoV-2 JN.1 sub-variant in Tunisia, and reports its mutation profiles. Nasopharyngeal samples collected over a four-month period (October 2023 to January 2024) were subjected to RNA extraction and real-time RT-PCR confirmation of SARS-CoV-2 infection. The whole-genome sequencing was performed by an iSeq 100 sequencer and COVIDSeq kit reagents (Illumina, USA). Mutation analysis, using the NextClade platform and GISAID database, revealed the presence of JN.1 in 15 out of 80 positive cases (18.75%) during the study period. The emergence of JN.1 highlights the ongoing evolution of SARS-CoV-2 and the need for continued surveillance and research to better understand the characteristics and impact of emerging variants. [ABSTRACT FROM AUTHOR]

Assessing the spatial distribution of the erosion process is considered a critical initial step to provide valuable insights to decision-makers for devising an effective erosion mitigation strategy to reduce erosion damages. This research was conducted based on a revised universal soil loss equation (RUSLE) model integrated with the geographic information environment (GIS) within the Wadi El Ghareg watershed located in the Menzel Bourguiba region in northeastern Tunisia to simulate the spatial distribution of erosion across the basin which has been experiencing adverse effects of climate change, characterized by periods of drought and heavy rainfall. The RUSLE incorporates several variables, including rainfall erosivity (R), soil erodibility (K), cover management (C), slope length (LS), and conservation practices (P), serving as key predisposition parameters in this research. For the validation process of the applied model, 200 points were selected to create an inventory map; the points were selected based on satellite images and field surveys. The obtained thematic maps were normalized by fuzzy logic and overlaid using the model equation in the GIS. The results identified the most severely eroded areas requiring immediate erosion control measures. Hence, the results reveal that about 1.71% of the area is covered under severe erosion risk, 0.13% area under high erosion risk, 0.26% area under moderate erosion risk, 0.27% area under low erosion risk, and 97.63% of the area under very low erosion risk. The accuracy of the model was evaluated based on the receiver operating characteristic curves (ROC) and the areas under the curves (AUC). The result showed that this model had an excellent predictive accuracy for soil erosion susceptibility, with AUC values of 0.967. The final produced map will be used as a basis for suggesting a framework that can help make practical policy recommendations to fight against erosion in the context of sustainable management of the watershed. [ABSTRACT FROM AUTHOR]

Background: Objective structured clinical examination (OSCE) is well‐established and designed to evaluate students' clinical competence and practical skills in a standardized and objective manner. While OSCEs are widespread in higher‐income countries, their implementation in low‐resource settings presents unique challenges that warrant further investigation. Aim: This study aims to evaluate the perception of the health sciences students and their educators regarding deploying OSCEs within the School of Health Sciences and Techniques of Sousse (SHSTS) in Tunisia and their efficacity in healthcare education compared to traditional practical examination methods. Methods: This cross‐sectional study was conducted in June 2022, focusing on final‐year Health Sciences students at the SHSTS in Tunisia. The study participants were students and their educators involved in the OSCEs from June 6th to June 11th, 2022. Anonymous paper‐based 5‐point Likert scale satisfaction surveys were distributed to the students and their educators, with a separate set of questions for each. Spearman, Mann–Whitney U and Krusakll–Wallis tests were utilized to test the differences in satisfaction with the OSCEs among the students and educators. The Wilcoxon Rank test was utilized to examine the differences in students' assessment scores in the OSCEs and the traditional practical examination methods. Results: The satisfaction scores were high among health sciences educators and above average for students, with means of 3.82 ± 1.29 and 3.15 ± 0.56, respectively. The bivariate and multivariate analyzes indicated a significant difference in the satisfaction between the students' specialities. Further, a significant difference in their assessment scores distribution in the practical examinations and OSCEs was also demonstrated, with better performance in the OSCEs. Conclusion: Our study provides evidence of the relatively high level of satisfaction with the OSCEs and better performance compared to the traditional practical examinations. These findings advocate for the efficacy of OSCEs in low‐income countries and the need to sustain them. [ABSTRACT FROM AUTHOR]

Background: It has become increasingly clear that SARS-CoV-2 infection can lead to persistent physical and mental health problems lasting weeks or months, requiring prolonged periods of clinical care and increasing the burden on the healthcare system. This phenomenon, known as post COVID-19 syndrome (PCS), is a relatively new condition, its incidence is still unclear and differs between studies. Objectives: In this cohort study, we aimed to estimate the incidence of PCS and to identify its risk factors in the Tunisian population. Methods: This is a prospective cohort study that enrolled patients diagnosed with COVID-19 from the triage unit of the University Hospital of Monastir, Tunisia. between April 2021 and June 2022. Patients were contacted by phone for a follow-up evaluation of PCS 12- weeks after the diagnosis date. Results: A total of 1451 individuals diagnosed with COVID-19 during the study period, responded to the follow-up evaluation after 3 months. The incidence of PCS was found to be 44.03% (95% CI [41.47; 46.58]), with fatigue being the most common symptom (21.5%), followed by cognitive impairment (10.3%), including memory loss and difficulty concentrating. Multivariate analysis revealed that the main associated factors to PCS were female gender (RR = 1.54; CI95% [1.30 - 1.82]), pre-existing comorbidities (RR = 1.30; CI95% [1.10 - 1.52]), duration of acute COVID-19 illness (days) (RR = 1.02; CI95% [1.01 - 1.03]), hospitalization (RR = 1.27; CI95% [1.05 - 1.53]), number of COVID-19 episodes (RR = 1.46; CI 95% [1.28 - 1.67]) and patients having receive two or more doses of vaccine prior to COVID-19 infection (RR = 0.82; CI95% [0.70 - 0.96]). Conclusion: Our study allowed to estimate the incidence and identify risk factors of PCS. Recognizing these factors could help to better understand the underlying mechanisms and guide interventions for prevention and management of this condition. [ABSTRACT FROM AUTHOR]

The present paper highlighted the occurrence of Timarcha turbida (Erichson 1841) as an artichoke pest for the first time in Tunisian crops. In fact, Timarcha was never be reported previously to develop on a Compositae (Asteraceae) host plant. Here, larva and adult stages of the pest are described and host plants affinities in genus Timarcha are discussed. [ABSTRACT FROM AUTHOR]

Introduction: Resistance to carbapenems in Enterobacteriaceae is a challenge for public health. Carbapenemase production is the leading mechanism. This work aims to evaluate four phenotypic methods for carbapenemase detection in comparison with a molecular method. Materials and Methods: Thirty-seven nonrepeating Enterobacteriaceae strains with decreased susceptibility to ertapenem were included. Imipenem MIC, Modified Hodge Test (MHT), Neo-Rapid Carb Kit® and KPC, MBL, and OXA-48 Confirm Kit® were performed. Isolates were tested for blaOXA-48, blaNDM, and blaVIM genes by end-point polymerase chain reaction. The results of the molecular study were used as a reference test to determine the performances of the phenotypic tests. Results: Imipenem resistance does not seem to be a good marker for carbapenemase production with a sensitivity of 54% (95% CI: 38–71). MHT showed 82% sensitivity (95% CI: 65–91). Overall, the enzymatic test showed the best performances for carbapenemase detection with 100% sensitivity (95% CI: 89–100) and the best turnaround time. The characterization of carbapenemases classes by the combined discs test demonstrated 88% overall sensitivity (95% CI: 72–95). Conclusion: The results of this study support the combination of the enzymatic and the combined disc tests for carbapenemase detection in Enterobacteria. [ABSTRACT FROM AUTHOR]

Degradation of water quality is an emerging issue in many developing countries. In this context, industrial and domestic effluents heavily contaminate the coast of Moknine Continental Sebkha in Tunisia. The present study aimed to biomonitor the seawater quality of the Moknine Continental Sebkha coast using physicochemical and ecotoxicological approaches. The ecotoxicological assessment was performed using three species representing different trophic levels, namely Vibrio fischeri, Selenastrum capricornutum, and Lepidium sativum. In the physicochemical analysis such as BOD (biochemical oxygen demand), COD (chemical oxygen demand), TSS (total suspended solids), TOC (total organic carbon), NO3 ( (nitrate), AOX (adsorbable organic halogen), the recorded levels of pH and total suspended solids did not comply with the Tunisian standard (NT.09.11/1983). The ecotoxicological data confirmed that the tested water samples displayed toxicity to two test indicators L. sativum and S. capricornutum. A targeted chemical screening of the Moknine Continental Sebkha coast previously performed revealed the presence of total mercury, four phthalate acid esters, and one non-phthalate plasticizer, a fact that could explain the observed ecotoxicological effects and therefore might harm the biotic area and the health of the surrounding population. [ABSTRACT FROM AUTHOR]

Mining activities have a positive impact on the global economy by increasing the socio-economic impact of the country's economic growth. However, they pose a high environmental risk of damaging sediments, and aquatic ecosystems by accumulating potentially toxic elements. Located in northern Tunisia, Oued Kasseb is one of the outlets of the Medjerda River, Tunisia's main watercourse and a major source of irrigation and drinking water. Oued Kasseb is the nearest watercourse to the Pb–Zn mining district of Djebel Hallouf-Sidi Bouaouane, a century-old mine (1890–1986). This study focuses on evaluating the spatial distribution of heavy metals (arsenic (As), cadmium (Cd), chromium (Cr), copper (Cu), nickel (Ni), lead (Pb), and zinc (Zn)), their degree of contamination, using pollution indices, and on assessing the ecological and human health risks posed in the Oued Kasseb study area. The obtained heavy metal concentrations were in the following order: Pb > Zn > As > Cr > Ni > Cu > Cd. The spatial distribution shows that relatively high concentrations of metals were found in the vicinity of the Pb–Zn abandoned mine. The geoaccumulation index (I geo), the enrichment factor (EF), the contamination factor (CF), and the potential ecological risk index (RI) showed that the sediments are highly contaminated with As, Cd, Pb, and Zn, especially for sites surrounding the mine. The statistical analysis shows that As, Cd, Cu, and Pb are correlated strongly with Zn and appeared in the first component (F1:70.89%). The noncancerogenic risk revealed that As damages the children whereas it is not harmful to the adult group. The abandoned Pb–Zn mines are therefore the main source of heavy metals in the Oued Kasseb, causing serious environmental pollution and posing significant health risks. [ABSTRACT FROM AUTHOR]

Dental fluorosis (DF) is a prevalent developmental defect of tooth enamel caused by exposure to excessive fluoride, with the severity dependent on various factors. This study aimed to investigate the association between DF and a specific genetic polymorphism (rs412777) in the COL1A2 gene among a Tunisian population. A case-control study was conducted from July to November 2022, involving a total of 95 participants including 51 cases and 44 controls. Dental examinations and genetic analysis were performed to assess the relationship between the COL1A2 gene polymorphism and DF. The results of allelic distribution revealed that A allele carriers were significantly protected against (DF) when compared to those with the C allele (C vs. A, p = 0.001; OR = 0.375 (0.207–0.672)). This suggests a strong correlation between the presence of the C allele and the risk of developing DF. Additionally, significant association between the CC genotype of rs412777 and an increased risk of DF was found under both codominant and dominant genetic models (P = 0.002 and P < 0.001 respectively). The findings suggest that genetic predisposition plays a relevant role in the development of DF. Further research is needed to explore the potential use of genetic markers for DF and their implications for public health. This study provides the first insights into the genetic factors associated with DF in the Tunisian population, contributing to our understanding of this prevalent dental condition. [ABSTRACT FROM AUTHOR]

Extrapulmonary tuberculosis (EPTB) remains a challenging diagnosis. The purpose of this study was to assess the accuracy of Xpert MTB/RIF Ultra (Cepheid, USA) for rapid diagnosis of EPTB in Tunisia. Eight hundred and forty-seven extrapulmonary samples collected from 2017 to 2021, were subjected to Xpert MTB/RIF Ultra. Microscopy and culture were performed for all the specimens. The accuracy of Xpert Ultra was evaluated in comparison to the culture. Xpert Ultra diagnosed EPTB with a global sensitivity of 80.66% (74.3–85.75) and specificity of 70.87% (67.31–74.20). The molecular test was most accurate when performed in cerebrospinal fluids, bones and joints and cutaneous specimens showing a sensitivity of 100% and a specificity ranging from 70.60 to 91.11%. In lymph node samples comprising aspirates and biopsies, the sensitivity of Xpert Ultra was high 87.50% (77.23–93.53), however, the specificity was 51.08% (44.67–57.46). For pleural samples, the Xpert Ultra sensitivity was 77.50% (68.34–84.68) ranging from 71.43 to 80% in pleural biopsies and fluids respectively. The specificity in all pleural specimens was 79.56% (74.40–83.91). Xpert Ultra showed promise in the diagnosis of EPTB. The performances varied according to the site of the disease. The test may be more valuable if used in combination with other diagnostic modalities. [ABSTRACT FROM AUTHOR]

Introduction: Reports around the world indicate that COVID-19 pandemicmay be contributing to an increase in the incidence of new onset diabetic ketoacidosis (DKA). This has yet to be studied in Africa. We aimed to compare the incidence trend of new onset DKA before and during the COVID-19 pandemic, with a focus on the type of diabetes mellitus (DM). Materials and methodsThis was a cross sectional analytical study, over a 4-year period, between March 2018 until February 2022 conducted in the referral center: diabetology department of university hospital Farhat Hached Sousse, Tunisia. The study population included patients hospitalized for new onset DKA divided in two groups: G1: before COVID-19 pandemic and G2: during COVID-19 pandemic. Patients younger than 14, new onset DM not presenting with DKA, other types of diabetes (monogenic, secondary or pancreatic diabetes) were not included. A statistical analysis of the monthly incidence trend was conducted using the Jointpoint software providing the average monthly percentage of change (AMPC). Results: a total of 340 patients were included:137 registered before the pandemic and 203 during the pandemic, representing a 48.17% increase. The mean monthly incidence of new onset DKA during COVID-19 pandemic was statistically higher than that before COVID-19 pandemic (8.42 ± 4.87 vs 5.75 ± 4.29 DKA per month) (p=0.049). The temporal trend of DKA during the 4-year study showed a significant upward trend with a change in AMPC of +0.2% (p=0.037). The incidence of type 1 diabetes (T1D) and type 2 diabetes (T2D) increased by 50% and 44% respectively during COVID-19 pandemic. Anti-glutamic acid decarboxylase (anti-GAD) antibodies' titers significantly increased in G2 compared with G1 (median of 330 [Q1-Q3]=[58.5-1795]vs 92.5[Q1-Q3]=[22.5-1074] respectively)(p=0.021). Discussion: The incidence trend of DKA showed an increase during the COVID- 19 pandemic along with an increase of T1D and T2D implying that the pandemic may have been the underlying factor of this upward trend. [ABSTRACT FROM AUTHOR]

Tuta absoluta (Meyrick) (Lepidoptera: Gelechiidae) is the most destructive pest of tomato worldwide. Biological control has always been considered as a promising management approach of this pest in tomatoes. In this context, we evaluated the effectiveness of releasing Trichogramma cacoeciae Marchal parasitoids or Macrolophus pygmaeus (Rambur) predators in controlling T. absoluta in greenhouse tomatoes of northeastern Tunisia. Two weekly releases of either M. pygmaeus at 1 adult/m2 or T. cacoeciae at 20 adults/plant were assessed. Our results indicated that parasitism rates were significantly higher on the apical tomato leaves compared to the middle leaves. We found that the number of T. absoluta eggs and larvae was significantly reduced after releasing T. cacoeciae, while releases of M. pygmaeus did not significantly reduce T. absoluta densities. The present study demonstrated the great potential of releasing T. cacoeciae in controlling T. absoluta in greenhouse tomatoes of northeastern Tunisia. However, further studies are needed to evaluate other release rates of M. pygmaeus that could show promising effectiveness against T. absoluta in northeastern Tunisian greenhouses. [ABSTRACT FROM AUTHOR]

Background: Genetic variations in TP53 gene are known to be important in chronic lymphocytic leukemia (CLL) and may cause its inactivation which is associated with an aggressive form of the disease. Single nucleotide polymorphism (rs1042522:G>C) in TP53 gene at codon 72 encodes for arginine (Arg) or proline (Pro) variant which results in amino acid substitution affecting the apoptotic potential of TP53 protein. The aim of this study was to assess the correlation between TP53 codon 72 polymorphism and risk susceptibility as well as severity of CLL among Tunisian patients. Materials and methods: A case-control study was conducted in Tunisia from February 2019 to November 2021, 160 de novo CLL patients and 160 healthy volunteers matched in age and gender were involved. DNA was extracted from peripheral blood mononuclear cells and the rs1042522 was analyzed using PCR-RFLP. Results: Pro variant was associated with higher susceptibility to CLL than Arg variant (p= 0.023). A significant association was found between Pro variant and prognostic classification of Binet stage C (p= 0.001), low hemoglobin level (p= 0.003) and low platelet count (p= 0.016). Conclusion: We suggest that Pro variant may increase the risk of developing CLL in our population and could be associated with the severity of the disease. [ABSTRACT FROM AUTHOR]

Introduction: Increasing access to healthcare for expectant mothers is a national goal. In Monastir, Tunisia, some Peripheral Maternity Units (PMUs) required assessment. Our goals were to describe the delivery activities in MUs (maternity units) and to assess whether some of PMUs need to have their activities replaced. Method: We analyzed aggregate data of deliveries in Monastir from 2015 to 2020. The gouvernorate's seven public MUs were included. Only the morning activity was allotted for obstetricians and gynecologists, in RMUs 1 and 2, whereas they were not available in all PMUs. Data was gathered from the reports of the National Perinatal Program. Both the availability of Comprehensive Essential Obstetric Care (CEOC) and Basic Essential Obstetric Care (BEOC) were calculated. Trends were calculated using Joinpoint software. The Annual Percent Change (APC) was calculated. Results: The number of births decreased from 2015 to 2020 (APC= -4.3%: 95%CI : -6; -2.4; p = 0.003). The largest significant decreases in APCs of deliveries were reported in PMU 2 (APC = -12.6% (95%CI : -20; -4.4; p = 0.014), in PMU 3 (APC = -29.3% (95%CI : -36.5; -21.4; p = 0.001), and in PMU 4 (APC = -32.9% (95%CI: -49.1; -11.5); p = 0.016). If PMU 3 and 4 were no longer operating as maternity facilities, BEOC and CEOC standards would still be adequat. For accessibility, both PMU 3 and PMU 2 are accessible from PMU 4 and PMU 1, respectively. Conclusions: Pregnant women prefer to give birth in obstetric services with ability to perform emergency caesarean at the expense of PMU. Nowadays, it appears that accessibility is less important than the presence of qualified human resources when a pregnant woman choose a maternity hospital. [ABSTRACT FROM AUTHOR]

Drivers occupy a workstation that require safety measures. The objective of this paper was to assess the causes of occupational unfitness of professional drivers. This is a descriptive, retrospective study covering all cases of drivers sent for an evaluation of their fitness to work, carried out in the Department of occupational medicine at Farhat Hached teaching hospital in Sousse, from January 1st, 2008, until December 30th, 2020. 155 drivers were enrolled in this study. Most drivers drove buses (52.3%), 26.5% were diabetic, 29% had ophthalmological pathologies and 36.8% had chronic lower back pain. Seventy-four percent were defined unfit. Subjects over 50-years-old (p=0.034; OR = 2.45; 95% CI [1.05-5.71]), high job seniority (p=0.015; OR= 1.71; 95% CI [-7.60-0.81]), cardiac pathology (p=0.022; OR = 7.7; 95% CI [1.0-59.5]) and right and left single ocular visual acuity ≤ 5/10 (p=0.008; OR = 10.43; 95% CI [1.31-82.91] and p<10-3; OR = 17.51; 95% CI [2.23-137.5]) were significantly associated with a decision of unfitness. Regular medical surveillance of drivers is necessary and allows early detection of any deterioration in health that may constitute a contraindication to professional driving. [ABSTRACT FROM AUTHOR]

Purpose: The implementation of monetary policy by the central bank is an ongoing topic of discussion. This paper aims to explore monetary policy transmission shocks in times of uncertainty using the new World uncertainty index (WUI). The authors investigate the impact of crises, wars and pandemic shocks on selected macroeconomic variables. Design/methodology/approach: The authors use unit root tests, structural vector autoregressive model and the Granger causality test according to Toda–Yamamoto with quarterly data over 1999–2022. Findings: The results of this study show that in the short run, there is a unidirectional relationship between the money market rate and WUI, while the relationship between the latter and the money supply (M2) is bidirectional. The short-term effect runs from WUI to inflation. In the long run, the variance decomposition shows that global uncertainty explains around 12% of inflation pressures. The uncertainty caused by special events in the world creates positive shocks on inflation in Tunisia, which decreases the ability of the central bank to control inflation. Research limitations/implications: The results have implications over necessary and urgent actions to be implemented for a progressive economic recovery but point to a necessary transition to an inflation-targeting regime. Originality/value: Examining monetary policy under uncertainty is a recent phenomenon. The authors purposely use a novel WUI by Ahir et al. (2022) that is unexploited in literature. [ABSTRACT FROM AUTHOR]

Background: Healthcare workers (HCWs) are highly vulnerable to compassion fatigue (CF), which not only leads to decreased mental and physical health, but also to deterioration in the safety of care delivered. Our study aims to measure compassion satisfaction (CS), CF levels and their predictors among Tunisian HCWs. Methods: We conducted a cross-sectional study among HCWs caring for confirmed and suspected Covid-19 patients, staff at two university hospitals in Sousse, Tunisia during the 4thwave of coronavirus through a self-administrated Questionnaire, using the French version of the Professional Quality of Life scale ProQol, version 5. Results: A total of 274 professionals were recruited with a mean age of 32.87±8.35 years. HCWs tend to have an overall moderate levels of compassion satisfaction, secondary traumatic stress and burnout with mean scores 35.09±7.08, 29.72±7.62, 28.54±5.44 respectively. Self-reported resilience (β = 0.14, p = 10−3), work engagement (β = 0.39, p = 10−3) and burnout (β = -0.32, p = 10−3) were the predictors of compassion satisfaction in the linear regression analysis (adjusted r2 = 0.45). Similarly, limited work experience, compassion satisfaction and secondary traumatic sub-scores were the determinants of burnout (β = -0.1, p = 0.04; β = -0.54, p = 10−3; β = 0.35, p = 10−3 respectively); (adjusted r2 = 0.48). Regarding STS, female professionals (β = 0.20, p = 10−3), being married (β = 0.19, p = 10−3), the fear of transmitting the infection (β = 0.11, p = 0.03) and burnout (β = 0.39, p = 10−3) were the predictors for the occurrence of secondary traumatic stress (adjusted r2 = 0.48). Conclusion: More resilience promoting interventions and more coping skills programs must be implemented to fulfill HCWs' psychological well-being needs. [ABSTRACT FROM AUTHOR]

Background: Bullying is a serious problem that significantly affect adolescent well-being and health, needing the attention of teachers, school administrators, parents and public health professionals. In this study, we aimed at estimating the prevalence of bullying, from the perspective of victims in middle school students in the region of Monastir Tunisia, as well as analyzing its association with individual and family context variables. Methods: This is a cross-sectional study conducted in December 2017 and January 2018 among a sample of students from two middle schools in the region of Monastir (Tunisia), using the Global School-based Student Health Survey (GSHS) self-answered questionnaire. We defined bullying victimization as being bullied in at least one day in the previous 30 days. Binary logistic regression model was used to identify factors associated with being bullied. Results: Out of 802 students included in this study, nearly half (43.4%) reported having been bullied in the past month with CI 95%: 38.9–48.2. Gender did not interact with this behavior: (44.5%; CI 95%: 38.1–51.7) in boys versus (43.4% ; CI 95%: 37.2–50.2) in girls. Univariate analysis indicated significant differences regarding some individual factors such as physical fight, cigarette smoking, feeling lonely and being worried, in terms of prevalence of being bully victims. There were no significant differences in parental factors between the two groups (being bullied or not). Multivariate analysis showed the following factors as independently associated with bullying: being involved in physical fight (OR = 2.4; CI95%:1.77–3.25), feeling lonely (OR = 3.38; CI95% :2.04–5.57) and being worried (OR = 2.23; CI 95%:1.44–3.43). Conclusion: Bullying victimization was common among school-going adolescents and was linked with physical fight and psychosocial distress. This study highlights the need for school-based violence prevention programs to address this problem among the students. [ABSTRACT FROM AUTHOR]

Background: The emergence and the spread of coronavirus disease (COVID-19) induced by the SARS-CoV-2 virus has multiple consequences in all countries around the world. Male germ cells of infertile patients which are shown to be vulnerable to many environmental conditions, could be particularly vulnerable to such an exceptional pandemic situation. We aimed through the current study to investigate the potential variations in sperm quality of infertile patients during the COVID-19 pandemic in Tunisia. Methods: This was a cohort study including 90 infertile patients addressed to Laboratory of Cytogenetics and Reproductive Biology of Monastir Department of Maternity and Neonatology in Monastir, during the two first COVID-19 waves in Tunisia and who already have a spermogram before the pandemic period. Results: We have pointed out a significant decrease in both total and progressive sperm motility during COVID-19 pandemic (p<0.0001 and p = 0.001 respectively). The percentage of morphologically abnormal spermatozoa increased from 90.99±7.38 to 93.67±4.55% during the pandemic (p< 0.001). The remaining sperm parameters were similar between the two compared timepoints. Interestingly, the univariate analysis didn't show any other associated factor to the observed impairment in sperm mobility and morphology. Conclusion: These data highlight the severe impact of the pandemic of the male reproductive health of hypofertile patients. Delaying infertility investigations and management after pandemic waves is recommended to hope a better gamete quality and hence to improve conception potential. [ABSTRACT FROM AUTHOR]

Some morphological features of Dacus ciliatus (Loew) reported for the first time in Tunisia were studied herein. Also during this study, the efficacy of food attractants and attract-and-kill devices were tested against D. ciliatus. To do so, McPhail® traps baited with diammonium phosphate (DAP©) and protein hydrolysate (Ceratrap©), already known as food attractants for fruit flies, were compared in zucchini and cucumber crops. A novel attract and kill system (Ceranock© female and male) was also applied in the two cited crops. Moreover, our data highlighted the usefulness of DAP© as effective food attractant with a high number of trapped adults compared to Ceratrap© baited traps. Few adults were recorded by Ceratrap© only in Zucchini treated crop 1 (0.42±0.49 and 0.28±0.69 respectively for males and females) compared to the other surveyed crops. Attract and kill system achieved good control of the pest by decreasing the number of captured flies in treated crops compared to the untreated crops. The use of attract and kill system showed promising results and can successfully be used to manage the lesser pumpkin fly in Tunisian cucurbit crops. [ABSTRACT FROM AUTHOR]

Background: Musculoskeletal disorders are one of the most common occupational health problems and one of the leading causes of temporary disability. This study aimed to assess the biomechanical constraints of upper limb musculoskeletal disorders associated with Tunisian weavers' tasks. Methodology: An ergonomic approach was adopted with a representative sample of Tunisian weavers. First, the activity was observed mainly for identifying tasks and sub-tasks. Then, the biomechanical constraints were assessed based on the Borg scale and the software analyses and encoding of the 2,000 images extracted from the activity video recordings. These analyses were done with the ERGOROM software. Results: Four main tasks were identified (warping of the loom, weaving itself, beating up, and finishing). As for the subtasks, the six most important were thread coiling, shedding and picking, beating up the weft, knotting, cutting, and shearing. Semi-quantitative analysis revealed that weavers spent most of their working time in the constrained neck and upper limb postures. Shoulders were in flexion/abduction during 68.6% of the activity and pinch grip was spread over 83.3% of the working time. Furthermore, elbows and wrists were highly concerned by elevated gestural variability scores. The estimated deployed strength was "medium" to "strong" in 50% to nearly 80% of cases. Conclusion: According to the results, in carpet weavers, exposure to biomechanical constraints at risk of musculoskeletal disorders was high for the various joints and parts of the upper limbs. It is, therefore, necessary to carry out interventional studies for the development of ergonomic hand tools and workstations adapted to the traditional weaver activity. [ABSTRACT FROM AUTHOR]

Antimicrobial resistance is one of the most serious threats to human and animal health. Evidence suggests that the overuse of antimicrobial agents in animal production has led to the emergence and dissemination of multidrug-resistant isolates. The objective of this study was to assess the rate of extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli in calf feces and to characterize their resistance genes for antibiotics like beta-lactams and colistin, but also to determine their virulence genes. Fecal samples were collected from 100 diarrheic calves in the region of Bizerte, Tunisia. After isolation, E. coli isolates were screened for antimicrobial resistance against 21 antibiotics by the disc diffusion method. Characterization of β-lactamase genes and determination of associated resistance genes were performed by polymerase chain reaction. Among 71 E. coli isolates, 26 (36.6%) strains were ESBL-producing. Most of these isolates were multidrug-resistant (92.3%) and the most prevalent beta-lactamase genes detected were blaCTX-M (n = 26), blaSHV (n = 11), and blaTEM (n = 8), whereas only 1 isolate carried the blaCMY gene. In addition, resistance to carbapenems was detected in two isolates; one of them harbored both blaOXA-48 and blaIMP genes and the other isolate carried only the blaIMP gene. Several resistance genes were identified for the first time in Tunisia from cases of diarrheic calves. Furthermore, to the best of our knowledge, this is the first report of detection and identification of carbapenem resistance genes and virulence genes from calves in North Africa. A high occurrence of antimicrobial resistance of E. coli recovered from fecal samples of calves with diarrhea was observed, highlighting the need for prudent use of antimicrobial agents in veterinary medicine to decrease the incidence of multidrug-resistant bacteria for both animals and humans. [ABSTRACT FROM AUTHOR]

In this article, I intend to share the experience accumulated from the various stages of my academic life going over twenty years in the context of higher education in Tunisia. I will display, and this is what I do in the beginning of every academic year, my course objectives, methodology, material, student requirements, difficulties, and evaluation with a specific attention to Modernist American poetry. In doing so, i.e., in establishing the goal and the method before the course takes place in class, the itinerary is crystal clear in my mind from beginning to end. Nevertheless, I will unveil that, I have experienced several challenges such as lack of equipment and large groups of students who have become groundbreaking since the Jasmine Revolution of 2011. In addition to dealing with the new generations of students, my mission as a teacher of American Literature embraces developing my knowledge and my professional skills through gaining experience and coordinating with colleagues. From the existing teaching methods, I opted for an interactive communicative approach that involves the majority of students in the learning process. The American Poetry course, in particular, develops thanks to students' interaction with each other and with me. [ABSTRACT FROM AUTHOR]

Plasticizers are compounds often involved in the manufacturing of plastic products. Nevertheless, the ageing of the latter generates plasticizers that generally end up in the marine environment. In fact, marine pollution by phthalate acid esters (PAEs) and their alternatives has become an environmental and health issue of serious concern, as they are largely and ubiquitously present in the environment and aquatic organisms. In the present study, four PAEs, such as diethyl phthalate (DEP), diisobutyl phthalate (DiBP), dibutyl phthalate (DBP), and di(2-ethylhexyl) phthalate (DEHP), and one non-phthalate plasticizer (NPP), namely di-2-ethylhexyl terephthalate (DEHT), are wanted in different marine compartments from the coast of Mahdia in Tunisia such as sediment, seagrass, and mussel. The most abundant and frequently detected congener was DEHT at the concentrations reached 1.181 mg/kg in the sediment, 1.121 mg/kg in the seagrass, and 1.86 mg/kg in the mussel. This result indicates that the DEHT could emerge through the food chain and therefore bioaccumulate in marine compartments. In addition, we noticed that the seasonal variations of plasticizers were seriously affected by environmental factors including industrial and urban discharges. [ABSTRACT FROM AUTHOR]

Background: Burnout syndrome may affect the safety of frontline healthcare care workers (HCW) and patients. We aimed to measure the prevalence of burnout among HCW in care facilities in Tunisia during the Covid-19 pandemic and to identify its associated factors. Methods: We conducted a cross-sectional study among HCW practicing during the covid-19 pandemic in health care facilities in the governorate of Monastir. Data collection was carried out using an anonymous self-administered questionnaire composed by three sections: epidemiological and clinical characteristics, professional conditions and the Maslach Burn out Inventory (MBI-HSS). Results: This study included 371 HCW. The prevalence of burnout was 77.9% (CI 95%: 73.6% - 82.1%). The severe level was found in 71 participants (19.1%), the moderate level in 115 (31%) and the low level in 103 (27.8%). The distribution of the levels of the burnout dimensions among the participants was as follows: high emotional exhaustion (EE) (57.4%), high depersonalization (DP) (39.4%) and low personal accomplishment (22.6%). The main determinants of burnout among healthcare professionals during COVID 19 pandemic were: working more than 6 hours per day (OR = 1.19; CI95% [1.06; 1.34]), physician function (OR = 1.17; CI 95% [1.05; 1.31]), feeling a negative impact of work on family life (OR = 1.40; 95% CI [1.13; 1.73]), and high personal estimation of COVID 19 exposure (OR = 1.15; CI95% [1.02; 1.29]). Conclusion: During the COVID19 pandemic, the prevalence of burnout among health professionals was high. It was related to hard implication in COVID 19 management. Interventions like adjusting working hours, reducing workload, and providing psychological support should be taken. [ABSTRACT FROM AUTHOR]

Simple Summary: The aim of this research was to study the effect of MTNR1A gene polymorphisms on the reproductive performance of two Mediterranean sheep breeds. A total of 26 SNPs were found, and three SNPs caused amino acid changes. Two SNPs were totally linked and correlated with reproductive activity resumption. This study consists of a piece of new useful knowledge for the control of sheep reproductive seasonality and farm management that could improve genetic selection, especially in countries where agriculture relies mainly on sheep farming. Sheep farming plays an important economic role, and it contributes to the livelihoods of many rural poor in several regions worldwide and particularly in Tunisia. Therefore, the steady improvement of ewes' reproductive performance is a pressing need. The MTNR1A gene has been identified as an important candidate gene that plays a key role in sheep reproduction and its sexual inactivity. It is involved in the control of photoperiod-induced seasonality mediated by melatonin secretion. The aim of this study was to identify SNPs in the MTNR1A gene in two Tunisian breeds, Barbarine (B) and Queue Fine de l'Ouest (QFO). DNA extracted from the blood of 77 adult ewes was sequenced. Selected ewes were exposed to adult fertile rams. A total of 26 SNPs were detected; 15 SNPs in the promoter region and 11 SNPs in the exon II were observed in both (B) and (QFO) breeds. The SNP rs602330706 in exon II is a novel SNP detected for the first time only in the (B) breed. The SNPs rs430181568 and rs40738822721 (SNP18 and SNP20 in our study, respectively) were totally linked in this study and can be considered a single marker. DTL was associated with SNP18 and SNP20 in (B) ewes (p < 0.05); however, no significant difference was detected between the three genotypes (G/G, G/A, and A/A) at these two SNPs. Fertility rate and litter size parameters were not affected by SNP18 and SNP20. There was an association between these two polymorphisms and (B) lambs' birth weights (p < 0.05). Furthermore, the ewes with the A/A genotype gave birth to lambs with a higher weight compared to the other two genotypes for this breed (p < 0.05). There was not an association between SNP 18 and SNP20 and (QFO) ewes' reproductive parameters. These results might be considered in future sheep selection programs for reproductive genetic improvement. [ABSTRACT FROM AUTHOR]

(1) Background: Harmful algal blooms (HABs) can negatively impact marine ecosystems, but few studies have evaluated the microbial diversity associated with HABs and its potential role in the fates of these proliferations. (2) Methods: Marine prokaryotic diversity was investigated using high-throughput sequencing of the 16S rRNA gene during the bloom declines of two dinoflagellates detected in the summer of 2019 along the northern and southern Tunisian coasts (South Mediterranean Sea). The species Gymnodinium impudicum (Carthage, Tunis Gulf) and Alexandrium minutum (Sfax, Gabes Gulf) were identified using microscopy and molecular methods and were related to physicochemical factors and prokaryotic compositions. (3) Results: The abundance of G. impudicum decreased over time with decreasing phosphate concentrations. During the G. impudicum bloom decay, prokaryotes were predominated by the archaeal MGII group (Thalassarchaeaceae), Pelagibacterales (SAR11), Rhodobacterales, and Flavobacteriales. At Sfax, the abundance of A. minutum declined with decreasing phosphate concentrations and increasing pH. At the A. minutum peak, prokaryotic communities were largely dominated by anoxygenic phototrophic sulfur-oxidizing Chromatiaceae (Gammaproteobacteria) before decreasing at the end of the survey. Both the ubiquitous archaeal MGII group and Pelagibacterales were found in low proportions during the A. minutum decay. Contrary to the photosynthetic Cyanobacteria, the photo-autotrophic and -heterotrophic Rhodobacterales and Flavobacteriales contents remained stable during the dinoflagellate bloom decays. (4) Conclusions: These results indicated changes in prokaryotic community diversity during dinoflagellate bloom decays, suggesting different bacterial adaptations to environmental conditions, with stable core populations that were potentially able to degrade HABs. [ABSTRACT FROM AUTHOR]

The North-Western Sahara Aquifer System (NWSAS) is a complex multi-layered aquifer system with extraordinary continental groundwater reserves. This largest aquifer in the world straddles three countries: Algeria, Libya, and Tunisia. It contains more than 50,000 billion cubic meters of water; of which 70% is in Algerian territory in the southeast of the country. This water is the result of accumulation over 1 million years. In the Wadi Mya basin (Algeria), this system is characterized by two overlaid aquifer systems: the complex terminal (CT), a shallow aquifer housed in the Senonian-Eocene and Mio-Pliocene formations, and the continental intercalary (CI), a deep aquifer hosted in the Albian, Aptian and Barremian formations. The main purpose of this study is to carry out a correlation between the geochemical composition of the water and the facies of the aquifer formation. The adopted approach will allow deciphering the hydro-chemical relationships between the different levels of the two aquifer systems in the Wadi Mya basin. To acquire the chemical composition of water, the study method goes through a targeted sampling and physicochemical analysis of water followed by a statistical analysis as well as correlation and geochemical modelling: the interpretation of specific diagrams (Piper), correlations between chemical elements in binary graphs, and principal component analysis (PCA). The performed geochemical modelling by examining the saturation index and chemical balance of water helps to better understand the origin of mineralization, elucidate the mixing of waters originating from different aquifers, as well as highlight the relationship between deep and shallow aquifers in the Wadi Mya Basin hydrodynamic conversion. The obtained results indicate that the overall mineralization occurring within the study area is dominated by sodium chloride and calcium chloride-sulfate facies. This can be explained by the dissolution of halite, gypsum, and anhydrite evaporitic rocks, intercalated in the aquifer matrix besides the effects of the extended stay of fossil waters with low recharging and cation exchange reactions resulting from water-rock interactions. The interference recorded between the geochemical signatures of the two aquifers favors the hypothesis of interconnection between aquifers through fractures. Through the implementation of such academic research, this invaluable source of life will stay sustainable for future generations. [ABSTRACT FROM AUTHOR]

• A native xerophyte plant species from the Gulf of Gabes is tolerant to fluoride pollution. • Fluoride pollution impacts plant phenology. • Both biovolume and plant lifecycle chronology are modified under fluoride pollution. Exploring fluoride impacts on species' survival strategies and predicting later pollution effects on community structure is a key question in ecological studies. To address this issue, a field study was conducted during two seasons on fluoride-contaminated soil in southern Tunisia. Gabes was the most polluted site, with almost 1600 ppm. Smara was the reference site, with almost 56 ppm. F accumulations were above the usual background concentrations. Fluorine (F) concentrations in the plant aerial part of Atractilys serratuloides , an arid gypsum-tolerant plant species that is abundant in the surroundings of superphosphate factories in Tunisia, reached around 300 ppm in Gabes. Simultaneously, plant seasonal development (life cycle) monitoring was also carried out to assess the shoot vegetative growth and phenological stages of Atractilys serratuloides under fluoride pollution. Earlier reproduction events (flowering and fructification) were detected at the expense of reduced shoot vegetative growth of this species in both polluted sites, especially in the summer season. This strategy may enhance A. serratuloides ' earlier achievement of its reproduction stage and thus fosters its chance of colonizing the F-enriched soils in the factories' surroundings. [ABSTRACT FROM AUTHOR]

The genes of the major histocompatibility complex (MHC) are among the best candidates for studying adaptive variation driven often by pathogen-mediated selection. However, diversity of these genes might be differently shaped by selective and non-selective evolutionary mechanisms. In this study, we assessed the spatial distribution of MHC class II DRB exon 2 gene diversity in hares from Tunisia (Lepus capensis) across a steep ecological gradient and tried to disentangle the driving mechanisms shaping the observed diversity. We also compared the current data with previous results from the MHC class II DQA and DQB loci of the same individuals. We found a relatively high level of diversity and spatial differentiation similar to that observed earlier for DQA and DQB. We also detected clear evidence of positive selection acting on the DRB gene. Nevertheless, recombination was considered as a more important process shaping the evolution of the DRB locus. Our information theory-based models revealed statistically meaningful climate effects on the occurrence of some alleles (i.e., protein variants), regardless of their geographical distribution patterns, supposedly reflecting adaptation to spatial pathogen variation. [ABSTRACT FROM AUTHOR]

Health care delivery continues to be unsafe despite major patient safety (PS) improvement efforts over the past decade. Medical school education plays an important role in promoting this culture during initial training. To determine undergraduate medical students' attitudes toward PS at a Tunisian medical school. We carried out a cross-sectional study among undergraduate medical students at Ibn Al Jazzar Medical School in Sousse, Tunisia, using a self-administered questionnaire inspired from the valid tool: Attitudes to Patient Safety Questionnaire (APSQ III). A total of 178 medical students responded to the questionnaire. Medical students tend to have an overall positive perceptions of PS culture with a global mean score 5.33 ± 0.5. Among the individual domains 'Working hours as a cause of error' earned the highest score (6.38 ± 1.0) followed in order by 'Team functioning' (6.24 ± 0.8), 'Error inevitability' (5.91 ± 1.0) and 'Patient involvement in reducing error' (5.50 ± 1.0). The lowest score was for 'Professional incompetence as a cause of error' (4.01 ± 1.0). A PS domain's mean scores comparison based on socio-demographic variables: gender, age, academic year and on PS training revealed a statistically significant difference (p < 0.05) for five PS key dimensions: ' Error reporting confidence ', ' Working hours as a cause of error ', ' Professional incompetence as a cause of error ', ' Team functioning ' and 'PS training received'. Tunisian medical students showed positive attitude towards PS. Nevermore, intensive in terms of frequency and duration sessions, based on various teaching methods may be needed to fulfill students' educational needs. [ABSTRACT FROM AUTHOR]

Background: Actually, no data on the prevalence of plasmid colistin resistance in Tunisia are available among clinical bacteria. Objectives: This study aimed to investigate the current epidemiology of colistin resistance and the spread of the mcr gene in clinical Gram-negative bacteria (GNB) isolated from six Tunisian university hospitals. Methods: A total of 836 GNB strains were inoculated on COL-R agar plates with selective screening agar for the isolation of GNB resistant to colistin. For the selected isolates, mcr genes, beta-lactamases associated-resistance genes and molecular characterisation were screened by PCRs and sequencing. Results: Colistin-resistance was detected in 5.02% (42/836) of the isolates and colistin-resistant isolates harboured an ESBL (blaCTX-M-15) and/or a carbapenemase (blaOXA-48, blaVIM) encoding gene in 45.2% of the cases. The mcr-1 gene was detected in four E. coli isolates (0.59%) causing urinary tract infections and all these isolates also contained the blaTEM-1 gene. The blaCTX-M-15 gene was detected in three isolates that also carried the IncY and IncFIB replicons. The genetic environment surrounding the mcr-carrying plasmid indicated the presence of pap-2 gene upstream mcr-1 resistance marker with unusual missing of ISApl1 insertion sequence. The Conclusions: This study reports the first description of the mcr-1 gene among clinical E. coli isolates in Tunisia and provides an incentive to conduct routine colistin susceptibility testing in GNB clinical isolates. [ABSTRACT FROM AUTHOR]

Post-COVID19 patients suffer from persistent respiratory, cardiovascular, neurological, and musculoskeletal health complaints such as dyspnea, chest pain/discomfort, and fatigue. In Tunisia, the potential benefits of a cardiorespiratory rehabilitation program (CRRP) after COVID19 remain unclear. The main aim of this study was to evaluate the impact of a CRRP on submaximal exercise capacity, evaluated through the 6-min walk test (6MWT) data in post-COVID19 Tunisian patients. This was a cross-sectional study including 14 moderate to severe COVID19 patients aged from 50 to 70 years. CRRP was performed after the end of patients’ hospitalization in COVID19 units for extensive or severe extents of COVID19. Dyspnea (modified medical research council), spirometry data, handgrip strength values, 6MWT data, and 6-min walk work (i.e., 6-min walk distance x weight) were evaluated 1-week pre-CRRP, and 1-week post-CRRP. CRRP included 12 sessions [3 sessions (70 min each)/week for 4 weeks]. Exercise-training included aerobic cycle endurance, strength training, and educational sessions. Comparing pre- and post- CRRP results showed significant improvements in the means±standard deviations of dyspnea by 1.79 ± 0.80 points (p < 0.001), forced expiratory volume in one second by 110 ± 180 ml (p = 0.04), 6-min walk distance by 35 ± 42 m (p = 0.01), 6-min walk work by 2,448 ± 3,925 mkg (p = 0.048), resting heart-rate by 7 ± 9 bpm (p = 0.02) and resting diastolic blood pressure by 6 ± 10 mmHg (p = 0.045). In Tunisia, CRRP seems to improve the submaximal exercise capacity of post-COVID19 patients, mainly the 6-min walk distance and work. [ABSTRACT FROM AUTHOR]

Background: Healthcare workers (HCWs) are at high risk of hepatitis C virus (HCV) infection. Indeed, they are exposed to blood and body fluid which put them at an important risk of transmission of various blood borne pathogens including HCV. The goal of this study was to determine the magnitude of occupational exposure to hepatitis C virus infection as well as the factors associated to this exposure among HCWs at a Tunisian University Hospital in 2017. Methods: A hospital-based cross-sectional study was carried out at Fattouma Bourguiba University Hospital in Monastir Governorate (Tunisia) from 01 June 2017 to 31 August 2017. Data were collected using an anonymous questionnaire. To determine factors associated with occupational exposure to hepatitis C virus infection, we performed multivariate analysis. Results: Among the 1493 included participants, more than half (56.7) had at least one exposure to blood or body fluid. A history of needle stick injury was reported by 48.3% of the respondents. Exposure to blood or body fluid splash into the face was announced by 32.1% HCWs. Doctors had the highest risk of exposure (AOR = 12.425; 95% CI: [05.310–29.075]). Participants working at surgical departments were the most exposed comparing to workers at others departments (AOR = 7.440; 95% CI: [4.461–12.408]). Two exposed female HCWs were tested positive corresponding to a HCV infection prevalence of 0.13% (95% IC: [0.11–0.16%]). Conclusion: Occupational exposure to hepatitis C virus infection was high at the university hospital of Monastir. Despite the low magnitude of HCV infection, preventive actions should be taken to promote the safety of health care personnel. [ABSTRACT FROM AUTHOR]

This study aimed to improve the effectiveness of Thymus capitatus and Thymus algeriensis essential oils (EOs), as food preservatives, through their encapsulation in different delivery systems (DSs), namely nanoemulsions and biopolymeric nanoparticles. DSs' preparation is tailored to enhance not only physical stability but also resulting Eos' antioxidant and antibacterial activities through different fabrication methods (high-pressure homogenization emulsification or antisolvent precipitation) and using different emulsifiers and stabilizers. DSs are characterized in terms of droplet size distribution, ζ-potential, and stability over time, as well as antioxidant and antibacterial activities of encapsulated EOs. The antioxidant activity was studied by the FRAP assay; the antibacterial activity was evaluated by the well diffusion method. EOs of different compositions were tested, namely two EOs extracted from Thymus capitatus, harvested from Tunisia during different periods of the year (TC1 and TC2), and one EO extracted from Thymus algeriensis (TA). The composition of TC1 was significantly richer in carvacrol than TC2 and TA. The most stable formulation was the zein-based nanoparticles prepared with TC1 and stabilized with maltodextrins, which exhibit droplet size, polydispersity index, ζ-potential, and encapsulation efficiency of 74.7 nm, 0.14, 38.7 mV, and 99.66%, respectively. This formulation led also to an improvement in the resulting antioxidant (60.69 µg/mg vs. 57.67 µg/mg for non-encapsulated TC1) and antibacterial (inhibition diameters varying between 12 and 33 mm vs. a range between 12 and 28 mm for non-encapsulated TC1) activities of EO. This formulation offers a promising option for the effective use of natural antibacterial bioactive molecules in the food industry against pathogenic and spoilage bacteria. [ABSTRACT FROM AUTHOR]

Background: Since 2012, few reports on the molecular epidemiology of Pseudomonas aeruginosa were reported in Tunisia. Objectives: This study aimed to evaluate carbapenem-resistance determinants and molecular epidemiology and to compare the carbapenemase-phenotypic detection methods of multidrug-resistant P. aeruginosa isolates. Methods: During a period of four years (2014 to 2017), all imipenem-ceftazidime-resistant P. aeruginosa isolates were retrospectively selected at the microbial laboratory of Charles Nicolle hospital of Tunis. These isolates were examined by the modified Hodge test, modified carbapenem inactivation method (mCIM), and another mCIM, called CIMTris, and their performance was evaluated using PCR analysis as the gold standard. Results: A total of 35 isolates were recovered among patients hospitalized in different units. All strains were colistin-susceptible.All carbapenem-resistant isolates showed a high-level resistance to carbapenems. CIMTris and mCIM showed 96.15% and 46.15% sensitivity and 44.44% and 100% specificity, respectively, for detecting carbapenemase production.Conclusions: CIMTris is a promising approach for detecting carbapenemase activity in P. aeruginosa and merits further testing. Moreover, this study described the first detection of GES-5- and GES-9-producing P. aeruginosa in Tunisia as well as the co-occurrence of the blaGES-5 and blaVIM-11 carbapenemase genes in one isolate. These findings are of great concern because the rapid dissemination of MDR strains represents a major therapeutic and epidemiological threat. [ABSTRACT FROM AUTHOR]

Background: The baculovirus Spodoptera littoralis nucleopolyhedrovirus (SpliNPV) is an entomopathogenic virus utilized as a biological control agent of the Egyptian cotton leaf worm, Spodoptera littoralis. Several studies have focused on the identification of different SpliNPV isolates from a biological and molecular point of view, but few of them conducted in-depth analyses of the genomic composition of these isolates. Results: Identification of a novel isolate of SpliNPV, termed Tun2, which was purified from infected S. littoralis larvae from Tunisia was reported. This isolate was propagated in vivo and its median lethal concentration (LC50) was determined to be 1.5 × 104 occlusion bodies (OBs)/ml for third instar S. littoralis larvae at 7 days of post-infection. OB production in late fourth instar larvae was estimated to be at least 2.7 × 109 OBs/g larval weight. The completely sequenced genome of SpliNPV-Tun2 was 137,099 bp in length and contained 132 open reading frames (ORF). It showed a 98.2% nucleotide identity to the Egyptian isolate SpliMNPV-AN1956, with some striking differences; between both genomes, insertion and deletion mutations were noticed in 9 baculovirus core genes, and also in the highly conserved polyhedrin gene. The homologs of ORF 106 and ORF 107 of SpliNPV-AN1956 appeared to be fused to a single ORF 106 in SpliNPV-Tun2, similar to the homologous ORF 110 in SpltNPV-G2. Conclusion: SpliNPV-Tun2 is proposed as a new variant of SpliNPV and a potential candidate for further evaluation as a biocontrol agent for S. littoralis and probably other Spodoptera species. [ABSTRACT FROM AUTHOR]

Agricultural activities have become a major source of groundwater nitrate contamination. In this context, this study aims to analyse nitrate concentrations in a shallow aquifer of Mahdia-Kssour Essef in central-eastern Tunisia, identify the assignable sources, and predict the future levels using artificial neural network (ANN) and autoregressive integrated moving average (ARIMA) models. The results showed that nitrate concentrations measured in 21 pumping wells across the plain ranged from 17 to 521 mg L−1. A total of 67% of the monitoring points greatly exceed the standard guideline value of 50 mg L−1. The main relevant anthropogenic and natural factors, such as soil texture, land use, fertilizers application rates, livestock waste disposal, and groundwater table, are positively correlated with groundwater nitrate concentration. The ANN model showed good fitting between measured and simulated results with coefficient of determination (R2), root-mean-square error (RMSE), and mean absolute error (MAE) values of 0.88, 53.95, and 39.64, respectively. The ARIMA applied on annual average nitrate concentrations from 1998 to 2017 revealed that the best fitted model (p, d, q) is (1, 2, 1). The R2 value is approximately 0.36, and the Theil inequality coefficient and bias proportion values are small and close to zero. These results proved the ARIMA model's adequacy in forecasting annual average nitrate concentrations of 116 mg L−1 in 2025. These findings may be useful in making groundwater management decisions, particularly in rural and semi-arid areas, and the proposed ARIMA model could be used as a managed tool to monitor and reduce the nitrate intrusion into groundwater. [ABSTRACT FROM AUTHOR]

This work presents the volatile compounds and phenolic profile investigation of the leaves of Brassica oleracea L. growing in Tunisia, together with antioxidant and antibacterial properties. Volatile constituents were determined by HS-SPME coupled to GC/MS, and the results showed that α-pinene (31.6%) and limonene (16.9%) were the main volatiles. The phenolic profile was determined by HPLC analysis, the methanol extract revealed the presence of four hydroxycinnamic acids (chlorogenic, ferulic, p-coumaric and sinapic acids), two hydroxybenzoic acids (syringic and gallic acids), and four flavonoids (catechol, catechin hydrate, epigallocatechin and epicatechin 3-O-gallate). The methanol extract showed the best significantly antiradical activity by DPPH (2,2-diphenyl-1-picrylhydrazyl) and ABTS ((2,2'-azino-bis(3-ethylbenzothiazoline-6-sulfonic acid)) antioxidant assays, with EC50 of 0.32 and 0.45 mg/mL, respectively. For antibacterial activity, the methanol extract inhibits all the tested strains. It can be concluded that kohlrabi leaves are rich in bioactive compounds and are a potential source of natural antioxidants and antibacterials. [ABSTRACT FROM AUTHOR]

Nanopesticides are novel formulations that can be applied against a wide range of insect pests as a sustainable alternative to less effective chemical pesticides. Here, acute toxicity of nano (abamectin-PLA-NS (1%) and abamectin-PLA-NS (0.1%)) and commercial formulations of abamectin was evaluated against the South American tomato pinworm, Tuta absoluta, in laboratory and open-field conditions in northeastern Tunisia. Additionally, side effects of nano and commercial formulations of abamectin were also investigated towards the two predatory mirids Macrolophus pygmaeus and Nesidiocoris tenuis either under laboratory or open-field conditions. Laboratory results of acute toxicity revealed no differences between the tested abamectin formulations (against T. absoluta larvae. LC50 values were 0.28, 0.23, and 0.23 for abamectin EC; 0.30, 0.18, and 0.18 for abamectin-PLA-NS (1%) and 0.57, 0.28, and 0.25 for abamectin-PLA- NS (0.1%) corresponding to three time intervals (24, 72 and 120 h after treatment). Abamectin EC, abamectin-PLA-NS (1%) and abamectin-PLA-NS (0.1%) applied at higher doses (0.6 mL/L and 1.2 mL/L) showed higher efficacy percentages (> 90%) in controlling T. absoluta larvae, fourteen days after treatment in open-field tomatoes. Commercial abamectin formulation showed higher toxicity toward M. pygmaeus adults and N. tenuis nymphs compared to nano formulations applied at the two aforementioned doses. High mortality rates, reaching 100%, were reported for M. pygmaeus adults exposed to 1 and 3 day-old residues for commercial formulation at 0.6 mL/L and 1.2 mL/L in laboratory conditions. However, in open-field tomatoes, low acute toxicity was induced by abamectin-PLA-NS (0.1%), ranging from 25 to 41.17%, compared to abamectin EC, ranging from 58.33 to 94.11%, and abamectin-PLA-NS (1%), ranging from 58.33 to 76.47%, at 0.6 mL/L against N. tenuis nymphs at apical leaves. For middle leaves, only abamectin-PLA-NS (0.1%) applied at 0.3 mL/L did not show significant toxicity against N. tenuis nymphs with low mortality level up to 7%, fourteen days after treatment. The practical implications of these results for enhancing integrated pest management programs of T. absoluta in tomatoes are discussed herein. [ABSTRACT FROM AUTHOR]

Cultivating cereals in monoculture systems contributes to the decrease in grain yield and quality. Currently, under Mediterranean climate conditions of Tunisia, wheat mono-cropping covers more than 70% of cereal areas. In order to reveal the impact of this practice on cereal productivity, five improved durum wheat cultivars (Karim, Khiar, Om Rabiaa, Razzek, and Maali) were conducted under two conditions of previous wheat crop: one-year wheat previous crop (W) and two successive years (W-W). Then, they were assessed for grain yield (GY), yield components (NKS, TKW, NS), straw yield, harvest index (SY, HI), and grain quality parameters during three consecutive cropping seasons (2017, 2018, and 2019). The results showed significant effects of cropping season for all measured parameters, except thousand kernel weight (TKW). A significant effect (p < 0.05) of Pre-Crop was observed on yield components. However, grain yield (GY) was improved after one-year wheat Pre-Crop (W) (4082.3 kg ha−1) more than after two years (W-W) (3277.3 kg ha−1). Our results show that, based on the three-year experiment, almost all yield related traits were significantly affected by the genotype except HI and NS. The highest GYs were recorded for Om Rabiaa (4010.4 kg ha−1) and Nasr (3765.76 kg ha−1). All grain quality was significantly (p < 0.05) affected by cropping season, but only gluten content (GC) and vitreousness aspect (Vit A) were affected by genotype. On the other hand, the Pre-Crop W-W decreased grain protein concentration (GPC) (12.13%) and GC (22.14%) but no significant effect was observed on the Vit A of grain in our study. Furthermore, GY was positively correlated with HI (r = 0.64), NKS (r = 0.59), SN (r = 0.49), GPC (r = 0.23), and GC (r = 0.23). According to stability analysis, the Karim cultivar is the most stable genotype in wheat mono-cropping for GY and straw yield (SY). Altogether, this study provides useful information for farmers on how to produce a satisfactory yield for durum wheat cultivation under mono-cropping wheat conditions in the sub-humid environment of the Mediterranean climate of Tunisia. [ABSTRACT FROM AUTHOR]

This study aims to analyse Tunisian farmers' ability to pay (ATP) in a citrus area and propose a penalising price strategy based on the block-pricing process to decrease over-irrigation without affecting farmers' incomes. The methodology is based on the residual imputation approach to determine farmers' ATP, a stochastic production frontier to estimate the technical efficiency to determine optimal water irrigation quantity and calculation of the price elasticity of demand for an effective penalty and the Gini index before and after penalisation to study equity improvement. A survey was carried out on a sample of 147 citrus farms in the Nabeul Governorate, Northeastern Tunisia. The technical efficiency analysis confirms that an optimal quantity of 5000 m3/ha guarantees the maximisation of yields and profits. Above this quantity, the amount of overused water could be penalised without significantly affecting farmers' incomes. Results also reveal that water overconsumption represents 28% of available resources and the ATP varies according to technical efficiency. Therefore, the proposed penalty system could reduce water overconsumption by 44.56% without deteriorating agricultural welfare. To improve water management as well as farmers' welfare, this study recommends an increase in the technical efficiency level of farms to optimise all production factors for any implemented pricing policy. [ABSTRACT FROM AUTHOR]

Introduction: Breast cancer is a major public health problem worldwide. It is the leading cause of cancer deaths in females. In developing countries like Tunisia, the frequency of this cancer is still growing. The aim of this study was to determine the crude and standardized incidence rates, trends and predictions until 2030 of breast cancer incidence rates in a Tunisian governorate. Methods: This is a descriptive study including all female patients diagnosed with breast cancer in Monastir between 2002 and 2013. The data were collected from the cancer register of the center. Tumors were coded according to the 10th version of international classification of disease (ICD-10). Trends and predictions until 2030 were calculated using Poisson linear regression. Results: A total of 1028 cases of female breast cancer were recorded. The median age of patients was 49 years (IQR: 41–59 years) with a minimum of 16 years and a maximum of 93 years. The age-standardized incidence rate (ASR) was of 39.12 per 100000 inhabitants. It increased significantly between 2002 and 2013 with APC of 8.4% (95% CI: 4.9; 11.9). Prediction until 2030 showed that ASR would reach 108.77 (95% CI: 57.13–209.10) per 100000 inhabitants. Conclusion: The incidence and the chronological trends of breast cancer highlighted that this disease is of a serious concern in Tunisia. Strengthening preventive measures is a primary step to restrain its burden. [ABSTRACT FROM AUTHOR]