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The potential use of Cu-based shape memory alloys (SMA) in retrofitting historical monuments is investigated in this paper. This study is part of the ongoing work conducted in Tunisia within the framework of the FP6 European Union project (WIND-CHIME) on the use of appropriate modem seismic protective systems in the conservation of Mediterranean historical buildings in earthquake-prone areas. The present investigation consists of a finite element simulation, as a preliminary to an experimental study where a cantilever masonry wall, representing a part of a historical monument, is subjected to monotonic and quasi-static cyclic loadings around a horizontal axis at the base level. The wall was retrofitted with an array of copper SMA wires with different cross-sectional areas. A new model is proposed for heat-treated copper SMAs and is validated based on published experimental results. A series of nonlinear finite element analyses are then performed on the wall for the purpose of assessing the SMA device retrofitting capabilities. Simulation results show an improvement of the wall response for the case of monotonic and quasi-static cyclic loadings. [ABSTRACT FROM AUTHOR]

A methodology for the seismic vulnerability assessment of historical monuments is presented in this paper. The ongoing work has been conducted in Tunisia within the framework of the FP6 European Union project (WIND-CHIME) on the use of appropriate modem seismic protective systems in the conservation of Mediterranean historical buildings in earthquake-prone areas. The case study is the five-century-old Zaouia of Sidi Kassem Djilizi, located downtown Tunis, the capital of Tunisia. Ambient vibration tests were conducted on the case study using a number of force-balance accelerometers placed at selected locations. The Enhanced Frequency Domain Decomposition (EFDD) technique was applied to extract the dynamic characteristics of the monument. A 3-D finite element model was developed and updated to obtain reasonable correlation between experimental and numerical modal properties. The set of parameters selected for the updating consists of the modulus of elasticity in each wall element of the finite element model. Seismic vulnerability assessment of the case study was carried out via three-dimensional time-history dynamic analyses of the structure. Dynamic stresses were computed and damage was evaluated according to a masonry specific plane failure criterion. Statistics on the occurrence, location and type of failure provide a general view for the probable damage level and mode. Results indicate a high vulnerability that confirms the need for intervention and retrofit. [ABSTRACT FROM AUTHOR]

Introduction: Access to medication is a major public health issue worldwide and can be considered as an indicator of the quality of public health services in a country., Aim: To evaluate patient satisfaction with the services provided by the external pharmacy in the drug distribution circuit in public healthcare facilities in Tunisia., Methods: To achieve this goal, a satisfaction survey was conducted on a sample of 200 patients at the external pharmacies of two university hospitals in Tunis, namely the La Rabta University Hospital and the Charles Nicolle University Hospital., Results: This survey revealed that despite the efforts made by the state and the importance of the drug market in Tunisia, 80% of patients reported difficulties in finding their medication in the healthcare facilities where they consult, and more than 60% are forced to obtain them from private pharmacies. The survey also highlighted a contrast between the quality of services provided by the external hospital pharmacy and those of private pharmacies. Indeed, only 25% of the surveyed patients were satisfied with the services provided by the external pharmacy. Although this satisfaction was conditioned by several factors, the main concern of the patients remained the availability of medication. In fact, with little difference in terms of care, 80.5% of the participants favored the idea of transferring the services provided by the external pharmacy to private pharmacies., Conclusion: In summary, this study has highlighted the need to rethink the drug supply and distribution system and to explore alternative approaches to significantly improve access to medication and the quality of services provided by external pharmacies in Tunisian public hospitals.

In view of the possible disruptions in the manufacturing and supply of health products following the coronavirus disease 2019 (COVID-19) pandemic, the Tunisian medicines regulatory authority was mobilized to guarantee patient safety. Teleworking has become the ultimate way of service continuity. The planning was revised according to health priorities. Work procedures were set online. A minimum list of medicines known as "medicines of health and strategic interest" was established. The Directorate of Pharmacy and Medicines (DPM) has been working on updating medicines stock data. A provisional suspension of authorizations for medicines export for 1 mo was decided. A fast-track procedure allowing the validation of alternative sources of raw materials has been put in place. An appeal for a fast track manufacture of hydroalcoholic gel/solutions was launched. A Monitored Emergency Use of Unregistered and Investigational Interventions (MEURI) procedure has been adopted in order to dispense off-label prescriptions of hydroxychloroquine and azithromycin combination. Focus groups were organized in order to set up therapeutic trials exploring possible strategies of COVID-19 treatment, such as serotherapy and BCG vaccine. This proactive and anticipatory policy has made it possible to meet the health challenges dictated by this crisis.

Introduction: Chronic hepatitis C (CHC) is assimilated to a systemic disease because of its multiple extrahepatic manifestations particularly rheumatological., Aim: To determine the prevalence and the characteristics of rheumatological manifestations (RM) associated with CHC., Methods: a retrospective study including all patients suffering from CHC followed over a period of 11 years (2002 - 2012) at the department of gastroenterology B at La Rabta hospital. Were excluded all patients co-infected by hepatitis B virus or by human immunodefficiency virus and those having decompensated cirrhosis. Different RM were collected and analyzed according to the epidemiological, clinico-biological, immunological, virological and histological data of the CHC., Results: two hundred and four patients affected by CHC were included, meanly aged by 52 years [22- 66 years]. The sex-ratio was 0,46. RM were noted in 76 patients (37,25%) dominated by inflammatory polyarthralgia of big joints (88,15%). Non erosive arthritis was observed in a woman, myalgia was noted in 11 cases (14,47%) among them, 2 appeared under antiviral treatment. Dryness syndrome was observed in 17 cases (22,36%). RM were associated to other extrahepatic manifestations of CHC in 69,7% of cases, notably to mixed cryoglobulinemia (MC) (60%) and to non specific antinuclear antibodies (21,6%). A partial to total amelioration of RM was noted in most patients under antiviral treatment often associated to symptomatic measures. In univariate analysis, only female sex and presence of MC were significantly correlated to the presence of RM., Conclusion: RM occur frequently inCHC and are dominated by arthralgia, myalgia and dryness syndrome. Authentic arthritis are uncommon and constitute a diagnostic problem particularly when they inaugurate the disease. MC is the immunological factor the most associated with RM. MR treatment remains mainly antiviral.