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Genetic classification of Parkinson's disease (PD) subtypes may become the preferred diagnostic tool for neurologists. Herein we compare clinical features from a large cohort of patients with familial PD of unknown aetiology or attributable to distinct genetic forms. Comprehensive neurological examinations were performed in 231 familial PD patients from Tunisia. Analysis was previously performed to screen for mutations in leucine rich repeat kinase 2 (LRRK2), PTEN induced kinase 1 (PINK1) and parkin (PRKN). Clinical features were compared between patients with genetically undefined PD (n=107) and those with LRRK2 (n=73) and PINK1 (n=42) mutations using regression analyses adjusted for gender, age of onset and disease duration. PRKN cases (n=9) were too few for meaningful statistical analysis. In comparison with genetically undefined patients, LRRK2 mutation carriers had more severe motor symptoms (median Unified Parkinson's Disease Rating Scale scores approximately 1.6 times higher, p<0.001), a higher rate of dyskinesia (OR 4.21, p=0.002) and use of dopamine agonists (OR 3.64, p<0.001), and less postural tremor (OR 0.21, p<0.001). PINK1 mutation carriers presented an increased rate of drug induced dyskinesia (OR 3.81, p=0.007) and a lower rate of postural tremor (OR 0.16, p<0.001) than genetically undefined patients. As expected, PINK1 patients had younger ages and ages at disease onset, and a longer disease duration compared with LRRK2 mutation carriers and genetically undefined patients. Clinical differences between LRRK2, PINK1 and genetically undefined familial PD appear more pronounced than previously appreciated, and may prove useful in clinical practice. As future therapies are targeted to specific protein abnormalities, identifying the genetic causes and associated clinical and pathological features will determine diagnosis, preventative medicine and drug intervention strategies. [ABSTRACT FROM AUTHOR]

Abstract: Sicilo-Sarde is a local breed from northern Tunisia resulting from crossing Sarda and Comisana dairy sheep and is traditionally used for cheese production after lamb weaning. A sample of 52 adult Sicilo-Sarde lactating ewes was used for studying their udder morphological traits and milk yield potential during weeks 4–8 (milking–suckling period) and 10 (milking period) of lactation. Daily milk yield was estimated on a daily basis by using the double oxytocin injection method 4h after machine-milking at d 30 and 45. Udder and teat morphology were also measured at d 45 of lactation. Cisternal area (by ultrasonography) and udder compartments (cisternal and alveolar milk) were evaluated 8h after milking by using atosiban and oxytocin on d 72 of lactation. Milk yield averaged 0.56±0.10L/d and ewes had small (volume, 496±28mL) and healthy udders (CMT, <1), with medium sized teats (length, 18.5±4.9mm; diameter, 10.0±2.0mm) attached at 45±10°. A drop in milk production (49%) was found in the transition from suckling (day 30) to milking (week 10). Udder cisterns were multilocular and small sized (half udder area, 11.6±4.5cm2), although cisternal milk accounted for 54% of the total milk in the udder. Correlation between cisternal milk and cisternal area was moderate (R 2 =0.48; P <0.05). Lag time and total milking time were 1.9±0.1 and 31±5s, respectively. In conclusion, the Sicilo-Sarde ewes evaluated showed medium sized cisterns and teats which were morphologically adequate for machine milking, although milk production needs to be improved. [Copyright &y& Elsevier]

Objectives: While the existing literature extensively covers the topic of tacrolimus variability, it remains crucial to gather data that are tailored to the Tunisian population. Our primary goal was to assess the variability in tacrolimus bioavailability using the Cp(0)/weight dosage ratio in Tunisian kidney transplant patients. We also aimed to determine the correlations between blood trough level (Cp(0)) and the area under the concentration-time curve (AUC0-12 h) in this cohort., Methods: This retrospective study included patients treated with oral tacrolimus for the prevention of organ rejection between 2009 and 2023. The correlation between parameters was analyzed through a Pearson coefficient and a regression model. We assessed the inter- and intraindividual variability by calculating the coefficient of variation for patients with at least three samples., Results: Analysis of 2,124 samples revealed a weak correlation (R=0.121) between Cp(0) and weight dosage. We found that 79.3 % of patients exhibited high variability in the Cp(0)/weight dosage ratio. A strong correlation (R=0.797) was found between Cp(0) and the AUC0-12 h. We also found that 47.6 % of patients showed high variability in the AUC0-12 h/Cp(0) ratio., Conclusions: This study underscores the necessity for individualized therapeutic drug monitoring in Tunisian kidney transplant recipients due to the high variability in the Cp(0)/weight dosage ratio. The AUC0-12 h/Cp(0) ratio is proposed as a more consistent parameter for therapeutic drug monitoring, offering potential improvements in tacrolimus therapy management., (© 2024 Walter de Gruyter GmbH, Berlin/Boston.)

This study investigated the complex cultural, social, and economic factors influencing the choice of academic field among Jewish and Muslim students in Israeli higher education. By employing a mixed-methods approach, combining quantitative surveys and conjoint analysis, this research revealed significant differences between the two groups. Our findings indicate that Muslim students exhibit significantly higher levels of individualism compared to Jewish students, as measured by the individualism scale. They also place greater importance on prior work experience and teacher influence when choosing a field of study. In contrast, Jewish students prioritize earning potential. The findings underscore the need for culturally responsive educational policies and support systems that cater to the diverse needs and aspirations of students from different socio-cultural backgrounds. This study contributes to understanding the multifaceted dynamics shaping educational choices in multicultural societies and highlights the importance of fostering inclusive learning environments. Future research should include additional ethnic groups and explore the long-term impact of educational pathways on social and economic mobility., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Zouari, Shtudiner. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Objectives: In this study, we explore the impact of postprandial exercise timing (morning vs evening) on glycemia in individuals with type 1 diabetes (T1D) during short all-out sprints on a cycle ergometer., Methods: Ten healthy, physically sedentary male (n=7) and female (n=3) volunteers with T1D, 22.8±2.8 years of age, and with a diabetes duration of 9.7±5.5 years and glycated hemoglobin level of 8.6±1.2%, underwent comprehensive screening and assessment of their physical health and fitness status before study participation, under the guidance of a physician. Each participant underwent 2 postprandial exercise sessions on separate days: the first in the morning at 8:00 AM and the second in the evening at 8:00 PM, both conducted 60 minutes after a standardized meal., Results: Morning exercise showed a less pronounced reduction in plasma glucose (PG) levels compared with evening exercise (-2.01±1.24 vs -3.56±1.6 mmol/L, p=0.03). In addition, higher cortisol levels were observed in the morning vs evening (128.59±34 vs 67.79±26 ng/mL, p<0.001)., Conclusions: Morning repeated sprint exercise conducted in the postprandial state consistent with the protective effect of higher cortisol levels resulted in a smaller reduction in PG levels compared with evening exercise. This highlights the potential influence of exercise timing on glycemic responses and cortisol secretion in the management of T1D., (Copyright © 2024 The Author(s). Published by Elsevier Inc. All rights reserved.)