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Rationale: Acute complications of cirrhosis can be life- threatening. One of the less common acute complications is hepatic hydrothorax whose medical management is rarely successful and is still controversial. Patient concerns: A 51-year-old patient presenting to the emergency room for a massive pleural effusion. Diagnosis: A hepatic hydrothorax with a placed chest tube whose removal was not possible. Interventions: Increased doses of diuretics with a strict salt-free diet. Outcomes: An improvement of the clinical state, with no recurrent pleural effusion up to one month. Lessons: Medical management of hepatic hydrothorax is possible.

Introduction Physical and psychological health, social relationships and professional environment determine the quality of life of nurses. Objectives This study aims to evaluate the quality of life of Hospital nurses and to identify the factors that influenced this assessment. Methods We conducted a cross-sectional study concerning nurses who answered a questionnaire developed and structured in order to assess the quality of life and with the appliance of the World Health Organization Quality of Life Instrument (WHOQoL-BREF). The statistical processing was done with IBM SPSS Statistics for Windows, Version 21.0. Results Most of the nurses were women (78.30%), married (81.70%) and with a specialization degree (65 %). The mean age of the study population was 50.20 years (±7.20 years). Most of them considered their quality of life good or very good (46.7%) and were satisfied or very satisfied with their health (48.4%). There is a significant association between quality of life and satisfaction with life (p=0.000). The average score of Physical health was 55.76(±13.89). The average scale of Psychological health was 61.45 (±15.14). A significant correlation was observed between lack of antecedents and a better physical health (p=0.000).The psychological health was correlated with age (p=0.000) and social relationships (p=0.000). Conclusions Studying the quality of life of nurses is particularly important, since it can lead to the development of a policy for improving the working conditions in the public sector. Conflict of interest No significant relationships.

Introduction Addictive behaviors on the workplace are a real public health problem because of its consequences not only on workers but also on productivity at work. Objectives To explore the relationship between addictive behaviors and productivity at work among employees of a Tunisian oil rig. Methods A cross-sectional study was conducted in the first half of 2018. The assessment of work productivity was done using the validated WPAI-GH questionnaire. Smoking dependence was assessed via the Fagerström score and alcohol abuse by the FACE questionnaire. Results It was 94 employees working in an onshore oil field with an average age of 41.1 years. Average job seniority was 14.3 years. Active smoking was noted in 34.7% of cases. Alcohol consumption was noted in 19.1% of cases. In the 7 days preceding the survey, the average percentage of absenteeism was 3.64 ± 21.7% and the presenteeism was 17.66 ± 25.58%. The average decline in productivity was 14.8 ± 43.7% and the average decline in daily activities was 20.21 ± 31.45%. These parameters were not correlated with smoking and alcoholism. Conclusions Addictive behaviors in the workplace still a denied reality.Increasing awareness and clarifying expectations can be a good first step in order to ameliorate employee functioning and decrease productivity problems.

Introduction In emergency departments, workers regularly report unfavorable working conditions. It’s a stressful workplace with excessive workloads, high demands on patient care including exposure to violence, time pressures and overcrowding. Objectives -Identify the prevalence of violence, psychological distress and job stress in the emergency department. -Investigate risk factors of aggression among emergency department staff. Methods This study is a descriptive-cross sectional analysis study conducted on emergency department staff. Data were collected through a questionnaire including sociodemographic information, circumstances of the aggression, the Karasek questionnaire, and the GHQ-12 (General Health Questionnaire). Results Our study included 62 health workers. Half of the population were physicians. The prevalence of assault was estimated at 59.6%. Psychological distress was noted in 64.5% of cases. Occupational stress was estimated at 75.8%. The most common type of assault was verbal aggression (86.4%). The aggressor was most often an accompanying person. The occurrence of violence was not associated with the worker’s psychological distress or job stress. On the other hand, we noted an association between aggression and variable work schedule. Conclusions Violence against healthcare workers in the emergency department is an important phenomenon. Preventive actions should be taken to improve health professional wellbeing at work. Disclosure No significant relationships.

Introduction Stress can be described as a dynamic and reciprocal relationship between the person and the environment. Nursing is considered as an occupation with a constellation of circumstances leading to stress. Objectives This study aims to assess perceived stress among staff nurses in Hedi Chaker and Habib bourguiba Hospital from Sfax city, Tunisia Methods Nurses from Hedi Chaker and Habib bourguiba University hospitals in Sfax- Tunisia were invited to complete a structured self-report questionnaire. The questionnaire consists of the following parts: Perceived Stress Scale (10-item form), personal data and information relevant to types of work shifts and years of experience. Results A total of 146 (males = 49; females = 97) nurses participated in this study. The mean age was 37 years. Nearly 82 % of the participants considered themselves in very good health. Rotating shifts work was noted in 72.50% of cases. The average length of working experience was 7.96 years. The stress in most of nurses was in severe level (74.65%), followed by mild (23.28%) and moderate (2.05%) levels. High level of perceived stress was significantly associated with general health problems (P= 0.032). No significant association was found between level of perceived stress, types of work shifts and years of experience. Conclusions The results show a significantly high level of stress among staff nurses. Hence, nurses need support and subsequent interventions to cope with stress. Actions in this direction may contribute to the improvement of health, well-being and quality of life of the professionals. Conflict of interest No significant relationships.

Introduction Psychosocial risks (PSR) represent a new scourge of risks at work. The direct links between these risks and occupational accidents (OA) are not well documented, but some work restraints such as time pressure are common factors for both stress and accidents. Objectives To establish a relationship between different PSR perceived by health staff and the occurrence of OA. Methods Cross-sectional study conducted among staff working at Habib Bourguiba Hospital in Sfax from 1st January to 31 March 2015. The evaluation of mental health was performed by using the validated French version of questionnaire KARASEK. Results The study involved 326 care staff (115 men and 211 women). The average age was 36 years old. The participants were mainly nurses (30.6%) and trainee physicians (35.6%). Blood exposure accidents were predominant (66.1% of cases) and were associated with high psychological demands at work with OR = 2.539 (95% CI [1.037 - 6.219]). Health care workers had a high psychological demand in 85.3% and a low latitude in 78.8% of cases. According to the Karasek model, tense employees accounted for 68.7% and assets 16.6%. OAs occurring during care were associated with night work and working in the emergency and resuscitation department (OR = 5,772 (95% CI [1,227-27,146] and OR = 5,778 (95% CI [1,702 -19,619]) respectively). Conclusions The prevention of OA goes through the management of PSR, which remains a major concern for health and safety workers at work via the application of preventive strategies based on in-depth analysis of work situations.

Introduction Workaholism is an “irrational commitment to excessive work” as described by Cherrington. It’s considered as an emerging phenomenon that has been the topic of much debate. Indeed, over the last four decades, many contradictions have arisen among researchers investigating its negative consequences. Objectives -Determine the prevalence of workaholism among a population of engineers. -Evaluate the socio-professional impact of workaholism on this population. Methods This study is a descriptive-cross sectional analysis conducted on active engineers for one month. Data were collected through an online questionnaire, including socio-professional data and the WART (Work Addiction Risk Test) questionnaire. Results Our population consisted of 75 engineers with an average age of 29± 4.6 years and sex-ratio of 1.2. Among this group, 26.7% of engineers were at risk of work addiction, while a certain addiction was noted among the third of the population. Workaholism was positively correlated with the lack of entertainment, especially sports activity (p= 0.012). Moreover, workaholic subjects were more likely to work more than 8 hours a day (p=0.004) and without a weekly break (p=0.043). Workaholism was not associated with the level of job satisfaction. Conclusions Workaholism is an emerging phenomenon among engineers that can lead, in some cases, to depression and burnout. Therefore, the role of the occupational physician consists in the detection of early signs of workaholism and in raising awareness of this hidden problem. Conflict of interest No significant relationships.

هدف البحث الحالي إلى تحليل مضمون كتاب العربية لغتي للصف الرابع الأساسي لتعرّف مدى تضمنه لمهارات التواصل الشفوي (مهارة الاستماع، مهارة التحدث). وقد اعتمد الباحث أسلوب تحليل المضمون من المنهج الوصفي، أما عينة البحث فكانت كتاب العربية لغتي الفصل الأول، والذي يحتوي ثلاث وحدات فقط، والمقرر للصف الرابع الأساسي من وزارة التربية السورية للعام الدراسي 2020/2021، وكانت أداة البحث استمارة تحليل لمهارات التواصل الشفوي, بناءً على قائمة أعدها الباحث تضمنت (56) مهارة تواصل شفوي موزعة إلى (30) مهارة للتحدث، (26) مهارة للاستماع. توصل الباحث إلى النتائج الآتية: أن مهارات الاستماع في كتاب العربيّة لغتي للصف الرابع الأساسي، حصلت على تكرارات مقدارها (72)، وبنسبة مئوية (64.86%). أما المهارات التحدث فقد كأن تضمينها متوسط بتكرارات مقدارها (39)، وبنسبة مئوية (35.14%). كما بينت النتائج أن أكثر مهارات التواصل الشفوي التي تم التركيز عليها هي مهارتي (تركيز الانتباه على الفكرة الرئيسة، تركيز الانتباه على الفكرة الفرعيّة). بناء على هذه النتائج قدم الباحث مقترحات عدة أهمها: الاهتمام بضرورة تضمين مهارات التواصل الشفوي التي ظهر فيها ضعف واضح في محتوى كتاب العربية لغتي للصف الرابع الأساسي، تدعيم المحتوى بأنشطة مقصودة تساعد على إكساب تلاميذ الصف الرابع الأساسي مهارات التواصل الشفوي.

In the last few years, a new class of fractional-order (FO) systems, known as Katugampola FO systems, has been introduced. This class is noteworthy to investigate, as it presents a generalization of the well-known Caputo fractional-order systems. In this paper, a novel lemma for the analysis of a function with a bounded Katugampola fractional integral is presented and proven. The Caputo–Katugampola fractional derivative concept, which involves two parameters 0 < α < 1 and ρ > 0, was used. Then, using the demonstrated barbalat-like lemma, two identification problems, namely, the “Fractional Error Model 1” and the “Fractional Error Model 1 with parameter constraints”, were studied and solved. Numerical simulations were carried out to validate our theoretical results.

هدف البحث الحالي إلى الكشف عن درجة امتلاك تلاميذ الصف الرابع الأساسي لمهارات التواصل الشفوي (الاستماع والتحدث)، وقد استخدم الباحث المنهج الوصفي، حيث تكونت عينة البحث من (670) تلميذاً وتلميذة من الصف الرابع الأساسي في مدارس مدينة اللاذقية للعام الدراسي 2019/2020، حيث طبّق عليهم اختبار أداء مهارات التواصل الشفوي من إعداد الباحث ، وتضمن (17) سؤالاً. بعد التحقق من صدقه بعرضه على مجموعة من المختصين في هذا المجال في كليتي التربية بجامعتي دمشق وتشرين ، وتمّ التأكد من ثباته بطريقة (Cronbach Alpha) ، وقد بلغ معامل الثبات للاختبار ككل (0.845)، ومن خلال الثبات بالإعادة الذي بلغ (0.976). وانتهى البحث إلى النتائج الآتية: إنّ درجة امتلاك تلاميذ الصف الرابع الأساسي لمهارات التواصل الشفوي جاءت بدرجة جيدة. إنّ درجة امتلاك تلاميذ الصف الرابع الأساسي لمهارة الاستماع جاءت بدرجة جيدة. إنّ درجة امتلاك تلاميذ الصف الرابع الأساسي لمهارة التحدث جاءت بدرجة منخفضة. توجد فروق في درجة امتلاك تلاميذ الصف الرابع الأساسي لمهارات التواصل الشفوي عموماً وفي مهارة الاستماع حسب متغير الجنس، وجاءت هذه الفروق لصالح الإناث، في حين لا توجد فروق في مهارة التحدث بين الذكور والإناث.

This research aims to identify to what extent Included Oral Communication Skills In Sciences Book from the Schools' teachers point of view in Lattakia city, and to analyzing the basic fourth class to knew the oral communication skills which are included in it and the sub skills ( listening and talking skills) and it included (56) oral communication skills distributed to (30) skills for talking and (26) for listening and the researcher depended in his analysis for the results on the descriptive curriculum and used content analysis to reach the most importune main and secondary oral communication skills included in the basic fourth class in the Syrian Arab republic for the year 2018-2019. The research ended up with the following results that the degree Included Oral Communication Skills In Sciences Book from the Schools' teachers point of view in Lattakia city was middle degree, and the content analysis results indicated to the incompatibility in distributing the repetitions on the oral communication skills contained within the biology book of the fourth grade. The sample of the content analysis showed that the four communication skill in the analyst is not compatible in distributing the researcher on skill of listing and taking founded fourth class. In the light of the result which they reached important of them: concentrating an oral communication skills which include science curriculum listening and talking skills which will help students to improve the standers of their studies. هدف البحث إلى تعرف مدى تضمين مهارات التواصل الشفوي في كتاب العلوم للصف الرابع الأساسي من وجهة نظر معلمي العلوم، وإلى تحليل مضمون كتاب العلوم للصف الرابع الأساسي لتعرّف مدى تضمنه لمهارات التواصل الشفوي (مهارة الاستماع، مهارة التحدث). وقد اعتمد الباحث أسلوب تحليل المضمون من المنهج الوصفي، أما عينة البحث فكانت (68) مدرس علوم، إضافة إلى كتاب العلوم للفصل الثاني، والذي يحتوي ثلاث وحدات فقط، والمقرر للصف الرابع الأساسي من وزارة التربية السورية للعام الدراسي 2018/ 2019 وكانت أداة البحث استمارة تحليل لمهارات التواصل الشفوي, بناءً على قائمة أعدها الباحث تضمنت (56) مهارة تواصل شفوي موزعة إلى (30) مهارة للتحدث، (26) مهارة للاستماع. توصل الباحث إلى النتائج الآتية: إن درجة تضمين مهارات التواصل الشفوي في كتاب العلوم للصف الرابع الأساسي من وجهة نظر معلمي العلوم جاءت بدرجة متوسطة، كما أتت مهارات التواصل الشفوي بدرجة منخفضة في كتاب العلوم وغير متوافقة في توزيع التكرارات على قائمة التحليل مهارات التواصل الشفوي المتواجدة في كتاب العلوم للصف الرابع الأساسي، وكذلك عدم توافق مهارات الاستماع والتحدث في توزيع التكرارات على مهارات الاستماع والتحدث المتواجدة في كتاب العلوم للصف الرابع الأساسي حيث إن أربع مهارات وردة بدرجة متوسطة وبقية المهارات وردت بدرجة ضعيفة. وفي ضوء نتائج البحث، اقترح الباحث ضرورة الاهتمام بمهارات التواصل الشفوي بشكل أكبر, وتضمينها في مناهج العلوم.

Wireless Sensor Networks (WSNs) are prone to highly constrained resources, as a result ensuring the proper functioning of the network is a requirement. Therefore, an effective WSN management system has to be integrated for the network efficiency. Our objective is to model, design, and propose a homogeneous WSN hybrid architecture. This work features a dedicated power utilization optimization strategy specifically for WSNs application. It is entitled Hybrid Energy-Efficient Power manager Scheduling (HEEPS). The pillars of this strategy are based on the one hand on time-out Dynamic Power Management (DPM) Intertask and on the other hand on Dynamic Voltage and Frequency Scaling (DVFS). All tasks are scheduled under Global Earliest Deadline First (GEDF) with new scheduling tests to overcome the Dhall effect. To minimize the energy consumption, the HEEPS predicts, defines and models the behavior adapted to each sensor node, as well as the associated energy management mechanism. HEEPS’s performance evaluation and analysis are performed using the STORM simulator. A comparison to the results obtained with the various state of the art approaches is presented. Results show that the power manager proposed effectively schedules tasks to use dynamically the available energy estimated gain up to 50%.

Objectives: To analyze the serotype distribution of Streptococcus pneumoniae clinical isolates collected in the south of Tunisia over a 5-year period in different age groups and to assess their antimicrobial susceptibility patterns. Methods: A total of 305 non-duplicate S. pneumoniae isolates were collected between January 2012 and December 2016 at the university hospital in Sfax, Tunisia. All isolates were serotyped by multiplex PCR. The antibiotic susceptibility of all isolates was determined using the disk diffusion test or Etest assay. Results: Among the 305 pneumococcal isolates, 76 (24.9%) were invasive and 229 (75.1%) were non-invasive. The most common serotypes were 19F (20%), 14 (16.7%), 3 (9.2%), 23F (7.5%), 19A (5.9%), and 6B (5.9%). Potential immunization coverage rates for pneumococcal conjugate vaccines PCV7, PCV10, and PCV13 were 58%, 59.3%, and 78.7%, respectively. Three-quarters (75.3%) of pneumococcal isolates were non-susceptible to penicillin. The resistance rate to erythromycin was 71.4%. Only two isolates were resistant to levofloxacin. Conclusions: 19F and 14 were the most prevalent serotypes in the south of Tunisia. The inclusion of a PCV in the immunization program could be useful for reducing the burden of pneumococcal diseases. The high resistance rate to penicillin and macrolides is alarming. Prudent use of antibiotics is crucial to prevent the selection of multidrug-resistant pneumococci. Keywords: Streptococcus pneumoniae, Antibiotic, Serotype, PCV, Tunisia

The purpose of the present in vitro study was to investigate the bond strength of root canal dentin and the filling ability of a new multi-fiber-reinforced composite post (mFRC) compared to a conventional single fiber-reinforced-composite post (sFRC). Twenty-eight freshly maxillary first permanent single-rooted premolars were instrumented and divided into groups (n = 14). Group 1: single-fiber-reinforced composite (sFRC), group 2: multi-fiber-reinforced composite (mFRC). Bonding procedures were performed using a dual-cure universal adhesive system and resin cement. All specimens were sectioned so that seven discs of 1 mm of thickness were obtained from each root. An optical microscope was used before the push-out test to measure the total area of the voids and to determine the length of the smaller/bigger circumferences. The push-out bond strength (PBS) test was performed using an Instron universal testing machine. Data were then compared by one-way ANOVA on ranks (α = 0.05). The dentin–cement–post interface was observed using scanning electron microscopy (SEM). At the coronal third, a significantly higher bond strength (p < 0.05) was obtained in the sFRC group (44.7 ± 13.1 MPa) compared to the mFRC group (37.2 ± 9.2 MPa). No significant difference was detected between the groups at the middle third (sFRC group “33.7 ± 12.5 MPa” and mFRC group “32.6 ± 12.4 MPa”) (p > 0.05). Voids were significantly lower in the mFRC compared to those observed in the sFRC group (p < 0.05) at the coronal third. Whereas, no significant difference was found at the middle third (p > 0.05) between the tested groups. Filling ability was overall improved when employing mFRC, although such technique might have characteristic limitations concerning the bond strength to dentin.

In this paper, we address the problem of forest fires’ early detection and segmentation in order to predict their spread and help with fire fighting. Techniques based on Convolutional Networks are the most used and have proven to be efficient at solving such a problem. However, they remain limited in modeling the long-range relationship between objects in the image, due to the intrinsic locality of convolution operators. In order to overcome this drawback, Transformers, designed for sequence-to-sequence prediction, have emerged as alternative architectures. They have recently been used to determine the global dependencies between input and output sequences using the self-attention mechanism. In this context, we present in this work the very first study, which explores the potential of vision Transformers in the context of forest fire segmentation. Two vision-based Transformers are used, TransUNet and MedT. Thus, we design two frameworks based on the former image Transformers adapted to our complex, non-structured environment, which we evaluate using varying backbones and we optimize for forest fires’ segmentation. Extensive evaluations of both frameworks revealed a performance superior to current methods. The proposed approaches achieved a state-of-the-art performance with an F1-score of 97.7% for TransUNet architecture and 96.0% for MedT architecture. The analysis of the results showed that these models reduce fire pixels mis-classifications thanks to the extraction of both global and local features, which provide finer detection of the fire’s shape.

Vitiligo is a multifactorial dermatosis with many etiological hypotheses that have been suggested for its occurrence. To our knowledge, few epidemiological studies are available on vitiligo induction factors and particularly on the role of exposure to chemicals in the onset of the disease has been found. Therefore, there is need to investigate the relationship between vitiligo and chemical exposures in order to understand this mysterious disease. We conducted a case--control study of patients with vitiligo whose diagnosis was made by a specialist in dermatology. The total study period was of 6 months extending from 1 July to 31 December 2019. The minimum sample size was determined as 46 cases and 92 controls. The control group was gender, age, and professional status matched to the vitiligo group. In the binary logistic regression model, household chemicals/colored toothpaste use, a history of a repeated antibiotic use, and an occupational exposure to phenol/catechol derivatives were significantly associated with vitiligo (three to fourfold increase). Our results suggest that chemical factors play a key role in the occurrence of vitiligo. Therefore, prevention of this dermatosis requires the identification of exposure to the incriminated chemicals in any patient followed for vitiligo. The earlier the diagnosis of 'chemical' or chemically aggravated vitiligo, the better the prognosis for this disease. [ABSTRACT FROM AUTHOR]