Search

Abstract Background Long-term deterioration in the mental health of healthcare workers (HCWs) has been reported during and after the COVID-19 pandemic. Determining the impact of COVID-19 incidence and mortality rates on the mental health of HCWs is essential to prepare for potential new pandemics. This study aimed to investigate the association of COVID-19 incidence and mortality rates with depressive symptoms over 2 years among HCWs in 20 countries during and after the COVID-19 pandemic. Methods This was a multi-country serial cross-sectional study using data from the first and second survey waves of the COVID-19 HEalth caRe wOrkErS (HEROES) global study. The HEROES study prospectively collected data from HCWs at various health facilities. The target population included HCWs with both clinical and non-clinical roles. In most countries, healthcare centers were recruited based on convenience sampling. As an independent variable, daily COVID-19 incidence and mortality rates were calculated using confirmed cases and deaths reported by Johns Hopkins University. These rates represent the average for the 7 days preceding the participants’ response date. The primary outcome was depressive symptoms, assessed by the Patient Health Questionnaire-9. A multilevel linear mixed model (LMM) was conducted to investigate the association of depressive symptoms with the average incidence and mortality rates. Results A total of 32,223 responses from the participants who responded to all measures used in this study on either the first or second survey, and on both the first and second surveys in 20 countries were included in the analysis. The mean age was 40.1 (SD = 11.1), and 23,619 responses (73.3%) were from females. The 9323 responses (28.9%) were nurses and 9119 (28.3%) were physicians. LMM showed that the incidence rate was significantly and positively associated with depressive symptoms (coefficient = 0.008, standard error 0.003, p = 0.003). The mortality rate was significantly and positively associated with depressive symptoms (coefficient = 0.049, se = 0.020, p = 0.017). Conclusions This is the first study to show an association between COVID-19 incidence and mortality rates with depressive symptoms among HCWs during the first 2 years of the outbreak in multiple countries. This study’s findings indicate that additional mental health support for HCWs was needed when the COVID-19 incidence and mortality rates increase during and after the early phase of the pandemic, and these findings may apply to future pandemics. Trial registration Clinicaltrials.gov, NCT04352634.

ABSTRACT Background POLIII‐related leukodystrophies are a group of recently recognized hereditary white matter diseases with a similar clinical and radiological phenotype. No Tunisian studies have been published about POLIII‐related leukodystrophy due to POLR3A variants. The aim of this study was to contribute to the clinical, radiological, and genetic characterization of POLR3A‐related leukodystrophy in a Tunisian cohort. Methods We report six cases of genetically confirmed POLR3A‐related leukodystrophy belonging to six unrelated Tunisian families, along with a review of previously published pediatric cases. Results All patients were born to consanguineous marriages and originated from the North or the Center of Tunisia. Age at onset varied between 15 months and 6 years. The clinical phenotype was similar in all patients with cerebellar ataxia, tremor, and nystagmus being the key features. Brain imaging showed diffuse hypomyelination in all patients with progressive cerebellar atrophy in three patients. Molecular analysis identified the same bi‐allelic NM_007055.4:c.2011T>C; p.(Trp671Arg) variant in the POLR3A gene in all patients. Conclusion We hypothesize a founder effect for the identified variant given its recurrence in six unrelated individuals with a similar clinical phenotype. Given the apparent genetic homogeneity of Tunisian POLR3A patients, the recurrent variant should be directly targeted. This should facilitate diagnosis in index patients, and genetic counseling.

Background a valid measurement tool is required to assess the nutrition knowledge of children. The questionnaire of nutrition knowledge (QuesCa) has so far not been in use in Arabic-speaking populations. The objective of this study was to validate the Arabic version of the QuesCa questionnaire in a sample of Arabic-speaking children. Methods this is a cross-sectional study which envolved 524 preadolescents and teenagers, with 315 participants aged between 9 and 11 years and 209 participants aged between 12 and 15 years. Children were recruited from the national centre for school and university medicine in Tunis and from randomly selected school nurseries. Results The adapted QuesCa AR comprised 9 items for children aged 9-11 and 12-15, which included traditional African foods. The 9-item QuesCa 9-11 AR scale showed a low internal consistency reliability (Cronbach alpha for the total scale was 0.337). The overall Cronbach’s alpha value of the QuesCA 12-15 AR obtained was 0.284 for the 9 items. The multivariate analysis specific to the 9-11 age group showed that neither gender nor socio-economic level, nor affiliation to a public or private institution could predict the level of nutritional knowledge among Tunisian children aged 9 to 11. However, it did show an association between a good level of nutritional knowledge in Tunisian children aged 12 to 15 years with having a good socioeconomic level and being educated in a private institution. Conclusions The QuesCa AR’s inclusion of traditional African foods makes it a tool for researchers in Arab countries to assess nutrition knowledge levels.

Translation outside the context of Language Service Providers (LSPs) represents a sizeable share of the translation market. However, this facet of the activity remains less visible and less open to monitoring. This study investigates translation as a situated practice in the context of Oman within institutions where the translation activity does not represent a primary purpose. Adopting a quantitative approach, the study employed an online survey to investigate indicators of the institutionalization of translation, such as resourcing, working conditions, distribution of work, interaction, workflows, and quality management policies. The findings show that translation activities within institutions in Oman are thriving. However, the study revealed that translation practices are subject to considerable variation and that, despite notable exceptions, translation is frequently affected by challenges related to inadequate staffing, resources, and quality assurance procedures. These practices are mainly ad hoc, providing little evidence that translation needs are treated as an integral part of the institution’s functioning. These findings align with observations in other contexts and underscore the need to recognise the significant role translation plays in the functioning of the institution and the need to effectively integrate translation activities within their institutional environments to enhance quality standards in this often-overlooked segment of the translation industry. More generally, the findings confirm the necessity for Translation Studies to appreciate the significance of institutional translation as a facet of translation as a situated activity.

This study explores the novel use of mixed cultures of microalgae—Spirulina platensis, Micractinium, and Chlorella—for nutrient removal from dairy wastewater (DW). Microalgae were isolated from a local wastewater treatment plant and cultivated under various light conditions. The results showed significant biomass production, with mixed cultures achieving the highest biomass (2.51 g/L), followed by Spirulina (1.98 g/L) and Chlorella (1.92 g/L). Supplementing DW (75%) with BG medium (25%) significantly enhanced biomass and pH levels, improving pathogenic bacteria removal. Spirulina and mixed cultures exhibited high nitrogen removal efficiencies of 92.56% and 93.34%, respectively, while Chlorella achieved 86.85% nitrogen and 83.45% phosphorus removal. Although growth rates were lower under phosphorus-limited conditions, the microalgae adapted well to real DW, which is essential for effective algal harvesting. Phosphorus removal efficiencies ranged from 69.56% to 86.67%, with mixed cultures achieving the highest removal. Microbial and coliform removal efficiencies reached 97.81%, with elevated pH levels contributing to significant reductions in fecal E. coli and coliform levels. These findings suggest that integrating microalgae cultivation into DW treatment systems can significantly enhance nutrient and pathogen removal, providing a sustainable solution for wastewater management.

Given the global decline in adherence to the Mediterranean Diet (MD), even within its native region, it is key to identify the factors influencing this trend to mitigate the negative health outcomes associated with westernized diets. To this end, 4025 individuals (49.6% women, 42.6 ± 14.2 y/o) from Greece, Italy, Morocco, Slovenia, and Tunisia remotely completed a series of measures assessing motives, attitudes, and psychosocial factors related to MD adherence, which was evaluated using the MEDAS questionnaire. The results suggested medium-to-low adherence across all countries, with the highest adherence in Italy and Morocco and the lowest in Slovenia. Structural equation modeling revealed that positive attitudes toward the healthiness of food were the strongest predictors of adherence, whereas picky eating was a significant negative predictor in all countries except Greece. Adherence to the MD was positively influenced by health motivations in Morocco and weight control in Slovenia and Greece, while sensory appeal negatively influenced adherence in Italy. Additionally, price and convenience were significant barriers in Tunisia and Greece, whereas a preference for local and seasonal foods promoted adherence in Morocco and Greece. Overall, our findings underscore the need for country-specific interventions and policies that address distinct local factors and motivations to ease favorable shifts in dietary patterns toward MD principles.

Fouling and biofouling remain significant challenges in seawater desalination plants. One practical approach to address these issues is to develop anti-biofouling membranes. Therefore, novel hybrid zinc phthalocyanine/polyvinylidene fluoride-co-hexafluoropropylene (Zn(4-PPOx)4Pc/PVDF-HFP) membranes were prepared by electrospinning to evaluate their properties against biofouling. The hybrid nanofiber membrane was characterized by atomic force microscopy (AFM), attenuated total reflectance-Fourier transform infrared (ATR-FTIR) spectroscopy, and contact angle measurements. The theoretical calculations of PVDF-HFP, Zn(4-PPOx)4Pc), and Zn(4-PPOx)4Pc/PVDF-HFP nanofibers were performed using a hybrid functional RB3LYP and the 6-31 G (d,p) basis set, employing Gaussian 09. DFT calculations illustrated that the calculated physical and electronic parameters ensured the feasibility of the interaction of PVDF-HFP with Zn(4-PPOx)4Pc via a halogen–hydrogen bond, resulting in a highly stable and remarkably reactive structure. Moreover, molecular electrostatic potential (MEP) maps were drawn to identify the reactive regions of the Zn(4-PPOx)4Pc and PVDF-HFP/Zn(4-PPOx)4Pc nanofibers. Molecular docking analysis revealed that Zn(4-PPOx)4Pc has highest binding affinity (−8.56 kcal/mol) with protein from S. aureus (1N67) mainly with ten amino acids (ASP405, LYS374, GLU446, ASN406, ALA441, TYR372, LYS371, TYR448, LYS374, and ALA442). These findings highlight the promising potential of Zn(4-PPOx) 4Pc/PVDF-HFP nanocomposite membranes in improving the efficiency of water desalination by reducing biofouling and providing antibacterial properties.

Abstract Diabetes and hypertension are a serious public health problem worldwide. In the last decades, prevalence of these two metabolic diseases has dramatically increased in the Middle East and North Africa region, especially in Tunisia. This study aimed to determine the prevalence of type 2 diabetes (T2D) and High Blood Pressure (HBP) in Zaghouan, a North-East region of Tunisia. To this end, an exploratory study with stratified random sampling of 420 participants has been carried out. Various data were collected. Blood samples and urine were drawn for biochemical assay. Then, all data were analyzed using the statistical R software. Results showed an alarming situation with an inter-regional difference in prevalence of obesity (50.0%, CI 95.0%), HBP (39.0%, CI 95.0%) and T2D (32.0%, CI 95.0%). This study allowed the discovery of 24, 17 and 2 new cases of T2D, HBP and T2D&HBP respectively. The association of some socio-economic factors and biochemical parameters with these chronic diseases has been highlighted. To conclude, the health situation in the governorate of Zaghouan requires urgent interventions to better manage the growing epidemic of non-communicable diseases (NCD) in the region. This study demonstrated the importance of engaging health policy makers in road mapping and implementing national NCD prevention programs.

Research Question: What’s the extent voluntary and timely disclosure of environmental information could be explained by the corporate governance? And what’s the extent can the media exposure affect the relationship between corporate governance and the quality of disclosure of environmental information on the one hand, and what’s the extent can media legitimacy affect this relationship on the other hand? Motivation: The majority of the literature has examined the effect of corporate governance on the voluntary environmental disclosure while neglecting their effect on the timely disclosure of environmental information. Our study seeks to fill this gap by testing the moderating effect of media exposure and media legitimacy on the relationship between responsible governance measured by an index and the quality of environmental disclosure as measured by voluntary disclosure and timely disclosure. This paper is the first comprehensive attempt to analyses the interaction between media exposure and media legitimacy and responsible governance with environmental disclosure quality Idea: This study examines how media exposure and media legitimacy moderate the relationship between the responsible governance and environmental disclosure quality as measured by voluntary and timely disclosure. Data: The data were collected from the reference documents available on the Thomson Reuters Eikon database, including annual reports and sustainability reports. Thus, we collected the data from the Datastream database and from Factiva Database. Tools: This study uses a sample of 81 French non-financial companies listed on the SBF 120 index for the period 2014-2019. Feasible Generalized Least Square (FGLS) regression method is used to estimate the econometric models. Findings: The results obtained show that, for 486 French firm-year observations during the period 2014–2019, show that the media exposure moderates the relationship between the responsible governance and the quality of environmental disclosure as measured by voluntary and timely disclosure. Our results show also that the media legitimacy did not moderate the relationship between the responsible governance and the quality of environmental information. Contribution: The originality of our work consists of the fact that it is one of the first works that deals with the moderator effect of media exposure and media legitimacy on the relationship between responsible governance measured by an index and the quality of disclosure of environmental information measured by voluntary disclosure and timely disclosure. To our knowledge, no empirical study has been done this relationship on the timely disclosure of environmental information in the French context or in other contexts.

IntroductionType 2 diabetes (T2D) is a multifactorial disease involving genetic and environmental components. Several genome-wide association studies (GWAS) have been conducted to decipher potential genetic aberrations promoting the onset of this metabolic disorder. These GWAS have identified over 400 associated variants, mostly in the intronic or intergenic regions. Recently, a growing number of exome genotyping or exome sequencing experiments have identified coding variants associated with T2D. Such studies were mainly conducted in European populations, and the few candidate-gene replication studies in North African populations revealed inconsistent results. In the present study, we aimed to discover the coding genetic etiology of T2D in the Tunisian population.MethodsWe carried out a pilot Exome Wide Association Study (EWAS) on 50 Tunisian individuals. Single variant analysis was performed as implemented in PLINK on potentially deleterious coding variants. Subsequently, we applied gene-based and gene-set analyses using MAGMA software to identify genes and pathways associated with T2D. Potential signals were further replicated in an existing large in-silico dataset, involving up to 177116 European individuals.ResultsOur analysis revealed, for the first time, promising associations between T2D and variations in MYORG gene, implicated in the skeletal muscle fiber development. Gene-set analysis identified two candidate pathways having nominal associations with T2D in our study samples, namely the positive regulation of neuron apoptotic process and the regulation of mucus secretion. These two pathways are implicated in the neurogenerative alterations and in the inflammatory mechanisms of metabolic diseases. In addition, replication analysis revealed nominal associations of the regulation of beta-cell development and the regulation of peptidase activity pathways with T2D, both in the Tunisian subjects and in the European in-silico dataset.ConclusionsThe present study is the first EWAS to investigate the impact of single genetic variants and their aggregate effects on T2D risk in Africa. The promising disease markers, revealed by our pilot EWAS, will promote the understanding of the T2D pathophysiology in North Africa as well as the discovery of potential treatments.

Introduction: Monogenic diabetes (MD) accounts for 3%–6% of all cases of diabetes. This prevalence is underestimated due to its overlapping clinical features with type 1 and type 2 diabetes. Hence, genetic testing is the most appropriate tool for obtaining an accurate diagnosis. In Tunisia, few cohorts of MD have been investigated until now. The aim of this study is to search for pathogenic variants among 11 patients suspected of having MD in Tunisia using whole-exome sequencing (WES).Materials and methods: WES was performed in 11 diabetic patients recruited from a collaborating medical center. The pathogenicity of genetic variation was assessed using combined filtering and bioinformatics prediction tools. The online ORVAL tool was used to predict the likelihood of combinations of pathogenic variations. Then, Sanger sequencing was carried out to confirm likely pathogenic predicted variants among patients and to check for familial segregation. Finally, for some variants, we performed structural modeling to study their impact on protein function.Results: We identified novel variants related to MD in Tunisia. Pathogenic variants are located in several MODY and non-MODY genes. We highlighted the presence of syndromic forms of diabetes, including the Bardet–Biedl syndrome, Alström syndrome, and severe insulin resistance, as well as the presence of isolated diabetes with significantly reduced penetrance for Wolfram syndrome-related features. Idiopathic type 1 diabetes was also identified in one patient.Conclusion: In this study, we emphasized the importance of genetic screening for MD in patients with a familial history of diabetes, mainly among admixed and under-represented populations living in low- and middle-income countries. An accurate diagnosis with molecular investigation of MD may improve the therapeutic choice for better management of patients and their families. Additional research and rigorous investigations are required to better understand the physiopathological mechanisms of MD and implement efficient therapies that take into account genomic context and other related factors.

Introduction: A substantial proportion of obese subjects are metabolically healthy and free from metabolic complications. Many mechanisms that could explain the existence of the metabolically healthy obese phenotype have been suggested, involving in particular a healthy lifestyle and diet. The aim of this study was to study the anthropometric, nutritional and biological profile of two groups: obese with metabolic syndrome (MS+) and obese without metabolic syndrome (MS-).

Novice translation graduates are often found to be slow translators. The fact that this deficiency is usually rectified through professional experience implies that initial performance issues are the outcome of a complex interplay of factors, which do not involve intrinsic abilities. Based on insights from cognitively oriented research on students’ beliefs about language learning and the impact these beliefs have on students’ performance, the present study posits that the beliefs students have towards the question of translation speed represent one of the factors that fashion their productivity. Targeting graduates from the English Language and Translation programme at a private university in an Arab Gulf State, a mixed method approach, including a survey and a semi-structured interview, was adopted to explore the beliefs students have towards the question of speed and to identify the sources of these beliefs in their training programme. Analysis reveals that productivity awareness among the investigated population is almost non-existent and points at the predominantly product-oriented approach that characterises their learning experience as the main source of this condition. This article argues that improving students’ awareness of productivity requirements is not just a case of integrating timed activities, but calls for the adoption of multi-layered process-oriented training principles and practices at the level of delivery, feedback, and assessment criteria.

Background Nutrition is the most important environmental factor in the development and progression of childhood obesity, which is very common in Arabic countries.Aim Study of associated factors and nutritional status of childhood obesity.Methods This was a comparative study of 50 obese children recruited from the outpatient department of the children’s hospital, as well as 35 controls. The two groups were matched for gender and age. Anthropometric measurements have been undertaken. A food history as well as a frequency of consumption of certain foods were performed.Results There were 32 girls in obese group. Breastfeeding was more common in the control group (p = 0.04) but gestational diabetes, pregnancy weight gain, and macrosomia were greater in obese people (p = 0.002; 0.0001 and 0.004) . Food diversification was early in the obese (p = 0.05). Mobile phone use was higher among obese people (p = 0.001) but time spent watching TV was not significant (p = 0.06). There was no significant difference between the two groups regarding: the number of hours of sleep, and the practice of sport. Sedentary lifestyle concerned 34% of obese versus 8.57% controls. Intense physical activity was practiced by 14.29% of the controls against any obese (p = 0.0001). The anthropometric parameters of the parents of the obese were more important than those of the controls. The average BMI of the obese was 25.63 Kg/m2.The frequency of consumption showed a more caloric and fat diet in obese group.The diet of the controls was richer in proteins and lipids but better distributed in MUFA and PUFA, but the energy intake of the obese was significantly higher (10,612 versus 4097 Kcal/d). The mineral and vitamin intakes of the obese were correct.Conclusions The fight against childhood obesity essentially involves prevention and promotion of a good lifestyle.

The housing problem in Tunisia has become more acute due to the high cost of construction materials, thus constituting a source of concern for the population. To resolve the crisis, upgrading abundant local materials has become a necessity. This paper aimed to assess the potential use of Jebel Menchar's geomaterial to develop compressed earth brick (CEB). Laboratory tests were performed to determine the physical, chemical and mineralogical properties. Series of destructive and non-destructive tests were carried out to characterize the properties of bricks based on their composition in terms of compressive strength, flexural strength, water absorption and ultrasonic testing. The results indicated that all of the bricks studied exhibited a compressive strength greater than 2.3 Mpa during the 28-day experiments, thus suggesting a high potential ability to reduce building material problems, while also providing the brick industry a useful and inexpensive new raw material with less CO2 emissions. Resumen: El problema de la vivienda en Túnez se ha agudizado debido al alto costo de los materiales de construcción, lo que constituye un motivo de preocupación para la población. Para resolver la crisis, la actualización de abundantes materiales locales se ha convertido en una necesidad. Este artículo tuvo como objetivo evaluar el uso potencial del geomaterial de Jebel Menchar para desarrollar ladrillos de tierra comprimida (CEB, por sus siglas en inglés). Se realizaron pruebas de laboratorio para determinar las propiedades físicas, químicas y mineralógicas. Se llevaron a cabo una serie de ensayos destructivos y no destructivos para caracterizar las propiedades de los ladrillos en función de su composición en términos de resistencia a la compresión, resistencia a la flexión, absorción de agua y ensayos ultrasónicos. Los resultados indicaron que todos los ladrillos estudiados exhibieron una resistencia a la compresión superior a 2,3 Mpa durante los experimentos de 28 días, lo que sugiere una capacidad de alto potencial para reducir los problemas de los materiales de construcción, al tiempo que proporciona a la industria del ladrillo una nueva materia prima útil y económica con menos emisiones de CO2.

A magnetite chlorodeoxycellulose/ferroferric oxide (CDC@Fe3O4) heterogeneous photocatalyst was synthesised via treated and modified cotton in two steps. The designed nanocomposites were characterised by FTIR, TGA, XRD, SEM, and VSM analyses. The Fenton-photocatalytic decomposition efficiency of the synthesised magnetic catalyst was evaluated under visible sunlight using Methyl Orange (MO) as a model organic pollutant. The impacts of several degradation parameters, including the light source, catalyst load, irradiation temperature, oxidant dose, and pH of the dye aqueous solution and its corresponding concentration on the Fenton photodegradation performance, were methodically investigated. The (CDC@Fe3O4) heterogeneous catalyst showed a remarkable MO removal rate of 97.9% at 10 min under visible-light irradiation. (CDC@Fe3O4) nanomaterials were also used in a heterogeneous catalytic optimised protocol for a multicomponent reaction procedure to obtain nine tetra-substituted imidazole derivatives. The green protocol afforded imidazole derivatives in 30 min with good yields (91–97%) at room temperature and under ultrasound irradiation. Generally, a synthesised recyclable heterogeneous nano-catalyst is a good example and is suitable for wastewater treatment and organic synthesis.

Machine translation (MT) has made significant strides and has reached accuracy levels that often make the post-editing (PE) of MT output a viable alternative to manual translation. However, despite professional translators increasingly considering PE as a valid stage in their translation workflow, little has been done to investigate MT output for the purpose of informing training in PE. Against this background, the present project focuses on the handling of tense and aspect configurations in the English translation of Arabic sentences using current neural machine translation (NMT) systems. Using a dataset of representative Arabic sentences, the output of five NMT engines was assessed against reference translations. The investigation reveals regressing accuracy levels when comparing morphological, structural, and contextual tenses. These findings are believed to represent valuable information that contributes to a more informed training in the PE of Arabic-into-English NMT output.