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Apoptosis, or programmed cell death, is a fundamental process that maintains tissue homeostasis, eliminates damaged or infected cells, and plays a crucial role in various biological phenomena. The deregulation of apoptosis is involved in many human diseases, including cancer. One of the emerging players in the intricate regulatory network of apoptosis is apoptosis inhibitor 5 (API5), also called AAC-11 (anti-apoptosis clone 11) or FIF (fibroblast growth factor-2 interacting factor). While it may not have yet the same level of notoriety as some other cancer-associated proteins, API5 has garnered increasing attention in the cancer field in recent years, as elevated API5 levels are often associated with aggressive tumor behavior, resistance to therapy, and poor patient prognosis. This review aims to shed light on the multifaceted functions and regulatory mechanisms of API5 in cell fate decisions as well as its interest as therapeutic target in cancer.

Intending to provide efficient and compact wastewater remediation, the present work is exploiting and introducing a novel composite prepared from porous starch aerogel (PSA) and organically modified Ca-montmorillonite (OMMT) for the removal of dyes from aqueous samples. First, potato starch components were used as a hydrolysis precursor to obtain PSA. The organoclay samples were prepared by co-intercalation of octadecylamine (ODA) into Ca-MMT using a low-temperature melting procedure. Composites with different starch-to-organoclay ratios of 10:1, 1:1, and 1:10 were then prepared by a blending process in distilled water and used for methyl orange (MO) uptake. The removal of methyl orange dyes increased with the amount of organoclay in the PSA matrix. Characterization revealed that organoclay synergy improved the PSA surface chemistry, while an important improvement in textural properties and thermal stability was also observed. The composite’s efficiency was demonstrated by high removal capabilities towards MO in most experimental runs, with a maximum adsorption capacity beyond 344.7 mg/g. The fitting result showed that MO adsorption follows a monolayer adsorption model, and chemisorption was the rate-controlling step. Nonetheless, this study proved the great potential of PSA/OMMT in dyeing wastewater treatment. Furthermore, starch modification is proven as an effective approach to enhancing the performance of starch-derived adsorbents.

Abstract Background An unprecedent increase in the number of cases and deaths reported from dengue virus (DENV) infection has occurred in the southwestern Indian ocean in recent years. From 2017 to mid-2021 more than 70,000 confirmed dengue cases were reported in Reunion Island, and 1967 cases were recorded in the Seychelles from 2015 to 2016. Both these outbreaks displayed similar trends, with the initial circulation of DENV-2 which was replaced by DENV-1. Here, we aim to determine the origin of the DENV-1 epidemic strains and to explore their genetic characteristics along the uninterrupted circulation, particularly in Reunion. Methods Nucleic acids were extracted from blood samples collected from dengue positive patients; DENV-1 was identified by RT-qPCR. Positive samples were used to infect VERO cells. Genome sequences were obtained from either blood samples or infected-cell supernatants through a combination of both Illumina or MinION technologies. Results Phylogenetic analyses of partial or whole genome sequences revealed that all DENV-1 sequences from Reunion formed a monophyletic cluster that belonged to genotype I and were closely related to one isolate from Sri Lanka (OL752439.1, 2020). Sequences from the Seychelles belonged to the same major phylogenetic branch of genotype V, but fell into two paraphyletic clusters, with greatest similarity for one cluster to 2016–2017 isolate from Bangladesh, Singapore and China, and for the other cluster to ancestral isolates from Singapore, dating back to 2012. Compared to publicly available DENV-1 genotype I sequences, fifteen non-synonymous mutations were identified in the Reunion strains, including one in the capsid and the others in nonstructural proteins (NS) (three in NS1, two in NS2B, one in NS3, one in NS4B, and seven in NS5). Conclusion In contrast to what was seen in previous outbreaks, recent DENV-1 outbreaks in Reunion and the Seychelles were caused by distinct genotypes, all likely originating from Asia where dengue is (hyper)endemic in many countries. Epidemic DENV-1 strains from Reunion harbored specific non-synonymous mutations whose biological significance needs to be further investigated.

Known risk factors of breast cancer only explain a minority of cases. Other environmental, occupational and lifestyle-related risk factors have also been suggested to play a role. The aim of our study was to assess the relationship between lifestyle and occupational factors and breast cancer risk. In order to do this, a case-control study was conducted on 110 women with histological confirmed breast cancer during the 2013–2016 period at Farhat Hached University Hospital, Sousse, Tunisia, and 150 cancer-free controls matched by age (within 5-year intervals). A semi-quantitative estimate of exposure to self-reported occupational risk factors taking into account the daily exposure frequency (H), the exposure duration in years (D) and the exposure level (N) was recorded. One occupational condition, pesticide exposure, was independently associated with breast cancer (pa=0.003; ORa=8.68 95%CI [2.11-35.55]). Being overweight and dairy product consumption were also factors independently associated with breast cancer (pa=0.000; ORa =3.44 95% CI = [ 1.82,6.52] and pa=0.001, ORa= 6.74 95%CI = [2.13-21.27] respectively). Our results suggest a role for lifestyle and work-related factors in increasing the risk of developing breast cancer.

Abstract Background The drive to vaccinate large populations is nowadays the main instrument for combating the pandemic and preventing serious disease and death. However, breakthrough infection (post-vaccination infection) still happens after vaccination among fully vaccinated people. We aimed to assess the severity outcomes and to determine its associated factors among vaccinated COVID-19 cases in the governorate of Sousse, Tunisia. Methods We carried out a five-month observational longitudinal study including all the population of Sousse. Confirmed infections of SARS-CoV-2 and the vaccination status are recorded in the daily COVID- 19 database of the Regional Office of the Tunisian Ministry of Health. We included all post-vaccination COVID-19 cases for the analysis of the COVID-19 serious outcomes. Data were collected via 15-min telephonic call interviews conducted by trained interviewers. Descriptive analysis with calculating incidence rates of confirmed COVID-19 cases per 100,000 inhabitants was conducted. In binary logistic regression, adjusted odds ratios along with 95% intervals confidence were performed to determine factors related to severe or critical COVID-19. Results As of 31 July 2021, 107,545 persons over 19 years old have received at least one dose of COVID-19 vaccination. Among the vaccinated population, we traced and included 765 breakthrough infection cases, and the incidence rate was 711.3 per week. The majority were female (sex-ratio = 0.8), and the average age of the overall cases was 55.7 years. The prevalence of severe or critical cases in vaccinated COVID-19 patients occurs in 10.8% of cases. Patients with a medical history of cardiovascular diseases had more than two times increased odds to have a severe or critical disease. We also found the highest self-estimation of adherence to preventive measures was inversely correlated to serious cases and having an incomplete vaccination schema was strongly associated with complications. Conclusions We tried to provide evidence about the breakthrough infections to improve measures of prevention and control of COVID-19. Boosting immunity for vulnerable patients added to maintaining and promoting preventive measures are not only essential to prevent severe cases of breakthrough infections of COVID-19, but also other influenza-like diseases.

The objective of this work is to carry out a sizing program of the photovoltaic system isolated from the grid by determining the size of the subsystems that make up the photovoltaic generator, the batteries, the charge regulator and the transformers... etc. This depends on the energy consumed by the total loads, the average annual solar irradiation, and the characteristics of the module and battery as inputs. This program was realized in the form of a graphical interface. We will present as an applied example the sizing of a house located in the south of Algeria, in particular in Ghardaïa, and this program has been broadcast on other sites.

Dengue virus (DENV) is the most prevalent mosquito-borne Flavivirus that affects humans worldwide. Aedes albopictus, which is naturally infected with the bacteria Wolbachia, is considered to be a secondary vector of DENV. However, it was responsible for a recent DENV outbreak of unprecedented magnitude in Reunion Island, a French island in the South West Indian Ocean. Moreover, the distribution of the cases during this epidemic showed a spatially heterogeneous pattern across the island, leading to questions about the differential vector competence of mosquito populations from different geographic areas. The aim of this study was to gain a better understanding of the vector competence of the Ae. albopictus populations from Reunion Island for local DENV epidemic strains, while considering their infection by Wolbachia. Experimental infections were conducted using ten populations of Ae. albopictus sampled across Reunion Island and exposed to three DENV strains: one strain of DENV serotype 1 (DENV-1) and two strains of DENV serotype 2 (DENV-2). We analyzed three vector competence parameters including infection rate, dissemination efficiency and transmission efficiency, at different days post-exposition (dpe). We also assessed whether there was a correlation between the density of Wolbachia and viral load/vector competence parameters. Our results show that the Ae. albopictus populations tested were not able to transmit the two DENV-2 strains, while transmission efficiencies up to 40.79% were observed for the DENV-1 strain, probably due to difference in viral titres. Statistical analyses showed that the parameters mosquito population, generation, dpe and area of sampling significantly affect the transmission efficiencies of DENV-1. Although the density of Wolbachia varied according to mosquito population, no significant correlation was found between Wolbachia density and either viral load or vector competence parameters for DENV-1. Our results highlight the importance of using natural mosquito populations for a better understanding of transmission patterns of dengue. [ABSTRACT FROM AUTHOR]

The widespread application of the hydrocarbons benzene, toluene, ethylbenzene and xylene (BTEX) has led to their consideration as major aquatic environmental pollutants, and exposure to these hydrocarbons has become a serious concern given their detrimental health effects on aquatic species. We investigated in the present study the impact of chronic exposure to BTEX on the testis of the freshwater leech Erpobdella johanssoni. The results revealed that BTEX induced severe histological alterations revealed by vacuolar degeneration in the spermatogenic cysts, and a complete loss of normal cysts was observed. The cytophore was grossly destroyed, and extensive necrosis and detached germ cells from cytophore were observed. Interestingly, BTEX exposure induced a significant increase in malondialdehyde (MDA) levels by 85.71% in the testicular tissue of treated leeches compared to the control (P

BackgroundDengue is the world's most prevalent mosquito-borne viral disease. It is endemic in many tropical and subtropical countries and represents a significant global health burden. The first reports of dengue virus (DENV) circulation in the South West Indian Ocean (SWIO) islands date back to the early 1940s; however, an increase in DENV circulation has been reported in the SWIO in recent years. The aim of this review is to trace the history of DENV in the SWIO islands using available records from the Comoros, Madagascar, Mauritius, Mayotte, Seychelles, and Reunion. We focus in particular on the most extensive data from Reunion Island, highlighting factors that may explain the observed increasing incidence, and the potential shift from one-off outbreaks to endemic dengue transmission.MethodsFollowing the PRISMA guidelines, the literature review focused queried different databases using the keywords "dengue" or "Aedes albopictus" combined with each of the following SWIO islands the Comoros, Madagascar, Mauritius, Mayotte, Seychelles, and Reunion. We also compiled case report data for dengue in Mayotte and Reunion in collaboration with the regional public health agencies in these French territories. References and data were discarded when original sources were not identified. We examined reports of climatic, anthropogenic, and mosquito-related factors that may influence the maintenance of dengue transmission independently of case importation linked to travel.Findings and conclusionsThe first report of dengue circulation in the SWIO was documented in 1943 in the Comoros. Then not until an outbreak in 1976 to 1977 that affected approximately 80% of the population of the Seychelles. DENV was also reported in 1977 to 1978 in Reunion with an estimate of nearly 30% of the population infected. In the following 40-year period, DENV circulation was qualified as interepidemic with sporadic cases. However, in recent years, the region has experienced uninterrupted DENV transmission at elevated incidence. Since 2017, Reunion witnessed the cocirculation of 3 serotypes (DENV-1, DENV-2 and DENV-3) and an increased number of cases with severe forms and deaths. Reinforced molecular and serological identification of DENV serotypes and genotypes circulating in the SWIO as well as vector control strategies is necessary to protect exposed human populations and limit the spread of dengue.

Introduction The shortage of doctors has become a worrying problem in Tunisia. It is influenced by the phenomenon of immigration which remains poorly studied despite its magnitude. Objectives To describe the migration intentions of Tunisian young doctors and to identify the associated factors that influence their decisions. Methods This is a cross-sectional, analytical survey conducted between January and June 2019. It included all young doctors practicing in academic hospitals of Sousse (Tunisia). Data collection was based on a standardized self-administered questionnaire. Results A total of 182 valid questionnaires were collected. The median age was 26.9±2.5 years and the sex-ratio was 0.47. Immigration projects were reported by 38.5% of participants. The main destination was France (36.3%%). The main contributing factors were marital status (p

The number of dengue cases has increased dramatically over the past 20 years and is an important concern, particularly as the trends toward urbanization continue. While the majority of dengue cases are thought to be asymptomatic, it is unknown to what extent these contribute to transmission. A better understanding of their importance would help to guide control efforts. In 2019, a dengue outbreak in La Reunion resulted in more than 18,000 confirmed cases. Between October 2019 and August 2020, 19 clusters were investigated in the south, west, and east of the island, enabling the recruitment of 605 participants from 368 households within a 200 m radius of the home of the index cases (ICs). No active asymptomatic infections confirmed by RT-PCR were detected. Only 15% were possible asymptomatic dengue infections detected by the presence of anti-dengue IgM antibodies. Only 5.3% of the participants had a recent dengue infection confirmed by RT-PCR. Although the resurgence of dengue in La Réunion is very recent (2016), the rate of anti-dengue IgG positivity, a marker of past infections, was already high at 43% in this study. Dengue transmission was focal in time and space, as most cases were detected within a 100-m radius of the ICs, and within a time interval of less than 7 days between infections detected in a same cluster. No particular demographic or socio-cultural characteristics were associated with dengue infections. On the other hand, environmental risk factors such as type of housing or presence of rubbish in the streets were associated with dengue infections.

Abstract Background and Aim The COVID‐19 is a stigmatizing infectious disease even after healing. Until now, no COVID‐19 stigma scale validated in Tunisian Arabic language among the general population is available. Developing such tools is necessary to detect COVID‐19 stigma and reduce it effectively. Indeed, stigmatization of COVID‐19 patients could increase the spread of this disease and its related mental health issues. We aimed at testing the validity of a translated and modified version of the 12‐item HIV stigma scale among Tunisian COVID‐19 patients. Methods A cross‐sectional study was conducted between November and December 2020 among a representative sample of COVID‐19 patients in the governorate of Sousse, Tunisia, after quarantine. The 12‐item HIV stigma scale was translated in Tunisian Arabic and then modified to be adapted to the Tunisian context. The preliminary modified version was administrated to the participants by pretrained medical doctors during phone calls. It consisted on 20 items covering the four stigma dimensions (personalized stigma, disclosure concerns, concerns with public attitudes, and negative self‐image). The psychometric evaluation of this version included internal consistency as well as principal component analysis (PCA). Results The responses of 346 COVID‐19 patients were obtained. Their median age was 40 years (interquartile range: 30‐54.5). Females represented 60.4% of them. The PCA resulted in a three factor solution with 14 items. This 14‐item scale demonstrated good internal consistency with a global Cronbach's α of 0.91 and values of 0.94, 0.93, and 0.98 for social stigma, negative self‐image, and disclosure concerns, respectively. Conclusion This study provides a reliable and valid instrument for stigma measuring among Tunisian COVID‐19 patients. The use of this scale would contribute in reducing the spread of this new infectious disease and its related mental health issues.

The generation of hydrogen peroxide on commercial and synthesized ZnO from different precursors was studied using two model molecules, formic acid (FA) and phenol (Ph), as well as phenolic intermediates, hydroquinone (HQ), benzoquinone (BQ), and catechol (CAT). The samples were characterized using X-ray Diffraction (XRD), Transmission Electronic Microscopy (TEM), RAMAN, and Electron Paramagnetic Resonance (EPR) before evaluating their photocatalytic properties. We found that the improved efficiency is accompanied by a high level of H2O2 production, fewer oxygen vacancies, and that the number of moles of H2O2 formed per number of carbon atoms removed is similar to the degradation of FA and Ph with a factor of 1. Moreover, a comparative study on the formation of H2O2 was carried out in the presence of TiO2 rutile and TiO2 anatase, with commercial ZnO. Our results exhibit the impact of the presence of TiO2 on the decomposition of hydrogen peroxide and the formation of phenolic intermediates, which are much lower than those of ZnO only, which is in agreement with the formation of hydroxyl radicals °OH and superoxide O2°− degrading significantly hydroquinone (HQ), benzoquinone (BQ), and cathecol (CAT).

Background: Work related upper limb disorders (WRULDs) are a major occupational health concern. The health field, with its various occupational categories, is a conducive environment for the emergence of these conditions. Midwives are particularly at risk for WRULDs. Objective: To determine the prevalence of WRULDs among midwives exersing at a Tunisian academic maternity and identify its associated factors. Methods: This is a cross-sectional descriptive study conducted among midwives working at the maternity Departement of the Farhat Hached Teaching Hospital in the central region of Tunisia, during the period from March to May 2016. This study was based on a self-administered questionnaire including socio-professional characteristics, the “Nordic” questionnaire for the assessment of WRULDs in the last 12 months and the last 7 days, and the job content questionnaire for the evaluation of the psychosocial environment at work. Results: A total of 54 midwives participated to our study with a response rate of 84.3%. The mean age was 46.1 + 8.7 years. In the last week before the study, the median number of deliveries performed by midwives per day was 3. Job strain was noted in 33.3% of cases. During the last 12 months, the prevalence of WRULDs was 90.7%. The complaints were located at the neck in 72.7% of cases. For the last seven days, this prevalence was 53.7%. Obesity and upper limb trauma history were significantly associated with WRULDs over the last 7 days. No social-occupational risk factors were associated with WRULDs in midwives in the last 12 months. Conclusion: Our study found a high prevalence of WRULDs in midwives, emphasizing the need of adequate prevention in order to reduce the importance of this occupational disease and its harmful consequences.

Background. Chronic pain (CP) is a real public health concern. It is a common cause of poor quality of life and workplace absenteeism. It is well studied in many medical and surgical fields. However, only few data are available as regards to its occurrence in trauma patients. Purpose. To assess the prevalence, associated factors, and psychosocial impact of CP following chest trauma. Methods. This is an observational, descriptive, and analytic cross-sectional study performed in a Tunisian department of anesthesia and intensive care over a two-month period. Adult patients admitted one year ago for isolated chest trauma were enrolled. Data were collected by a phone interview. Studied variables were sociodemographic characteristics, traumatic injuries and their management, the occurrence of CP, and its psychosocial impact. CP was diagnosed by the Brief Pain Inventory (BPI) considering an evolution period of at least 3 months. Its impact was assessed by the BPI and the Posttraumatic stress disorder Checklist Scale (PCLS). Results. Fifty-four patients were included in the study. The prevalence of CP was 79.6%. The average CP intensity was 3.18 ± 1.4. It was neuropathic in 90.7%. Its main associated factors were pleural effusion (p=0.016), time to ICU admission (p=0.05), and posttraumatic stress disorders (p=0.017). After a multivaried analysis, only pleural effusion was associated with CP (p=0.01, OR = 6.9 CI 95% [1.2–37.3]). Probable or very likely PTSDs were noted, respectively, in 10 and 9 cases. Regarding the psychosocial impact of CP, the most commonly affected dimensions were general activity, work, sleep, and mood. Conclusion. CP following chest trauma is frequent and severe requiring preventive measures such as high risk patients screening, better management of acute pain, and a multidisciplinary approach for patients with diagnosed CP.

The operating theatre staff is exposed to various constraints such as excessive working hours, severe medical conditions and dreadful consequences in case of malpractice. These working conditions may lead to high and chronic levels of stress, which can interfere with medical staff well-being and patients quality of care. The aim of this study is toassess the impact of music therapy on stress levels and burnout risk on the operating room staff. This is a pre-experimental study including the operating rooms staff of urology and maxillofacial surgery in the academic hospital of Sahloul Sousse (Tunisia) over a period of six weeks. The study consisted of three phases. The first was an initial assessment of stress level with a predefined survey. The second included three music therapy sessions per day over one month. The third was an immediate stress level reassessment following the intervention. Stress levels were evaluated using the Perceived Stress Scale version PSS-10 and the Maslach Burnout Inventory. The overall response rate was 73.9%.The average age of the study population was 37.8 ± 7.7 years with a female predominance (64.7%). After the music therapy program, Perceived Stress Scale average score decreased from 22 ± 8.9 to 16 ± 7.9 (p = 0.006). Concerning the burnout, only the average score of emotional exhaustion decreased significantly from 27 ± 10.8 to 19.2 ± 9.5 (p = 0.004). Music therapy is an innovative approach that seems to reduce operating theatre staff stress. It must be considered as a non pharmacological, simple, economic and non invasive preventive tool.