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TAVI requires a large-bore arteriotomy. Closure is usually performed by the suture system. Some studies report a vascular complication rate of up to 21%. MANTA is a recently developed percutaneous closure system dedicated to large caliber vessels based on an anchoring system. Early studies report a lower rate of vascular complications with MANTA devices. This single-center retrospective study included all patients who underwent femoral TAVI at the Brest University Hospital from 20 November 2019 to 31 March 2021. The primary endpoint is the rate of vascular complications (major and minor) pre and post-TAVI procedure. In total, 264 patients were included. There were no significant differences in vascular complications (major and minor) between the two groups (13.6% in the MANTA group versus 21.2% in the PROSTAR group; p = 0.105), although there was a tendency to have fewer minor vascular complications in the Manta group (12.1% versus 20.5%; p = 0.067). Manta was associated with a lower rate of bleeding complications (3.8% versus 15.2%; p = 0.002), predominantly minor complications with fewer closure failures (4.5% versus 13.6%; p = 0.01), less use of covered stents (4.5% versus 12.9%; p = 0.016), and with no difference in the need for vascular surgery compared to the Prostar group (1.5% versus 2.3%; p = 0.652). On the other hand, Manta was associated with a higher rate of femoral stenosis (4.5% versus 0%; p = 0.013) without clinical significance (1.5% versus 0%; p = 0.156). The Manta and Prostar devices are equivalent in terms of vascular complications. The Manta, compared to the Prostar, is associated with fewer bleeding complications.

As elevated levels of the soluble CXCL16 (sCXCL16) chemokine have been reported in severe coronavirus disease 2019 (COVID-19) patients, this study examined whether sCXCL16 concentration on the first day of hospitalization predicted death in COVID-19 patients. A total of 76 patients with COVID-19 were admitted to the Military Hospital of Tunis, Tunisia, between October 2020 and April 2021, and later classified as survivors or nonsurvivors based on their outcomes. At admission, the groups were matched by age, gender, comorbidities, and the percentage of patients with moderate conditions. On the first day of admission, serum's sCXCL16 concentrations were measured using a magnetic-bead assay. There was an eightfold increase in serum sCXCL16 levels in the nonsurvivors' group (3661.51 ± 2464.87 pg/mL vs. 454.3 ± 338.07 pg/mL, p < 0.0001). For the optimal cutoff value of sCXCL16 at 2095 pg/mL, we found a 94.6% sensitivity and a 97.4% specificity, with an area under curve of 0.981 (p = 5.03E-08; 95% confidence interval [95% CI]: 0.951-1.0114). Considering the risk of death at a concentration above the threshold, the unadjusted odds ratio was 36 (p < 0.0001). The adjusted odd ratio was estimated at 1.003 (p < 0.0001; 95% CI: 1.002-1.004). Finally, there was a significant difference between survival and nonsurvival groups in leukocyte numbers (p = 0.006), lymphocytes (p = 0.001), polymorphonuclear neutrophils (p = 0.001), and C-reactive protein levels (p = 0.007), except for monocytes (p = 0.881). Based on these results, sCXCL16 level could be used for detecting nonsurvival COVID-19 patients. Therefore, we recommend assessing this marker in hospitalized COVID-19 patients., (© 2023 The Authors. Journal of Medical Virology published by Wiley Periodicals LLC.)

To investigate the impact of biochar on eggplant growth, physiology, and yield parameters under separate and associated drought and salt stress, a pot experiment was carried out. An eggplant variety ('Bonica F1') was exposed to one NaCl concentration (S1 = 300 mM), three irrigation regimes (FI: full irrigation; DI: deficit irrigation; ARD: alternate root-zone drying irrigation), and one dose of biochar (B1 = 6% by weight). Our findings demonstrated that associated drought and salt stress had a greater negative impact on 'Bonica F1' performance in comparison to single drought or salt stress. Whereas, adding biochar to the soil improved the ability of 'Bonica F1' to alleviate the single and associated effects of salt and drought stress. Moreover, in comparison to DI under salinity, biochar addition in ARD significantly increased plant height, aerial biomass, fruit number per plant, and mean fresh weight per fruit by 18.4%, 39.7%, 37.5%, and 36.3%, respectively. Furthermore, under limited and saline irrigation, photosynthetic rate (A n ), transpiration rate (E), and stomatal conductance (g s ) declined. In addition, the interaction between ARD and biochar effectively restored the equilibrium between the plant chemical signal (ABA) and hydraulic signal (leaf water potential). As a result, mainly under salt stress, with ARD treatment, intrinsic water use efficiency (WUE i ) and yield traits were much higher than those in DI. Overall, biochar in combination with ARD could be an efficient approach for preserving crop productivity.

Listeria monocytogenes ( L. monocytogenes ) is a serious food-borne pathogen that can cause listeriosis, an illness caused by eating food contaminated with this pathogen. Currently, the treatment or prevention of listeriosis is a global challenge due to the resistance of bacteria against multiple commonly used antibiotics, thus necessitating the development of novel green antimicrobials. Scientists are increasingly interested in microbial surfactants, commonly known as "biosurfactants", due to their antimicrobial properties and eco-friendly nature, which make them an ideal candidate to combat a variety of bacterial infections. Therefore, the present study was designed to use a network pharmacology approach to uncover the active biosurfactants and their potential targets, as well as the signaling pathway(s) involved in listeriosis treatment. In the framework of this study, 15 biosurfactants were screened out for subsequent studies. Among 546 putative targets of biosurfactants and 244 targets of disease, 37 targets were identified as potential targets for treatment of L. monocytogenes infection, and these 37 targets were significantly enriched in a Gene Ontology (GO) analysis, which aims to identify those biological processes, cellular locations, and molecular functions that are impacted in the condition studied. The obtained results revealed several important biological processes, such as positive regulation of MAP kinase activity, protein kinase B signaling, ERK1 and ERK2 cascade, ERBB signaling pathway, positive regulation of protein serine/threonine kinase activity, and regulation of caveolin-mediated endocytosis. Several important KEGG pathways, such as the ERBBB signaling pathway, TH17 cell differentiation, HIF-1 signaling pathway, Yersinia infection, Shigellosis, and C-type lectin receptor signaling pathways, were identified. The protein-protein interaction analysis yielded 10 core targets (IL2, MAPK1, EGFR, PTPRC, TNF, ITGB1, IL1B, ERBB2, SRC, and mTOR). Molecular docking was used in the latter part of the study to verify the effectiveness of the active biosurfactants against the potential targets. Lastly, we found that a few highly active biosurfactants, namely lichenysin, iturin, surfactin, rhamnolipid, subtilisin, and polymyxin, had high binding affinities towards IL2, MAPK1, EGFR, PTPRC, TNF, ITGB1, IL1B, ERBB2, SRC, and mTOR, which may act as potential therapeutic targets for listeriosis. Overall, based on the integrated network pharmacology and docking analysis, we found that biosurfactants possess promising anti-listeriosis properties and explored the pharmacological mechanisms behind their effect, laying the groundwork for further research and development.

Background: Children with sickle cell anemia (SCA) are at an increased risk of cardiovascular complications. The aim of this study was to assess the role of speckle tracking echocardiography in detecting subclinical myocardial damage in children with SCA., Methods: A cross-sectional case-control study was conducted at the echocardiography laboratory of the military hospital of Tunis between July and December 2018. Thirty patients with SCA were included. A control(C) group including 30 normally developing children was selected and matched to the SCA group by sex and age. We compared between the two groups: conventional echocardiographic parameters including cardiac output, left ventricular ejection fraction (LVEF), thickness and the global longitudinal strain (GLS). The echocardiographic measurements were indexed according to body surface area. The left ventricular (LV) GLS association with clinical characteristics and echocardiographic parameters were also evaluated., Results: Patients and controls were matched for age and sex: the mean age was (11± 2years) in SCA group versus (12± 1 years) in C group with a sex ratio of (1.31 versus 1.27, respectively). Body surface area was comparable. LV hypertrophy and dilation were revealed in the SCA group, whereas measurements were normal in the C group. No significant differences were observed for cardiac output (p=0.4). LVEF were preserved in both groups. However, two-dimensional (2D) LVGLS was impaired in 46% of SCA group (n=14) with mean value of (-21%±3.07 vs -25%±2.98; p<0.01).In SCA group, impaired LVGLS was significantly associated with LV mass (r = - 0.399, p<0.01), LV tele diastolic diameter(r= -0.419, p<0.01) and left atrial volume (r= - 0.399, p< 0.04). In multivariate analysis, LV mass was the only independent factor., Conclusions: In the present study, LVGLS measurement revealed subclinical LV systolic impairment in patients with SCA. Therefore, 2D strain could be beneficial to detect the natural history of LV dysfunction in SCA., Competing Interests: No competing interests were disclosed., (Copyright: © 2022 Chenik S et al.)

The impact of heat and drought stresses, either individually or combined, on physiological and biochemical parameters of four eggplant varieties (Solanum melongena L.) was investigated. The results showed that associated stress generated the highest increment in proline content, MDA concentration, and H2O2 accumulation and generated the lowest increment in RWC. In addition, ‘Bonica’ and ‘Galine’ exhibited higher starch accumulation and lower electrolyte leakage (EL) under combined stress. Moreover, drought and heat stresses applied individually contributed to a substantial decline in Chla, Chlb, total Chl, Chla/b, and carotenoids (p > 0.05) in ‘Adriatica’ and ‘Black Beauty’. The decreasing level of pigments was more substantial under associated drought and heat stresses. The simultaneous application of drought and heat stresses reduced PSII efficiency (Fv/Fm), quantum yield (ΦPSII), and photochemical efficiency (qp) and boosted non-photochemical quenching (NPQ) levels. However, the change recorded in the chlorophyll fluorescence parameters was less pronounced in ‘Bonica’ and ‘Galine’. In addition, the gas exchange parameters, transpiration rate (E), CO2 assimilation rate (A), and net photosynthesis (Pn) were decreased in all varieties under all stress conditions. However, the reduction was more pronounced in ‘Adriatica’ and ‘Black Beauty’. Under associated stress, antioxidant enzymes, SOD, APX, CAT, and GR exhibited a significant increment in all eggplant cultivars. However, the rising was more elevated in ‘Bonica’ and ‘Galine’ (higher than threefold increase) than in ‘Adriatica’ and ‘Black Beauty’ (less than twofold increase). Furthermore, ‘Bonica’ and ‘Galine’ displayed higher non-enzyme scavenging activity (AsA and GSH) compared to ‘Adriatica’ and ‘Black Beauty’ under associated stress. Under stressful conditions, nutrient uptake was affected in all eggplant cultivars; however, the root, stem, and leaf N, P, and K contents, in ‘Adriatica’ and ‘Black Beauty’ were lower than in ‘Bonica’ and ‘Galine’, thereby showing less capacity in accumulating nutrients. The coexistence of drought and heat stresses caused more damage on eggplant varieties than the single appearance of drought or heat stress separately. ‘Bonica’ and ‘Galine’ showed better distinguished performance compared to ‘Adriatica’ and ‘Black Beauty’. The superiority of ‘Bonica’ and ‘Galine’ in terms of tolerance to heat and drought stresses was induced by more effective antioxidant scavenging potential, enhanced osmolyte piling-up, and prominent ability in keeping higher photosynthetic efficiency and nutrient equilibrium compared with ‘Adriatica’ and ‘Black Beauty’.

Objectives: This study aims to assess the efficacy of a combination treatment of doxycycline and zinc in the primary prevention of COVID-19 infection in Tunisian health care workers compared with two control groups., Methods: We conducted a prospective, randomized, double-blind clinical trial over 5 months to determine the efficacy of a preventive combination treatment dose of doxycycline (100 mg/day) and zinc (15 mg/day), compared with a single-dose treatment with doxycycline versus placebo. The effectiveness of preventive treatment was measured by the significant decline in the number of cases of COVID-19 infection and/or a decrease in the viral load as determined by SARS-CoV-2 cycle threshold value using reverse transcription polymerase chain reaction tests., Results: We detected a significant decrease of SARS-CoV-2 infection in the group that received both doxycycline and zinc compared with other participants. We also demonstrated that COVID-19 infection was neither associated with diabetes (P = 0.51) nor associated with hypertension (P = 0.99), asthma (P = 0.52), and chronic obstructive pulmonary disease (P = 0.27)., Conclusion: Our findings indicated that preventive therapy reduced the risk of SARS-CoV-2. These results suggest that the combination of doxycycline and zinc has a protective effect in patients with SARS-CoV-2 infection., Competing Interests: Conflict of interest statement The authors have no competing interests to declare., (Copyright © 2022 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Introduction: Since December 2019, a novel coronavirus (SARS-CoV-2) has triggered a global pandemic with a heavy medical and societal-economic toll. The health consequences were not similar during the successive waves that affected several countries. The aim of our study was to compare the sociodemographic, clinical and evolutionary features of COVID-19 patients hospitalized at the Military Hospital of Tunis (HMPIT) during the 2 nd and 3 rd waves that affected the country., Patients and Methods: Observational prospective study involving 1,527 COVID-19 patients hospitalized at HMPIT over 11 months, divided into two periods: from July 2020 to December 2020 called the second wave (V2) and from January 2021 to May 2021 called the third wave (V3). We compared the epidemiological data, the clinical form and the evolution of the patients for each period., Results: The number of hospitalized patients was 636 during V2 compared to 891 during V3. Average age was 63.5 ± 15.3 years during V2 versus 65.8 ± 17.8 years during V3 (P = not significant [NS]). The percentage of young adults [18-40 years] was 6.5% during V2 compared to 6.7% during V3 (P = NS). The gender ratio (M/F) was 1.59 for V2 and 1.42 for V3 (P = NS). Comorbidities were present in 65% of V2 patients and 66.3% of V3 patients (P = NS), with hypertension being the most prevalent one in both groups (47.2% for V2 versus 44.9% for V3; P = NS), followed by overweight, dyslipidemia and diabetes (33% for V2 versus 39.3% for V3; P = 0.012). The median duration between symptoms onset and hospitalization was 7 days [5-10] during V2 versus 8.5 days during V3 [5-12] (P = 0.0004). The severe clinical form was present in 49% of patients admitted during V2 compared to 34.8% during V3 (P < 10 -3 ). The critical form represented 18.6% of cases during V2 against 16.8% during V3 (P = NS). The average hospital length of stay in COVID units (outside of intensive care unit) was 8.4 ± 5.4 days during V2 and 9.8 ± 5.7 days during V3. The average length of stay was significantly longer for the intensive care unit (11.3 ± 3.4 days for V2 versus 13.8 ± 3.9 days for V3; P = 0.01). The case fatality rate was 24.5% during V2 and 20.7% during V3 (P = NS). Median age of death was 70.2 years [42-88] during V2 and 70.4 years [22-96] during V3 with 2 patients less than 40 years of age (1%) for the latter period. The gender ratio (M/F) of deceased patients was 3.21 for V2 and 1.5 for V3 (P = 0.001). The case fatality rate was higher in the intensive care unit (65.4% for V2 versus 69.7% for V3; P = NS). Causes of death were dominated by ARDS (acute respiratory distress syndrome) for both periods (55.1% for V2 versus 70.8% for V3; P = 0.002), followed by septic shock (12.8% for V2 versus 10.8% for V3; P = NS) and multi-organ failure (9.6% for V2 versus 7.0% for V3; P = NS)., Conclusion: This study revealed a decrease in severe and critical clinical forms during the 3rd wave, as well as a decrease in the case fatality rate compared to the previous wave, due to improved management and vaccination. On the other hand, the percentage of ARDS was significantly higher during this wave probably related to the beginning of circulation in our country of the Delta variant causing more severe clinical cases., (Copyright © 2022 SFMTSI.)

Background: Li-Fraumeni syndrome (LFS) is a rare autosomal hereditary predisposition to multiples cancers, mainly affecting young individuals. It is characterized by a broad tumor spectrum. To our best knowledge, only one Tunisian study with a confirmed LFS was published., Methods: Our study focused on the clinical, histopathological and genetic results of two patients with rare tumor phenotype and tried to establish genotype-phenotype correlation. The clinical diagnosis was based on Chompret-Bonaiti criteria relative to LFS. Molecular study was assessed using Sanger sequencing of the hotspot germline variants of TP53 gene., Results: We report 2 Tunisian families fulfilling the clinical criteria of Chompret-Bonaiti. The tumor phenotype was bilateral breast cancer (BC) in 27-year-old woman and multiple tumors for the second proband, with an onset age of 14, 35 and 36 yo for osteosarcoma, BC and esophageal cancer respectively. Each of them had a rare histological type of breast cancer associated with LFS, phyllode tumor and intralobular carcinoma. Both patients had cancer family history. The molecular study showed deleterious heterozygous germline TP53 variants in each index case: The first had a well-known hotspot missense variation c.742C>T p.(R248W) with a rare histological association, explaining genotype phenotype correlation. The second case had a nonsense variation c.159G>A p.(W53*), rare worldwide, extending the phenotype spectrum in LFS. Immunohistochemistry study in tumor samples confirmed the lack of p53 protein expression., Conclusions: Conclusively, germline TP53 testing is primordial in patients with a family history suggestive of LFS for clinical practice avoiding genotoxic treatments and adapting the surveillance. National database in LFS listing clinical and mutational data is important to set, particularly for variants rarely reported worldwide. Experience from different countries must be integrated to harmonize global protocols for cancer surveillance in LFS., (© 2022. The Author(s).)

The impact of salinity on the physiological and biochemical parameters of tolerant (‘Bonica’) and susceptible (‘Black Beauty’) eggplant varieties (Solanum melongena L.) was determined. The results revealed that the increase in salinity contributes to a significant decline in net photosynthesis (An) in both varieties; however, at the highest salt concentration (160 mM NaCl), the decrease in photorespiration (Rl) was less pronounced in the tolerant cultivar ‘Bonica’. Stomatal conductance (gs) was significantly reduced in ‘Black Beauty’ following exposure to 40 mM NaCl. However, gs of ‘Bonica’ was only substantially reduced at the highest level of NaCl (160 mM). In addition, a significant decrease in Chla, Chlb, total Chl, Chla/b and carotenoids (p > 0.05) was found in ‘Black Beauty’, and soluble carbohydrates accumulation and electrolyte leakage (EL) were more pronounced in ‘Black Beauty’ than in ‘Bonica’. The total phenols increase in ‘Bonica’ was 65% higher than in ‘Black Beauty’. In ‘Bonica’, the roots displayed the highest enzyme scavenging activity compared to the leaves. Salt stress contributes to a significant augmentation of root catalase and guaiacol peroxidase activities. In ‘Bonica’, the Na concentration was higher in roots than in leaves, whereas in ‘Black Beauty‘, the leaves accumulated more Na. Salt stress significantly boosted the Na/K ratio in ‘Black Beauty’, while no significant change occurred in ‘Bonica’. ACC deaminase activity was significantly higher in ‘Bonica’ than in ‘Black Beauty’.

An efficient regeneration protocol was applied to regenerate shoots on salt stress-tolerant calli lines of aubergine ( Solanum melongena ). These NaCl-tolerant cell lines were obtained by two different methods. On the one hand, the developed callus tissue was transferred to a medium with a continuous salt content of 40, 80, 120, or 160 mM NaCl. On the other hand, the callus tissue was subjected to a stepwise increasing salinity to 160 mM NaCl every 30 days. With the second method, calli which could be selected were characterized by compact growth, a greenish color, and absence of necrotic zones. When grown on salt-free medium again, NaCl-tolerant calli showed a decline in relative growth rate and water content in comparison to the control line. This was more obvious in the 120 mM NaCl-tolerant callus. Lipid peroxidase activity increased in 40 and 80 mM NaCl-tolerant calli; yet did not increase further in 120 mM-tolerant callus. An increase in ascorbic acid content was observed in 80 and 120 mM NaCl-tolerant calli compared to the 40 mM NaCl-tolerant lines, in which ascorbic acid content was twice that of the control. All NaCl-tolerant lines showed significantly higher superoxide dismutase (SOD) (208-305-370 µmol min -1 mg -1 FW) and catalase (CAT) (136-211-238 µmol min -1 mg -1 FW) activities compared to control plants (231 and 126 µmol min -1 mg -1 FW). Plants were regenerated on the calli lines that could tolerate up to 120 mM NaCl. From the 32 plants tested in vitro, ten plants with a higher number of leaves and root length could be selected for further evaluation in the field. Their high salt tolerance was evident by their more elevated fresh and dry weight, their more increased relative water content, and a higher number and weight of fruits compared to the wild-type parental control. The presented work shows that somaclonal variation can be efficiently used to develop salt-tolerant mutants.