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Il presente lavoro cerca di fornire una visione su come l’arte teatrale possa contribuire allo sviluppo del pensiero antropologico e sociolinguistico, il suo metodo d’impiego e il suo impatto verso fenomeni glottologici e socio-culturali nel processo di creatività artistica spettacolare. A tale fine, l’attività teatrale dei drammaturghi contemporanei tra cui il produttore di scena e regista italiano Dario Fo (1926-2016), fornisce un oggetto d’indagine che rappresenta l’incarnazione della problematica sociale e la questione Linguistica. Attraverso la sua messa in scena e la propria eccezionale performance drammatica, possiamo rivelare la natura della società, i codici verbali e gli stili di comunicazione presenti, i suoi costumi, riti e tradizioni, evidenziando anche le sue preoccupazioni ed i sistemi politici. Abstract The current work aims to provide insight into how theatrical art can contribute to the development of anthropological and sociolinguistic thought, his way of application and his impact on linguistic and socio-cultural phenomena in the artistic process. To achieve this end, the scenic activity of contemporary playwrights including Italian stage producer and director Dario Fo (1962-2016), provides a subject of investigation that represents the embodiment of the social issues and language concerns. Throught his staging and exceptional dramatic performance, we can reveal the nature of society, verbal codes and communication styles present and their customs, rituals and traditions, highlighting their worries and political systems.

Abstract Background Branched-chain amino acid (BCAA) supplementation is one of the most popular strategies used by the general population and athletes to reduce muscle soreness and accelerate the recovery process of muscle damage biomarkers after an intense exercise or training session. Objectives This systematic review and meta-analysis investigated the effects of BCAA supplementation on muscle damage biomarkers and muscle soreness after exercise-induced muscle damage (EIMD). Methods The systematic literature search for randomized controlled trials was conducted using seven databases, up to September 13th, 2022. The eligibility criteria for selecting studies were as follows: studies performed on healthy active participants, using BCAA at least once, controlled with a placebo or control group, performing resistance or endurance exercises, and followed up at least once post-EIMD. The methodological quality of the studies was assessed using the “SIGN RCT checklist”. Random-effects meta-analyses were processed to compute the standardized mean difference (Hedges’ g). Meta-regression analyses were completed with daily and total dosage and supplementation as continuous moderator variables. Results Of the 18 studies included in this meta-analysis, 13 were of high quality and five were of acceptable quality. Our results revealed BCAA supplementation elicits a significant effect on reducing creatine kinase (CK) levels immediately (g = − 0.44; p = 0.006) and 72 h (g = − 0.99; p = 0.002), but not 24 h, 48 h, and 96 h post-EIMD. Additionally, a significant effect on delayed onset of muscle soreness (DOMS) was identified at 24 h (g = − 1.34; p

Abstract Extrapulmonary tuberculosis (EPTB) remains a challenging diagnosis. The purpose of this study was to assess the accuracy of Xpert MTB/RIF Ultra (Cepheid, USA) for rapid diagnosis of EPTB in Tunisia. Eight hundred and forty-seven extrapulmonary samples collected from 2017 to 2021, were subjected to Xpert MTB/RIF Ultra. Microscopy and culture were performed for all the specimens. The accuracy of Xpert Ultra was evaluated in comparison to the culture. Xpert Ultra diagnosed EPTB with a global sensitivity of 80.66% (74.3–85.75) and specificity of 70.87% (67.31–74.20). The molecular test was most accurate when performed in cerebrospinal fluids, bones and joints and cutaneous specimens showing a sensitivity of 100% and a specificity ranging from 70.60 to 91.11%. In lymph node samples comprising aspirates and biopsies, the sensitivity of Xpert Ultra was high 87.50% (77.23–93.53), however, the specificity was 51.08% (44.67–57.46). For pleural samples, the Xpert Ultra sensitivity was 77.50% (68.34–84.68) ranging from 71.43 to 80% in pleural biopsies and fluids respectively. The specificity in all pleural specimens was 79.56% (74.40–83.91). Xpert Ultra showed promise in the diagnosis of EPTB. The performances varied according to the site of the disease. The test may be more valuable if used in combination with other diagnostic modalities.

Background: The importance of transition of care for adolescents with rheumatological illnesses from pediatric to adult rheumatology is increasing as the childhood rheumatologic diseases continue to adulthood. Despite that, transition practice in Saudi Arabia is not yet well-developed. Objectives: This study aims to evaluate the current transition of care practice for adolescents with rheumatological diseases to the adult healthcare facilities and the obstacles in achieving the best transition of care in Saudi Arabia. Setting and methods: This is a non-interventional cross-sectional study conducted using an online survey that was distributed to pediatric and adult rheumatologists in Saudi Arabia. Google forms and Microsoft Excel 2016 were used for data entry and analysis. Descriptive statistics, frequencies and percentages were performed for categorical variables. Results: A total number of 60 rheumatologists (27 pediatric and 33 adult) participated in the survey. Fifty-six (94%) of the participants do not follow any standardized programs for transition of care. All participants agreed on the need for a defined protocol for transition of care. The major barriers for successful transition of care were lack of protocols (63%), lack of healthcare providers (56%), and lack of well-developed systems that makes it difficult to access patient's electronic health records (55%). Conclusion: A well-structured protocol for transition of care of adolescents with rheumatologic illnesses from pediatric to adult rheumatology in Saudi Arabia is still an unmet need. Efforts should be directed towards improving the practice of transition of care by establishing this protocol, enhancing the connectivity between pediatric and adult healthcare facilities, and encouraging pediatric and adult rheumatologists to adapt the transition of care protocol in their daily clinical practice.

A phylogenetic conservation analysis of Trop-2 across vertebrate species showed a high degree of sequence conservation, permitting to explore multiple models as pre-clinical benchmarks. Sequence divergence and incomplete conservation of expression patterns were observed in mouse and rat. Primate Trop-2 sequences were found to be 95%–100% identical to the human sequence. Comparative three-dimension primate Trop-2 structures were obtained with AlphaFold and homology modeling. This revealed high structure conservation of Trop-2 (0.66 ProMod3 GMQE, 0.80–0.86 ± 0.05 QMEANDisCo scores), with conservative amino acid changes at variant sites. Primate TACSTD2/TROP2 cDNAs were cloned and transfectants for individual ORF were shown to be efficiently recognized by humanized anti-Trop-2 monoclonal antibodies (Hu2G10, Hu2EF). Immunohistochemistry analysis of Macaca mulatta (rhesus monkey) tissues showed Trop-2 expression patterns that closely followed those in human tissues. This led us to test Trop-2 targeting in vivo in Macaca fascicularis (cynomolgus monkey). Intravenously injected Hu2G10 and Hu2EF were well tolerated from 5 to 10 mg/kg. Neither neurological, respiratory, digestive, urinary symptoms, nor biochemical or hematological toxicities were detected during 28-day observation. Blood serum pharmacokinetic (PK) studies were conducted utilizing anti-idiotypic antibodies in capture-ELISA assays. Hu2G10 (t1/2 = 6.5 days) and Hu2EF (t1/2 = 5.5 days) were stable in plasma, and were detectable in the circulation up to 3 weeks after the infusion. These findings validate primates as reliable models for Hu2G10 and Hu2EF toxicity and PK, and support the use of these antibodies as next-generation anti-Trop-2 immunotherapy tools.

In arid and semi-arid regions like Tunisia, irrigation water is typically saline, posing a risk of soil and crop salinization and yield reduction. This research aims to study the combined effects of soil matric and osmotic potential stresses on tomato root water uptake. Plants were grown in pot and field experiments in loamy-clay soils and were irrigated with three different irrigation water qualities: 0, 3.5, and 7 dS/m. The Hydrus-1D model was used to simulate the combined dynamics of subsurface soil water and salts. Successful calibration and validation of the model against measured water and salt profiles enabled the examination of the combined effects of osmotic and matric potential stresses on root water uptake. Relative yields, indirectly estimated from actual and potential transpiration, indicated that the multiplicative stress response model effectively simulated the measured yields and the impact of saline water irrigation on crop yields. The experimental and modeling results provide information to aid in determining the salinity levels conducive to optimal crop growth. The findings indicate that the selected salinity levels affect tomato growth to varying degrees. Specifically, the salinity levels conducive to optimal tomato growth were between 0 and 3.5 dS/m, with a significant growth reduction above this salinity level. The gradual salinization of the root zone further evidenced this effect. The scenario considering a temperature increase of 2 °C had no significant impact on crop yields in the pot and field experiments.

Abstract In this paper, an intelligent approach based on fuzzy logic has been developed to ensure operation at the maximum power point of a PV system under dynamic climatic conditions. The current distortion due to the use of static converters in photovoltaic production systems involves the consumption of reactive energy. For this, separate control of active and reactive powers using a proportional-integral controller is applied. Using batteries for energy storage in the photovoltaic system has become an increasingly promising solution to improve energy quality: current and voltage. For this purpose, the energy management of batteries for regulating the charge level under dynamic climatic conditions has been studied. The research presented in this paper provides an important contribution to the application of fuzzy theory to improve the power and performance of a hybrid system comprising a grid-connected PV, battery, and energy management strategy. Therefore, to highlight the advantage of the FL-MPPT studied in this paper, its performance has been compared and analyzed with conventional P&O and NNT algorithms. Simulation results are carried out in MatLab/Simulink tools. According to the analysis of the results, a better energy quality has been proven.

Background: Sticker sarcoma, also called venereal sarcoma or venereal lymphosarcomatosis, is a tumor of the external genital organs in females and males. In male animals the penis and foreskin (prepuce) are affected, in the female, it happens in vagina (vagina) and labia (vulva). The diagnosis of sticker sarcoma is based on the chronic discharge, the typical locations and the characteristic appearance of the tumor. Methods: We have relied on the treatment method on the complete surgical removal of all cancer cells that we can access. Results: After surgery, we notice recurrent tumors about six months after surgical treatment, indicating the need for other treatments in addition to surgery. Conclusion: Although spontaneous regressions of sticker sarcoma are documented (with permanent immunity), chemotherapy is the treatment of choice today. Irradiation should also be effective. If the tumor is only removed surgically, there is a high rate of recurrence, and this is what happened with the case that we treated, as the tumor reappeared after less than six months. [ABSTRACT FROM AUTHOR]

Over the past two decades, the rate of urbanization has increased significantly worldwide, with more than half of the population already living in cities; this trend continues in numerous countries and regions. Tunisia is a North African country with a rich history and diverse cultural heritage. In Greater Tunis, its capital city, urbanization has accelerated since 1960. Rapid urbanization has increased the demand for grey infrastructure and led to changes in land-use patterns and the destruction of the environment. This study aims to understand and depict the relationship between urban expansion and the green infrastructure in the Greater Tunis area. This study uses land-use data, administrative boundaries vector data, and Google satellite imagery datasets to calculate and analyze the changes in the land use transfer matrix and landscape pattern index of built-up land and green spaces in the Tunisian capital for three periods: 2000, 2010, and 2020. We found that the expansion of built-up areas in Tunis has increased from 8.8% in 2000 to 12.1% in 2020, and changes in green spaces have decreased from 23% in 2000 to 20.9% in 2020. Without planning guidelines, the layout of green spaces has become more fragmented and disorganized. For this reason, we provide programs and suggestions for building a complete ecological network of green spaces in order to provide references and lessons for related studies and cities facing the same problems.

Food and feed contamination with mycotoxins is a major public health concern. Humans and animals are exposed to these toxins by consuming contaminated products throughout their lives. In this study, a method based on dispersive liquid–liquid microextraction (DLLME), followed by liquid chromatography with fluorescence detection (LC-FLD), was validated for the determination of aflatoxins (AFs) M1, B1, B2, G1, G2, zearalenone (ZEN), and ochratoxin A (OTA). The method was applied to 150 raw cow milk samples and 90 market durum wheat samples from two Tunisian climatic regions: the littoral region (Mahdia) and the continental region (Béja). This work was carried out to obtain more surveillance data to support rapid initiatives to assure safe foods and protect consumer health and to estimate the daily exposure of the Tunisian population consuming those products. AFG2 and OTA were found in wheat with incidences of 54.4 and 11.1%, respectively. On the other side, milk samples were contaminated by AFG2, AFB1, and AFB2 with incidences of 8.7%, 2.0%, and 0.67%, respectively. Some of the samples showed OTA concentrations above the maximum limit allowed by the European Union, which represents a health risk for consumers in Tunisia, where no legislation exists about the maximum content of mycotoxins in food.

Abstract Background Pheochromocytoma and paraganglioma are rare neuroendocrine tumors of the chromaffin tissue, which may produce catecholamines. The aim of our study was to analyze the clinical and para-clinical aspects as well as the therapeutic and evolutionary aspects of pheocromocytomas and paragangliomas based on a series of 40 cases. Methods Our retrospective population-based research study includes 40 patients. Then, a statistical analysis was carried out using the SPSS software (version21). Results Our study involves 40 patients, including 23 women (57, 5%) and 17 men (42,5%). The mean age at the time of the diagnosis was 43.8 ± 16.8 years. The circumstances of the discovery were mainly characterized by adrenal incidentaloma and hypertension. The biological diagnosis was based on the dosage of urinary metanephrines and plasma-free metanephrines in, respectively, 61.5% and 18% of cases. A computerized tomography scan and/or a magnetic resonance imaging scan could help to locate the tumor in 100% of cases. Our series includes 3 cases of bilateral pheochromocytoma, 3 cases of paragangliomas and 1 case of malignant pheochromocytoma, while a hereditary form was retained in 3 patients. In fact, thirty-two patients were operated; cure was clinically labeled in 100% and biologically in 87.5% of patients. Conclusions The main points for improvement that our study has revealed are; a patient follow-up after surgery, which was not always regular, and an insufficient screening for genetic diseases associated with pheochromocytomas and paragangliomas.

Facebook reviews contain reviews and reviewers' information and include a set of likes, comments, sharing, and reactions called Facebook Behaviors (FBs). We extend existing research on review helpfulness to fit Facebook reviews by demonstrating that Facebook behaviors can impact review helpfulness. This study proposes a theoretical model that explains reviews' helpfulness based on FBs and baseline features. The model is empirically validated using a real Facebook data set and different feature selection methods (FS) to determine the importance level of such features to maximize the helpfulness prediction. Consequently, a combination of the impactful features is identified based on a robust and effective model. In this context, the like and love behaviors deliver the best predictive performance. Furthermore, we employ different classification techniques and a set of influencer features. The results showed the performance of the proposed model by 0.925 of accuracy.The outcomes of the current study can be applied to develop a smart review ranking system for Facebook product pages.

We recently reported that activation of Trop-2 through its cleavage at R87-T88 by ADAM10 underlies Trop-2–driven progression of colon cancer. However, the mechanism of action and pathological impact of Trop-2 in metastatic diffusion remain unexplored. Through searches for molecular determinants of cancer metastasis, we identified TROP2 as unique in its up-regulation across independent colon cancer metastasis models. Overexpression of wild-type Trop-2 in KM12SM human colon cancer cells increased liver metastasis rates in vivo in immunosuppressed mice. Metastatic growth was further enhanced by a tail-less, activated ΔcytoTrop-2 mutant, indicating the Trop-2 tail as a pivotal inhibitory signaling element. In primary tumors and metastases, transcriptome analysis showed no down-regulation of CDH1 by transcription factors for epithelial-to-mesenchymal transition, thus suggesting that the pro-metastatic activity of Trop-2 is through alternative mechanisms. Trop-2 can tightly interact with ADAM10. Here, Trop-2 bound E-cadherin and stimulated ADAM10-mediated proteolytic cleavage of E-cadherin intracellular domain. This induced detachment of E-cadherin from β-actin, and loss of cell-cell adhesion, acquisition of invasive capability, and membrane-driven activation of β-catenin signaling, which were further enhanced by the ΔcytoTrop-2 mutant. This Trop-2/E-cadherin/β-catenin program led to anti-apoptotic signaling, increased cell migration, and enhanced cancer-cell survival. In patients with colon cancer, activation of this Trop-2–centered program led to significantly reduced relapse-free and overall survival, indicating a major impact on progression to metastatic disease. Recently, the anti-Trop-2 mAb Sacituzumab govitecan-hziy was shown to be active against metastatic breast cancer. Our findings define the key relevance of Trop-2 as a target in metastatic colon cancer.

The project ‘Research and Training on Irrigation with Saline Water in Tunisia’, with the project report published by UNESCO in 1970, was set up to specify Tunisian standards for the use of saline water and to mitigate their effects on crop yields. The objective of this study is to assess the risk of long-term soil salinization by considering the agricultural practices mentioned in the project for the ‘Water Quality’ experiment in the semi-arid region of Cherfech (Tunisia). A Hydrus-1D model was used to simulate the movement of water and the transfer of salts. Soil hydraulic and solute transport parameters were estimated using inverse modeling. Calibration and validation of the model were made for the water and salt profiles carried out with four irrigation qualities QA, QB, QC and QD. Four scenarios over 50 years were studied: (i) S1 with rainfall (400 mm) only; (ii) S2 with rainfall and irrigation (1,400 mm); (iii) S3 with a 2 °C increase in temperature; (iv) S4 with the addition of 100 mm·d−1 of rainfall. The four scenarios highlighted the high risk of soil salinization, especially for the QB, QC and QD qualities after 20 years of irrigation and the deep dynamics of water and salts beyond the root zone which increases the risk of groundwater salinization. HIGHLIGHTS Saline water in Tunisia is a significant constraint on development.; The UNESCO project report Research and Training on Irrigation with Saline Water in Tunisia of 1970 is the only local reference for decision makers.; Inverse modeling is an essential tool to estimate soil transport parameters.; Assessment of soil salinization under different climate change scenarios.; Use of saline water based on the project practices can lead to the destruction of agricultural soils after 20 years.;

Milk is a staple food that is essential for human nutrition because of its high nutrient content and health benefits. However, it is susceptible to being contaminated by Aflatoxin M1 (AFM1), which is a toxic metabolite of Aflatoxin B1 (AFB1) presented in cow feeds. This research investigated AFM1 in Tunisian raw cow milk samples. A total of 122 samples were collected at random from two different regions in 2022 (Beja and Mahdia). AFM1 was extracted from milk using the QuEChERS method, and contamination amounts were determined using liquid chromatography (HPLC) coupled with fluorescence detection (FD). Good recoveries were shown with intra-day and inter-day precisions of 97 and 103%, respectively, and detection and quantification levels of 0.003 and 0.01 µg/L, respectively. AFM1 was found in 97.54% of the samples, with amounts varying from values below the LOQ to 197.37 µg/L. Lower AFM1 was observed in Mahdia (mean: 39.37 µg/L), respectively. In positive samples, all AFM1 concentrations exceeded the EU maximum permitted level (0.050 µg/L) for AFM1 in milk. In Tunisia, a maximum permitted level for AFM1 in milk and milk products has not been established. The risk assessment of AFM1 was also determined. Briefly, the estimated intake amount of AFM1 by Tunisian adults through raw cow milk consumption was 0.032 µg/kg body weight/day. The Margin of Exposure (MOE) values obtained were lower than 10,000. According to the findings, controls as well as the establishment of regulations for AFM1 in milk are required in Tunisia.

Electronic and electrical wastes (EEW) have increased exponentially in recent years due to technological progress. The uncontrolled incineration of these wastes causes pollution of air, soil, and water that has dangerous effects on health of human beings and other living organisms. This work isolated fungi that are capable of degrading some of these electronic wastes. In this study, fungi isolated from soil polluted by EEW were grown on potatoes dextrose agar (PDA) medium. The estimation of the biodegradation was achieved by inoculation of both rechargeable batteries and printed circuit boards on a minimum solid and liquid medium with selected fungal strains. During the process of biodegradation on solid medium, microscopic observation was done, and on liquid medium the production of keratinolytic enzymes was evaluated using a colorimetric method after incubation with keratine powder. After 30 days, the obtained results showed that Geotrichum candidum is capable of degrading battery and circuit boards with rates of 23% and 71%, respectively, while Rhizopus stolonifer reduced battery weight by 7% and printed circuit boards by 60%. Microscopic observations showed no morphological modification in Geotrichum candidum, while there was sporocyst formation in Rhizopus stolonifer. The detection of enzymatic production indicated that there is a relation between the biodegradation process of electronic wastes and keratinolytic enzymes in Geotrichum candidum.

Trop-2 is a transmembrane signal transducer that can induce cancer growth. Using antibody targeting and N-terminal Edman degradation, we show here that Trop-2 undergoes cleavage in the first thyroglobulin domain loop of its extracellular region, between residues R87 and T88. Molecular modeling indicated that this cleavage induces a profound rearrangement of the Trop-2 structure, which suggested a deep impact on its biological function. No Trop-2 cleavage was detected in normal human tissues, whereas most tumors showed Trop-2 cleavage, including skin, ovary, colon, and breast cancers. Coimmunoprecipitation and mass spectrometry analysis revealed that ADAM10 physically interacts with Trop-2. Immunofluorescence/confocal time-lapse microscopy revealed that the two molecules broadly colocalize at the cell membrane. We show that ADAM10 inhibitors, siRNAs and shRNAs abolish the processing of Trop-2, which indicates that ADAM10 is an effector protease. Proteolysis of Trop-2 at R87-T88 triggered cancer cell growth both in vitro and in vivo. A corresponding role was shown for metastatic spreading of colon cancer, as the R87A-T88A Trop-2 mutant abolished xenotransplant metastatic dissemination. Activatory proteolysis of Trop-2 was recapitulated in primary human breast cancers. Together with the prognostic impact of Trop-2 and ADAM10 on cancers of the skin, ovary, colon, lung, and pancreas, these data indicate a driving role of this activatory cleavage of Trop-2 on malignant progression of tumors.

Abstract Papillary thyroid carcinoma is the most common type of thyroid cancer and accounts for almost 89.4% of all thyroid carcinomas. Hodgkin lymphoma is a heterogeneous group of neoplasms and represents 10% of lymphomas. These two cancers do not share the same risk factors. Some studies have reported the association of thyroid papillary carcinoma with lymphomas, mainly Hodgkin's lymphoma, treated with radiotherapy. However, to our knowledge less than 10 cases have illustrated synchronous papillary thyroid carcinoma and Hodgkin lymphoma with no history of radiotherapy. We present the case of a 49‐year‐old female patient, with no history of past exposure to radiation, who was incidentally diagnosed with Hodgkin lymphoma during the work up for papillary thyroid carcinoma. Our patient had total thyroïdectomy with cervical lymphadenectomy. The histopathologic examination concluded to a papillary thyroid carcinoma of classical variant. And the lymph node dissection enabled us to diagnose not only papillary thyroid carcinoma's lymph node metastasis, but also Hodgkin Lymphoma. This discovery of the Hodgkin lymphoma was totally incidental. The discovery of synchronous tumors in patients with papillary thyroid carcinoma has been reported in the literature. However, the diagnosis of Hodgkin through lymph node dissection for papillary thyroid carcinoma is extremely rare. This underlines the singularity and the importance of our case. The synchronous papillary thyroid carcinoma and Hodgkin lymphoma is a rare condition, which may pose significant diagnostic and treatment dilemmas. To date, there is no standardized approach due to lack of experience. The molecular mechanisms of this link are poorly understood and yet remain to be elucidated.

Abstract Splenogonadal fusion is an abnormal connection between the spleen and gonads. This rare entity can be easily confused with testicular tumors. It usually accompanies congenital malformations, such as cryptorchidism, making diagnosis more difficult. Surgeons must be aware of this entity to avoid unnecessary orchiectomy. In some cases, biopsy may help with diagnosis.

Ectopic pheochromocytomas, also called paragangliomas, are defined as catecholamine -secreting tumors, which develop outside the adrenal medulla.Pheochromocytomas of the urinary tract represent less than 1% of all paragangliomas and are most commonly located in the bladder. Nevertheless, prostatic pheochromocytoma is an extremely rare clinical entity and only a few cases have been reported in the medical literature.Herein, we report a case of ectopic pheochromocytoma arising from the prostate, revealing with hypertensive crisis occurring immediately after ejaculation.

Abstract Background A patient-centred approach is increasingly the mandate for healthcare delivery, especially with the growing emergence of chronic conditions. A relevant but often overlooked obstacle to delivering person-centred care is the identification and consideration of all demands based on individual experience, not only disease-based requirements. Mindful of this approach, there is a need to explore how patient demands are expressed and considered in healthcare delivery systems. This study aims to: (i) understand how different types of demands expressed by patients are taken into account in the current delivery systems operated by Health Care Organisations (HCOs); (ii) explore the often overlooked content of specific non-clinical demands (i.e. demands related to interactions between disease treatments and everyday life). Method We adopted a mixed method in two cancer centres, representing exemplary cases of organisational transformation: (i) circulation of a questionnaire to assess the importance that breast cancer patients attach to every clinical (C) and non-clinical (NC) demand identified in an exploratory inquiry, and the extent to which each demand has been taken into account based on individual experiences; (ii) a qualitative analysis based on semi-structured interviews exploring the content of specific NC demands. Results Further to the way in which the questionnaires were answered (573 answers/680 questionnaires printed) and the semi-structured interviews (36) with cancer patients, results show that NC demands are deemed by patients to be almost as important as C demands (C = 6.53/7 VS. NC = 6.13), but are perceived to be considered to a lesser extent in terms of pathway management (NC = 4.02 VS C = 5.65), with a significant variation depending on the type of non-clinical demands expressed. Five types of NC demands can be identified: demands relating to daily life, alternative medicine, structure of the treatment pathway, administrative and logistic assistance and demands relating to new technologies. Conclusions This study shows that HCOs should be able to consider non-clinical demands in addition to those referring to clinical needs. These demands require revision of the healthcare professionals’ mandate and transition from a supply-orientated system towards a demand-driven approach throughout the care pathway. Other sectors have developed hospitality management, mass customisation and personalisation to scale up approaches that could serve as inspiring examples.

The crowd counting task has become a pillar for crowd control as it provides information concerning the number of people in a scene. It is helpful in many scenarios such as video surveillance, public safety, and future event planning. To solve such tasks, researchers have proposed different solutions. In the beginning, researchers went with more traditional solutions, while recently the focus is on deep learning methods and, more specifically, on Convolutional Neural Networks (CNNs), because of their efficiency. This review explores these methods by focusing on their key differences, advantages, and disadvantages. We have systematically analyzed algorithms and works based on the different models suggested and the problems they are trying to solve. The main focus is on the shift made in the history of crowd counting methods, moving from the heuristic models to CNN models by identifying each category and discussing its different methods and architectures. After a deep study of the literature on crowd counting, the survey partitions current datasets into sparse and crowded ones. It discusses the reviewed methods by comparing their results on the different datasets. The findings suggest that the heuristic models could be even more effective than the CNN models in sparse scenarios.

Background/Aims. Hepatorenal syndrome (HRS) is a form of functional renal failure arising in advanced cirrhosis and is characterized by a poor survival rate. Anemia is frequently observed during the clinical course of cirrhosis. Our study aimed to investigate the hematologic findings in patients with cirrhosis to determine the effects of anemia on renal functions in type 2 HRS and if it was a potential aggravating factor. Materials and Methods. This prospective study, in which all consecutive patients with cirrhosis were enrolled, was performed at a tertiary-level hospital (Military Hospital of Tunis) from January 2019 to June 2019. A total of 9 patients with HRS fulfilled the type 2 HRS diagnostic criteria, and 41 patients with cirrhosis without HRS were included. All data regarding patients were obtained from the medical record. Demographic data, routine hemograms, biochemical, and urinary test results were collected. Models of end-stage liver disease (MELD) and Child–Turcotte–Pugh (CTP) scores were calculated. Results. The most common etiology of cirrhosis was viral hepatitis (66%). According to the CTP score, 23 patients were in the CTP-A stage, 13 in the CTP-B stage, and 14 patients were in the CTP-C stage. Patients with type 2 HRS had significantly lower hemoglobin levels compared with non-HRS stable cirrhosis patients. As hemoglobin levels decreased, renal function worsened on patients with type 2 HRS. Patients with lower hemoglobin levels had poor prognosis and survival compared with patients with higher hemoglobin levels. Logistic regression analysis showed that lower hemoglobin levels and higher MELD and CTP scores were statistically significant for an onset of type 2 HRS. Conclusion. Renal dysfunction is a frequent complication in patients with end-stage chronic liver disease. The role of anemia in aggravating HRS in patients with cirrhosis is explained by hypoxia that can lead to microcirculatory renal ischemia. Other studies are required to determine if anemia is a precipitant factor for HRS or not.

Data analytics based on the produced data from the Internet of Things (IoT) devices is expected to improve the individuals’ quality of life. However, ensuring security and privacy in the IoT data aggregation process is a non-trivial task. Generally, the IoT data aggregation process is based on centralized servers. Yet, in the case of distributed approaches, it is difficult to coordinate several untrustworthy parties. Fortunately, the blockchain may provide decentralization while overcoming the trust problem. Consequently, blockchain-based IoT data aggregation may become a reasonable choice for the design of a privacy-preserving system. To this end, we propose PrivDA, a Privacy-preserving IoT Data Aggregation scheme based on the blockchain and homomorphic encryption technologies. In the proposed system, each data consumer can create a smart contract and publish both terms of service and requested IoT data. Thus, the smart contract puts together into one group potential data producers that can answer the consumer’s request and chooses one aggregator, the role of which is to compute the group requested result using homomorphic computations. Therefore, group-level aggregation obfuscates IoT data, which complicates sensitive information inference from a single IoT device. Finally, we deploy the proposal on a private Ethereum blockchain and give the performance evaluation.

Medicago sativa is the main perennial legume in many places in the world such as South-East Tunisian Oases. The widespread use of this species is due to its high adaptability, forage yield potential and to its good quality. Furthermore, the succession of drought years in South-East Tunisian Oases especially in Gabes influenced fodder distribution and digestibility. To a better understanding of the variation of the nutritive value of (Medicago sativa L.) plants, the effect of four drought levels (25%; 50%; 75% and 100% of field capacity) on nutritive quality was investigated for three populations [P1 (Gannouch); P2 (Chenini) and P3 (Tebelbou)] cultivated in these oases. Results showed that drought reduced leaves, shoots and roots dry matter, while this effect was more pronounced for above organs (values reached 1.2 mg) than below organs (values reached 1.8 mg). However, drought decreased phosphor, calcium, magnesium and nitrogen contents, neutral detergent fibre, acid detergent fibre and in acid detergent lignin content for P1 and P2, this stress enhanced potassium uptake, leaves shoots and roots shoots ratios especially for P3, values passed from 1.56 for control treatment to 2.06 for 25% of field capacity. This population seems to be the most resistant to drought by maintaining reduced leaf area and elevated ratios. This result indicates that Medicago sativa succeed to maintain a good nutritive value under stress conditions. To the best of our knowledge, it is important to study the effect of this stress on others varieties to more understand its effect on nutritive value.

Calicotome villosa is a spontaneous Mediterranean legume that can be a good candidate as pioneer plants to limit regression of vegetation cover and loss of biodiversity in Tunisian arid soils. In order to grow legumes in such soils, pairing rhizobia and nodule associated bacteria (NAB) might provide numerous advantages. In this work, cultivable biodiversity of rhizobial symbionts and NAB in nodules of C. villosa plants growing in five arid regions of south Tunisia was characterized. Phylogenetic analysis using 16S rDNA gene, dnak, recA and nodD sequences separated nodule-forming bacteria in six clades associated to genera Ensifer, Neorhizobium, Phyllobacterium and Rhizobium. Among NAB, the strain Variovorax sp. CT7.15 was selected due to its capacity to solubilise phosphate and, more interestingly, its high level of aminocyclopropane-1-carboxylate deaminase (ACC deaminase) activity. C. villosa plants were inoculated with representative rhizobia of each phylogenetic group and co-inoculated with the same rhizobia and strain CT7.15. Compared with single rhizobia inoculation, co-inoculation significantly improved plant growth and nodulation, ameliorated plant physiological state and increased nitrogen content in the plants, independently of the rhizobia used. These results support the benefits of pairing rhizobia and selected NAB to promote legume growth in arid or degraded soils.

La myosite ossifiante circonscrite (MOC) est une pathologie rare caractérisée par une ossification hétérotopique non tumorale des tissus mous. C'est une pathologie du sujet jeune, survenant le plus souvent après un traumatisme. Sa localisation est ubiquitaire, prédominante au niveau des ceintures et des membres. Nous rapportons l'observation d'une jeune patiente présentant une MOC paravertébrale sans contexte traumatique, dans le but de rappeler les critères diagnostics et les aspects en imagerie.

Les sarcomes utérins sont des cancers rares caractérisés par leur polymorphisme clinique et histologique. Ce sont des tumeurs malignes de mauvais pronostic. Ils se révèlent, généralement, par des symptômes non spécifiques à type de douleurs pelviennes, métrorragies. Un tableau d'abdomen aigu avec hémopneumopéritoine est une présentation rare .Nous rapportons le cas d'un léiomyosarcome utérin qui s'est manifesté par une péritonite aigue généralisée inaugurale chez une femme de 43 ans. Le diagnostic de perforation utérine sur tumeur maligne a été suspecté par l'imagerie préopératoire en urgence (échographie et TDM) et confirmé histologiquement.

In vitro screening using methanolic extracts of different marine algae and one sea grass showed antibacterial activity against eight virulent strains of fish and human pathogens. 1:1 (V: V) ratios of each methanolic extract were mutually added to give 21 interactions. The interaction between Udotea sp and Codium fragile extracts exhibited higher activities against Edwardsiella tarda (18±0.9mm), Vibrio ordalli (16±0.8mm), Klebsiella pneumonia (20±1mm) and Pseudomonas aeruginosa (16±0.8mm). The bioactivity of this interaction was found to be more effective than that obtained from some common antibiotics including: Lincolin, Streptomycin and Gentamycin. The chemical constituents of these two algal extracts and their interaction were characterized using thin layer chromatography and gas chromatographic – mass spectral analysis. The bioactivity of the separated compounds was estimated. Palmitic acid was the most active fatty acid.

Malignant epithelioid hemangioendothelioma (EH) is a rare tumor of vascular origin. We report a case of a woman who was found to have multiple hepatic masses in the right lobe of the liver on radiologic investigations, initially misdiagnosed as a metastatic carcinoma. The diagnosis of EH was made on histopathological study and confirmed by immunohistochemistry, which showed diffuse response for CD34 marker and no response to tissue CEA, HMB-45 or S-100 protein. Partial hepatectomy was made with good results.

Whole mature seeds of eight selected varieties, subspecies and accessions of three Vicia L. species grown in Tunisia were investigated for their fatty acid (FA) profile. The FA composition ranged from lauric (C12:0) to lignoceric (C24:0) acids. The total FA content was 1235.14 to 1580.34 mg 100 g–1 dry matter (DM). Linoleic acid (C18:2 c9c12; 647.87 to 801.93 mg 100 g–1 DM, i.e. >50% of total FA), oleic acid (C18:1 c9; 181.32 to 346.79 mg 100 g–1 DM, i.e. 13.2 to 24.6% of total FA) and a-linolenic acid (C18:3 c9c12c15; 42.01 to 97.72 mg 100 g–1 DM, i.e. 3.4 to 7.1% of total FA) were the most abundant unsaturated FA. Palmitic acid (C16:0; 189.86 to 281.07 mg 100 g–1 DM, i.e. 15.4 to 17.8% of total FA) and stearic acid (C18:0; 24.35 to 52.75 mg 100 g–1 DM, i.e. 2.0 to 4.0% of total FA) were the major saturated ones. The sum of all other FA did not exceed 3.0% of TFA. The favourable FA profile of the studied vetch seeds makes them interesting cheap diet components to be used in the nutrition of ruminants and non-ruminants reared in the dryland agricultural regions of Mediterranean countries.

INTRODUCTION: Surgery remains the basic treatment of hepatic hydatid cyst (HHC). However, it is associated with significant morbidity. The aim of our study was to evaluate mortality and morbidity of surgery of the HHC and to highlight the risk factors. METHODS: A retrospective study was conducted from January 1, 1996 to December 31, 2006. 391 patients hospitalized for HHC and operated in the Department of General Surgery ,A, of the Rabta Hospital in Tunis, Tunisia. RESULTS: The overall mortality rate was 0.7% while the overall morbidity rate was 20.4%. About 16.6% suffered from specific complications, while 3.8% suffered from non-specific complications. Predictors of morbidity in a univariate analysis included cysts larger than 9 cm, dome cysts, cysts with bilious contents, type II, III, IV or V on ultrasound classification, fissured cysts and intrabiliary rupture of hepatic hydatid cyst. The multivariate study consisted of independent predictors of disease at the site of the liver dome, the cysto-biliary fistula and intrabiliary rupture of hepatic hydatid cyst. CONCLUSION: The hepatic hydatid cyst of the dome and the existence of preoperative complications in particular intrabiliary rupture of hepatic hydatid cyst are the main factors of morbidity. A better understanding of these factors allows the surgeon to choose the appropiate surgical technique that is associated with less morbidity.

Introduction: Cardiothyreosis corresponds to the cellular effects of free thyroid hormones on the vascular wall and the myocardium. We aim to describe the clinical, para-clinical and therapeutic aspects of cardiothyreosis and to detail prognostic factors., Methods: We conducted a descriptive retrospective study at the Endocrinology-Diabetology Department of the Hedi Chaker University Hospital in Sfax-Tunisia. We collected medical records of 100 patients with cardiothyreosis between January 1999 and December 2019. We included patients with cardiothyreosis who underwent adequate cardiac evaluation. We excluded patients with cardiac abnormalities related to conditions other than hyperthyroidism, patients who died and patients without cardiothyreosis., Results: We included 100 adult patients (43 men and 57 women). The mean age was 49.3 ±12.9 years (20-79 years). The diagnosis of cardiothyreosis was concomitant with that of hyperthyroidism in 72% of cases. Weight loss and palpitations were the two most frequently reported signs in 91% of cases each. Hypertension was systolic in 15 patients. The average heart rate was 103.1 beats/min (52-182 bpm). The mean TSH and FT4 levels were 0.042 μIU/ml and 59.6 pmol/l, respectively. Rhythm disorders and heart failure were the most common cardiac complications with 81 and 56 cases, respectively. Cardiac ultrasound showed dilatation of the left atrium in 28.3% of patients. Pulmonary arterial hypertension was present in 43% of cases. 57 patients had been treated with benzylthiouracil at a mean dose of 157.45 mg/day. Radical treatment with radioactive iodine was indicated in 81 patients. The evolution of cardiothyreosis was favourable in 58 patients., Conclusion: Cardiothyreosis is a serious complication of hyperthyroidism. Future prospective studies will be of great help to better characterise and manage cardiothyreosis., Competing Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2023.)

Pellagra is a nutritional disease caused by the deficiency of niacin. It is a clinical syndrome characterized by four "D's": diarrhea, dermatitis, dementia and ultimately death. We describe a case of pellagra as the initial presentation of congenital duodenal diaphragm., (Copyright © 2012. Published by Elsevier Masson SAS.)