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Basal ganglia (BG) lesions are rarely reported in patients with uremia and may manifest by movement disorders. However, their exact incidence and pathogenesis have not been extensively studied. This study aimed to determine the frequency, types, risk variables (clinical, laboratory, and imaging), and manifestations of BG lesions with uremia and patients’ neurologic outcomes.
This observational study included 70 adults (mean age: 45.87 ± 3.36 years; duration of uremia: 5.5 ± 1.5 years). They underwent extensive evaluations (clinical, laboratory, and neuroimaging) and had prospectively evaluated clinically every 3 months for 2 years. Repeated magnetic resonance imaging (MRI) brains were done to patients with movement disorders and correlated with their neurologic outcomes.
BG lesions were found in 15 patients (21.4%) and 6 (8.6%) had movement disorders [Parkinsonism (n = 4), choreo-dystonia (n = 1) and dystonia (n = 1)] after the onset of uremia (mean = 10 months). There were no characteristic risk variables that distinguished patients with movement disorders from those without. Five developed movement disorders prior to the period of the study and one was de novo. The majority was females and had diabetes and higher frequencies of abnormal renal dysfunction, metabolic derangements, and white matter hyperintensities in MRIs. Movement disorders persisted in all patients despite the resolution of neuroimaging in three patients.
There is no clear threshold for renal failure to result in movement disorders due to BG lesions. The clinical outcome is variables depending on each patient’s comorbidities and complications. Persistent neuronal damage (due to uremic toxins/metabolic/nutritional and ischemic/microvascular factors) has been suggested as the cause of poor neurologic outcomes.
In the literature, there have been several methods and definitions for working out whether two theories are “equivalent” (essentially the same) or not. In this article, we do something subtler. We provide a means to measure distances (and explore connections) between formal theories. We introduce two natural notions for such distances. The first one is that of axiomatic distance, but we argue that it might be of limited interest. The more interesting and widely applicable notion is that of conceptual distance which measures the minimum number of concepts that distinguish two theories. For instance, we use conceptual distance to show that relativistic and classical kinematics are distinguished by one concept only.
Artificial Neural Networks (ANNs)-based techniques have dominated state-of-the-art results in most problems related to computer vision, audio recognition, and natural language processing in the past few years, resulting in strong industrial adoption from all leading technology companies worldwide. One of the major obstacles that have historically delayed large-scale adoption of ANNs is the huge computational and power costs associated with training and testing (deploying) them. In the mean-time, Neuromorphic Computing platforms have recently achieved remarkable performance running the bio-realistic Spiking Neural Networks at high throughput and very low power consumption making them a natural alternative to ANNs. Here, we propose using the Random Neural Network, a spiking neural network with both theoretical and practical appealing properties, as a general purpose classifier that can match the classification power of ANNs on a number of tasks while enjoying all the features of being a spiking neural network. This is demonstrated on a number of real-world classification datasets.
When patients feel spiritually supported by staff, we find increased use of hospice and reduced use of aggressive treatments at end of life, yet substantial barriers to staff spiritual care provision still exist. We aimed to study these barriers in a new cultural context and analyzed a new subgroup with “unrealized potential” for improved spiritual care provision: those who are positively inclined toward spiritual care yet do not themselves provide it.
We distributed the Religion and Spirituality in Cancer Care Study via the Middle East Cancer Consortium to physicians and nurses caring for advanced cancer patients. Survey items included how often spiritual care should be provided, how often respondents themselves provide it, and perceived barriers to spiritual care provision.
We had 770 respondents (40% physicians, 60% nurses) from 14 Middle Eastern countries. The results showed that 82% of respondents think staff should provide spiritual care at least occasionally, but 44% provide spiritual care less often than they think they should. In multivariable analysis of respondents who valued spiritual care yet did not themselves provide it to their most recent patients, predictors included low personal sense of being spiritual (p < 0.001) and not having received training (p = 0.02; only 22% received training). How “developed” a country is negatively predicted spiritual care provision (p < 0.001). Self-perceived barriers were quite similar across cultures.
Significance of results
Despite relatively high levels of spiritual care provision, we see a gap between desirability and actual provision. Seeing oneself as not spiritual or only slightly spiritual is a key factor demonstrably associated with not providing spiritual care. Efforts to increase spiritual care provision should target those in favor of spiritual care provision, promoting training that helps participants consider their own spirituality and the role that it plays in their personal and professional lives.
Two administrations of the Coloured Progressive
Matrices in Egypt were compared. The first was
administered to a large, representative national
sample between 2011 and 2013. The second was
administered to primary school pupils in villages in
Menoufia in northern Egypt in 2017. Adjusting for
the Flynn Effect, the IQ of the rural northern
Egyptians was shown to be statistically
significantly higher than the national average. It
is demonstrated that this is consistent with
regional socioeconomic differences in Egypt, which
strongly imply that northern Egypt has a higher
average IQ than southern Egypt.
This study was based on data for a sample of 1756 Egyptian primary school children (863 boys and 893 girls) aged 5–11 years assessed for intelligence with Raven’s Coloured Progressive Matrices (CPM). The results showed that boys obtained a slightly higher IQ than girls and had greater variance.
Health Technology Assessment (HTA) reports adaptation process is an important tool for emerging HTA agencies. INASanté (National Instance for Accreditation in Healthcare) has chosen to rely on this approach, to develop its first health intervention assessment report: comparative study of computed tomographic colonography versus standard colonoscopy for colorectal cancer screening.
Following consultations with healthcare professionals, the PICO question related to the colorectal cancer screening issue in Tunisia was determined. A literature search strategy covering 10 years (2006-2016) was carried out. Several databases including HTA on the net were explored. Then two independent reviewers conducted literature screening and realized a PRISMA flow diagram. Full text selected reports were submitted to three critical appraisal tools: PRISMA checklist, INAHTA checklist and Critical Appraisal Tools (FLC 2.0). The EUnetHTA adaptation toolkit was used to determine reports adaptability by assessing relevance, reliability and transferability. A structured study of the Tunisian context based on a qualitative data analysis was elaborated. The data synthesis and reporting were finalized with the contribution of a working group. Then an external peer review was conducted before the report dissemination.
Eighty reports were screened to finally retain four eligible. After a critical appraisal performed by two independent reviewers, two reports from the Canadian Agency for Drug and Technolgies in Healthcare and AETSA were selected to be assessed using the EUnetHTA adaptation toolkit. Regarding transferability criteria, the second report was retained. The context study has consisted in a qualitative analysis of seventeen individual interviews with healthcare professionals involved in colorectal cancer screening issues and an up to date Tunisian literature review. The final adapted report was a combination between relevant extracted data from AETSA report and synthesis of the Tunisian context analysis.
This HTA report represents a tool for policy makers to establish the appropriate colorectal cancer screening program for the Tunisian context. HTA reports adaptation process is the best way to give evidence on emerging technologies without wasting time and resources.
Glasses doped with rare earth elements (lanthanide series) are the most popular materials used in upconversion devices. The main aspect to develop these devices is to find suitable host materials for rare earth ions. The host material should have a high transmission of the upconverted photons, high thermal stability, good mechanical properties, low price, and easy to manufacture and shaping. Present work is concerned with studying the mechanical and structural properties for the oxide glass system doped with rare earth metal (erbium oxide, Er2O3). Ultrasonic pulse-echo technique is used to measure the sound velocities in the glass system (30%B2O3·30%Bi2O3·20%Li2O·10%BaO·10%Pb3O4·xEr2O3), (x = 0, 0.5, 1, 2, 3, 4) mol%. Ultrasound velocities (longitudinal and shear) are measured as a function of the Er2O3 content at a frequency of 4 MHz for longitudinal wave and 2 MHz for the shear wave at a temperature of 300 K. The elastic moduli and some physical parameters, such as Debye temperature, coordination number, and compressibility, were evaluated. Furthermore, the dimensionality of the glass network has been calculated in terms of the d ratio which equals G/B ratio. These parameters beside the x-ray diffraction, differential scanning calorimetry, and Fourier Transform Infrared (FTIR) measurements throw more light on the structure of the glass system. The measurements in this study exhibit remarkable anomalous changes in the network structure of the investigated glass doped with Er2O3.
A spelling error detection and correction application is typically based on three main components: a dictionary (or reference word list), an error model and a language model. While most of the attention in the literature has been directed to the language model, we show how improvements in any of the three components can lead to significant cumulative improvements in the overall performance of the system. We develop our dictionary of 9.2 million fully-inflected Arabic words (types) from a morphological transducer and a large corpus, validated and manually revised. We improve the error model by analyzing error types and creating an edit distance re-ranker. We also improve the language model by analyzing the level of noise in different data sources and selecting an optimal subset to train the system on. Testing and evaluation experiments show that our system significantly outperforms Microsoft Word 2013, OpenOffice Ayaspell 3.4 and Google Docs.
Members of the Epinephelinae subfamily of serranids (‘grouper’) are heavily
exploited by bottom longline in the Gulf of Gabès located in the south of
Tunisia. In addition to direct mortality, hook and release mortalities
likely occur when fish are caught and released, due to injuries sustained
from hooking as well as those associated with retrieval. During five
experimental trips (29 fishing sets) conducted in August 2011 from the port
of Djerba (south of the Gulf of Gabès), we evaluated the effect of hook
styles (9/0 ‘J’ and 12/0 circle hook) on groupers and non-target species. A
total of 340 specimens representing 10 species were captured. The higher
catch rate was registered for Epinephelus aeneus. The
majority of groupers captured were female mature. The circle hook increased
the capture of the most common grouper E. aeneus and did
not affect the catch of Epinephelus marginatus and
Epinepheleus costae. The effect of the type of hook on
hooking location was inconclusive. Managing of the grouper fishery using
some management actions such as size limits, bag limits, and closed seasons
may prevent more unnecessary losses of grouper species. From this
preliminary study, a definite conclusion for or against the use of circle
hook cannot be drawn. Further research on the role of gear modification and
hook designs in reducing by-catch, hooking-related injury and mortality
should be encouraged.
In this paper, we present and study a mixed variational method in order to approximate,
with the finite element method, a Stokes problem with Tresca friction boundary conditions.
These non-linear boundary conditions arise in the modeling of mold filling process by
polymer melt, which can slip on a solid wall. The mixed formulation is based on a
dualization of the non-differentiable term which define the slip conditions. Existence and
uniqueness of both continuous and discrete solutions of these problems is guaranteed by
means of continuous and discrete inf-sup conditions that are proved. Velocity and pressure
are approximated by P1 bubble-P1 finite element and piecewise linear
elements are used to discretize the Lagrange multiplier associated to the shear stress on
the friction boundary. Optimal a priori error estimates are derived using
classical tools of finite element analysis and two uncoupled discrete inf-sup conditions
for the pressure and the Lagrange multiplier associated to the fluid shear stress.
We review clinical, neuroimaging, and genetic information on six individuals with isolated sulfite oxidase deficiency (ISOD).
All patients were examined, and clinical records, biochemistry, neuroimaging, and sulfite oxidase gene (SUOX) sequencing were reviewed.
Data was available on six individuals from four nuclear families affected by ISOD. Each individual began to seize within the first week of life. neurologic development was arrested at brainstem reflexes, and severe microcephaly developed rapidly. neuroimaging within days of birth revealed hypoplasia of the cerebellum and corpus callosum and damage to the supratentorial brain looking like severe hypoxic-ischemic injury that evolved into cystic hemispheric white matter changes. Affected individuals all had elevated urinary S-sulfocysteine and normal urinary xanthine and hypoxanthine levels diagnostic of ISOD. Genetic studies confirmed SUOX mutations in four patients.
ISOD impairs systemic sulfite metabolism, and yet this genetic disease affects only the brain with damage that is commonly confused with the clinical and radiologic features of severe hypoxic-ischemic encephalopathy.
This project represents a straight continuation of the research activities of the LTI and
which helped to simulate and understand the electrical response of multi-contact systems.
In order to make further progress in the electrical modeling, the electrical transfer
model is applied to the case of bearing operation. The 2D modeling by discrete elements
reproduces the dynamic bearing. The method proposes to take measurements of electrical
resistance on bearings to detect defects. This is an original method that stems from work
published in MSSP. Indeed, while many studies have been conducted on monitoring bearing
defects by analyzing vibration signals, the use of localized electrical measurements on
bearings is a promising approach, not yet exploited. The introduction of the first
defects, as a local breaking of mechanical contact causes periodic disturbances in the
calculation of the electrical resistance. One of our objectives is to characterize the
defects position and the size of the defects, by analyzing disturbances in the electrical
In the Gulf of Gabès (Tunisia), a fleet of bottom longliners operates in summer and in the beginning of autumn targeting groupers. This fleet interacts with loggerhead turtles. During twenty trips in which 48,020 hooks were deployed, a total of 16 loggerheads were captured, most of them were juveniles, and direct mortality was estimated to be 43.75%. During the fishing operation, the hauling of the gear started one to three hours after and sometimes occurred immediately after setting. Results obtained show that the soak time did not affect the capture of turtles and target species, whereas it influenced the mortality rate of turtles. Bottom longline should be studied more in depth throughout the Mediterranean Sea, as well as parameters related to the interaction with sea turtles. However, mitigation measures to reduce turtle by-catch are urgently needed. In this way, we propose: (i) reducing the fishing soak time; (ii) experimenting with gear modification such as the use of circle hooks; and (iii) conducting an awareness campaign aimed at fishermen to show them how to deal with turtle by-catch.
Genetic diversity of loggerhead turtles, Caretta caretta, nesting on the Kuriat Islands, the most important Tunisian nesting beach (central Mediterranean), was investigated using both nuclear and mitochondrial markers. Allozyme electrophoresis of 63 hatchlings from four different clutches showed a low genetic diversity. The genotypic composition of two clutches did not match Mendelian expectations suggesting the occurrence of multiple paternity. The analysis of 380 bp of the mitochondrial DNA control region revealed no genetic variability. Only one haplotype was described in our sample (N = 16), which corresponds to the sequence of the most common haplotype found on the Mediterranean nesting beaches (CC-A2). The low genetic diversity detected by both mitochondrial and allozyme markers is discussed taking into account available data about past and present situations of loggerhead nesting activity in this site. Adequate conservation measures should be urgently taken to protect the nesting population in this area.
Introduction. Ficus carica L., well adapted to the Mediterranean climate, is ubiquitous in Tunisia. In spite of the large possibilities of its adaptation to the Tunisian climate, its cultivation remains traditional. In Tunisia, this species is represented by a large number of varieties which are facing genetic erosion. To save these genetic resources, we studied some of the Tunisian varieties using molecular markers. The aim of this analysis was to study the genetic diversity of some cultivars and to characterize them. Materials and methods. Six microsatellites were used to characterize 16 cultivars (Ficus carica L.) belonging to two fig tree collections in the south of Tunisia. Results. The molecular markers used appeared highly polymorphic in common fig trees since 4–12 alleles per locus and a mean of heterozygoty of 0.656 were scored. The resolving power (Rp) of the six microsatellites tested ranged from 2.12 to 3.87 for the 16 cultivars studied, showing a significant genetic diversity (Ht = 0.762). Genetic differentiation between geographical groups was low (Gst = 0.032). The factorial correspondence analysis showed no well-defined relation between the 16 cultivars and their geographical origin. The genotype patterns allowed us to discriminate all of the cultivars. Conclusion. The characterization of the accessions belonging to different varieties was possible, showing the power and efficiency of the molecular tools used.
Introduction. Une étude a été réalisée pour évaluer la variabilité génétique d'une collection d'écotypes de figuier (Ficus carica L.) établie dans la région du Sahel, en Tunisie. Elle a été basée sur l'observation de caractères morphologiques relatifs au développement végétatif de l'arbre. Matériel et méthodes. Les mensurations de feuilles et rameaux de 17 écotypes de figuiers tunisiens ont été mesurées à raison de deux arbres échantillonnés par cultivar. Les résultats ont été soumis à une analyse de variance et à des analyses multivariées qui ont permis d'obtenir une matrice des corrélations entre caractères mesurés et une table des distances de Mahalanobis entre les écotypes. Résultats et discussion. La variabilité intracultivar s'est révélée très faible. En revanche, la diversité intercultivar apparaît très importante et cela indépendamment de l'origine géographique et du sexe de la plante. Conclusion. Quelques paramètres morphologiques ont permis de bien différencier les cultivars. Ils pourraient être utilisés comme descripteurs chez cette espèce.
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