State-society relations and industrial sustainable growth:The case of post-Revolution Tunisia

This paper investigates the effect of state-society relations (SSR) in the industrial sector on the sustainable economic growth of post-Revolution Tunisia. The empirical part of the paper depends mainly on qualitative data collected from fieldwork interviews with the most important actors and publications of civil society organizations. The paper suggests the presence of state capture as the defining characteristic of SSR in post-Revolution Tunisia. The combination of having powerful tycoons, weaker state, and ineffectively organized social actors produced conditions that harmed sustainability. These settings allowed tycoons to violate environmental regulations and prevented Green innovation through the adoption of Green technologies. Yet, factors such as low value-added creation, increased labor-intensity, and low environmental awareness or prioritization all interact with state capture to lower sustainability. In those sectors where tycoons are active and dominant, competing social actors are incapable of effectively exploiting the presence of a freer political system, ultimately failing to successfully organize resisting coalitions, as evident in the textile sector. While higher resistance is witnessed where tycoons are not dominant as was the case in the phosphate sector, tycoons could still use the situation to their advantage.</p

Bioactive Cytotoxic Agents and Chemokine Production Inhibitors in LPS-Induced Raw264.7 Macrophage Cell Line from Flowers of Crepis Senecioides

Crepis senecioides is one of the endemic plant species found in Libya. The ethanol extract (E) of the flowers was partitioned on silica gel column with dichloromethane affording four compounds. Their structures were elucidated by the physicochemical and spectral data as germanicol acetate (1), 3`,3``butyl, 8`,8``carboxy) di-octyl phethalate (2), taraxasterol (3) and β-sitosterol (4). effect of the tested samples 1 and 2 on the viability of RAW macrophage 264.7 were studied. anti-cancer activity was tested on several human cell lines. Anti-inflammatory effect was also screened. Compound 1 had promising cellular cytotoxicity with IC50 60.26µg/mL on HepG2. Compound 2 had a talented cellular cytotoxicity with IC50 50.18 µg/mL on PC3. Both 1 and 2 exerted alike cytotoxicity with IC50 µg/mL 78.53, 78.14 on PC3 and MCF-7 carcinoma cell lines respectively. The treatment of LPS-stimulated macrophage with 2 led to a highly significant inhibition 45.05% in the nitrite concentration in LPS-stimulated macrophage. Compound 1 had a promising cellular cytotoxicity on HepG2, while 2 exhibited an inhibition on chemokine expression in LPS-induced RAW 264.7 macrophages and had talented cellular cytotoxicity on PC3. Keywords: Crepis senecioide;, Asteraceae; Anti-inflammatory; cytotoxic effect; terpenoids; phethalate derivative

Presentation Services in MADEUS: an Authoring Environment for Multimedia Documents

The recent advances in multimedia systems, together with the advent of high speed networks, paved the way to a new generation of applications. In particular, authoring environments have found in multimedia the means of increasing the richness of information contained in electronic documents. One of the goals of the Opera team is designing an authoring environment for multimedia documents, called MADEUS, which meets the following requirements: a high level of expressiveness for both spatial and temporal dimensions; a user-friendly interface allowing highly interactive design process, scriptless and structured-based editing and automatic production of spatial and temporal layout; the portability and cross-platform interchange of multimedia documents. To achieve this research goal we first focus on finding a good representation of time for multimedia documents. This representation is required to capture the temporal dimension of media objects like video, audio, etc. and is also used to temporally organize objects with respect to each other. Time representation is clearly the main difference between multimedia authoring environment and traditional editing environments. We present in this paper our first investigational results in our experimental authoring environment MADEUS. A large part of these results are based on the experience acquired in implementing the MADEUS prototype

Using Fuzzy TOPSIS and Balanced Scorecard for Kaizen Evaluation

Background: Kaizen is a very important continuous improvement technique; however, measuring kaizen results/benefits have not been clearly and comprehensively addressed by the literature. Objectives: This paper aims to propose a kaizen measuring system by integrating a Balanced Scorecard (BSC) and a Fuzzy Technique for Order Performance by Similarity to Ideal Solution (Fuzzy TOPSIS). Methods/Approach: Three research instruments were distributed to kaizen experts to allocate kaizen benefits into the four BSC perspectives. The best measures of kaizen benefits were determined by employing the Fuzzy TOPSIS technique. Results: The results present a kaizen performance evaluation system where the benefits were allocated into the four BSC perspectives, and the best measure for each kaizen benefit was chosen using fuzzy TOPSIS. Conclusions: The research contributes to the literature by proposing a kaizen measurement system that will pair each benefit of using kaizen with BSC perspectives and measures, thus expanding the advantages of adopting kaizen to any sector or industry

Protective Role of Commiphora molmol Extract against Liver and Kidney Toxicity Induced by Carbon Tetrachloride in Mice

Purpose: To explore the protective role of Mirazid® (MRZ), a mixture extracted from Commiphora molmol Engler (Burseraceae), against toxicity induced by carbon tetrachloride (CCl4).Method: Forty male Swiss albino mice were divided into 4 groups. Group 1 was control and included mice which were injected with normal saline; group 2 was positive control and included mice that had no treatment for 17 days followed by intraperitoneal (i.p) injection of 200 mg/kg/day MRZ for 7 consecutive days; groups 3 and 4 included mice which were injected intraperitoneally (i.p) with 0.8 mL/kg of 30 % CCl4 on days 1, 4, 7, 10, 13 and 16; animals of group 4 were then post treated with 200 mg/kg/day MRZ for 7 consecutive days. At the end of the experiment, the mice were euthanized and subjected to a complete necropsy. Hematological and biochemical parameters were assessed. To estimate the histological changes, liver and kidney sections were exposed to microscopic examination.Results: The levels of leucocytes, granulocytes, alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin, urea, creatinine, cholesterol and triglycerides showed a significant increase (p ˂ 0.05) while the levels of lymphocytes, platelets counts, total protein and albumin showed a significant decrease (p ˂ 0.05) in CCl4-injected mice when compared with the control groups, respectively. Histological observation of the liver and kidney showed necrotic areas with cellular infiltration and atrophied renal glomerulei with degenerated renal tubule lining, respectively. Mice that were treated with MRZ after CCl4 showed that the levels of lymphocytes, ALT, AST and albumin had insignificant change (p &gt; 0.05) compared with the control groups, respectively.Conclusion: MRZ partially ameliorates the toxicity induced by CCl4 in mice by improving ALT, AST and protein profiles. Therefore, further investigations are required to figure out its antioxidant potential in order to ascertain if it can be used as an antioxidant drug.Keywords: Carbon tetrachloride, Mirazid®, Toxicity, Biochemical, Heamatological, Lipid profile, Liver and kidney function

Comparing low-dose (DART) and enhanced low-dose dexamethasone regimens in preterm infants with bronchopulmonary dysplasia

IntroductionDetermining the optimal dexamethasone dosage for facilitating extubation in extremely low birth weight (ELBW) infants with bronchopulmonary dysplasia (BPD) remains uncertain. This study aims to compare the effectiveness of low-dose (DART) and enhanced low-dose dexamethasone regimens in achieving successful extubation in these infants.MethodsWe conducted a retrospective cohort study at the Women's Wellness and Research Center (WWRC) involving ELBW infants who received dexamethasone for BPD prevention or treatment, or for extubation between January 1st, 2015, and December 31st, 2019. Our goal was to assess successful extubation within various time points of treatement.ResultsA total of 77 patients, matched in gestational age and BW, were enrolled in the study, receiving a total of 121 dexamethasone courses. Low-dose dexamethasone courses were administered 75 times to 49 infants, while 46 courses of enhanced low-dose were given to 28 infants. Treatment commenced at 30.8 ± 3.4 weeks post-menstrual age, compared to 32.1 ± 2.5 weeks in the enhanced low-dose group (p = 0.014). The median (IQR) course duration was seven (3–10) days in the low-dose group, while it was 10 (8–14) days in the enhanced low-dose group (p &lt; 0.001). The median (IQR) course dose was 0.73 (0.53–0.86) mg/kg in the low-dose group and 1.27 (0.97–2.05) mg/kg in the enhanced low-dose group (p &lt; 0.001). There were no differences in extubation success at any time point between the two groups at 72 h and seven days after treatment initiation, by course completion, and within seven days after treatment completion. However, regression analysis identified several predictors of successful extubation; baseline FiO2, course duration, and duration of invasive mechanical ventilation were negatively associated with successful extubation at various time points, while received dose per kg and cumulative dose positively correlated with successful extubation at different time points. No significant differences were observed in secondary outcomes, including death or BPD.ConclusionThe choice between low-dose and enhanced low-dose dexamethasone regimens may not significantly impact extubation success. However, careful consideration of dosing, ventilation status, and treatment duration remains crucial in achieving successful extubation. This study highlights the need for personalized dexamethasone therapy in ELBW infants

Relating circulating thyroid hormone concentrations to serum interleukins-6 and -10 in association with non-thyroidal illnesses including chronic renal insufficiency

<p>Abstract</p> <p>Background</p> <p>Because of the possible role of cytokines including interleukins (IL) in systemic non-thyroidal illnesses' (NTI) pathogenesis and consequently the frequently associated alterations in thyroid hormone (TH) concentrations constituting the euthyroid sick syndrome (ESS), we aimed in this research to elucidate the possible relation between IL-6 & IL-10 and any documented ESS in a cohort of patients with NTI.</p> <p>Methods</p> <p>Sixty patients and twenty healthy volunteers were recruited. The patients were subdivided into three subgroups depending on their underlying NTI and included 20 patients with chronic renal insufficiency (CRI), congestive heart failure (CHF), and ICU patients with myocardial infarction (MI). Determination of the circulating serum levels of IL-6 and IL-10, thyroid stimulating hormone (TSH), as well as total T4 and T3 was carried out.</p> <p>Results</p> <p>In the whole group of patients, we detected a significantly lower T3 and T4 levels compared to control subjects (0.938 ± 0.477 vs 1.345 ± 0.44 nmol/L, p = 0.001 and 47.9 ± 28.41 vs 108 ± 19.49 nmol/L, p < 0.0001 respectively) while the TSH level was normal (1.08+0.518 μIU/L). Further, IL-6 was substantially higher above controls' levels (105.18 ± 72.01 vs 3.35 ± 1.18 ng/L, p < 0.00001) and correlated negatively with both T3 and T4 (r = -0.620, p < 0.0001 & -0.267, p < 0.001, respectively). Similarly was IL-10 level (74.13 ± 52.99 vs 2.64 ± 0.92 ng/ml, p < 0.00001) that correlated negatively with T3 (r = -0.512, p < 0.0001) but not T4. Interestingly, both interleukins correlated positively (r = 0.770, p = <0.001). Moreover, IL-6 (R²= 0.338, p = 0.001) and not IL-10 was a predictor of low T3 levels with only a borderline significance for T4 (R²= 0.082, p = 0.071).</p> <p>By subgroup analysis, the proportion of patients with subnormal T3, T4, and TSH levels was highest in the MI patients (70%, 70%, and 72%, respectively) who displayed the greatest IL-6 and IL-10 concentrations (192.5 ± 45.1 ng/L & 122.95 ± 46.1 ng/L, respectively) compared with CHF (82.95 ± 28.9 ng/L & 69.05 ± 44.0 ng/L, respectively) and CRI patients (40.05 ± 28.9 ng/L & 30.4 ± 10.6 ng/L, respectively). Surprisingly, CRI patients showed the least disturbance in IL-6 and IL-10 despite the lower levels of T3, T4, and TSH in a higher proportion of them compared to CHF patients (40%, 45%, & 26% vs 35%, 25%, & 18%, respectively).</p> <p>Conclusion</p> <p>the high prevalence of ESS we detected in NTI including CRI may be linked to IL-6 and IL-10 alterations. Further, perturbation of IL-6 and not IL-10 might be involved in ESS pathogenesis although it is not the only key player as suggested by our findings in CRI.</p

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

It is time to define an organizational model for the prevention and management of infections along the surgical pathway : a worldwide cross-sectional survey

Background The objectives of the study were to investigate the organizational characteristics of acute care facilities worldwide in preventing and managing infections in surgery; assess participants' perception regarding infection prevention and control (IPC) measures, antibiotic prescribing practices, and source control; describe awareness about the global burden of antimicrobial resistance (AMR) and IPC measures; and determine the role of the Coronavirus Disease 2019 pandemic on said awareness. Methods A cross-sectional web-based survey was conducted contacting 1432 health care workers (HCWs) belonging to a mailing list provided by the Global Alliance for Infections in Surgery. The self-administered questionnaire was developed by a multidisciplinary team. The survey was open from May 22, 2021, and June 22, 2021. Three reminders were sent, after 7, 14, and 21 days. Results Three hundred four respondents from 72 countries returned a questionnaire, with an overall response rate of 21.2%. Respectively, 90.4% and 68.8% of participants stated their hospital had a multidisciplinary IPC team or a multidisciplinary antimicrobial stewardship team. Local protocols for antimicrobial therapy of surgical infections and protocols for surgical antibiotic prophylaxis were present in 76.6% and 90.8% of hospitals, respectively. In 23.4% and 24.0% of hospitals no surveillance systems for surgical site infections and no monitoring systems of used antimicrobials were implemented. Patient and family involvement in IPC management was considered to be slightly or not important in their hospital by the majority of respondents (65.1%). Awareness of the global burden of AMR among HCWs was considered very important or important by 54.6% of participants. The COVID-19 pandemic was considered by 80.3% of respondents as a very important or important factor in raising HCWs awareness of the IPC programs in their hospital. Based on the survey results, the authors developed 15 statements for several questions regarding the prevention and management of infections in surgery. The statements may be the starting point for designing future evidence-based recommendations. Conclusion Adequacy of prevention and management of infections in acute care facilities depends on HCWs behaviours and on the organizational characteristics of acute health care facilities to support best practices and promote behavioural change. Patient involvement in the implementation of IPC is still little considered. A debate on how operationalising a fundamental change to IPC, from being solely the HCWs responsibility to one that involves a collaborative relationship between HCWs and patients, should be opened.Peer reviewe