Comparing Strategies to Prevent Stroke and Ischemic Heart Disease in the Tunisian Population: Markov Modeling Approach Using a Comprehensive Sensitivity Analysis Algorithm.

Background. Mathematical models offer the potential to analyze and compare the effectiveness of very different interventions to prevent future cardiovascular disease. We developed a comprehensive Markov model to assess the impact of three interventions to reduce ischemic heart diseases (IHD) and stroke deaths: (i) improved medical treatments in acute phase, (ii) secondary prevention by increasing the uptake of statins, (iii) primary prevention using health promotion to reduce dietary salt consumption. Methods. We developed and validated a Markov model for the Tunisian population aged 35–94 years old over a 20-year time horizon. We compared the impact of specific treatments for stroke, lifestyle, and primary prevention on both IHD and stroke deaths. We then undertook extensive sensitivity analyses using both a probabilistic multivariate approach and simple linear regression (metamodeling). Results. The model forecast a dramatic mortality rise, with 111,134 IHD and stroke deaths (95% CI 106567 to 115048) predicted in 2025 in Tunisia. The salt reduction offered the potentially most powerful preventive intervention that might reduce IHD and stroke deaths by 27% (−30240 [−30580 to −29900]) compared with 1% for medical strategies and 3% for secondary prevention. The metamodeling highlighted that the initial development of a minor stroke substantially increased the subsequent probability of a fatal stroke or IHD death. Conclusions. The primary prevention of cardiovascular disease via a reduction in dietary salt consumption appeared much more effective than secondary or tertiary prevention approaches. Our simple but comprehensive model offers a potentially attractive methodological approach that might now be extended and replicated in other contexts and populations

The votes in the Constituent Assembly of Tunisia, 2011-2014

The Constituent Assembly of Tunisia was in charge of devising a new Tunisian constitution for the the fall of President Zine El Abidine Ben Ali regime. It was constituted of 217 lawmakers representing Tunisians living both in the country and abroad. This data contains all the 1725 votes happened during the work of this constituent assembly of each each lawmaker elected in this assembly. In the file dataVotesANC, each contains the vote of one lawmaker with information about his age, sexe, and political party. Each column is a vote where its description can be found in the file DescriptionVar_dataVotesANC.cs

Swallowing Sound Recognition at Home Using GMM

International audienceBackgroundAiming for autonomous living for the people after a stroke is the challenge these days especially for swallowing disorders or dysphagia. The most common cause of dysphagia is stroke. In France, stroke occurs every 4 minutes, which implies 13000 hospitalizations per year. Currently, continuous medical home monitoring of patients is not available. The patient must be hospitalized or visit the medical community for possible follow-up. It is in this context that E-SwallHome (Swallowing & Breathing: Modelling and e-Health at Home) project proposes to develop tools, from hospital care until the patient returns home, which are able to monitor in real time the process of swallowing.MethodThis paper presents a relevant health problem affecting patient recovering from stroke. We propose a frequency acoustical analysis for automatic detection of swallowing process and a non-invasive acoustic based method to differentiate between swallowing sounds and other sounds in normal ambient environment during food intake.ResultThe proposal algorithm for events detection gives a global rate of good detection of 87.31%. Classification of sounds of swallowing and other sounds based on Gaussian Mixture Models (GMM), using the leave-one-out approach according to the small amount of data in our database, gives a good recognition rate of swallowing sounds of 84.57%.ConclusionThe proposal method has great potential to assist in the clinical evaluation using only swallowing sounds, which is a non-invasive technic for swallowing studies

Firms’ trade-financing decisions during crises

Firms procure funds not only from specialized financial intermediaries, but also from suppliers, generally by delaying payments. The empirical evidence on trade credit raises questions that are hard to reconcile with existing theories: • What justifies the widespread use of trade credit by financially unconstrained firms that have access to seemingly cheaper alternative sources? • Why is the reliance on trade credit not always increasing in the degree of credit rationing? • Does input lending affect the borrower’s choice of inputs? • Does the degree of creditor protection affect financing and input choices? This chapter addresses these questions in a unified framework

Do the levels of industrial pollutants influence the distribution and abundance of dinoflagellate cysts in the recently-deposited sediment of a Mediterranean coastal ecosystem ?

We studied the relationships between sediment industrial pollutants concentrations, sediment characteristics and the dinoflagellate cyst abundance within a coastal lagoon by investigating a total of 55 sampling stations within the Bizerte lagoon, a highly anthropized Mediterranean ecosystem. The sediment of Bizerte lagoon is characterized by a high dinocyst abundance, reaching a maximum value of 2742 cysts.g(-1) of dry sediment. The investigated cyst diversity was characterized by the presence of 22 dominant dinocyst morphotypes belonging to 11 genera. Two dinoflagellate species dominated the assemblage: Alexandrium pseudogonyaulax and Protoperidinium claudicans, representing 29 to 89% and 5 to 38% of the total cyst abundance, respectively, depending on the station. Seven morphotypes belonging to potentially toxic species were detected, including Alexandrium minutum, A. pseudogonyaulax, Alexandrium catenella/tamarense species complex, Lingulodinium polyedrum, Gonyaulax cf. spinifera complex, Prorocentrum micans and Protoceratium reticulatum. Pearson correlation values showed a positive correlation (alpha = 0.05) between cyst abundance and both water content and fine silt sediment content. Clustering revealed that the highest abundance of cysts corresponds to stations presenting the higher amounts of heavy metals. The simultaneous autoregressive model (SAM) highlighted a significant correlation (alpha = 0.05) between cyst accumulation and two main factors: sediment water content and sediment content for several heavy metals, including Hg, Cd, Cu, Ni and Cr. These results suggest that the degree of heavy metal pollution could influence cyst accumulation patterns

Physicochemical and sensory characteristics of virgin olive oils in relation to cultivar, extraction system and storage conditions

This research was carried out to evaluate the effects of variety, extraction systemand storage conditions such as packaging type and temperature variation on the quality of virgin olive oil. Several parameters were studied, namely, quality indices, polyphenols, tocopherols, volatile compounds and sensory properties. Thus, two olive varieties Chemlali (Tunisia) and Coratina (Italy) were selected. The olive oils were extracted by different industrial processes (super press, dual and triple phase decanter) then stored in the established conditions (ambient and refrigerator temperature) in the following packaging materials: clear and dark glass bottles and metal bottles. The oils were analyzed before and after being stored for 9 months. Principal Component Analysis and Graphical Modeling were applied to fully explore the influence of the studied factors. Results revealed that among samples, oils from Coratina cultivar were the richest in γ-tocopherol while Chemlali oils contained the highest amount of Δ-tocopherol. Quality indices namely K232 and K270 values were mainly influenced by the storage date and packaging material.Meanwhile, free acidity and peroxide value were mainly influenced by the extraction system. Concerning tocopherols, α-tocopherol content was mainly influenced by the packaging material, β-tocopherol was mainly affected by the storage date, for γ-tocopherol content the main influencing factor was the cultivar whereas for Δ-tocopherol the main influencing factor was the extraction system. Regarding volatile compounds their amounts were influenced mainly by the storage date, thatwas influenced by the packaging material, where a considerable decrease was observed after storage which was reflected by the change of sensory characteristics of stored oils: loss of positive attributes fruitiness, bitterness and pungency and onset of defects which were mainly influenced by the storage date (fruity and bitter attributes), packaging material (pungent, rancid and fusty attributes) and extraction system (musty attribute