De l'eau aux dattes : aperçu de la filière datte tunisienne et perspectives d'interventions

La modernisation et l'extension des aménagements hydrauliques dans les oasis du Sud tunisien renchérissent le coût de l'eau tout en accentuant la pression sur la ressource. Or ces oasis sont majoritairement orientées vers la production d'une variété de datte destinée principalement au marché international, la Deglet el Nour. La valorisation de l'eau par ces systèmes de production, et plus généralement, leur durabilité économique et écologique sont donc dépendantes du fonctionnement et des performances de la filière datte, particulièrement dans sa composante exportatrice. Partant des nombreuses études réalisées, complétées par un ensemble d'interviews réalisé dans le cadre du projet Sirma, cet article présente un aperçu de l'organisation et du fonctionnement de la filière. Celle-ci comprend 3 grands types d'acteurs : des producteurs nombreux, de petite taille et atomisés, des conditionneurs-exportateurs peu nombreux mais intégrant faiblement l'amont et l'aval, et des collecteurs jouant le rôle d'intermédiaires entre les précédents. La filière fonctionne essentiellement sous la forme d'un marché spot, sans réelle maîtrise des quantités et qualités livrées. Des stratégies d'investissement dans des capacités de stockage apparaissent néanmoins avec le décalage à venir entre la période de récolte (octobre à décembre) et le ramadan, pic de consommation. Quelques perspectives d'intervention sont tirées de ce premier diagnostic, replacées dans une problématique plus générale de supply chain management

Simulation of a water market in Tunisia : A case study of GIC Melalsa – Kairouan

International audienceWater pricing has been a key concern in Tunisia for the last two decades. It is recognized that the average price of water remains very low as compared to the marginal value of water as well to the cost of mobilization of water. Alternatives to better allocation of water resources have been sought mainly with the increasing scarcity of this resource and the expanding irrigated lands. Failure to estimate a water price that reflects its real value would lead to sub-optimal allocation of water and in general to policy failure problems. Water markets have been a promising institutional arrangement for better allocation of water as demonstrated by diverse experiences of many countries. This paper attempts to examine the effects of the implementation of a market for water in Tunisia. Our hypothesis is that market allocation of water resources would improve the value of water (water price) and its distribution among farmers. Users will adjust their demand for water and then change production patterns, which lead to improved farm revenues (total farmers revenues). The paper compares the baseline (current) allocation to allocations based on alternative market structures extremes namely pure competition and monopoly

Optical techniques for 3D surface reconstruction in computer-assisted laparoscopic surgery

One of the main challenges for computer-assisted surgery (CAS) is to determine the intra-opera- tive morphology and motion of soft-tissues. This information is prerequisite to the registration of multi-modal patient-specific data for enhancing the surgeon’s navigation capabilites by observ- ing beyond exposed tissue surfaces and for providing intelligent control of robotic-assisted in- struments. In minimally invasive surgery (MIS), optical techniques are an increasingly attractive approach for in vivo 3D reconstruction of the soft-tissue surface geometry. This paper reviews the state-of-the-art methods for optical intra-operative 3D reconstruction in laparoscopic surgery and discusses the technical challenges and future perspectives towards clinical translation. With the recent paradigm shift of surgical practice towards MIS and new developments in 3D opti- cal imaging, this is a timely discussion about technologies that could facilitate complex CAS procedures in dynamic and deformable anatomical regions

Guidance on Noncorticosteroid Systemic Immunomodulatory Therapy in Noninfectious Uveitis: Fundamentals Of Care for UveitiS (FOCUS) Initiative

Topic: An international, expert-led consensus initiative to develop systematic, evidence-based recommendations for the treatment of noninfectious uveitis in the era of biologics. Clinical Relevance: The availability of biologic agents for the treatment of human eye disease has altered practice patterns for the management of noninfectious uveitis. Current guidelines are insufficient to assure optimal use of noncorticosteroid systemic immunomodulatory agents. Methods: An international expert steering committee comprising 9 uveitis specialists (including both ophthalmologists and rheumatologists) identified clinical questions and, together with 6 bibliographic fellows trained in uveitis, conducted a Preferred Reporting Items for Systematic Reviews and Meta-Analyses protocol systematic review of the literature (English language studies from January 1996 through June 2016; Medline [OVID], the Central Cochrane library, EMBASE, CINAHL, SCOPUS, BIOSIS, and Web of Science). Publications included randomized controlled trials, prospective and retrospective studies with sufficient follow-up, case series with 15 cases or more, peer-reviewed articles, and hand-searched conference abstracts from key conferences. The proposed statements were circulated among 130 international uveitis experts for review. A total of 44 globally representative group members met in late 2016 to refine these guidelines using a modified Delphi technique and assigned Oxford levels of evidence. Results: In total, 10 questions were addressed resulting in 21 evidence-based guidance statements covering the following topics: when to start noncorticosteroid immunomodulatory therapy, including both biologic and nonbiologic agents; what data to collect before treatment; when to modify or withdraw treatment; how to select agents based on individual efficacy and safety profiles; and evidence in specific uveitic conditions. Shared decision-making, communication among providers and safety monitoring also were addressed as part of the recommendations. Pharmacoeconomic considerations were not addressed. Conclusions: Consensus guidelines were developed based on published literature, expert opinion, and practical experience to bridge the gap between clinical needs and medical evidence to support the treatment of patients with noninfectious uveitis with noncorticosteroid immunomodulatory agents

The coronal approach in maxillofacial surgery. Notes on the surgical anatomy

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