Le marché de bestiaux du gouvernorat de Sidi Bouzid: un levier de développement rural du Centre tunisien

L’élevage ovin est une activité traditionnelle dans toutes les régions de la Tunisie et surtout le Centre et le Sud. Sur le plan national et jusqu'à une date récente seule la viande bovine retenait l'attention des pouvoirs publics et les opérateurs privés. Face aux enjeux actuels de satisfaction des besoins du pays en viandes rouges et la mise à niveau de la filière des ovins, on assiste à un processus de développement du secteur qui connaît une restructuration du cheptel et une intensification de la production en intégrant les cultures fourragères ainsi qu’une mise à niveau des marchés de bestiaux. Dans le gouvernorat de Sidi Bouzid où l’élevage ovin occupe une place de choix dans l’économie régionale, les systèmes de production agricole connaîssent une mutation profonde. Le développement du secteur irrigué et la diversification des systèmes de cultures et d'élevage expliquent la croissance de l’agriculture et le développement de la région. Cette mutation a touché aussi la structure du marché et les circuits de commercialisation des animaux. La commercialisation des viandes rouges est étroitement liée à l’élevage de bétail qui reste encore très dépendant des conditions climatiques et des politiques suivies. Dans la région de Sidi Bouzid, on dénombre des circuits différenciés de distribution des animaux et la concurrence est relativement forte. La performance du marché est caractérisée par la faiblesse des marges bénéficiaires dégagées par les éleveurs et les bouchers en comparaison avec les intermédiaires. Ce travail cherche à analyser la structure, les comportements des acteurs et la performance du marché de bestiaux de Sidi Bouzid –l’un des plus grands et connus des marchés du pays- et son rôle dans la dynamique de la filière ovine et dans le développement régional.Agricultural and Food Policy, Community/Rural/Urban Development, Environmental Economics and Policy, Food Consumption/Nutrition/Food Safety, Food Security and Poverty, Institutional and Behavioral Economics, International Relations/Trade, Marketing, Production Economics, Productivity Analysis, Research and Development/Tech Change/Emerging Technologies, Research Methods/ Statistical Methods, Resource /Energy Economics and Policy,

Process capability indices and X , R control chart limit adjustments by taking into account measurement system errors

This paper investigates the effects of measurement system variability arising from evaluations of process capabilities. In this work, relationships between true process capability indices, Cp,True and Cpm,True, and their corresponding observed indices, Cp,Obs and Cpm,Obs, are developed depending on the levels of type I and II errors. Moreover, the method for adjusting control chart limits used to monitor the process is proposed based on measurement system variability. An industrial case study is used to highlight the findings of this investigation and to discuss the adjustment levels that should be conducted depending on the values of type I and type II errors

Osteite frontale post-sinusitique: Etude rétrospective à propos de 31 cas

Objective : Post-sinusitic frontal osteitis is defined as an extension of frontal sinus infection to the adjacent bony structures. It is an emergency that should rapidly be diagnosed and treated. The aim of this study is to analyze epidemiologic, clinical and paraclinical features, and to review different therapeutic modalities of this disease.Materials and methods : We carry a retrospective study about 31 patients diagnosed and treated between 1996 and 2010. All patients underwent complete ENT and neurological examination, biological investigations, sino-nasal and cerebral CT scan. Antibiotherapy was administrated intravenously. Surgical drainage of the frontal sinus was performed eitherby trephination, by osteoplastic flap confection, or by Lemoyne drain placement. Endonasal drainage consisted of middle meatotomy with anterior ethmoidectomy. Frontal sinus cranialisation was performed with coronal approach. Evolution was assessed on clinical, biological and radiological criteria.Results : Mean age was 24,4 years (8-62 years) and sex-ratio 4,16. Frontal headache (10 cases) and intracranial hypertension signs (8 cases) were the most frequent functional symptoms. Frontal tumefaction was noted in 9 patients, associated in 5 cases with orbital tumefaction of the internal eye angle. Rhinological signs were essentially purulent rhinorrhea(9 cases) and nasal obstruction (5 cases). Nasal endoscopy showed purulent secretions at themiddlemeatus in 12 cases. CT scan revealed a typical aspect of frontal osteitis with bony lysis. A sub-periostal abscess was associated in 7 patients. Intracranial extension was noted in 15 cases and orbital extension in 7 cases. Bacteriological examination was positivein 8 cases. Most frequent bacteria were streptococcus and staphylococcus aureus (3 cases each). Antibiotic therapy was initially administrated in all cases. Concerning initial surgical treatment, 9 patients underwent frontaldrainage and 2 others orbital drainage. On the other hand, 4 patients underwent only sub-periostal abscess drainage. This one was associated with cranialisation in another case. For patients having endocranial complications, empyema drainage was realized in 14 cases, associed in 6 of them with cranialisation. Cerebral abscess drainage was performedin one other patient. Clinical and radiological evolution was favourable in 24 patients (77,4%). The seven other patients were reoperated because of persistence or aggravation of clinical symptoms. Later evolution was favourable.Conclusion : Post-sinusitic frontal osteitis a rare and serious affection. Diagnosis, based on clinical and radiological features, should be early made. Adequate treatment have to be instituted to prevent life-threatening complications.Keywords : osteitis, frontal sinus, sinusitis, computed tomography, drainage, cranialisatio

Effect of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker initiation on organ support-free days in patients hospitalized with COVID-19

IMPORTANCE Overactivation of the renin-angiotensin system (RAS) may contribute to poor clinical outcomes in patients with COVID-19. Objective To determine whether angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) initiation improves outcomes in patients hospitalized for COVID-19. DESIGN, SETTING, AND PARTICIPANTS In an ongoing, adaptive platform randomized clinical trial, 721 critically ill and 58 non–critically ill hospitalized adults were randomized to receive an RAS inhibitor or control between March 16, 2021, and February 25, 2022, at 69 sites in 7 countries (final follow-up on June 1, 2022). INTERVENTIONS Patients were randomized to receive open-label initiation of an ACE inhibitor (n = 257), ARB (n = 248), ARB in combination with DMX-200 (a chemokine receptor-2 inhibitor; n = 10), or no RAS inhibitor (control; n = 264) for up to 10 days. MAIN OUTCOMES AND MEASURES The primary outcome was organ support–free days, a composite of hospital survival and days alive without cardiovascular or respiratory organ support through 21 days. The primary analysis was a bayesian cumulative logistic model. Odds ratios (ORs) greater than 1 represent improved outcomes. RESULTS On February 25, 2022, enrollment was discontinued due to safety concerns. Among 679 critically ill patients with available primary outcome data, the median age was 56 years and 239 participants (35.2%) were women. Median (IQR) organ support–free days among critically ill patients was 10 (–1 to 16) in the ACE inhibitor group (n = 231), 8 (–1 to 17) in the ARB group (n = 217), and 12 (0 to 17) in the control group (n = 231) (median adjusted odds ratios of 0.77 [95% bayesian credible interval, 0.58-1.06] for improvement for ACE inhibitor and 0.76 [95% credible interval, 0.56-1.05] for ARB compared with control). The posterior probabilities that ACE inhibitors and ARBs worsened organ support–free days compared with control were 94.9% and 95.4%, respectively. Hospital survival occurred in 166 of 231 critically ill participants (71.9%) in the ACE inhibitor group, 152 of 217 (70.0%) in the ARB group, and 182 of 231 (78.8%) in the control group (posterior probabilities that ACE inhibitor and ARB worsened hospital survival compared with control were 95.3% and 98.1%, respectively). CONCLUSIONS AND RELEVANCE In this trial, among critically ill adults with COVID-19, initiation of an ACE inhibitor or ARB did not improve, and likely worsened, clinical outcomes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT0273570