La demande de la qualité de l'audit externe : Quel apport de la théorie d'agence dans le contexte tunisien ?

Notre recherche a pour objectif d'étudier, en une analyse longitudinale, le pouvoir explicatif de la théorie de l'agence sur la demande d'une meilleure qualité de l'audit externe. Celle-ci est appréhendée en fonction de la réputation de l'auditeur externe. Sur un échantillon de 166 observations ‘entreprisesannées' relatif à la période 2000-2006, les résultats d'une estimation logistique en panel montrent que la concentration de propriété (mesurant les coûts d'agence actionnaires majoritaires/ actionnaires minoritaires) et uniquement l'endettement à terme (mesurant les coûts d'agence actionnaires / créanciers) exercent un impact négatif sur la demande d'une meilleure qualité d'audit. En plus, la taille de l'audité s'avère un facteur déterminant du choix d'un ‘Big4'. Par ailleurs, la présence des administrateurs externes et la participation institutionnelle semblent influencer positivement la demande de la qualité de l'audit externe.qualité d'audit; conflit d'agence; analyse longitudinale; entreprises cotées

A Multiagent Architecture for Mobile Robot Navigation Using Hierarchical Fuzzy and Sliding Mode Controllers

The challenge of this work is to implement an algorithm which enables the robot to achieve independent activities in the purpose of achieving a common goal, which consists in autonomous navigation in a partially unknown environment. The use of multiagent system is convenient for such a problem. Hence, we have designed a structure composed of four agents dedicated to perception, navigation, static, and dynamic obstacle avoidance. Those agents interact through a coordination system

Coûts d’agence, changement d’auditeur et qualité d’audit : Quel enseignement à tirer du contexte tunisien?

La présente étude vise à tester l’impact des coûts d’agence de fonds propres, actionnaires majoritaires-actionnaires minoritaires et de dettes sur la demande de la qualité d’audit lors d’un changement d’auditeur externe. Nous attribuons une meilleure qualité au grand réseau international d’audit « Big 4 ». Notre échantillon est composé par 23 entreprises tunisiennes cotées et la période d’étude s’étale entre 2007 et 2017. Les résultats montrent que l’intensité des coûts d’agence n’influence pas la demande d’une meilleure qualité d’audit lors d’un changement d’auditeur. Toutefois, nous avons montré que tout changement de dirigeant chez les entreprises tunisiennes cotées occasionne conjointement un changement d’auditeur et la demande d’une meilleure qualité d’audit. Les résultats de l’étude montrent que la variation des coûts d’agence de dettes sur la durée du mandat influence négativement la décision de changement de l’auditeur, de telle sorte qu’un accroissement des coûts d’agence de dettes occasionne un renouvellement du mandat de l’auditeur en place. &nbsp

Ostéome ostéoïde intra-articulaire de la hanche: deux observations et revue de la littérature

L’ostéome ostéoïde est une tumeur osseuse bénigne qui affecte les adultes jeunes et se localise préférentiellement au niveau des os longs. La localisation intra-articulaire est rare et atteint le plus souvent la hanche. La symptomatologie clinique est alors atypique et peut faire errer le diagnostic constituant un défi diagnostique pour les cliniciens. Nous rapportons deux observations d’ostéome ostéoïde intra-articulaires de la hanche chez deux hommes âgés 24 et 45 ans, révélés par des douleurs de la hanche gauche de type inflammatoire évoluant depuis un an et un an et demi respectivement. Chez les deux patients, le tableau atypique de l’ostéome ostéoïde a été à l’origine d’un retard diagnostic. La tomodensitométrie est dans cette indication l’examen le plus spécifique qui a permis d’évoquer le diagnostic d’ostéome ostéoïde. Une fois le diagnostic est posé, l’exérèse chirurgicale à ciel ouvert a permis la guérison avec disparition totale des douleurs. L’examen histologique a confirmé le diagnostic final d’ostéome ostéoïde intra-articulaire dans les deux cas

0363: Acute coronary syndrome complicated with left ventricular diastolic dysfunction: what is the contribution of brain natriuretic peptid?

BackgroundThe utility of Brain Natriuretic Peptide (BNP) for detecting leftventricular (LV) diastolic dysfunction in patients presenting an acute coronary syndrome without heart failure symptoms is unclear. In this study, we investigated the relation between BNP plasma levels and LV diastolic dysfunction in patients with postmyocardial infarction without systolic dysfunction.MethodsWe studied 81 patients (12 women, mean age 55±11.79) admitted in our center for myocardial infarction with or without ST segment elevation. Patients with heart failure symptoms or abnormal systolic function were excluded. LV diastolic function was assessed with conventional Doppler, by means of mitral inflow and with tissue Doppler echocardiography by means of mitral annulus. The ratio of early diastolic transmitral E wave velocities to tissue Doppler mitral annulus early diastolic E’ wave velocities (E/E’), was used to detect LV filling pressures. Patients were divided in three groups according to E/E’ ratios < 10 (group I), E/E’ ratios between 10 and 15 (group II) and E/E’ ratios >15 (group III).Abstract 0109 – Table: Patients’ baseline characteristicsPatients’baseline characteristicsBMS (n=30)DES (n=300)pSex, M/F30/030/01Age, y52,03±6,3550,2±8,450,34Body mass index*, kg/m225,79±2,5625,00±2,970,28Hypertension, %16,661,661Dyslipidemia, %33,3333,331Diabetes mellitus, %001Family history, %26,666,660,07Cigarette smoking, %73,33600,41Previous CAD, Stroke, PAOD, %001Indication of coronary angiographyAMI (STEMI/NSTEMI, %86,6676,660,5UA, %13,3316,661SCAD, %06,660,49Time interval between PCI and blood sampling, d39,16±7,6838,73±6,760,81Stent length, mm16,3±4,2417,56±5,710,33LVEF, %58,66±7,3061,13±6,180,16Drug therapies*Statin, %1001001ASA, %1001001Second anti-platelet drugClopidogrel, %46,6643,331Prasugrel, %53,33501Ticagrelor, %06,660,49β-blocker, %85,71 (n=28)60 (n=25)0,059ACE inhibitor, %0 (n=28)0 (n=26)1OAC, %001Blood tests*LDL cholesterol, g/L0,75±0,180,68±0,190,19HDL cholesterol, g/L0,39±0,100,43±0,110,19Triglyceride, g/L0,96±0,320,93±0,290,72Hemoblogin, g/dl14,34±0,9714,4±0,830,82Platelets, G/L242,93±55,90239,56±49,610,8Serum creatinine, μmol/L2,07±2,021,39±1,300,12Fasted glycaemia, g/L0,97±0,111,01±0,090,14HbA1c, %5,74±0,395,73±0,400,92Continuous variables are presented as sample mean and standard deviation. P-values reflect comparisons between patients with a BMS and patients with DES and are derived from Student’s t-tests for continuous variables whereas qualitative data were compared with Fisher’s exact test.The characteristics marked with an asterisk were collected on the same day that blood was sampled (one month after PCI)ResultsThe BNP blood levels were positively correlated significantly with E/E’ ratio (p < 0.02). Patients with elevated LV end diastolic pressure (LVEDP), defined as E/E’ >15 (n = 27) had highest BNP (302±68pg/ml) levels. E/E’ 10 to 15 group (n = 24) had a mean BNP level of 136.4±27pg/ml, and those with E/E’ < 10 (n = 29) had 82±20pg/ml. A BNP value of 107.8pg/ml had a sensitivity of 89%, a specificity of 61% for predicting E/E’ >15. The area under the ROC curve for BNP to detect any diastolic dysfunction was 0.757. A BNP value of 72.7pg/ml had a sensitivity of 82.2% and a specificity of 66.7% for detecting a diastolic dysfunction.ConclusionsA rapid assay for BNP can detect the presence of diastolic abnormalities on echocardiography. In patients with preserved systolic function post myocardial infarction, elevated BNP levels might help to reinforce the diagnosis of LV diastolic dysfunction

Translation into Arabic and validation of the ASES index in assessment of shoulder disabilities

AbstractObjectiveTo translate into Arabic and validate the “American Shoulder and Elbow Surgeons Evaluation Form” (ASES) for use in a Tunisian population presenting with periarticular pathologies of the shoulder.BackgroundNo functional index assessing the functional capacities of the shoulder is presently available in Arabic.Patients and methodsThe translation was achieved by means of forward/backward translation. Adaptations were carried out subsequent to a preliminary test involving 15 persons. Patients with periarticular shoulder disabilities were included. Clinical measurements evaluated pain and functional disability by means of the visual analogue scale (VAS). Interrater concordance (repeatability) was assessed using the intraclass correlation coefficient (ICC) and the Bland and Altman method. Construct validity (convergent and discriminant validity) was investigated using the Spearman rank correlation coefficient and a factorial analysis followed by orthogonal rotation. The internal consistency of each factor was graded in terms of the Cronbach alpha coefficient.ResultsEighty (80) patients were included in the study. Interrater concordance was excellent (ICC=0.96). The Bland and Altman method showed a low-variability mean difference. Correlations of the index score with the pain VAS (r=−0.49) and functional disability (r=−0.58) suggested satisfactory convergent validity, and our index likewise showed good discriminant validity. Factorial analysis led to the extraction of two factors with a cumulative variance rate of 92.6% that could not be explained.ConclusionTranslated into Arabic, the ASES index was found to possess high metrological qualities. While the index has been satisfactorily validated with regard to a Tunisian population, additional studies are needed to verify its applicability to other Arab populations

Le mal de pott sous occipital révélé par un abcès rétro pharyngien a propos d’un cas

Introduction : Pott's disease is the most frequent localisation of osteo-articular tuberculosis. The suboccipital localisation remains rare. Case report : A 12-years old boy, admitted for cervicalgy and dysphagia. His clinical exam revealed a swelling of posterior pharyngeal wall associated with a basicervical tumefaction fistulased to the skin. Cervical spine MRI and cervico-thoracic tomodensitometry show a retro-pharyngeal collection associated with necrosed mediastinal adenopathies and apical pulmonar retractile lesion. The patient underwent, in emergency, an incision of the retro-pharyngeal abscess. The biological assessment revealed an inflommatory syndrom. A tuberculine intra dermo-reaction was negative whereas the BK research were positive. The diagnosis of suboccipital Pott's disease associated with pulmonar tuberculosis was done. The anti-tuberculosis drug was mentained for 11 months with a good recovery. The follow-up was 6 years. Discussion : The sub occipital pain Pott localisation was rare. The cervicalgy was the important clinical sign of consultation. Whearas, the dysphagia and retro-pharyngeal abscess could be revealing. The MRI was necessary for an early diagnosis. The diagnosis confirmation was made by the presence of Mycobacterium Koch in the pottic lesion. The treatment was based on the anti-tuberculosis drugs for a period of 11 months completed with an orthopedic or surgical stabilisation of cervical occipital jonction.Keywords : Pott’s disease, tuberculosis, cervical spine, MRI, Mycobacterium Koch

Relationship between biomarkers of muscle damage and redox status in response to a weightlifting training session: effect of time-of-day

The aims of the present study were to: (1) investigate the effect of a weightlifting training session and time-of-day (TOD) upon biological parameters (i.e., oral temperature, hematological, C-reactive protein (CRP), and oxidative stress) and (2) assess their possible link with muscle damage responses. Nine weightlifters (21 ± 0.5 years) performed, in a randomized order, three Olympic-Weightlifting sessions (i.e., at 08:00, 14:00, and 18:00). Blood samples were collected at rest, 3 min and 48 h after each training session. Between pre- and post-training session, ANOVA showed significant increases in oxidative stress markers at the three TODs (p < 0.01) and significant increases for creatine kinase (CK) and lactate dehydrogenase (LDH) only at 08:00 and 18:00 (p < 0.05). At rest, the results showed a significant diurnal variation for the majority of the selected parameters except for malondialdehyde (MDA), total bilirubin, and CRP with higher values observed at 18:00 (p < 0.05). After the training session, given the higher rate of increase during the morning session, these diurnal variations persisted for temperature and WBC (p < 0.01) and were suppressed for CK, LDH, uric acid (UA), catalase, and glutathione peroxidase. The main significant correlations (p < 0.001) were observed between: (1) CK and MDA (r = 0.6) and CK and UA (r = 0.66 and r = 0.82) during the morning and evening training sessions; (2) CK and CRP only during the morning session (r = 0.5); and (3) CRP and WBC during the three training sessions (r = 0.8). In conclusion, the present findings: (1) confirm that the muscle damage responses could be induced by a high level of oxidative stress and (2) suggest to avoid scheduling training sessions in the morning given the higher muscle damage, inflammatory, and oxidative responses at this TOD