Extraction assistée par enzyme du jus de la pulpe fraîche du rônier (Borassus aethiopum Mart.) acclimaté au Benin : caractérisation physico-chimique et microbiologique

Dans cette étude, deux enzymes de type pectinases (Klerzyme 120 et Rapidase press) ont été utilisées pour l’extraction du jus de la pulpe fraîche de rônier. L’évaluation des conditions optimales d’extraction a permis d’obtenir les meilleurs rendements à 50 °C après 120 min d’incubation. Ces rendements sont respectivement de 79,8% et 78,4% pour le jus extrait avec la Rapidase press et la Klerzyme120. L’évaluation des caractéristiques physico-chimiques et nutritionnelles à savoir le pH, l’acidité titrable, la teneur en matière sèche, les teneurs en sucres totaux, en caroténoïdes, en vitamine C et en sels minéraux ont permis de mettre au point une fiche technique (diagramme) de production du jus de rônier à base d’enzyme (pectinase). La détermination des paramètres microbiologiques des jus a montré que le barème de pasteurisation appliqué est efficace avec une absence totale d’espèces pathogènes. Les jus obtenus sont très odorants et conservent l’arôme caractéristique du fruit.Mots clés: Rônier, extraction, enzyme, jus, pectinase, caractérisation

Trends in Secondary Prevention of Coronary Heart Disease in Tunisia: Prevention of Recurrences of MI and Stroke

ObjectivesThe survival benefits achieved by prescription of antiplatelet agents, B-adrenoreceptor antagonists (beta-blockers), angiotensin II receptor blockers (ARB), and lipid lowering agents in patients surviving the myocardial infarction (MI) have been well documented in large clinical trial. Despite well-established benefits, these pharmacological agents continue to be underutilized. The main objective of this study was to evaluate the progress of cardiovascular secondary prevention practices in Tunisia.MethodsThe PREMISE (Prevention of Recurrence of Myocardial Infarction and Stroke) is a descriptive, cross-sectional study conducted in Tunisia in two phases (2002 and 2009). Seven hundred eighty two patients were recruited. The recruitment criteria were: previous MI, stable angina, unstable angina, percutaneous transluminal coronary angioplasty (PTCA), coronary artery bypass graft (CABG), stroke, transient ischemic attack (TIA) or carotid endarterectomy. This analysis is limited to coronary heart disease (CHD) patients. Five hundred hospital patients were interviewed and their medical records were reviewed: 250 in 2002 and 250 in 2009. Patients were included if they had confirmed diagnosis of MI, angina, CABG or PTCA, and if their first cardiovascular event had occurred more than one month but not later than 3 years ago. We compared the total of both patient groups, using the prevalence of Cardio-Vascular Risk Factors (CVRF) and the treatment prescribed at hospital discharge.ResultsThe proportion of patients with reported hypertension, diabetes, hypercholesterolemia and current smoker patients had decreased. Concerning pharmacological prescriptions, a significant increase was observed in prescribing statins (38.9% vs. 70.3%) and ACE inhibitors (49.3% vs. 69.9%), non pharmacological prescriptions as healthy diet or tobacco cessation had opposite trends. Adherence to treatment did not change substantially.ConclusionAlthough the use of cardioprotective drugs had increased in CHD patients, there are still gaps in secondary prevention in Tunisia. The recommended strategies of secondary prevention need to be applied more intensively in clinical practice

Evaluation de la qualité sanitaire des poudres de feuilles de Moringa oleifera Lam. commercialisées au profit des Personnes Vivant avec le VIH à Cotonou (Bénin)

Face au péril des carences nutritionnelles, la promotion des compléments alimentaires prend de l’ampleur au Bénin. L’objectif de cette étude est d’évaluer la qualité hygiénique des poudres de feuilles de Moringa oleifera commercialisées à Cotonou. 24 échantillons ont été achetés dans 12 points de vente et soumis à des analyses de laboratoire. L’enquête a révélé que, 25% des échantillons ne sont pas scellés, 58% des emballages sont non opaques, les dates de conditionnement et dates limites d’utilisation ne figurent pas sur 50% des échantillons. 43% des poids marqués ne sont pas conformes aux poids nets réels. La concentration moyenne des germes aérobies mésophiles (1,4.106 à 3.106 UFC/g) dépasse significativement la limite maximale d’acceptation du produit au plan microbiologique. Cette insalubrité des échantillons se confirme par la forte présence de Staphylocoques à coagulase positive (3.104), Escherichia coli (1,5.103 à 30.103), levures (1,1.103 à 15.103) et moisissures (3,4.103 à 30.103) respectivement dans 100%, 92%, 50% et 17% des poudres analysées. Par ailleurs, les bactéries Anaérobies Sulfito-Réductrices sont dans les limites d’acceptation de l’aliment. Au total, l’innocuité des poudres de Moringa commercialisées n’est pas garantie et il importe que les fabricants corrigent les failles en matière d’hygiène dans le processus de fabrication.Mots clés : Moringa oleifera, Complément alimentaire, nutrition, qualité, hygiène

A fast ILP-based Heuristic for the robust design of Body Wireless Sensor Networks

We consider the problem of optimally designing a body wireless sensor network, while taking into account the uncertainty of data generation of biosensors. Since the related min-max robustness Integer Linear Programming (ILP) problem can be difficult to solve even for state-of-the-art commercial optimization solvers, we propose an original heuristic for its solution. The heuristic combines deterministic and probabilistic variable fixing strategies, guided by the information coming from strengthened linear relaxations of the ILP robust model, and includes a very large neighborhood search for reparation and improvement of generated solutions, formulated as an ILP problem solved exactly. Computational tests on realistic instances show that our heuristic finds solutions of much higher quality than a state-of-the-art solver and than an effective benchmark heuristic.Comment: This is the authors' final version of the paper published in G. Squillero and K. Sim (Eds.): EvoApplications 2017, Part I, LNCS 10199, pp. 1-17, 2017. DOI: 10.1007/978-3-319-55849-3\_16. The final publication is available at Springer via http://dx.doi.org/10.1007/978-3-319-55849-3_1

Forecasting Tunisian type 2 diabetes prevalence to 2027: validation of a simple model.

BACKGROUND: Most projections of type 2 diabetes (T2D) prevalence are simply based on demographic change (i.e. ageing). We developed a model to predict future trends in T2D prevalence in Tunisia, explicitly taking into account trends in major risk factors (obesity and smoking). This could improve assessment of policy options for prevention and health service planning. METHODS: The IMPACT T2D model uses a Markov approach to integrate population, obesity and smoking trends to estimate future T2D prevalence. We developed a model for the Tunisian population from 1997 to 2027, and validated the model outputs by comparing with a subsequent T2D prevalence survey conducted in 2005. RESULTS: The model estimated that the prevalence of T2D among Tunisians aged over 25 years was 12.0% in 1997 (95% confidence intervals 9.6%-14.4%), increasing to 15.1% (12.5%-17.4%) in 2005. Between 1997 and 2005, observed prevalence in men increased from 13.5% to 16.1% and in women from 12.9% to 14.1%. The model forecast for a dramatic rise in prevalence by 2027 (26.6% overall, 28.6% in men and 24.7% in women). However, if obesity prevalence declined by 20% in the 10 years from 2013, and if smoking decreased by 20% over 10 years from 2009, a 3.3% reduction in T2D prevalence could be achieved in 2027 (2.5% in men and 4.1% in women). CONCLUSIONS: This innovative model provides a reasonably close estimate of T2D prevalence for Tunisia over the 1997-2027 period. Diabetes burden is now a significant public health challenge. Our model predicts that this burden will increase significantly in the next two decades. Tackling obesity, smoking and other T2D risk factors thus needs urgent action. Tunisian decision makers have therefore defined two strategies: obesity reduction and tobacco control. Responses will be evaluated in future population surveys

Algorithm Engineering in Robust Optimization

Robust optimization is a young and emerging field of research having received a considerable increase of interest over the last decade. In this paper, we argue that the the algorithm engineering methodology fits very well to the field of robust optimization and yields a rewarding new perspective on both the current state of research and open research directions. To this end we go through the algorithm engineering cycle of design and analysis of concepts, development and implementation of algorithms, and theoretical and experimental evaluation. We show that many ideas of algorithm engineering have already been applied in publications on robust optimization. Most work on robust optimization is devoted to analysis of the concepts and the development of algorithms, some papers deal with the evaluation of a particular concept in case studies, and work on comparison of concepts just starts. What is still a drawback in many papers on robustness is the missing link to include the results of the experiments again in the design

A cost effectiveness analysis of salt reduction policies to reduce coronary heart disease in four Eastern Mediterranean countries.

BACKGROUND: Coronary Heart Disease (CHD) is rising in middle income countries. Population based strategies to reduce specific CHD risk factors have an important role to play in reducing overall CHD mortality. Reducing dietary salt consumption is a potentially cost-effective way to reduce CHD events. This paper presents an economic evaluation of population based salt reduction policies in Tunisia, Syria, Palestine and Turkey. METHODS AND FINDINGS: Three policies to reduce dietary salt intake were evaluated: a health promotion campaign, labelling of food packaging and mandatory reformulation of salt content in processed food. These were evaluated separately and in combination. Estimates of the effectiveness of salt reduction on blood pressure were based on a literature review. The reduction in mortality was estimated using the IMPACT CHD model specific to that country. Cumulative population health effects were quantified as life years gained (LYG) over a 10 year time frame. The costs of each policy were estimated using evidence from comparable policies and expert opinion including public sector costs and costs to the food industry. Health care costs associated with CHDs were estimated using standardized unit costs. The total cost of implementing each policy was compared against the current baseline (no policy). All costs were calculated using 2010 PPP exchange rates. In all four countries most policies were cost saving compared with the baseline. The combination of all three policies (reducing salt consumption by 30%) resulted in estimated cost savings of $235,000,000 and 6455 LYG in Tunisia;$39,000,000 and 31674 LYG in Syria; $6,000,000 and 2682 LYG in Palestine and$1,3000,000,000 and 378439 LYG in Turkey. CONCLUSION: Decreasing dietary salt intake will reduce coronary heart disease deaths in the four countries. A comprehensive strategy of health education and food industry actions to label and reduce salt content would save both money and lives