Major mistakes in scientific medical writing based on manuscripts' reviews.

INTRODUCTION: Peer review is a crucial process in ensuring the quality and accuracy of scientific research. It allows experts in the field to assess manuscripts submitted for publication and provide feedback to authors to improve their work. AIM: To describe mistakes encountered while peer reviewing scientific manuscripts submitted to "La Tunisie Médicale" journal. METHOD: This was a bibliometric study of research manuscripts submitted to "La Tunisie Médicale" and reviewed during 2022. The data collected included the type of the manuscripts and the number of reviews conducted per manuscript. The study also identified variables related to writing mistakes encountered during the peer review process. RESULTS: A total of 155 manuscripts (68% original articles) were peer reviewed and 245 reviews were delivered, by two reviewers. Out of 62 mistakes detected, 21% concerned the results section. In 60% of the manuscripts, the keywords used were not MeSH (Medical Subject Headings) terms. The introduction lacked in-text citations in 30% of the reviewed manuscripts, while the method section did not have a clear study framework (27%). The two major mistakes detected in the results section were the misuse of abbreviations in tables/figures, and the non-respect of the scientific nomenclature of tables/figures with respectively 39% and 19% of manuscripts. CONCLUSION: This study identified 62 mistakes while reviewing scientific manuscripts submitted to "La Tunisie Médicale" journal. Scholars can benefit from participation in scientific writing seminars and the use of a safety checklist for scientific medical writing to avoid basic mistakes.

Predictors of the publication of the doctoral thesis at the Faculty of Medicine of Sousse (Tunisia).

AIM: To identify the predictive factors for the publication of theses defended at the Faculty of Medicine of Sousse (FMSO) in Tunisia. METHODS: The development of the dissertation was studied following the interrogation of three databases "Medline", "Scopus" and "article @INIST" as well as "Scholar Google". The drafting quality of the thesis summary was assessed using a grid of 20 iso-weighted items. The predictors of publication were studied by binary logistic regression, with a significance level of 10%. RESULTS: Out of the 670 theses defended at the FMSO, the mention "proposal for the thesis prize" was awarded for 22% of the thesis students. These theses were of the "clinical" type in 68% of cases, 80% of which were in "case study" format. The writing quality was deemed satisfactory in 47% of the theses. The publication rate was only 10.3%. The univariate analysis found three factors determining the publication of theses: the field of non-clinical research: epidemiological or fundamental, good editorial quality and the mention "proposal for the thesis prize". After adjustment, the latter was the only independent predictor of the publication of the thesis (ORa=1.60[1.007-2.559]). CONCLUSION: This low rate of publication of theses at the FMSO illustrates the difficulties of thesis students and their directors in research methodology and scientific writing. Theses accepted with distinction must be better accompanied to facilitate their publication.

Who are the Best Scientists in Tunisia? Analysis of the 2023 edition of the "Research.com" platform.

AIM: Describe the performance of scientists assigned to Tunisian research structures, according to their academic disciplines, according to the Research.com platform https://research.com/), in 2023. METHODS: This is a reading focused on the productivity of scientists working in Tunisia, of the new 2023 edition of the international Research.com platform, ensuring the monitoring of 26 academic disciplines and 166880 scientists, affiliated with around three thousand research structures, and representing 1% of leading scientists in a discipline. In this platform, the ranking of researchers was based on the D-index indicator (equivalent to the h-index of a given discipline), calculated as of December 21, 2022. RESULTS: Around fifteen of the "Best Scientists", affiliated with Tunisian research structures, were selected by the Research.com platform (2023), belonging to eight disciplines including particularly "Chemistry", "Plant Sciences and Agronomy" and "Engineering and Technology". These researchers were attached to seven establishments including the universities of "Sfax" and "Monastir" and the "Borj Cedria - Sidi Thabet Biotechnology Center". Among these winners: Professors Moncef NASRI (Sfax, "Biology and Biochemistry", D-index=74), Chedly ABDELLY (Borj Cedria, "Agronomy", D-index=72) and Adel M. ALIMI (Sfax, "computer science¼, D-index=44). CONCLUSION: In Tunisia, the list of "Best scientists" in the Research.com ranking (2023) made it possible to identify two colleges of leaders in scientific research ("Health Sciences" and "Fundamental Sciences"), constituting priority consortia for strengthening the national strategy to support the mobility and networking of researchers, as well as the proliferation and visibility of their publications.

Epidemiology of metabolic syndrome in Tunisia. HSHS 5 study.

OBJECTIVE: To measure the prevalence of metabolic syndrome and its components in the HSHS cohort (Hammam Sousse, Tunisia), in 2009, and to identify its determining factors. METHODS: This was a descriptive epidemiological study of the "community based" type having focused on a random sample of people aged 20 and over. The metabolic syndrome was defined according to the criteria of the "International Diabetes Federation" (IDF 2005) and those of the "National Cholesterol Education Program-Adult Treatment Panel III" (NCEP-ATP III, 2001). RESULTS: The study involved 1441 people including 960 women (66.6%). The age- and sex-adjusted prevalences of increased waist circumference, blood pressure, blood sugar and triglycerides, and decreased HDL-cholesterol were respectively 63.2%, 95%CI[62.5-63.8]; 47.7%, 95%CI[47.4-48.6]; 25.7%, 95%CI[25.1-26.2]; 11.9%, 95%CI[11.4-12.3] and 65,6%, 95%CI[65.0-66.2], according to IDF thresholds and 37.4%, 95%CI[36.3-37.6]; 45.7%, 95%CI[45.4-46.6]; 13.8%, 95%CI[13.4-14.2]; 8.4%, 95%CI[8.0-8.7] and 61.9%, 95%CI[61.2-62.5], according to those of the NCEP-ATP III. The prevalence of metabolic syndrome adjusted for age and sex was 36.5% 95%CI[33.0%-38.9%] according to the IDF definition and 23.0% 95%CI[20.4%-25.6%] according to that of NCEP-ATP III. The multivariate study by logistic regression made it possible to retain three significant independent determining factors of the metabolic syndrome: age ≥40 years, low level of physical activity and family history of diabetes mellitus with respectively adjusted ORs of 3.77 95%CI[2.70-5.27], 1.39 95%CI[1.01-1.89], 1.62 95%CI[1.21-2.15], according to IDF and 5.87 95%CI[3.88 -8.88], 1.47 95%CI[1.07-2.01] and 1.45 95%CI[1.07-1.96], according to NCEP-ATP III . CONCLUSION: With this high prevalence rate of the metabolic syndrome, the establishment of an action plan would be essential. This plan should be based on the combination of the promotion of physical activity and screening for the components of the metabolic syndrome, particularly in subjects aged 40 or over, with a family history of diabetes mellitus.

Epidemiology of obesity in Tunisia: HSHS4 study (Hammam Sousse Sahloul Heart Study).

INTRODUCTION: The HSHS study is a community-based survey focused on cardiovascular risk factors. AIM: The objectives of this specific analysis were to determine the prevalence of obesity and overweight in the general population of Hammam Sousse (Tunisia) and to identify their predisposing factors. METHODS: HSHS was conducted with a random sample of households, composed by the EPI (Expanded Program on Immunization) technique. All people aged 20 and over, met on the day of the survey, at their homes, were included. Obesity, overweight and weight overload were defined with reference to Body Mass Index (BMI): Obesity (BMI≥30 kg/m²), Overweight (25≤BMI (25≤BMI <30 kg/m²), weight overload (BMI≥25 kg/m²). Physical activity was evaluated according to the level of energy equivalents (Metabolic Equivalent Task) or MET, this level was considered low below 600 MET min/week. The calculated prevalences were accompanied by their 95%CI (Confidence Intervals). The multivariate study was conducted by logistic regression, measuring the adjusted Odds Ratio (ORa) Results: The study population was composed of 481 men and 960 women, (sex-ratio=0.50). The age ranged from 20 to 96 years with an average of 49.6±16444 years in men and 46.6±16.2 in women (p <0.05). After adjusting for age and sex, the prevalence rates of overweight, obesity, and weight overload were respectively 36.18%, 95%CI [35.38%-36.62%], 28.11%; 95%CI [27.42%-28.58%] and 64.28%; 95%CI [63.38%-64.62%]. Obesity was determined, in addition to female sex, age 40 or over and low level of education, by low level of physical activity (ORa=1.56; 95%CI [1.21-2.03], p<10-2). CONCLUSION: In adults, the prevalence of obesity and overweight were high and determined by insufficient physical activity. The results of this study, which can be extrapolated to other Tunisian cities, should motivate the general population to establish a heart health promotion plan, in partnership with civil society.

[Epidemiology of smoking in the male population in Tunisia. HSHS Study 6].

OBJECTIVES: To determine the prevalence of smoking in the male population of Hammam Sousse (Tunisia), to describe its modalities and to analyse its determining factors. METHODS: This was a "community-based" study, carried out on a random sample of households, including a population of males aged 20 or over. The data were collected, at home, using a specific support consisting of a lifestyle questionnaire, a physical examination, and a biological assessment, oriented towards cardiovascular risk factors. Smoking behaviour covered both forms of cigarettes and Narghile. "Current smokers" included all men declaring that they smoked at the time of the survey, including "regular smokers", who smoked daily at the time of the survey, and "occasional smokers", less than once a day. The group of "non-smokers" at the time of the survey was the sum of "ex-smokers" and those "who had never smoked". The prevalences were calculated after their weighting according to age and the adjusted odds ratios were measured following a multivariate study by logistic regression. RESULTS: The study population was composed of 481 men with an average age of 49.6±16.35 years and a median of 49 years. Mean body mass index and systolic blood pressure were 26.9 kg/m2 ±4.20 and 151.9 mmHg±24.36, respectively. After adjusting for age, the proportions of current users, former users and subjects who had never used tobacco (all forms combined) were respectively 50.4% (95% CI [49.49-51.3]), 17.4% (95% CI [16.71-18.08]) and 30.9% (95% CI [30.06-31.73]). Daily cigarette consumption was characterized by an average onset at age 20.1±6.91 years, an average duration of 27.0±15.22 years and an average amount of 17.6±9.8 cigarettes smoked per day. After adjusting for age, level of education, and socioeconomic level, smoking behaviour was attributed to a single independent risk factor: the presence of a smoker in the family, with an adjusted OR of 45.17 (p (p<10-3) for regular cigarette smokers, and 29.66 for regular tobacco users of all forms. CONCLUSION: Smoking would be a real endemic in Tunisia, threatening the cardiovascular health of the country. The national health system is called upon to strengthen its action plan for the prevention and control of smoking, in all living environments: family, school, work, health centre, etc.

Perception of Tunisian Public Health Practitioners on the Role of Primary Health Care during the COVID-19 Pandemic.

CONTEXT: Primary Health Care is the first level of healthcare delivery services. Its role in the management of epidemics has been documented especially during the SARS and Ebola epidemics, and more recently during the COVID-19 pandemic. OBJECTIVE: To describe public health experts' perceptions of the implication of Primary Health Care on managing the COVID-19 pandemic in Tunisia. METHODS: This qualitative study was based on a structured interview covering five domains: 1. Preparedness, 2. Implication, 3. Health delivery, 4. Response and 5. Fight against COVID-19 in Primary Health Care in Tunisia. Convenient sampling was done to include public health practitioners and experts. RESULTS: A total of 25 experts were included with a sex ratio that was equal to 0.92, including two international experts, and four that were working in the Ministry of Health. The majority of respondents affirmed that the Tunisian PHC was not prepared to fight against the COVID-19 pandemic. Concerning the response role of PHC against COVID-19, some experts stated that PHC played an important role in the early stages of the pandemic. Almost all included participants claimed that PHC was marginalized from the national strategy against COVID-19. In addition, all respondents affirmed that there had been a weakening effect of the delivery of the minimum healthcare package that was dispended by the PHC after the pandemic. However, they all expressed the ability of PHC to manage future epidemics. CONCLUSION: The Tunisian PHC system did not play an efficient role in the current COVID-19 pandemic. However future lessons should be deduced for further implications in potential upcoming epidemics.

Epidemiology of elderly dependency in Tunisia. HSHS study 7.

AIM: Measure the functional autonomy of elderly people and identify its components and determinants in the HSHS (Hammam-Sousse Sahloul Heart Study) population (phase 2009, Tunisia). METHODS: This study was concerned with the quality of life of elderly people aged 65 years or more, living at home from the HSHS cohort divided into two groups: young-old (65-74 years old) and old-old (≥75 years old). The autonomy was assessed using the "Activities of Daily Living" (ADL) scale ranging from 0 to 6, the "Instrumental Activities of Daily Living" (IADL) scale ranging from 0 to 8 and, the combined scale ranging from zero to 14, iso-weighted at one point per activity. Autonomy in daily activities was retained for an ADL score=6, and an IADL score (F=8; H=5). Subjects with an overall score (sum of ADL and IADL) of 10-14 points were considered globally autonomous. RESULTS: The population study was predominantly female (sex-ratio=0,6) with an important proportion of old-old (M=43%, F=37%). Autonomy rates were by ADL (M=57.4%, F=36.1%, p < 10-2), IADL (M=16%, F=23.9%), and by combined score (M=60.6%, F=69%, p=NS). The typology of dependency was dominated by transferring (M=35%, F=61%) and bathing (M=14%, F=19%) for ADL activities, and shopping (M=36%, F=49%) and the use of means of transport (M=22%, F=43%) for IADL activities. After adjustment, autonomy in daily activities was attributed to two independent factors: male sex (ORa=3.98, CI95% [1.328-11.971]) and age group 65-75 (ORa=4.04, CI95% [2.039- 8.025]). Autonomy in instrumental activities was associated with age group (ORa=31.5, CI95% [4.087-233.514]). Finally, overall autonomy (current and instrumental) was associated independently after logistic regression, with four independent factors, two of which were not modifiable: being female (ORa=3.1, CI95% [1.2-8.1]) and 65 to 75 years (ORa=6.2, CI95% [3.1-12.3]) and two modifiable factors: no recent hospitalization (ORa=3.8, CI95% [1.4-10.4]) and a sufficient level of physical activity (ORa=2.6, CI95% [1.3-5.3]). CONCLUSION: The physical dependency rate of the elderly is very high in Tunisia. The promotion of physical activity, the extension of similar studies and the development of could improve the support of these people.