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  1. Mean reversion and convergence of ecological footprint in the MENA region: evidence from a fractional integration procedure
    Bello MO, Gil-Alana LA, Ch'ng KS
    Environ Sci Pollut Res Int, 2023 Mar;30(12):35384-35397.
    PMID: 36534250 DOI: 10.1007/s11356-022-24678-y
    This paper deals with the analysis of mean reversion and convergence of the ecological footprint (EF) in the MENA region. Using a long memory model based on fractional integration, we find that the results are very heterogeneous across countries depending on the assumptions made on the error term and the use of original versus logged data. Nevertheless, some conclusions can be obtained. Thus, mean reversion is decisively found in the case of Tunisia, and other countries showing some degree of reversion to the mean include Israel, Syria, Yemen, and Iran. Dealing with the issue of convergence within the MENA countries, similar conclusions hold and only Tunisia reports statistical evidence of convergence for the two types of errors. Additional evidence is found in the case of Syria, Yemen, and Jordan with uncorrelated errors and for Iran with autocorrelation. It is recommended that environmental policies targeted at stabilizing the trends in EF in the MENA region should not be indiscriminately applied in consideration of the heterogeneous nature of the series in the region.
    Matched MeSH terms: Tunisia
  2. The export of plastic surgical training programs to emerging countries
    Stark RB
    Plast Reconstr Surg, 1967 Jun;39(6):541-8.
    PMID: 6025681
    Matched MeSH terms: Tunisia
  3. Characteristics of Chamaerops humilis L. var. humilis seed oil and study of the oxidative stability by blending with soybean oil
    Mokbli S, Sbihi HM, Nehdi IA, Romdhani-Younes M, Tan CP, Al-Resayes SI
    J Food Sci Technol, 2018 Jun;55(6):2170-2179.
    PMID: 29892118 DOI: 10.1007/s13197-018-3134-x
    Herein we examine the characteristics of date seed oil extracted from Chamaerops humilis L. var. humilis seeds (HSO) cultivated in a gardening zone in Tunisia. Its physicochemical properties, fatty acid composition, and thermal and antioxidant properties were evaluated and compared with those of seed oil from another variety of Chamaerops humilis. The results showed that HSO possessed higher contents of oleic (44%) and linoleic (20%) acids than the other seed oil. The total tocopherol and tocotrienol content was 88 mg/100 g oil, where α-tocotrienol (64%) was the major isomer. The total phenolic (91 μg/g oil) and flavonoid contents (18 μg/g oil) of the HSO were determined, and its antioxidant capacities, measured in terms of ABTS and DPPH radical-scavenging capacities, were 210 µM TEAC/g DW and 4.3 mM TEAC/g DW, respectively. The oxidative stability index (OSI) of the oil was 16 h at 110 °C. Furthermore, the OSI of soybean oil was significantly enhanced upon blending with HSO. HSO exhibited higher thermal stability than the other oils and significantly different thermal behavior. The determination of fatty acid composition, physicochemical properties, bioactive content, oxidative stability, and thermal behavior of HSO demonstrated that this renewable resource can be used for edible purposes.
    Matched MeSH terms: Tunisia
  4. Evidence of natural infections with Trypanosoma, Anaplasma and Babesia spp. in military livestock from Tunisia
    Selmi R, Dhibi M, Ben Said M, Ben Yahia H, Abdelaali H, Ameur H, et al.
    Trop Biomed, 2019 Sep 01;36(3):742-757.
    PMID: 33597496
    Livestock constitute habitual hosts and carriers for several infectious pathogens which may represent a serious public health concern affecting the readiness of military forces and lead to wide economic losses. The present report aimed to investigate the prevalence of some haemopathogens infecting military livestock, particularly, dromedaries, sheep and horses using Giemsa-stained blood smears. A total of 300 animals (100 from each species) were selected, clinically examined and sampled. Trypanosoma spp. (22.0%), Anaplasma spp. (17.0%) and Babesia spp. (1.0%) were identified in camels' blood. Six dromedaries were found to be co-infected by Trypanosoma and Anaplasma organisms (6.0%). Camels of female gender, infested by ticks and showing clinical signs were statistically more infected by Trypanosoma spp., compared to those of male gender, free of ticks and apparently healthy (P= 0.027, 0.000 and 0.004, respectively). Babesia spp. infection (1.0%) was identified, for the first time in Tunisia, in one adult female camel that presented abortion and anemia. Anaplasma spp. was the only haemopathogen identified in examined sheep (6.0%) and horses (17.0%). Horses infested by Hippobosca equina flies and sheep infested by Rhipicephalus turanicus ticks were more infected by Anaplasma spp. than other non-infested animals (P=0.046 and 0.042, respectively). Hyalomma dromedarii, H. impeltatum and H. excavatum were the most prevalent diagnosed ticks removed from camels with an intensity of infestation of 1.2 ticks per animal. However, in sheep, only R. turanicus was identified. H. equina and Tabanus spp. were the potential hematophagous flies found in dromedaries and horses herds. This useful data must be taken into consideration during animal treatment and vectors' control programs in Tunisian military farms which help to limit the diffusion of vector-borne diseases, keep our livestock healthy and reduce economic losses.
    Matched MeSH terms: Tunisia/epidemiology
  5. Characterization of resistance to pirimiphos-methyl (an organophosphate insecticide) in Culex pipiens pipiens (Diptera: Culicidae) from Northern and Southern Tunisia
    Tabbabi A, Daaboub J, Ben-Cheikh R, Laamari A, Feriani M, Boubaker C, et al.
    Trop Biomed, 2018 Dec 01;35(4):872-879.
    PMID: 33601837
    Despite the public health importance of Culex pipiens pipiens, their resistance to pirimiphos-methyl insecticides has not been explored enough. Late third and early fourth larvae of Culex pipiens pipiens were collected from three localities between 2003 and 2005 in Northern and Southern Tunisia. All bioassays were carried out using pirimiphosmethyl and propoxur insecticides. Populations of Culex pipiens pipiens were susceptible, moderate and resistant to pirimiphos-methyl insecticide. Resistance to this compound ranged from 2.62 in sample # 2 to 19.9 in sample # 1. The moderate resistance (5.25) was recorded in sample # 3. Synergist's tests showed that the resistance to pirimiphos-methyl was not affected by detoxification enzymes. However, biochemical assays showed the involvement of both metabolic (esterases) and target site (insensitive acetylcholinesterase) resistance mechanisms. The highest frequencies of the resistant phenotypes ([RS] and [RR]) (<0.74) were detected in the most resistant samples (#1). Four esterases enzymes including C1 encoded by the Est-1 locus and three esterases encoded by the Ester super locus: A2-B2, A4-B4 (or A5-B5, which has the same electrophoretic mobility) and B12 were detected. The highest (0.61) and the lowest (0.22) frequencies of these esterases were recorded in samples # 1 (Sidi Hcine) and # 2 (El Fahs) which recorded the highest and the lowest level of resistance, respectively. Monitoring of insecticide resistance should be evaluated regularly for management of vector control.
    Matched MeSH terms: Tunisia
  6. Multiple resistance mechanisms associated with low pirimifos-methyl resistance in Culex pipiens pipiens in three populations of Tunisia
    Tabbabi A, Daaboub J, Laamari A, Ben-Cheikh R, Feriani M, Boubaker C, et al.
    Trop Biomed, 2018 Dec 01;35(4):1107-1114.
    PMID: 33601857
    The aim of this study was to evaluate the resistance status of Culex pipiens pipiens to pirimiphos-methyl insecticide. Three field populations of mosquitoes were collected from Tunisia and analyzed in laboratory. The samples studied showed low level of resistance not exceeding 5-folds. The low resistance recorded is particularly interesting, because it leaves a range of tools useable by vector control services. Both metabolic and target-site resistance mechanisms were identified. Different esterases of high activity including A2-B2, A4-B4 (and/or A5-B5) and B12 were observed in studied field samples using starch electrophoresis although opposite results were found using synergists tests on samples # 1 and 3. The polymorphism of AChE1 (Acetylcholinesterase) was analyzed and three phenotypes were detected: susceptible (ACHE1S, phenotype [SS]), resistant (ACHE1R, phenotype [RR]), and heterozygous (phenotype [RS]) of ACHE1. The resistance of Culex pipiens pipiens to pirimiphos-methyl remains low although the occurrences of multiple resistance mechanisms are able to confer high resistance levels to organophosphate insecticides. Therefore, continuous monitoring of resistance is fundamental for rational use of insecticides and mosquito control programs.
    Matched MeSH terms: Tunisia
  7. Fulltext Contribution of Arab countries to pharmaceutical wastewater literature: a bibliometric and comparative analysis of research output
    Zyoud SH, Zyoud SH, Al-Jabi SW, Sweileh WM, Awang R
    Ann Occup Environ Med, 2016;28:28.
    PMID: 27382475 DOI: 10.1186/s40557-016-0117-0
    BACKGROUND: Recently, the pharmaceutical manufacturing industry has been growing rapidly in many countries in the world, including in Arab countries. Pharmaceuticals reach aquatic environments and are prevalent at small concentrations in wastewater from the drug manufacturing industry and hospitals. Such presence also occurs in domestic wastewater and results from the disposal of unused and expired medicines. Therefore, the objective of this study was to analyze and compare the quantity and quality of publications made by researchers in Arab countries on pharmaceutical wastewater.

    METHODS: To retrieve documents related to pharmaceutical wastewater, we used the Scopus database on November 21, 2015. All documents with terms related to pharmaceutical wastewater in the title or abstract were analysed. Results obtained from Arab countries were compared with those obtained from Turkey, Iran and Israel.

    RESULTS: Globally, a total of 6360 publications were retrieved while those from Arab countries, Iran, Turkey and Israel, were 179, 113, 96 and 54 publications respectively. The highest share of publications belonged to Kingdom of Saudi Arabia (KSA) with a total of 47 (26.2 %) publications, followed by Egypt (38; 21.2 %), Tunisia (17; 9.5 %) and Morocco (16; 8.9 %). The total number of citations was 1635, with a mean of 9.13 and a median (inter quartile range) of 3 (1.0-10.0). The study identified 87 (48.6 %) documents with 32 countries of international collaboration with Arab countries. It was noted that Arab researchers collaborated mainly with authors in Western Europe (54; 30.2 %), followed by authors from the Asiatic region (29; 16.2 %) and Northern America (15; 8.4 %). The most productive institution was King Saud University, KSA (13; 7.3 %), followed by the National Research Centre, Egypt (10; 7.3 %).

    CONCLUSIONS: This study showed that KSA has the largest share of productivity on pharmaceutical wastewater research. Bibliometric analysis demonstrated that research productivity, mainly from Arab countries in pharmaceutical wastewater research, was relatively lagging behind. More research effort is required for Arab countries to catch up with those of non-Arab Middle Easter countries on pharmaceutical wastewater research.

    Matched MeSH terms: Tunisia
  8. Fulltext Metabolite characterization of different palm date varieties and the correlation with their NO inhibitory activity, texture and sweetness
    Abdul-Hamid NA, Mediani A, Maulidiani M, Shadid K, Ismail IS, Abas F, et al.
    J Food Sci Technol, 2018 Apr;55(4):1541-1551.
    PMID: 29606769 DOI: 10.1007/s13197-018-3073-6
    The aim of this study was to examine the variation in metabolite constituents of five commercial varieties of date fruits; Ajwa, Safawi and Ambar which originated from Madinah, the Iranian Bam and Tunisian Deglet Noor. The differences of metabolome were investigated using proton nuclear magnetic resonance (1H NMR) spectroscopy combined with multivariate data analysis (MVDA). Principal Component Analysis (PCA) revealed clear separation between the date varieties. The Tunisian Deglet Noor demonstrated distinct cluster from the rest of the palm date samples based on the metabolite composition as shown by the pattern observed in Hierarchical Clustering Analysis (HCA) and PCA. Deglet Noor exhibited a significant higher level of sucrose (δ 5.40) and fructose (δ 4.16) in comparison with the other four varieties which can be associated with the distinctive sweet taste of this variety. Dates originated from Madinah and Tunisia exhibited a contrast manner in the amount of xylose and moisture content. These two aspects may contribute towards the soft texture of Tunisian dates. All Madinah dates were found to contain phenolic compounds which were well established as great antioxidant and anti-inflammatory agent. Ajwa dates exerted greater effect in inhibiting the generation of nitric oxide (NO) from the stimulated RAW264.7 cells at 95.37% inhibition. Succinic acid was suggested to have the most significant correlation with the trend of NO inhibitory shown by the selected date palm varieties.
    Matched MeSH terms: Tunisia
  9. Can clean biomass energy use lower CO2 emissions in African economies? Empirical evidence from dynamic long-run panel framework
    Sulaiman C, Abdul-Rahim AS
    Environ Sci Pollut Res Int, 2020 Oct;27(30):37699-37708.
    PMID: 32607996 DOI: 10.1007/s11356-020-09866-y
    This paper seeks to answer an empirical question of whether clean biomass energy consumption lowers CO2 emissions while controlling for technical innovation in eight selected countries from Africa for the 1980-2015 period. The countries which are chosen based on availability of data on biomass energy and technological innovation include Egypt, Algeria, South Africa, Mauritius, Kenya, Morocco, Tunisia, and Zambia. Applying pooled mean group, mean group, and dynamic fixed effect panel estimators, the results indicate that clean biomass energy use decreases CO2 emission in the long run. But the effect of biomass energy consumption on CO2 emission is insignificant in the short run. The findings imply that CO2 emission can be reduced by increasing clean biomass energy in the energy mix of these countries. Similarly, environmental quality and economic growth can be achieved simultaneously by increasing the share of biomass energy in large-scale production process. Furthermore, the environmental Kuznets curve (EKC), which hypothesizes an inverted U-shaped relationship between CO2 emission and economic growth, was validated in the long run. This suggests that the EKC pattern is only observed in the long run. Thus, as part of recommendation from this study, policy makers in these countries should formulate more policies that will enhance clean biomass energy production and its usage to substitute significant percentage of fossil fuel use in production process.
    Matched MeSH terms: Tunisia
  10. Fulltext Phylogeography and phylogeny of Rhinoviruses collected from Severe Acute Respiratory Infection (SARI) cases over successive epidemic periods in Tunisia
    Haddad-Boubaker S, Ben Hamda C, Ghedira K, Mefteh K, Bouafsoun A, Boutiba-Ben Boubaker I, et al.
    PLoS One, 2021;16(11):e0259859.
    PMID: 34807924 DOI: 10.1371/journal.pone.0259859
    Rhinoviruses (RV) are a major cause of Severe Acute Respiratory Infection (SARI) in children, with high genotypic diversity in different regions. However, RV type diversity remains unknown in several regions of the world. In this study, the genetic variability of the frequently circulating RV types in Northern Tunisia was investigated, using phylogenetic and phylogeographic analyses with a specific focus on the most frequent RV types: RV-A101 and RV-C45. This study concerned 13 RV types frequently circulating in Northern Tunisia. They were obtained from respiratory samples collected in 271 pediatric SARI cases, between September 2015 and November 2017. A total of 37 RV VP4-VP2 sequences, selected among a total of 49 generated sequences, was compared to 359 sequences from different regions of the world. Evolutionary analysis of RV-A101 and RV-C45 showed high genetic relationship between different Tunisian strains and Malaysian strains. RV-A101 and C45 progenitor viruses' dates were estimated in 1981 and 1995, respectively. Since the early 2000s, the two types had a wide spread throughout the world. Phylogenetic analyses of other frequently circulating strains showed significant homology of Tunisian strains from the same epidemic period, in contrast with earlier strains. The genetic relatedness of RV-A101 and RV-C45 might result from an introduction of viruses from different clades followed by local dissemination rather than a local persistence of an endemic clades along seasons. International traffic may play a key role in the spread of RV-A101, RV-C45, and other RVs.
    Matched MeSH terms: Tunisia/epidemiology
  11. Fulltext Inherited IL-12p40 deficiency: genetic, immunologic, and clinical features of 49 patients from 30 kindreds
    Prando C, Samarina A, Bustamante J, Boisson-Dupuis S, Cobat A, Picard C, et al.
    Medicine (Baltimore), 2013 Mar;92(2):109-122.
    PMID: 23429356 DOI: 10.1097/MD.0b013e31828a01f9
    Autosomal recessive interleukin (IL)-12 p40 (IL-12p40) deficiency is a rare genetic etiology of mendelian susceptibility to mycobacterial disease (MSMD). We report the genetic, immunologic, and clinical features of 49 patients from 30 kindreds originating from 5 countries (India, Iran, Pakistan, Saudi Arabia, and Tunisia). There are only 9 different mutant alleles of the IL12B gene: 2 small insertions, 3 small deletions, 2 splice site mutations, and 1 large deletion, each causing a frameshift and leading to a premature stop codon, and 1 nonsense mutation. Four of these 9 variants are recurrent, affecting 25 of the 30 reported kindreds, due to founder effects in specific countries. All patients are homozygous and display complete IL-12p40 deficiency. As a result, the patients lack detectable IL-12p70 and IL-12p40 and have low levels of interferon gamma (IFN-γ). The clinical features are characterized by childhood onset of bacille Calmette-Guérin (attenuated Mycobacterium bovis strain) (BCG) and Salmonella infections, with recurrences of salmonellosis (36.4%) more common than recurrences of mycobacterial disease (25%). BCG vaccination led to BCG disease in 40 of the 41 patients vaccinated (97.5%). Multiple mycobacterial infections were rare, observed in only 3 patients, whereas the association of salmonellosis and mycobacteriosis was observed in 9 patients. A few other infections were diagnosed, including chronic mucocutaneous candidiasis (n = 3), nocardiosis (n = 2), and klebsiellosis (n = 1). IL-12p40 deficiency has a high but incomplete clinical penetrance, with 33.3% of genetically affected relatives of index cases showing no symptoms. However, the prognosis is poor, with mortality rates of up to 28.6%. Overall, the clinical phenotype of IL-12p40 deficiency closely resembles that of interleukin 12 receptor β1 (IL-12Rβ1) deficiency. In conclusion, IL-12p40 deficiency is more common than initially thought and should be considered worldwide in patients with MSMD and other intramacrophagic infectious diseases, salmonellosis in particular.
    Matched MeSH terms: Tunisia/epidemiology
  12. Histocompatibility leukocyte antigen patterns and nasopharyngeal carcinoma
    Simons MJ, Day NE
    Natl Cancer Inst Monogr, 1977 Dec;47:143-6.
    PMID: 613232
    Incidence patterns indicated the prominent role of genetic factors in this type of cancer. A histocompatibility leukocyte antigen (HLA) profile of A2 and B-locus antigen, Singapore 2 (Sin 2), was identified. An association between these genes and increased risk for nasopharyngeal carcinoma (NPC), was confirmed. The risk was restricted to the "co-occurrence" of A2, B-Sin 2, suggesting that the genotype predisposing to the development of NPC was the A, B-Sin 2 haplotype. Similar associations were found to exist in Malaysian and Hong Kong Chinese so the A2, B-Sin 2 phenotype is a feature common to Asian Chinese in at least three locations. Preliminary HLA studies of medium NPC incidence in Tunisians and Malays indicated that patients with NPC of both ethnic types have altered HLA antigen profiles. If the findings of a locus-B antigen deficit in Tunisians and the role of A9 with B-locus antigens in Malays can be confirmed and clarified, the histocompatibility genetic hypothesis of NPC predisposition would be substantially strengthened.
    Matched MeSH terms: Tunisia
  13. Fulltext Clinical, immunological, molecular and therapeutic findings in monogenic immune dysregulation diseases: Middle East and North Africa registry
    Jamee M, Azizi G, Baris S, Karakoc-Aydiner E, Ozen A, Kiliç SŞ, et al.
    Clin Immunol, 2022 Nov;244:109131.
    PMID: 36179983 DOI: 10.1016/j.clim.2022.109131
    Monogenic immune dysregulation diseases (MIDD) are caused by defective immunotolerance. This study was designed to increase knowledge on the prevalence and spectrum of MIDDs, genetic patterns, and outcomes in Middle East and North Africa (MENA). MIDD patients from 11 MENA countries (Iran, Turkey, Kuwait, Oman, Algeria, Egypt, United Arab Emirates, Tunisia, Jordan, Qatar, and Azerbaijan) were retrospectively evaluated. 343 MIDD patients (58% males and 42% female) at a median (IQR) age of 101 (42-192) months were enrolled. The most common defective genes were LRBA (23.9%), LYST (8.2%), and RAB27A (7.9%). The most prevalent initial and overall manifestations were infections (32.2% and 75.1%), autoimmunity (18.6% and 41%), and organomegaly (13.3% and 53.8%), respectively. Treatments included immunoglobulin replacement therapy (53%), hematopoietic stem cell transplantation (HSCT) (14.3%), immunosuppressives (36.7%), and surgery (3.5%). Twenty-nine (59.2%) patients survived HSCT. Along with infectious complications, autoimmunity and organomegaly may be the initial or predominant manifestations of MIDD.
    Matched MeSH terms: Tunisia
  14. Suicidal Thoughts, Attempts and Motives Among University Students in 12 Muslim-Majority Countries
    Eskin M, AlBuhairan F, Rezaeian M, Abdel-Khalek AM, Harlak H, El-Nayal M, et al.
    Psychiatr Q, 2019 03;90(1):229-248.
    PMID: 30498939 DOI: 10.1007/s11126-018-9613-4
    There is a scarcity of research on suicidal phenomena in the Muslim world. Therefore, this study aimed at investigating the self-reported prevalence of suicidal thoughts, attempts and motives in 12 Muslim countries. A total of 8417 (54.4% women) university students were surveyed by means of a self-report questionnaire. Overall, 22% of the participants reported suicidal ideation and 8.6% reported attempting suicide. The odds of suicidal thoughts were elevated in Azerbaijan, Indonesia and Saudi Arabia, while reduced ORs were recorded in Egypt, Jordan, Lebanon and Malaysia. While odds of suicide attempts were high in Azerbaijan, Palestine and Saudi Arabia reduced odds ratios (OR) were detected in Indonesia, Iran, Jordan, Lebanon, Malaysia and Tunisia. Taking drugs and using a sharp instrument were the two most frequently used methods to attempt suicide. Only 32.7% of attempts required medical attention. Escape motives were endorsed more than social motives by participants who attempted suicide. Suicidal behaviors were more frequent in women than in men. Compered to men, fewer attempts by women required medical attention. Moreover, our results show that making suicide illegal does not reduce the frequency of suicidal behavior. Results from this comparative study show that suicidal thoughts and attempts are frequent events in young adults in countries where religious scripture explicitly prohibit suicide and the frequencies of nonfatal suicidal behavior show large variation in nations adhering to the same religion.
    Matched MeSH terms: Tunisia/ethnology
  15. Population and the World Bank
    Sankaran S
    Finance Dev, 1973 Dec;10(4):18-21.
    PMID: 12257161
    Matched MeSH terms: Tunisia
  16. From farm to fork: identical clones and Tn6674-like elements in linezolid-resistant Enterococcus faecalis from food-producing animals and retail meat
    Elghaieb H, Tedim AP, Abbassi MS, Novais C, Duarte B, Hassen A, et al.
    J Antimicrob Chemother, 2020 01 01;75(1):30-35.
    PMID: 31605129 DOI: 10.1093/jac/dkz419
    OBJECTIVES: Increasing numbers of linezolid-resistant Enterococcus carrying optrA are being reported across different niches worldwide. We aimed to characterize the first optrA-carrying Enterococcus faecalis obtained from food-producing animals and retail meat samples in Tunisia.

    METHODS: Seven optrA-carrying E. faecalis obtained from chicken faeces (n=3, August 2017) and retail chicken meat (n=4, August 2017) in Tunisia were analysed. Antimicrobial susceptibility was determined by disc diffusion, broth microdilution and Etest against 13 antibiotics, linezolid and tedizolid, respectively (EUCAST/CLSI). optrA stability (∼600 bacterial generations), transfer (filter mating) and location (S1-PFGE/hybridization) were characterized. WGS (Illumina-HiSeq) was done for four representatives that were analysed through in silico and genomic mapping tools.

    RESULTS: Four MDR clones carrying different virulence genes were identified in chicken faeces (ST476) and retail meat (the same ST476 clone plus ST21 and ST859) samples. MICs of linezolid and tedizolid were stably maintained at 8 and 1-2 mg/L, respectively. optrA was located in the same transferable chromosomal Tn6674-like element in ST476 and ST21 clones, similar to isolates from pigs in Malaysia and humans in China. ST859 carried a non-conjugative plasmid of ∼40 kb with an impB-fexA-optrA segment, similar to plasmids from pigs and humans in China.

    CONCLUSIONS: The same chromosomal and transferable Tn6674-like element was identified in different E. faecalis clones from humans and animals. The finding of retail meat contaminated with the same linezolid-resistant E. faecalis strain obtained from a food-producing animal highlights the potential role of the food chain in the worrisome dissemination of optrA that can be stably maintained without selective pressure over generations.

    Matched MeSH terms: Tunisia
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