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Background: Bone disease is common in patients undergoing hemodialysis. It is the result of bone turnover abnormalities and the decrease of bone mineral density (BMD). We aimed to determine the usefulness of serum bone turnover markers and BMD measurement by dual-energy x-ray absorptiometry (DXA) in hemodialysis patients. Methods: We conducted a cross-sectional study including 90 hemodialysis for more than 12 months. Bone mineral density was assessed by DXA. Peripheral blood samples were obtained from each patient before dialysis in a fasting state within a week of the DXA. Biochemical variables of calcium and phosphate were measured. One bone formation marker (bone-specific alkaline phosphatase (bAP), one bone resorption marker (carboxy-terminal telopeptides of type 1 collagen (CTX)) were measured. Total alkaline phosphatase (TAP), intact parathyroid hormone (PTH) and fibroblast growth factor 23 (FGF23) which is a bone-derived hormone were also measured. Results: CTX values were 6.25 times higher than the normal limit of the assay. Bone alkaline phosphatase levels were less than 10 ng/mL in 28.8% of cases. 23% of patients have osteoporosis and 45% have osteopenia. Femoral BMD had negative correlations with age and PTH levels. FGF23 levels were significantly increased in patients with osteoporosis affecting the lumbar. The levels of bAP and CTX showed a positive correlation. Both circulating bAP and CTX levels showed also positive correlations with PTH levels. Fractures, observed in 12.2% of cases, were associated with low PTH values and the existence of osteoporosis. Conclusions: Our study showed that osteoporosis and fracture are common in dialysis patients. The reduced BMD was associated with advanced age and elevated levels of PTH. Markers of bone turnover and FGF23 may play a role in the diagnosis of bone disease in hemodialysis patients. DXA measurement is necessary for the monitoring for bone loss.

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Bank governance has received special attention after the financial crises of 2008 that have occurred. Nevertheless, the literature presents seemingly conflicting evidence on the implications of governance for bank credit risk quality. The purpose of this article is to examine the impact of corporate governance variables of board size, board composition and board gender diversity on credit risk. Panel data regression analysis is applied to a sample of listed banks from the Tunisia during the 2000-2014 period. We improve the robustness of our results by employing four measures of credit risk commonly used in the literature as the dependent variable in our study. Our results show that the higher the number of board members, the lower the quality of credit is and, consequently, the credit risk increases. The concentration of power within the board of directors may increase bank risks when the cumulative functions of CEO and chairman negatively affect the weight of the board and make it less effective. Also, our findings highlight the importance of board independence and the presence of foreign directors in enhancing credit quality. Nevertheless, we document that the NPLs ratio increases and NPL coverage ratio decreases in the presence of state directors. Finally, we find evidence that the presence of a woman on board influences credit risk, as it is argued that female directors may differ from male directors with regard to their risk attitude, and this, in turn, may influence board's monitoring ability and its decision-making process. Therefore, this evidence provides beneficial information for supervising authorities, stakeholders and academics, and banks should take this into account during the composition of their board of directors.

Political uncertainty and terrorist attacks have shown a remarkable surge around the world. These events creates uncertainty by increasing the risk to invest in some countries and this adversely affects stock markets, and can lead to lower economic growth, increased cost to companies, and negative affects to the society. This study examines the impact of political instability and terrorist attacks on the Tunisian stock market using data for two sub-periods: the pre-revolution period and the period during the revolution. Using an EGARCH model, empirical evidence shows that both types of events (political and terrorist) affect the performance and volatility of the Tunindex market especially after the revolution. Indeed, political events and those linked to terrorist attacks reduce returns and increase the volatility of the stock index. However, the effect of these events on the behavior of the stock market was lower for the period before the revolution.

The incidence of hypertension was evaluated in 359 patients with primary chronic glomerulonephritis who underwent renal biopsy. It was compared to a control group of 7,468 subjects who were obtained from an epidemiologic study performed in the same area at the same period. The prevalence of hypertension was 42%. On the basis of multiple regression analysis, the level of blood pressure was shown to be positively correlated to four independent variables: age, body mass index, degree of renal insufficiency and presence of proliferative glomerulonephritis. It was concluded that, although renal insufficiency increases the incidence of hypertension, proliferative lesions play an important contributive role in the development of hypertension.