Search results for: Bahlous Afef

Authors: Bahlous Afef, Bouzid Kahena, Bardkis Ahlem, Mrad Mehdi, Kalai Eya, Sonia Bahri, Abdelmoula Jaouida

Abstract:

Diabetic nephropathy is the first cause of chronic renal failure and hemodialysis use in several countries including Tunisia. The role of hypertension (HT) as major risk factor for nephropathy is undeniable. The aim of our study was to determine the relationship between blood pressure and nephropathy in a population of diabetic type 2 recently discovered. Materials and methods: We conducted a prospective study focused on 60 patients with type 2 diabetes recently discovered (<5 years). Each patient have benefited from: -a full clinical examination with measurement of blood pressure - exploring a blood-glucose control and renal function -urinary exploration with the determination of proteinuria microalbuminumie of 24 hours with a immunoturbidimetric method using Architect (ABBOTT CI 8200). Results and discussion: Hypertension was present in 46.7% of cases. Twenty patients, 35% of the study population showed nephropathy. Four of these patients (6.66% of cases) had proteinuria, while 16 (26.6% of patients) had microalbuminuria (> 30mg/24 hours). Systolic blood pressure was significantly (p < 0.05) associated with the presence of nephropathy (139 +19.44) vs. for the group with normal renal function (128.65 +15.12 mmHg). Conclusion: The etiology of diabetic nephropathy is multifactorial. However, systolic blood pressure and glycemic control remains the major risk factors. Better glycemic control and treatment of hypertension allowed preventing and slowing the progression of diabetic nephropathy.

Keywords: hypertension, nephropathy, hemodialysis, diabetes

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Authors: Afef Badri

Abstract:

The role of metaphor in creating the coherence and the cohesion of discourse in online interactive talk has almost received no attention. This paper intends to provide some theoretical reflections on metaphorical coherence as a jointly constructed process that evolves in online, face-to-face interactions. It suggests that the presence of a global conceptual structure in a conversation makes it conceptually cohesive. Yet, coherence remains a process largely determined by other variables (shared goals, communicative intentions, and framework of understanding). Metaphorical coherence created by these variables can be useful in detecting bias in media reporting.

Keywords: coherence, cohesion, face-to-face interactions, metaphor

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Authors: Afef Dridi, Salah Mezlini

Abstract:

Since experimental devices cannot calculate stress and deformation of complex structures. The Finite Element Method FEM has been widely used in several fields of research. One of these fields is orthodontics. The advantage of using such a method is the use of an accurate and non invasive method that allows us to have a sufficient data about the physiological reactions can happening in soft tissues. Most of researches done in this field were interested in the study of stresses and deformations induced by orthodontic apparatus in soft tissues (alveolar tissues). Only few studies were interested in the distribution of stress and strain in the orthodontic brackets. These studies, although they tried to be as close as possible to real conditions, their models did not reproduce the clinical cases. For this reason, the model generated by our research is the closest one to reality. In this study, a numerical model was developed to explore the stress and strain distribution under the application of real conditions. A comparison between different material properties was also done.

Keywords: visco-hyperelasticity, FEM, orthodontic treatment, inverse method

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Authors: Bohli Afef

Abstract:

The fifth-generation (5G) wireless systems is featured by extreme densities of cell stations to overcome the higher future demand. Hence, interference management is a crucial challenge in 5G ultra-dense cellular networks. In contrast to the classical inter-cell interference coordination approach, which is no longer fit for the high density of cell-tiers, this paper proposes a novel virtual coordination based on the dynamic common cognitive monitor channel protocol to deal with the inter-cell interference issue. A tractable and flexible model for the coverage probability of a typical user is developed through the use of the stochastic geometry model. The analyses of the performance of the suggested protocol are illustrated both analytically and numerically in terms of coverage probability.

Keywords: ultra dense heterogeneous networks, dynamic common channel protocol, cognitive radio, stochastic geometry, coverage probability

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Authors: Gueidi Afef, Gharsellaoui Hamza, Ben Ahmed Samir

Abstract:

This paper deals with the secret of the continual progression data that new data management solutions have been emerged: The NoSQL databases. They crossed several areas like personalization, profile management, big data in real-time, content management, catalog, view of customers, mobile applications, internet of things, digital communication and fraud detection. Nowadays, these database management systems are increasing. These systems store data very well and with the trend of big data, a new challenge’s store demands new structures and methods for managing enterprise data. The new intelligent machine in the e-learning sector, thrives on more data, so smart machines can learn more and faster. The robotics are our use case to focus on our test. The implementation of NoSQL for Robotics wrestle all the data they acquire into usable form because with the ordinary type of robotics; we are facing very big limits to manage and find the exact information in real-time. Our original proposed approach was demonstrated by experimental studies and running example used as a use case.

Keywords: NoSQL databases, database management systems, robotics, big data

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Authors: Mohamed Aymen Slim, Afef Abdelkrim, Mohamed Benrejeb

Abstract:

The handwriting is a physical demonstration of a complex cognitive process learnt by man since his childhood. People with disabilities or suffering from various neurological diseases are facing so many difficulties resulting from problems located at the muscle stimuli (EMG) or signals from the brain (EEG) and which arise at the stage of writing. The handwriting velocity of the same writer or different writers varies according to different criteria: age, attitude, mood, writing surface, etc. Therefore, it is interesting to reconstruct an experimental basis records taking, as primary reference, the writing speed for different writers which would allow studying the global system during handwriting process. This paper deals with a new approach of the handwriting system modeling based on the velocity criterion through the concepts of artificial neural networks, precisely the Radial Basis Functions (RBF) neural networks. The obtained simulation results show a satisfactory agreement between responses of the developed neural model and the experimental data for various letters and forms then the efficiency of the proposed approaches.

Keywords: Electro Myo Graphic (EMG) signals, experimental approach, handwriting process, Radial Basis Functions (RBF) neural networks, velocity modeling

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Authors: Chargui Abderrahman, Nehdi Afef , BelaïD Amine , Djerbi Nadir, Tauc Michel, Hofman Paul, Mograbi Baharia, El May MichèLe

Abstract:

K63-linked ubiquitination — i.e. conjugation of a chain of ubiquitins (Ub) linked through lys63 — has emerged as a key mechanism regulating signalling transduction pathways. Although critical, very little information is currently available about how subversion of K63 ubiquitination might contribute to cancers and inflammatory diseases. The present study provides the first evidence that Cadmium (Cd), a widespread environmental carcinogen and toxicant, is a powerful activator of K63 ubiquitination. Indeed, Cd induces accumulation of K63 polyUb proteins. Importantly, Cd-induced ubiquitination does not stem on oxidative damage or proteasome impairment. Rather, we demonstrate that Cd not only activates K63 ubiquitination but also amplifies their accumulation by overloading the capacity of autophagy pathway. At molecular level, Cd-induced ubiquitination is correlated with stabilization of HIF-1 and the activation of NF-B, two transcription factors. Strikingly, prolonged cell exposure to high Cd concentrations induces an exaggerated K63 ubiquitination that fosters aggresome formation, thus precluding these proteins from interacting with their downstream nuclear targets. We therefore propose that the aberrant activation of K63 ubiquitination by the carcinogen Cadmium could promote cell proliferation and inflammation at low levels while high levels committed cell to death.

Keywords: cadmium, environmental exposure, Lysine-63-ubiquitination, kidney, apoptosis, proliferation, autophagy

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Authors: Afef Badri

Abstract:

Metaphorical creativity does not constitute a static property of discourse. It is an interactive dynamic process created online. There has been a lack of research concerning online produced metaphorical creativity. This paper intends to account for metaphorical creativity in online talk-in-interaction as a dynamic process that emerges as discourse unfolds. It brings together insights from the emergentist approach to the study of metaphor in verbal interactions and insights from conceptual blending approach as a model for analysing online metaphorical constructions to propose a model for studying metaphorical creativity in interactive talk. The model is based on three focal points. First, metaphorical creativity is a dynamic emergent and open-to-change process that evolves in real time as interlocutors constantly blend and re-blend previous metaphorical contributions. Second, it is not a product of isolated individual minds but a joint achievement that is co-constructed and co-elaborated by interlocutors. The third and most important point is that the emergent process of metaphorical creativity is tightly shaped by contextual variables surrounding talk-in-interaction. It is grounded in the framework of interpretation of interlocutors. It is constrained by preceding contributions in a way that creates textual cohesion of the verbal exchange and it is also a goal-oriented process predefined by the communicative intention of each participant in a way that reveals the ideological coherence/incoherence of the entire conversation.

Keywords: communicative intention, conceptual blending, the emergentist approach, metaphorical creativity

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Authors: Nejla Fourati, Zied Fessi, Fatma Dhouib, Wicem Siala, Leila Farhat, Afef Khanfir, Wafa Mnejja, Jamel Daoud

Abstract:

Purpose: Radiation induced hypothyroidism in nasopharyngeal cancer (NPC) ranged from 15% to 55%. In reported data, it is considered as a common late complication of definitive radiation and is mainly observed 2 years after the end of treatment. The aim of this study was to evaluate the incidence of early hypothyroidism within 6 months after radiotherapy. Patients and methods: From June 2017 to February 2020, 35 patients treated with concurrent chemo-radiotherapy (CCR) for NPC were included in this prospective study. Median age was 49 years [23-68] with a sex ratio of 2.88. All patients received intensity modulated radiotherapy (IMRT) at a dose of 69.96 Gy in 33 daily fractions with weekly cisplatin (40mg/m²) chemotherapy. Thyroid stimulating hormone (TSH) and Free Thyroxine 4 (FT4) dosage was performed before the start of radiotherapy and 6 months after. Different dosimetric parameters for the thyroid gland were reported: the volume (cc); the mean dose (Dmean) and the %age of volume receiving more than 45 Gy (V45Gy). Wilcoxon Test was used to compare these different parameters between patients with or without hypothyroidism. Results: At baseline, 5 patients (14.3%) had hypothyroidism and were excluded from the analysis. For the remaining 30 patients, 9 patients (30%) developed a hypothyroidism 6 months after the end of radiotherapy. The median thyroid volume was 10.3 cc [4.6-23]. The median Dmean and V45Gy were 48.3 Gy [43.15-55.4] and 74.8 [38.2-97.9] respectively. No significant difference was noted for all studied parameters. Conclusion: Early hypothyroidism occurring within 6 months after CCR for NPC seems to be a common complication (30%) that should be screened. Good patient monitoring with regular dosage of TSH and FT4 makes it possible to treat hypothyroidism in asymptomatic phase. This would be correlated with an improvement in the quality of life of these patients. The results of our study do not show a correlation between the thyroid doses and the occurrence of hypothyroidism. This is probably related to the high doses received by the thyroid in our series. These findings encourage more optimization to limit thyroid doses and then the risk of radiation-induced hypothyroidism

Keywords: nasopharyngeal carcinoma, hypothyroidism, early complication, thyroid dose

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Authors: Omar Nouri, Wafa Mnejja, Nejla Fourati, Fatma Dhouib, Wicem Siala, Ilhem Charfeddine, Afef Khanfir, Jamel Daoud

Abstract:

Background and objective: Induction chemotherapy (IC) followed by concomitant chemo radiotherapy with intensity modulated radiation (IMRT) technique is actually the recommended treatment modality for locally advanced nasopharyngeal carcinomas (NPC). The aim of this study was to evaluate the prognostic factors predicting loco regional relapse with this new treatment protocol. Patients and methods: A retrospective study of 52 patients with NPC treated between June 2016 and July 2019. All patients received IC according to the protocol of the Head and Neck Radiotherapy Oncology Group (Gortec) NPC 2006 (3 TPF courses) followed by concomitant chemo radiotherapy with weekly cisplatin (40 mg / m2). Patients received IMRT with integrated simultaneous boost (SIB) of 33 daily fractions at a dose of 69.96 Gy for high-risk volume, 60 Gy for intermediate risk volume and 54 Gy for low-risk volume. Median age was 49 years (19-69) with a sex ratio of 3.3. Forty five tumors (86.5%) were classified as stages III - IV according to the 2017 UICC TNM classification. Loco regional relapse (LRR) was defined as a local and/or regional progression that occurs at least 6 months after the end of treatment. Survival analysis was performed according to Kaplan-Meier method and Log-rank test was used to compare anatomy clinical and therapeutic factors that may influence loco regional free survival (LRFS). Results: After a median follow up of 42 months, 6 patients (11.5%) experienced LRR. A metastatic relapse was also noted for 3 of these patients (50%). Target volumes coverage was optimal for all patient with LRR. Four relapses (66.6%) were in high-risk target volume and two (33.3%) were borderline. Three years LRFS was 85,9%. Four factors predicted loco regional relapses: histologic type other than undifferentiated (UCNT) (p=0.027), a macroscopic pre chemotherapy tumor volume exceeding 100 cm³ (p=0.005), a reduction in IC doses exceeding 20% (p=0.016) and a total cumulative cisplatin dose less than 380 mg/m² (p=0.0.34). TNM classification and response to IC did not impact loco regional relapses. Conclusion: For nasopharyngeal carcinoma, tumors with initial high volume and/or histologic type other than UCNT, have a higher risk of loco regional relapse. Therefore, they require a more aggressive therapeutic approaches and a suitable monitoring protocol.

Keywords: loco regional relapse, modulation intensity radiotherapy, nasopharyngeal carcinoma, prognostic factors

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Authors: Omar Nouri, Wafa Mnejja, Fatma Dhouib, Syrine Zouari, Wicem Siala, Ilhem Charfeddine, Afef Khanfir, Leila Farhat, Nejla Fourati, Jamel Daoud

Abstract:

Purpose and Objective: Intensity modulated radiation (IMRT) technique, associated with induction chemotherapy (IC) and/or concomitant chemotherapy (CC), is actually the recommended treatment modality for nasopharyngeal carcinomas (NPC). The aim of this study was to evaluate the therapeutic results and the patterns of relapse with this treatment protocol. Material and methods: A retrospective monocentric study of 145 patients with NPC treated between June 2016 and July 2021. All patients received IMRT with integrated simultaneous boost (SIB) of 33 daily fractions at a dose of 69.96 Gy for high-risk volume, 60 Gy for intermediate risk volume and 54 Gy for low-risk volume. The high-risk volume dose was 66.5 Gy in children. Survival analysis was performed according to the Kaplan-Meier method, and the Log-rank test was used to compare factors that may influence survival. Results: Median age was 48 years (11-80) with a sex ratio of 2.9. One hundred-twenty tumors (82.7%) were classified as stages III-IV according to the 2017 UICC TNM classification. Ten patients (6.9%) were metastatic at diagnosis. One hundred-thirty-five patient (93.1%) received IC, 104 of which (77%) were TPF-based (taxanes, cisplatin and 5 fluoro-uracil). One hundred-thirty-eight patient (95.2%) received CC, mostly cisplatin in 134 cases (97%). After a median follow-up of 50 months [22-82], 46 patients (31.7%) had a relapse: 12 (8.2%) experienced local and/or regional relapse after a median of 18 months [6-43], 29 (20%) experienced distant relapse after a median of 9 months [2-24] and 5 patients (3.4%) had both. Thirty-five patients (24.1%) died, including 5 (3.4%) from a cause other than their cancer. Three-year overall survival (OS), cancer specific survival, disease free survival, metastasis free survival and loco-regional free survival were respectively 78.1%, 81.3%, 67.8%, 74.5% and 88.1%. Anatomo-clinic factors predicting OS were age > 50 years (88.7 vs. 70.5%; p=0.004), diabetes history (81.2 vs. 66.7%; p=0.027), UICC N classification (100 vs. 95 vs. 77.5 vs. 68.8% respectively for N0, N1, N2 and N3; p=0.008), the practice of a lymph node biopsy (84.2 vs. 57%; p=0.05), and UICC TNM stages III-IV (93.8 vs. 73.6% respectively for stage I-II vs. III-IV; p=0.044). Therapeutic factors predicting OS were a number of CC courses (less than 4 courses: 65.8 vs. 86%; p=0.03, less than 5 courses: 71.5 vs. 89%; p=0.041), a weight loss > 10% during treatment (84.1 vs. 60.9%; p=0.021) and a total cumulative cisplatin dose, including IC and CC, < 380 mg/m² (64.4 vs. 87.6%; p=0.003). Radiotherapy delay and total duration did not significantly affect OS. No grade 3-4 late side effects were noted in the evaluable 127 patients (87.6%). The most common toxicity was dry mouth which was grade 2 in 47 cases (37%) and grade 1 in 55 cases (43.3%).Conclusion: IMRT for nasopharyngeal carcinoma granted a high loco-regional control rate for patients during the last five years. However, distant relapses remain frequent and conditionate the prognosis. We identified many anatomo-clinic and therapeutic prognosis factors. Therefore, high-risk patients require a more aggressive therapeutic approach, such as radiotherapy dose escalation or adding adjuvant chemotherapy.

Keywords: therapeutic results, prognostic factors, intensity-modulated radiotherapy, nasopharyngeal carcinoma

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