Search results for: H. Nouira

Authors: Tesnim Charrad, Kaouther Nouira, Ahmed Ferchichi

Abstract:

In order to reduce the number of deaths due to heart problems, we propose the use of Hierarchical Temporal Memory Algorithm (HTM) which is a real time anomaly detection algorithm. HTM is a cortical learning algorithm based on neocortex used for anomaly detection. In other words, it is based on a conceptual theory of how the human brain can work. It is powerful in predicting unusual patterns, anomaly detection and classification. In this paper, HTM have been implemented and tested on ECG datasets in order to detect cardiac anomalies. Experiments showed good performance in terms of specificity, sensitivity and execution time.

Keywords: cardiac anomalies, ECG, HTM, real time anomaly detection

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Authors: Imen Labidi, Said Nouira

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Dung beetles Scarabaeides of Tunisia constitute a major component of soil fauna, especially in the Mediterranean region. In the first phase of the present study, an intensive investigation of this group following the gathering of all the bibliographic, museological data and based on a recent collection of 17020 specimens in 106 localities in Tunisia, allowed to confirm with certainty the presence of 94 species distributed in 43 genera, 4 families and 3 sub-families. Only 81 species distributed in 38 genres, 4 families, and 3 sub-families, have been found during our prospections. The population of dung beetles Scarabaeides is composed of 58% of Aphodiidae, 39.51% of Scarabaeidae, and 8.64% of Geotrupidae. Biogeographic affinities of the species were determined and showed that 42% of the identified species have a wide Palaearctic distribution, the endemism is very low, only 3 species are endemic to Tunisia Mecynodes demoflysi, Neobodilus marani, and Thorectes demoflysi, 29 species have a wide distribution, 35 are northern and 17 are southern species. Moreover, others are dependent on very specific Biotopes like Sisyphus schaefferi linked to the northwest of Tunisia and Scarabaeus semipunctatus related to the coastal area north of Tunisia.

Keywords: dung beetles, Tunisia, composition, biogeography

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Authors: Kamélia Bouderbala, Hichem Nouira, Etienne Videcoq, Manuel Girault, Daniel Petit

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Thermal drifts caused by the power dissipated by the mechanical guiding systems constitute the main limit to enhance the accuracy of an ultra-high precision cylindricity measuring machine. For this reason, a high precision compact prototype has been designed to simulate the behaviour of the instrument. It ensures in situ calibration of four capacitive displacement probes by comparison with four laser interferometers. The set-up includes three heating wires for simulating the powers dissipated by the mechanical guiding systems, four additional heating wires located between each laser interferometer head and its respective holder, 19 Platinum resistance thermometers (Pt100) to observe the temperature evolution inside the set-up and four Pt100 sensors to monitor the ambient temperature. Both a Reduced Model (RM), based on the Modal Identification Method (MIM) was developed and optimized by comparison with the experimental results. Thereafter, time dependent tests were performed under several conditions to measure the temperature variation at 19 fixed positions in the system and compared to the calculated RM results. The RM results show good agreement with experiment and reproduce as well the temperature variations, revealing the importance of the RM proposed for the evaluation of the thermal behaviour of the system.

Keywords: modal identification method (MIM), thermal behavior and drift, dimensional metrology, measurement

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Authors: Nouira Mariem, Ben Rayana Hazem, Ennigrou Samir

Abstract:

Background and aim: During the past decade, the frequency of extrapulmonary forms of tuberculosis has increased. These forms are under-diagnosed using conventional tests. The aim of this study was to evaluate the performance of the Tuberculin Skin Test (TST) for the diagnosis of tuberculosis, using the ROC curve and Fagan’s Nomogram methodology. Methods: This was a case-control, multicenter study in 11 anti-tuberculosis centers in Tunisia, during the period from June to November2014. The cases were adults aged between 18 and 55 years with confirmed tuberculosis. Controls were free from tuberculosis. A data collection sheet was filled out and a TST was performed for each participant. Diagnostic accuracy measures of TST were estimated using ROC curve and Area Under Curve to estimate sensitivity and specificity of a determined cut-off point. Fagan’s nomogram was used to estimate its predictive values. Results: Overall, 1053 patients were enrolled, composed of 339 cases (sex-ratio (M/F)=0.87) and 714 controls (sex-ratio (M/F)=0.99). The mean age was 38.3±11.8 years for cases and 33.6±11 years for controls. The mean diameter of the TST induration was significantly higher among cases than controls (13.7mm vs.6.2mm;p=10-6). Area Under Curve was 0.789 [95% CI: 0.758-0.819; p=0.01], corresponding to a moderate discriminating power for this test. The most discriminative cut-off value of the TST, which were associated with the best sensitivity (73.7%) and specificity (76.6%) couple was about 11 mm with a Youden index of 0.503. Positive and Negative predictive values were 3.11% and 99.52%, respectively. Conclusion: In view of these results, we can conclude that the TST can be used for tuberculosis diagnosis with a good sensitivity and specificity. However, the skin induration measurement and its interpretation is operator dependent and remains difficult and subjective. The combination of the TST with another test such as the Quantiferon test would be a good alternative.

Keywords: tuberculosis, tuberculin skin test, ROC curve, cut-off

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Authors: Maatouk Mohamed, Nouira Mariem

Abstract:

Background and aims: Healthcare-associated infections (HAI) represent a major public health problem worldwide. They represent one of the most serious adverse events in health care. The objectives of our study were to estimate the prevalence of HAI at the Charles Nicolle Hospital (CNH) and to identify the main associated factors as well as to estimate the frequency of antibiotic use. Methods: It was a cross sectional study at the CNH with a unique passage per department (OctoberDecember 2018). All patients present at the wards for more than 48 hours were included. All patients from outpatient consultations, emergency and dialysis departments were not included. The site definitions of infections proposed by the Centers for Disease Control and Prevention (CDC) were used. Only clinically and/or microbiologically confirmed active HAIs were included. Results: A total of 318 patients were included with a mean age of 52 years and a sex ratio (Female/Male) of 1.05. A total of 41 patients had one or more active HAIs, corresponding to a prevalence of 13.1% (95% CI: 9.3%-16.9%). The most frequent sites infections were urinary tract infections and pneumonia. Multivariate analysis among adult patients (>=18 years) (n=261), revealed that infection on admission (p=0.01), alcoholism (p=0.01), high blood pressure (p=0.008), having at least one invasive device inserted (p=0.004), and history of recent surgery (p=0.03), increased significantly the risk of HAIs. More than 1 of 3 patients (35.4%) were under antibiotics on the day of the survey, of which more than half (57.4%) were under 2 or more types of antibiotics. Conclusion: The prevalence of HAIs and antibiotic prescriptions at the CNH were considerably high. An infection prevention and control committee, as well as the development of an Antibiotic stewardship program with continuous monitoring using repeated prevalence surveys must be implemented to limit the frequency of these infections effectively.

Keywords: tumors, oesophagectomy, esophagogastric junction, systematic review

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Authors: Nouira Mariem, Ennigrou Samir

Abstract:

Background and aims: Healthcare-associated infections (HAI) represent a major public health problem worldwide. They represent one of the most serious adverse events in health care. The objectives of our study were to estimate the prevalence of HAI at the Charles Nicolle Hospital (CNH) and to identify the main associated factors as well as to estimate the frequency of antibiotic use. Methods: It was a cross-sectional study at the CNH with a unique passage per department (October-December 2018). All patients present at the wards for more than 48 hours were included. All patients from outpatient consultations, emergency, and dialysis departments were not included. The site definitions of infections proposed by the Centers for Disease Control and Prevention (CDC) were used. Only clinically and/or microbiologically confirmed active HAIs were included. Results: A total of 318 patients were included, with a mean age of 52 years and a sex ratio (female/male) of 1.05. A total of 41 patients had one or more active HAIs, corresponding to a prevalence of 13.1% (95% CI: 9.3%-16.9%). The most frequent site infections were urinary tract infections and pneumonia. Multivariate analysis among adult patients (>=18 years) (n=261) revealed that infection on admission (p=0.01), alcoholism (p=0.01), high blood pressure (p=0.008), having at least one invasive device inserted (p=0.004), and history of recent surgery (p=0.03), increased the risk of HAIs significantly. More than 1 of 3 patients (35.4%) were under antibiotics on the day of the survey, of which more than half (57.4%) were under two or more types of antibiotics. Conclusion: The prevalence of HAIs and antibiotic prescriptions at the CNH were considerably high. An infection prevention and control committee, as well as the development of an antibiotic stewardship program with continuous monitoring using repeated prevalence surveys, must be implemented to limit the frequency of these infections effectively.

Keywords: prevalence, healthcare associated infection, antibiotic, Tunisia

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Authors: Arfaoui Emna, Nouira Mariem

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Background and aims: Breastfeeding is the reference feeding for a child, especially during the first months of life. It is not widespread in many countries due to many factors. There has been a decline in exclusive breastfeeding (EB) practice, particularly in the middle- and low-income countries, i.e., Tunisia. The aim of our study was to describe the knowledge, attitudes, and practice of a sample of Tunisian mothers toward breastfeeding. Methods: It was a descriptive cross-sectional study conducted during the year 2022 over a period of two months in three health structures in the north of Tunisia among mothers of infants aged 2 to 18 months. Levels of mothers’ knowledge (low/moderate/high) were determined using a score ranging from 0 to 11 points. EB was defined as the proportion of infants who were exclusively breastfed during the first six months of life. Results: A total of 180 women with a mean age of 33±4.9 years were included. The average knowledge score was equal to 6.4 ±1.5 points, with extremes ranging from 3 to 11 points. Most of the respondents had a moderate knowledge level (44.4%). More than half of surveyed mothers (66.1%) thought that breastfeeding deforms breasts, and 16.7% thought that breastfeeding is specific to women who do not work. Breastfeeding experience during the first week of life was considered difficult in 70% of cases. The prevalence of EB up to 6 months of age was equal to 16.4% [10.8-23.2]. The main reported obstacles during breastfeeding practice were having an insufficient quantity of breast milk (18.3%) and child difficulties with sucking (12.8%), and having pain in the breast while breastfeeding (12.80%). Conclusion: Our results highlighted the insufficient level of knowledge and a low prevalence of EB in our study population. Improving mothers’ knowledge and promoting EB practice is needed. Implementing health education strategies involving healthcare workers, who represent a main actor in education and breastfeeding promotion, is very important to reach a satisfactory frequency for EB.

Keywords: breastfeeding, practices, knowledge, Tunisia

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Authors: Mekni Sabrine, Nouira Mariem

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Background and aim: Allogeneic hematopoietic stem cell transplantation is a curative treatment for several hematological diseases; however, it has a non-negligible morbidity and mortality depending on several prognostic factors, including pre-transplant hyperferritinemia. The aim of our study was to estimate the impact of hyperferritinemia on survivals and on the occurrence of post-transplant complications. Methods: It was a longitudinal study conducted over 8 years and including all patients who had a first allograft. The impact of pretransplant hyperferritinemia (ferritinemia ≥1500) on survivals was studied using the Kaplan Meier method and the COX model for uni- and multivariate analysis. The Khi-deux test and binary logistic regression were used to study the association between pretransplant ferritinemia and post-transplant complications. Results: One hundred forty patients were included with an average age of 26.6 years and a sex ratio (M/F)=1.4. Hyperferritinemia was found in 33% of patients. It had no significant impact on either overall survival (p=0.9) or event -free survival (p=0.6). In multivariate analysis, only the type of disease was independently associated with overall survival (p=0.04) and event-free survival (p=0.002). For post-allograft complications: The occurrence of early documented infections was independently associated with pretransplant hyperferritinemia (p=0.02) and the presence of acute graft versus host disease( GVHD) (p<10-3). The occurrence of acute GVHD was associated with early documented infection (p=0.002) and Cytomegalovirus reactivation (p<10-3). The occurrence of chronic GVHD was associated with the presence of Cytomegalovirus reactivation (p=0.006) and graft source (p=0.009). Conclusion: Our study showed the significant impact of pre-transplant hyperferritinemia on the occurrence of early infections but not on survivals. Early and more accurate assessment iron overload by other tests such as liver magnetic resonance imaging with initiation of chelating treatment could prevent the occurrence of such complications after transplantation.

Keywords: allogeneic, transplants, ferritin, survival

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Authors: Rindra Rantoson, Hichem Nouira, Nabil Anwer, Charyar Mehdi-Souzani

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Multiple measurements by means of various data acquisition systems are generally required to measure the shape of freeform workpieces for accuracy, reliability and holisticity. The obtained data are aligned and fused into a common coordinate system within a registration technique involving coarse and fine registrations. Standardized iterative methods have been established for fine registration such as Iterative Closest Points (ICP) and its variants. For coarse registration, no conventional method has been adopted yet despite a significant number of techniques which have been developed in the literature to supply an automatic rough matching between data sets. Two main issues are addressed in this paper: the coarse registration and the fine registration. For coarse registration, two novel automated methods based on the exploitation of discrete curvatures are presented: an enhanced Hough Transformation (HT) and an improved Ransac Transformation. The use of curvature features in both methods aims to reduce computational cost. For fine registration, a new variant of ICP method is proposed in order to reduce registration error using curvature parameters. A specific distance considering the curvature similarity has been combined with Euclidean distance to define the distance criterion used for correspondences searching. Additionally, the objective function has been improved by combining the point-to-point (P-P) minimization and the point-to-plane (P-Pl) minimization with automatic weights. These ones are determined from the preliminary calculated curvature features at each point of the workpiece surface. The algorithms are applied on simulated and real data performed by a computer tomography (CT) system. The obtained results reveal the benefit of the proposed novel curvature-based registration methods.

Keywords: discrete curvature, RANSAC transformation, hough transformation, coarse registration, ICP variant, point-to-point and point-to-plane minimization combination, computer tomography

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Authors: Maatouk Mohamed, Nouira Mariem, Hamdi Kbir Gh, Mahjoubi M. F., Ben Moussa M.

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Background and aim: Preoperative biliary drainage (PBD) has been introduced to lower bilirubin levels and to control the negative effects of obstructive jaundice in patients with malignant obstructive jaundice undergoing pancreaticoduodenectomy (PD). The optimal time interval between PBD and PD is still not clear. Delaying surgery by 4 to 6 weeks is the commonly accepted practice. However, delayed PD has been shown to decrease the rate of resection and adversely affect the tumor grading and prognosis. Thus, the purpose of our systematic review and meta-analysis was to evaluate the optimal period for PBD prior to PD: short or prolonged in terms of postoperative morbidity and survival outcomes. Methods: Trials were searched in PubMed, Science Direct, Google Scholar, and Cochrane Library until November 2022. Studies using PBD in patients with malignant obstructive jaundice that compared short duration group (SDG) (surgery performed within 3-4 weeks) with prolonged duration group (PDG) (at least 3-4 weeks after PBD) were included in this study. The risk of bias was assessed using the Rob v2 and Robins-I tools. The priori protocol was published in PROSPERO (ID: CRD42022381405). Results: Seven studies comprising 1625 patients (SDG 870, PDG 882) were included. All studies were non-randomized, and only one was prospective. No significant differences were observed between the SDG and PDG in mortality (OR= 0.59; 95% CI [0.30, 1.17], p=0.13), major morbidity (Chi² = 30.28, p <0.00001; I² = 87%), pancreatic fistula (Chi² = 6.61, p = 0.25); I² = 24%), post pancreatectomy haemorrhage (OR= 1.16; 95% CI [0.67, 2.01], p=0.59), positive drainage culture (OR= 0.36; 95% CI [0.10, 1.32], p=0.12), septic complications (OR= 0.78; 95% CI [0.23, 2.72], p=0.70), wound infection (OR= 0.08, p=0.07), operative time (MD= 0.21; p=0.21). Conclusion: Early surgery within 3 or 4 weeks after biliary drainage is both safe and effective. Thus, it is reasonable to suggest early surgery following PBD for patients having resectable periampullary cancers.

Keywords: preoperative biliary drainage, pancreatic cancer, pancreatic surgery, complication

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Authors: F. Viprey, H. Nouira, S. Lavernhe, C. Tournier

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Manufacturing of freeform parts may be achieved on 5-axis machine tools currently considered as a common means of production. In particular, the geometrical quality of the freeform parts depends on the accuracy of the multi-axis structural loop, which is composed of several component assemblies maintaining the relative positioning between the tool and the workpiece. Therefore, to reach high quality of the geometries of the freeform parts the geometric errors of the 5 axis machine should be evaluated and compensated, which leads one to master the deviations between the tool and the workpiece (volumetric accuracy). In this study, a novel hole-bar design was developed and used for the characterization of the geometric errors of a RRTTT 5-axis machine tool. The hole-bar standard design is made of Invar material, selected since it is less sensitive to thermal drift. The proposed design allows once to extract 3 intrinsic parameters: one linear positioning and two straightnesses. These parameters can be obtained by measuring the cylindricity of 12 holes (bores) and 11 cylinders located on a perpendicular plane. By mathematical analysis, twelve 3D points coordinates can be identified and correspond to the intersection of each hole axis with the least square plane passing through two perpendicular neighbour cylinders axes. The hole-bar was calibrated using a precision CMM at LNE traceable the SI meter definition. The reversal technique was applied in order to separate the error forms of the hole bar from the motion errors of the mechanical guiding systems. An inter-comparison was additionally conducted between four NMIs (National Metrology Institutes) within the EMRP IND62: JRP-TIM project. Afterwards, the hole-bar was integrated in RRTTT 5-axis machine tool to identify its volumetric errors. Measurements were carried out in real time and combine raw data acquired by the Renishaw RMP600 touch probe and the linear and rotary encoders. The geometric errors of the 5 axis machine were also evaluated by an accurate laser tracer interferometer system. The results were compared to those obtained with the hole bar.

Keywords: volumetric errors, CMM, 3D hole-bar, inter-comparison

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