Search results for: Khaoula Bensaida

Authors: Khaoula Bensaida, Osama Eljamal

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The electrical energy generation through Microbial Fuel Cells (MFCs) using microorganisms is a renewable and sustainable approach. It creates truly an efficient technology for power production and wastewater treatment. MFC is an electrochemical device which turns wastewater into electricity. The most important part of MFC is microbes. Nano zero-valent Iron NZVI technique was successfully applied in degrading the chemical pollutants and cleaning wastewater. However, the use of NZVI for enhancing the current production is still not confirmed yet. This study aims to confirm the effect of these particles on the current generation by using MFC. A constructed microbial fuel cell, which utilizes domestic wastewater, has been considered for wastewater treatment and bio-electricity generation. The two electrodes were connected to an external resistor (200 ohms). Experiments were conducted in two steps. First, the MFC was constructed without adding NZVI particles (Control) while at a second step, nanoparticles were added with a concentration of 50mg/L. After 20 hours, the measured voltage increased to 5 and 8mV, respectively. To conclude, the use of zero-valent iron in an MFC system can increase electricity generation.

Keywords: bacterial growth, electricity generation, microbial fuel cell MFC, nano zero-valent iron NZVI.

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Authors: Ahmed BenSaïda

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This study examines the relationship between crude oil and the Gulf Cooperation Council (GCC) region stock markets by employing a regime-switching approach. The methodology provides new insights into how the interrelationship between oil and GCC stock markets may fluctuate in different economic or market regimes, which is crucial for understanding the transmission of oil shocks and tailoring policy responses. Our findings indicate that the spillovers between the underlying assets are asymmetric. Specifically, during the turmoil periods, the connectedness is intense among these assets, whereas during tranquil periods, the linkage is moderate. Furthermore, an increase in oil prices can positively contribute to the profits of firms that are heavily dependent on oil, leading to an increase in the linkage between these countries and crude oil. The findings have important implications for investors and decision-makers in the GCC region.

Keywords: GCC indices, oil, regime-switching, spillovers

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Authors: Ahmed BenSaïda

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This paper investigates the association between financial technology (FinTech) growth and bank performance in the Gulf Cooperation Council (GCC) region. Application is conducted on a panel dataset containing the annual observations of banks covering the period from 2012 to 2021. FinTech growth is set as an explanatory variable on three proxies of bank performance. These proxies are the return on assets (ROA), return on equity (ROE), and net interest margin (NIM). Moreover, several control variables are added to the model, including bank-specific and macroeconomic variables. The results are significant as all the proxies of the bank performance are negatively affected by the growth of FinTech startups. Consequently, banks are urged to proactively invest in FinTech startups and engage in partnerships to avoid the risk of disruption.

Keywords: financial technology, bank performance, GCC countries, panel regression

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Authors: Fatma Khaled, Khaoula Hidouri, Bechir Chaouachi

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Desalination using solar energy coupled with membrane techniques such as vacuum membrane distillation (VMD) is considered as an interesting alternative for the production of pure water. During this work, a developed model of a polytetrafluoroethylene (PTFE) hollow fiber membrane module of a VMD unit of seawater was carried out. This simulation leads to establishing a comparison between the effects of two different equations of the vaporization latent heat on the membrane surface temperature and on the unit productivity. Besides, in order to study the effect of putting membrane modules in series on the outlet fluid temperature and on the productivity of the process, a simulation was executed.

Keywords: vacuum membrane distillation, membrane module, membrane temperature, productivity

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Authors: Khaoula Hidouri, Ali Benhmidene, Bechir Chouachi

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The purification of brackish seawater becomes a necessity and not a choice against demographic and industrial growth especially in third world countries. Two models can be used in this work: simple solar still and simple solar still coupled with a heat pump. In this research, the productivity of water by Simple Solar Distiller (SSD) and Simple Solar Distiller Hybrid Heat Pump (SSDHP) was determined by the orientation, the use of heat pump, the simple or double glass cover. The productivity can exceed 1.2 L/m²h for the SSDHP and 0.5 L/m²h for SSD model. The result of the global efficiency is determined for two models SSD and SSDHP give respectively 30%, 50%. The internal efficiency attained 35% for SSD and 60% of the SSDHP models. Convective heat coefficient can be determined by attained 2.5 W/m²°C and 0.5 W/m²°C respectively for SSDHP and SSD models.

Keywords: productivity, efficiency, convective heat coefficient, SSD model, SSDHPmodel

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Authors: Khaoula Hidouri, Ali Benhmidene, Bechir Chouachi, Dhananjay R. Mishra, Ammar Houas

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Activated carbon DSAC36-24 iy is adsorbent materials, characterized by a specific surface area of 548.13 m²g⁻¹. Their manufacture uses the natural raw materials like the nucleus of dates. In this study the treatment is done in two stages: A chemical treatment by H₃PO₄ followed by a physical treatment under nitrogen for 1 hour then under stream of CO₂ for 24 hours. A characterization of the various parameters was determined such as the measurement of the specific surface area, determination of pHPZC, bulk density, iodine value. The study of the adsorption of organic molecules (hydroquinone, paranitrophenol, 2,4-dinitrophenol, 2,4,6-trinitrophenol) indicates that the adsorption phenomena are essentially due to the van der Waals interaction. In the case of organic molecules carrying the polar substituents, the existence of hydrogen bonds is also proved by the donor-acceptor forces. The study of the pH effect was done with modeling by different models (Langmuir, Freundlich, Langmuir-Freundlich, Redlich-Peterson), a kinetic treatment is also followed by the application of Lagergren, Weber, Macky.

Keywords: adsoprtion ishoterms, adsorption kinetics, DSAC36-24, organic molecule

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Authors: Amari Khaoula, Berrahou Mohamed

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The topic of our article revolves around a numerical and comparative analysis between two notched Boron/epoxy plates that are U-shaped and the other V-shaped, cracked, and repaired by a rectangular patch of the same composite material; the finite element method was used for the analytical study and comparison of the results obtained for determining the optimal shape of notch which will give a longer life to the repair. In this context, we studied the variation of the stress intensity factor, the evolution of the damaged area, and the calculation of the ratio of the damaged area according to the crack length and the concentration of the Von Mises stresses as a function of the lengths of the paths. According to the results obtained, we conclude that the notch plate U is the optimal one than notch plate V because it has lower values either for the stress intensity factor (SIF), damaged area ratio (Dᵣ), or the Von Mises stresses.

Keywords: the notch U, the notch V, the finite element method FEM, comparison, rectangular patch, composite, stress intensity factor, damaged area ratio, Von Mises stresses

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Authors: Houria Djebar, Amina Saib, Malika Berredjem, Khaoula Bechlem, Mohammed-Reda Djebar

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Reactive oxygen species (ROS) have a high potential to damage almost all types of cellular components of the body, which explains their involvement in the induction and/or amplification of several pathologies. Supplementation of the body by exogenous antioxidants is very useful against these harmful species. In this context, we attempted to evaluate the in vitro and in vivo antioxidant activities of three newly synthesized amidophosphonates (AP1, AP2, and AP3). The results relating to the in vitro tests for DPPH radical scavenging activity shows that these amidophosphonates have a modest antiradical power (ARP) less effectively pronounced compared with an analogue marketed in Algeria: (Dursban) Clorpiryphos ethyl. However, in vivo effects were evaluated on some antioxidant systems (LP intensity, CAT activity and GSH content), or in combination with 2, 2-diphenyl-picrylhydrazyle (DPPH) radical in paramecium tetraurelia used as a complementary system to rapidly elucidate the cytotoxicity. On the basis of the results obtained it can be concluded that amidophosphonates studied exhibited a mild protective effect. The mechanism for how they influenced the antioxidant activities was discussed.

Keywords: Paramecium tetraurelia, amidophosphonates, antioxidant activity, DPPH free radical, in vitro experiments, biochemical parameters

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Authors: Khaoula Azraiel, Mohamed Mehdi Abassi, Amel Sadraoui, Walid Hammami, Azouz Msaddek, Imed Cheikh, Maria Mancebo, Elisabet Perez-Navarro, Antonio Caruz, Henda Triki, Ahlem Djebbi

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IL28B rs12979860 genotype is confirmed as an important predictor of response to peginterferon/ribavirin therapy in patients with chronic hepatitis C (CHC). IFNL4 ss469415590 is a newly discovered polymorphism that could also affect the sustained virological response (SVR). The aim of this study was to evaluate the association of IL28B and IFNL4 genotypes with peginterferon/ribavirin treatment response in Tunisians patients with CHC and to determine which of these SNPs, was the stronger marker. A total of 120 patients were genotyped for both rs12979860 and ss469415590 polymorphisms. The association of each genetic marker with SVR was analyzed and comparison between the two SNPs was calculated by logistic regression models. For rs12979860, 69.6% of patients with CC, 41.8% with CT and 42.8% with TT achieved SVR (p = 0.003). Regarding ss469415590, 70.4% of patients with TT/TT genotype achieved SVR compared to 42.8% with TT/ΔG and 37.5% with ΔG /ΔG (p = 0.002). The presence of CC and TT/TT genotypes was independently associated with treatment response with an OR of 3.86 for each. In conclusion, both IL28B rs12979860 and IFNL4 ss469415590 variants were associated with response to pegIFN/RBV in Tunisian patients, without any additional benefit in performance for IFNL4. Our results are different from those detected in Sub-Saharan Africa countries.

Keywords: Hepatitis C virus, IFNL4, IL28B, Peginterferon/ribavirin, polymorphism

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Authors: Abdelhamid Nechad, Ahmed Maghni, Khaoula Zahir

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Energy transition is one of Morocco's key sustainable development issues and is at the heart of the 2030 National Sustainable Development Strategy. On the one hand, it reflects the Moroccan government's determination to reduce the negative impact of energy consumption on the environment, and on the other, its determination to rely essentially on renewable energies to meet its energy needs. With this in mind, several tools are being implemented, including green bonds designed to finance projects with a high environmental or climate impact. Thus, since 2015, several green bonds have been issued for a cumulative total of $0.4 Billion . This article aims to examine the impact of green bonds on Morocco's energy transition. Through the Granger causality and cointegration test, this article examines the existence of a short- and long-term causal relationship between green bond issuance and investment in renewable energy projects on the one hand, and between green bond issuance and CO₂ emission reductions on the other. The results suggest that there is no short-term causal relationship between green bond issuance and renewable energy investments on one hand and CO₂ emissions reduction on the other hand. However, in the long run, there is a relationship between green bond issuance and CO₂ emissions reduction in Morocco.

Keywords: climate impact, CO₂ emissions, energy transition, green bonds, Morocco

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Authors: Abderrahman Hassi, Omar Bacadi, Khaoula Zitouni

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Abdelkader El Mouaziz is a Moroccan long-distance runner with a career-best time of 2:06:46 in the Chicago Marathon. El Mouaziz is a winner of the Madrid Marathon in 1994, the London Marathon in 1999 and 2001, as well as the New York Marathon in 2001. While he was playing for the Moroccan national team, he used to train in the Ifrane-Azrou region owing to its altitude, fresh forests, non-polluted air and quietness. After winning so many international competitions and retiring, he left his native Casablanca and went back to the Ifrane-Azrou region and started a business that employs ten people. In March 2010, El Mouaziz opened a bed and breakfast called Tourtite with a nice view on the mountain near the city of Ifrane in the way to Azrou. He wanted to give back to the region that helped him become a sport legend. His management style is not different than his sport style: performance and competitiveness combined with fair play. The objective of the present case study is to further enhance the understanding of the dynamics of transferring athletic championship-winning principles to entrepreneurial activities. The case study is a real-life situation and experience designed to provoke and stimulate reflections about a particular approach of management, especially for start-up businesses.

Keywords: sport, winning principles, entrepreneurship, Abdelkader El Mouaziz

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Authors: Bouharati Lokman, Bouharati Imen, Bouharati Khaoula, Bouharati Oussama, Bouharati Saddek

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Ionizing radiation exposure is an established cancer risk factor. Compared to other common environmental carcinogens, it is relatively easy to determine organ-specific radiation dose and, as a result, radiation dose-response relationships tend to be highly quantified. Nevertheless, there can be considerable uncertainty about questions of radiation-related cancer risk as they apply to risk protection and public policy, and the interpretations of interested parties can differ from one person to another. Examples of tools used in the analysis of the risk of developing cancer due to radiation are characterized by uncertainty. These uncertainties are related to the history of exposure and different assumptions involved in the calculation. We believe that the results of statistical calculations are characterized by uncertainty and imprecision. Having regard to the physiological variation from one person to another. In this study, we develop a tool based on fuzzy logic inference. As fuzzy logic deals with imprecise and uncertain, its application in this area is adequate. We propose a fuzzy system with three input variables (age, sex and body attainable cancer). The output variable expresses the risk of infringement rate of each organ. A base rule is established from recorded actual data. After successful simulation, this will instantly predict the risk of infringement rate of each body following chronic exposure to 0.1 Gy.

Keywords: radiation exposure, cancer, modeling, fuzzy logic

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Authors: Hiba Akrout, Khaoula Hidouri, Béchir Chaouachi, Romdhane Ben Slama

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A simple solar distiller has been constructed in order to desalt water via the solar distillation process. An experimental study has been conducted in June. The aim of this work is to study the effect of the distance between the cold condensing surface and the hot steam generation surface in order to optimize the geometric characteristics of a simple solar still. To do this, we have developed a mathematical model based on thermal and mass equations system. Subsequently, the equations system resolution has been made through a program developed on MATLAB software, which allowed us to evaluate the production of this system as a function of the distance separating the two surfaces. In addition, this model allowed us to determine the evolution of the humid air temperature inside the solar still as well as the humidity ratio profile all over the day. Simulations results show that the solar distiller production, as well as the humid air temperature, are proportional to the global solar radiation. It was also found that the air humidity ratio inside the solar still has a similar evolution of that of solar radiation. Moreover, the solar distiller average height augmentation, for constant water depth, induces the diminution of the production. However, increasing the water depth for a fixed average height of solar distiller reduces the production.

Keywords: distillation, solar energy, heat transfer, mass transfer, average height

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Authors: Ayoub Bouazza, Ali Faddouli, Said Amal, Rachid Benhida, Khaoula Khaless

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Brine waste generated from reverse osmosis (RO) desalination plants contains various valuable compounds, mainly salts, trace elements, and organic matter. These wastes are up to two times saltier than standard seawater. Therefore, there is a strong economic interest in recovering these salts. The current practice in desalination plants is to reject the brine back to the sea, which affects the marine ecosystem and the environment. Our study aims to bring forth a reliable management solution for the valorisation of waste brines. Natural evaporation, isothermal evaporation at 25°C and 50°C, and evaporation using continuous heating were used to crystallize valuable salts from a reverse osmosis desalination plant brine located on the Moroccan Atlantic coast. The crystallization sequence of the brine was studied in comparison with standard seawater. The X-Ray Diffraction (XRD) of the precipitated solid phases showed similar results, where halite was the main solid phase precipitated from both the brine and seawater. However, Jänecke diagram prediction, along with FREZCHEM simulations, showed that Kainite should crystallize before Epsomite and Carnallite. As the absence of kainite formation in many experiments in the literature has been related to the metastability of kainite and the critical relative humidity conditions, and the precipitation of K–Mg salts is very sensitive to climatic conditions. An evaporation process is proposed as a solution to achieve the predicted crystallization path and to affirm the recovery of Kainite.

Keywords: salts crystallization, reverse osmosis, solar evaporation, frezchem, ZLD

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Authors: Jemai Rabeb, Benhmidene Ali, Hidouri Khaoula, Chaouachi Bechir

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The diffusion-absorption refrigeration cycle consists of a generator bubble pump, an absorber, an evaporator and a condenser, and usually operates with ammonia/water/ hydrogen or helium as the working fluid. The aim of this paper is to study the stability problem a bubble pump. In fact instability can caused a reduction of bubble pump efficiency. To achieve this goal, we have simulated the behaviour of two-phase flow in a bubble pump by using a drift flow model. Equations of a drift flow model are formulated in the transitional regime, non-adiabatic condition and thermodynamic equilibrium between the liquid and vapour phases. Equations resolution allowed to define void fraction, and liquid and vapour velocities, as well as pressure and mixing enthalpy. Ammonia-water mixing is used as working fluid, where ammonia mass fraction in the inlet is 0.6. Present simulation is conducted out for a heating flux of 2 kW/m² to 5 kW/m² and bubble pump tube length of 1 m and 2.5 mm of inner diameter. Simulation results reveal oscillations of vapour and liquid velocities along time. Oscillations decrease with time and with heat flux. For sufficient time the steady state is established, it is characterised by constant liquid velocity and void fraction values. However, vapour velocity does not have the same behaviour, it increases for steady state too. On the other hand, pressure drop oscillations are studied.

Keywords: bubble pump, drift flow model, instability, simulation

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Authors: Berkas Khaoula

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Based on selection characteristics, high-density polyethylene (HDPE) extruded pipes are among the most economical and durable materials as well-designed solutions for water and gas transmission systems. The main reasons for such a choice are the high quality-performance ratio and the long-term service durability under aggressive conditions. Due to inevitable interactions with soils of different chemical compositions and transported fluids, aggressiveness becomes a key factor in studying resilient strength and life prediction limits. This phenomenon is known as environmental stress cracking resistance (ESCR). In this work, the effect of 3 acidic environments (5% acetic, 20% hydrochloric and 20% sulfuric) on HDPE-100 samples (~10x11x24 mm3). The results presented in the form (Δm/m0, %) as a function of √t indicate that the absorption, in the case of strong acids (HCl and H2SO4), evolves towards negative values involving material losses such as antioxidants and some additives. On the other hand, acetic acid and deionized water (DW) give a form of linear Fickean (LF) and B types, respectively. In general, the acids cause a slow but irreversible alteration of the chemical structure, composition and physical integrity of the polymer. The DW absorption is not significant (~0.02%) for an immersion duration of 69 days. Such results are well accepted in actual applications, while changes caused by acidic environments are serious and must be subjected to particular monitoring of the OIT factor (Oxidation Induction Time). After 55 days of aging, the H2SO4 and HCl media showed particular values with a loss of % mass in the interval [0.025-0.038] associated with irreversible chemical reactions as well as physical degradations. This state is usually explained by hydrolysis of the polymer, causing the loss of functions and causing chain scissions. These results are useful for designing and estimating the lifetime of the tube in service and in contact with adverse environments.

Keywords: HDPE, environmental stress cracking, absorption, acid media, chemical aging

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Authors: Berkas Khaoula, Chaoui Kamel

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Polyethylene (PE) pipes are one of the best options for water and gas transmission networks. The main reason for such a choice is its high-quality performance in service conditions over long periods of time. PE pipes are installed in contact with different soils having various chemical compositions with confirmed aggressiveness. As a result, PE pipe surfaces undergo unwanted oxidation reactions. Usually, the polymer mixture is designed to include some additives, such as anti-oxidants, to inhibit or reduce the degradation effects. Some other additives are intended to increase resistance to the ESC phenomenon associated with polymers (ESC: Environmental Stress Cracking). This situation occurs in contact with aggressive external environments following different contaminations of soil, groundwater and transported fluids. In addition, bacterial activity and other physical or chemical media, such as temperature and humidity, can play an enhancing role. These conditions contribute to modifying the PE pipe structure and degrade its properties during exposure. In this work, the effect of distilled water, sodium hypochlorite (bleach), diluted sulfuric acid (H2SO4) and toluene-methanol (TM) mixture are studied when extruded PE samples are exposed to those environments for given periods. The chosen exposure periods are 7, 14 and 28 days at room temperature and in sealed glass containers. Post-exposure observations and ISO impact tests are presented as a function of time and chemical medium. Water effects are observed to be limited in explaining such use in real applications, whereas the changes in TM and acidic media are very significant. For the TM medium, the polymer toughness increased drastically (from 15.95 kJ/m² up to 32.01 kJ/m²), while sulfuric acid showed a steady augmentation over time. This situation may correspond to a hardening phenomenon of PE increasing its brittleness and its ability for structural degradation because of localized oxidation reactions and changes in crystallinity.

Keywords: polyethylene, toluene-methanol mixture, environmental stress cracking, degradation, impact resistance

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Authors: Ben Cheikh Asma, Bouafia Nabiha, Ammar Asma, Ezzi Olfa, Meddeb Khaoula, Chouchène Imed, Boussarsar Hamadi, Njah Mansour

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Background: Hospital Acquired Infection (HAI) constitutes an important worldwide health problem. It was associated with high mortality rate in intensive care units (ICU). This study aimed to determine HAI mortality rate in Tunisian intensive care units and identify its risk factors. Methods: We conducted a prospective observational cohort study over a 12 months period (September 15th 2015 to September 15 th 2016) in the adult medical ICU of University Hospital-Farhat Hached (Sousse-Tunisia). All patients admitted in the ICU for more than 48 hours were included in the study. We used an anonymous standardized survey record form to collect data by a medical hygienist assisted by an intensivist. We adopted definitions of Center for Diseases Control and prevention of Atlanta to detect HAI, Kaplan Meier survival analysis and Cox proportional hazard regression to identify independent risk factor of HAI mortality. Results: Of 171 patients, 67 developed ICU-acquired infection (global incidence rate=39.2%). The mean age of patients was 59 ± 21.2 years and 60.8% were male. The most frequently identified infections were pulmonary acquired infection (ventilator associated pneumonia (VAP) and infected atelectasis with density rates 21.4 VAP/1000 days of mechanical ventilation and 9.4 infected atelectasis /1000 days of mechanical ventilation; respectively) and central venous catheter associated infection (CVC - AI) with density rate 28.4 CVC-AI / 1000 CVC-days). HAI mortality rate was 66.7% (n=44). The median survival was 20 days 3.36, 95% Confidential Interval [13.39 – 26.60]. Specific mortality rates according to infectious site were 65.5%, 36.4% and 4.5% respectively for VAP, CVC associated infection and infected atelectasis. In univariate analysis, a significant associations between mortality and cardiovascular history (p=0.04) tracheotomy (p=0.00), peripheral venous catheterization (p=0.04), VAP (p=0.04) and infected atelectasis (p=0.04) were detected. Independent risk factors for HAI mortality were VAP with Hazard Ratio = 3.14, 95% Confidential Interval [1.63 – 6.05] (p=0.001) and tracheotomy (Hazard Ratio=0.22, 95% Confidential Interval [0.10 – 0.44], p=0.000). Conclusions: In the present study, hospital acquired infection mortality rate was relatively high. We need to intensify the fight against these infections especially ventilator-associated pneumonia that is associated with higher risk of mortality in many studies. Thus, more effective infection control interventions were necessary in our hospital.

Keywords: hospital acquired infection, intensive care unit, mortality, risk factors

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Authors: masmoudi Jabri Khaoula, Zitouni Hana, Bousselmi Latifa, Akrout Hanen

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Mathematical modeling has become an essential tool for sustainable wastewater management, particularly for the simulation and the optimization of complex processes involved in activated sludge systems. In this context, the activated sludge model (ASM3h) was used for the simulation of a Biological Membrane Reactor (MBR) as it includes the integration of biological wastewater treatment and physical separation by membrane filtration. In this study, the MBR with a useful volume of 12.5 L was fed continuously with poultry slaughterhouse wastewater (PSWW) for 50 days at a feed rate of 2 L/h and for a hydraulic retention time (HRT) of 6.25h. Throughout its operation, High removal efficiency was observed for the removal of organic pollutants in terms of COD with 84% of efficiency. Moreover, the MBR has generated a treated effluent which fits with the limits of discharge into the public sewer according to the Tunisian standards which were set in March 2018. In fact, for the nitrogenous compounds, average concentrations of nitrate and nitrite in the permeat reached 0.26±0.3 mg. L-1 and 2.2±2.53 mg. L-1, respectively. The simulation of the MBR process was performed using SIMBA software v 5.0. The state variables employed in the steady state calibration of the ASM3h were determined using physical and respirometric methods. The model calibration was performed using experimental data obtained during the first 20 days of the MBR operation. Afterwards, kinetic parameters of the model were adjusted and the simulated values of COD, N-NH4+and N- NOx were compared with those reported from the experiment. A good prediction was observed for the COD, N-NH4+and N- NOx concentrations with 467 g COD/m³, 110.2 g N/m³, 3.2 g N/m³ compared to the experimental data which were 436.4 g COD/m³, 114.7 g N/m³ and 3 g N/m³, respectively. For the validation of the model under dynamic simulation, the results of the experiments obtained during the second treatment phase of 30 days were used. It was demonstrated that the model simulated the conditions accurately by yielding a similar pattern on the variation of the COD concentration. On the other hand, an underestimation of the N-NH4+ concentration was observed during the simulation compared to the experimental results and the measured N-NO3 concentrations were lower than the predicted ones, this difference could be explained by the fact that the ASM models were mainly designed for the simulation of biological processes in the activated sludge systems. In addition, more treatment time could be required by the autotrophic bacteria to achieve a complete and stable nitrification. Overall, this study demonstrated the effectiveness of mathematical modeling in the prediction of the performance of the MBR systems with respect to organic pollution, the model can be further improved for the simulation of nutrients removal for a longer treatment period.

Keywords: activated sludge model (ASM3h), membrane bioreactor (MBR), poultry slaughter wastewater (PSWW), reuse

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Authors: Nabiha Bouafia, Asma Ben Cheikh, Asma Ammar, Olfa Ezzi, Mohamed Mahjoub, Khaoula Meddeb, Imed Chouchene, Hamadi Boussarsar, Mansour Njah

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Background: Hospital acquired infections (HAI) cause significant morbidity, mortality, length of stay and hospital costs, especially in the intensive care unit (ICU), because of the debilitated immune systems of their patients and exposure to invasive devices. The aims of this study were to determine the rate and the risk factors of HAI in an ICU of a university hospital in Tunisia. Materials/Methods: A prospective study was conducted in the 8-bed adult medical ICU of a University Hospital (Sousse Tunisia) during 14 months from September 15th, 2015 to November 15th, 2016. Patients admitted for more than 48h were included. Their surveillance was stopped after the discharge from ICU or death. HAIs were defined according to standard Centers for Disease Control and Prevention criteria. Risk factors were analyzed by conditional stepwise logistic regression. The p-value of < 0.05 was considered significant. Results: During the study, 192 patients had admitted for more than 48 hours. Their mean age was 59.3± 18.20 years and 57.1% were male. Acute respiratory failure was the main reason of admission (72%). The mean SAPS II score calculated at admission was 32.5 ± 14 (range: 6 - 78). The exposure to the mechanical ventilation (MV) and the central venous catheter were observed in 169 (88 %) and 144 (75 %) patients, respectively. Seventy-three patients (38.02%) developed 94 HAIs. The incidence density of HAIs was 41.53 per 1000 patient day. Mortality rate in patients with HAIs was 65.8 %( n= 48). Regarding the type of infection, Ventilator Associated Pneumoniae (VAP) and central venous catheter Associated Infections (CVC AI) were the most frequent with Incidence density: 14.88/1000 days of MV for VAP and 20.02/1000 CVC days for CVC AI. There were 5 Peripheral Venous Catheter Associated Infections, 2 urinary tract infections, and 21 other HAIs. Gram-negative bacteria were the most common germs identified in HAIs: Multidrug resistant Acinetobacter Baumanii (45%) and Klebsiella pneumoniae (10.96%) were the most frequently isolated. Univariate analysis showed that transfer from another hospital department (p= 0.001), intubation (p < 10-4), tracheostomy (p < 10-4), age (p=0.028), grade of acute respiratory failure (p=0.01), duration of sedation (p < 10-4), number of CVC (p < 10-4), length of mechanical ventilation (p < 10-4) and length of stay (p < 10-4), were associated to high risk of HAIS in ICU. Multivariate analysis reveals that independent risk factors for HAIs are: transfer from another hospital department: OR=13.44, IC 95% [3.9, 44.2], p < 10-4, duration of sedation: OR= 1.18, IC 95% [1.049, 1.325], p=0.006, high number of CVC: OR=2.78, IC 95% [1.73, 4.487], p < 10-4, and length of stay in ICU: OR= 1.14, IC 95% [1.066,1.22], p < 10-4. Conclusion: Prevention of nosocomial infections in ICUs is a priority of health care systems all around the world. Yet, their control requires an understanding of epidemiological data collected in these units.

Keywords: healthcare associated infections, incidence, intensive care unit, risk factors

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