Search results for: Yasmine Essafi Zouari

Authors: Yasmine Essafi Zouari, Aya Nasreddine

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Following a long inflationary period from the post-war era to the mid-1980s (+10.1% annually), France went through a moderate inflation period between 1986 and 2001 (+2.1% annually) and even lower inflation between 2002 and 2016 (+1.4% annually). In 2022, inflation in France increased rapidly and reached 4.5% over one year in March, according to INSEE estimates. Over a long period, even low inflation has an impact on portfolio value and households’ purchasing power. In such a context, inflation hedging should remain an important issue for investors. In particular, long-term investors, who are concerned with the protection of their wealth, seek to hold effective hedging assets. Considering a mixed-asset portfolio composed of housing assets (residential real estate in 150 Grand Paris communes) as well as financial assets, and using both correlation and regression analysis, results confirm the attribute of the direct housing investment as an inflation hedge especially particularly against its unexpected component. Further, cash and bonds were found to provide respectively a partial and an over hedge against unexpected inflation. Stocks act as a perverse hedge against unexpected inflation and provide no significant positive hedge against expected inflation.

Keywords: direct housing, inflation, hedging ability, optimal portfolio, Grand Paris metropolis

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Authors: Zouari Ezzeddine, Ghraieb Ikram

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From the results of the academic literature which evokes the limitations of previous studies, this article shows the reasons for multidimensionality Prediction of financial bubbles. A new framework for modeling study predicting financial bubbles by linking a set of variable presented on several dimensions dictating its multidimensional character. It takes into account the preferences of financial actors. A multicriteria anticipation of the appearance of bubbles in international financial markets helps to fight against a possible crisis.

Keywords: classical measures, predictions, financial bubbles, multidimensional, artificial neural networks

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Authors: Zouari Ezzeddine, Tarchoun Monaem

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Despite the multiplicity of advanced approaches, the concept of financial integration couldn’t be an explicit analysis. Indeed, empirical studies appear that the measures of international financial integration are one-dimensional analyses. For the ambivalence of the concept and its multiple determinants, it must be analyzed in multidimensional level. The interest of this research is a proposal of a decision support by multicriteria approach for determining the positions of countries according to their international and financial dependencies links with the behavior of financial actors (trying to make governance decisions or diversification strategies of international portfolio ...

Keywords: financial integration, decision support, behavior, multicriteria approach, governance and diversification

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Authors: Sawsen Khlifa, Chiheb AMeur Abid, Belhassan Zouari

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Modular verification approaches have been widely attempted to cope with the well known state explosion problem. This paper deals with the modular verification of modular Petri nets. We propose a reduced version for the modular state space of a given modular Petri net. The new structure allows the creation of smaller modular graphs. Each one draws the behavior of the corresponding module and outlines some global information. Hence, this version helps to overcome the explosion problem and to use less memory space. In this condensed structure, the verification of some generic properties concerning one module is limited to the exploration of its associated graph.

Keywords: distributed systems, modular verification, petri nets, state space explosition

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Authors: Raida Zouari, Iness Ahriz, Rafik Zayani, Ali Dziri, Ridha Bouallegue

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This paper proposes a room level indoor localization algorithm based on the use Multi-Layer Neural Network (MLNN) classifiers and one versus one strategy. Seven parameters of the Channel Impulse Response (CIR) were used and Gram-Shmidt Orthogonalization was performed to study the relevance of the extracted parameters. Simulation results show that when relevant CIR parameters are used as position fingerprint and when optimal MLNN architecture is selected good room level localization score can be achieved. The current study showed also that some of the CIR parameters are not correlated to the location and can decrease the localization performance of the system.

Keywords: mobile indoor localization, multi-layer neural network (MLNN), channel impulse response (CIR), Gram-Shmidt orthogonalization

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Authors: Alanod Alqasim, Yasmine Iskandarani, Sita Algethami, Jawaher alzughaiby

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This study focuses on the usage of AI (Artificial Intelligence) systems and features on the Instagram application and how it influences user experience and satisfaction. The aim is to evaluate the techniques and current capabilities, restrictions, and potential future directions of AI in an Instagram application. Following a concise explanation of the core concepts underlying AI usage on Instagram. To answer this question, 19 randomly selected users were asked to complete a 9-question survey on their experience and satisfaction with the app's features (Filters, user preferences, translation tool) and authenticity. The results revealed that there were three prevalent allegations. These declarations include that Instagram has an extremely attractive user interface; secondly, Instagram creates a strong sense of community; and lastly, Instagram has an important influence on mental health.

Keywords: AI (Artificial Intelligence), instagram, features, satisfaction, experience

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Authors: Rym Zouari, Sami Ben Amar, Abdelwaheb Dogui

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This paper presents an experimental characterization of the anisotropic mechanical behavior of 4 textile woven fabrics with different weaves (Twill 3, Plain, Twill4 and Satin 4) by off-axis tensile testing. These tests are applied according seven directions oriented by 15° increment with respect to the warp direction. Fixed and articulated jaws are used. Analysis of experimental results is done through global (Effort/Elongation curves) and local scales. Global anisotropy was studied from the Effort/Elongation curves: shape, breaking load (Frup), tensile elongation (EMT), tensile energy (WT) and linearity index (LT). Local anisotropy was studied from the measurement of strain tensor components in the central area of the specimen as a function of testing orientation and effort: longitudinal strain ɛL, transverse strain ɛT and shearing ɛLT. The effect of used jaws is also analyzed.

Keywords: anisotropy, off-axis tensile test, strain fields, textile woven fabric

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Authors: Yasmine Ahmed Shemeis

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Determining the impact of productivity increases on wage levels is often difficult due to the unavailability of individual-level productivity data. Accordingly, we proxy for productivity using a self-perceived measure of health based on the postulated positive relationship between better health and productivity improvements. Using Egypt’s labour market data for the years 2012 and 2018 and utilizing a Maximum Likelihood Estimation method, we address two issues: the endogeneity of health in the estimation of wages and a sample selection bias. Our findings indicate the great value that better health has in enhancing wage levels in Egypt’s private sector. Also, we find that overlooking the endogeneity of health underestimates its effect on wages. Thus, the improvement of health states is likely to be beneficial in improving labour market outcomes in terms of wages as well as labour productivity in Egypt.

Keywords: labour, Productivity, Wages, Endogeneity, Sample Selection

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Authors: Meha Alouini, Wissem Mnif, Yasmine Souissi

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This work will be conducted within the framework of the environmental sustainable development. It involves waste recovering into biodiesel fuel. Low cost feedstocks such as waste of frying oil and animal fats have been utilized to replace refined vegetable oil for biodiesel production. Biodiesel which refers to fatty acid methyl esters (FAME) was carried out by both chemical and enzymatic reaction of transesterification. In order to compare the two studied reactions the obtained biodiesel was characterized by determining its esters content and its fuel properties according to the European standard EN 14214. It was noted that the chemical method gave the product with the best physical property. But the biological one was found more effective for obtaining important ester content. Thus it would be interesting to optimize the enzymatic pathway of production of biodiesel to obtain a better property of biodiesel.

Keywords: biodiesel, fatty acid methyl esters, transesterification, waste frying oil, waste beef fat

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Authors: Yasmine Abu Adla, Racha Soubra, Milana Kasab, Mohamad O. Diab, Aly Chkeir

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Over the past several years, researchers have shown a great interest in assessing the mobility of elderly people to measure their functional status. Usually, such an assessment is done by conducting tests that require the subject to walk a certain distance, turn around, and finally sit back down. Consequently, this study aims to provide an at home monitoring system to assess the patient’s status continuously. Thus, we proposed a technique to automatically detect when a subject sits down while walking at home. In this study, we utilized a Doppler radar system to capture the motion of the subjects. More than 20 features were extracted from the radar signals, out of which 11 were chosen based on their intraclass correlation coefficient (ICC > 0.75). Accordingly, the sequential floating forward selection wrapper was applied to further narrow down the final feature vector. Finally, 5 features were introduced to the linear discriminant analysis classifier, and an accuracy of 93.75% was achieved as well as a precision and recall of 95% and 90%, respectively.

Keywords: Doppler radar system, stand-to-sit phase, TUG test, machine learning, classification

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Authors: Miladi Yasmine, Bouhlel Salah, Garnit Hechmi

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Hydrothermal vein-type deposits of the Hammam Jedidi F-Ba(Pb-Zn-Cu) are hosted in Lower Jurassic, Cretaceous and Tertiary series, and located near a very important structural lineament (NE-SW) corresponding to the Hammam Jedidi Fault in the Tunisian Dorsale. The circulation of the ore forming fluid is triggered by a regional tectonic compressive phase which occurred during the miocène time. Mineralization occurs as stratabound and vein-type orebodies adjacent to the Triassic salt diapirs and within fault in Jurassic limestone. Fluid inclusions data show that two distinct fluids were involved in the mineralisation deposition: a warmer saline fluid (180°C, 20 wt % NaCl equivalent) and cooler less saline fluid (126°C, 5wt%NaCl equivalent). The contrasting salinities and halogen ratios suggest that this two fluid derived from one of the brine originated after the dissolution of halite as suggested by its high salinity. The other end member, as indicated by the low Cl/Br ratios, acquired its low salinity by dilution of Br enriched evaporated seawater. These results are compatible with Mississippi-Valley- type mineralization.

Keywords: Jebel Oust, fluid inclusions, North Eastern Tunisia, mineralization

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Authors: Miladi Yasmine, Bouhlel Salah, Garnit Hechmi, David Banks

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The Jebel Mecella F (Ba-Pb-Zn) ore deposits of the Zaghouan district are located in northeastern Tunisia, 60 km south of Tunis. The host rocks belong to the Ressas Formation of Kimmeridgian-Tithonian age and lower Cretaceous layers. Mineralisations occur as stratiform lenses and fracture fillings. The ore mineral assemblage is composed of fluorite, barite, sphalerite galena, and quartz. Primary fluid inclusions in sphalerite have homogenization temperatures ranging from 129 to 145°C final melting temperature range from -14.9 to -10.0, corresponding to salinities of 14.0 to 17.7 wt% NaCl equivalent. Fluid inclusions in fluorite homogenize to the liquid phase between 116 and 160°C. The final ice melting temperature ranges from -23 to -15 °C, corresponding to salinities between 17 and 24 wt% NaCl equivalent. The LAICP-MS analyses of the fluid inclusions in fluorite show that these fluids are dominated by Na>K>Mg. Furthermore, the high K/Na values from fluid inclusions suggest the brine interacted with K-rich rocks in the basement or in siliciclastic sediments in the basins. The ore fluids in Jebel Mecella are highly saline and Na-K dominated with lower Mg concentrations, and come from the leaching of the dolomitic host rocks. These results are compatible with Mississippi-Valley-type mineralizing fluids.

Keywords: Jebel Mecella, fluid inclusions, micro thermometry, LA-ICP-MS

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Authors: Miladi Yasmine, Bouhlel Salah, David Banks

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The Hammam Zriba (F-Ba-Sr-Pb-Zn) ore deposits of the Zaghouan district are located in northeast Tunisia, 60 Km south of Tunis. The host rocks belong to the Ressas Formation (Tithonian age) and lower Cretaceous layers. Mineralization occurs as stratiform replacement heaps and lenses. The mineral assemblage is composed of fluorite, barite, sphalerite, and galena. Primary fluid inclusions in sphalerite have homogenization temperatures ranging from 83 to 140°C, final melting temperature range from −18 to −7.0, corresponding to salinities of 5 to 21 wt % NaCl equivalent. Fluid inclusions in fluorite homogenize to the liquid phase between 132 and 178°C. Final ice melting temperatures range from −25 to −6.8 °C, corresponding to salinities between 17 and 24 wt% NaCl Equivalent. The LA-ICP-MS analyses of the fluid inclusions in fluorite show that these fluids are dominated by Na>Ca>K>Mg, with the concentration of Fe being equivalent to that of Mg. Microthermometric analyses of the fluid inclusions observed in fluorite and sphalerite show that two distinct fluids were involved in the mineralization deposition: a warmer saline fluid (132-178°C, 17-24 wt % NaCl equivalent) and cooler saline fluid (83°C-140, 5-21 wt %NaCl equivalent). The ore fluid result from highly saline and Na-Ca dominated with lower Mg concentrations come from the leaching of the dolomitic host rocks by the fluids.

Keywords: Hammam Zriba , fluid inclusions, LA-ICP-MS, Zaghouan district

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Authors: S. Zouari, H. Ghorbel, H. Liao, R. Elleuch

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Research is increasingly moving towards the use of surface treatment processes to limit environmental effects. Electrolytic plating has traditionally been seen as a way to protect brass products, especially faucets, from mechanical and chemical damage. However, this method was not effective industrially, economically and ecologically. The aim of this work is to develop non-usual polymer coatings for brass faucets in order to improve the performance of brass and to replace electrolytic chromium coatings, thereby reducing environmental impact. Fluorinated-Ethylene-Propylene polymer (FEP) was chosen for its excellent mechanical and chemical properties and its good environmental performance. This coating was developed by spraying (painting) process onto brass substrates. The coatings obtained were characterized using a scanning electron microscope to evaluate the morphology of the deposits and their porosity rate. Grid adhesion, surface energy and corrosion tests (salt spray) were also performed to evaluate the mechanical and chemical behavior of these coatings properly. The results show that the deposits obtained have a homogeneous microstructure with a very low porosity rate. The results of the grid adhesion test prove the conformity of the test according to the NF077 standard. The coatings have a hydrophobic character following the low values of surface energy obtained and a very good resistance to corrosion. These results are interesting and may represent real technological issues in the industrial field.

Keywords: FEP coatings, spraying process, brass, adhesion, surface energy, corrosion resistance

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Authors: I. Farid, K. Zouari

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An attempt has been made to examine the effect of water storage structures on groundwater recharge in a semi-arid agroclimatic setting in Jeloula Basin (Central Tunisia). In this area, surface water in rivers is seasonal, and therefore groundwater is the perennial source of water supply for domestic and agricultural purposes. Three pumped storage water power plants (PSWPP) have been built to increase the overall water availability in the basin and support agricultural livelihoods of rural smallholders. The scale and geographical dispersion of these multiple lakes restrict the understanding of these coupled human-water systems and the identification of adequate strategies to support riparian farmers. In the present review, hydrochemistry and isotopic tools were combined to get an insight into the processes controlling mineralization and recharge conditions in the investigated aquifer system. This study showed a slight increase in the groundwater level, especially after the artificial recharge operations and a decline when the water volume moves down during drought periods. Chemical data indicate that the main sources of salinity in the waters are related to water-rock interactions. Data inferred from stable isotopes in groundwater samples indicated recharge with modern rainfall. The investigated surface water samples collected from the PSWPP are affected by a significant evaporation and reveal large seasonal variations, which could be controlled by the water volume changes in the open surface reservoirs and the meteorological conditions during evaporation, condensation, and precipitation. The geochemical information is comparable to the isotopic results and illustrates that the chemical and isotopic signatures of reservoir waters differ clearly from those of groundwaters. These data confirm that the contribution of the artificial recharge operations from the PSWPP is very limited.

Keywords: Jeloula basin, recharge, hydrochemistry, isotopes

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Authors: Mohamed Trigui, Fatma Masmoudi, Imen Zouari

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Massive utilizations of chemical fertilizer and chemical pesticides in agriculture sector to improve the farming productivity have created increasing environmental damages. Then, agriculture must become sustainable, focusing on production systems that respect the environment and help to reduce climate change. Isolation and microbial identification of new bacterial strains from naturally saline habitats and compost extracts could be a prominent way in pest management and crop production under saline conditions. In this study, potential mechanisms involved in plant growth promotion and suppressive activity against fungal diseases of a compost extract produced from poultry manure/olive husk compost and halotolerant and halophilic bacterial strains under saline stress were investigated. On the basis of the antimicrobial tests, different strains isolated from Sfax solar saltern (Tunisia) and from compost extracts were selected and tested for their plant growth promoting traits, such as siderophores production, nitrogen fixation, phosphate solubilization and the production of extracellular hydrolytic enzymes (protease and lipase) under in-vitro conditions. Among 450 isolated bacterial strains, 16 isolates showed potent antifungal activity against the tested plant pathogenic fungi. Their identification based on 16S rRNA gene sequence revealed they belonged to different species. Some of these strains were also characterized for their plant growth promoting capacities. Obtained results showed the ability of four strains belonging to Bacillus genesis to ameliorate germination rate and root elongation compared to the untreated positive controls. Combinatorial capacity of halotolerant bacteria with antimicrobial activity and plant growth promoting traits could be promising sources of interesting bioactive substances under saline stress.

Keywords: abiotic stress, biofertilizer, biotic stress, compost extract, halobacteria, plant growth promoting (PGP), soil fertility

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Authors: Yasmine Aridi, Lara Nasreddine, Maya Khalil, Arafat Tfayli, Anas Mugharbel, Farah Naja

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Breast cancer is the most commonly diagnosed cancer site among women worldwide and the second most common cause of cancer mortality. Breast cancer rates differ vastly between geographical areas, countries, and within the same country. In Lebanon, the proportion of breast cancer to all other sites of tumor is 38.2%; these rates are still lower than those observed worldwide, but remain the highest among Arab countries. Studies and evidence based reviews show a strong association between breast cancer development and prognosis and dietary habits, specifically the Mediterranean diet (MD). As such, the aim of this study is to examine dietary patterns and adherence to the MD among a sample of 182 breast cancer female patients in Beirut, Lebanon. Subjects were recruited from two major hospitals; a private medical center and a public hospital. All subjects were administered two questionnaires: socio- demographics and Mediterranean diet adherence. Five Mediterranean scores were calculated: MS, MSDPS, PMDI, PREDIMED and DDS. The mean age of the participants was 53.78 years. The overall adherence to the Mediterranean diet (MD) was low since the sample means of 3 out of the 5 calculated scores were less than the scores’ medians. Given that 4 out of the 5 Mediterranean scores significantly varied between the recruitment sites, women in the private medical center were found to adhere more to the MD. Our results also show that the majority of the sample population’s intakes are exceeding the recommendations for total and saturated fat, while meeting the requirements for fiber, EPA, DHA and Linolenic Acid. Participants in the private medical center were consuming significantly more calories, carbohydrates, fiber, sugar, Lycopene, Calcium, Iron and Folate and less fat. After conducting multivariate linear regression analyses, the following significant results were observed: positive associations between MD (CPMDI, PREDIMED) and monthly income & current state of health, while negative associations between MD (MSDPS, PREDIMED) and age & employment status. Our findings indicated a low overall adherence to the MD and identified factors associated with it; which suggests a need to address dietary habits among BC patients in Lebanon, specifically encouraging them to adhere to their traditional Mediterranean diet.

Keywords: Adherence, Breast cancer, Dietary patterns, Mediterranean diet, Nutrition

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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

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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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Authors: Yasmine Salehy, Yann Leroy, Francois Cluzel, Hong-Minh Hoang, Laurence Fournaison, Anthony Delahaye, Bernard Yannou

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Taking into consideration all the life cycle of a product is now an important step in the eco-design of a product or a technology. Life cycle assessment (LCA) is a standard tool to evaluate the environmental impacts of a system or a process. Despite the improvement in refrigerant regulation through protocols, the environmental damage of refrigeration systems remains important and needs to be improved. In this paper, the environmental impacts of refrigeration systems in a typical supermarket are compared using the LCA methodology under different conditions. The system is used to provide cold at two levels of temperature: medium and low temperature during a life period of 15 years. The most commonly used architectures of supermarket cold production systems are investigated: centralized direct expansion systems and indirect systems using a secondary loop to transport the cold. The variation of power needed during seasonal changes and during the daily opening/closure periods of the supermarket are considered. R134a as the primary refrigerant fluid and two types of secondary fluids are considered. The composition of each system and the leakage rate of the refrigerant through its life cycle are taken from the literature and industrial data. Twelve scenarios are examined. They are based on the variation of three parameters, 1. location: France (Paris), Spain (Toledo) and Sweden (Stockholm), 2. different sources of electric consumption: photovoltaic panels and low voltage electric network and 3. architecture: direct and indirect refrigeration systems. OpenLCA, SimaPro softwares, and different impact assessment methods were compared; CML method is used to evaluate the midpoint environmental indicators. This study highlights the significant contribution of electric consumption in environmental damages compared to the impacts of refrigerant leakage. The secondary loop allows lowering the refrigerant amount in the primary loop which results in a decrease in the climate change indicators compared to the centralized direct systems. However, an exhaustive cost evaluation (CAPEX and OPEX) of both systems shows more important costs related to the indirect systems. A significant difference between the countries has been noticed, mostly due to the difference in electric production. In Spain, using photovoltaic panels helps to reduce efficiently the environmental impacts and the related costs. This scenario is the best alternative compared to the other scenarios. Sweden is a country with less environmental impacts. For both France and Sweden, the use of photovoltaic panels does not bring a significant difference, due to a less sunlight exposition than in Spain. Alternative solutions exist to reduce the impact of refrigerating systems, and a brief introduction is presented.

Keywords: eco-design, industrial engineering, LCA, refrigeration system

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Authors: Golson Mohamed, Yasmine Gamasy, Khaled EL-Khatib, Anas Al-Natour, Shady Fadel, Haytham Rashwan, Haytham Badawy, Nadia Farghaly

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Introduction: Wilm's tumor is the most common malignant renal tumor in children. Much progress has been made in the management of patients with this malignancy over the last 3 decades. Today treatments are based on several trials and studies conducted by the International Society of Pediatric Oncology (SIOP) in Europe and National Wilm's Tumor Study Group (NWTS) in the USA. It is necessary for us to understand why do we follow either of the protocols, NWTS which follows the upfront surgery principle or the SIOP which follows the upfront chemotherapy principle in all stages of the disease. Objective: The aim of is to assess outcome in patients treated with preoperative chemotherapy and patients treated with upfront surgery to compare their effect on overall survival. Study design: to decide which protocol to follow, study was carried out on records for patients aged 1 day to 18 years old suffering from Wilm's tumor who were admitted to Alexandria University Hospital, pediatric oncology, pediatric urology and pediatric surgery departments, with a retrospective survey records from 2010 to 2015, Design and editing of the transfer sheet with a (PRISMA flow study) Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Data were fed to the computer and analyzed using IBM SPSS software package version 20.0. (11) Qualitative data were described using number and percent. Quantitative data were described using Range (minimum and maximum), mean, standard deviation and median. Comparison between different groups regarding categorical variables was tested using Chi-square test. When more than 20% of the cells have expected count less than 5, correction for chi-square was conducted using Fisher’s Exact test or Monte Carlo correction. The distributions of quantitative variables were tested for normality using Kolmogorov-Smirnov test, Shapiro-Wilk test, and D'Agstino test, if it reveals normal data distribution, parametric tests were applied. If the data were abnormally distributed, non-parametric tests were used. For normally distributed data, a comparison between two independent populations was done using independent t-test. For abnormally distributed data, comparison between two independent populations was done using Mann-Whitney test. Significance of the obtained results was judged at the 5% level. Results: A significantly statistical difference was observed for survival between the two studied groups favoring the upfront chemotherapy(86.4%)as compared to the upfront surgery group (59.3%) where P=0.009. As regard complication, 20 cases (74.1%) out of 27 were complicated in the group of patients treated with upfront surgery. Meanwhile, 30 cases (68.2%) out of 44 had complications in patients treated with upfront chemotherapy. Also, the incidence of intraoperative complication (rupture) was less in upfront chemotherapy group as compared to upfront surgery group. Conclusion: Upfront chemotherapy has superiority over upfront surgery.As the patient who started with upfront chemotherapy shown, higher survival rate, less percent in complication, less percent needed for radiotherapy, and less rate in recurrence.

Keywords: Wilm's tumor, renal tumor, chemotherapy, surgery

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