Genetic algorithm with cross-validation-based epidemic model and application to the early diffusion of COVID-19 in Algeria.

A dynamical epidemic model optimized using a genetic algorithm and a cross-validation method to overcome the overfitting problem is proposed. The cross-validation procedure is applied so that available data are split into a training subset used to fit the algorithm's parameters, and a smaller subset used for validation. This process is tested on Italy, Spain, Germany, and South Korea cases before being applied to Algeria. Interestingly, our study reveals an inverse relationship between the size of the training sample and the number of generations required in the genetic algorithm. Moreover, the enhanced compartmental model presented in this work has proven to be a reliable tool to estimate key epidemic parameters and the non-measurable asymptomatic infected portion of the susceptible population to establish a realistic nowcast and forecast of the epidemic's evolution. The model is employed to study the COVID-19 outbreak dynamics in Algeria between February 25th, 2020, and May 24th, 2020. The basic reproduction number and effective reproduction number on May 24th, after three months of the outbreak, are estimated to be 3.78 (95% CI 3.033-4.53) and 0.651 (95% CI 0.539-0.761), respectively. Disease incidence, CFR, and IFR are also calculated. Numerical programs developed for this study are made publicly accessible for reproduction and further use.

[Interests and limitations of percutaneous coronary intervention strategy in nonagenarian patients: A single center experience]. / Intérêts et limites de l'angioplastie coronaire chez les patients nonagénaires : expérience monocentrique.

AIM: To expose our center results in the angioplasty in nonagenarians and to evaluate its effectiveness but also the MACEs and the mortality in the short and long term. METHODS: A retrospective study of 98 patients admitted to the Antibes hospital center from November 2013 to September 2018. RESULTS: The median age was 91.8 [90.8-93.4]. 52.6% was male. 9.7% of the patients had a polyvascular site. 50.6% of patients had moderate renal failure. The radial approach was used in 88.4% of cases. 21.6% of patients had tri-truncal lesions, while 46.4% were monotruncular, LAD artery was the culprit artery in 67% of cases. One stent per lesion was used in the majority of cases. Our successful rate was 90%. After angioplasty, 96% of the patients underwent double antiaggregation platelet therapy, 74.4% under clopidogrel. The presence of arrhythmias before angioplasty, the femoral approach, the coronary dissection and cardiogenic shock after angioplasty were predictors of short- and long-term mortality. Diabetes, history of myocardial infarction, impaired left ventricular ejection fraction, calcified coronary lesions, occurrence of arrhythmias or signs of heart failure on post-procedure were predictors of MACE occurrence. CONCLUSIONS: This study demonstrates that angioplasty in selected population of nonagenarians is perfectly feasible with a good risk/benefit ratio and specifies the different predictors of MACE, both short- and long-term mortality.

QT Prolongation Complicated with Torsades de Pointes in Prosthetic Mitral Valve Endocarditis: A Case Report.

We present the case of a 49-year-old male patient with prosthetic mitral valve endocarditis associated with QT prolongation and torsades de pointes. He was asymptomatic until the end of January 2012, when he was admitted to our hospital emergency unit because of syncope, fever, and suspicion of endocarditis. Cardiologic evaluation was requested and the transthoracic (TTE) and transesophageal (TEE) echocardiograms revealed vegetations on the prosthetic mitral valve. All cultures were positive for methicillin-sensitive Staphylococcus aureus. The corrected QT (QTc) interval was markedly prolonged upon admission (QTc 540 ms). He experienced torsades de pointes (TdP) several times and he was recovered after bystander cardiopulmonary resuscitation. The clinical course and the long QTc interval with deep inverted T wave were completely normalized 4 weeks after. He continued on triple antibiotic therapy for 45 days with a good revolution. The clinical features and the possible mechanisms of QT prolongation (inflammation, infection) of this patient are discussed.

[Rhinocerebral mucormycosis complicated by hemophagocytic lymphohistiocytosis: case report from Tunisia]. / Mucormycose rhinocérébrale compliquée d'un syndrome d'activation macrophagique: une observation Tunisienne.

Mucormycosis is a rare and often fatal fungal infection caused by fungi of the Mucorales order. It is mostly seen in people with weakened immune systems or with uncontrolled diabetes, and can cause extensive soft tissue damage and decay. Hemophagocytic lymphohistiocytosis has been reported only rarely and never described in an intensive care or emergency department setting. The purpose of this report is to describe a fatal case of sinonasal mucormycosis complicated by hemophagocytic lymphohistiocytosis in a diabetic child.

The cactus effect: an alternative to the lupin effect for increasing ovulation rate in sheep reared in semi-arid regions?

The present study evaluated the effects of supplementation with cactus cladodes on follicular dynamics and ovulatory response of sheep reared in semi-arid areas. A total of 76 ewes were distributed into two equal groups supplemented with either concentrated feed or cactus cladodes. After 30 days of supplementation, no differences were found between feeding regimens on the final live weight (LW; 41.5 ± 0.6 and 42.1 ± 0.7 kg in the Concentrate and Cactus groups respectively) and body condition score (BCS; 1.8 ± 0.3 and 1.8 ± 0.4 for Concentrate and Cactus group respectively). Moreover, no differences were found between the initial and the final values of both LW and BCS; thus, there were no effects of supplementation on any of both parameters. Analysis of follicular population showed that, during the follicular phase induced by ram effect, the number of follicles reaching ovulatory size increased in both groups. However, the number was always higher in Cactus ewes and, at oestrus, Cactus ewes had 1.6 ± 0.2 and Concentrate sheep had 1.2 ± 0.2 large follicles (p < 0.05). Thereafter, ovulation rate was affected by duration of supplementation; being higher in sheep fed with cactus for 6-10 days (1.7 ± 0.1) than in ewes supplied with cactus for more than 11 days (1.3 ± 0.1; p < 0.05), in sheep fed with concentrate for 6-10 days (1.2 ± 0.1; p < 0.01) and even than in individuals subjected to classical flushing with concentrate (1.3 ± 0.1; p < 0.05).

Scale effect on wave propagation of double-walled carbon nanotubes with initial axial loading.

This paper studies the vibrational characteristics of double-walled carbon nanotubes (DWNTs) with initial stress using a nonlocal Euler-Bernoulli beam model. Both the effect of initial stress and the effect of small length scale are discussed in detail. The effect of van der Waals forces is incorporated in the formulation. The corresponding resonant vibrational characteristics are presented in detail; they are shown to be very different from those predicted by classical elasticity theory when nonlocal effects are significant. The influence of initial stress in carbon nanotubes on their flexural vibration modes is dependent on the tension or compression form of the initial stress. The investigation of the effects of initial stress on transverse wave propagation in carbon nanotubes may be used as a useful reference for the application and the design of nanoelectronic and nanodrive devices, nano-oscillators, and nanosensors, in which carbon nanotubes act as basic elements.

[Carney's triad: a new case]. / Le syndrome de Carney: un nouveau cas.

Carney's triad is a very unusual syndrome, associating three different tumours on the same patient, a young woman generally: a gastric leiomyoblastoma, a pulmonary chondroma and an extra-adrenal paraganglioma. The authors report through the literature review and a new case of Carney's syndrome associating gastric leiomyoblastoma and extra-adrenal paragangliomas, the different diagnostic and therapeutic criterias.

[Malignant adrenocortical tumour with inferior vena cava invasion]. / Le corticosurrénalome avec envahissement de la veine cave inférieure.

Carcinoma of the adrenal cortex is a rare tumour. The incidence of vena cava involvement may be present in 15 to 20% of patients. The intra caval tumour thrombus can attain the right atrium. Even if some authors consider these lesions as a metastasis, long-term survival can be obtained after radical resection. The surgical tactical depend on the extension of thrombus into the vena cava inferior. The authors report a case with 4 years survival without recurrence after surgical treatment.

[Heller's myotomy without fundoplication: a series of 123 patients]. / L'opération de Heller sans système anti-reflux. A propos de 123 cas.

INTRODUCTION: Surgical treatment of achalasia of lower oesophageal sphincter is Heller's myotomy, usually associated with a fundoplication due to an high risk of postoperative gastro-oesophageal reflux. The value of this fundoplication is discussed. The aim of this study was to evaluate retrospectively the results of Heller's myotomy without fundoplication but performed according to a precise technique preventing postoperative reflux. PATIENTS AND METHODS: Between 1975 and 1999, 123 patients underwent Heller's myotomy without systematic fundoplication. Diagnosis of achalasia was performed clinically and confirmed by investigations: baryum meal, fibroscopy and manometry. Myotomy was performed through an abdominal approach in 117 (95%) patients. Dissection preserved fixity of abdominal oesophagus in all cases, particularly its posterior meso. Myotomy was performed on abdominal oesophagus but not below the cardia. Posterior fundoplication was associated in 2 patients. RESULTS: One patient (0,8%) died from massive aspiration. Morbidity (1,6%) consisted in one peritonitis and one postoperative occlusion. At follow-up (mean = 5 years; range: 1-20), functional results were satisfying (excellent and good) in 112 (92%) patients. Seven patients (6%) developed postoperative reflux, including one who need surgical treatment. Dysphagia persisted in 3 patients (2%) who had to be reoperated. CONCLUSION: Results of this series show that systematic fundoplication is not necessary in Heller's myotomy for achalasia of lower oesophageal sphincter.

[Leiomyoma of the esophagus]. / Léiomyome de l'oesophage.

BACKGROUND: Leiomyoma is a benign tumor rarely occurring in the esophagus. Only 1% of esophageal tumors are leiomyomas. CASE REPORT: A 70-year-old man underwent surgery for an asymptomatic tumor of the thoracic esophagus. The tumor was enucleated via right thoracotomy and histology confirmed the diagnosis of leiomyoma. Outcome was favorable. DISCUSSION: Leiomyomas of the esophagus generally develop from the muscularis and exceptionally from the muscularis mucosae, producing a parietal tumor or a pediculated endoluminal tumor respectively. Surgery is indicated for all cases, with the possible exception of asymptomatic leiomyoma. Encleation can be achieved by videothoracoscopy. Resection of the esophagus can be discussed if enucleation is impossible for giant tumors, or ring tumors at the esogastric junction, or if the mucosae wound cannot be repaired. Endoscopic resection is indicated for pediculated leiomyoma. Malignant transformation is exceptional but an association between esophageal myomatosis and carcinoma of the esophagus is possible. Certain authors thus advocate resection for all cases, even small asymptomatic leiomyomas.

[Adenocarcinoma of the anal glands]. / Adénocarcinome des glandes anales.

The study aim was to report an adenocarcinoma of the anal glands revealed by an anal abscess in a 64-year-old man. Malignant transformation of an anal fistula is discussed in the genesis of this disease. Clinical symptoms are not specific. Abdomino-perineal resection of the rectum is the usual surgical treatment and adjuvant radiation therapy didn't prove its efficiency.

[Inflammatory pseudotumor of the spleen]. / Pseudotumeur inflammatoire de la rate.

Inflammatory pseudotumor of the spleen is a very rare benign lesion of unknown etiology. Splenectomy is recommended to obtain histological diagnosis and to eliminate a malignant tumor.