Automatic Generation of Locally Refined Composite Grids for Efficient Solute Transport Modeling.

Widely used numerical models of solute transport processes in subsurface aquifers are limited to nonlocally refined rectangular, or logically rectangular, structured grids. This presents an unsuitable option to efficient numerical simulations maintaining an acceptable level of accuracy. Optimal selection of locally refined cells for efficient solute transport models is challenging to the current generation of numerical models. We present a novel and relatively simple to implement algorithm addressing these shortcomings. This method operates in four steps involving travel times simulations, a grid coarsening stage followed by a selective local grid refinement based on a cell-wise indicator, and a final postprocessing step. The refinement index is the sum of weighted logarithmic distributions of scaled forward and backward travel times. We calculate representative flow and transport properties at the two scales of the composite grid with a flow-based upscaling technique. We present two test problems to demonstrate the performances of this new gridding algorithm. We obtain the most important speedups for composite grids generated with the highest indicator thresholds. When hydrodynamic dispersion effects increase, we obtain less important speedups. An important outcome of this work is that grid design depends on nature and strength of the underlying flow and solute transport processes. Therefore, we suggest developing solute transport workflows integrating this grid generation algorithm as an integral component to build comprehensive and efficient groundwater models.

A genome-wide association study of pulmonary tuberculosis in Morocco.

Although epidemiological evidence suggests a human genetic basis of pulmonary tuberculosis (PTB) susceptibility, the identification of specific genes and alleles influencing PTB risk has proven to be difficult. Previous genome-wide association (GWA) studies have identified only three novel loci with modest effect sizes in sub-Saharan African and Russian populations. We performed a GWA study of 550,352 autosomal SNPs in a family-based discovery Moroccan sample (on the full population and on the subset with PTB diagnosis at <25 years), which identified 143 SNPs with p < 1 × 10(-4). The replication study in an independent case/control sample identified four SNPs displaying a p < 0.01 implicating the same risk allele. In the combined sample including 556 PTB subjects and 650 controls these four SNPs showed suggestive association (2 × 10(-6) < p < 4 × 10(-5)): rs358793 and rs17590261 were intergenic, while rs6786408 and rs916943 were located in introns of FOXP1 and AGMO, respectively. Both genes are involved in the function of macrophages, which are the site of latency and reactivation of Mycobacterium tuberculosis. The most significant finding (p = 2 × 10(-6)) was obtained for the AGMO SNP in an early (<25 years) age-at-onset subset, confirming the importance of considering age-at-onset to decipher the genetic basis of PTB. Although only suggestive, these findings highlight several avenues for future research in the human genetics of PTB.

Cutaneous tuberculosis revealing multifocal tuberculosis in immunocompetent patients.

Multifocal tuberculosis (TB) is rare. It occurs especially in immunocompromised patients. Association with skin involvement is rarer, and few cases are reported in the literature. The present study reports 7 cases of multifocal TB with cutaneous localization in immunocompetent patients. Cutaneous forms of TB included in this series are: gummas, scrofuloderma, vasculitis TB and lupus TB. The patients had at least two extra skin locations, namely: osteoarticular, lung, pleural, scrotal, muscular, digestive, laryngeal, nodal and splenic locations. These patients had no context of immunosuppression which is uncommon, but should be kept in mind, especially in endemic countries.

[Surgical treatment of acral melanoma: a report of eight cases]. / Traitement chirurgical du mélanome acral: à propos de huit cas.

Acral melanoma represents 3 to 15% of all cutaneous melanoma. In Morocco, this location is predominant. Through our study, we intend to analyze the therapeutic aspects of acral melanoma, while focusing on the epidemiological, clinical, pathological and prognostic profile of acral melanoma cases listed in osteoarticular surgery department of the CHU Hassan II of Fez in the period from January 2009 to December 2012. The mean age of the patients was 63 years, with slight predominance of women. The most commonly involved location was plantar region (including the heel) and pigmented color was the most common. The concept of micro trauma was found in almost half of our patients. Plantar localization was the most commun lesion. Inguinal lymph nodes attended three patients and one patient had deep lymph nodes. Only one of them had a lymphadenectomy. Nodular melanoma os the most found histological type in our study with a Breslow thickness of 8.5mm on average, and Clark level IV is found in the majority of cases. Excision of the tumour was performed in all patients. It was estimated wide in all cases. Five patients received reparative surgery consisting of flap coverage. This study has proved a high incidence of poor prognostic factors clinically and histologically.

[Sporadic anterior cervical hypertrichosis]. / Hypertrichose cervicale antérieure sporadique.

BACKGROUND: Anterior cervical hypertrichosis is a rare and little-known form of congenital localized hypertrichosis. It is characterized by the presence of a tuft of terminal hairs in the anterior cervical region. We report four typical clinical observations of this condition. PATIENTS AND METHODS: Four patients aged from 5 to 21 years were seen for a tuft of terminal long hair on the neck, next to the cricoid cartilage, recorded at birth or during early childhood. There was no indication of previous trauma or topical drug application. No similar familial history was found. In one case, histological examination performed for suspicion of an "atypical" smooth muscle hamartoma contributed nothing of note. No neurological abnormalities were observed. In one case there was a history of chronic juvenile idiopathic arthritis and familial thyroid disease. Treatment with 5 sessions of laser hair removal was proposed in one case and the improvement was considered satisfactory by the patient. DISCUSSION: Anterior cervical hypertrichosis constitute a specific clinical picture of a benign nature, and is sometimes associated with neurological, orthopaedic or ocular abnormalities. Although rarely reported, its frequency is probably underestimated.

[Dysfunctional uterine bleeding in adolescents (63 cases)]. / Les saignements uterins dysfonctionnels chez l'adolescente (à propos de 63 observations).

The pubertary uterine hemorrhage are always fonctionels. 63 cases were observed in three years. The importance of the hemorrhage is responsible in 17.4% of the hospitalisations. The etiology was searched in all cases. The hormonal treatment is prescribed in the first intention in 58.7% of cases.