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Volar dislocation of the distal radio-ulnar joint (DRUJ) is a rare occurrence in the literature, with only a few cases reported. Dorsal dislocation is more common than a volar dislocation. It can be easily missed due to the lack of a specific clinical presentation. They can be treated by closed reduction or more commonly by open reduction internal fixation. We present a case of volar dislocation of the DRUJ with an ulnar head fracture reduced by closed reduction. We report the case of a right-handed 35-year-old patient with no medical history who presented to our emergency department after sustaining a fall on his left hand. The trauma dated of 1 day and X-ray was initially judged normal in the emergency department. Due to the persistence of the pain and the functional impotence, the patient presented again to our department. The investigation showed that the patient's hand was in a supine position when the fall occurred. On physical examination, the forearm was locked in supination, with no passive or active pronation elicited. There was a loss of the dorsal ulnar prominence with a palpable deformity on the volar aspect of the wrist. There was no skin lesion and the neurovascular status of the hand was normal. Initial radiographs were made. Anteroposterior and lateral radiographs of the forearm and wrist showed a volar dislocation of the DRUJ with an associated ulnar head fracture. A closed reduction attempt in the emergency department was unsuccessful. The patient was admitted and under general anesthesia, the dislocation was reduced by pronating the forearm and applying direct pressure over the distal ulna. The wrist was tested after the reduction and the DRUJ was stable. Above-elbow cast was applied in a pronation position for a period of 5 weeks. Upon cast removal, the result was excellent. The patient regained full range of motion of the wrist and elbow, there was no instability nor pain or tenderness. Grip force was conserved. A radiographic assessment confirmed the reduction. Volar locked dislocation of DRUJ is a rare injury. A high index of clinical suspicion and proper X-ray is required for prompt detection. Computed tomography scanning can be useful if the diagnosis is not certain. If the reduction of the joint is stable, there is no need for fixation. Early diagnosis and appropriate treatment are the keys for a good outcome.

We present our recent theoretical and experimental advancements in studying complex multiple nonlinear interactions of coherent solitary wave structures on unstable background – breathers. We use the focusing one-dimensional nonlinear Schrödinger equation (NLSE) as a theoretical model. First, we describe the nonlinear mutual interactions between a pair of co-propagative breathers called breather molecules. Then with the novel approach of breather interaction management, we adjust the initial positions and phases of several breathers to observe various desired wave states at controllable moments of evolution. Our experiments carried out on a light wave platform with a nearly conservative optical fiber system accurately reproduce the predicted dynamics. In addition, we consider generalizations of the scalar breathers theory to the vector two-component NLSE describing polarized light and show examples of resonance vector breathers transformations.

Eleven new differently substituted N,7-diphenylpyrimido [4,5-d]pyrimidin-4-amines 4a–k were synthesized from readily available reagents in a simple and inexpensive two-step procedure with yields up to 57%. Neuroprotective analysis against H2O2 and analysis using ORAC assays identified compounds 4g, 4i and 4j as promising antioxidant compounds. These compounds also showed potent inhibition of Aβ1–42 self-aggregation, and suitable physicochemical properties predicted by Datawarior software V6.1.0, this biological activity and physicochemical property being of great interest for pathologies linked to oxidative stress, such as Alzheimer’s disease.

Sarcoidosis is a multi-system granulomatosis of unknown etiology, defined by the presence of epithelioid and gigantocellular granulomas, without caseous necrosis. Ocular sarcoidosis manifests mainly as bilateral granulomatous anterior uveitis. Occlusion of the central retinal vein in sarcoidosis is a rare manifestation, which is the particularity of our observation.

Castleman’s disease (CD), known as angiofollicular lymph node hyperplasia, is an uncommon condition. The two most common histological subtypes are hyaline vascular and plasma cell. We performed a retrospective analysis to define the clinic-pathological features and survival of CD, which is quite rare focusing on the particularities of our series with a review of the recent literature.

Abstract Background Breast cancer in Tunisia is often diagnosed at a late stage with long delay in time to consultation and to diagnosis.The aim of this study is to estimate the sensitivity and specificity of the transcutaneous breast cancer detection by canine olfactionin Tunisian women and to identify the potential confounding factors. Methods This is a diagnostic case control study that took place from October 2021 to November 2022 in the Department of Medical Oncology at the University Hospital Farhat Hached of Sousse and in the security and training dog center located in Sousse (K9 Dog Center Security & Training). A two-year-old male Belgian Malinois was trained to detect breast cancer on skin secretion samples in compresses that had been worn overnight by women on their breast and then a double-blind testing was performed. There was no contact between women and the dog. From the mentioned responses of the dog, four parameters were calculated: sensitivity, specificity, Positive Predictive Value (PPV) and Negative Predictive Value (NPV). Results Two hundred women were included in this trial: 100 breast cancer (BC) patients recruited from Farhat Hached University Hospital of Sousse and 100 healthy volunteers (HV).The calculated sensitivity was 84% (95% CI 78–89%) and the calculated specificity was 81% (95% CI 75–86%). The calculated predictive values were: PPV = 83,51% (95% CI 78,37–88,65%) and NPV = 81,55% (95% CI 76.17–86.93%). In the multivariate study, only four confounding factors of test’s sensitivity were retained: age (OR = 1.210 [95% CI = 1.085–1.349]; p = 0.001), history of diabetes(OR = 0.017 [95% CI = 0.001–0.228]; p = 0.002), sampling at hospital (OR = 0.010 [95% CI = 0.003–0.464]; p = 0.010) and testing during chemotherapy courses (OR = 0.034 [95% CI = 0.003–0.404]; p = 0.007).For test’s specificity, we retained the three following confounding factors: age (OR = 1,104 [95% CI = 1.021–1.195]; p = 0.014), history of benign mastopathy (OR = 0.243 [95% CI = 0.074–0.805]; p = 0.021)and history of arterial hypertension (OR = 0.194 [95% CI = 0.053–0.707]; p = 0.013). Conclusion This is a pilot study that opens new avenues in developing a reliable cancer diagnostic tool that integrates the dog's olfactory ability to detect breast cancer using a transcutaneous sampling method. It could be a pre-test to select patients who are eligible to a screening mammogram, especially in low-income countries where there is no national mammography screening program. Pactr.org identifier PACTR202201864472288, registration date 11/01/2022.

Introduction: Mucinous ovarian carcinoma is often diagnosed early and can affect young patients. The preservation of the female reproductive organ is one of the critical issues, especially for nulliparous women. This case report aims to reconsider the safe outcome of fertility-sparing surgery for infiltrative type mucinous ovarian carcinoma. Case Presentation: A 28-year-old woman with a right mucinous ovarian carcinoma, infiltrative subtype stage IA was treated by right salpingo-oophorectomy, omentectomy, and lymph nodes staging. A 5-year follow-up showed no signs of relapse, and she completed two full-term natural pregnancies. Conclusion: Conservative surgery is a crucial matter for this patient category. The infiltrative type has a poorer prognosis, but few papers have reported the outcome and the safety of fertility-sparing surgery in this context.

A cross-sectional study was carried out, between April 2021 and June 2022, to understand the role of dogs in the circulation of rickettsiosis in Tunisia. The presence of specific IgG antibodies against Rickettsia conorii was analyzed by indirect immunofluorescence test. By qPCR, blood and ticks were collected from 136 dogs examined at the Canine Department of National School for Veterinary Medicine of Tunisia. These dogs were also analyzed to detect Rickettsia DNA. The rate of Rickettsia seropositivity in 136 dogs was 55.14%. A total of 51 (53%) seropositive dogs showed clinical and biological signs such as fever and anorexia as well as thrombocytopenia and anemia. By qPCR, targeting the mitochondrial 16S rRNA gene, no Rickettsia DNA was detected in the blood. On the other hand, qPCR followed by sequencing revealed the presence of R. conorii subsp. raoultii in 7 tick pools of the 51 pools composed of the 227 ticks collected. A One Health approach to raise the awareness of dog owners to control tick infestations is imperative, given the dangers of canine zoonoses.

Artificial intelligence-based tools are rapidly revolutionizing the field of higher education, yet to be explored in terms of their impact on existing higher education institutions' (HEIs) practices adopted for continuous learning improvement, given the sparsity of the literature and empirical experiments in undergraduate degree programs. After the entry of ChatGPT--a conversational artificial intelligence (AI) tool that uses a deep learning model to generate human-like text response based on provided input--it has become crucial for HEIs to be exposed to the implications of AI-based tools on students' learning outcomes, commonly measured using an assessment-based approach to improve program quality, teaching effectiveness, and other learning support. An empirical study has been conducted to test the ChatGPT capability of solving a variety of assignments (from different level courses of undergraduate degree programs) to compare its performance with the highest scored student(s). Further, the ChatGPT-generated assignments were tested using the best-known tools for plagiarism detection to determine whether they could pass the academic integrity tests, including Turnitin, GPTZero, and Copyleaks. The study reported the limitations of the Bot and highlighted the implications of the newly launched AI-based ChatGPT in academia, which calls for HEIs' managers and regulators to revisit their existing practices used to monitor students' learning progress and improve their educational programs.

Abstract A deterministic system of ocean surface waves and flow in the oceanic boundary layer is key to understanding the dynamics of the upper ocean. For the description of such complex systems, a higher‐order shear‐current modified nonlinear Schrödinger equation is newly derived and then used to physically interpret the interplay between Stokes drift, Eulerian return flow due to a passing wave group, and an open‐ocean vertically sheared flow in the extreme sea wave generation. The conditions for the suppression or enhancement of the modulation instability in the rogue wave dynamics in the presence of a background flow are reported, whose relevance and influence to the Craik‐Leibovich type 2 instability in triggering a Langmuir‐type circulation is discussed. The findings highlight the need for future studies to establish and assess the energy transfer from waves to currents or in the reversing order, asserting a plausible physical mechanism for the dissipation of the surface wave energy through wave‐current interactions in the open ocean.

This paper focuses on the multi-objective Travelling Salesman Problem for which the aim is to find the set of efficient solutions. To obtain this Pareto set's solutions, a novel metaheuristic named DM4-PMO is proposed. The DM4-PMO is based on the first enhancement of the new Dhouib-Matrix-4 (DM4) method and composed of two steps. First, a weighted sum function with a multi variation of weights is used to find the first non-dominated pareto frontier solutions. Second, a lexicographical resolution is applied in some non-dominated solutions found in the first Pareto frontier to generate the final Pareto frontier solutions. The performance of the proposed approach is demonstrated by the experiment on two-objective problems that are taken from TSP-LIB and DIMACS datasets. The test results show that the proposed DM4-PMO is robust, fast, and simply structured, and obtain a Pareto non-dominated set solutions in short computational times using very few user-defined parameters.