Revolutionizing breast ultrasound diagnostics with EfficientNet-B7 and Explainable AI.

Breast cancer is a leading cause of mortality among women globally, necessitating precise classification of breast ultrasound images for early diagnosis and treatment. Traditional methods using CNN architectures such as VGG, ResNet, and DenseNet, though somewhat effective, often struggle with class imbalances and subtle texture variations, leading to reduced accuracy for minority classes such as malignant tumors. To address these issues, we propose a methodology that leverages EfficientNet-B7, a scalable CNN architecture, combined with advanced data augmentation techniques to enhance minority class representation and improve model robustness. Our approach involves fine-tuning EfficientNet-B7 on the BUSI dataset, implementing RandomHorizontalFlip, RandomRotation, and ColorJitter to balance the dataset and improve model robustness. The training process includes early stopping to prevent overfitting and optimize performance metrics. Additionally, we integrate Explainable AI (XAI) techniques, such as Grad-CAM, to enhance the interpretability and transparency of the model's predictions, providing visual and quantitative insights into the features and regions of ultrasound images influencing classification outcomes. Our model achieves a classification accuracy of 99.14%, significantly outperforming existing CNN-based approaches in breast ultrasound image classification. The incorporation of XAI techniques enhances our understanding of the model's decision-making process, thereby increasing its reliability and facilitating clinical adoption. This comprehensive framework offers a robust and interpretable tool for the early detection and diagnosis of breast cancer, advancing the capabilities of automated diagnostic systems and supporting clinical decision-making processes.

Psidium guajav-mediated zinc oxide nanoparticles as a multifunctional, microbicidal, antioxidant and antiproliferative agent against destructive pathogens.

Bio-inspired zinc oxide nanoparticles are gaining immense interest due to their safety, low cost, biocompatibility, and broad biological properties. In recent years, much research has been focused on plant-based nanoparticles, mainly for their eco-friendly, facile, and non-toxic character. Hence, the current study emphasized a bottom-up synthesis of zinc oxide nanoparticles (ZnO NPs) from Psidium guajava aqueous leaf extract and evaluation of its biological properties. The structural characteristic features of biosynthesized ZnO NPs were confirmed using various analytical methods, such as UV-Vis spectroscopy, X-ray diffraction (XRD), energy-dispersive X-ray analysis (EDX), Fourier transform infrared spectroscopy (FT-IR), dynamic light scattering (DLS), Scanning electron microscopy (SEM) and high-resolution transmission electron microscopy (HR-TEM). The synthesized ZnO NPs exhibited a hydrodynamic shape with an average particle size of 11.6-80.2 nm. A significant antimicrobial efficiency with minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) of 40 and 27 µg/ml for Enterococcus faecalis, followed by 30 and 40 µg/ml for Staphylococcus aureus, 20 and 30 µg/ml for Staphylococcus mutans, 30 µg/ml for Candida albicans was observed by ZnO NPs. Additionally, they showed significant breakdown of biofilms of Streptococcus mutans and Candida albicans indicating their future value in drug-resistance research. Furthermore, an excellent dose-dependent activity of antioxidant property was noticed with an IC50 of 9.89 µg/ml. The antiproliferative potential of the ZnO NPs was indicated by the viability of MDA MB 231 cells, which showed a drastic decrease in response to increased concentrations of biosynthesized ZnO NPs. Thus, the present results open up vistas to explore their pharmaceutical potential for the development of targeted anticancer drugs in the future.

A Randomized Comparison of Positional Stability: The EZ-Blocker Versus Left-Sided Double-Lumen Endobronchial Tubes in Adult Patients Undergoing Thoracic Surgery.

OBJECTIVE: To assess if there is a difference in the repositioning rate of the EZ-Blocker versus a left-sided double-lumen endobronchial tube (DLT) in patients undergoing thoracic surgery and one-lung ventilation. DESIGN: Prospective, randomized. SETTING: Single center, university hospital. PARTICIPANTS: One hundred sixty-three thoracic surgery patients. INTERVENTIONS: Patients were randomized to either EZ-Blocker or a DLT. MEASUREMENTS AND MAIN RESULTS: The primary outcome was positional stability of either the EZ-Blocker or a left-sided double-lumen endobronchial tube, defined as the number of repositionings per hour of surgery and one-lung ventilation. Secondary outcomes included an ordinal isolation score from 1 to 3, in which 1 was poor, up to 3, which represented excellent isolation, and a visual analog postoperative sore throat score (0-100) on postoperative days (POD) one and two. Rate of repositionings per hour during one-lung ventilation and surgical manipulation in left-sided cases was similar between the two devices: 0.08 ± 0.15 v 0.11 ± 0.3 (p = 0.72). In right-sided cases, the rate of repositioning was higher in the EZ-Blocker group compared with DLT: 0.38 ± 0.65 v 0.09 ± 0.21 (p = 0.03). Overall, mean isolation scores for the EZ-Blocker versus the DLT were 2.76 v 2.92 (p = 0.04) in left-sided cases and 2.70 v 2.83 (p = 0.22) in right-sided cases. Median sore throat scores for left sided cases were 0 v 5 (p = 0.13) POD one and 0 v 5 (p = 0.006) POD two for the EZ-Blocker and left-sided DLT, respectively. CONCLUSION: For right-sided procedures, the positional stability of the EZ-Blocker is inferior to a DLT. In left-sided cases, the rate of repositioning for the EZ-Blocker and DLT are not statistically different.

Case Start Time Affects Intraoperative Transfusion Rates in Adult Cardiac Surgery: A Single-Center Retrospective Analysis.

OBJECTIVE: The goal of the study was to investigate the role time of day plays in perioperative outcomes. The authors examined intraoperative transfusion rates throughout the day in adult cardiac surgery patients. They hypothesized that the rate of transfusion changes with later case start times in scheduled cardiac surgery. DESIGN: Retrospective observational study. SETTING: Single academic medical center. PARTICIPANTS: Adults undergoing cardiac surgery involving cardiopulmonary bypass. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: The primary outcome was a composite variable of transfusion. The association between the time of day and the rate of transfusion was explored with a multivariate logistic regression to fit the effect of starting time as a cubic spline. There were 1,421 cases that met inclusion criteria. There were 1,220 cases that were matched for modeling. The estimated probability of a patient receiving a transfusion changed significantly with later case start times in the multivariable model after adjusting for initial hemoglobin, age, sex, height, ideal body weight, diabetes, peripheral vascular disease, stroke, chronic kidney disease, chronic obstructive pulmonary disease, duration of cardiopulmonary bypass, aortic cross clamp time, attending surgeon, and attending anesthesiologist (p = 0.032, C-statistic = 0.807, n = 1220). The estimated probability of receiving an intraoperative red blood cell transfusion increased with later case start times in the multivariable model (p = 0.027, C-statistic = 0.902, n = 1220). There was no difference in the probability of transfusion for plasma, cryoprecipitate, or platelets. CONCLUSIONS: The observed rate of intraoperative blood product transfusion changed with later case start times in a multivariable model of scheduled cardiac surgery.

Unwashed grapes as a cause of organophosphate poisoning in a child in rural India.

This report describes the symptoms of pesticide poisoning in a previously healthy teenage girl. After consuming unwashed grapes for several days, the girl developed the following symptoms: drowsiness, vomiting, truncal weakness and fasciculations in the tongue and hands. Blood tests confirmed exposure to a small amount of the organophosphate (OP) compound, a type of chemical found in certain pesticides. The girl was treated with supportive care and cholinesterase reactivators, which minimised the damage caused by OP poisoning. Within 48 hours, the girl's symptoms improved and she made a full recovery. This case highlights that OP poisoning can present without classic cholinergic crisis symptoms (SLUDGING), including miosis. Fasciculations, as observed in this case, are a significant clue to the diagnosis.

Determinants of High HIV Infection Prevalence in Vijayapura, Bagalkot, and Belagavi Districts in Karnataka, India.

Introduction India has the second-highest number of people living with human immunodeficiency virus (PLHIV). Despite the national decline in the prevalence of the human immunodeficiency virus (HIV) from 2000 to 2021, regional variations persist, particularly in the northeastern and southern states. High-risk populations, including female sex workers (FSW), men who have sex with men (MSM), and injecting drug users (IDU), significantly contribute to these dynamics. This study focuses on high-prevalence districts in Karnataka. Objectives This study aims to identify socioeconomic and behavioral factors associated with high HIV prevalence in high-burden districts of South Indian states. Methodology A cross-sectional study was conducted using data from Integrated Counseling and Testing Centers (ICTCs) and Designated STI/RTI (sexually transmitted infections/reproductive tract infections) Clinics (DSRCs) across 24 centers in the three districts. The centers were determined using a simple random sampling method. Data from 2501 HIV-positive individuals were analyzed, focusing on demographics, risk behaviors, and treatment history. Results Males constituted the majority of HIV cases, accounting for 448 (56.0%) in Vijayapura, 334 (51.4%) in Bagalkot, and 644 (61.1%) in Belagavi districts, with a significant portion referred by government hospitals. High HIV prevalence was linked to adults aged 25-49 years of age; the number of people with HIV was high among daily wage workers and individuals with multiple sexual partners compared to married and educated people. Newly diagnosed discordant couples ranged from 129 (12.2%) in Belagavi to 133 (18.4%) in Vijayapura districts. Most patients were on first-line antiretroviral therapy (ART), with loss to follow-up attributed to system negligence and poor compliance. Conclusion Key determinants of high HIV prevalence include gender, age, marital status, socioeconomic status, and sexual behavior. Effective interventions require targeted education, improved healthcare services, robust surveillance, and strengthened collaboration among stakeholders.

Hashimotos Thyroiditis with Coexistent Papillary Carcinoma and Non-hodgkin Lymphoma-thyroid.

Lymphocytic thyroiditis and hashimoto's thyroiditis (HT) are the two main forms of autoimmune thyroiditis among which the latter is most frequent. A vast majority of cases of papillary carcinoma and primary thyroid lymphoma (PTL) arise in the setting of HT. A case of 32-year-old female who presented with thyroid enlargement, post-thyroidectomy showed hashimoto's thyroiditis (HT) with coexistent papillary carcinoma and non-hodgkin lymphoma (NHL). The immunohistochemistry was positive for CD 20, CD 45, bcl 2 for lymphoma, low and high molecular cytokeratin for papillary carcinoma. The staging studies showed no evidence of metastasis. It is thus concluded that papillary carcinoma and NHL can coexist with HT. The thyroid lymphoma or papillary carcinoma has to be thought off, whenever patients presents with sudden enlargement in a known case of HT. A patient presenting with concomitant primary thyroid lymphoma and papillary thyroid carcinoma must be judiciously evaluated, since, the treatment has to prioritize the tumor with worst stage at the time of diagnosis.

Temporal expression, polar distribution and transition of an epitope domain in the perinuclear theca during mouse spermatogenesis.

A novel domain of epitopes is expressed by a family of high-Mr proteins at the anterior pole of the germ cell nucleus during spermiogenesis, and later by two low-Mr proteins at the anterior and posterior poles of the nucleus during sperm maturation in the epididymis. Initially, monoclonal antibodies (mAbs) PNT-1 (IgG2b) and PNT-2 (IgG2a) bound to antigens present in a cap-like configuration at the apical pole of the spermatid nucleus at step 5 of spermiogenesis. The distribution of epitopes on the nucleus expanded posteriorly until, in testicular sperm they covered the anterior pole down to the distal limits of the subacrosomal perforatorium. By contrast, sperm from the epididymis and vas deferens bound both mAbs in two distinct regions on the nucleus, one on the dorsal margin of the anterior pole, and the other in a ventral zone at the posterior pole. On SDS-PAGE and isoelectric focusing (IEF) immunoblots, both mAbs bound three major proteins with Mr of approximately 80,000, 77,000 and 75,000 from spermatids and testicular sperm, and proteins of Mr 50,000 and 48,000 in epididymal and vas deferens sperm. Both the high- and low-Mr protein families were recovered in germ cell nuclear/perinuclear matrices. Their mobilities on SDS-PAGE were not altered by exo- or endoglycosidases or by aminoethylation in denaturing conditions. mAb PNT-1 bound to the sperm proteins with a Ka of 3.53 x 10(12) M-1 and mAb PNT-2 with a Ka of 2.08 x 10(12) M-1. From competition binding data, mAbs PNT-1 to -10 appeared to recognize six adjacent or overlapping epitopes on the same proteins. These data suggest the high-Mr proteins, the thecins, present at the anterior pole of haploid germ cells are processed at the onset of sperm maturation to yield two low-Mr proteins that then occupy two distinct domains at the anterior and posterior poles of the nucleus.

Measles virus nucleocapsid protein can function in Sendai virus defective interfering particle genome synthesis in vitro.

The Sendai virus P and L proteins, the viral RNA polymerase, and the nucleocapsid protein, NP, synthesized in a transient mammalian expression system support the replication of Sendai virus defective interfering particle (DI) genome RNA in vitro. We have shown that the measles virus nucleocapsid protein, N, can substitute for the Sendai NP protein in genome synthesis. The chimeric product nucleocapsids, which contained Sendai RNA encapsidated with measles N protein, were atypical since they were sensitive to micrococcal nuclease digestion, unlike wild-type Sendai or measles nucleocapsids. The utilization of measles N protein required the endogenous Sendai virus RNA polymerase, since DI nucleocapsids free of polymerase were not replicated. Although both Sendai virus NP and P proteins and measles N and P proteins formed complexes when they were coexpressed, sedimentation analysis showed that measles N protein self-assembled and did not form a complex when expressed with the Sendai P protein. Furthermore, when the Sendai P-L polymerase complex was provided separately, measles N protein alone synthesized DI genome RNA in the absence of Sendai P protein. These data suggest that the self-assembled form of measles N protein functions in Sendai DI genome synthesis.

The perinuclear matrix as a structural element of the mouse sperm nucleus.

The mouse sperm nucleus, after the removal of protamines and DNA, consisted of a skeletal structure that conformed to the original nuclear shape. Sperm were extracted with 1% SDS, and the isolated nuclei, along with the enveloping perinuclear theca, were incubated in 25 mM dithiothreitol, and exposed to different reagents in an effort to displace the protamines, P1 and P2. Protamines, labeled with [3H]arginine, were displaced from the nucleus by CaCl2.MgCl2, but only partially by anionic detergents, monovalent cations, and polyvalent anions. Displacement of P1 and P2 was achieved by digesting the nuclei with DNase I and simultaneously extracting with CaCl2.MgCl2 (3:2; mol:mol) in stepwise increments of 125, 150, 175, 200, and 250 mM. Protamine displacement was concentration-dependent, occurring with an EC50 of approximately 205 mM and with maximal displacement at approximately 250 mM CaCl2.MgCl2. The nucleus was reduced to a skeletal structure consisting of the perinuclear theca and an internal network of transverse fibers. The evidence was consistent with the former being derived from the perforatorium and postacrosomal nuclear sheath (both cytoplasmic structures), whereas the fibers were most likely of nuclear origin. By SDS-PAGE and isoelectric focusing (IEF), perinuclear matrices consisted of greater than or equal to 230 protein spots, with M(r)s in the range of 70,000 to 8000 and pIs of greater than or equal to 7.5 to approximately 4.7, respectively. Monoclonal antibodies prepared against perinuclear matrices bound to specific proteins on IEF immunoblots and, based on light and electron microscopic observations, to discrete domains of the sperm perinuclear theca and nucleus.

Full-length tobacco mosaic virus RNAs and defective RNAs have different 3' replication signals.

The viral replicase complex of positive-stranded RNA viruses interacts with cis-acting elements that are usually located at the termini of the viral RNAs. On comparison of the replication requirement of a tobacco mosaic virus (TMV)-based defective RNA (dRNA) and its helper virus, we found different requirements for replication of TMV RNAs in cis and in trans. The level of replication of full-length TMV RNA decreased substantially in the absence of pseudoknot (pk) 1 and/or 2, whereas identical deletions in dRNAs did not affect their replication. However, pk3 was required for replication of both full-length TMV RNAs and dRNAs. The requirements for homologous sequences were greater for dRNA replication than for replication of full-length TMV RNAs. Defective RNAs with heterologous 3' nontranslated regions (NTRs) failed to be replicated or replicated minimally, whereas replication of similarly mutated full-length RNAs was much less affected. Increasing amounts of contiguous heterologous sequences in the dRNAs compensated for the impaired interactions between the replicase and 3' NTR. The precision requirement appeared to involve the terminal 28 nucleotides, specifically the pseudoknot in the aminoacyl acceptor arm of the tRNA like structure, which was important in replication of both dRNAs and full-length TMV RNAs.

Mutations in conserved domain I of the Sendai virus L polymerase protein uncouple transcription and replication.

To begin to map functional domains of the Sendai P-L RNA polymerase complex we wanted to characterize the P binding site on the Sendai L protein. Analysis of in vitro and in vivo P-L polymerase complex formation with carboxyl-truncations of the L protein showed that the N-terminal half of the protein was required. Site-directed mutagenesis of the Sendai virus L gene was employed to change amino acids within a highly conserved region of the N-terminal domain I from amino acids (aa) 348-379 singly or in pairs from the Sendai to the corresponding measles L sequence or to alanine. The mutant L proteins coexpressed with the viral P and NP proteins in mammalian cells were assayed for their ability to form the P-L complex and to synthesize RNA in vitro and showed a variety of defective phenotypes. While most of the mutant L proteins still formed the P-L polymerase complex, a change from serine to arginine at aa 368 and a three-amino-acid insertion at aa 379 virtually abolished both complex formation and RNA synthesis. Changes of aas 370 and 376-377 in the L protein gave only small decreases in viral RNA synthesis. Substitutions at either aas 349-350 or aas 354-355 and a three-amino-acid insertion at aa 348 in the L protein yielded enzymes that catalyzed significant transcription, but were defective in DI RNA replication, thus differentially affecting the two processes. Since DI leader RNA, but not genome RNA, was still synthesized by this class of mutants, the defect in replication appears to be in the ability of the mutant enzyme to package newly synthesized nascent RNA. Single changes at aas 362, 363, and 366 in the L protein gave enzymes with severely decreased overall RNA synthesis, although some leader RNA was synthesized, suggesting that they cannot transcribe or replicate past the leader gene. These studies have identified a region in conserved domain I critical for multiple functions of the Sendai virus L protein.