Convolutional neural network-based models for diagnosis of breast cancer.

Breast cancer is the most prevailing cancer in the world and each year affecting millions of women. It is also the cause of largest number of deaths in women dying in cancers. During the last few years, researchers are proposing different convolutional neural network models in order to facilitate diagnostic process of breast cancer. Convolutional neural networks are showing promising results to classify cancers using image datasets. There is still a lack of standard models which can claim the best model because of unavailability of large datasets that can be used for models' training and validation. Hence, researchers are now focusing on leveraging the transfer learning approach using pre-trained models as feature extractors that are trained over millions of different images. With this motivation, this paper considers eight different fine-tuned pre-trained models to observe how these models classify breast cancers applying on ultrasound images. We also propose a shallow custom convolutional neural network that outperforms the pre-trained models with respect to different performance metrics. The proposed model shows 100% accuracy and achieves 1.0 AUC score, whereas the best pre-trained model shows 92% accuracy and 0.972 AUC score. In order to avoid biasness, the model is trained using the fivefold cross validation technique. Moreover, the model is faster in training than the pre-trained models and requires a small number of trainable parameters. The Grad-CAM heat map visualization technique also shows how perfectly the proposed model extracts important features to classify breast cancers.

Effect of progenitor cell mobilization with granulocyte-macrophage colony-stimulating factor in patients with peripheral artery disease: a randomized clinical trial.

IMPORTANCE: Many patients with peripheral artery disease (PAD) have walking impairment despite therapy. Experimental studies in animals demonstrate improved perfusion in ischemic hind limb after mobilization of bone marrow progenitor cells (PCs), but whether this is effective in patients with PAD is unknown. OBJECTIVE: To investigate whether therapy with granulocyte-macrophage colony-stimulating factor (GM-CSF) improves exercise capacity in patients with intermittent claudication. DESIGN, SETTING, AND PARTICIPANTS: In a phase 2 double-blind, placebo-controlled study, 159 patients (median [SD] age, 64 [8] years; 87% male, 37% with diabetes) with intermittent claudication were enrolled at medical centers affiliated with Emory University in Atlanta, Georgia, between January 2010 and July 2012. INTERVENTIONS: Participants were randomized (1:1) to received 4 weeks of subcutaneous injections of GM-CSF (leukine), 500 µg/day 3 times a week, or placebo. Both groups were encouraged to walk to claudication daily. MAIN OUTCOMES AND MEASURES: The primary outcome was peak treadmill walking time (PWT) at 3 months. Secondary outcomes were PWT at 6 months and changes in circulating PC levels, ankle brachial index (ABI), and walking impairment questionnaire (WIQ) and 36-item Short-Form Health Survey (SF-36) scores. RESULTS: Of the 159 patients randomized, 80 were assigned to the GM-CSF group. The mean (SD) PWT at 3 months increased in the GM-CSF group from 296 (151) seconds to 405 (248) seconds (mean change, 109 seconds [95% CI, 67 to 151]) and in the placebo group from 308 (161) seconds to 376 (182) seconds (change of 56 seconds [95% CI, 14 to 98]), but this difference was not significant (mean difference in change in PWT, 53 seconds [95% CI, -6 to 112], P = .08). At 3 months, compared with placebo, GM-CSF improved the physical functioning subscore of the SF-36 questionnaire by 11.4 (95% CI, 6.7 to 16.1) vs 4.8 (95% CI, -0.1 to 9.6), with a mean difference in change for GM-CSF vs placebo of 7.5 (95% CI, 1.0 to 14.0; P = .03). Similarly, the distance score of the WIQ improved by 12.5 (95% CI, 6.4 to 18.7) vs 4.8 (95% CI, -0.2 to 9.8) with GM-CSF compared with placebo (mean difference in change, 7.9 [95% CI, 0.2 to 15.7], P = .047). There were no significant differences in the ABI, WIQ distance and speed scores, claudication onset time, or mental or physical component scores of the SF-36 between the groups. CONCLUSIONS AND RELEVANCE: Therapy with GM-CSF 3 times a week did not improve treadmill walking performance at the 3-month follow-up. The improvements in some secondary outcomes with GM-CSF suggest that it may warrant further study in patients with claudication. TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT01041417.

Zoonotic ectopic fascioliasis: review and discussion.

Ectopic fascioliasis (EF) has direct and indirect effects on both humans and animals. The phenomenon of EF was individual cases in the period from 1950 up to the end of last century. From the period of 2000 up to 2006, plenty of researches were on EF in the developed and undeveloped countries. Nineteen EF cases infected with the immature and few with the mature worms were 13 females and 6 males. Three cases of lymphatic, pleural and breast fascioliasis reached the adults and laid their eggs in a lymph node in the cervical region pleural cavity and breast tissues. Until recent, knowledge about the ectopic fascioliasis pathway is little. Fasciola hepatica was the commonest species in most cases. The effect of fascioliasis might be direct to liver as ectopic foci or indirect on other organs due to the metabolites and secretory excretory products. All ages and both sexes were EF infected. Watercress topped the list of water plants born encysted metacercariae followed by lettuce, mint, and alfalfa. Nearly 24 million Egyptians at risk and about 800,000 were infected. On the global scale, about 180 million are at risk of infection.

A new parasitic metacercaria from the land snail Monacha obstructa pfeiffer1842 with critical review on relevant metacercariae belonging to the genus Brachylaima Dujardin 1843.

Out of 328 specimens of the land snail Monacha obstructa, 105 (32%) were infected with a new metacercaria belonging to the genus Brachylaima Dujardin 1843. The present snail is considered as a new host for this parasite in Egypt. Morphological and morphometric patterns were elucidated. Number of recovered infective metacercariae ranged between 4-35 per kidney of snail host. Metacercariae inhabited only the kidney of infected snails. Total length of mature metacercariae ranged from 1800mu-2050mu (1940mu). The anterior extremity is dome shaped and ceca were highly expanded, undulating, and filled with masses of brown cells and renal tissues. Metacercariae were fully mature, unencyted and highly active. They were either roaming in pathways inside the kidney or firmly anchored to renal tissues via oral sucker. Oral sucker length/total body length is 1:8.5. The histopathological effects involved disintegration of renal lamellae and formation of numerous necrotic masses. Invading metacercariae faced no host resistance and they were surrounded by a parasitovorus vacuole as a mean of immune-evasion. SEM studies revealed that dorsal surface of ventral sucker area is covered with rows of minute spines, Oral suker also is provided with a median tongue-like shaped septum. The rest of integument is aspinose. A critical review for relevant metacercariae of genus Brachylaima is provided.

Studies on the genus Stylocephalus ellis, 1912 (Apicomplexa: Eugregarinida: Stylocephalidae) in beetles (Coleoptera: Tenebrionidae) from El Fayoum Governorate, Egypt.

Four species of the genus Stylocephalus Ellis, 1912 were recorded and described from beetles in El Fayoum Governorate; S. longicollis, S. phalloides, S. variabilis and S. eastoni. Both S. phalloides and S. variabilis were recorded in Zophosis sp. and Pimelia angulata, respectively for the first time in Egypt. Out of 105 Blaps polychresta, 18 (17.14%) were infected with S. longicollis and 57 (54.29%) with S. eastoni. Out of 30 Pimelia angulata, 17 (56.76%) were infected with S. variabilis and all examined Zophosis sp. (n = 67) were infected with S. phalloides. Scanning electron microscopy on S. longicollis revealed morphological features not reported before; three pairs of longitudinal ribs extending from the second fifth till the posterior extremity of old sporont and a minute pore on the anterior tip of epimerite. In S. eastoni, the epimerite-host epithelium relationship revealed that the parasite invades host's gut with the distal part of epimerite. Regarding the gross pathological symptoms, heavily infected hosts showed a sluggish motility, short antennae, swollen abdomen, lack of fat accumulation, and putrid smell in dead beetles.

The effect of severe cystic hydatidosis on the liver of a Najdi sheep with special reference to the cyst histology and histochemistry.

A single case of severe hydatidosis in a liver of a Najdi sheep was studied. The estimated age of animal was 1.5 years and the liver was infected with 29 cysts and their diameters ranged from 4.0 mm to 5.1 cm. Cysts with diameter less than 10 mm were immature and those more than 1.5 cm were fertile and developed protroscoleces. Harvested protroscolices measured 120x60 to 140x80 um. Comparative histochemical studies by haematoxylin & eosin, periodic acid Schiff (PAS) and Mossaon's trichrome stains revealed that the cystic wall consisted of three layers which are germinal, laminated and fibrous respectively. The thickness varied with each stain. The glycogen and mucopolysaccharide content increased in infected sheep. Histopathological changes were the formation of fibrotic capsules around biliary tracts and portal vein and also leaky liver was marked in all the sections examined. Meanwhile, pre-malignant changes were seen in the different foci particularly around the biliary tracts and portal veins. The histochemical structure of the hydatid cyst wall may pave the way for effective therapeutic treatment.