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Highlights Clear cell adenocarcinoma of the lower urinary tract is rare, with heterogenous morphology. GATA3 expression can be seen in these tumors, causing diagnostic challenge in the urinary tract or in the metastatic setting. Along with morphologic clues, immunohistochemical panel of PAX8, GATA3, and p63 might be useful to distinguish these tumors from urothelial carcinoma.

Existence of tension – compression yield asymmetry is a serious limitation to the load bearing capablities of Magnesium alloys in a number of light weight structural applications. The present work is aimed at nullifying the tension to compression asymmetry problem and strain hardening anomalies in a Magnesium – Silver – Rare Earth alloy by engineering different levels of microstructural conditions via friction stir processing and post process annealing. The existence and extent of yield asymmetry ratio in the range of microstructural conditions was experimentally obtained through quasistatic tensile and compression tests. The yield asymmetry problem was profoundly present in specimens of coarse grained microstructures when compared to their fine grained and ultra fine grained counterparts. The impact of the microstructure and associated mechanisms of plasticity on the macroscopic strain hardening behavior was established by Kock – Mecking's analysis. Crystal plasticity simulations using Viscoplastic Self Consistency approach revealed the consequential role of extension twinning mechanism for the existence of yield asymmetry and anomalies in strain hardening behavior. This was especially dominant with coarsening of grain size. Electron Microscopy and characterization were conducted thoroughly in partially deformed specimens to confirm the predictions of the above simulations. The role of crystallographic texture for inducing the polarity to Tension – Compression yield asymmetry was corroborated. A critical grain size in Magnesium – Silver – Rare earth alloy was hereby established which could nullify influences of extension twinning in yield asymmetry ratio.

Abstract Background Diffuse large B cell lymphoma (DLBCL) can occur at nodal and/or extra-nodal sites. After the gastrointestinal tract, cutaneous involvement predominates in extra-nodal DLBCL. Skin involvement at presentation can be in the form of plaques, papules, nodules or ulcers. Differentiating primary cutaneous DLBCL from systemic DLBCL with cutaneous involvement is important for appropriate patient management. Case presentation We describe here, two interesting cases of skin involvement in DLBCL- one primary cutaneous DLBCL and the other, cutaneous involvement in systemic DLBCL with different clinico-pathological profiles. Though both cases had almost similar morphology of the skin lesions (ulcero-proliferative) at presentation, the disease was confined to the skin in the former, while the latter had involvement of lymph nodes and bone marrow. Conclusions Meticulous clinical evaluation, appropriate histopathological and immunohistochemical workup helped in their diagnosis and correct classification of the disease status, guiding the further treatment decisions.

In this paper, we show that adversarial training time attacks by a few pixel modifications can cause undesirable overfitting in neural networks for both discriminative and generative models. We propose an evolutionary algorithm to search for an optimal pixel attack using a novel cost function inspired by domain adaptation literature to design our training time attack. The proposed cost function explicitly maximizes the generalization gap and domain divergence between clean and corrupted images. Empirical evaluations demonstrate that our adversarial training attack can achieve significantly low testing accuracy (with high training accuracy) on multiple datasets by just perturbing a single pixel in the training images. Even under the use of popular regularization techniques, we identify a significant performance drop compared to clean data training. Our attack is more successful than previous pixel-based training time attacks on state-of-the-art Convolutional Neural Networks (CNNs) architectures, as evidenced by significantly lower testing accuracy. Interestingly, we find that the choice of optimization plays an essential role in robustness against our attack. We empirically observe that Stochastic Gradient Descent (SGD) is resilient to the proposed adversarial training attack, different from adaptive optimization techniques such as the popular Adam optimizer. We identify that such vulnerabilities are caused due to over-reliance on the cross-entropy (CE) loss on highly predictive features. Therefore, we propose a robust loss function that maximizes the mutual information between latent features and input images, in addition to optimizing the CE loss. Finally, we show that the discriminator in Generative Adversarial Networks (GANs) can also be attacked by our proposed training time attack resulting in poor generative performance. Our paper is one of the first works to design attacks for generative models.

Wilms tumor in children has cure rates of 90% at 5 years with a combined modality of treatment with surgery, chemotherapy and/or radiation. Wilms tumor recurs in 15–20% patients and almost all of them occur within 2 years of diagnosis. Late recurrence in Wilms tumor is rare with only a handful of case reports. No clear cut guidelines exist for management of recurrent Wilms tumor. The outcome with early and late relapses remain similar. Here we report a case of Wilms tumor presenting with recurrence 20 years after first diagnosis and review the literature on very late recurrences.

Objectives: Acute rupture of achilles tendon is a commonly occurring injury affecting mostly the young individuals involved in sports activities. Operative management is most often employed to treat such injuries. This study was aimed to evaluate the functional outcome in patients with acute tendo achilles tear managed by open repair using a suture anchor. Methods: This was a prospective study conducted between September 2018 to August 2020 on patients who underwent suture anchor repair for acute tendo achilles tear. All patients were followed up for at least 9 months. The patients were clinically evaluated and AOFAS score was used to assess their functional outcome. Results: In a total of 38 patients, 28 (73.7%) patients showed Excellent and 7 (18.4%) patients had Good results whereas 1 (2.6%) had Fair and 2 (5.3%) patients demonstrated Poor surgical result at the final follow-up. 89.5% patients did not have any complication. The average AOFAS score was 90.97 ± 10.24. Conclusion: Operative treatment with suture anchor in acute tendo achilles tear has a high success rate, quick recovery after surgery, lower rate of complications, faster return to daily activities, excellent aesthetic and comparable functional results and is also a safe, simple and accepted surgical technique.

Therecent emergence of on-surface LNA-based assays as potentiallybetter alternatives over DNA-based approaches, due to enhanced sensitivityand target specificity, raises the need for the precise identificationof the factors that control the performance of these assays. In thiswork, we investigated whether the probe density of fully modifiedssLNA probes on the gold(111) surface could influence the target recognitioncapacity of the LNA sensing layer and illustrated simple means tocontrol it, primarily by adjusting the salt concentration, natureof the cation, and pH of the immobilization buffer. It was observedthat monovalent Na+could more effectively control thesensor probe density compared to bivalent Mg2+, leadingto better target recognition. Interestingly, unlike in the case ofssDNA sensor probes, the target recognition efficiency of the LNAlayer at the optimum probe density was found to be almost spacer-independent,probably due to the rigidity of the LNA backbone. The optimized LNAsensor layer could discriminate single base mismatches, detect a minimumtarget DNA concentration of 5 nM, and sense a significant level ofhybridization within a time scale of a few minutes. To our knowledge,for the first time, we identify the factors that control the on-surfaceLNA probe density for maximizing the performance of the LNA sensinglayer. [ABSTRACT FROM AUTHOR]

Abstract Background Thromboangiitis obliterans or Buerger’s disease is a form of peripheral vascular disease in young male smokers. The involvement of the intestine occurs in only about 2% of the cases, when they may present as acute abdomen due to mesenteric ischemia. The uncommonness of the condition makes it a less suspected differential diagnosis, leading to a delay in appropriate management, thereby increasing chances of morbidity or mortality. Cessation of smoking is known to stall the disease progression including visceral involvement, but may not always be the case as happened in the case being presented. Case presentation Our Indian Hindu male patient, a known smoker, presented with diffuse abdominal pain along with bouts of vomiting and loose motions. He had a prior history of amputation of the right foot, 4 years before. At presentation he had abdominal distension with diffuse tenderness and guarding. An omental band attached to the tip of the appendix was discovered at the initial exploration along with dilated proximal bowel loops, for which a release of the omental band along with appendectomy was done. He developed an enterocutaneous fistula on the 6th postoperative day for which he had to be reexplored, and multiple jejunal perforations were found. Segmental jejunal resection and a Roux-en-Y gastrojejunostomy with distal ileostomy were done along with a feeding jejunostomy. The patient however again had feculent discharge from the wound for which a third exploration was done. The gastrojejunostomy and feeding jejunostomy sites were leaky, both of which were repaired primarily. The patient developed septicemia which progressed to refractory septic shock, and he ultimately succumbed to his illness on the 23rd postoperative day of the index surgery. Conclusion Acute abdomen in a young man who is a chronic smoker and having an antecedent history of amputation of some part of an extremity for a nontraumatic cause should raise the suspicion of Buerger’s disease of the intestine. Although it is a progressive disease and the situation has already progressed by the time intestinal symptoms manifest, early detection may give some scope of salvage and decrease the morbidity and mortality.