Development of Cyber Security Platform for Experiential Learning

The cyber security education market has grown-up exponentially, with a CAGR of 13.9 % as reported by Data Intelo. The report published by the World Economic Fo- rum 2023 indicates a shortfall of 2.27 million cyber security experts in 2021 across different roles and hence manifest that Skill-based cyber security education is the need of the hour. Cybersecurity as a field has evolved as a multi-discipline, multi-stakeholder and multi-role discipline. Therefore, the need to address formal education with an outcome-based philosophy is imperative to address for a wider audience with varied past training in their formal education. With the Internet becoming an essential part of human life, providing security of data passed over the Internet is becoming increasingly crucial. Therefore, the role in the organization which is quite demanding is to have expertise in handling and configuring network security, a subdomain of cyber security as a priority area. The rapid increase in the network attack landscape is constantly demanding monitoring of network attacks as well as a need to promote collaborative R&D and education in the sphere of cyber security due to a shortage of skilled resources. Platform-based education is a potential direction to achieve the objective and address the skill gap required in cyber security. The present research proposes a comprehensive web-based platform that can be used to communicate, collaborate and practice various use cases in the domain of network intrusion detection tools using machine learning algorithms and to evaluate user experience. The proposed platform CySecLearn is a collection of various functionalities and features that ensures experiential learning, will help the learner to develop critical thinking and expertise in network security and promote digital literacy in the domain of cyber security

Lung cancer with multiple lung abscesses: an unusual presentation

Lung abscess is caused due to localized suppuration in the lung usually caused by microbial infection of the lung. Here we are describing an interesting case of multiple lung abscess associated with non-small cell lung cancer. The diagnosis was suspected on CT scan thorax and was confirmed by fibreoptic bronchoscopy and endobronchial biopsy. Hence, lung cancer should be suspected in any case of lung abscess when it is showing no signs of resolution even after aggressive conservative management with broad spectrum antibiotics

Rise of Asian research in orthopaedic and sports medicine: a bibliometric analysis from 1996 to 2022

Objectives: This study examines the growth and impact of orthopaedic and sports medicine (OSM) publications across 30 Asian countries from 1996 to 2022 using a bibliometric (scientometric) approach. Despite Asia’s rising academic achievements, prior studies have not comprehensively mapped publication trends in this field across the region. This analysis aims to perform bibliometric analysis in OSM research in the Asian Countries. Methods: Publication data were sourced from the SCImago Journal & Country Rank portal, derived from the SCOPUS database, covering the period from 1996 to 2022, with updates available until April 2023. The analysis focused on the top Asian countries and included key indicators such as H-index and total citations to assess research impact. Results: The study identified a substantial rise in OSM publications from Asia, with total output increasing 14.27-fold—compared to a 5.54-fold increase globally. Between 1996 and 2022, 111,342 OSM publications originated from Asian countries, out of 666,847 globally. However, citation counts for Asian research declined from 26,263 in 1996 to 6020 in 2022, likely reflecting the time-lag effect in citation accumulation for recent publications. Possible contributing factors are discussed. Conclusion: This study highlights a remarkable surge in orthopaedic and sports medicine publications from Asia, surpassing global growth trends. While citation metrics appear lower in recent years—likely due to the recency of publications—the overall trend suggests a strong and growing research in Asia. China and Japan lead in output and impact, respectively, while India’s rapid rise reflects increasing academic potential. However, enhancing research quality and visibility and reducing self-citation are essential to elevate global impact. Countries like Hong Kong, Singapore, and Sri Lanka demonstrate high citation efficiency. With optimal collaboration and strategic investment, Asian countries are well positioned to play a leading role in global orthopaedic research

Prognostic Impact of Pattern of Mandibular Involvement in Gingivo-Buccal Complex Squamous Cell Carcinomas:Marrow and Mandibular Canal Staging System

PURPOSE: To study the pattern of mandibular involvement and its impact on oncologic outcomes in patients with gingivo-buccal complex squamous cell carcinoma (GBC-SCC) and propose a staging system based on the pattern of bone involvement (MMC: Marrow and mandibular canal staging system) and compare its performance with the 8th edition of the American Joint Committee on Cancer (AJCC8). METHODS: This retrospective observational study included treatment-naïve GBC-SCC patients who underwent preoperative computed tomography (CT) imaging between January 1, 2012, and March 31, 2016, at a tertiary care cancer center. Patients with T4b disease with high infratemporal fossa involvement, maxillary erosion, and follow-up of less than a year were excluded. The chi-square or Fisher’s exact test was used for descriptive analysis. Kaplan–Meier estimate and log-rank test were performed for survival analysis. Multivariate analysis was done using Cox regression analysis after making adjustments for other prognostic factors. p-Value <0.05 was considered as significant. Based upon the survival analysis with different patterns of bone invasion, a new staging system was proposed “MMC: Marrow and mandibular canal staging system”. “Akaike information criterion” (AIC) was used to study the relative fitted model of the various staging (TNM staging—AJCC8) with respect to survival parameters. RESULTS: A total of 1,200 patients were screened; 303 patients were included in the study. On radiology review, mandibular bone was involved in 62% of patients. The pattern of bone involvement was as follows: deep cortical bone erosion (DCBE) in 23%, marrow in 34%, and marrow with the mandibular canal in 43% of patients. Patients with DCBE and no bone involvement (including superficial cortical) had similar survival [disease-free survival (DFS) and locoregional recurrence-free survival (LRRFS)], and this was significantly better than those with marrow with or without mandibular canal involvement (for both DFS and LRRFS). Patients with DCBE were staged using the MMC, and when compared with the AJCC8, the MMC system was better for the prediction of survival outcomes, as AIC values were lower compared with those of the AJCC8. There was a significant association (p = 0.013) between the type of bone involvement and the pattern of recurrence. CONCLUSIONS: For GBC-SCC, only marrow with or without mandibular canal involvement is associated with poorer survival outcomes. As compared with the AJCC8, the proposed Mahajan et al. MMC staging system downstages DCBE correlates better with survival outcomes

Role of CT imaging in addressing resectability issues in differentiated thyroid cancer: imaging-based Mahajan grading system for TI and ETE

Background and objectiveExtrathyroidal extension (ETE) is the term used to describe the growth of the primary thyroid tumor beyond the thyroid capsule. ETE is a critical prognostic marker for thyroid tumors, necessitating accurate preoperative assessment. This study aims to evaluate the diagnostic performance of computed tomography (CT)-based grading for ETE and tracheal invasion (TI) for preoperative prediction in patients with differentiated papillary thyroid carcinoma (PTC) and compare the diagnostic accuracy with ultrasound (US).Materials and methodsThis retrospective study was approved by our institutional review board. Preoperative US and CT were performed for 83 patients who underwent surgery for PTC between 1 January 2010 and 31 December 2020. The US and CT features of ETE and TI of each case were retrospectively and independently investigated by two radiologists. The diagnostic performances of US and CT, including their specificity, sensitivity, positive predictive value (PPV), and negative predictive value (NPV) for ETE, and their accuracy in predicting ETE and TI were analyzed. As per the grading for ETE on USG and CT, lesions were graded into three grades and Mahajan grading was also devised on CT to predict the TI and graded into four grades.ResultsThe accuracy and specificity of CT are relatively good for identifying tumor infiltration into the adjacent structures and range from 82% to 87% and 95% to 98%, respectively. It, however, has a low sensitivity, between 14.3% and 77.78%, when compared to US, which suggests that in case of any doubt regarding CT evidence of tumor infiltration into surrounding structures, additional clinical examination must be performed. CT showed better sensitivity (78%) and specificity (75%) in detecting TI compared to previous studies. The diagnostic accuracy of CT Mahajan grading was 91.5% with p &lt;0.005 in the prediction of TI.ConclusionPreoperative US should be regarded as a first-line imaging modality for predicting minimal ETE, and CT should be additionally performed for the evaluation of maximal ETE. The specificity and PPV of CT are higher than those of US in detecting overall ETE and TI of PTC. The US- and CT-based grading systems have the potential to optimize preoperative surgical planning

Role of imaging in the management of thyroglossal duct cyst carcinomas (TGC-TIRADS): a single centre retrospective study over 16 years

IntroductionThyroglossal duct cyst (TGDC) is the most frequently encountered developmental anomaly in thyroid genesis with a reported incidence of 7% in the adult population. The cyst is known to develop anywhere along the pathway of thyroid descent but is more frequently seen in the infrahyoid neck in the midline. The incidence of malignancy in a TGDC is approximately 1%; a majority of these are papillary carcinomas. This study was conducted at a single tertiary care centre which spanned over a decade which adds practice changing evidence-based knowledge to existing literature on this rare entity. A comprehensive study which conclusively establishes the imaging features predictive of malignancy in TGDC carcinomas (TGDCa), the protocol for optimal management, clinical outcome and long-term survival of these patients is not available. Although TGDC carcinoma is thought to have an excellent prognosis, there is not enough data available on the long-term survival of these patients. The aim of this study was to identify whether neck ultrasound (US) can serve as an accurate imaging tool for the preoperative diagnosis of TGDC carcinomas.MethodsWe accessed the electronic medical records of 86 patients with TGDC between January 2005 to December 2021. Of these, 22 patients were detected with TGDC papillary carcinoma on histopathologic examination. Relevant imaging, treatment and follow up information for all cases of TGDC carcinoma were retrospectively reviewed. We compared US characteristics predictive of malignancy across outcomes groups; malignant vs benign using the Chi-square test. Based on the results, a TGC-TIRADS classification was proposed with calculation of the percentage likelihood of malignancy for each category.ResultsCompared to benign TGDCs, malignant TGDCs were more likely to present with following US characteristics: irregular or lobulated margins (90.40 vs. 38.10%), solid-cystic composition (61.90 vs. 17.07%), internal vascularity (47.62 vs. 4.88 %), internal calcification (76.19 vs. 7.32 %) (each p value &lt; 0.005). Calcifications and internal vascularity were the most specific while irregular/lobulated margins were the most sensitive feature for malignancy. AUC under the ROC curve was 0.88. Allpatients were operated and were disease free at the end of 5 years or till the recent follow up.DiscussionUS is the imaging modality of choice for pre-operative diagnosis of TGDC carcinoma. Thepre-operative diagnosis and risk stratification of thyroglossal lesions will be aided by the application of the proposed TGC-TIRADS classification, for which the percentage likelihood of malignancy correlated well with the results in our study. Sistrunk procedure is adequate for isolated TGDC carcinoma; suspicious neck nodes on imaging also necessitates selective nodal dissection. Papillary carcinomas have an excellent prognosis with low incidence of disease recurrence