Improving sepsis classification performance with artificial intelligence algorithms: A comprehensive overview of healthcare applications.

PURPOSE: This study investigates the potential of machine learning (ML) algorithms in improving sepsis diagnosis and prediction, focusing on their relevance in healthcare decision-making. The primary objective is to contribute to healthcare decision-making by evaluating the performance of various supervised and unsupervised models. MATERIALS AND METHODS: Through an extensive literature review, optimal ML models used in sepsis research were identified. Diverse datasets from relevant sources were employed, and rigorous evaluation metrics, including accuracy, specificity, and sensitivity, were applied. Innovative techniques were introduced, such as a Stacked Blended Ensemble Model and Skopt Optimization with Blended Ensemble, incorporating Bayesian optimization for hyperparameter tuning. RESULTS: ML algorithms demonstrate efficacy in sepsis diagnosis, presenting an improved balance between specificity and sensitivity, critical for effective clinical decision-making. Classifier ensemble models show enhanced accuracy and efficiency, with novel optimization techniques contributing to improved adaptability. CONCLUSION: The study emphasizes the potential benefits of ML algorithms in sepsis management, advocating for ongoing research to optimize performance and ensure ethical utilization in healthcare decision-making. Ethical considerations, interpretability, and transparency are crucial factors in implementing these algorithms in clinical practice.

Clinical profile of 1208 newly diagnosed colorectal cancer patients in Tamil Nadu-A multi-centric survey.

BACKGROUND: An increasing incidence of colorectal cancer (CRC) is being reported in developing countries, including India. Most Indian studies on CRC are retrospective and single-centered. The present study is an attempt to understand the current clinical profile and stage of newly diagnosed CRCs across multiple centers in Tamil Nadu, India. METHODS: A multi-centric observational survey was conducted between September 1, 2021, and August 31, 2022, under the aegis of the Indian Society of Gastroenterology - Tamil Nadu chapter. Patients 18 years of age and older with a recent diagnosis of CRC fulfilling the inclusion criteria were prospectively recruited at the participating centers. Their demographic, clinical, biochemical, endoscopic, histopathologic, radiologic and risk factor details were systematically collected and analyzed. RESULTS: Across 23 centers in Tamil Nadu, 1208 patients were recruited. The male:female ratio was 1.49:1, while mean (SD) age was 57.7 (13.5) years. A majority (81.9%) were Tamils and 78.5% belonged to lower socioeconomic classes. The predominant symptoms were hematochezia (30.2%) and a change in bowel habits (27.5%). The most common locations were the rectum (34.3%) and rectosigmoid (15.1%). Synchronous CRCs were seen in 3.3% and synchronous colorectal polyps in 12.8%. Predisposing factors for CRC were seen in 2%. A past history of any cancer among CRC patients was obtained in 3.1% and a family history of any cancer was found in 7.6%. Patients who were either overweight or obese constituted 46.4% of the study population. At presentation, the predominant stages were stage III (44.7%) and stage IV (20.8%). CONCLUSIONS: A majority of patients with newly diagnosed CRC in Tamil Nadu belonged to the lower socioeconomic classes. About 60% had CRCs located within the reach of the flexible sigmoidoscope. Two-thirds of the patients exceeded stage II disease at presentation. TRIAL REGISTRATION: Not applicable.

Occupational Injuries and Health Status Among Rural Tribal Non-Traditional Fishing Communities in the Coastal Region of Tamil Nadu, India.

OBJECTIVES: This study evaluated the occupational injuries and health hazards associated with fishing as an occupation among non-traditional rural tribal fishing communities in the coastal region of Tamil Nadu, India. METHODS: This cross-sectional study included a total of 170 individuals belonging to a fishing community, comprising both male (n = 82) and female (n = 88) participants. The demographic details including occupational history, lifestyle characteristics, socio-economic status, personal habits, and health status were assessed through the questionnaire survey. RESULTS: The fishing community has a low socioeconomic status and poor literacy, lifestyle, and personal habits. The mean age of the participants was 38.8 yrs (male 34.8; female 39.9 yrs). Only 10% reported usage of personal protective equipment (PPE), and the work duration varied from 8 to 24 hrs in a day. While male subjects reported smoking habits (12%) and alcohol consumption (23%), none of the females reported alcohol consumption and smoking habits. The major occupational injuries that occurred were due to catfish (72%) and oysters (48%). A large number of female subjects reported musculoskeletal pains. The body mass index of about 28% of fishermen was above the normal range. Abnormal blood sugar, blood pressure, and respiratory and neurological symptoms were the other major health complaints. The major environmental hazards reported were salinity, solar radiation, tides, and high wind. CONCLUSION: Injuries from handling fish and oysters were observed to be the major occupational burden. Additonally, a high prevalence of musculoskeletal pain and chronic health illness was commonly observed among the fishers. Adequate training and awareness programs are required for effective management of occupational health hazards and health promotion.

Nintedanib-induced osteomyelitis of the jaw against the background of COVID-19 infection.

PURPOSE: Various medications are administered to treat Coronavirus Disease 2019 (COVID-19) infection and prevent its complications. Some medicines have complications and long-term effects, which may mimic other conditions, making precise diagnosis difficult. This report aims to bring to light one such complication, medication-related osteonecrosis of the jaw (MRONJ), secondary to a commonly prescribed medication for preventing lung fibrosis post-COVID-19 infection. METHOD: A 33-year-old male reported to our department with the typical clinical and radiological features of Mucormycosis of the upper jaw post-COVID-19 infection. However, on detailed evaluation of his history (controlled diabetic and short duration of steroid therapy) and review of the mycology staining, bacteriology, culture, and histopathological reports, we came to a negative diagnosis for Mucormycosis. The patient was, however, on treatment for the prevention of lung fibrosis with Nintedanib (tyrosine kinase inhibitor) 150 mg twice a day for one month. RESULT: In the absence of predisposing factors and negative laboratory findings for mucormycosis, we arrived at a diagnosis of MRONJ, attributable to Nintedanib therapy given to prevent lung fibrosis post-COVID-19 infection. CONCLUSION: The use of Nintedanib has recently increased due to the high incidence of lung fibrosis post-COVID-19 infection. However, Nintedanib should be considered a causative agent for osteonecrosis of the jaw in the absence of other obvious predisposing factors. Therefore, Nintedanib must be administered after a thorough consideration of risk factors.

Trajectory-Extending Kinetic Monte Carlo Simulations to Evaluate Pure and Gas Mixture Diffusivities through a Dense Polymeric Membrane.

With renewed interest in CO2 separations, carbon molecular sieving (CMS) membrane performance evaluation requires diffusion coefficients as inputs to have a reliable estimate of the permeability. An optimal material is desired to have both high selectivity and permeability. Gases diffusing through dense CMS and polymeric membranes experience extended subdiffusive regimes, which hinders reliable extraction of diffusion coefficients from mean squared displacement data. We improve the sampling of the diffusive landscape by implementing the trajectory-extending kinetic Monte Carlo (TEKMC) technique to efficiently extend molecular dynamics (MD) trajectories from ns to µs time scales. The obtained self-diffusion coefficient of pure CO2 in CMS membranes derived from a 6FDA/BPDA-DAM precursor polymer melt is found to linearly increase from 0.8-1.3 × 10-6 cm2 s-1 in the pressure range of 1-20 bar, which supports previous experimental findings. We also extended the TEKMC algorithm to evaluate the mixture diffusivities in binary mixtures to determine the permselectivity of CO2 in CH4 and N2 mixtures. The mixture diffusion coefficient of CO2 ranges from 1.3-7 × 10-6 cm2 s-1 in the binary mixture CO2/CH4, which is significantly higher than the pure gas diffusion coefficient. Robeson plot comparisons show that the permselectivity obtained from pure gas diffusion data is significantly lower than that predicted using mixture diffusivity data. Specifically, in the case of the CO2/N2 mixture, we find that using mixture diffusivities led to permselectivities lying above the Robeson limit highlighting the importance of using mixture diffusivity data for an accurate evaluation of the membrane performance. Combined with gas solubilities obtained from grand canonical Monte Carlo (GCMC) simulations, our work shows that simulations with the TEKMC method can be used to reliably evaluate the performance of materials for gas separations.

Carcinoma buccal mucosa treated with definitive hypofractionated accelerated radiotherapy: a retrospective analysis of treatment outcomes.

Introduction: Oral cancer is a major public health concern in India. Both conventional and altered fractionation radiotherapy schedules have been used in curative treatment of oral cancer. This study aimed to retrospectively evaluate the clinical profile and treatment outcomes of patients with carcinoma buccal mucosa who underwent treatment with definitive hypofractionated accelerated radiotherapy. Methods: A total of 517 patients treated from January 2011 to December 2016 were eligible for the analysis. All patients were treated with definitive hypofractionated accelerated radiotherapy schedule of 5,250 cGy in 15 fractions over 3 weeks. Survival estimates were generated using the Kaplan-Meier method. Results: At a median follow-up of 77.4 months, 473 (91.5%) patients attained complete remission with radiation therapy. The 5-year disease-free survival (DFS) and overall survival (OS) rates were 69% and 80.5%, respectively. The 5-year OS for stage I, II, III and IVa tumours was 80.3%, 84.4%, 81.4% and 73.7%, respectively, and the DFS was 75.7%, 73.2%, 69.6% and 60.2%, respectively. Age >50 years was found to be a significant factor affecting DFS (P = 0.026) and OS (P = 0.048) in multivariate analysis. Fifty-three (10.3%) patients developed osteoradionecrosis of the mandible. Conclusion: Excellent outcome could be achieved in less-aggressive, low-volume carcinoma of the buccal mucosa with radical accelerated hypofractionated radiotherapy. A radiotherapy schedule over a 3-week period is useful in high-volume centres.

In search of universalities in the dissociative photoionization of PANHs via isomerizations.

In search of the cause behind the similarities often seen in the fragmentation of PANHs, vacuum ultraviolet (VUV) photodissociation of two pairs of isomers quinoline-isoquinoline and 2-naphthylamine-3-methyl-quinoline are studied using the velocity map imaging technique. The internal energy dependence of all primary fragmentation channels is obtained for all four target molecules. The decay dynamics of the four molecules is studied by comparing their various experimental signatures. The dominant channel for the first pair of isomers is found to be hydrogen cyanide (HCN) neutral loss, while the second pair of isomers lose HCNH neutral as its dominant channel. Despite this difference in their primary decay products and the differences in the structures of the four targets, various similarities in their experimental signatures are found, which could be explained by isomerization mechanisms to common structures. The fundamental role of these isomerization in controlling different dissociative channels is explored via a detailed analysis of the experimental photoelectron-photoion coincidences and the investigation of the theoretical potential energy surface. These results add to the notion of a universal PANH fragmentation mechanism and suggests the seven member isomerization as a key candidate for this universal mechanism. The balance between isomerization, dissociation, and other key mechanistic processes in the reaction pathways, such as hydrogen migrations, is also highlighted for the four molecules.

Rainfall-Runoff modelling using SWAT and eight artificial intelligence models in the Murredu Watershed, India.

The growing concerns surrounding water supply, driven by factors such as population growth and industrialization, have highlighted the need for accurate estimation of streamflow at the river basin level. To achieve this, rainfall-runoff models are widely employed as valuable tools in watershed management. For this specific study, two modelling approaches were employed: the Soil and Water Assessment Tool (SWAT) model and a set of eight artificial intelligence (AI) models. The AI models consisted of seven data-driven approaches, namely k-nearest neighbour regression, support vector regression, linear regression, artificial neural networks, random forest regression, XGBoost, and Histogram-based Gradient Boost regression. Additionally, a deep learning model known as Long Short-Term Memory (LSTM) was also utilized. The study focused on monthly streamflow modelling in the Murredu River basin, with a calibration period from 1999 to 2003 and a validation period from 2004 to 2005, spanning a total of 7 years from 1999 to 2005. The results indicated that all nine models were generally suitable for simulating the rainfall-runoff process, with the LSTM model demonstrating exceptional performance in both the calibration (R2 is 0.97 and NSE is 0.96) and validation (R2 is 0.97 and NSE is 0.92) periods. Its high coefficient of determination (R2) and Nash-Sutcliffe efficiency (NSE) values indicated its superior ability to accurately model the rainfall-runoff relationship. While the other models also produced satisfactory results, the findings suggest that selecting the most efficient model, such as the LSTM model, could significantly contribute to the effective management and planning of sustainable water resources in the Murredu watershed.

A Review on Imaging Techniques and Artificial Intelligence Models for Osteoporosis Prediction.

Osteoporosis causes harmful influences on both men and women of all races. Bone mass, also referred to as "bone density," is frequently used to assess the health of bone. Humans frequently experience bone fractures as a result of trauma, accidents, metabolic bone diseases, and disorders of bone strength, which are typically led by changes in mineral composition and result in conditions like osteoporosis, osteoarthritis, osteopenia, etc. Artificial intelligence holds a lot of promise for the healthcare system. Data collection and preprocessing seem to be more essential for analysis, so bone images from different modalities, such as X-ray, Computed Tomography (CT), and Magnetic Resonance Imaging (MRI), are taken into consideration that help to recognize, classify, and evaluate the patterns in clinical images. This research presents a comprehensive overview of the performance of various image processing techniques and deep learning approaches used to predict osteoporosis through image segmentation, classification, and fault detection. This survey outlined the proposed domain-based deep learning model for image classification in addition to the initial findings. The outcome identifies the flaws in the existing literature's methodology and lays the way for future work in the deep learning-based image analysis model.

Use of Anti-epileptic Drugs for Post Traumatic Seizure: A Global Survey.

Background: Post traumatic seizures (PTS) and post traumatic epilepsy (PTE) are potential consequences of traumatic brain injury (TBI). There is no consensus regarding its management among treating doctors. Purpose: We have undertaken a global survey to assess the variability of management practices of PTS and PTE and highlight the pressing need to formulate uniform practice guidelines. Methods: A questionnaire consisting of sixteen questions were developed with the help of Google survey and sent through e-mail, or social media platforms like WhatsApp, Facebook messenger or Telegram, to practicing Neurologists and Neurosurgeons round the world. Results: There were a total of 220 responses. Majority of our responders (n = 202; 91.8%) would start an anti-epileptic (AED) prophylaxis to prevent PTS; 18 people (8.18%) told that they would not start AED prophylaxis for TBI. Phenytoin (n = 98; 48.5%) followed by Levetiracetam (n = 78; 38.6%) was the preferred drug, although the latter was significantly preferred by high and upper middle-income countries (p<.001). Majority (n = 99; 49%) would not use it beyond two weeks. Most clinicians would manage PTE with a single drug (n = 160; 72.7%) either Phenytoin (n = 69; 31.3%) or levetiracetam (n = 67; 30.4%). Most of them (n = 174; 86%) would treat for less than one year. Conclusions: Practices in the management of PTS and PTE vary widely among clinicians. Our study point towards the need for the development of a more robust and comprehensive practice guidelines for the management of the same.

Dosimetric Study to Estimate Deviations in Delivered Radiation Dose due to Occluded Air Spaces in Vaginal Vault Brachytherapy Applications.

BACKGROUND: To develop a dosimetric tool to estimate the dose delivered in the presence of air pockets with EBT3 film while simulating the conditions of vaginal vault brachytherapy (VVBT) with 3.0 diameter cylindrical applicator at a prescription dose distance of 5mm from the surface of it. MATERIALS AND METHOD: Six acrylic plates (10 cm x 10 cm, 0.5 cm thick) with four different types of slots were designed and produced locally. They can hold a cylindrical vaginal brachytherapy applicator in the centre, air equivalent material from the applicator's surface [(sizes 4.5 mm (A), 3.0 mm (B), and 2.0 mm (C)], EBT3 film at the prescribed dose distance, and holder rods. Plates were layered together with acrylic rods and assembled in a holding box in a water phantom. Three treatment plans done in TPS with prescription doses of 2 Gy, 3 Gy, and 4 Gy at 5.0 mm with a treatment length of 6 cm, and were executed in Co-60-based HDR brachytherapy unit (M/s SagiNova, Germany) with & without the placement of air equivalent material, and the dose received at slot locations A, B, & C were noted. RESULTS: The mean percentage deviation of measured dose without and with presence of air pocket at A, B and C was 13.9%, 11.0% and 6.4% respectively for all dose prescriptions. As the air pocket size expanded radially from 2.0 mm to 4.5 mm, the increase in dosage ranged from 6.4% to 13.9% which was due to the fact that the film was held at dosage prescription distance and the lack of attenuation of photons radially through air pocket. CONCLUSIONS: The present study can be carried out with a 3D printed phantom that simulates VVBT application having air pockets of different dimensions at different locations and also can be analyzed with Monte Carlo simulations.

Facial Plates in Phalanx Fracture-Non-Union of Great Toe - A Case Report.

Introduction: Phalanx fractures of the lower limb have high rates of union when manage conservatively. Case Report: A 26-year-old male with fracture of great toe proximal phalanx fracture which was initially managed conservatively with buddy strapping, who missed follow-up and presented late to outpatient department at 6 months with persistence of pain and difficulty in weight bearing. Here, we treated the patient with L-facial plate (2.0 system). Conclusion: Fracture non-union of proximal phalanx can be managed surgically with L- facial plates and screw and bone grafting which will provide full weight bearing and walk normally without any pain and with adequate range of movements.

Thyroid Autoimmunity and Subclinical Hypothyroidism in Prolactinoma: A Case Control Study.

Background: This study was aimed at determining the frequency of thyroid autoimmunity and subclinical hypothyroidism in patients with hyperprolactinemia due to prolactinoma compared to well-matched healthy controls. Methods: This was a cross-sectional study wherein 78 treatment naïve prolactinoma patients and ninety-two healthy control subjects were recruited. Serum prolactin (PRL), thyroid-stimulating hormone (TSH), total thyroxine (T4), circulating anti-thyroid peroxidase (anti-TPO), and anti-thyroglobulin (anti-Tg) antibody levels were measured in all study subjects. Progression of the antibody-positive population to subclinical hypothyroidism was determined. Results: The median PRL level among patients was 166 ng/ml (IQR 85-467) compared to 11.4 ng/ml (IQR 8.5-15.9) in controls (P < 0.001). There was no significant difference in levels of T4 (P = 0.83) and TSH (P = 0.82) between the cases and controls. Overall, 25% of patients had the presence of anti-thyroid antibodies as compared to 20% of controls (P = 0.56). SCH was more common in antibody-positive hyperprolactinemia subjects compared with antibody-positive controls. Conclusion: We did not find an increased prevalence of thyroid autoimmunity among untreated prolactinoma patients compared to healthy controls. At the same time, subclinical hypothyroidism was more common in thyroid antibody-positive patients with hyperprolactinemia than positive controls.

Automated Brain Tumour Detection and Classification using Deep Features and Bayesian Optimised Classifiers.

PURPOSE: Brain tumour detection and classification require trained radiologists for efficient diagnosis. The proposed work aims to build a Computer Aided Diagnosis (CAD) tool to automate brain tumour detection using Machine Learning (ML) and Deep Learning (DL) techniques. MATERIALS AND METHODS: Magnetic Resonance Image (MRI) collected from the publicly available Kaggle dataset is used for brain tumour detection and classification. Deep features extracted from the global pooling layer of Pretrained Resnet18 network are classified using 3 different ML Classifiers, such as Support vector Machine (SVM), K-Nearest Neighbour (KNN), and Decision Tree (DT). The above classifiers are further hyperparameter optimised using Bayesian Algorithm (BA) to enhance the performance. Fusion of features extracted from shallow and deep layers of the pretrained Resnet18 network followed by BA-optimised ML classifiers is further used to enhance the detection and classification performance. The confusion matrix derived from the classifier model is used to evaluate the system's performance. Evaluation metrics, such as accuracy, sensitivity, specificity, precision, F1 score, Balance Classification Rate (BCR), Mathews Correlation Coefficient (MCC) and Kappa Coefficient (Kp), are calculated. RESULTS: Maximum accuracy, sensitivity, specificity, precision, F1 score, BCR, MCC, and Kp of 99.11 %, 98.99 %, 99.22 %, 99.09 %, 99.09 %, 99.10 %, 98.21 %, 98.21 %, respectively, were obtained for detection using fusion of shallow and deep features of Resnet18 pretrained network classified by BA optimized SVM classifier. Feature fusion performs better for classification task with accuracy, sensitivity, specificity, precision, F1 score, BCR, MCC and Kp of 97.31 %, 97.30 %, 98.65 %, 97.37 %, 97.34 %, 97.97%, 95.99 %, 93.95 %, respectively. CONCLUSION: The proposed brain tumour detection and classification framework using deep feature extraction from Resnet 18 pretrained network in conjunction with feature fusion and optimised ML classifiers can improve the system performance. Henceforth, the proposed work can be used as an assistive tool to aid the radiologist in automated brain tumour analysis and treatment.

Incidence of Carpal Tunnel Syndrome in Distal Radius Fractures Treated by Various Modalities in a Tertiary Care Center: A Single Center Study.

Background Distal end radius fractures (DRF), which account for 17.5% of all fractures, are the most frequent fracture seen in emergency rooms. In patients with DRFs, delayed carpal tunnel syndrome (CTS) occurs in about 20% of cases. When patients are treated with DRFs using different modalities, CTS results in poor functional outcomes. Our study aims to identify the prevalence of CTS in DRF patients receiving treatment with various modalities. Materials and methods Two hundred twenty patients with a history of DRFs who were treated by a variety of modalities at R.L. Jalappa Hospital and Research Center between January 2013 and January 2018 are included in this retrospective analysis. The medical records from the department of the hospital's paperwork were used to gather the patient's information and radiographs. The information was gathered, tabulated, and examined. Results In our study, the incidence of CTS in DRF was calculated using a sample size of 220 and found to be 32.73%. The incidence of CTS was shown to be higher in groups with more comminution than less comminution when treatment modalities were analyzed. These groups included closed reduction and internal fixation (CRIF)/open reduction and internal fixation (ORIF) with K wire, external fixation, conservative with the cast, ORIF with variable angle volar locking plate (VAVLP), and ORIF with volar T locking plates (VTLP). Conclusions After DRFs, carpal tunnel syndrome is the most significant consequence limiting functional results, hence preventing it requires considerably more attention and care.

Comparison of Various Modalities in the Treatment of Early Knee Osteoarthritis: An Unsolved Controversy.

Introduction Osteoarthritis (OA) of the knee is a common degenerative disease, relatively more prevalent among middle-aged people. It is one of the major reasons for walking-related disability. Recently, early knee OA has been seen as an imperative concern in many younger patients who struggle with the disabling effect of pain and management is extremely speckled. Degenerative changes such as loss of cartilage, subchondral bone changes, synovial inflammation, and meniscal degeneration are seen in OA. Symptoms are relieved by therapeutic strategies such as lifestyle behaviour changes, exercise, and oral and injectable medications. Intra-articular delivery of drugs acts as a direct effect on the target tissue, which grossly reduces side effects and is commonly preferred nowadays. The current study is a comparative assessment of the functional outcomes associated with various treatment modalities in osteoarthritis of the knee, i.e., arthroscopic debridement, arthroscopic debridement with microfracture, platelet-rich plasma (PRP) injection, and hyaluronic acid. Methods A retrospective observational hospital-based study was conducted among 139 cases of osteoarthritis. Patients aged between 40-60 years with diagnosed Kellgren- Lawrence grade 1 and 2 OA knee, who underwent arthroscopic debridement, arthroscopic debridement with microfracture, PRP injection, or hyaluronic acid in our institute were included. Results The mean age was 52.83 + 6.8 years. The mean BMI was 27.45 + 1.6 kg/m2. At the time of diagnosis of OA, the mean visual analogue scale for pain (VAS) and Western Ontario and McMaster Universities Arthritis Index (WOMAC) scores were 7.26 +0.7 and 55.30 + 2.21 respectively. Out of the total, 88 (63.3%) were females and 51 (36.7%) were males. Right-sided OA knee was seen in the majority of study participants. Of the total, 93 (66.9%) patients had grade 2 and only 46 (33.1%) had grade 1 OA. A statistically significant difference was found between the mean VAS and WOMAC score at the time of diagnosis, three weeks, three months, as well as at six months of therapy. In the hyaluronic acid treatment, no significant difference was found in mean VAS and WOMAC scores. Conclusion Various treatments are available for early-diagnosed OA. According to the findings of this study, overall improvement was seen in VAS and WOMAC scores at the follow-up after six months of specific treatment. In a period over six months, arthroscopic debridement with micro-fracture was more effective and safe when compared with other modalities of treatment for early OA knee. Also, injection of PRP was superior to other methods for VAS pain reduction, and WOMAC-pain and WOMAC-stiffness scores improved at one month.

A Comprehensive Review of Self-Healing Polymer, Metal, and Ceramic Matrix Composites and Their Modeling Aspects for Aerospace Applications.

Composites can be divided into three groups based on their matrix materials, namely polymer, metal and ceramic. Composite materials fail due to micro cracks. Repairing is complex and almost impossible if cracks appear on the surface and interior, which minimizes reliability and material life. In order to save the material from failure and prolong its lifetime without compromising mechanical properties, self-healing is one of the emerging and best techniques. The studies to address the advantages and challenges of self-healing properties of different matrix materials are very limited; however, this review addresses all three different groups of composites. Self-healing composites are fabricated to heal cracks, prevent any obstructed failure, and improve the lifetime of structures. They can self-diagnose their structure after being affected by external forces and repair damages and cracks to a certain degree. This review aims to provide information on the recent developments and prospects of self-healing composites and their applications in various fields such as aerospace, automobiles etc. Fabrication and characterization techniques as well as intrinsic and extrinsic self-healing techniques are discussed based on the latest achievements, including microcapsule embedment, fibers embedment, and vascular networks self-healing.

Solitary fibrous tumor of the masticator space - Report of a rare case.

The solitary fibrous tumor (SFT) is a potentially malignant spindle cell neoplasm of the mesenchymal origin that was originally described as a thoracic lesion originating from the pleural tissue. Recently, numerous extrapleural sites of origin have been described, also affecting the head and neck region. SFTs are benign in most cases, but 10%-15% of extrapleural SFTs show malignant behavior in the form of recurrent or metastatic disease. We present the case of a 25-year-old female who presented with an asymptomatic left-sided facial swelling of over three years. She had a diffuse swelling in the left preauricular region, extending to the temporal region deep to the zygomatic arch. On magnetic resonance imaging, the vascular lobulated mass occupied the masticator space, infratemporal fossa, and parapharyngeal space, eroding the mandible. An ultrasound-guided fine-needle aspiration cytology was suggestive of SFT, positive for signal transducer and activator of transcription 6 and negative for TLE1. After preoperative embolization, the tumor was excised through a midline lip split approach with posterior segmental mandibulectomy and reconstruction with a titanium plate. Histopathological report was consistent with SFT. Due to high-risk features, she was advised adjuvant radiation therapy. SFTs of the head and neck are exceedingly rare and those with aggressive behavior even more so. To our knowledge, this is the only case of SFT arising in the masticator space. Diagnosis is often difficult and not definitive without immunohistochemistry. In most cases, complete surgical excision is the only treatment necessary. Regardless, all patients require close clinical follow-up for several years.

Isolated Luxatio Erecta Femoris - Case Series and Review of Literature.

Introduction: Luxatio erecta femoris or inferior hip dislocation is the rarest type of hip dislocation. It can be caused by a severe trauma to the hip and the mechanism of injury is often very complex. Very few cases have been reported in the literature, and often associated with other musculoskeletal injuries. Overall about 30 cases were reported till recently. Case Presentations: We came across five cases of Luxatio erecta femoris from our six year study period from 2015 to 2020. All five cases were males (mean age-28.4 years, age range 20-40 years). All of them were isolated injuries (pure dislocation without any associated femur, acetabular, or pelvic fractures). We will present the details of these cases along with review of literature, trying to unravel the mechanism of such an injuries. Conclusion: With the increase in high energy road traffic accidents, the incidence of luxatio erecta femoris in adults has increased. We could identify all those injuries and treated it with excellent clinical outcome. This type of rare dislocations if properly identified, we can manage it without much delay and very minimal complications.

Photodissociation of quinoline cation: Mapping the potential energy surface.

A detailed exploration of the potential energy surface of quinoline cation (C9H7N·+) is carried out to extend the present understanding of its fragmentation mechanisms. Density functional theory calculations have been performed to explore new fragmentation schemes, giving special attention to previously unexplored pathways, such as isomerization and elimination of HNC. The isomerization mechanisms producing five- to seven-membered ring intermediates are described and are found to be a dominant channel both energetically and kinetically. Energetically competing pathways are established for the astrochemically important HNC-loss channel, which has hitherto never been considered in the context of the loss of a 27 amu fragment from the parent ions. Elimination of acetylene was also studied in great detail. Overall, the computational results are found to complement the experimental observations from the concurrently conducted PEPICO investigation. These could potentially open the doors for rich and interesting vacuum ultraviolet radiation-driven chemistry on planetary atmospheres, meteorites, and comets.