A Novel Framework for Melanoma Lesion Segmentation Using Multiparallel Depthwise Separable and Dilated Convolutions with Swish Activations.

Skin cancer remains one of the deadliest kinds of cancer, with a survival rate of about 18-20%. Early diagnosis and segmentation of the most lethal kind of cancer, melanoma, is a challenging and critical task. To diagnose medicinal conditions of melanoma lesions, different researchers proposed automatic and traditional approaches to accurately segment the lesions. However, visual similarity among lesions and intraclass differences are very high, which leads to low-performance accuracy. Furthermore, traditional segmentation algorithms often require human inputs and cannot be utilized in automated systems. To address all of these issues, we provide an improved segmentation model based on depthwise separable convolutions that act on each spatial dimension of the image to segment the lesions. The fundamental idea behind these convolutions is to divide the feature learning steps into two simpler parts that are spatial learning of features and a step for channel combination. Besides this, we employ parallel multidilated filters to encode multiple parallel features and broaden the view of filters with dilations. Moreover, for performance evaluation, the proposed approach is evaluated on three different datasets including DermIS, DermQuest, and ISIC2016. The finding indicates that the suggested segmentation model has achieved the Dice score of 97% for DermIS and DermQuest and 94.7% for the ISBI2016 dataset, respectively.

Determinants of COVID-19 Vaccine Acceptance among Dental Professionals: A Multi-Country Survey.

PURPOSE: This study sought to investigate the acceptance rate and associated factors of COVID-19 vaccines among dentists and dental students in seven countries. MATERIAL AND METHODS: A structured questionnaire prepared and guided by the report of the SAGE Working Group on Vaccine Hesitancy was distributed among groups of dentists and dental students in seven countries across four continents. RESULTS: A total of 1527 subjects (850 dentists and 677 dental students) participated in this survey. Although 72.5% of the respondents reported their intention to accept COVID-19 vaccines (dentists: 74.4%, dental students: 70.2%), there was a significant difference in agreement between dentists/dental students across countries; generally, respondents in upper-middle-, and high-income countries (UM-HICs) showed significantly higher acceptance rates compared to those in low- and lower-middle income countries (L-LMICs). Potential predictors of higher vaccine acceptance included being a dentist, being free of comorbidity, being well-informed about COVID-19 vaccines, having better knowledge about COVID-19 complications, having anxiety about COVID-19 infection, having no concerns about the side effects of the produced vaccines and being a resident of an UM-HIC. CONCLUSION: The results of our survey indicate a relatively good acceptance rate of COVID-19 among the surveyed dentists and dental students. However, dentists and dental students in L-LMICs showed significantly lower vaccine acceptance rates and trust in COVID-19 vaccines compared to their counterparts in UM-HICs. Our results provide important information to policymakers, highlighting the need for implementation of country-specific vaccine promotion strategies, with special focus on L-LMICs.

Association of dietary calcium, magnesium, and vitamin D with type 2 diabetes among US adults: National health and nutrition examination survey 2007-2014-A cross-sectional study.

Higher dietary intake of calcium (Ca), magnesium (Mg), and vitamin D has been associated with reduced risk of type 2 diabetes (T2DM), and a higher intracellular ratio of Ca to Mg leads to insulin resistance. Previous epidemiological studies did not examine the combined effects of dietary Ca, Mg, and vitamin D as well as ratio of Ca to Mg with T2DM. Therefore, we assessed the relationship between dietary intakes of Mg, Ca, and vitamin D (using 24-hr recalls) individually and in composite and T2DM in the National Health and Nutrition Examination Survey 2007-2014, which involved 20,480 adults (9,977 men and 10,503 women) with comprehensive information on related nutrients, and anthropometric, demographic, and biomarker variables using multivariable logistic regression. The results indicated that dietary calcium at Q3 (812 mg/day) was significantly linked with T2DM in women (OR: 1.30; 95% CI: 1.02, 1.65). Dietary vitamin D at Q3 (5.25 µg/day) significantly reduced the odds of T2DM by 21% in men (OR: 0.79; 95% CI: 0.64, 0.98). This is an interesting study that has important implications for dietary recommendations. It is concluded that US adults having dietary Ca below the RDA were associated with increased risk of T2DM in all population and women, while higher ratio of Ca to Mg was associated with increased risk of T2DM in all population and increased vitamin D intake is related to decreased risk of T2DM in men. Moreover, further research is needed to make more definitive nutritional recommendations.

A Global Survey of COVID-19 Vaccine Acceptance Among Healthcare Workers.

Objectives: Even though several effective vaccines are available to combat the COVID-19 pandemic, wide disparities in vaccine distribution, and vaccine acceptance rates between high- and low-income countries appear to be major threats toward achieving population immunity. Our global descriptive study aims to inform policymakers on factors affecting COVID-19 vaccine acceptance among healthcare workers (HCWs) in 12 countries, based on income index. We also looked for possible predictors of vaccine acceptance among the study sample. Methods: A structured questionnaire prepared after consultation with experts in the field and guided by the "Report of the SAGE working group on vaccine hesitancy" was administered among 2,953 HCWs. Upon obtaining informed consent, apart from demographic information, we collected information on trust in vaccines and health authorities, and agreement to accept a COVID-19 vaccine. Results: Although 69% of the participants agreed to accept a vaccine, there was high heterogeneity in agreement between HCWs in low and lower-middle income countries (L-LMICs) and upper-middle- and high-income countries (UM-HICs), with acceptance rates of 62 and 75%, respectively. Potential predictors of vaccine acceptance included being male, 50 years of age or older, resident of an UM-HIC, updating self about COVID-19 vaccines, greater disease severity perception, greater anxiety of contracting COVID-19 and concern about side effects of vaccines. Conclusions: COVID-19 vaccine acceptance among HCWs in L-LMICs was considerably low as compared to those from UM-HICs. The lowest vaccine acceptance rates were among HCWs from the African continent. This underlines the need for the implementation of country-specific vaccine promotion strategies, with special focus on increasing vaccine supply in L-LMICs.

Root canal morphology of mandibular canines in the Syrian population: A CBCT Assessment.

INTRODUCTION: The recent study aimed to assess the root canal morphology of mandibular canines in the Syrian population depending on the cone beam computed tomography (CBCT) images. MATERIALS AND METHODS: A total of 418 fully developed mandibular canines in Syrian individuals aged between 16 and 60 years were included. The presence of at least one mandibular right or left canine with fully developed roots was recorded in each image. The root canal configurations were classified according to the method of Vertucci. The mandibular canines were examined in sagittal, coronal, and axial dimensions. The CBCT images were evaluated by three endodontists with at least 9 years of clinical experience in endodontics. Data were analyzed with descriptive analysis and Chi-square tests using the Statistical Package for the Social Sciences (SPSS) software version 25 (SPSS Inc, Chicago, IL, USA). RESULTS: Out of the 418 mandibular canines, 409 (97.85%) were single-rooted canines while only 9 (2.15%) were double-rooted canines. The most common type of Vertucci in single-rooted canines was Type I (1-1) in the percentage of 95.87% and the least type was Type V (1-2) in the percentage of (0.24%). The Chi-square tests showed no significant association between gender and number of roots (P = 0.64) and gender and root canal configuration in single-rooted canine (P = 0.194). CONCLUSION: Single-rooted with Type I canal configuration was the most common anatomy in mandibular canines in the Syrian population. Incidence of more than one root canal foramen at the end of the single root was detected in one case only.

The knowledge about coronavirus (COVID-19) among populations in two different Arab countries.

COVID-19 is an infectious disease caused by a newly discovered coronavirus. Most patients infected with the COVID-19 virus experience mild to moderate respiratory symptoms and heal without any special treatment. This survey aimed to assess the knowledge of Syrian and Saudi populations about the general information, symptoms, and methods of prevention of coronavirus (COVID-19). MATERIALS AND METHODS: A standardized questionnaire composed of four sections (demography, general information about COVID-19, symptoms of COVID-19 infection, and methods of prevention) including 34 questions divided between the four mentioned sections were sent online to different social media in the Syrian Arab Republic and Kingdom of Saudi Arabia as a Google drive form. The collected data were coded, computerized, and analyzed using methods of descriptive statistics by SPSS 25. A Chi-square test was done. RESULTS: The total number of participants was 790; most of them were in the age group of 18-30 years (60.3%) wherein females formed about 59.2% of the whole sample. About 94.6% of the respondents from Syria agreed that several coronaviruses are known to cause respiratory infections while 45.6% of Saudi people knew that diarrhea is one of the symptoms of coronavirus (COVID-19). The good results of this current study were clear in the section of coronavirus (COVID-19) prevention as most of the information was correct in more than 60% of answers. CONCLUSION: The knowledge of Syrian and Saudi populations about the general information, symptoms, and methods of prevention of coronavirus COVID-19 was very good to excellent except in very limited points.

Root canal treatment of mandibular canine with two root canals: A case report series.

Canine is the cornerstone of the mouth due to its position, which reflects its significance of mastication with incisors and premolars. Anomalous root canal morphology can be found in any tooth with different degrees. The unusual configuration of root canal system may lead to a lot of procedural errors during cleaning and shaping, and this, in turn, may increase the probability of root canal treatment failure. In most cases, mandibular canines have one root of a centrally located root canal and 15% of this type of tooth has two root canals.

Evaluation of the Apical Seal of Mineral Trioxide Aggregate in the Absence and Presence of Smear Layer.

AIM: The aim of this study was to in vitro evaluate the apical sealability of mineral trioxide aggregate (MTA) when used as an orthograde root filling material, and to evaluate whether smear layer removal has any influence on the apical seal of this material. MATERIALS AND METHODS: Forty single-rooted human mandibular premolars were selected in this in vitro study. The selected teeth were randomly divided into two equal groups (n = 20) based on the irrigation type. Group 1 was irrigated using distilled water to keep the smear layer intact, and group 2 was irrigated using NaOCl 5.25% and ethylenediaminetetraacetic acid (EDTA) 17% to remove the smear layer. All teeth were instrumented using a step-back technique and obturated using white MTA. Microleakage of 0.2% rhodamine B solution at the tooth-material interface was evaluated to assess the apical seal of MTA. The data were analyzed statistically using Mann-Whitney test U-test (p = 0.05). RESULTS: When the smear layer was present, MTA revealed less leakage compared to the group of MTA without smear layer with statistically significant difference (p <0.05). CONCLUSION: The apical seal produced by MTA when smear layer is left intact was better than the apical seal of MTA when smear layer is removed.It can be stated that MTA is a promising root canal filling material with good sealing ability in the presence of a smear layer. CLINICAL SIGNIFICANCE: Using white MTA material for the obturation of root canals is a useful procedure. It could be done without complexity in irrigation during root canal treatment and cause no discoloration to the teeth.

Dentists' Knowledge, Attitude and Practice of Root Canal Treatment Procedure: Survey-based Research.

AIM: The aim of this survey was to assess the dentists' knowledge, attitude and practice of endodontic treatment procedures and materials in Damascus city (capital of Syria), and the effect of endodontic specialty and years of experience on the survey findings. MATERIALS AND METHODS: Two hundred direct contacts (25 multiple-choice questions containing) questionnaires were distributed to randomly selected dentists practicing in Damascus city in 11 different areas, and a questionnaire contained questions regarding dentists' knowledge, attitude, and practice of root canal treatment procedure. The collected data were entered into a personal computer and analyzed using the statistical package for the social sciences (SPSS), 25 edition. RESULTS: One hundred eighty-eight questionnaires were collected with a 94% response rate. About 71.8% were general dental practitioners (GDPs), 25.5% were not practicing molar endodontics, and only 5.3% were referring difficult cases to endodontists. 32.4% and 21.8% of respondents were practicing vital and necrotic single visit root canal treatment, respectively. Only 6.9% were using rubber dam isolation, and more than half of the respondents used the standardized preparation technique. Non-setting calcium hydroxide was used 100% as an intra-canal medicament during necrotic root canal treatment sessions.96.3% of our respondents prefer delaying final restoration to next visit for symptoms disappearance. CONCLUSION: It was evident that more practicing experience does not improve treatment options selections of endodontic treatment. So the continuous educational programs are a very important way to change the old or wrong concepts in dental offices. CLINICAL SIGNIFICANCE: The sample covered a large number of dentists who are working in Damascus; the most developed place in Syria. It is also considered that for carrying out such kind of surveys as long as the dentists are familiar with this type of studies.

Modalities of using endodontic nickel-titanium rotary instruments and factors influencing their implementation in dental practice.

BACKGROUND: To establish the extent of using nickel titanium rotary instruments (NiTi-RIs), to identify reasons for using / not using NiTi-RIs, to explore usage modalities and to identify factors and measures that can increase implementation of NiTi-RIs in general dental practice. METHODS: Two pilot questionnaires were conducted on academic staff members at College of Dentistry, Taibah University, general dentists (GDs) and endodontists to finalise the questionnaire. A sample size was calculated considering the expected and minimum accepted response rates (60 and 48%, respectively) and a 99.9% Confidence Level. The online-questionnaire was sent to 600 GDs and all endodontists (175) working in Saudi Arabia. A reminder was emailed after 10 weeks to encourage non-respondents to complete the questionnaire. Responses, were collected and converted into numerical data which were analysed using the Chi-square test (p = 0.05). RESULTS: Significantly most respondents (71.9%) used NiTi-RIs (p < 0.001); with more endodontists (96.9%) than GDs (60%). Most users (62.5%) had been using NiTi-RIs for More than 3 years (p < 0001). The trend of using NiTi-RIs increased as participants' experience and the number of root-canal treatments performed per week increased (p = 0.021). While most respondents (45.3%) used NiTi-RIs because of faster root-canal preparation, the majority of non-users (85.3%) didn't do so because of high cost. The highest proportion (43.3%) reported better undergraduate education as the most important factor that can significantly increase NiTi-RIs usage. The majority (91.8%) prepared glide-path before using NiTi-RIs; especially with stainless steel hand-files (63.3%). CONCLUSIONS: NiTi-RIs are relatively well adopted in Saudi dental practice. However, better education, especially during undergraduate training and lower cost can increase their usage. Overall, clinicians showed good awareness of NiTi-RIs usage aspects which reflected on usage modalities.

Radiographic Assessment of the Quality of Root Canal Fillings Performed by Senior Dental Students.

OBJECTIVE: To evaluate the radiographic technical quality of root canal fillings performed by senior dental students at Alfarabi colleges for dentistry, Kingdom of Saudi Arabia. METHODS: Radiographic assessment was conducted for 246 teeth (390 root canals) endodontically treated by senior dental students to evaluate the quality of root canal fillings. Three criteria were evaluated to assess the technical quality of root canal fillings: length, density, and taper. The root canal filling was considered acceptable if it had an adequate length with no voids and consistent taper from the orifice to the apex. Statistical analysis was conducted using Kruskal-Wallis, Mann-Whitney, and chi-square tests (P=0.05). RESULTS: Acceptable root canal fillings were detected in 127 (32.6%) patients. The frequency of an acceptable root canal filling was the highest for the upper anterior teeth (40%). There were significant differences in the length and density among the types of teeth (P<0.05). However, there was no significant difference in the taper among the types of teeth (P>0.05). CONCLUSION: The quality of root canal fillings performed by senior undergraduate dental students at AlFarabi colleges for dentistry was acceptable in 32.6% of patients. This outcome enhanced the poor performance of undergraduate dental students in the area of endodontics.

Radiographic Assessment of the Prevalence of Pulp Stones in a Yemeni Population Sample.

OBJECTIVE: To determine the prevalence and distribution of pulp stones in the posterior teeth of a sample of adult Yemeni dental patients using digital panoramic radiographs. METHODS: In total, 913 panoramic radiographs from patients attending the hospital dental clinics of at University of Sciences and Technology, Sana'a, Yemen, from January 2013 to December 2014 were examined. The occurrence of pulp stones in the posterior teeth of adult subjects was recorded. Associations between pulp stones and gender, age, arch, side and tooth type were studied. RESULTS: The overall prevalence of pulp stones was 18.6% for individuals (170 out of 913 subjects) and 3.99% for examined teeth (351 out of 8802 teeth). The pulp stone occurrence was significantly higher in the maxilla than in the mandible for each tooth type and location (P<0.001). Pulp stones occurred more often on the right side (P<0.001). First molars represented 71% of the affected teeth with the maxillary right first molar showing the highest occurrence. Fifty-six percent of the affected subjects had pulp stones in more than one tooth. No significant difference in the occurrence of pulp stones was detected between genders or among age groups (P>0.05). CONCLUSION: The prevalence of pulp stones is different among populations. Pulp stones were found in approximately one-fifth of subjects in the Yemeni population, where up to 90% of the population have a Qat-chewing habit. This habit usually causes mechanical and chemical irritation and results in pulp calcification.