Deep learning for detection and 3D segmentation of maxillofacial bone lesions in cone beam CT.

OBJECTIVES: To develop an automated deep-learning algorithm for detection and 3D segmentation of incidental bone lesions in maxillofacial CBCT scans. METHODS: The dataset included 82 cone beam CT (CBCT) scans, 41 with histologically confirmed benign bone lesions (BL) and 41 control scans (without lesions), obtained using three CBCT devices with diverse imaging protocols. Lesions were marked in all axial slices by experienced maxillofacial radiologists. All cases were divided into sub-datasets: training (20,214 axial images), validation (4530 axial images), and testing (6795 axial images). A Mask-RCNN algorithm segmented the bone lesions in each axial slice. Analysis of sequential slices was used for improving the Mask-RCNN performance and classifying each CBCT scan as containing bone lesions or not. Finally, the algorithm generated 3D segmentations of the lesions and calculated their volumes. RESULTS: The algorithm correctly classified all CBCT cases as containing bone lesions or not, with an accuracy of 100%. The algorithm detected the bone lesion in axial images with high sensitivity (95.9%) and high precision (98.9%) with an average dice coefficient of 83.5%. CONCLUSIONS: The developed algorithm detected and segmented bone lesions in CBCT scans with high accuracy and may serve as a computerized tool for detecting incidental bone lesions in CBCT imaging. CLINICAL RELEVANCE: Our novel deep-learning algorithm detects incidental hypodense bone lesions in cone beam CT scans, using various imaging devices and protocols. This algorithm may reduce patients' morbidity and mortality, particularly since currently, cone beam CT interpretation is not always preformed. KEY POINTS: • A deep learning algorithm was developed for automatic detection and 3D segmentation of various maxillofacial bone lesions in CBCT scans, irrespective of the CBCT device or the scanning protocol. • The developed algorithm can detect incidental jaw lesions with high accuracy, generates a 3D segmentation of the lesion, and calculates the lesion volume.

Microbially-Induced-Calcite-Precipitation (MICP): A biotechnological approach to enhance the durability of concrete using Bacillus pasteurii and Bacillus sphaericus.

Developing bio-based self-healing concrete aims to minimize durability problems related to cracking. In this study, MICP was used as a smart and eco-friendly approach to produce bio-based durable materials. Bacillus pasteurii (BP) and Bacillus sphaericus (BS) were added into mortar mixtures with 0.25% and 0.5% cement weight. All treated samples exhibited a significant decline in water uptake, capillary permeability, and volume of permeable voids, as compared to control with no bacteria. All treated samples showed significant increase in compressive strength by 28-50%, after 28 days of curing. At the age of 120 days, the flexural strength of all treated samples was significantly increased by 19.29-65.94%. SEM imaging and EDAX confirmed that treated samples were denser with less voids due to MICP. DTA verified that the calcite amount and the crystallinity degree were improved in treated samples. Load deflection of bacterial Reinforced-Laminates had less deformation than control. Reloaded bacterial Reinforced-Laminates exhibited excellent restoration of physico-mechanical properties and performance, after 28, 90, and 120 days, confirming the healing process. Microbial self-healing is an innovative approach for continuous repair of micro-cracks in concrete, improving its durability, thus can reduce the maintenance costs.

Gastric outlet obstruction - looking for a syndrome: Bouveret or Mirizzi?

INTRODUCTION AND IMPORTANCE: Gastric outlet obstruction can result from any pathological process that causes intrinsic blockage or extrinsic pressure on the distal stomach and duodenum. Gallstone related gastric outlet obstruction is a well-known entity classically due to a cholecystoenteric fistula formation. CASE PRESENTATION: We present here a case of a 36-year-old man who presented with right upper quadrant abdominal pain associated with marked nausea and vomiting. Abdominal CT scan done in the emergency department revealed a large impacted infundibular gallstone with signs of acute cholecystitis, associated with prominent gastric distention. Gastric outlet obstruction was due to stenosis at the duodenal level from external compression by the large impacted stone with no evidence of fistula. Laparoscopic cholecystectomy was performed with total resolution of symptoms. CLINICAL DISCUSSION: Gastric outlet obstruction can be secondary to many etiologies, and notably gallstone disease. Classically this is due to formation of a cholecystoenteric fistula and intrinsic obstruction by the migrated stone. Our case is unique in that a large impacted infundibular gallstone caused gastric outlet obstruction with absence of any fistula or gallstone migration. CONCLUSION: Gastric outlet obstruction due to external compression by a non-migrated gallstone is a rare undescribed entity. Surgical treatment should not be delayed to prevent complications and fistula formation.

Production of bioconcrete with improved durability properties using Alkaliphilic Egyptian bacteria.

Microbial-based self-healing of concrete represents innovative technology for improving micro-crack sealing. Microbial bioactivity can induce calcite-precipitation in concrete, which seals micro-cracks. In this respect, two Egyptian bacterial isolates were selected and identified, as Bacillus subtilis (Bs) and Bacillus megaterium (Bm) using MALDI-TOF/MS-Biotyper®. Peak patterns of the bacterial ribosomal proteins showed a high match between samples and standards, which verified species consistency. Bs and Bm were added to the mortar mixture in two concentrations (0.5%, 1%) of cement weight, then the mechanical and physical properties were tested throughout a 180-day time course. The compressive strength of Bm0.5 bacterial mortar samples was increased by 21.4% after 28 days, as compared to control. The rate of water absorption of Bm samples was decreased by 12.4% after 180 days. Bacterial mortar samples showed significant restoration of compressive strength than the original samples by 44%, 21%, and 52.6% for Bs1, Bm0.5, and Bs0.5, respectively. SEM and EDAX analyses confirmed that bacterial samples were denser with fewer voids than the control, as a result of microbial nanosized calcite-precipitation. DTA verified that the amount of CaCO3 and its degree of crystallinity were increased in the bacterial mortar samples. Load-deflection of reinforced-laminates for bacterial mortar samples showed ductile behavior and less deformation as compared to control. In this work, novel concrete with improved mechanical and physical properties has been developed using selected Egyptian microorganisms, it can promote self-healing of micro-cracks with improved durability of the concrete. The application of self-healing bioconcrete can reduce the inspection and maintenance costs. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s13205-021-02781-0.

Periampullary Neuroendocrine Tumor as a Cause of Acute Pancreatitis.

BACKGROUND Duodenal and ampullary carcinoids are very rare tumors accounting respectively for 2% and 0.03% of all carcinoid tumors. Clinical findings vary according to the location of the tumor within the periampullary region; with epigastric pain being the most common presenting symptom in duodenal carcinoids and jaundice the most common clinical finding in ampullary carcinoids. Treatment options include pancreaticoduodenectomy, local excision, and endoscopic excision. CASE REPORT In this case report, we present a 60-year-old male who presented with a one-week history of intractable epigastric pain. He was diagnosed with duodenal periampullary carcinoid tumor and treated with local excision. CONCLUSIONS Although duodenal and ampullary carcinoid tumors may have different clinical presentations, as well as histochemistry characteristics and metastatic potential, they appear to benefit from the same surgical treatment.

Predictors of Continued Breastfeeding at One Year among Women Attending Primary Healthcare Centers in Qatar: A Cross-Sectional Study.

The number of babies in Qatar being exclusively breastfed is significantly lower than the global target set by the World Health Organization. The purpose of this study was to assess knowledge, attitude, and practice (KAP), selected barriers, and professional support as well as their association with continued breastfeeding at one year of age. A sample of Qatari and non-Qatari mothers (N = 195) who attended a well-baby clinic held at primary health care centers in Qatar completed a self-administered questionnaire. Descriptive analysis, the Pearson Chi-squared test, and logistic regression were performed. Around 42% of the mothers stopped breastfeeding when their child was aged between 0 and 11 months old. Mothers who had only one or female child stopped breastfeeding between the ages of 0 and 6 months (p = 0.025, 0.059). The more optimal the breastfeeding practices followed by the mothers, the older the age of the infant when they stopped breastfeeding (p = 0.001). The following factors were inversely associated with breastfeeding duration: the mother's perceptions that she "did not know how to breastfeed," or "wasn't making enough milk," and the need "to return to work/school", with p = 0.022, 0.004, and 0.022, respectively. These findings present factors that should be considered when planning for health education and promotion programs to prolong breastfeeding duration in Qatar.

Microparticles (CD146) and Arterial Stiffness Versus Carotid Intima Media Thickness as an Early Predictors of Vascular Affection in Systemic Lupus Patients.

OBJECTIVES: This study aims to evaluate cluster of differentiation 146 (CD146) and pulse wave velocity (PWV) as non-invasive methods for prediction of early vascular affection in systemic lupus erythematosus (SLE) patients without symptoms of vascular disease, to detect the outcome and reproducibility of these methods, and to correlate CD146 and PWV with lipid profile, intima media thickness (IMT), and ankle brachial index. PATIENTS AND METHODS: Thirty female SLE patients (mean age 26.6±6.6 years; range 15 to 35 years) fulfilling the American College of Rheumatology 1997 revised criteria for SLE classification, and 15 age and sex matched healthy controls were included. All participants were performed full clinical assessments including measurement of Systemic Lupus Erythematosus Disease Activity Index, lipid profile, CD146, carotid IMT, PWV, and rise time as an indication of how fast the waveform rises. RESULTS: Cluster of differentiation 146 levels were elevated in patients with SLE compared to controls (p<0.001). There was a statistically significant difference between patients and controls in the femoral, lower thigh, and ankle rise time. There was a statistically significant correlation between IMT and ages of patients, Systemic Lupus Erythematosus Disease Activity Index, and brachial-below knee PWV, while there was no correlation between IMT and disease duration, lipid profile, brachial-femoral PWV, and brachial-ankle PWV. There was statistically significant correlations between brachial-femoral PWV and serum cholesterol level, and between brachial-ankle PWV and low density lipoprotein cholesterol. CONCLUSION: Our results showed that SLE vascular affection is more pronounced in small arteries. Also, elevated CD146 and brachial-femoral PWV are useful early markers of vascular affection in SLE as well as rise time may be a marker for arterial stiffness.