Genomic characterization of circulating human respiratory syncytial viruses A and B in Kuwait using whole-genome sequencing.

The human respiratory syncytial virus (RSV) is considered one of the most common viruses that infect children globally. The virus is known to have extensive gene sequence variability within and between RSV groups A and B globally; however, there is no information on the whole-genome characterization and diversity of RSV in Kuwait. Therefore, this study aimed to sequence the entire genome of RSV strains isolated from patients with acute respiratory tract infection (ARTI) in Kuwait. Therefore, this study aimed to sequence the entire genome of RSV strains isolated from patients with ARTI in Kuwait. Between January 2020 and September 2022, 7,093 respiratory samples were collected from hospitalized infants, children, and adults and were analyzed for respiratory viruses by multiplex real-time PCR. Whole-genome sequencing using the Oxford Nanopore sequencing technology was performed on 84 RSV-positive samples. The results revealed a higher prevalence of group A (76%) than group B (24%) RSV isolates. Phylogenetic analysis showed that RSV-A strains clustered with the GA2.3.5 sub-genotype and RSV-B strains clustered with the GB5.0.5a sub-genotype; however, forming new lineages of RSV-A and RSV-B circulated in Kuwait during this period. Genetic variability was higher among the group A viruses than group B viruses, and the rate of synonymous and missense mutations was high in genes other than the G protein-coding gene. We also detected several known and unique molecular markers in different protein-coding genes. This is the first study in Kuwait to characterize the whole genomes of RSV A and B to identify the circulating genotypes, comprehend the genetic diversity and the evolution of the virus, and identify important genetic markers associated with specific genotypes.IMPORTANCEWhole-genome sequencing of respiratory syncytial virus (RSV) strains in Kuwait using MinION Nanopore technology was used to characterize and analyze the genotypes and sub-genotypes of the RSV circulating among patients with acute respiratory tract infections in Kuwait. This study also identified known and unknown gene mutations and imported genetic markers associated with specific genotypes. These results will assist in establishing a framework for RSV classification and allow for a better consideration of the mechanisms leading to the generation of diversity of RSV. In addition, these data will allow a comparison of vaccine viruses with those in Kuwait, providing useful insights into future vaccine and therapy strategies for RSV in Kuwait.

The impact of psychiatric comorbidity on Parkinson's disease outcomes: a systematic review and meta-analysis.

Background: The burden of psychiatric symptoms in Parkinson's disease includes depression, anxiety, apathy, psychosis, and impulse control disorders. However, the relationship between psychiatric comorbidities and subsequent prognosis and neurological outcomes is not yet well understood. In this systematic review and meta-analysis, in individuals with Parkinson's disease, we aimed to characterise the association between specific psychiatric comorbidities and subsequent prognosis and neurological outcomes: cognitive impairment, death, disability, disease progression, falls or fractures and care home admission. Methods: We searched MEDLINE, Embase, PsycINFO and AMED up to 13th November 2023 for longitudinal observational studies which measured disease outcomes in people with Parkinson's disease, with and without specific psychiatric comorbidities, and a minimum of two authors extracted summary data. Studies of individuals with other parkinsonian conditions and those with outcome measures that had high overlap with psychiatric symptoms were excluded to ensure face validity. For each exposure-outcome pair, a random-effects meta-analysis was conducted based on standardised mean difference, using adjusted effect sizes-where available-in preference to unadjusted effect sizes. Study quality was assessed using the Newcastle-Ottawa Scale. Between-study heterogeneity was assessed using the I2 statistic and publication bias was assessed using funnel plots. PROSPERO Study registration number: CRD42022373072. Findings: There were 55 eligible studies for inclusion in meta-analysis (n = 165,828). Data on participants' sex was available for 164,514, of whom 99,182 (60.3%) were male and 65,460 (39.7%) female. Study quality was mostly high (84%). Significant positive associations were found between psychosis and cognitive impairment (standardised mean difference [SMD] 0.44, [95% confidence interval [CI] 0.23-0.66], I2 30.9), psychosis and disease progression (SMD 0.46, [95% CI 0.12-0.80], I2 70.3%), depression and cognitive impairment (SMD 0.37 [95% CI 0.10-0.65], I2 27.1%), depression and disease progression (SMD 0.46 [95% CI 0.18-0.74], I2 52.2), depression and disability (SMD 0.42 [95% CI 0.25-0.60], I2 7.9%), and apathy and cognitive impairment (SMD 0.60 [95% CI 0.02-1.19], I2 27.9%). Between-study heterogeneity was moderately high. Interpretation: Psychosis, depression, and apathy in Parkinson's disease are all associated with at least one adverse outcome, including cognitive impairment, disease progression and disability. Whether this relationship is causal is not clear, but the mechanisms underlying these associations require exploration. Clinicians should consider these psychiatric comorbidities to be markers of a poorer prognosis in people with Parkinson's disease. Future studies should investigate the underlying mechanisms and which treatments for these comorbidities may affect Parkinson's disease outcomes. Funding: Wellcome Trust, UK National Institute for Health Research (NIHR), National Institute for Health Research (NIHR) Biomedical Research Centre (BRC) at South London and Maudsley NHS Foundation Trust and King's College London, National Institute for Health Research (NIHR) Biomedical Research Centre (BRC) at University College London Hospitals NHS Foundation Trust, National Brain Appeal.

Neuro-oncological research output in Africa: a scoping review of primary brain tumors.

BACKGROUND: There is evidence that individuals of African ancestry, particularly those residing in Africa, suffer from an unfortunate amount of under-representation in cancer research worldwide. AIM: We aimed to analyze current research output and potentially predict future trends in neuro-oncological research in Africa. Investigating deficits in the field will assist in identifying top-performing countries, which ones face challenges, and how to solve them. Therefore, targeted interventions can be applied to overcome these challenges. METHODS: We conducted a systematic computer-based search on the following databases (PubMed, Scopus, Web of Science, and Embase) for research articles related to the neuro-oncological field in Africa. We aimed to retrieve any article published in the period between 1 January 2000 and 10 January 2023. RESULTS: We included 200 eligible articles in our study. The output of neuro-oncological research has been increasing over the past two decades, peaking in 2019. Among the included articles, clinical practice issues constituted the majority (80%), while public health-related topics accounted for 20% of the publications. Regarding the type of neurological tumor, neuroblastoma was the most common, with 26 articles (13%), meningioma with 21 (10.5%), and glioma with 16 articles (8%). CONCLUSION: The interest in African neuro-oncological research is increasing. Hence, there is a need for ongoing efforts to address issues with clinical practice and public health related to neurological tumors in the continent. Future studies should concentrate on filling in knowledge gaps and investigating novel methods for neuro-oncological conditions that affect African populations in terms of prevention, diagnosis, treatment, and management strategies.

Insights into head and neck cancer research in Egypt: A scoping review.

BACKGROUND: Head and neck cancer (HNC) encompasses malignant tumors in areas like the oral cavity, pharynx, and larynx. This analysis identifies strengths and deficiencies in HNC research, aiming to improve published papers' quality, quantity, and diversity. It also encourages more participation from oncologists, particularly in Egypt, to bridge the gap with Western healthcare standards. METHODS: A systematic search was conducted in databases including PubMed, Scopus, Web of Science, and Embase. The goal was to gather research articles on HNC in Egypt published from January 1, 2000, to December 31, 2022. RESULTS: From 2150 articles, 1329 were screened by title and abstract, leading to 193 for full-text review. Finally, 174 articles were included in the final analysis. 2020 saw the highest number of publications. The majority were primary research articles, with randomized controlled trials being prevalent. Most studies were clinical, focusing on radiotherapy, and involved adult patients, emphasizing service delivery. Publications were predominantly in non-Egyptian journals, with the Egyptian Journal of Radiology and Nuclear Medicine being the most frequent. Research was mainly conducted by Egyptian authors and at Cairo University. CONCLUSION: The growing prevalence of HNC in Egypt underscores the need for more comprehensive research on its various aspects, including etiology, risk factors, and prevention. There's a call for increased research outputs at different Egyptian universities, multicenter studies, and international collaborations. This approach can improve the understanding and management of HNC, contributing to global discussions and advancing treatment and prevention strategies in Egypt.

Characteristics of the clinical and global neurosurgical research publications from Africa: A scoping review.

Introduction: Scientific research has a direct, profound impact on healthcare systems worldwide. While an upward trend can be observed in the number of produced papers in the neurosurgical specialty, disparities still exist between African neurosurgeons on one side and between African neurosurgeons and neurosurgeons from high income countries, on the other. Research question: This study aims to analyze neurosurgical research produced in Africa to identify gaps in the literature and provide recommendations for aspiring African neurosurgeons for essential research areas. Materials and methods: Four electronic databases (PubMed, Scopus, Web of Science, and Embase) were systematically searched for relevant articles on neurosurgery published by African authors. The three main inclusion criteria were: Articles published in the Neurosurgical field, articles published by African authors (whether first authors or co-authors) and articles published in Africa. Data extracted included the study design, scope, neurosurgical subspecialty, and the authors' nationalities. Results: A total of 982 articles were included in the analysis. Of these articles, 889 (90.6%) were primary, 48 (4.9%) secondary, and 44 (4.5%) other types of research. Global Neurosurgery papers represent 7% of African neurosurgery research output. Most common primary studies included retrospective cohort (32.4%), case reports (28.3%), and prospective cohort (13.8%) studies. The most common secondary research articles were literature reviews (4.9%), letters to the editor (1.2%), and systematic reviews and meta-analyses (0.8%). Common research areas were neuro-oncology 242 (24.7%), spinal surgery 157 (16%), and cerebrovascular (14%). The most common nationalities of the first authors were Egyptian (32.4%), Moroccan (15%), and Nigerian (14.2%). Discussion and conclusion: This study identifies increased African authorship in neurosurgical research in recent years. Nevertheless, many countries still lack representation in the neurosurgical research scene.Furthermore, a high percentage of the published papers is of low evidence. Therefore, we recommend that African neurosurgical researchers focus more on clinical trials and systematic reviews that directly translate to improving clinical practice. African neurosurgeons should also consider more collaboration between African authors.

Comparison Between Mini-Percutaneous Nephrolithotomy and Standard Percutaneous Nephrolithotomy in Management of Large Renal Stones: A Randomized, Controlled Clinical Trial.

Objectives: The aim of this study was to compare mini-percutaneous nephrolithotomy (PNL) and standard PNL in management of renal stones (20-40 mm) with regard to the operative time, fluoroscopy time, blood loss, stone-free rate, and postoperative complications. Subjects and Methods: This prospective, randomized comparative study was carried out on 93 patients divided into two groups: Group A included 44 patients who underwent standard PNL, whereas Group B included 49 patients who underwent mini-PNL. Results: Standard PNL showed shorter operative time, yet longer hospitalization and nephrostomy and catheterization time. The mean drop in hemoglobin level was significantly lower in the mini-PNL group. In the 1st postoperative week, the stone-free rate was higher in the standard PNL group, but this was statistically insignificant. However, 4 weeks postoperatively, the stone-free rate was significantly higher in Group A. Postoperative pain and the need for postoperative analgesia were significantly higher in standard PNL patients. Conclusions: Standard PNL achieved a higher stone-free rate and shorter operative time, while mini-PNL had the advantage of shorter hospitalization time and lower incidence of pain and postoperative complications.

Causes of death among patients with cutaneous melanoma: a US population-based study.

Research on mortality outcomes and non-cancer-related causes of death in patients with cutaneous melanoma (CM) remains limited. This study aimed to identify the prevalence of non-cancer-related deaths following CM diagnosis. The data of 224,624 patients diagnosed with malignant CM in the United States between 2000 and 2019 were extracted from the Surveillance, Epidemiology, and End Results (SEER) database. We stratified our cohort based on their melanoma stage at diagnosis and further calculated standardized mortality ratios (SMRs) for each cause of death, comparing their relative risk to that of the general US population. The total number of fatalities among melanoma patients was 60,110, representing 26.8% of the total cases. The percentage of deaths is directly proportional to the disease stage, reaching 80% in distant melanoma. The highest fatalities among the localized melanoma group (25,332; 60.5%) occurred from non-cancer causes, followed by melanoma-attributable deaths (10,817; 25.8%). Conversely, melanoma is the leading cause of death in regional and distant melanoma cohorts. Cardiovascular and cerebrovascular diseases were the most prevalent non-cancer causes of death among the three disease-stage cohorts. Compared to the general population, we did not observe an increased risk of death due to non-cancer causes in the localized CM cohort, while patients diagnosed with regional and distant CMs had a statistically significant higher risk of death from all the reported major causes of death.

Causes of death after laryngeal cancer diagnosis: A US population-based study.

BACKGROUND: Several reports examined the survival of laryngeal cancer (LC) patients, most of these studies only focused on the prognosis of the disease, and just a small number of studies examined non-cancer-related causes of death. The objective of the current study is to investigate and quantify the most common causes of deaths following LC diagnosis. METHODS: The data of 44,028 patient with LC in the United States diagnosed between 2000 and 2018 were retrieved from the Surveillance, Epidemiology, and End Results (SEER) program and analyzed. We stratified LC patients according to various demographic and clinical parameters and calculated standardized mortality ratios (SMRs) for all causes of death. RESULTS: Over the follow-up period, 25,407 (57.7%) deaths were reported. The highest fatalities (11,121; 43.8%) occurred within 1-5 years following LC diagnosis. Non-cancer causes of death is the leading cause of death (8945; 35.2%), followed by deaths due to laryngeal cancer (8,705; 34.3%), then other cancers deaths (7757; 30.5%). The most common non-cancer causes of death were heart diseases (N = 2953; SMR 4.42), followed by other non-cancer causes of death (N = 1512; SMR 3.93), chronic obstructive pulmonary diseases (N = 1420; SMR 4.90), then cerebrovascular diseases (N = 547; SMR 4.28). Compared to the general population, LC patients had a statistically significant higher risk of death from all reported causes. CONCLUSIONS: Non-cancer causes of death is the leading cause of death in LC patients, exceeding deaths attributed to LC itself. These findings provide important insight into how LC survivors should be counselled regarding future health risks.

Molecular epidemiology and genetic characterization of SARS-CoV-2 in Kuwait: A descriptive study.

Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has been fatal to human health, affecting almost the entire world. Here we reported, for the first time, characterization of the genetic variants of SARS-CoV-2 circulating in Kuwait to understand their genetic diversity and monitor the accumulation of mutations over time. This study randomly enrolled 209 COVID-19 patients whose nasopharyngeal swabs were positive for SARS-CoV-2 between February 2020 and June 2021 using RT-PCR. The whole genomes of SARS-CoV-2 from the nasopharyngeal swabs were sequenced using the Oxford Nanopore sequencing technology following the ARTIC network protocol. Whole-genome sequencing has identified different clades/sub-clades circulating in Kuwait, mimicking the virus's global spread. Clade 20A was dominant from February 2020 until January 2021, and then clade 20I (Alpha, V1) emerged and dominated. In June 2021, the number of cases infected with clades 21I, 21A, and 21 J (Delta) increased and dominated. We detected several known clade-defining missense and synonymous mutations and other missense mutations in the genes encoding important viral proteins, including ORF1a, S, ORF3a, ORF8 regions and a novel mutation in the N region. ORF1ab region harbored more mutations and deletions (n = 62, 49.2%) compared to the other 12 gene regions, and the most prevalent missense mutations were P314L (97%) in ORF1b and D614G (97%) in the S glycoprotein regions. Detecting and analyzing mutations and monitoring the evolution of SARS-CoV-2 over time is essential to help better understand the spread of various clades/strains of SARS-CoV-2 and their implications for pathogenesis. In addition, knowledge of the circulating variants and genome sequence variability of SARS-CoV-2 may potentially influence the development of vaccines and antiviral drugs to control the COVID-19 pandemic.

Maintenance requirements and marginal bone loss associated with implant-retained overdentures: a retrospective cohort study.

OBJECTIVES: To evaluate the maintenance requirements and the presence of prosthetic complications associated with marginal bone loss in the implant-retained bar and locator prostheses. MATERIALS AND METHODS: The study was executed between the years 2013 and 2018 on 114 patients who had undergone 283 dental implants. Patients were examined at follow-up recall sessions at 12 and 24 months after the placement of the dentures. The clinical examination also included intraoral and extraoral examinations of the patients; compatibility of the prostheses placed to about occlusion; an adaptation of the prosthesis to the tissues, health, and continuity of the soft tissues; complaints of the patients; implant success rates; and marginal bone loss, and prosthetic complications were evaluated at follow-up sessions, and statistical analysis was performed. RESULTS: Locator attachment was placed in 94 patients with separated mandibles and maxillae, and a removable prosthesis with a bar attachment was placed in 20 patients. When evaluating the level of marginal bone loss regardless of the presence of complications, the area where the implant was set, the number of days after loading, and the type of retainer, it was found to be significant at the end of the 12th the 24th months. The results showed a significant relationship between the prosthesis type and the presence of complications at month 24 (p < 0.05). There was no significant relationship between the position of the denture and the presence of complications at month 12 (p > 0.05). There was no significant relationship between the location of the denture and the presence of complications at month 24 (p > 0.05). CONCLUSION: Complications do not affect marginal bone loss, but the resulting marginal bone loss is the result of the patient not paying enough attention to oral hygiene. Routine inspections of the prosthesis after the completion of treatment seem to be important. If the requirements resulting from these checks are met, complications that may occur in the future will be prevented. CLINICAL RELEVANCE: The maintenance requirements and the presence of prosthetic complications associated with marginal bone loss in the implant-retained bar and locator prostheses were evaluated. Complications occurred more frequently with the bar-supported removable implant prostheses.

Efficacy of the current investigational drugs for the treatment of COVID-19: a scoping review.

To date, there is no final FDA-approved treatment for COVID-19. There are thousands of studies published on the available treatments for COVID-19 virus in the past year. Therefore, it is crucial to synthesize and summarize the evidence from published studies on the safety and efficacy of experimental treatments of COVID-19. We conducted a systematic literature search of MEDLINE, PubMed, Cochrane Library, GHL, OpenGrey, ICTRP, and ClinicalTrials.gov databases through April 2020. We obtained 2699 studies from the initial literature search. Of them, we included 28 eligible studies that met our eligibility criteria. The sample size of the included studies is 2079 individuals. We extracted and pooled the available data and conducted a quality assessment for the eligible studies. From the 28 studies, only 13 studies provide strong evidence. Our results showed that Favipiravir and Hydroxycholoroquine shorten viral clearance and clinical recovery time and promote pneumonia absorption. On the other hand, Lopinavir-ritonavir either alone or combined with arbidol or interferons has no significant difference superior to the standard care. Corticosteroids, Convalescent plasma transfusion, and anticoagulant therapies provide a better prognosis. Remedsivir, Tocilizumab, Immunoglobulin, Mesenchymal stem cell transplantation showed effective treatment results, but further confirmatory studies are needed. In conclusion, Favipiravir and Remedsivir might be promising drugs in the treatment of COVID-19 patients. .

Comparison of the Crestal Bone Loss Between Implant-Supported Prosthesis With Sinus Augmentation and Distal Cantilevered Implant-Supported Prosthesis Without Sinus Augmentation.

This study aimed to compare the crestal bone loss between a 2-implant-supported, noncantilevered 3-unit fixed partial prosthesis (TUFPP) with sinus augmentation and a 2-implant-supported, distal cantilevered TUFPP without sinus augmentation in the posterior maxilla having insufficient crestal bone. The study subjects were enrolled in 2 groups. Group 1 included patients with 2 implants: an anterior implant placed in the native bone and a posterior implant inserted with simultaneous sinus augmentation using a xenogenic bone graft to support a TUFPP. Group 2 included patients with 2 implants inserted in the native bone to support a distal cantilevered TUFPP. The crestal bone levels at the distal and mesial aspects of each implant were measured at baseline and 6-, 12-, and 24-month follow-up controls on panoramic radiographs. Fifty-two patients and 104 implants were included. There was a significant difference in distal crestal bone loss between anterior and posterior implants in group 1 at 6 months (P < .05) but not at 12 and 24 months (P > .05). Distal crestal bone loss was significantly increased in group 1 posterior implants compared to the group 2 posterior implants at 6 months (P < .05). There was no significant difference in mesial bone loss between the anterior and posterior implants in both groups at all follow-up controls (P > .05). There was also no significant mesial crestal bone loss in relation to the anterior and posterior implants of both groups at all follow-up controls (P > .05). Noncantilevered 2-implant-supported TUFPP with sinus augmentation may have similar medium-term crestal bone loss when compared to cantilevered 2-implant-supported TUFPP without sinus augmentation. Further prospective studies should be designed to compare the performance of the 2-implant-supported cantilevered TUFPP and 2-implant-supported TUFPP with sinus augmentation.

Effects of implant-related variables on the marginal bone loss around dental implants.

OBJECTIVE: Marginal bone loss (MBL), a prognostic parameter for implant success, is associated with implant- and patient-related variables. The purpose of this study was to analyze the effects of the crown-to-implant ratio and independent factors of implant diameter, implant length, implant type, location, and platform switching on distal and mesial MBLs at the 6-, 12-, 24-, and 36-month recall sessions of single crown implant-supported restorations. METHOD AND MATERIALS: Radiographic and clinical data of patients treated with single crown implants were collected. MBL was measured at the baseline and recall sessions on panoramic radiographs. The crown-to-implant ratio was calculated by dividing the length of the crown by that of the dental implant. RESULTS: The crown-to-implant ratio had a moderately positive correlation with distal MBL at the 6-month recall session (P < .05, r = 0.469) and a weakly positive correlation at the 12- (P < .05, r = 0.220), 24- (P < .05, r = 0.214), and 36- (P < .05, r = 0.250) month recall sessions. Distal and mesial MBL did not significantly differ among the four implant types at any recall session (P > .05). The crown-to-implant ratio had no significant correlation with mesial MBL at the 12-, 24-, or 36-month recall session (P > .05), and a moderately positive correlation at the 6-month recall session (P < .001, r = 0.434). CONCLUSIONS: MBL was similar among different implant types in the short and medium terms. There was a positive correlation between distal MBL and the crown-to-implant ratio.