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Purpose: To evaluate the effect of different printing orientations and post-polymerization time with thermal cycling on the translucency of 3D-printed denture base resins., Methods: Heat-polymerized (HP) acrylic resin specimens were fabricated and 3D-printed denture base materials (NextDent, ASIGA, FormLabs) were printed with different printing orientations (0, 45, 90 degrees) and subjected to different post-polymerization times (15-, 30-, 60-, and 90-min). All specimens were polished and immersed in distilled water for 1 day at 37°C. CIEDE2000 was used to measure the translucency parameters (TP 00 ) before and after thermal cycling (5000 cycles) recording the color parameters (L * , a * , b * ) against a black and white background using a spectrophotometer. k-factors ANOVA followed by post hoc Tukey's test (α = .05) was performed for statistical analysis., Results: The k-factors ANOVA test showed a significant effect of resin material, post-polymerization time, and printing orientation on translucency (p < 0.001). In comparison to HP, all 3D-printed resins showed lower translucency with all post-polymerization times and printing orientation (p < 0.001) except FormLabs resin (p > 0.05). For all 3D-printed resins, the translucency increased, with increasing the post-polymerization time (p < 0.001) and 60- and 90-min showed the highest translucency. For printing orientation, 90 and 45 degrees significantly showed high translucency in comparison to 0 degrees (p < 0.001). FormLabs showed significantly higher translucency when compared with NextDent and ASIGA per respective printing orientation and post-polymerization time. The translucency significantly decreased after thermal cycling for all tested resins (p < 0.001)., Conclusion: The findings of this study demonstrated that the translucency of 3D-printed resins is influenced by the printing orientation, post-polymerization time, and resin type. As a result, choosing a resin type, and printing orientation, with a longer post-polymerization time should be considered since it may improve the esthetic appearance of the 3D-printed resins., (© 2024 by the American College of Prosthodontists.)

Introduction: This study aimed to evaluate denture care and hygiene and oral health-related quality of life (OHRQoL) among complete denture (CD) wearers in the Eastern Province of Saudi Arabia., Methodology: This cross-sectional study was conducted on CD wearers in the Eastern Province of Saudi Arabia. A pre-tested questionnaire was administered among study participants. Questionnaire was divided in three sections: (1) patients' demographic data, (2) awareness and maintenance of CD and (3) OHRQoL. Independent sample t-test and one-way ANOVA test were performed., Results: The study included data of 300 participants with 71% of males and 28% of females. Majority of participants (82.7%) cleaned CD daily, removed CD while sleeping (88.0%) and knew that unhygienic dentures can cause oral infection (92.7%). Only 19.3% used denture cleansing tables, 41% used toothpaste, and 60.7% rinsed CD with water. Regarding OHIP-DENT domains, highest score was for functional limitation domain (2.20 ± 1.67) and the lowest for handicap domain (0.94 ± 1.09). The mean OHIP-DENT score of the sample was 12.02 ± 8.52. Females (p = 0.006), participants below 65 years of age (p = 0.029), non-Saudis (p = 0.042), those with university education (p = 0.030) and low monthly income (p = 0.045) and participants who visited dentist due to problem with CD (p = 0.041) demonstrated significantly higher mean OHIP-DENT score., Conclusion: Majority of participants demonstrated appropriate denture care behaviours because they were aware of the importance of denture care and hygiene. Female gender, age below 65 years, non-Saudi nationality, university education, low monthly income and visiting dentist due to problem were related to poor OHRQoL., (© 2023 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Objective: This bibliographic analysis was designed to review all dental publications in the Kingdom of Saudi Arabia (KSA) and evaluate the effect of international collaboration on the impact of published articles., Methods: The Web of Science (WOS) database was used to extract all related published articles in the KSA from 1982 to 2021. The keywords were connected using Boolean Operators to download related articles. Downloaded articles were screened according to the following inclusion criteria: collaboration journal category, journal discipline, number of citations, number of authors, and impact factor. After applying the inclusion criteria and excluding single-author articles, 5,689 documents were included in the final analysis. The chi-square test and two-independent samples t -test were used to determine the statistical significance between the variables., Results: A significantly higher proportion of articles with international collaboration (51.4%) were published in dental journals than those published nationally (43.3%) or within the institutional level (41.8%) ( P  < 0.0001). In addition, the average number of citations (9.28 ± 23.8) ranged from 0 to 749, received by an article and the impact factor of the journal in which the article was published, significantly higher in the case of internationally collaborative work compared with national or within institutional collaboration ( P  < 0.0001)., Conclusion: International collaboration positively affected the impact factor, number of citations, and quartile rank of published articles. Moreover, the number of co-authors in different countries contributes to the international collaboration effect., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2023 The Authors. Production and hosting by Elsevier B.V. on behalf of King Saud University.)

Persistent severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections have been reported in immune-compromised individuals and people undergoing immune-modulatory treatments. Although intrahost evolution has been documented, direct evidence of subsequent transmission and continued stepwise adaptation is lacking. Here we describe sequential persistent SARS-CoV-2 infections in three individuals that led to the emergence, forward transmission, and continued evolution of a new Omicron sublineage, BA.1.23, over an eight-month period. The initially transmitted BA.1.23 variant encoded seven additional amino acid substitutions within the spike protein (E96D, R346T, L455W, K458M, A484V, H681R, A688V), and displayed substantial resistance to neutralization by sera from boosted and/or Omicron BA.1-infected study participants. Subsequent continued BA.1.23 replication resulted in additional substitutions in the spike protein (S254F, N448S, F456L, M458K, F981L, S982L) as well as in five other virus proteins. Our findings demonstrate not only that the Omicron BA.1 lineage can diverge further from its already exceptionally mutated genome but also that patients with persistent infections can transmit these viral variants. Thus, there is, an urgent need to implement strategies to prevent prolonged SARS-CoV-2 replication and to limit the spread of newly emerging, neutralization-resistant variants in vulnerable patients., (© 2023. The Author(s).)

Male sex is a major risk factor for SARS-CoV-2 infection severity. To understand the basis for this sex difference, we studied SARS-CoV-2 infection in a young adult cohort of United States Marine recruits. Among 2,641 male and 244 female unvaccinated and seronegative recruits studied longitudinally, SARS-CoV-2 infections occurred in 1,033 males and 137 females. We identified sex differences in symptoms, viral load, blood transcriptome, RNA splicing, and proteomic signatures. Females had higher pre-infection expression of antiviral interferon-stimulated gene (ISG) programs. Causal mediation analysis implicated ISG differences in number of symptoms, levels of ISGs, and differential splicing of CD45 lymphocyte phosphatase during infection. Our results indicate that the antiviral innate immunity set point causally contributes to sex differences in response to SARS-CoV-2 infection. A record of this paper's transparent peer review process is included in the supplemental information., Competing Interests: Declaration of interests C.W.G., R.A.L., S.E.L., M.A.S., M.S.T., D.L.W., and A.G.L. are military service members or government service employees. This work was prepared as part of their official duties. Title 17, US Code §105 provides that copyright protection under this title is not available for any work of the US Government. Title 17, US code §101 defines a US Government work as a work prepared by a military service member or employee of the US Government as part of that person’s official duties. The views expressed in the article are those of the authors and do not necessarily express the official policy and position of the US Navy, the Department of Defense, and the US Government or the institutions affiliated with the authors. O.G.T. is on the advisory board of Cell Systems., (Copyright © 2022 The Author(s). Published by Elsevier Inc. All rights reserved.)

Background: Marine recruits training at Parris Island experienced an unexpectedly high rate of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, despite preventive measures including a supervised, 2-week, pre-entry quarantine. We characterize SARS-CoV-2 transmission in this cohort., Methods: Between May and November 2020, we monitored 2,469 unvaccinated, mostly male, Marine recruits prospectively during basic training. If participants tested negative for SARS-CoV-2 by quantitative polymerase chain reaction (qPCR) at the end of quarantine, they were transferred to the training site in segregated companies and underwent biweekly testing for 6 weeks. We assessed the effects of coronavirus disease 2019 (COVID-19) prevention measures on other respiratory infections with passive surveillance data, performed phylogenetic analysis, and modeled transmission dynamics and testing regimens., Results: Preventive measures were associated with drastically lower rates of other respiratory illnesses. However, among the trainees, 1,107 (44.8%) tested SARS-CoV-2-positive, with either mild or no symptoms. Phylogenetic analysis of viral genomes from 580 participants revealed that all cases but one were linked to five independent introductions, each characterized by accumulation of mutations across and within companies, and similar viral isolates in individuals from the same company. Variation in company transmission rates (mean reproduction number R 0 ; 5.5 [95% confidence interval [CI], 5.0, 6.1]) could be accounted for by multiple initial cases within a company and superspreader events. Simulations indicate that frequent rapid-report testing with case isolation may minimize outbreaks., Conclusions: Transmission of wild-type SARS-CoV-2 among Marine recruits was approximately twice that seen in the community. Insights from SARS-CoV-2 outbreak dynamics and mutations spread in a remote, congregate setting may inform effective mitigation strategies., (Copyright © 2022 The Author(s). Published by Wolters Kluwer Health, Inc.)

Emerging and re-emerging respiratory viruses can spread rapidly and cause pandemics as demonstrated by the recent severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic. The early human immune responses to respiratory viruses are in the nasal cavity and nasopharyngeal regions. Defining biomarkers of disease trajectory at the time of a positive diagnostic test would be an important tool to facilitate decisions such as initiation of antiviral treatment. We hypothesize that nasopharyngeal tRNA profiles could be used to predict Coronavirus Disease 19 (COVID-19) severity. We carried out multiplex small RNA sequencing (MSR-seq) on residual nasopharyngeal swabs to measure simultaneously full-length tRNA abundance, tRNA modifications, and tRNA fragmentation for the human tRNA response to SARS-CoV-2 infection. We identified distinct tRNA signatures associated with mild symptoms versus severe COVID-19 manifestations requiring hospitalization. These results highlight the utility of host tRNA properties as biomarkers for the clinical outcome of SARS-CoV-2., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Katanski, Alshammary, Watkins, Huang, Gonzales-Reiche, Sordillo, van Bakel, Mount Sinai PSP study group, Lolans, Simon and Pan.)

The coronavirus disease 2019 (COVID-19) pandemic has sparked the rapid development of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) diagnostics. However, emerging variants pose the risk for target dropout and false-negative results secondary to primer/probe binding site (PBS) mismatches. The Agena MassARRAY® SARS-CoV-2 Panel combines reverse-transcription polymerase chain reaction and matrix-assisted laser desorption/ionization time-of-flight mass-spectrometry to probe for five targets across N and ORF1ab genes, which provides a robust platform to accommodate PBS mismatches in divergent viruses. Herein, we utilize a deidentified data set of 1262 SARS-CoV-2-positive specimens from Mount Sinai Health System (New York City) from December 2020 to April 2021 to evaluate target results and corresponding sequencing data. Overall, the level of PBS mismatches was greater in specimens with target dropout. Of specimens with N3 target dropout, 57% harbored an A28095T substitution that is highly specific for the Alpha (B.1.1.7) variant of concern. These data highlight the benefit of redundancy in target design and the potential for target performance to illuminate the dynamics of circulating SARS-CoV-2 variants., (© 2021 Wiley Periodicals LLC.)

Type I interferons (IFN-Is) are a group of potent inflammatory and antiviral cytokines. They induce IFN stimulated genes (ISGs), which act as proinflammatory mediators, antiviral effectors, and negative regulators of the IFN-I signaling cascade itself. One such regulator is interferon stimulated gene 15 (ISG15). Humans with complete ISG15 deficiency express persistently elevated levels of ISGs, and consequently, exhibit broad spectrum resistance to viral infection. Here, we demonstrate that IFN-I primed fibroblasts derived from ISG15-deficient individuals are more resistant to infection with single-cycle HIV-1 compared to healthy control fibroblasts. Complementation with both wild-type (WT) ISG15 and ISG15ΔGG (incapable of ISGylation while retaining negative regulation activity) was sufficient to reverse this phenotype, restoring susceptibility to infection to levels comparable to WT cells. Furthermore, CRISPR-edited ISG15ko primary CD4+ T cells were less susceptible to HIV-1 infection compared to cells treated with non-targeting controls. Transcriptome analysis of these CRISPR-edited ISG15ko primary CD4+ T cells recapitulated the ISG signatures of ISG15 deficient patients. Taken together, we document that the increased broad-spectrum viral resistance in ISG15-deficiency also extends to HIV-1 and is driven by a combination of T-cell-specific ISGs, with both known and unknown functions, predicted to target HIV-1 replication at multiple steps., Competing Interests: I have read the journal’s policy and the authors of this manuscript have the following competing interests: DB is founder and part owner of Lab11 Therapeutics Inc.

SARS-CoV-2 lineages have diverged into highly prevalent variants termed "variants of concern" (VOCs). Here, we characterized emerging SARS-CoV-2 spike polymorphisms in vitro and in vivo to understand their impact on transmissibility and virus pathogenicity and fitness. We demonstrate that the substitution S:655Y, represented in the gamma and omicron VOCs, enhances viral replication and spike protein cleavage. The S:655Y substitution was transmitted more efficiently than its ancestor S:655H in the hamster infection model and was able to outcompete S:655H in the hamster model and in a human primary airway system. Finally, we analyzed a set of emerging SARS-CoV-2 variants to investigate how different sets of mutations may impact spike processing. All VOCs tested exhibited increased spike cleavage and fusogenic capacity. Taken together, our study demonstrates that the spike mutations present in VOCs that become epidemiologically prevalent in humans are linked to an increase in spike processing and virus transmission., Competing Interests: Declaration of interests The A.G.-S. laboratory has received research support from Pfizer, Senhwa Biosciences, Kenall Manufacturing, Avimex, Johnson & Johnson, Dynavax, 7Hills Pharma, N-fold LLC, Pharmamar, ImmunityBio, Accurius, Nanocomposix, Hexamer, and Merck, outside of the reported work. A.G.-S. has consulting agreements for the following companies involving cash and/or stock: Vivaldi Biosciences, Contrafect, 7Hills Pharma, Avimex, Vaxalto, Pagoda, Accurius, Esperovax, Farmak, Applied Biological Laboratories, and Pfizer, outside of the reported work. A.G.-S. is inventor on patents and patent applications on the use of antivirals and vaccines for the treatment and prevention of virus infections, owned by the Icahn School of Medicine at Mount Sinai, New York. The Icahn School of Medicine at Mount Sinai has filed a patent application relating to SARS-CoV-2 serological assays, which lists Viviana Simon as co-inventor. Mount Sinai has spun out a company, Kantaro, to market serological tests for SARS-CoV-2. The Krogan Laboratory has received research support from Vir Biotechnology and F. Hoffmann-La Roche. Nevan Krogan has consulting agreements with the Icahn School of Medicine at Mount Sinai, New York; Maze Therapeutics; and Interline Therapeutics. He is a shareholder in Tenaya Therapeutics, Maze Therapeutics, and Interline Therapeutics and is financially compensated by GEn1E Lifesciences, Inc. and Twist Bioscience Corp., (Copyright © 2022 Elsevier Inc. All rights reserved.)

Viruses package host RNAs in their virions which are associated with a range of functions in the viral life cycle. Previous transcriptomic profiling of host RNA packaging mostly focused on retroviruses. Which host RNAs are packaged in other viruses at the transcriptome level has not been thoroughly examined. Here we perform proof-of-concept studies using both small RNA and large RNA sequencing of six different SARS-CoV-2 viral isolates grown on VeroE6 cells to profile host RNAs present in cell free viral preparations and to explore SARS-CoV-2 genomic RNA modifications. We find selective enrichment of specific host transfer RNAs (tRNAs), tRNA fragments and signal recognition particle (SRP) RNA in SARS-CoV-2 viral preparations. Different viral preparations contain the same set of host RNAs, suggesting a common mechanism of packaging. We estimate that a single SARS-CoV-2 particle likely contains up to one SRP RNA and four tRNA molecules. We identify tRNA modification differences between the tRNAs present in viral preparations and those in the uninfected VeroE6 host cells. Furthermore, we find uncharacterized candidate modifications in the SARS-CoV-2 genomic RNA. Our results reveal an under-studied aspect of viral-host interactions that may be explored for viral therapeutics., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Peña, Zhang, Watkins, Halucha, Alshammary, Hernandez, Liu, Albrecht, Garcia-Sastre, Simon, Katanski and Pan.)

The Omicron (B.1.1.529) variant of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was initially identified in November 2021 in South Africa and Botswana, as well as in a sample from a traveller from South Africa in Hong Kong 1,2 . Since then, Omicron has been detected globally. This variant appears to be at least as infectious as Delta (B.1.617.2), has already caused superspreader events 3 , and has outcompeted Delta within weeks in several countries and metropolitan areas. Omicron hosts an unprecedented number of mutations in its spike gene and early reports have provided evidence for extensive immune escape and reduced vaccine effectiveness 2,4-6 . Here we investigated the virus-neutralizing and spike protein-binding activity of sera from convalescent, double mRNA-vaccinated, mRNA-boosted, convalescent double-vaccinated and convalescent boosted individuals against wild-type, Beta (B.1.351) and Omicron SARS-CoV-2 isolates and spike proteins. Neutralizing activity of sera from convalescent and double-vaccinated participants was undetectable or very low against Omicron compared with the wild-type virus, whereas neutralizing activity of sera from individuals who had been exposed to spike three or four times through infection and vaccination was maintained, although at significantly reduced levels. Binding to the receptor-binding and N-terminal domains of the Omicron spike protein was reduced compared with binding to the wild type in convalescent unvaccinated individuals, but was mostly retained in vaccinated individuals., (© 2021. The Author(s), under exclusive licence to Springer Nature Limited.)

Objective: With this cross-sectional study, we aimed to evaluate factors associated with moderate and high risk of periodontal disease (PD) progression in the Saudi population., Methods: We reviewed 281 patients' clinical charts from predoctoral periodontal clinics at the dental teaching hospital in the College of Dentistry (COD) at Imam Abdulrahman Bin Faisal University (IAU) in Dammam, Saudi Arabia. After obtaining ethical approval, we determined the Periodontal Risk Assessment (PRA) of the included patients based on the modified criteria developed by Lang and Tonetti (2003). We used logistic regression on stratified data and divided the results into two categories (low-moderate and high risk) to assess the effect modifier for potential risk factors. We used SPSS version 22 for data analysis, and considered a P-value ≤ 0.05 to be statistically significant., Results: Out of the 281 patients, 104 (37.0%) were male and 177 (63.0%) were female, with a mean age of 39.9 ± 14.0 years; 78.1% were Saudi nationals, 77% were married, and 44.6% were in the age group of 30 to 49. The PRA revealed 86 (30.5%) to represent high risk, 108 (38.3%) denoted moderate risk, and 88 (31.2%) signaled low risk for periodontitis. Logistic regression analysis showed that males were three times more likely to have high PRA (OR = 3.24) and to be married (OR = 2.77), as well as to be active smokers (OR = 8.87). The highest predictive factors of high PRA were 8 or more pockets ≥ 5 mm (OR = 29.0), those with active diabetes mellitus (DM; OR = 10.2), and those with 8 or more missing teeth (OR = 9.15)., Conclusion: Saudi males who are married and have residual periodontal pockets, are actively diabetic, and with missing teeth are at high risk of PD. Further research is needed with a larger sample size comparing the general population with and without PD., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2021 The Authors.)

Background: Highly efficacious vaccines against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) have been developed. However, the emergence of viral variants that are more infectious than the earlier SARS-CoV-2 strains is concerning. Several of these viral variants have the potential to partially escape neutralizing antibody responses, warranting continued immune-monitoring., Methods: We used a panel of 30 post-mRNA vaccination sera to determine neutralization and RBD and spike binding activity against a number of emerging viral variants. The virus neutralization was determined using authentic SARS-CoV-2 clinical isolates in an assay format that mimics physiological conditions., Findings: We tested seven currently circulating viral variants of concern/interest, including the three Iota sublineages, Alpha (E484K), Beta, Delta and Lambda in neutralization assays. We found only small decreases in neutralization against Iota and Delta. The reduction was stronger against a sub-variant of Lambda, followed by Beta and Alpha (E484K). Lambda is currently circulating in parts of Latin America and was detected in Germany, the US and Israel. Of note, reduction in a receptor binding domain and spike binding assay that also included Gamma, Kappa and A.23.1 was negligible., Interpretation: Taken together, these findings suggest that mRNA SARS-CoV-2 vaccines may remain effective against these viral variants of concern/interest and that spike binding antibody tests likely retain specificity in the face of evolving SARS-CoV-2 diversity., Funding: This work is part of the PARIS/SPARTA studies funded by the NIAID Collaborative Influenza Vaccine Innovation Centers (CIVIC) contract 75N93019C00051. In addition, this work was also partially funded by the Centers of Excellence for Influenza Research and Surveillance (CEIRS, contract # HHSN272201400008C), the JPB Foundation, the Open Philanthropy Project (research grant 2020-215611 (5384), by anonymous donors and by the Serological Sciences Network (SeroNet) in part with Federal funds from the National Cancer Institute, National Institutes of Health, under Contract No. 75N91019D00024, Task Order No. 75N91020F00003., Competing Interests: Declaration of Competing Interest The Icahn School of Medicine at Mount Sinai has filed patent applications relating to SARS-CoV-2 serological assays and NDV-based SARS-CoV-2 vaccines which list Florian Krammer as co-inventor. Viviana Simon and Fatima Amanat are also listed on the serological assay patent application as co-inventors. Mount Sinai has spun out a company, Kantaro, to market serological tests for SARS-CoV-2. Florian Krammer has consulted for Merck and Pfizer (before 2020), and is currently consulting for Pfizer, Seqirus and Avimex. The Krammer laboratory is also collaborating with Pfizer on animal models of SARS-CoV-2., (Copyright © 2021 The Authors. Published by Elsevier B.V. All rights reserved.)

In this study we profiled vaccine-induced polyclonal antibodies as well as plasmablast-derived mAbs from individuals who received SARS-CoV-2 spike mRNA vaccine. Polyclonal antibody responses in vaccinees were robust and comparable to or exceeded those seen after natural infection. However, the ratio of binding to neutralizing antibodies after vaccination was greater than that after natural infection and, at the monoclonal level, we found that the majority of vaccine-induced antibodies did not have neutralizing activity. We also found a co-dominance of mAbs targeting the NTD and RBD of SARS-CoV-2 spike and an original antigenic-sin like backboost to spikes of seasonal human coronaviruses OC43 and HKU1. Neutralizing activity of NTD mAbs but not RBD mAbs against a clinical viral isolate carrying E484K as well as extensive changes in the NTD was abolished, suggesting that a proportion of vaccine-induced RBD binding antibodies may provide substantial protection against viral variants carrying single E484K RBD mutations., Competing Interests: Declaration of interests The Icahn School of Medicine at Mount Sinai has filed patent applications relating to SARS-CoV-2 serological assays and NDV-based SARS-CoV-2 vaccines which list F.K. as co-inventor. V.S. and F.A. are also listed on the serological assay patent application as a co-inventors. Mount Sinai has spun out a company, Kantaro, to market serological tests for SARS-CoV-2. F.K. has consulted for Merck and Pfizer (before 2020) and is currently consulting for Pfizer, Seqirus, and Avimex. The Krammer laboratory is also collaborating with Pfizer on animal models of SARS-CoV-2. A.H.E. has consulted for InBios and Fimbrion Therapeutics (before 2021) and is currently a consultant for Mubadala Investment Company. The Ellebedy laboratory received funding under sponsored research agreements that are unrelated to the data presented in the current study from Emergent BioSolutions and from AbbVie., (Copyright © 2021 Elsevier Inc. All rights reserved.)

Numerous reports document the spread of SARS-CoV-2, but there is limited information on its introduction before the identification of a local case. This may lead to incorrect assumptions when modeling viral origins and transmission. Here, we utilize a sample pooling strategy to screen for previously undetected SARS-CoV-2 in de-identified, respiratory pathogen-negative nasopharyngeal specimens from 3,040 patients across the Mount Sinai Health System in New York. The patients had been previously evaluated for respiratory symptoms or influenza-like illness during the first 10 weeks of 2020. We identify SARS-CoV-2 RNA from specimens collected as early as 25 January 2020, and complete SARS-CoV-2 genome sequences from multiple pools of samples collected between late February and early March, documenting an increase prior to the later surge. Our results provide evidence of sporadic SARS-CoV-2 infections a full month before both the first officially documented case and emergence of New York as a COVID-19 epicenter in March 2020.

Objective: To evaluate the quality of life (QOL) of dental professionals in the Eastern Province of Saudi Arabia., Methods: This cross-sectional study recruited dental professionals (general dentists, specialists, and consultants) from public and private sectors in the Eastern Province of Saudi Arabia. The World Health Organization's QOL Assessment-BREF (WHOQOL-BREF) questionnaire was administered among study participants. The questionnaire addresses four domains of QOL which are physical, psychological, social relationships, and environment., Results: There were 313 dental professionals in the study with a mean age of 35.72 (8.58) years. The mean score of QOL in the sample was 63 (13.9) on a 0-100 scale. 75% of the participants rated their QOL as good or very good. Of four domains, the social relationship domain had the highest mean score of QOL (67.04 SD: 23.52) and the physical domain had the lowest score (59.66 SD: 14.69). There were significant differences in the QOL of consultants (66.46 SD: 12.55), specialists (65.42 SD: 12.91), and general dentists (61.06 SD: 14.18) ( P  0.010). The participants with medical illness had significantly lower QOL (56.91 SD: 12.83) than those without medical illness (63.67 SD: 13.92) ( P  0.01). There were significant differences in the QOL of participants with 0-10 years since graduation (61.97 SD: 14.71), 11-20 years (61.92 SD: 13.56), and more than 20 years (68.53 SD: 10.71) ( P  0.009)., Conclusion: The qualifications, medical illness, and years since graduation were important determinants of QOL among dental professionals. Measures should be taken to improve QOL of dental professionals which can enhance the quality of patient care., Competing Interests: The authors declare that there are no conflicts of interest., (Copyright © 2020 Nabras Alrayes et al.)

International Guidelines recommend ambulatory blood pressure monitoring (ABPM) for the management of hypertension. ABPM phenotypes predict outcomes independent of office blood pressure (BP). The authors explored the prevalence and clinical correlates of ABPM phenotypes and relationship with office BP in Saudi patients (n = 428, mean age 53.5 ± 14.6, 55% male) referred to a Specialist Hypertension clinic in Riyadh, Saudi Arabia. ABPM phenotypes included sustained normotension (27%), masked hypertension, MHT(32%), sustained hypertension, SHT(52%), and white coat hypertension(2.6%). MHT was more prevalent using asleep than 24-hours (26.4% vs 12.9%, P < .01) or awake BP (26.4% vs 8.5%, P < .001) and observed in 85% of pre-hypertensive patients. Isolated nocturnal hypertension was more prevalent in MHT vs SHT (70% vs 30%, P < .001). Office BP overestimated control rates compared with ABPM (48% vs 12.9%, P < .001). Our study shows that one in three Saudi patients will be managed inappropriately if office BP alone was relied upon for management of hypertension., (© 2020 Wiley Periodicals LLC.)

New York City (NYC) has emerged as one of the epicenters of the current severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic. To identify the early transmission events underlying the rapid spread of the virus in the NYC metropolitan area, we sequenced the virus that causes coronavirus disease 2019 (COVID-19) in patients seeking care at the Mount Sinai Health System. Phylogenetic analysis of 84 distinct SARS-CoV-2 genomes indicates multiple, independent, but isolated introductions mainly from Europe and other parts of the United States. Moreover, we found evidence for community transmission of SARS-CoV-2 as suggested by clusters of related viruses found in patients living in different neighborhoods of the city., (Copyright © 2020 The Authors, some rights reserved; exclusive licensee American Association for the Advancement of Science. No claim to original U.S. Government Works.)

Heparin-induced thrombocytopenia (HIT) is a serious complication of the administration of heparin and its derivatives. Non-heparin anticoagulants such as argatroban and fondaparinux are widely used in the management of HIT to compare the effectiveness of argatroban and fondaparinux in the resolution of thrombocytopenia and to compare clinical outcomes in patients with isolated HIT. A retrospective cohort analysis was performed at King Abdulaziz Medical City (KAMC) on patients diagnosed with isolated HIT between 31 Jan, 2014 and 30 June, 2017. Demographics data, non-heparin anticoagulants, related laboratory results, and clinical outcomes were retrieved and analysed. The cohort comprised a total of 95 adult patients who received either argatroban (56 patients) or fondaparinux (39 patients) for isolated HIT. The median age and sex distribution were similar in both argatroban and fondaparinux groups. The mean (+ SD) time (in days) for the resolution of thrombocytopenia was 3.5 (± 1.8) for patients who received argatroban and 3.7 (± 1.7) for patients administered fondaparinux (p = 0.843). Thromboembolic events occurred in five patients (8.9%) administered argatroban and in three patients (7.7%) administered fondaparinux (p = 0.382). There was no significant difference in the rates of bleeding or death (p = 0.829); however, the small number of cases limits our ability to draw conclusions about these outcomes. In this retrospective study, fondaparinux and argatroban were similarly effective in resolving thrombocytopenia, preventing further thromboembolic events, and maintaining safety in patients with confirmed HIT. To confirm this observation, larger prospective studies are needed.