Investigation of the factors responsible for the low oral bioavailability of alizarin using a sensitive LC-MS/MS method: In vitro, in situ, and in vivo evaluations.

Alizarin (1,2-dihydroxyanthraquinone) is an anthraquinone reddish dye widely used for painting and textile dyeing. As the biological activity of alizarin has recently attracted increasing attention from researchers, its therapeutic potential as complementary and alternative medicine is of interest. However, no systematic research has been conducted on the biopharmaceutical and pharmacokinetic aspects of alizarin. Therefore, this study aimed to comprehensively investigate the oral absorption and intestinal/hepatic metabolism of alizarin using a simple and sensitive tandem mass spectrometry method developed and validated in-house. The present method for the bioanalysis of alizarin has merits, including a simple pretreatment procedure, small sample volume, and adequate sensitivity. Alizarin exhibited pH-dependent moderate lipophilicity and low solubility with limited intestinal luminal stability. Based on the in vivo pharmacokinetic data, the hepatic extraction ratio of alizarin was estimated to be 0.165-0.264, classified as a low level of hepatic extraction. In an in situ loop study, considerable fractions (28.2%-56.4%) of the alizarin dose were significantly absorbed in gut segments from the duodenum to ileum, suggesting that alizarin may be classified as the Biopharmaceutical Classification System class II. An in vitro metabolism study using rat and human hepatic S9 fractions revealed that glucuronidation and sulfation, but not NADPH-mediated phase I reactions and methylation, are significantly involved in the hepatic metabolism of alizarin. Taken together, it can be estimated that the fractions of oral alizarin dose unabsorbed from the gut lumen and eliminated by the gut and liver before reaching the systemic circulation are 43.6%-76.7%, 0.474%-36.3%, and 3.77%-5.31% of the dose, respectively, resulting in a low oral bioavailability of 16.8%. Therefore, the oral bioavailability of alizarin depends primarily on its chemical degradation in the gut lumen and secondarily on first-pass metabolism.

Data-driven scalable pipeline using national agent-based models for real-time pandemic response and decision support.

This paper describes an integrated, data-driven operational pipeline based on national agent-based models to support federal and state-level pandemic planning and response. The pipeline consists of (i) an automatic semantic-aware scheduling method that coordinates jobs across two separate high performance computing systems; (ii) a data pipeline to collect, integrate and organize national and county-level disaggregated data for initialization and post-simulation analysis; (iii) a digital twin of national social contact networks made up of 288 Million individuals and 12.6 Billion time-varying interactions covering the US states and DC; (iv) an extension of a parallel agent-based simulation model to study epidemic dynamics and associated interventions. This pipeline can run 400 replicates of national runs in less than 33 h, and reduces the need for human intervention, resulting in faster turnaround times and higher reliability and accuracy of the results. Scientifically, the work has led to significant advances in real-time epidemic sciences.

Heat-Killed Enterococcus faecalis EF-2001 Induces Human Dermal Papilla Cell Proliferation and Hair Regrowth in C57BL/6 Mice.

Minoxidil is the most widely used treatment for hair growth, but has been associated with several side effects. In this study, we investigated the effects of heat-killed Enterococcus faecalis EF-2001 on hair loss prevention and regrowth using human dermal papilla cells and male C57BL/6 mice. To examine the effects of EF-2001, we used minoxidil as the positive control. In the in vitro experiments, EF-2001 treatment (75-500 µg/mL) led to the proliferation of human dermal papilla cells in a concentration-dependent manner. In the in vivo experiment, the topical application of 200 µL EF-2001 on the dorsal surface of C57BL/6 male mice led to hair growth. Changes in hair regrowth were examined by visual comparison and hematoxylin and eosin staining of skin sections. We also determined the expression levels of marker genes (Wnt) and growth factors (fibroblast growth factor, insulin growth factor 1, and vascular endothelial growth factor) in the skin tissues of the back of each mouse using a quantitative polymerase chain reaction. EF-2001 accelerated the progression of hair regrowth in mice and promoted hair-follicle conversion from telogen to anagen, likely by increasing the expression levels of growth factors and marker genes.

Clinical Course and Outcomes of 3,060 Patients with Coronavirus Disease 2019 in Korea, January-May 2020.

BACKGROUND: The fatality rate of patients with coronavirus disease 2019 (COVID-19) varies among countries owing to demographics, patient comorbidities, surge capacity of healthcare systems, and the quality of medical care. We assessed the clinical outcomes of patients with COVID-19 during the first wave of the epidemic in Korea. METHODS: Using a modified World Health Organization clinical record form, we obtained clinical data for 3,060 patients with COVID-19 treated at 55 hospitals in Korea. Disease severity scores were defined as: 1) no limitation of daily activities; 2) limitation of daily activities but no need for supplemental oxygen; 3) supplemental oxygen via nasal cannula; 4) supplemental oxygen via facial mask; 5) non-invasive mechanical ventilation; 6) invasive mechanical ventilation; 7) multi-organ failure or extracorporeal membrane oxygenation therapy; and 8) death. Recovery was defined as a severity score of 1 or 2, or discharge and release from isolation. RESULTS: The median age of the patients was 43 years of age; 43.6% were male. The median time from illness onset to admission was 5 days. Of the patients with a disease severity score of 3-4 on admission, 65 (71.5%) of the 91 patients recovered, and 7 (7.7%) died due to illness by day 28. Of the patients with disease severity scores of 5-7, 7 (19.5%) of the 36 patients recovered, and 8 (22.2%) died due to illness by day 28. None of the 1,324 patients who were < 50 years of age died; in contrast, the fatality rate due to illness by day 28 was 0.5% (2/375), 0.9% (2/215), 5.8% (6/104), and 14.0% (7/50) for the patients aged 50-59, 60-69, 70-79, and ≥ 80 years of age, respectively. CONCLUSION: In Korea, almost all patients of < 50 years of age with COVID-19 recovered without supplemental oxygen. In patients of ≥ 50 years of age, the fatality rate increased with age, reaching 14% in patients of ≥ 80 years of age.

Medical Drama Viewing and Healthy Lifestyle Behaviors: Understanding the Role of Health Locus of Control Beliefs and Education Level.

The present study advances the understanding of how medical drama viewing influences healthy lifestyle behaviors (e.g., smoking, exercising, and consuming vegetables) by examining the role of the health locus of control (HLOC) beliefs and education level. An analysis of nationally representative data reveals that watching medical dramas is positively associated with chance and powerful others' HLOC beliefs. In addition, healthy lifestyle behaviors are positively associated with the internal HLOC belief and are negatively associated with the chance and powerful others' HLOC beliefs. Research findings demonstrate that there are indirect effects of medical drama viewing on these behaviors via chance and powerful others' HLOC beliefs. The indirect effect through the powerful others' HLOC belief is also contingent on the education level. The implications for the role of HLOC beliefs and education level in terms of the effects of medical dramas on health-promoting behaviors are discussed.

When Information from Public Health Officials is Untrustworthy: The Use of Online News, Interpersonal Networks, and Social Media during the MERS Outbreak in South Korea.

Public health officials (PHOs) are responsible for providing trustworthy information during a public health crisis; however, there is little research on how the public behaves when their expectations for such information are violated. Drawing on media dependency theory and source credibility research as our primary theoretical framework, we tested how credibility of information from PHOs is associated with people's reliance on a particular communication channel in the context of the 2015 Middle East Respiratory Syndrome (MERS) outbreak in South Korea. Using nationally representative data (N = 1036) collected during the MERS outbreak, we found that less credible information from PHOs led to more frequent use of online news, interpersonal networks, and social media for acquiring MERS-related information. However, credibility of information from PHOs was not associated with the use of television news or print newspapers. The theoretical and practical implications of our results on communication channels usage are discussed.

ICE-MoCha: Intelligent Crowd Engineering using Mobility Characterization and Analytics.

Human injuries and casualties at entertaining, religious, or political crowd events often occur due to the lack of proper crowd safety management. For instance, for a large scale moving crowd, a minor accident can create a panic for the people to start stampede. Although many smart video surveillance tools, inspired by the recent advanced artificial intelligence (AI) technology and machine learning (ML) algorithms, enable object detection and identification, it is still challenging to predict the crowd mobility in real-time for preventing potential disasters. In this paper, we propose an intelligent crowd engineering platform using mobility characterization and analytics named ICE-MoCha. ICE-MoCha is to assist safety management for mobile crowd events by predicting and thus helping to prevent potential disasters through real-time radio frequency (RF) data characterization and analysis. The existing video surveillance based approaches lack scalability thus have limitations in its capability for wide open areas of crowd events. Via effectively integrating RF signal analysis, our approach can enhance safety management for mobile crowd. We particularly tackle the problems of identification, speed, and direction detection for the mobile group, among various crowd mobility characteristics. We then apply those group semantics to track the crowd status and predict any potential accidents and disasters. Taking the advantages of power-efficiency, cost-effectiveness, and ubiquitous availability, we specifically use and analyze a Bluetooth low energy (BLE) signal. We have conducted experiments of ICE-MoCha in a real crowd event as well as controlled indoor and outdoor lab environments. The results show the feasibility of ICE-MoCha detecting the mobile crowd characteristics in real-time, indicating it can effectively help the crowd management tasks to avoid potential crowd movement related incidents.

Genetic overexpression of COMP-Ang1 impairs BM microenvironment and induces senescence of BM HSCs.

Supplemental Angiopoietin 1 (Ang1) exerts its therapeutic potential on microvascular regression-associated diseases, and this potential is linked with the function of hematopoietic stem cells (HSCs). However, the underlying mechanisms of the effect of enhanced angiogenesis on the modulation of HSCs are not yet defined. Here, we generated transgenic mice expressing Cartilage Oligomeric Matrix Protein (COMP)-Ang1 in keratin 14-expressing cells. The mutant animals expressed excessive angiogenic characteristics in the skin and bone marrow (BM) along with redder skin with more numerous and branched vessels compared with their wild-type (WT) littermates. The mutants displayed reduced long bone formation and osteoclast activity than did WT littermates and had fewer CD150+CD48-Lineage-Sca-1+c-Kit+ (LSK) cells in the BM. The mutants also exhibited greater senescence-associated (SA) ß-gal activity, p16INK4a protein expression, and superoxide anion levels in CD150+CD48-LSK cells in the BM. Furthermore, transplantation assay revealed that the mutant-derived LSK cells were inferior to the cells derived from WT littermate in inducing competitive repopulating capacity in the recipients. Collectively, our results demonstrate that persistent and prolonged administration of COMP-Ang1 by inducible transgenic expression mediates excessive angiogenesis in the body and impairs BM microenvironment, eventually leading to senescence of BM HSCs.

Bandwidth Cost Minimization via User Association for Enterprise WLANs.

Enterprise Wireless LANs (E-WLANs) such as airport WiFi, have become a convenient way for Internet access for mobile users. In an E-WLAN, access points (APs) are usually deployed with high-density around the infrastructure to provide sufficient coverage and for a better service, where a mobile user chooses one AP to associate with among multiple available APs in the vicinity. Many studies have been done on developing user association techniques to increase system performance, with various objectives including network throughput maximization, load balancing etc. Our work is unique in that we focused on bandwidth cost minimization via user association from the perspective of the E-WLAN operators. Specifically, by considering the bandwidth demands from mobile users, we modeled the joint user association and cost minimization problem in the heterogeneous E-WLAN with additional constraints from individual bandwidth demands as an optimization problem. To solve the optimization problem efficiently, we propose an approximation algorithm using relaxation and rounding techniques. We prove that the proposed algorithm has performance bound with a constant ratio to the optimization problem. Furthermore, our simulation results exhibit the superiority of our proposed algorithm over prior schemes.

Stages of pTDP-43 pathology in amyotrophic lateral sclerosis.

OBJECTIVE: To see whether the distribution patterns of phosphorylated 43kDa TAR DNA-binding protein (pTDP-43) intraneuronal inclusions in amyotrophic lateral sclerosis (ALS) permit recognition of neuropathological stages. METHODS: pTDP-43 immunohistochemistry was performed on 70 µm sections from ALS autopsy cases (N = 76) classified by clinical phenotype and genetic background. RESULTS: ALS cases with the lowest burden of pTDP-43 pathology were characterized by lesions in the agranular motor cortex, brainstem motor nuclei of cranial nerves V, VII, and X-XII, and spinal cord α-motoneurons (stage 1). Increasing burdens of pathology showed involvement of the prefrontal neocortex (middle frontal gyrus), brainstem reticular formation, precerebellar nuclei, and the red nucleus (stage 2). In stage 3, pTDP-43 pathology involved the prefrontal (gyrus rectus and orbital gyri) and then postcentral neocortex and striatum. Cases with the greatest burden of pTDP-43 lesions showed pTDP-43 inclusions in anteromedial portions of the temporal lobe, including the hippocampus (stage 4). At all stages, these lesions were accompanied by pTDP-43 oligodendroglial aggregates. Ten cases with C9orf72 repeat expansion displayed the same sequential spreading pattern as nonexpansion cases but a greater regional burden of lesions, indicating a more fulminant dissemination of pTDP-43 pathology. INTERPRETATION: pTDP-43 pathology in ALS possibly disseminates in a sequential pattern that permits recognition of 4 neuropathological stages consistent with the hypothesis that pTDP-43 pathology is propagated along axonal pathways. Moreover, the finding that pTDP-43 pathology develops in the prefrontal cortex as part of an ongoing disease process could account for the development of executive cognitive deficits in ALS.

Anti-inflammatory effects of rutin on HMGB1-induced inflammatory responses in vitro and in vivo.

OBJECTIVE AND DESIGN: High mobility group box 1 (HMGB1) protein acts as a late mediator of severe vascular inflammatory conditions. Rutin (RT), an active flavonoid compound, is well known to possess potent antiplatelet, antiviral and antihypertensive properties. In this study, we investigated the anti-inflammatory effects of RT against pro-inflammatory responses in human umbilical vein endothelial cells (HUVECs) induced by HMGB1 and the associated signaling pathways. METHODS: The anti-inflammatory activities of RT were determined by measuring permeability, monocytes adhesion and migration, and activation of pro-inflammatory proteins in HMGB1-activated HUVECs and mice. RESULTS: We found that RT potently inhibited HMGB1 release, down-regulated HMGB1-dependent inflammatory responses in human endothelial cells, and inhibited HMGB1-mediated hyperpermeability and leukocyte migration in mice. In addition, treatment with RT resulted in reduced cecal ligation and puncture-induced release of HMGB1 and sepsis-related mortality. Further studies revealed that RT suppressed the production of tumor necrosis factor-α and interleukin 6 and the activation of nuclear factor-κB and extracellular regulated kinases 1/2 by HMGB1. CONCLUSION: Collectively, these results indicate that RT could be a candidate therapeutic agent for treatment of various severe vascular inflammatory diseases via inhibition of the HMGB1 signaling pathway.

Band gap control using electric field of photonic gel cells fabricated with block copolymer and hydrogel.

Optical and electrical characteristics of the devices using photonic gel film and hydrogel electrolyte were studied. Poly(styrene-b-2-vinylpyridine) (PS-b-P2VP) lamellar film with alternating hydrophobic block and hydrophilic polyelectrolyte block polymers (52 kg/mol-b-57 kg/mol) were prepared for the photonic gel. Poly(isobutylene-co-maleic acid) sodium salts were prepared for the hydrogel. This hydrogel fiber is common water swelling material and it owned ions for a device has conductivity. Photonic gel and hydrogel was spin coating onto Indium-tin-oxide (ITO) glass for make electric fields. The reflectance maximum wavelength of photonic crystal device shifted from 538 nm and reached to 557 nm, 585 nm and 604 nm during 30 min voltage applying time. The bandwidth variation was very limited. Loss of electrolyte was much less with hydrogel compared to the pure water. We can control color of hydrogel used photonic device by electric field with reasonable time range under moderate electric field by applying 2 V between two facing electrodes.

A platform for discovery: The University of Pennsylvania Integrated Neurodegenerative Disease Biobank.

Neurodegenerative diseases (NDs) are defined by the accumulation of abnormal protein deposits in the central nervous system (CNS), and only neuropathological examination enables a definitive diagnosis. Brain banks and their associated scientific programs have shaped the actual knowledge of NDs, identifying and characterizing the CNS deposits that define new diseases, formulating staging schemes, and establishing correlations between neuropathological changes and clinical features. However, brain banks have evolved to accommodate the banking of biofluids as well as DNA and RNA samples. Moreover, the value of biobanks is greatly enhanced if they link all the multidimensional clinical and laboratory information of each case, which is accomplished, optimally, using systematic and standardized operating procedures, and in the framework of multidisciplinary teams with the support of a flexible and user-friendly database system that facilitates the sharing of information of all the teams in the network. We describe a biobanking system that is a platform for discovery research at the Center for Neurodegenerative Disease Research at the University of Pennsylvania.

The relationships among depression, physical health conditions and healthcare expenditures for younger and older Americans.

BACKGROUND AND AIMS: Little is known about the extent depression adds to the costs of treatment for physical health conditions. This study examined the paths and the extent to which depression in conjunction with a physical health problem is associated with an increase in healthcare expenditures and how that is different between younger and older adults. METHODS: Data from the 2007 Medical Expenditure Panel Survey (MEPS) were analyzed. Depression status and physical health conditions were identified through ICD-9 codes. The multiple group structural equation modeling (SEM) was employed to examine the moderated mediation effects. RESULTS: Approximately 11% of adults had clinical depression. The multiple group SEM for both younger and older adult groups supports not only a direct effect of depression on expenditures but also an indirect effect via comorbid health conditions. Furthermore, the indirect effect was significantly more prominent among older respondents than among younger ones, indicating significant moderated mediation by age. CONCLUSIONS: Depression has greater effects on comorbid health conditions and an increase in total healthcare expenditures through comorbid conditions among older adults. Findings of this study suggest that proper detection and treatment of depression is beneficial in reducing overall healthcare expenditures, especially among older adults.

High resolution synthetic residential energy use profiles for the United States.

Efficient energy consumption is crucial for achieving sustainable energy goals in the era of climate change and grid modernization. Thus, it is vital to understand how energy is consumed at finer resolutions such as household in order to plan demand-response events or analyze impacts of weather, electricity prices, electric vehicles, solar, and occupancy schedules on energy consumption. However, availability and access to detailed energy-use data, which would enable detailed studies, has been rare. In this paper, we release a unique, large-scale, digital-twin of residential energy-use dataset for the residential sector across the contiguous United States covering millions of households. The data comprise of hourly energy use profiles for synthetic households, disaggregated into Thermostatically Controlled Loads (TCL) and appliance use. The underlying framework is constructed using a bottom-up approach. Diverse open-source surveys and first principles models are used for end-use modeling. Extensive validation of the synthetic dataset has been conducted through comparisons with reported energy-use data. We present a detailed, open, high resolution, residential energy-use dataset for the United States.

Validation of Fitbit Inspire 2TM Against Polysomnography in Adults Considering Adaptation for Use.

Purpose: The commercialization of sleep activity tracking devices has made it possible to manage sleep quality at home. However, it is necessary to verify the reliability and accuracy of wearable devices through comparison with polysomnography (PSG), which is the standard for tracking sleep activity. This study aimed to monitor overall sleep activity using Fitbit Inspire 2™ (FBI2) and to evaluate its performance and effectiveness through PSG under the same conditions. Patients and Methods: We compared the FBI2 and PSG data of nine participants (four male and five female participants; average age, 39 years) without severe sleeping problems. The participants wore FBI2 continuously for 14 days, considering the period of adaptation to the device. FBI2 and PSG sleep data were compared using paired t-tests, Bland-Altman plots, and epoch-by-epoch analysis for 18 samples by pooling data from two replicates. Results: The average values for each sleep stage obtained from FBI2 and PSG showed significant differences in the total sleep time (TST), deep sleep, and rapid eye motion (REM). In the Bland-Altman analysis, TST (P = 0.02), deep sleep (P = 0.05), and REM (P = 0.03) were significantly overstated in FBI2 compared to PSG. In addition, time in bed, sleep efficiency, and wake after sleep onset were overestimated, while light sleep was underestimated. However, these differences were not statistically significant. FBI2 showed a high sensitivity (93.9%) and low specificity (13.1%), with an accuracy of 76%. The sensitivity and specificity of each sleep stage was 54.3% and 62.3%, respectively, for light sleep, 84.8% and 50.1%, respectively, for deep sleep, and 86.4% and 59.1%, respectively for REM sleep. Conclusion: The use of FBI2 as an objective tool for measuring sleep in daily life can be considered appropriate. However, further research is warranted on its application in participants with sleep-wake problems.

Efficacy of Carbon Nanodots and Manganese Ferrite (MnFe2O4) Nanoparticles in Stimulating Growth and Antioxidant Activity in Drought-Stressed Maize Inbred Lines.

Despite being the third most-consumed crop, maize (Zea mays L.) is highly vulnerable to drought stress. The predominant secondary metabolite in plants is phenolic acids, which scavenge reactive oxygen species to minimize oxidative stress under drought stress. Herein, the effect of carbon nanodots (CND) and manganese ferrite (MnFe2O4) nanoparticles (NP) on the drought stress tolerance of maize has been studied. The experimental results revealed that the highest leaf blade length (54.0 cm) and width (3.9 cm), root length (45.2 cm), stem diameter (11.1 mm), root fresh weight (7.0 g), leaf relative water content (84.8%) and chlorogenic (8.7 µg/mL), caffeic (3.0 µg/mL) and syringic acid (1.0 µg/mL) contents were demonstrated by CND-treated (10 mg L-1) inbred lines (GP5, HW19, HCW2, 17YS6032, HCW3, HCW4, HW7, HCW2, and 16S8068-9, respectively). However, the highest shoot length (71.5 cm), leaf moisture content (83.9%), shoot fresh weight (12.5 g), chlorophyll content (47.3), and DPPH free radical scavenging activity (34.1%) were observed in MnFe2O4 NP-treated (300 mg L-1) HF12, HW15, 11BS8016-7, HW15, HW12, and KW7 lines, respectively. The results indicate that CND and MnFe2O4 NP can mitigate drought stress effects on different accessions of the given population, as corroborated by improvements in growth and physio-biochemical traits among several inbred lines of maize.

Evaluation of Rapid Multiplex Reverse Transcription-Quantitative Polymerase Chain Reaction Assays for SARS-CoV-2 Detection in Individual and Pooled Samples.

Although coronavirus disease 2019 (COVID-19) is no longer a Public Health Emergency of International Concern (PHEIC), severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has had a vast impact to date. Hence, continuous management is required, given the uncertainty caused by the potential evolution of SARS-CoV-2. Reverse transcription-quantitative PCR (RT-qPCR) diagnosis has been fundamental in overcoming this issue. In this study, the performances of two rapid RT-qPCR assays (Real-Q Direct SARS-CoV-2 Detection Kit and Allplex™ SARS-CoV-2 fast PCR Assay) with short PCR times were comparatively evaluated using a STANDARD M nCoV Real-Time Detection Kit (STANDARD M, conventional RT-qPCR assay). All kits showed a limit of detection values (102-103 copies/reaction). The evaluation showed that the two rapid assay tests had ≥97.89% sensitivity and ≥99.51% specificity (κ = 0.98) for individual samples and ≥97.32% sensitivity and ≥97.67% specificity for pooled samples compared to STANDARD M. These results indicate that the two rapid RT-qPCR kits, which showed significant time reduction in performance, are as effective as a conventional RT-qPCR assay. They are likely to increase not only the number of tests that can be performed but also the efficiency of sustainable management of COVID-19 in the long term.

Evaluation of Four Rapid Antigen Tests for the Detection of SARS-CoV-2 Infection with Nasopharyngeal Swabs.

Owing to the high transmissibility of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants, the capacity of testing systems based on the gold standard real-time reverse transcription-polymerase chain reaction (rRT-PCR) is limited. Rapid antigen tests (RATs) can substantially contribute to the prevention of community transmission, but their further assessment is required. Here, using 1503 nasopharyngeal swabs, we compared the diagnostic performance of four RAT kits (Abbott Panbio™ COVID-19 Ag Rapid Test, SD Biosensor Standard™ Q COVID-19 Ag Test, Humasis COVID-19 Ag Test, and SG Medical Acrosis COVID-19 Ag Test) to the cycle threshold (Ct) values obtained from rRT-PCR. The precision values, area under the curve values, SARS-CoV-2 variant detection ability, and non-SARS-CoV-2 specificity of all four kits were similar. An assay using the Acrosis kit had a significantly better positive detection rate with a higher recall value and cut-off value than that using the other three RAT kits. During the current COVID-19 pandemic, the Acrosis kit is an effective tool to prevent the spread of SARS-CoV-2 in communities.

Evaluation of Multiplex Rapid Antigen Tests for the Simultaneous Detection of SARS-CoV-2 and Influenza A/B Viruses.

Single-target rapid antigen tests (RATs) are commonly used to detect highly transmissible respiratory viruses (RVs), such as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and influenza viruses. The simultaneous detection of RVs presenting overlapping symptoms is vital in making appropriate decisions about treatment, isolation, and resource utilization; however, few studies have evaluated multiplex RATs for SARS-CoV-2 and other RVs. We assessed the diagnostic performance of multiplex RATs targeting both the SARS-CoV-2 and influenza A/B viruses with the GenBody Influenza/COVID-19 Ag Triple, InstaView COVID-19/Flu Ag Combo (InstaView), STANDARDTM Q COVID-19 Ag Test, and STANDARDTM Q Influenza A/B Test kits using 974 nasopharyngeal swab samples. The cycle threshold values obtained from the real-time reverse transcription polymerase chain reaction results showed higher sensitivity (72.7-100%) when the values were below, rather than above, the cut-off values. The InstaView kit exhibited significantly higher positivity rates (80.21% for SARS-CoV-2, 61.75% for influenza A, and 46.15% for influenza B) and cut-off values (25.57 for SARS-CoV-2, 21.19 for influenza A, and 22.35 for influenza B) than the other two kits, and was able to detect SARS-CoV-2 Omicron subvariants. Therefore, the InstaView kit is the best choice for routine screening for both SARS-CoV-2 and influenza A/B in local communities.