Diagnostic Accuracy of Rapid Antigen Tests for COVID-19 Detection: A Systematic Review With Meta-analysis

Introduction: Reverse transcription-polymerase chain reaction (RT-PCR) to detect SARS-CoV-2 is time-consuming and sometimes not feasible in developing nations. Rapid antigen test (RAT) could decrease the load of diagnosis. However, the efficacy of RAT is yet to be investigated comprehensively. Thus, the current systematic review and meta-analysis were conducted to evaluate the diagnostic accuracy of RAT against RT-PCR methods as the reference standard. Methods: We searched the MEDLINE/Pubmed and Embase databases for the relevant records. The QUADAS-2 tool was used to assess the quality of the studies. Diagnostic accuracy measures [i.e., sensitivity, specificity, diagnostic odds ratio (DOR), positive likelihood ratios (PLR), negative likelihood ratios (NLR), and the area under the curve (AUC)] were pooled with a random-effects model. All statistical analyses were performed with Meta-DiSc (Version 1.4, Cochrane Colloquium, Barcelona, Spain). Results: After reviewing retrieved records, we identified 60 studies that met the inclusion criteria. The pooled sensitivity and specificity of the rapid antigen tests against the reference test (the real-time PCR) were 69% (95% CI: 68–70) and 99% (95% CI: 99–99). The PLR, NLR, DOR and the AUC estimates were found to be 72 (95% CI: 44–119), 0.30 (95% CI: 0.26–0.36), 316 (95% CI: 167–590) and 97%, respectively. Conclusion: The present study indicated that using RAT kits is primarily recommended for the early detection of patients suspected of having COVID-19, particularly in countries with limited resources and laboratory equipment. However, the negative RAT samples may need to be confirmed using molecular tests, mainly when the symptoms of COVID-19 are present. Keywords: COVID-19, SARS-CoV-2, rapid antigen test, specificity, sensitivity, meta-analysi

Modulating Earth Gravitational Force for Astronauts in Microgravity Environment to Reduce Space Side Effects on Their Health

Abstract Prolonged zero-g (more precisely, microgravity

Datasheet1_Ezetimibe and atherosclerotic cardiovascular disease: a systematic review and meta-analysis.docx

IntroductionIndividuals diagnosed with atherosclerotic cardiovascular disease (ACD) are exposed to an increased risk of cardiovascular events. Reducing low-density lipoprotein cholesterol (LDL-C) levels has been established as an effective approach to mitigate these risks. However, a comprehensive and up-to-date meta-analysis investigating the LDL-C-lowering effectiveness and the impact on coronary atherosclerotic plaque compositions of Ezetimibe has been lacking.MethodsWe conducted a systematic review by meticulously analyzing databases such as MEDLINE, EMBASE, and the Cochrane CENTRAL for randomized controlled trials that evaluated the efficacy of ezetimibe in lowering LDL-C levels and its influence on coronary atherosclerotic plaques among individuals with ACD. This review encompassed studies available until August 1, 2023. In our analysis, we employed the weighted mean difference (WMD) as the aggregated statistical measure, accompanied by the corresponding 95% confidence interval (CI).ResultsWe encompassed a total of 20 eligible studies. Our findings unveiled that the combined therapy involving ezetimibe alongside statins led to a more substantial absolute decrease in LDL-C in comparison to using statins alone. This difference in means amounted to (−14.06 mg/dl; 95% CI −18.0 to −10.0; p = 0.0001). Furthermore, upon conducting subgroup analyses, it became evident that the intervention strategies proved effective in diminishing the volume of dense calcification (DC) in contrast to the control group.ConclusionsOur study findings indicate that the inclusion of ezetimibe in conjunction with statin therapy leads to a modest yet meaningful additional reduction in LDL-C levels when compared to using statins in isolation. Importantly, the introduction of ezetimibe resulted in a significant decrease in the volume of DC. However, it is worth noting that further investigation is warranted to delve deeper into this phenomenon.</p

Investigating the Potential of Streptomyces spp. in Suppression of Rhizoctonia solani (AG1-IA) Causing Rice Sheath Blight Disease in Northern Iran

A study was conducted in the Guilan Province of Iran, using a variety of Actinomycetes species isolated from the rice fields, with the intention of identifying useful biocontrol agents to lessen rice sheath blight disease. The antagonistic effects against the rice pathogen agent were also assessed both in vitro and in vivo. The antifungal abilities of more than 30 Actinomycetes isolates against the Rhizoctonia solani K&uuml;hn (AG1-IA) were used. The biocontrol abilities of the most active isolates were studied in a greenhouse. The size of the inhibition zone against pathogen development and the most potent antagonist Actinomycetes isolates were determined based on the dual culture screening test findings. The ability to create hydrolytic enzymes including amylase, chitinase, protease, and lipase were shown by hydrolytic enzyme assays on the putative antagonists. Antifungal activities of Streptomyces isolates against fungus mycelia were also studied using SEM since, compared to the control grown mycelia and mycelia adjacent to the inhibition zone in the plate, tests revealed an unusual and deformed structure; in our opinion, the chitinase secreted can destroy fungal mycelium. Chloroform test showed that its antifungal effect persists upon exposure to chloroform. All possible isolates belonged to the Streptomyces species, according to the 16S rDNA molecular analysis of the majority of active isolates. Comparing isolates, G had the highest impact in reducing sheath blight disease. The Iranian strain of the Streptomyces has antifungal capabilities, highlighting its potential as a viable biocontrol agent to be used in an Integrated Disease Management (IDM) program to control the rice sheath blight disease

Diagnostic, Prognostic, and Therapeutic Roles of Gut Microbiota in COVID-19: A Comprehensive Systematic Review

IntroductionThe Coronavirus Disease 2019 (COVID-19) pandemic caused by Severe Acute Respiratory Coronavirus 2 (SARS-CoV-2) emerged in late December 2019. Considering the important role of gut microbiota in maturation, regulation, and induction of the immune system and subsequent inflammatory processes, it seems that evaluating the composition of gut microbiota in COVID-19 patients compared with healthy individuals may have potential value as a diagnostic and/or prognostic biomarker for the disease. Also, therapeutic interventions affecting gut microbial flora may open new horizons in the treatment of COVID-19 patients and accelerating their recovery. MethodsA systematic search was conducted for relevant studies published from December 2019 to December 2021 using Pubmed/Medline, Embase, and Scopus. Articles containing the following keywords in titles or abstracts were selected: "SARS-CoV-2" or "COVID-19" or "Coronavirus Disease 19" and "gastrointestinal microbes" or "dysbiosis" or "gut microbiota" or "gut bacteria" or "gut microbes" or "gastrointestinal microbiota". ResultsOut of 1,668 studies, 22 articles fulfilled the inclusion criteria and a total of 1,255 confirmed COVID-19 patients were examined. All included studies showed a significant association between COVID-19 and gut microbiota dysbiosis. The most alteration in bacterial composition of COVID-19 patients was depletion in genera Ruminococcus, Alistipes, Eubacterium, Bifidobacterium, Faecalibacterium, Roseburia, Fusicathenibacter, and Blautia and enrichment of Eggerthella, Bacteroides, Actinomyces, Clostridium, Streptococcus, Rothia, and Collinsella. Also, some gut microbiome alterations were associated with COVID-19 severity and poor prognosis including the increment of Bacteroides, Parabacteroides, Clostridium, Bifidobacterium, Ruminococcus, Campylobacter, Rothia, Corynebacterium, Megasphaera, Enterococcus, and Aspergillus spp. and the decrement of Roseburia, Eubacterium, Lachnospira, Faecalibacterium, and the Firmicutes/Bacteroidetes ratio. ConclusionOur study showed a significant change of gut microbiome composition in COVID-19 patients compared with healthy individuals. This great extent of impact has proposed the gut microbiota as a potential diagnostic, prognostic, and therapeutic strategy for COVID-19. There is much evidence about this issue, and it is expected to be increased in near future

Table_1_Impact of educational interventions on the prevention of influenza: A systematic review.docx

IntroductionSeasonal influenza, a contagious viral disease affecting the upper respiratory tract, circulates annually, causing considerable morbidity and mortality. The present study investigates the effectiveness of educational interventions to prevent influenza.MethodsWe searched PubMed/Medline, Embase, and Cochrane Controlled Register of Trials (CENTRAL) for relevant clinical studies up to March 1 2022. The following terms were used: “influenza,” “flu,” “respiratory infection,” “prevent,” “intervention,” and “education.”ResultsOut of 255 studies, 21 articles satisfied the inclusion criteria and were included in our study: 13 parallel randomized controlled trials (RCT) studies, two cross-over RCT studies, two cohort studies, and four quasi-experimental studies. A total of approximately 12,500 adults (18 years old or above) and 11,000 children were evaluated. Educational sessions and reminders were the most common interventions. The measured outcomes were vaccination rates, the incidence of respiratory tract infection (RTI), and preventive behaviors among participants. Eighteen out of 21 articles showed a significant association between educational interventions and the outcomes.ConclusionsThe included studies in the current systematic review reported the efficacy of health promotion educational interventions in improving knowledge about influenza, influenza prevention behaviors, vaccination rates, and decreased RTI incidence regardless of the type of intervention and the age of cases.</p

Table_3_Impact of educational interventions on the prevention of influenza: A systematic review.docx

IntroductionSeasonal influenza, a contagious viral disease affecting the upper respiratory tract, circulates annually, causing considerable morbidity and mortality. The present study investigates the effectiveness of educational interventions to prevent influenza.MethodsWe searched PubMed/Medline, Embase, and Cochrane Controlled Register of Trials (CENTRAL) for relevant clinical studies up to March 1 2022. The following terms were used: “influenza,” “flu,” “respiratory infection,” “prevent,” “intervention,” and “education.”ResultsOut of 255 studies, 21 articles satisfied the inclusion criteria and were included in our study: 13 parallel randomized controlled trials (RCT) studies, two cross-over RCT studies, two cohort studies, and four quasi-experimental studies. A total of approximately 12,500 adults (18 years old or above) and 11,000 children were evaluated. Educational sessions and reminders were the most common interventions. The measured outcomes were vaccination rates, the incidence of respiratory tract infection (RTI), and preventive behaviors among participants. Eighteen out of 21 articles showed a significant association between educational interventions and the outcomes.ConclusionsThe included studies in the current systematic review reported the efficacy of health promotion educational interventions in improving knowledge about influenza, influenza prevention behaviors, vaccination rates, and decreased RTI incidence regardless of the type of intervention and the age of cases.</p

Table_2_Impact of educational interventions on the prevention of influenza: A systematic review.docx

IntroductionSeasonal influenza, a contagious viral disease affecting the upper respiratory tract, circulates annually, causing considerable morbidity and mortality. The present study investigates the effectiveness of educational interventions to prevent influenza.MethodsWe searched PubMed/Medline, Embase, and Cochrane Controlled Register of Trials (CENTRAL) for relevant clinical studies up to March 1 2022. The following terms were used: “influenza,” “flu,” “respiratory infection,” “prevent,” “intervention,” and “education.”ResultsOut of 255 studies, 21 articles satisfied the inclusion criteria and were included in our study: 13 parallel randomized controlled trials (RCT) studies, two cross-over RCT studies, two cohort studies, and four quasi-experimental studies. A total of approximately 12,500 adults (18 years old or above) and 11,000 children were evaluated. Educational sessions and reminders were the most common interventions. The measured outcomes were vaccination rates, the incidence of respiratory tract infection (RTI), and preventive behaviors among participants. Eighteen out of 21 articles showed a significant association between educational interventions and the outcomes.ConclusionsThe included studies in the current systematic review reported the efficacy of health promotion educational interventions in improving knowledge about influenza, influenza prevention behaviors, vaccination rates, and decreased RTI incidence regardless of the type of intervention and the age of cases.</p

The efficacy of mouthwashes in reducing SARS-CoV-2 viral loads in human saliva: A systematic review

This systematic review aimed to evaluate existing randomized controlled trials (RCT) and cohort studies on the efficacy of mouthwashes in reducing SARS-CoV-2 viral loads in human saliva.Searches with pertinent search terms were conducted in PubMed, MEDLINE, Scopus, and Web of Science databases for relevant records published up to Oct 15, 2022. Google Scholar and ProQuest were searched for grey literature. Manual searches were conducted as well for any pertinent articles. The protocol was prospectively registered at PROSPERO (CRD42022324894). Eligible studies were critically appraised for risk of bias and quality of evidence to assess the efficacy of mouthwash in reducing the SARS-CoV-2 viral load in human saliva.Eleven studies were included. The effect on viral load using various types of mouthwash was observed, including chlorhexidine (CHX), povidone-iodine (PI), cetylpyridinium chloride (CPC), hydrogen peroxide (HP), ß-cyclodextrin-citrox mouthwash (CDCM), and Hypochlorous acid (HCIO). Eight articles discussed CHX use. Five were found to be significant and three did not show any significant decrease in viral loads. Eight studies reviewed the use of PI, with five articles identifying a significant decrease in viral load, and three not showing a significant decrease in viral load. HP was reviewed in four studies, two studies identified significant viral load reductions, and two did not. CPC was reviewed in four studies, two of which identified significant viral load reductions, and two did not. CDCM was reviewed in one article which found a significant decrease in viral load reduction. Also, HCIO which was evaluated in one study indicated no significant difference in CT value.The current systematic review indicates that based on these eleven studies, mouthwashes are effective at reducing the SARS-CoV-2 viral load in human saliva. However, further studies should be performed on larger populations with different mouthwashes. The overall quality of evidence was high