In this study, the authors have successfully prepared the polyethylene glycol (PEG)-coated zinc oxide nanoparticles (ZNPs) and studied its effect in pancreatic cancer cells. The authors have observed a nanosized particle with spherical shape. In this study, the authors have demonstrated the cytotoxic effect of ZNP and PZNP in PANC1 cells. To be specific, PZNP was more cytotoxic compared to that of ZNP in PANC1 cancer cells. The authors have further showed that apoptosis is the main mode of cytotoxic activity. It is worth noting that PEGylation of ZNP did not decrease the cell killing activity of zinc particles, whereas it further increases its anticancer effect in the pancreatic cancer cells. The authors have observed a significant upregulation of proapoptotic BAX while expression of antiapoptotic Bcl-2 was significantly downregulated indicating the potent anticancer effect of zinc nanoparticles. Overall, PEGylation of ZNP could be an effective strategy to improve the stability, while at the same time, its anticancer activity could be enhanced for better therapeutic response.
Abstract Background Traditional Chinese medicine (TCM) has been applied in the treatment of COVID-19 in China, but its effectiveness and safety need evaluation. Methods A multi-center retrospective cohort study was carried out, with cumulative TCM treatment period of ≥ 3 days during hospitalization as exposure. Data came from consecutive inpatients in 4 medical centers in Wuhan, China. After data extraction, verification and cleaning, confounding factors were adjusted by inverse probability of treatment weighting, and the Cox proportional hazards regression model was used for statistical analysis. Results A total of 2272 COVID-19 patients were included, including 1684 in the TCM group and 588 in the control group. Compared with the control group, the hazard ratio for the deterioration rate in the TCM group was 0.52 [95% CI: (0.41, 0.64), P < 0.001]. The results were consistent across patients of varying severity at admission, and two sensitivity analyses confirmed the robustness of the results. In addition, the hazard ratio for all-cause mortality in the TCM group was 0.29 (95% CI = 0.19–0.44, P < 0.001). For safety, the proportion of patients with abnormal liver function or renal function in the TCM group was smaller. Conclusion This real-world study indicates that the addition of a full course of TCM therapy to basic conventional treatment, may reduce the deterioration rate and all-cause mortality of COVID-19 patients with safety. This result can provide evidence to support the current treatment of COVID-19 and new respiratory infectious diseases in the future. Additional prospective clinical trial is needed to evaluate the efficacy and safety of specific TCM interventions. Trial registration: ChiCTR, ChiCTR2200062917. Registered 23 August 2022, http://www.chictr.org.cn/showproj.aspx?proj=171556.
Abstract Background About 83,000 COVID-19 patients were confirmed in China up to May 2020. Amid the well-documented threats to physical health, the effects of this public health crisis - and the varied efforts to contain its spread - have altered individuals’ “normal” daily functioning. These impacts on social, psychological, and emotional well-being remain relatively unexplored – in particular, the ways in which Chinese men and women experience and respond to potential behavioral stressors. Our study investigated sex differences in psychological stress, emotional reactions, and behavioral responses to COVID-19 and related threats among Chinese residents. Methods In late February (2020), an anonymous online questionnaire was disseminated via WeChat, a popular social media platform in China. The cross-sectional study utilized a non-probabilistic “snowball” or convenience sampling of residents from various provinces and regions of China. Basic demographic characteristics (e.g., age and gender) – along with residential living arrangements and conditions – were measured along with psychological stress and emotional responses to the COVID-19 pandemic. Results 3,088 questionnaires were returned: 1,749 females (56.6%) and 1,339 males (43.4%). The mean stress level,as measured by a visual analog scale, was 3.4 (SD=2.4) - but differed significantly by sex. Besides sex, factors positively associated with stress included: age (<45 years), employment (unsteady income, unemployed), risk of infection (exposureto COVID-19，completed medical observation), difficulties encountered (diseases, work/study, financial, mental), and related behaviors (higher desire for COVID-19 knowledge, more time concerning on the COVID-19 outbreak). “Protective” factors included frequent contact with colleagues, calmness of mood comparing with the pre-pandemic, and psychological resilience. Males and females also differed significantly in adapting to current living/working, conditions, responding to run a fever, and needing psychological support services. Conclusions The self-reported stress of Chinese residents related to the COVID-19 pandemic was significantly related to sex, age, employment, resilience and coping styles. Future responses to such public health threats may wish to provide sex- and/or age-appropriate supports for psychological health and emotional well-being to those at greatest risk of experiencing stress.
BACKGROUND Interventions based on apps are becoming increasingly popular for the treatment of osteoarthritis, but research on the potential moderators of treatment efficacy is lacking. OBJECTIVE To examine the treatment efficacy, cost-effective, and safety associated with app-based interventions for populations with osteoarthritis and identify the potential factors associated with better treatment outcomes. METHODS PubMed, Web of Science, Embase, and the Cochrane Library were searched from their inception to September 19, 2024. Including randomized controlled trial on app-based interventions for osteoarthritis patients that report efficacy or health economic outcomes. The primary outcome measure is the change in pain intensity before and after treatment. Secondary outcomes included function, quality of life, adverse events and self-management. RESULTS The review includes 14 studies, comprising 12 randomized controlled trials and two health economics studies, with 1,410 participants. Compared with controls, app-based interventions reduction in pain and improvement in physical function (standardized mean difference [SMD] = -0.36; 95% confidence interval [CI]: -0.58 to -0.14; P < 0.001; I2 = 72% and SMD = 0.39; 95% CI: 0.16 to 0.62; P < 0.001; I2 = 67%; respectively), but no significance for quality of life and adverse events (SMD = 0.23; 95% CI: -0.04 to 0.50; P = 0.10; I2 = 68% = 1.33; 95% CI: 0.84 to 2.12; P = 0.23; I2= 7%; respectively). Subgroup analysis revealed a significant difference between those aged ≥ 60 years and those aged < 60 years (SMD = -0.29; 95%CI: -0.51 to -0.06 and SMD = -0.84; 95%CI : -1.25 to -0.43). CONCLUSIONS This study showed that app-based interventions are safe and effective for osteoarthritis patients, which might provide a cost-effective option, especially in resource-limited settings. Age is a critical factor for optimizing treatment benefits especially when considering individual needs. CLINICALTRIAL Prospero CRD42024559569
Abstract Background The potential roles of affective responses to environmental stressors in individuals’ physical and mental health are complex and multi-faceted. This study, then, explores Chinese citizens’ emotional responses to COVID-19-related stressors and influence factors which may boost or buffer such effects. Methods From late March to early June (2020), a cross-sectional study was conducted using an anonymous online questionnaire included demographic characteristics, COVID-19-related stressors related to individuals’ daily functioning, and the self-assessed impact of protective and adverse internal factors on emotions. Results 1,662 questionnaires were received from residents in 32 Chinese provinces classified by prevalence level according to COVID-19 infections. Among the 17 positive and negative emotional responses, agglomerative hierarchical clustering revealed four subclassifications: (1) stress relations; (2) missing someone relations; (3) individual relations; and (4) social relations. Additionally, heightened regional prevalence levels positively corresponded to intensity of stress relations. Lowest intensity of social relations was found in the areas surrounding Wuhan and coastal areas. Specially, economic- and work-related stressors as well as negative self-perceptions (e.g., suppression, emotionally unstable, self-denial) implicated in negative emotions. While positive emotions were tied to demographic characteristics (e.g., high education, young age and male) and protective traits (e.g., creativity, sympathy, social responsibility), and inversely linked to relationships- and pandemic-related stressors, etc. Conclusion Associations were clearly noted among Chinese residents’ emotions to specific stressors during pandemic. Providing appropriate psychological resources/supports during future or extended public health crises may help offset the cognitive burden of individuals striving to regain an adequate level of normalcy and emotional well-being.
Abstract Background Chinese herbal medicine is one of the most popular Chinese medicine (CM) therapies for primary insomnia. One of the important characteristics of CM is that different Chinese clinicians give different prescriptions even for the same patient. However, there must be some fixed drug patterns in every clinician’s prescriptions. This study aims to screen the effective core drug patterns in primary insomnia treatment of three prestigious Chinese clinicians. Methods/design A triple-blind, randomized, placebo-controlled, parallel-group clinical trial will be performed. Three clinicians will diagnose and treat every eligible patient individually and independently, producing three prescriptions from three clinicians for every patient. Patients will equally be randomized to one of four groups – medical group A, medical group B, medical group C, or placebo group – and observed for efficacy of treatment. The sample will include primary insomnia patients meeting DSM IV-TR criteria, Spiegel scale score >18, and age 18 to 65 years. A sequential design is employed. Interim analysis will be conducted when between 80 and 160 patients complete the study. The interim study could be stopped and treated as final if a statistically significant difference between treatment and placebo groups can be obtained and core effective drug patterns can be determined. Otherwise, the study continues until the maximum sample size reaches 300. Treatment of the CM group is one of three Chinese clinicians’ prescriptions, who provide independently prescriptions based on their own CM theory and the patient’s disease condition. Assessment will be by sleep diary and Pittsburgh sleep quality index, and CM symptoms and signs will be measured. Primary outcome is total sleep time. Assessment will be carried out at the washout period, weeks 1, 2, 3, and 4 and 4th week after the end of treatment. Effectiveness analysis will be per intent to treat. A multi-dimension association rule and scale-free networks method will be used to explore the effective core drug patterns. Discussion The effective core drug patterns will be found through analyzing several prestigious CM clinicians’ treatment information. Screening the effective core drug patterns from prestigious clinicians can accelerate the development of new CM drugs. Trial registration NCT01613183
Previous research has shown that electro-acupuncture (EA) may be effective for functional constipation. We report a protocol for a randomized controlled trial using EA to confirm the efficacy and safety for severe chronic functional constipation. This is a randomized, controlled trial. A total of 1,034 patients will be randomly allocated into the EA group (n=517) and the sham EA group (n=517). The EA group receives needling at ST25, SP14 and ST37 and the sham EA group receives needling at sham ST25, SP14 and ST37. The primary outcome measure is the changed number of weekly average complete spontaneous bowel movements(CSBMs) during 8 weeks of treatment, compared with baseline. The secondary outcome measures are: 1) the proportion of participants having three or more CSBMs on average per week; 2) the changed number of weekly average CSBMs during weeks 9 to 20; 3) the changed number of weekly average spontaneous bowel movements during 8 weeks of treatment; 4) stool consistency; 5) degree of difficulty in defecation; 6) patient assessment of constipation quality of life questionnaire (PAC-QOL); 7) incidence of adverse events; and 8) usage of medicine for constipation. This trial will evaluate the efficacy and safety of EA for severe chronic functional constipation. Protocol Registration System of ClinicalTrial.gov, NCT01726504
Importance Acupuncture is a promising therapy for irritable bowel syndrome (IBS), but the use of subjective scales as an assessment is accompanied by high placebo response rates. Objectives To preliminarily test the feasibility of using US Food and Drug Administration (FDA)–recommended end points to evaluate the efficacy of acupuncture in the treatment of IBS. Design, Setting, and Participants This pilot, multicenter randomized clinical trial was conducted in 4 tertiary hospitals in China from July 1, 2020, to March 31, 2021, and 14-week data collection was completed in March 2021. Individuals with a diagnosis of IBS with diarrhea (IBS-D) were randomized to 1 of 3 groups, including 2 acupuncture groups (specific acupoints [SA] and nonspecific acupoints [NSA]) and a sham acupuncture group (non-acupoints [NA]) with a 1:1:1 ratio. Interventions Patients in all groups received twelve 30-minute sessions over 4 consecutive weeks at 3 sessions per week (ideally every other day). Main Outcomes and Measures The primary outcome was the response rate at week 4, which was defined as the proportion of patients whose worst abdominal pain score (score range, 0-10, with 0 indicating no pain and 10 indicating unbearable severe pain) decreased by at least 30% and the number of type 6 or 7 stool days decreased by 50% or greater. Results Ninety patients (54 male [60.0%]; mean [SD] age, 34.5 [11.3] years) were enrolled, with 30 patients in each group. There were substantial improvements in the primary outcomes for all groups (composite response rates of 46.7% [95% CI, 28.8%-65.4%] in the SA group, 46.7% [95% CI, 28.8%-65.4%] in the NSA group, and 26.7% [95% CI, 13.0%-46.2%] in the NA group), although the difference between them was not statistically significant ( P = .18). The response rates of adequate relief at week 4 were 64.3% (95% CI, 44.1%-80.7%) in the SA group, 62.1% (95% CI, 42.4%-78.7%) in the NSA group, and 55.2% (95% CI, 36.0%-73.0%) in the NA group ( P = .76). Adverse events were reported in 2 patients (6.7%) in the SA group and 3 patients (10%) in NSA or NA group. Conclusions and Relevance In this pilot randomized clinical trial, acupuncture in both the SA and NSA groups showed clinically meaningful improvement in IBS-D symptoms, although there were no significant differences among the 3 groups. These findings suggest that acupuncture is feasible and safe; a larger, sufficiently powered trial is needed to accurately assess efficacy. Trial Registration Chinese Clinical Trial Registry: ChiCTR2000030670
Collecting a sufficient amount of 3D training data for autonomous vehicles to handle rare, but critical, traffic events (e.g., collisions) may take decades of deployment. Abundant video data of such events from municipal traffic cameras and video sharing sites (e.g., YouTube) could provide a potential alternative, but generating realistic training data in the form of 3D video reconstructions is a challenging task beyond the current capabilities of computer vision. Crowdsourcing the annotation of necessary information could bridge this gap, but the level of accuracy required to obtain usable reconstructions makes this task nearly impossible for non-experts. In this paper, we propose a novel hybrid intelligence method that combines annotations from workers viewing different instances (video frames) of the same target (3D object), and uses particle filtering to aggregate responses. Our approach can leveraging temporal dependencies between video frames, enabling higher quality through more aggressive filtering. The proposed method results in a 33% reduction in the relative error of position estimation compared to a state-of-the-art baseline. Moreover, our method enables skipping (self-filtering) challenging annotations, reducing the total annotation time for hard-to-annotate frames by 16%. Our approach provides a generalizable means of aggregating more accurate crowd responses in settings where annotation is especially challenging or error-prone.
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