Intelligent Head-Mounted Obstacle Avoidance Wearable for the Blind and Visually Impaired.

Individuals who are Blind and Visually Impaired (BVI) take significant risks and dangers on obstacles, particularly when they are unaccompanied. We propose an intelligent head-mount device to assist BVI people with this challenge. The objective of this study is to develop a computationally efficient mechanism that can effectively detect obstacles in real time and provide warnings. The learned model aims to be both reliable and compact so that it can be integrated into a wearable device with a small size. Additionally, it should be capable of handling natural head turns, which can generally impact the accuracy of readings from the device's sensors. Over thirty models with different hyper-parameters were explored and their key metrics were compared to identify the most suitable model that strikes a balance between accuracy and real-time performance. Our study demonstrates the feasibility of a highly efficient wearable device that can assist BVI individuals in avoiding obstacles with a high level of accuracy.

High-performance composite separators based on the synergy of vermiculite and laponite for lithium-ion batteries.

The electrochemical performance and safe operation of the separator plays an important role in lithium-ion batteries. The introduction of inorganic nanoparticles into the separators with organic matter as the matrix effectively improves the thermal stability and wettability of the composite separators, but it also blocks some pores and adversely affects the electrochemical performance. Herein, vermiculite and laponite nanoparticles are introduced into a poly(vinylidene fluoride) matrix to prepare organic-inorganic composite separators for lithium-ion batteries and the synergistic effect of the two inorganic nanofillers is explored. By adding the same amount of the two nanoparticles into the polymer matrix, the prepared separator has the highest ionic conductivity (0.72 mS cm-1) at room temperature and the lowest interfacial impedance (283 Ω). It has an initial discharge capacity of 161.2 mA h g-1 at a rate of 0.5C, a coulombic efficiency of 99.5% after 100 cycles, and a high capacity retention rate of 98.4%, which shows excellent rate performance. The results show that the two clay nanoparticles exert their respective advantages and exhibit a synergistic enhancement effect on the battery performance, which inspires new ideas for the preparation of new organic-inorganic composite separators.

Career Considerations in Nurse-Led Traditional Chinese Medicine Clinics: a Two-Center Qualitative Study.

Background: Growing demand exists for high-quality Traditional Chinese Medicine (TCM) care, particularly through Nurse-led TCM clinics (TCM-NLCs). Nurses with extensive experience in TCM departments represent a potential workforce for this healthcare model. This qualitative study aims to investigate the willingness of these candidates to engage in TCM-NLCs, with a specific focus on their main concerns and apprehensions when facing new challenges. Methods: Individual semi-structured face to face interviews were conducted with senior nurses from two TCM hospitals in Shanghai. Each participant had a minimum of three years of work experience in a TCM related department. Conventional qualitative content analysis was utilized. Results: Fourteen participants were interviewed and data saturation was achieved. Nurses exhibited strong interest in practicing in TCM-NLCs. They believed that such innovative TCM nursing service model not only extends nursing role, provides greater empowerment and opportunities for professional development but also meets patients' diverse healthcare needs, reduces reliance on other healthcare providers such as doctors, and increases hospital revenue. However, challenges such as deficiencies in evidence-based TCM nursing education, the absence of standardized practice guidelines, and limited prescriptive privileges were identified as primary obstacles to engaging in TCM-NLCs practice, potentially undermining the specialization of this advanced nursing practice model. Conclusion: Although the nurses interviewed were highly motivated, they generally lacked confidence to practice independently in TCM-NLCs. A pressing priority is to address their concerns by providing appropriate resources as well as education and policy support to enhance their competency and ensure their practice autonomy, therefore building a more qualified pool of professionals for advanced TCM nursing practice.

Commercial Chinese polyherbal preparation Zao Ren An Shen prescription for primary insomnia: a systematic review with meta-analysis and trial sequential analysis.

Background: Natural products are widely used for primary insomnia (PI). This systematic review with trial sequential analysis (TSA) aimed to summarize evidence pertaining to the effectiveness and safety of Zao Ren An Shen (ZRAS) prescription, a commercial Chinese polyherbal preparation, for treating PI. Methods: Controlled clinical trials appraising ZRAS compared to controls or as an add-on treatment were systematically searched across seven databases until January 2024. Cochrane ROB 2.0 and ROBINS-I tools were adopted to determine risk of bias. Quality of evidence was assessed using the GRADE framework. Results: We analyzed 22 studies, involving 2,142 participants. The effect of ZRAS in reducing Pittsburgh Sleep Quality Index scores was found to be comparable to benzodiazepines [MD = 0.39, 95%CI (-0.12, 0.91), p = 0.13] and superior to Z-drugs [MD = -1.31, 95%CI (-2.37, -0.24), p = 0.02]. The addition of ZRAS to hypnotics more significantly reduced polysomnographically-recorded sleep onset latency [MD = -4.44 min, 95%CI (-7.98, -0.91), p = 0.01] and number of awakenings [MD = -0.89 times, 95%CI (-1.67, -0.10), p = 0.03], and increased total sleep time [MD = 40.72 min, 95%CI (25.14, 56.30), p < 0.01], with fewer adverse events than hypnotics alone. TSA validated the robustness of these quantitative synthesis results. However, the quality of evidence ranged from very low to low. The limited data available for follow-up did not support meta-synthesis. Conclusion: While ZRAS prescription shows promising effectiveness in treating PI, the overall quality of evidence is limited. Rigorously-designed randomized control trials are warranted to confirm the short-term efficacy of ZRAS and explore its medium-to-long-term efficacy. Systematic Review Registration: (https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=471497), identifier (CRD42023471497).

Acupuncture for primary insomnia: Effectiveness, safety, mechanisms and recommendations for clinical practice.

Primary insomnia (PI) is an increasing concern in modern society. Cognitive-behavioral therapy for insomnia is the first-line recommendation, yet limited availability and cost impede its widespread use. While hypnotics are frequently used, balancing their benefits against the risk of adverse events poses challenges. This review summarizes the clinical and preclinical evidence of acupuncture as a treatment for PI, discussing its potential mechanisms and role in reliving insomnia. Clinical trials show that acupuncture improves subjective sleep quality, fatigue, cognitive impairments, and emotional symptoms with minimal adverse events. It also positively impacts objective sleep processes, including prolonging total sleep time, improving sleep efficiency, reducing sleep onset latency and wake after sleep onset, and enhancing sleep architecture/structure, including increasing N3% and REM%, and decreasing N1%. However, methodological shortcomings in some trials diminish the overall quality of evidence. Animal studies suggest that acupuncture restores circadian rhythms in sleep-deprived rodents and improves their performance in behavioral tests, possibly mediated by various clinical variables and pathways. These may involve neurotransmitters, brain-derived neurotrophic factors, inflammatory cytokines, the hypothalamic-pituitary-adrenal axis, gut microbiota, and other cellular events. While the existing findings support acupuncture as a promising therapeutic strategy for PI, additional high-quality trials are required to validate its benefits.

Identifying complementary and alternative medicine recommendations for insomnia treatment and care: a systematic review and critical assessment of comprehensive clinical practice guidelines.

Background: There is a need for evidence-informed guidance on the use of complementary and alternative medicine (CAM) for insomnia because of its widespread utilization and a lack of guidance on the balance of benefits and harms. This systematic review aimed to identify and summarize the CAM recommendations associated with insomnia treatment and care from existing comprehensive clinical practice guidelines (CPGs). The quality of the eligible guidelines was appraised to assess the credibility of these recommendations. Methods: Formally published CPGs incorporating CAM recommendations for insomnia management were searched for in seven databases from their inception to January 2023. The NCCIH website and six websites of international guideline developing institutions were also retrieved. The methodological and reporting quality of each included guideline was appraised using the AGREE II instrument and RIGHT statement, respectively. Results: Seventeen eligible GCPs were included, and 14 were judged to be of moderate to high methodological and reporting quality. The reporting rate of eligible CPGs ranged from 42.9 to 97.1%. Twenty-two CAM modalities were implicated, involving nutritional or natural products, physical CAM, psychological CAM, homeopathy, aromatherapy, and mindful movements. Recommendations for these modalities were mostly unclear, unambiguous, uncertain, or conflicting. Logically explained graded recommendations supporting the CAM use in the treatment and/or care of insomnia were scarce, with bibliotherapy, Tai Chi, Yoga, and auriculotherapy positively recommended based on little and weak evidence. The only consensus was that four phytotherapeutics including valerian, chamomile, kava, and aromatherapy were not recommended for insomnia management because of risk profile and/or limited benefits. Conclusions: Existing guidelines are generally limited in providing clear, evidence-informed recommendations for the use of CAM therapies for insomnia management due to a lack of high-quality evidence and multidisciplinary consultation in CPG development. More well-designed studies to provide reliable clinical evidence are therefore urgently needed. Allowing the engagement of a range of interdisciplinary stakeholders in future updates of CPGs is also warranted. Systematic review registration: https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=369155, identifier: CRD42022369155.

Managing depression with complementary and alternative medicine therapies: a scientometric analysis and visualization of research activities.

Background: Complementary and Alternative Medicine (CAM) interventions may prove to be an attractive option for the treatment of depression. The aim of this scientometric analysis is to determine the global scientific output of research regarding managing depression with CAM and identify the hotspots and frontiers within this theme. Methods: Publications regarding the utilization of CAM for treating depression were collected from the Web of Science Core Collection from 1993 to 2022, and analyzed and visualized by Bibliometrix R-package, VOSviewer, and CiteSpace. Results: A total of 1,710 publications were acquired. The number of annual publications showed an overall rapid upward trend, with the figure peaking at 179 in 2021. The USA was the leading research center. Totally 2,323 distinct institutions involving 7,638 scholars contributed to the research theme. However, most of the cooperation was limited to within the same country, institution or research team. The Journal of Alternative and Complementary Medicine was the most productive periodical. The CAM therapies of most interest to researchers were acupuncture and body-mind techniques, such as yoga, meditation and mindfulness. Systematic review and meta-analysis are commonly used methods. "Inflammation," "rating scale" and "psychological stress" were identified as the most studied trend topics recently. Conclusion: Managing depression with evidence-based CAM treatment is gaining attention globally. Body-mind techniques and acupuncture are growing research hotspots or emerging trending topics. Future studies are predicted to potentially investigate the possible mechanisms of action underlying CAM treatments in reducing depression in terms of modulation of psychological stress and inflammation levels. Cross-countries/institutes/team research collaborations should be encouraged and further enhanced.

Identifying complementary and alternative medicine recommendations for anxiety treatment and care: a systematic review and critical assessment of comprehensive clinical practice guidelines.

Background: Clinical practice guidelines (CPGs) are used to guide decision-making, especially regarding complementary and alternative medicine (CAM) therapies that are unfamiliar to orthodox healthcare providers. This systematic review aimed to critically review and summarise CAM recommendations associated with anxiety management included in the existing CPGs. Methods: Seven databases, websites of six international guidelines developing institutions, and the National Centre for Complementary and Integrative Health website were systematically searched. Their reporting and methodological quality were evaluated using the Reporting Items for practice Guidelines in Healthcare checklist and the Appraisal of Guidelines for Research and Evaluation (2nd version) instrument, respectively. Results: Ten CPGs were included, with reporting rates between 51.4 and 88.6%. Seven of these were of moderate to high methodological quality. Seventeen CAM modalities were implicated, involving phytotherapeutics, mind-body practice, art therapy, and homeopathy. Applied relaxation was included in 70% CPGs, which varied in degree of support for its use in the treatment of generalised anxiety disorder. There were few recommendations for other therapies/products. Light therapy was not recommended for use in generalised anxiety disorder, and St John's wort and mindfulness were not recommended for use in social anxiety disorder in individual guidelines. Recommendations for the applicability of other therapies/products for treating a specific anxiety disorder were commonly graded as "unclear, unambiguous, or uncertain". No CAM recommendations were provided for separation anxiety disorder, specific phobia or selective mutism. Conclusion: Available guidelines are limited in providing logically explained graded CAM recommendations for anxiety treatment and care. A lack of high-quality evidence and multidisciplinary consultation during the guideline development are two major reasons. High quality and reliable clinical evidence and the engagement of a range of interdisciplinary stakeholders are needed for future CPG development and updating. Systematic review registration: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022373694, identifier CRD42022373694.

An interfacial coating with high corrosion resistance based on halloysite nanotubes for anode protection of zinc-ion batteries.

Aqueous zinc-ion batteries are recognized as one of the most potential neutral aqueous batteries because of the high energy density, high specific capacity, low cost, and low pollution. However, the applications of zinc-ion batteries are seriously limited by the capacity fading, easy-corrosion, side reaction, and hydrogen evolution. Herein, we report a uniform halloysite nanotubes (HNTs) coating which can guide Zn2+ ions stripping/plating on the HNTs/Zn interfaces and protect the Zn anode. The HNTs coating significantly suppresses the corrosion of Zn anode and effectively reduces the hydrogen evolution and the formation of by-product. Furthermore, the HNTs-Zn anode exhibits lower resistance than bare Zn. Compared with the bare Zn anode batteries, HNTs-Zn/MnO2 batteries exhibit good capacity retention and can increase the discharge capacity to 79% at 3 C after 400 cycles. The novel design of interfacial coating based on halloysite nanotubes through electrophoretic deposition method provides a new way to fabricate economic and stable aqueous zinc-ion batteries.

Molecular Structure and Decomposition Kinetics of Kaolinite/Alkylamine Intercalation Compounds.

Although the development of clay/polymer nanocomposites and their applications have attracted much attention in recent years, a thorough understanding of the structure and the decomposition mechanism of clay/polymer nanocomposites is still lacking. In this research, the intercalation of kaolinite (Kaol) with different alkylamines were investigated by X-ray diffracion (XRD), Fourier-transform infrared spectroscopy (FTIR), and thermogravimetry and differential scanning calorimetry (TG-DSC). The results showed that the intercalation of Kaol/methanol compound with hexylamine (HA), dodecylamine (DA), and octadecylamine (OA) led to the expansion of the interlayer distance and resulted in the dominant basal diffraction at 2.86, 4.08, and 5.66 nm. The alky chains of HA, DA, and OA are tilted toward the Kaol surface in bilayer with an inclination angle of ~40°. The most probable mechanism function, activation energy E, and pre-exponential factor A were obtained by mutual authentication using KAS and Ozawa methods, itrative and Satava integral method. The average activation energy E of the three intercalation compounds are 104.44, 130.80, and 154.59 kJ mol-1, respectively. It shows a positive correlation with the alkyl chain length. The pre-exponential factor A was estimated to be 1.09 × 1015, 1.15 × 108, and 4.17 × 1021 s-1, respectively. The optimized mechanism function for the decomposition of alkylamine is G(α) = [(1-α) -1/3-1]2.