Boosting the Reversible, High-Rate Na+ Storage Capability of the Hard Carbon Anode Via the Synergistic Structural Tailoring and Controlled Presodiation.

Hard carbons (HCs) are extensively investigated as the potential anodes for commercialization of sodium-ion batteries (SIBs). However, the practical deployment of HC anode suffers from the retarded Na+ diffusion at the high-rate or low-temperature operation scenarios. Herein, a multiscale modification strategy by tuning HC microstructure on the particle level as well as replenishing extra Na+ reservoir for the electrode through a homogeneous presodiation therapy is presented. Consequently, the coulombic efficiency of HC anode can be precisely controlled till the close-to-unit value. Detailed kinetics analysis observes that the Na+ diffusivity can be drastically enhanced by two orders of magnitude at the low potential region (< 0.1 V vs. Na+ /Na), which accelerates the rate-limiting step. As pairing the presodiated HC anode (≈5.0 ± 0.2 mg cm-2 ) with the NaVPO4 F cathode (≈10.3 mg cm-2 ) in the 200 mAh pouch cell, the optimal balance of the cyclability (83% over 1000 cycles), low-temperature behavior till -40 °C as well as the maximized power output of 1500 W kg-1 can be simultaneously achieved. This synergistic modification strategy opens a new avenue to exploit the reversible, ultrafast Na+ storage kinetics of HC anodes, which thus constitutes a quantum leap forward toward high-rate SIB prototyping.

hnRNPC regulates cancer-specific alternative cleavage and polyadenylation profiles.

Alternative cleavage and polyadenylation (APA) can occur at more than half of all human genes, greatly enhancing the cellular repertoire of mRNA isoforms. As these isoforms can have altered stability, localisation and coding potential, deregulation of APA can disrupt gene expression and this has been linked to many diseases including cancer progression. How APA generates cancer-specific isoform profiles and what their physiological consequences are, however, is largely unclear. Here we use a subcellular fractionation approach to determine the nuclear and cytoplasmic APA profiles of successive stages of colon cancer using a cell line-based model. Using this approach, we show that during cancer progression specific APA profiles are established. We identify that overexpression of hnRNPC has a critical role in the establishment of APA profiles characteristic for metastatic colon cancer cells, by regulating poly(A) site selection in a subset of genes that have been implicated in cancer progression including MTHFD1L.

Fluorometric determination of the activity of the biomarker terminal deoxynucleotidyl transferase via the enhancement of the fluorescence of silver nanoclusters by in-situ grown DNA tails.

The activity of terminal deoxynucleotidyl transferase (TdTase) is a biomarker for routine diagnosis of acute leukemia. A method has been developed for the determination of TdTase activity. It is based on the use of silver nanoclusters (AgNCs) whose yellow fluorescence is enhanced by an in-situ grown DNA tail of TdTase-polymerized and guanine-rich DNA at the 3' end of a hairpin DNA. The fluorescence, best measured at excitation/emission peaks of 530/585 nm, increases linearly in the 1 to 35 mU mL-1 TdTase activity range. The detection limit is 0.8 mU mL-1. The method is cost-efficient, selective and convenient. It integrates enhancement of the fluorescence of AgNCs and target recognition into a single process. Graphical abstract Schematic presentation of a method for determination of TdTase activity. It is based on AgNCs fluorescence enhanced by in-situ grown TdTase-polymerized G-rich DNA tail. The method integrates AgNCs fluorescence enhancement and the target recognition into a single process.

Cleavage and polyadenylation: Ending the message expands gene regulation.

Cleavage and polyadenylation (pA) is a fundamental step that is required for the maturation of primary protein encoding transcripts into functional mRNAs that can be exported from the nucleus and translated in the cytoplasm. 3'end processing is dependent on the assembly of a multiprotein processing complex on the pA signals that reside in the pre-mRNAs. Most eukaryotic genes have multiple pA signals, resulting in alternative cleavage and polyadenylation (APA), a widespread phenomenon that is important to establish cell state and cell type specific transcriptomes. Here, we review how pA sites are recognized and comprehensively summarize how APA is regulated and creates mRNA isoform profiles that are characteristic for cell types, tissues, cellular states and disease.

Role played by the SP4 gene in schizophrenia and major depressive disorder in the Han Chinese population.

BACKGROUND: Psychiatric disorders such as schizophrenia and major depressive disorder (MDD) are likely to be caused by multiple susceptibility genes, each with small effects in increasing the risk of illness. Identifying DNA variants associated with schizophrenia and MDD is a crucial step in understanding the pathophysiology of these disorders. AIMS: To investigate whether the SP4 gene plays a significant role in schizophrenia or MDD in the Han Chinese population. METHOD: We focused on nine single nucleotide polymorphisms (SNPs) harbouring the SP4 gene and carried out case-control studies in 1235 patients with schizophrenia, 1045 patients with MDD and 1235 healthy controls recruited from the Han Chinese population. RESULTS: We found that rs40245 was significantly associated with schizophrenia in both allele and genotype distributions (Pallele = 0.0005, Pallele = 0.004 after Bonferroni correction; Pgenotype = 0.0023, Pgenotype = 0.0184 after Bonferroni correction). The rs6461563 SNP was significantly associated with schizophrenia in the allele distributions (Pallele = 0.0033, Pallele = 0.0264 after Bonferroni correction). CONCLUSIONS: Our results suggest that common risk factors in the SP4 gene are associated with schizophrenia, although not with MDD, in the Han Chinese population.

Thermophysical and mechanical properties of granite and its effects on borehole stability in high temperature and three-dimensional stress.

When exploiting the deep resources, the surrounding rock readily undergoes the hole shrinkage, borehole collapse, and loss of circulation under high temperature and high pressure. A series of experiments were conducted to discuss the compressional wave velocity, triaxial strength, and permeability of granite cored from 3500 meters borehole under high temperature and three-dimensional stress. In light of the coupling of temperature, fluid, and stress, we get the thermo-fluid-solid model and governing equation. ANSYS-APDL was also used to stimulate the temperature influence on elastic modulus, Poisson ratio, uniaxial compressive strength, and permeability. In light of the results, we establish a temperature-fluid-stress model to illustrate the granite's stability. The compressional wave velocity and elastic modulus, decrease as the temperature rises, while poisson ratio and permeability of granite increase. The threshold pressure and temperature are 15 MPa and 200 °C, respectively. The temperature affects the fracture pressure more than the collapse pressure, but both parameters rise with the increase of temperature. The coupling of thermo-fluid-solid, greatly impacting the borehole stability, proves to be a good method to analyze similar problems of other formations.

An in-situ polymerization strategy for gel polymer electrolyte Si||Ni-rich lithium-ion batteries.

Coupling the Si-based anodes with nickel-rich LiNixMnyCo1-x-yO2 cathodes (x ≥ 0.8) in the energy-dense cell prototype suffers from the mechanical instability of the Li-Si alloys, cathode collapse upon the high-voltage cycling, as well as the severe leakage current at elevated temperatures. More seriously, the cathode-to-anode cross-talk effect of transitional metal aggravates the depletion of the active Li reservoir. To reconcile the cation utilization degree, stress dissipation, and extreme temperature tolerance of the Si-based anode||NMC prototype, we propose a gel polymer electrolyte to reinforce the mechanical integrity of Si anode and chelate with the transitional cations towards the stabilized interfacial property. As coupling the conformal gel polymer electrolyte encapsulation with the spatial arranged Si anode and NMC811 cathode, the 2.7 Ah pouch-format cell could achieve the high energy density of 325.9 Wh kg-1 (based on the whole pouch cell), 88.7% capacity retention for 2000 cycles, self-extinguish property as well as a wide temperature tolerance. Therefore, this proposed polymerization strategy provides a leap toward the secured Li batteries.

A Hydrogel Electrolyte toward a Flexible Zinc-Ion Battery and Multifunctional Health Monitoring Electronics.

The compact design of an environmentally adaptive battery and effectors forms the foundation for wearable electronics capable of time-resolved, long-term signal monitoring. Herein, we present a one-body strategy that utilizes a hydrogel as the ionic conductive medium for both flexible aqueous zinc-ion batteries and wearable strain sensors. The poly(vinyl alcohol) hydrogel network incorporates nano-SiO2 and cellulose nanofibers (referred to as PSC) in an ethylene glycol/water mixed solvent, balancing the mechanical properties (tensile strength of 6 MPa) and ionic diffusivity at -20 °C (2 orders of magnitude higher than 2 M ZnCl2 electrolyte). Meanwhile, cathode lattice breathing during the solvated Zn2+ intercalation and dendritic Zn protrusion at the anode interface are mitigated. Besides the robust cyclability of the Zn∥PSC∥V2O5 prototype within a wide temperature range (from -20 to 80 °C), this microdevice seamlessly integrates a zinc-ion battery with a strain sensor, enabling precise monitoring of the muscle response during dynamic body movement. By employing transmission-mode operando XRD, the self-powered sensor accurately documents the real-time phasic evolution of the layered cathode and synchronized strain change induced by Zn deposition, which presents a feasible solution of health monitoring by the miniaturized electronics.

Upcycling the Spent Graphite Anode Into the Prelithiation Catalyst: A Separator Strategy Toward Anode-Free Cell Prototyping.

The substantial manufacturing of lithium-ion batteries (LIBs) requires sustainable, circular, and decarbonized recycling strategies. While efforts are concentrated on extracting valuable metals from cathodes using intricate chemical process, the direct, efficient cathode regeneration remains a technological challenge. More urgently, the battery supply chain also requires the value-added exploitation of retired anodes. Here, a "closed-loop" approach is proposed to upcycle spent graphite into the prelithiation catalyst, namely the fewer-layer graphene flakes (FGF), upon the exquisite tuning of interlayer spacing and defect concentration. Since the catalytic FGF mitigates the delithiation energy barrier from calcinated Li5FeO4 nanocrystalline, the composite layer of which cast on the polyolefin substrate thus enables a customized prelithiation capability (98% Li+ utilization) for the retired LiFePO4 recovery. Furthermore, the hydrophobic polymeric modification guarantees the moisture tolerance of Li5FeO4 agents, aligning with commercial battery manufacturing standards. The separator strategy well regulates the interfacial chemistry in the anode-free pouch cell (LiFePO4||Cu), the prototype of which balances the robust cyclability, energy density up to 386.6 Wh kg-1 as well as the extreme power output of 1159.8 W kg-1. This study not only fulfills the sustainable supply chain with graphite upcycling, but also establishes a generic, viable protocol for the anode-free cell prototyping.

High-capacity, fast-charging and long-life magnesium/black phosphorous composite negative electrode for non-aqueous magnesium battery.

Secondary non-aqueous magnesium-based batteries are a promising candidate for post-lithium-ion battery technologies. However, the uneven Mg plating behavior at the negative electrode leads to high overpotential and short cycle life. Here, to circumvent these issues, we report the preparation of a magnesium/black phosphorus (Mg@BP) composite and its use as a negative electrode for non-aqueous magnesium-based batteries. Via in situ and ex situ physicochemical measurements, we demonstrate that Mg ions are initially intercalated in black phosphorus two-dimensional structures, forming chemically stable MgxP intermediates. After the formation of the intermediates, Mg electrodeposition reaction became the predominant. When tested in the asymmetric coin cell configuration, the Mg@BP composite electrode allowed stable stripping/plating performances for 1600 h (800 cycles), a cumulative capacity of 3200 mAh cm-2, and a Coulombic efficiency of 99.98%. Assembly and testing of the Mg@BP | |nano-CuS coin cell enabled a discharge capacity of 398 mAh g-1 and an average cell discharge potential of about 1.15 V at a specific current of 560 mA g-1 with a low decay rate of 0.016% per cycle for 225 cycles at 25 °C.

Can Ultrasound-Guided Continuous Paravertebral Block Reduce the Incidence of Chronic Postsurgical Pain in Patients with Thoracoscopic Lung Cancer Surgery? A Randomized Controlled Trial.

Background: Thoracoscopic lung cancer surgery is accompanied by severe pain. Both continuous paravertebral block (CPVB) and continuous wound infiltration (CWI) are widely used for perioperative analgesia in thoracoscopic surgery. However, the effects of these different methods on chronic postsurgical pain (CPSP) are still unknown. Patients and Methods. This prospective randomized controlled trial assessed the eligibility of 113 patients. Ninety-seven patients who met the inclusion criteria were randomly divided into a CPVB group and a CWI group, and 80 patients were analyzed in the final study. The primary outcome measures were the incidence and intensity of chronic postsurgical pain (CPSP) at 3, 6, and 9 months after surgery. The secondary outcome measures were the numerical rating scale (NRS) score of rest and activity at 12, 18, and 24 hours and on the 2nd, 3rd, and 7th days postoperatively; the Barthel Activities of Daily Living (ADL) score of activity levels on the 1st, 2nd, 3rd, and 7th days postoperatively; and the long-term quality of the life score at 3, 6, and 9 months postoperatively. Results: The incidence of chronic postsurgical pain in the CWI group was significantly higher than that in the CPVB group at 3, 6, and 9 months after surgery (all P < 0.05). The intensity of chronic postsurgical pain was significantly decreased in the CPVB group at 3, 6, and 9 months after surgery (P < 0.05). NRS-R and NRS-A scores were significantly decreased in the CPVB group within the first week after thoracoscopic surgery (P < 0.001). ADL scores were increased in the CPVB group within 3 days postoperatively. However, there were no differences in the ADL score on the 7th postoperative day or the long-term quality of the life score at 3, 6, and 9 months postoperatively. Conclusion: Continuous ultrasound-guided paravertebral block reduced the intensity of acute pain within 7 days postoperatively and reduced the incidence of chronic pain at 3, 6, and 9 months after surgery, but there was no significant advantage in long-term quality of life. This trial is registered with ChiCTR2000038505.

Enhancing Temperature Adaptability of Aqueous Zinc Batteries via Antifreezing Electrolyte and Site-Selective ZnSe-Ag Interface Layer Design.

Rechargeable aqueous zinc batteries (RAZBs) represent a sustainable, environmentally benign, cost-efficient energy storage solution for the scaled renewable power system. However, the cycling endurance and temperature adaptability of RAZBs are hindered by practical technological barriers such as the subzero freezing point of aqueous electrolyte, severe cation dissolution of the cathode, and dendrite growth on the Zn anode. Herein, we optimize the hybrid electrolyte formulation of 8 M ZnCl2 in the ethylene glycol-water mixed solvent to reconfigure the hydrogen bonding and [Zn(H2O)1.80(EG)0.23]2+ solvation sheath, which well balances the ionic conductivity and the antifreezing property until -125 °C. As monitored by operando X-ray diffraction, meanwhile, the structural dissolution of the V2O5 cathode upon the dynamic cycling and static idling storage at elevated temperature are effectively restrained. At the anode side, the thermally induced substitution between the Ag2Se overcoating and Zn foil in situ constructs the site-selective, mosaic interface layer, in which the solvophilic ZnSe facilitates the desolvation, while the Ag species provide zincophilic nucleation sites for high-throughput Zn deposition. The synergistic coupling of the antifreezing electrolyte and anode interfacial design enables the wide-temperature-range adaptability of the RAZB prototype (10 µm Zn foil and 1 mAh cm-2 V2O5 cathode), which balances the cycling endurance (92.5% capacity retention rate for 1000 cycles), 84.7% mitigation of the self-discharge rate at 55 °C, as well as the secured cyclability even at -40 °C.

Unleashing the Potential of High-Capacity Anodes through an Interfacial Prelithiation Strategy.

The scalable development of an environmentally adaptive and homogeneous Li+ supplementary route remains a formidable challenge for the existing prelithiation technologies, restricting the full potential of high-capacity anodes. In this study, we present a moisture-tolerant interfacial prelithiation approach through casting a hydrophobic poly(vinylidene-co-hexafluoropropylene) membrane blended with a deep-lithiated alloy (Li22Si5@C/PVDF-HFP) onto Si based anodes. This strategy could not only extend to various high-capacity anode systems (SiOx@C, hard carbon) but also align with industrial roll-to-roll assembly processes. By carefully adjusting the thickness of the prelithiation layer, the densely packed Si@C electrode (4.5 mAh cm-2) exhibits significantly improved initial Coulombic efficiency until a close-to-unit value, as well as extreme moisture tolerance (60% relative humidity). Furthermore, it achieves more than 10-fold enhancement of ionic conductivity across the electrode. As pairing the prelithiated Si@C anode with the LiNi0.8Co0.1Mn0.1O2 cathode, the 2 Ah pouch-format prototype balances an energy density of ∼371 Wh kg-1 and an extreme power output of 2450 W kg-1 as well as 83.8% capacity retention for 1000 cycles. The combined operando phase tracking and spatial arrangement analysis of the intermediate alloy elucidate that the enhanced Li utilization derives from the gradient stress dissipation model upon a spontaneous Li+ redistribution process.

Identification of Potential Key circRNAs in Aged Mice With Postoperative Delirium.

Postoperative delirium (POD) is a common postoperative complication in elderly patients and seriously affects postoperative recovery. The exact mechanism of POD is still unclear. Therefore, it is necessary to explore the mechanism of POD in transcriptional regulation. At present, circRNAs have been proven to play an important role in a variety of mental health and cognitive disorders, such as Alzheimer's disease, depression and schizophrenia. To reveal the effect of circRNA on POD, we used microarray to analyze the differential expression profiles of circRNAs in the hippocampus of 12-month-old mice between the tibial fracture and control groups. A total of 1,4236 circRNAs were identified. Compared with the control group, there were 500 circRNAs with increased expression and 187 with decreased expression. The accuracy of the microarray data was further verified by qRT-PCR. Finally, GO enrichment and KEGG pathway analyses indicated that changes in axon orientation, ubiquitin-mediated proteolysis, glutamate synapses, the estrogen signaling pathway, the RAS signaling pathway and other systems may be important potential pathological mechanisms in the progression of POD. In particular, we found that the HOMER1 gene and its transcript mmu_circRNA_26701 are specifically expressed in the glutamate synapse, which may provide new clues and intervention targets for the progression of this refractory disease.

Prevalence and Risk Factors for Allergic Rhinitis in China: A Systematic Review and Meta-Analysis.

The prevalence of allergic rhinitis (AR) has increased tremendously in the recent year in China. Evidence-based medicine to objectively evaluate the prevalence and risk factors for AR in China is urgently required. Toward this, we systematically searched four English and four Chinese databases to identify the literature on the same, from the year of website establishment until November 2021. A total of 51 studies were evaluated, and data were obtained through Stata 16 analysis. Overall pooled risk factors for adult AR were smoking (odds ratio [OR] = 1.89, 95% confidence interval [CI]: 1.25, 2.87), asthma (OR = 3.30, 95% CI: 1.48, 7.39), a family history of AR (OR = 3.17, 95% CI: 2.31, 4.34), a family history of asthma (OR = 3.99, 95% CI: 2.58, 6.16), drug allergy (OR = 1.62, 95% CI: 1.38, 1.89), food allergy (OR = 2.29, 95% CI: 1.39, 3.78), pollen allergy history (OR = 2.41, 95% CI: 1.67, 3.46), antibiotic use (OR = 2.08, 95% CI: 1.28, 3.36), occupational dust exposure (OR = 2.05, 95% CI: 1.70, 2.47), home renovation (OR = 1.73, 95% CI: 0.99, 3.02), and middle school education (OR = 1.99, 95% CI: 1.29, 3.06). Overall pooled risk factors for AR in children were passive smoking (OR = 1.70, 95% CI: 1.02, 2.82), asthma (OR = 3.26, 95% CI: 2.42, 4.39), a family history of AR (OR = 2.59, 95% CI: 2.07, 3.24), a family history of allergy (OR = 4.84, 95% CI: 3.22, 7.26), a history of allergic diseases (OR = 2.11, 95% CI: 1.52, 2.94), eczema(OR = 2.29, 95% CI: 1.36, 3.85), owning pets (OR = 1.56, 95% CI: 1.37, 1.77), eating seafood (OR = 1.30, 95% CI: 1.10, 1.55), boys (OR = 1.58, 95% CI: 1.43, 1.74), and breastfeeding (OR = 0.82, 95% CI: 0.55, 1.22). The results of our meta-analysis showed that the prevalence of allergy rhinitis was 19% (95% CI 14-25) among adults and 22% (95% CI 17-27) among children, with boys showing a higher prevalence than girls. The development of AR in China is associated with several factors, including allergic diseases (eczema, asthma, pollen allergy, and food allergy), a family history of allergy (AR, asthma, and other allergies), and dwelling and working environment (smoking or passive smoking, occupational dust exposure, and owning pets); conversely, breastfeeding can reduce the risk.

Boosting Li-Ion Diffusion Kinetics of Na2Ti6-xMoxO13 via Coherent Dimensional Engineering and Lattice Tailoring: An Alternative High-Rate Anode.

Featured with an exposed active facet, favorable ion diffusion pathway, and tailorable interfacial properties, low-dimensional structures are extensively explored as alternative electroactive materials with game-changing redox properties. Through a stepwise "proton exchange-insertion-exfoliation" procedure, in this article, we develop Na2Ti6-xMoxO13 (NTMO) nanosheets with weakened out-of-plane bonding and in-plane Mo6+ doping of the tunnel structure. Real-time phase tracking of the laminated NTMO structures upon the lithiation/delithiation process suggests mitigated lattice variation; meanwhile, the kinetics simulation shows a mitigated Li-ion diffusion barrier along the [010] orientation. At an industrial-level areal capacity loading (2.5 mAh cm-2), the NTMO electrode maintains robust cycling endurance (91% capacity retention for 2000 cycles) even at 40 C, as well as the high energy/power densities in the as-constructed NTMO||LiFePO4 full cell prototype. The dimensional and lattice modifications presented in this study thus encourage further exploration of the tailored cation diffusion pathway for the construction of fast-charging batteries.

Auricular acupressure for adverse events following immunization after COVID-19 vaccine injection: A multicentre, blinded, randomized controlled trial.

BACKGROUND: Some adverse events following immunization (AEFI) were observed in potential corelation with COVID-19 vaccination but without prevention or ongoing trial for it. We aimed to investigate efficacy of auricular acupressure (AuriAc) therapy in preventing AEFI after first dosage of the vaccine. METHODS: We performed a multicentre randomized controlled trial with three arms, including AuriAc, SAuriAc (sham auricular acupressure), and TrAsU (treatment as usual) group, carried out in four medical institutions in Chengdu, China, from March 17th to April 23rd, 2021. We enrolled participants based on eligibility criteria and randomized them into three groups: AuriAc (AEFI-specific auricular points applied, n = 52), SAuriAc (n = 51) or TrAsU (n = 44) group. Primary outcomes were percentages of any AEFI and local pain, and secondary outcomes were percentages who reported other AEFI. They were followed at 1, 3, 5, 7, and 14 days, by phone or online, with severity evaluated. RESULTS: 147 participants (73.47% females) were included with median age as 31 years (25-45, IQR). One day after the injection, participants in AuriAc group reported significant reduction on percentages of any AEFI [intention-to-treat, difference of percentage (DP) = -20.13, 95%CI: - 0.39, - 0.02, p = 0.01; per-protocol, DP = -22.21, 95%CI: - 0.40, - 0.03, P = 0.02] and local pain (per-protocol, DP = -18.40, 95%CI: -0.36, -0.01, P = 0.04), compared with TrAsU group. The effects were slight at other follow-up days and for other outcomes, and with a low percentage of mild local allergic reactions. CONCLUSIONS: We firstly explored potential of AuriAc for preventing AEFI related to COVID-19 vaccine injection, which is beneficial for the vaccine recipients, but evidence is limited. TRIAL REGISTRATION: chictr.org.cn no. ChiCTR2100043210 (http://www.chictr.org.cn/showproj.aspx?proj=121519).

Unveiling the Reversibility and Stability Origin of the Aqueous V2 O5 -Zn Batteries with a ZnCl2 "Water-in-Salt" Electrolyte.

Aqueous V2 O5 -Zn batteries, an alternative chemistry format that is inherently safer to operate than lithium-based batteries, illuminates the low-cost deployment of the stationary energy storage devices. However, the cathode structure collapse caused by H2 O co-insertion in aqueous solution dramatically deteriorates the electrochemical performance and hampers the operation reliability of V2 O5 -Zn batteries. The real-time phase tracking and the density functional theory (DFT) calculation prove the high energy barrier that inhibits the Zn2+ diffusion into the bulk V2 O5 , instead the ZnCl2 "water-in-salt electrolyte" (WiSE) can enable the dominant proton insertion with negligible lattice strain or particle fragment. Thus, ZnCl2 WiSE enables the enhanced reversibility and extended shelf life of the V2 O5 -Zn battery upon the high temperature storage. The improved electrochemical performance also benefits by the inhibition of vanadium cation dissolution, enlarged voltage window, as well as the suppression of the Zn dendrite protrusion. This study comprehensively elucidates the pivotal role of a concentrated ZnCl2 electrolyte to stabilize the aqueous batteries at both the static storage and dynamic operation scenarios.

Traditional Chinese medicine auricular point acupressure for the relief of pain, fatigue, and gastrointestinal adverse reactions after the injection of novel coronavirus-19 vaccines: a structured summary of a study protocol for a multicentre, three-arm, single-blind, prospective randomized controlled trial.

OBJECTIVES: To investigate if traditional Chinese medicine (TCM) auricular point acupressure (APA) can alleviate and (or) reduce the pain (including injection site pain, headache, other muscle and joint pain), fatigue, and gastrointestinal adverse reactions (including nausea, vomiting, diarrhea), after the injection of novel coronavirus-19 vaccines (NCVs). TRIAL DESIGN: The study is designed as a multicentre, parallel-group, three-arm, single-blind, prospective, randomized (1:1:1 ratio) study. PARTICIPANTS: More than 360 participants will be recruited from healthy people who vaccinate NCVs in 5 community healthcare centres in the Sichuan province of China and 1 university hospital (Hospital of Chengdu University of Traditional Chinese Medicine). INCLUSION CRITERIA: ①Vaccinators meets the conditions of NCVs injection and have no contraindications to it. The details shall be subject to the instructions of the NCVs used and the statement of medical institutions. The first dose of NCVs injection shall be completed within 24 hours from the time of injection to the time of enrolment; ②No redness, swelling, injury or infection of the skin or soft tissue of both ears, which is not suitable for APA; ③No history of alcohol and adhesive tape contact allergy; ④18-59 years old, regardless of gender; ⑤Those who were able to complete the questionnaire independently at the time of the first and second dose of NCVs and on the 3rd, 7th and 15th day after the first and second dose of NCVs respectively; ⑥Those who agree to participate in the trial and sign the informed consent, and can seriously abide by the precautions after the injection of NCVs and the requirements of traditional Chinese medicine auricular point plasters sticking and acupressure. EXCLUSION CRITERIA: ①Those who are not suitable to be vaccinated because they belong to the contraindication or cautious population; ②Those who have participated in other clinical trials within 4 weeks before the start of this study; ③No chronic/habitual/persistent headache, Muscle or joint pain, fatigue, diarrhea, nausea, retching or vomiting before the injection of NCVs, and no related diseases present (details of this item is listed in full protocol); ④Those who are in use or have received TCMAPA within 2 weeks before the trial; ⑤Pregnant or lactating women; ⑥Participants with other serious primary diseases and psychosis. INTERVENTION AND COMPARATOR: ①Auricular point acupressure group: participants receive bilateral, symptom-specific TCMAPA in 5 auricular points (per side, 10 points bilateral) for 5 days, 3-4 times (about 1 min each time) of self-acupressure per day, after each NCVs injection (10 days in total). ②Sham auricular point acupressure group: participants receive bilateral, none symptom-specific, sham APA in 5 auricular points (per side, 10 points bilateral) for 5 days, 3-4 times (about 1 min each time) of self-acupressure per day, after each NCVs injection (10 days in total). ③Blank control group: Non-intervention blank control. The Hebei medical device Co. Ltd, Hebei, China manufactured the auricular point sticking plasters. MAIN OUTCOMES: Primary outcomes are all scores of visual analogue scale (VAS) based on subjective judgment of the participants included, including VAS score of pain at injection site, headache, muscle and joint pain, fatigue, nausea, retching, vomiting and diarrhea. Time points for outcomes above are the same: ①Immediately after first and second injection of the vaccine (Baseline assessment); ②Three days after first and second injection of the vaccine; ③Seven days after first and second injection of the vaccine; ④Fifteen days after first and second injection of the vaccine. RANDOMISATION: Participants will be randomized in 1:1:1 ratio to each group by computerized random number generator, and independently in each sub-centre. BLINDING (MASKING): Participants, information collectors and statistical evaluators will be blinded between APA group and sham APA group. No blinding in the control group. NUMBERS TO BE RANDOMISED (SAMPLE SIZE): No less than 360 participants will be randomized in 1:1:1 ratio to each group. TRIAL STATUS: Protocol version 2.0 of February 3rd, 2021. Recruitment is expected to start on February 18th, 2021, and to finish on March 12th, 2021. TRIAL REGISTRATION: This trial was registered in the China Clinical Trial Registry (ChiCTR) ( ChiCTR2100043210 ) on 8th February, 2021. FULL PROTOCOL: The full protocol is attached as an additional file, accessible from the Trials website (Additional file 1). In the interest in expediting dissemination of this material, the familiar formatting has been eliminated; this Letter serves as a summary of the key elements of the full protocol.

Auricular acupressure for adverse events following immunization related to COVID-19 vaccine injection: study protocol for a multicenter, three-arm, blinded randomized controlled trial.

BACKGROUND: Some pain, fatigue, and gastrointestinal adverse events were observed in potential association with injection of COVID-19 vaccines, while there was no preventive intervention for it. We aim to investigate the efficacy of auricular acupressure (AA) therapy in preventing and relieving AEFI after injection of COVID-19 vaccine. METHODS: The study design is a randomized, multicentre, three-arm controlled, single-blind trial. Participants meeting the inclusion criteria will be advertised and enrolled and assigned in the medical institutions randomly for post-injection observation. No less than 360 participants will be randomized into one of three groups: auricular acupressure group, sham auricular acupressure group, and wait-list group. Interventions will be performed immediately and will happen 4 to 5 times per day for 5 days. The primary clinical outcomes will be quality and quantity evaluation among participants who reported any AEFI and who reported local pain at injection site. Secondary outcomes will concern headache, muscle and (or) joint pain, fatigue, nausea, vomiting, diarrhoea, and other potential events. All the outcomes will be assessed at baseline and 1, 3, 5, 7, and 14 days after the injection. Both intention-to-treat and per-protocol analyses will be performed, with significance level determined as 5%. DISCUSSION: Results of this trial will help to clarify the value of auricular acupressure therapy in preventing and relieving overall and certain adverse events following immunization after injection of COVID-19 vaccine. TRIAL REGISTRATION: China Clinical Trial Registry (ChiCTR) ( ChiCTR2100043210 ). Registered on 8 February, 2021.