Oyster mantle-derived exosomes alleviate osteoporosis by regulating bone homeostasis.

Osteoporosis is a major public health problem with an urgent need for safe and effective therapeutic interventions. The process of shell formation in oysters is similar to that of bone formation in mammals, and oyster extracts have been proven to exert osteoprotective effects. Oyster mantle is the most crucial organ regulating shell formation, in which exosomes play an important role. However, the effects of oyster mantle-derived exosomes (OMEs) on mammalian osteoporosis and the underlying mechanisms remain unknown. The OMEs investigated herein was found to carry abundant osteogenic cargos. They could also survive hostile gastrointestinal conditions and accumulate in the bones following oral administration. Moreover, they promoted osteoblastic differentiation and inhibited osteoclastic differentiation simultaneously. Further mechanistic examination revealed that OMEs likely promoted osteogenic activity by activating PI3K/Akt/ß-catenin pathway in osteoblasts and blunted osteoclastic activity by inhibiting NF-κB pathway in osteoclasts. These favorable pro-osteogenic effects of OMEs were also corroborated in a rat femur defect model. Importantly, oral administration of OMEs effectively attenuated bone loss and improved the bone microstructure in ovariectomy-induced osteoporotic mice, and demonstrating excellent biosafety. The mechanistic insights from our data support that OMEs possess promising therapeutic potential against osteoporosis.

Effect of non-enzymatic browning on oysters during hot air drying process: Color and chemical changes and insights into mechanisms.

Hot air drying (HAD) is an extensive method used on oysters and it causes the most intuitive change, a color change. However, the mechanism of color change remains unclear. This study showed that oysters underwent browning during the HAD process. The colorimetric parameter L* decreased while a* and b* increased, all of which were well described by the first-order color kinetic model. Mechanistically, the HDA process induced the oxidative browning of phenols and the generation of Maillard reaction products (5-hydroxymethylfurfural and hydrophilic pyrrole). Meanwhile, the HAD process caused lipid oxidation, leading to the reduction of phosphatidylethanolamine and the generation of reactive carbonyl compounds (aldehydes and α-dicarbonyl compounds). Moreover, the accumulation of hydrophobic pyrroles, a lipid-induced Maillard-like reaction product, was observed. These results suggest that, in addition to phenolic oxidation, sugar- and amino acid-mediated non-enzymatic browning reactions, lipid-mediated Maillard-like reactions play important roles in oyster darkening during the HAD process.

Appendicular lean mass and the risk of stroke and Alzheimer's disease: a mendelian randomization study.

BACKGROUND: Appendicular lean mass (ALM) is a good predictive biomarker for sarcopenia. And previous studies have reported the association between ALM and stroke or Alzheimer's disease (AD), however, the causal relationship is still unclear, The purpose of this study was to evaluate whether genetically predicted ALM is causally associated with the risk of stroke and AD by performing Mendelian randomization (MR) analyses. METHODS: A two-sample MR study was designed. Genetic variants associated with the ALM were obtained from a large genome-wide association study (GWAS) and utilized as instrumental variables (IVs). Summary-level data for stroke and AD were generated from the corresponding GWASs. We used random-effect inverse-variance weighted (IVW) as the main method for estimating causal effects, complemented by several sensitivity analyses, including the weighted median, MR-Egger, and MR-pleiotropy residual sum and outlier (MR-PRESSO) methods. Multivariable analysis was further conducted to adjust for confounding factors, including body mass index (BMI), type 2 diabetes mellitus (T2DM), low density lipoprotein-C (LDL-C), and atrial fibrillation (AF). RESULTS: The present MR study indicated significant inverse associations of genetically predicted ALM with any ischemic stroke ([AIS], odds ratio [OR], 0.93; 95% confidence interval [CI], 0.89-0.97; P = 0.002) and AD (OR, 090; 95% CI 0.85-0.96; P = 0.001). Regarding the subtypes of AIS, genetically predicted ALM was related to the risk of large artery stroke ([LAS], OR, 0.86; 95% CI 0.77-0.95; P = 0.005) and small vessel stroke ([SVS], OR, 0.80; 95% CI 0.73-0.89; P < 0.001). Regarding multivariable MR analysis, ALM retained the stable effect on AIS when adjusting for BMI, LDL-C, and AF, while a suggestive association was observed after adjusting for T2DM. And the estimated effect of ALM on LAS was significant after adjustment for BMI and AF, while a suggestive association was found after adjusting for T2DM and LDL-C. Besides, the estimated effects of ALM were still significant on SVS and AD after adjustment for BMI, T2DM, LDL-C, and AF. CONCLUSIONS: The two-sample MR analysis indicated that genetically predicted ALM was negatively related to AIS and AD. And the subgroup analysis of AIS revealed a negative causal effect of genetically predicted ALM on LAS or SVS. Future studies are required to further investigate the underlying mechanisms.

Effect of branched 1,4-butanediol citrate oligomers with different molecular weights on toughness and aging resistance of glycerol plasticized starch.

The thermoplastic starch with glycerol is easy to retrograde and sensitive to hygroscopicity. In this study, branched 1,4-butanediol citrate oligomers with different molecular weights (P1, P2, and P3) are synthesized, and then mixed with glycerol (G) as the co-plasticizers to prepare thermoplastic starch (CS/PG). The results show that the molecular weight and branching degree of the branched 1,4-butanediol citrate oligomers increase as reaction time prolongs. Compared with glycerol plasticized starch, the thermoplastic starch films with branched 1,4-butanediol citrate oligomers/glycerol (10 wt%/20 wt%) have a better toughness, transmittance, and aging resistance, and have a lower crystallinity, hygroscopicity, and thermal stability. The toughness, transmittance, and aging resistance of CS/PG films are positively correlated with the molecular weight of the branched 1,4-butanediol citrate oligomers. These are due to the fact that the branched 1,4-butanediol citrate oligomer with a high molecular weight could form a stronger hydrogen bond and the more stable cross-linked structure with starch chains than that with a lower molecular weight. The elongation at break of CS/P3G film stored for 3 and 30 d are 98.0 % and 88.1 %, respectively. The mixture of branched butanediol citrate oligomers and glycerol, especially P3/G, has a potential application in the preparation of thermoplastic starch.

Comparative Analysis of Characteristic Volatile Compounds in Five Types of Infant Nutrition Powders by HS-GC-IMS and GC-MS.

This study employed the headspace-gas chromatography-ion migration spectrum (HS-GC-IMS) in conjunction with the gas chromatography-mass spectrometer (GC-MS) technique for the assessment of the flavor quality of complementary food powder intended for infants and young children. A total of 62 volatile compounds were identified, including aldehydes, esters, alcohols, ketones, pyrazines, and furans, among which aldehydes were the most abundant compounds. Based on the principal component analysis (PCA) and partial least squares discriminant analysis (PLS-DA) models, infant nutritional powder (YYB) from different manufacturers could be clearly distinguished. Among them, 2-hydroxybenzaldehyde, 1, 2-dimethoxyethane, 2-isobutyl-3-methoxypyrazine, and methyl butyrate were the four most critical differential volatiles. In addition, these differences were also manifested in changes in fatty acids. The reason for this phenomenon can be attributed to the difference in the proportion of raw materials used in nutrition powder, micronutrient content, and the packaging process. In conclusion, this study provides comprehensive information on the flavor quality of YYB, which can be used as a basis for quality control of YYB.

Leukocyte telomere length and sarcopenia-related traits: A bidirectional Mendelian randomization study.

Accumulating evidence indicated that leukocyte telomere length (LTL) was related to sarcopenia. However, it is still not clear whether the association of changes in LTL with sarcopenia is likely to be causal, or could be explained by reverse causality. Thus, we carried on bidirectional Mendelian randomization (MR) and multivariable MR analyses to identify the causal relationship between LTL and sarcopenia-related traits. Summary-level data and independent variants used as instruments came from large genome-wide association studies of LTL (472,174 participants), appendicular lean mass (450,243 participants), low grip strength (256,523 participants), and walking pace (450,967 participants). We identified suggestive association of longer LTL with larger appendicular lean mass [odds ratio (OR) = 1.053; 95% confidence interval (CI), 1.009-1.099; P = 0.018], and causal association of longer LTL with a lower risk of low grip strength (OR = 0.915; 95% CI, 0.860-0.974; P = 0.005). In the reverse MR analysis, we also observed a positive causal association between walking pace and LTL (OR = 1.252; 95% CI, 1.121-1.397; P < 0.001). Similar results can be repeated in sensitivity analyses. While in the multivariable MR analysis, the estimate of the impact of walking pace on LTL underwent a transformation after adjusting for T2DM (OR = 1.141; 95%CI: 0.989-1.317; P = 0.070). The current MR analysis supported a causal relationship between shorter telomere length and both low muscle mass and strength. Additionally, walking pace may affect LTL through T2DM.

Atmospheric organic nitrogen deposition around the Danjiangkou Reservoir: Fluxes, characteristics and evidence of agricultural source.

Dissolved organic nitrogen (DON) deposition was the substantial component of dissolved total nitrogen (DTN) deposition in the world's nitrogen deposition hot spots areas. However, the information on the importance for DON deposition and its sources was still scarce, which limited the comprehensive assessment of the ecological threat from nitrogen deposition. Six sampling sites around the Danjiangkou Reservoir were set up to collect the dry and wet deposition samples from October 2017 to September 2021. The results showed that dry and wet DTN deposition averaged 34.72 kg ha-1 yr-1 and 22.27 kg ha-1 yr-1, respectively. Dry NH4+-N, NO3--N and DON deposition averaged 14.28 kg ha-1 yr-1, 5.91 kg ha-1 yr-1 and 14.53 kg ha-1 yr-1, respectively. Wet NH4+-N, NO3--N and DON deposition averaged 11.14 kg ha-1 yr-1, 3.89 kg ha-1 yr-1and 7.24 kg ha-1 yr-1, respectively. The contributions of DON to DTN were 41.85% (in dry deposition) and 32.50% (in wet deposition), respectively. Dry DON deposition varied between 26.44 kg ha-1 yr-1 and 9.11 kg ha-1 yr-1, and significantly differed among six sampling sites (P < 0.05). The different intensity of agricultural activities disturbance at the sampling sites was the important reason for the spatial variations of DON deposition. DON deposition was significantly correlated with ammonium nitrogen (NH4+-N) deposition (P < 0.05). According to the results of positive matrix factorization (PMF) model, agriculture source contributed significantly to the DON deposition, the contributions at six sampling sites ranged from 45.8% to 73.7% in dry deposition, and from 56.8% to 81.6% in wet deposition. In summary, our findings found that agricultural activities were the important factors influencing the spatial patterns of DON deposition around Danjiangkou Reservoir and provided new evidence for the anthropogenic source of DON deposition in China.

Depression and sarcopenia-related traits: A Mendelian randomization study.

BACKGROUND: Observational studies have suggested that depression is associated with sarcopenia. However, the causal relationship between depression and sarcopenia remains unclear. AIM: To investigate the causal relationship between depression and sarcopenia. METHODS: We performed a Mendelian randomization (MR) analysis to identify the bidirectional relationship between depression and sarcopenia-related traits. Summary-level data and independent variants used as instrumental variables came from large genome-wide association studies of depression (414055 cases and 892299 controls), of appendicular lean mass (ALM, 450243 participants), and of hand grip strength (exposure: 360000 participants; outcome: 334925 participants). RESULTS: We identified a negative association of depression with lower ALM [odds ratio (OR): 0.932, 95% confidence interval (95%CI): 0.889-0.979, P = 0.005]. In the reverse MR analysis, we also observed an inverse association of hand grip strength with depression (OR: 0.200, 95%CI: 0.108-0.370, P < 0.001). Similar results were obtained in sensitivity analyses. CONCLUSION: Depression was causally related to decreased muscle mass, and declined muscle strength might lead to a higher risk of depression.

Correction: Zhang et al. Fucoidan from Laminaria japonica Ameliorates Type 2 Diabetes Mellitus in Association with Modulation of Gut Microbiota and Metabolites in Streptozocin-Treated Mice. Foods 2023, 12, 33.

In the original publication, there was a mistake in Figure 3 as published [...].

Stem cells in central nervous system diseases: Promising therapeutic strategies.

Central nervous system (CNS) diseases are a leading cause of death and disability. Due to CNS neurons have no self-renewal and regenerative ability as they mature, their loss after injury or disease is irreversible and often leads to functional impairments. Unfortunately, therapeutic options for CNS diseases are still limited, and effective treatments for these notorious diseases are warranted to be explored. At present, stem cell therapy has emerged as a potential therapeutic strategy for improving the prognosis of CNS diseases. Accumulating preclinical and clinical evidences have demonstrated that multiple molecular mechanisms, such as cell replacement, immunoregulation and neurotrophic effect, underlie the use of stem cell therapy for CNS diseases. However, several issues have yet to be addressed to support its clinical application. Thus, this review article aims to summarize the role and underlying mechanisms of stem cell therapy in treating CNS diseases. And it is worthy of further evaluation for the potential therapeutic applications of stem cell treatment in CNS disease.

Stabilization of High Internal Phase Oil-in-Water Emulsions Using "Whole" Gracilaria lemaneiformis Slurry.

In this study, a Gracilaria lemaneiformis slurry (GLS) was prepared using low-energy mechanical shearing. The resulting GLS, which was rich in polysaccharides, was utilized as an effective stabilizer for oil-in-water emulsions. The microstructures and stability of the resulting emulsions were controlled by adjusting the emulsion formulations, including Gracilaria lemaneiformis (GL) mass concentration and oil volume fraction (φ). The optimized GL mass concentration and φ conditions yielded high internal phase emulsions (HIPEs) with gel-like textures. Moreover, the presence of exogenous Ca2+ resulted in bridging structures in the emulsions, enhancing their viscoelasticity and forming a robust physical barrier against droplet coalescence. Our findings highlight the effectiveness of the GLS as an emulsifier for stabilizing HIPEs. Notably, this method relies solely on physical processes, aligning with the desirability of avoiding chemical additives, particularly in the food industry.

Impact mechanisms of aggregation state regulation strategies on the microwave absorption properties of flexible polyaniline.

In the field of electromagnetic (EM) wave absorption, intrinsic conductive polymers with conjugated long-chain structures, such as polyaniline (PANI) and polypyrrole (PPy), have gained widespread use due to their remarkable electrical conductivity and loss ability. However, current research in this area is limited to macroscopic descriptions of the absorption properties of these materials and the contribution of various components to the absorption effect. There has been insufficient exploration of the impact mechanisms of polymer aggregation states on the material's absorption performance and mechanism. To address this, a series of flexible PANI sponge absorbers with different molecular weights and aggregation states were prepared. By carefully controlling the crystallinity and other aggregation characteristics of PANI through the adjustment of its preparation conditions, we were able to influence its electrical conductivity and electromagnetic parameters, thereby achieving control over the material's absorption properties. The resulting PANI sponge absorbers exhibited an effective absorption bandwidth (EAB) that covered the entire X-band at a thickness of 3.2 mm. This study comprehensively explores the absorption mechanisms of conductive polymer absorbers, starting from the microstructure of PANI, and providing a more complete theoretical support for the research and promotion of polymer absorbers.

Highly selective detection of epinephrine by a "turn-off" fluorescent sensor based on N-doped carbon quantum dots.

Epinephrine (EP) is a catecholamine hormone with a variety of physiological activities. Monitoring the concentration of EP in drugs, food, biological samples and cosmetics is of great significance for their quality control. Herein, a novel fluorescence sensing method was designed for the high-specificity detection of EP based on N-doped carbon quantum dots (N-CDs). The EP could interact with the fluorescent senor of N-CDs which emits blue fluorescence to produce concentration- dependent fluorescence quenching through the photo-induced electron transfer (PET). The established sensing method has good linearity in the range of 0.5-10 µM with the LOD of 0.15 µM. More importantly, it is highly selective because similar components with phenolic hydroxyl groups or primary amino groups, even norepinephrine (NEP), could not interfere with the detection. This method can provide a low-cost, rapid and simple new way for the detection of EP, and has a good application prospect in point-of-care assay and in situ test.

Pickering emulsions synergistically stabilized by sugar beet pectin and montmorillonite exhibit enhanced storage stability and viscoelasticity.

Sugar beet pectin (SBP) is a naturally occurring emulsifying type of pectin fabricated into nanocomposites with montmorillonite (MMT) and then introduced as a stabilizer for high internal phase emulsions (HIPEs). SBP-MMT composites performed well in emulsifying medium-chain triglyceride with an oil volume fraction (φ) of 0.1-0.85 and SBP/MMT mass ratios of 1:0.1-1:0.75. The two representative high internal phase emulsions stabilized by SBP-MMT composites at different SBP/MMT mass ratios exhibited good stability against creaming and coalescence. In these emulsion systems, SBP and MMT formed a network in the continuous phase that markedly improved the rheological properties, including the storage modulus (by 3 orders of magnitude). Confocal light scattering microscopy analysis indicated that a fraction of MMT could work synergistically with SBP in adsorbing on oil droplet surfaces, enhancing stability. SBP-MMT composites stabilized high internal phase emulsions destabilized after the freeze-thaw treatment (-40 °C for 20 h and 25 °C for 4 h) but could be facilely re-emulsified via high-speed shearing. The gastrointestinal digestion behaviors were also modified by stabilizing SBP and MMT. Overall, this work reveals a hitherto undocumented strategy for fabricating highly stable emulsions based on SBP-MMT composites which have huge prospects for application in the food and related industries.

The impact of serum magnesium and calcium on the risk of epilepsy: A mendelian randomization study.

AIMS: To investigate the causal role of serum magnesium and calcium in epilepsy or any of its subtypes through Mendelian randomization (MR) approach. METHODS: Single nucleotide polymorphisms (SNPs) associated with serum magnesium and calcium were used as the instrumental variables. MR analyses were performed using the summary-level data for epilepsy extracted from International League Against Epilepsy Consortium (15,212 cases and 29,677 controls) to obtain the causal estimates. The analyses were replicated using FinnGen data (7224 epilepsy cases and 208,845 controls), and a meta-analysis was then conducted. RESULTS: The result of combined analyses showed that higher serum magnesium concentrations was associated with a reduced risk of overall epilepsy (odds ratios [OR] = 0.28, 95% confidence interval [CI], 0.12-0.62, p = 0.002). In ILAE, higher serum magnesium was suggestively associated with reduced risks of focal epilepsy (OR = 0.25, 95% CI 0.10-0.62, p = 0.003). However, the results cannot be repeated in sensitivity analyses. As for serum calcium, the results did not reach statistical significance with overall epilepsy (OR = 0.60, 95% CI, 0.31-1.17, p = 0.134). However, genetically predicted serum calcium concentrations showed an inverse association with risk of generalized epilepsy (OR = 0.35, 95% CI, 0.17-0.74, p = 0.006). CONCLUSION: The current MR analysis did not support a causal relationship between serum magnesium and epilepsy, but showed a causally negative association between genetically determined serum calcium and generalized epilepsy.

Sea cucumber sulfated polysaccharides and Lactobacillus gasseri synergistically ameliorate the overweight induced by altered gut microbiota in mice.

Sulfated polysaccharides from sea cucumber Stichopus japonicus (SCSPsj) have been found to modulate the gut microbiota by promoting the growth of probiotics. However, the effects of the combination of SCSPsj and probiotics are still less known. Thus, the present study aimed to investigate the effects of SCSPsj and Lactobacillus gasseri on gut microbiota-altered mice through gut microbiota and metabolomics analysis. In the present study, supplementation with SCSPsj, L. gasseri or the combination of SCSPsj and L. gasseri could effectively ameliorate the body weight gain and fat accumulation in gut microbiota-altered mice treated with low-dose penicillin. The better effect of the combination of SCSPsj and L. gasseri is attributed to the synergistic effect of SCSPsj and L. gasseri. 16S rRNA sequencing revealed that the combination of SCSPsj and L. gasseri can synergistically improve gut microbiota dysbiosis by increasing Lactobacillus and reducing Coriobacteriaceae_UCG-002. Furthermore, metabolomics results revealed that the combination of SCSPsj and L. gasseri can alleviate metabolic disorders by reducing the levels of lipid and lipid-like molecules in the serum samples, such as trans-vaccenic acid and 3ß-hydroxy-5-cholestene. Our findings have proved that the combination of SCSPsj and L. gasseri can benefit host health attributed to the synergistic effect, which is conducive to further application in functional food.

[Mammalian DMRTs: Structure, function and relationship with cancer].

DMRT, a gene family related to sexual determination, encodes a large group of transcription factors (DMRTs) with the double-sex and mab-3 (DM) domain (except for DMRT8), which is able to bind to and regulate DNAs. Current studies have shown that the DMRT gene family plays a critical role in the development of sexual organs (such as gender differentiation, gonadal development, germ cell development, etc.) as well as extrasexual organs (such as musculocartilage development, nervous system development, etc.). Additionally, it has been suggested that DMRTs may be involved in the cancer development and progression (such as prostate cancer, breast cancer, lung cancer, etc.). This review summarizes the research progress about the mammalian DMRTs' structure, function and its critical role in cancer development, progression and therapy (mainly in human and mice), which suggests that DMRT gene could be a candidate gene in the study of tumor formation and therapeutic strategy.

Metabolites of sea cucumber sulfated polysaccharides fermented by Parabacteroides distasonis and their effects on cross-feeding.

Sea cucumber sulfated polysaccharide (SCSPsj) is one of the dietary components which effectively modulates gut microbiota; however, the underlying mechanism remains unclear. In the present study, the interaction between SCSPsj and its utilizer (Parabacteroides distasonis) was investigated. Further study was carried out to explore the cross-feeding between intestinal Bacteroidales mediated by SCSPsj. The results revealed that SCSPsj can be fermented by P. distasonis to produce various microbial metabolites, including organic acids and derivatives, lipids and lipid-like molecules, organoheterocyclic compounds. SCSPsj can regulate the succinate pathway and acetyl-CoA pathway to influence the production of propanoic acid and acetic acid, respectively. Moreover, the SCSPsj-fermented supernatants of P. distasonis can only promote the growth of B. stercoris, B. vulgatus and P. johnsonii among 8 intestinal Bacteroidales strains through cross-feeding. The effect of cross-feeding was related to spatial distances and bacterial species. Moreover, the cross-feeding was correlated with compounds belonging to organic acids and derivatives, lipids and lipid-like molecules. These findings could provide new insights into the interaction between SCSPsj and gut microbiota.

Association between brain structures and migraine: A bidirectional Mendelian randomization study.

Background: Accumulating evidence of clinical and neuroimaging studies indicated that migraine is related to brain structural alterations. However, it is still not clear whether the associations of brain structural alterations with migraine are likely to be causal, or could be explained by reverse causality confounding. Methods: We carried on a bidirectional Mendelian randomization analysis in order to identify the causal relationship between brain structures and migraine risk. Summary-level data and independent variants used as instruments came from large genome-wide association studies of total surface area and average thickness of cortex (33,992 participants), gray matter volume (8,428 participants), white matter hyperintensities (50,970 participants), hippocampal volume (33,536 participants), and migraine (102,084 cases and 771,257 controls). Results: We identified suggestive associations of the decreased surface area (OR = 0.85; 95% CI, 0.75-0.96; P = 0.007), and decreased hippocampal volume (OR = 0.74; 95% CI, 0.55-1.00; P = 0.047) with higher migraine risk. We did not find any significant association of gray matter volume, cortical thickness, or white matter hyperintensities with migraine. No evidence supporting the significant association was found in the reverse MR analysis. Conclusion: We provided suggestive evidence that surface area and hippocampal volume are causally associated with migraine risk.

Digital Cognitive Behavioral Therapy for Insomnia Using a Smartphone Application in China: A Pilot Randomized Clinical Trial.

Importance: Digital cognitive behavioral therapy for insomnia (DCBT-I) requires adaptation to different sociocultural contexts. Moreover, studies comparing DCBT-I and sleep education in the same operating interface are lacking. Objective: To investigate the efficacy of a smartphone-based Chinese culture-adapted DCBT-I application (app) for insomnia compared with sleep education using the same app. Design, Setting, and Participants: This was a single-blinded, randomized clinical trial conducted from March 2021 to January 2022. Screening and randomization were conducted at Peking University First Hospital. Follow-up visits were performed online or in the same hospital. After assessing for eligibility, eligible participants were enrolled and allocated (1:1) to DCBT-I or sleep education groups. Data were analyzed from January to February 2022. Interventions: A Chinese smartphone-based app with the same interface was used in both DCBT-I and sleep education groups over 6 weeks, with 1-, 3-, and 6-month follow-ups. Main Outcomes and Measures: The primary outcome was Insomnia Severity Index (ISI) scores with the intention-to-treat principle. Secondary and exploratory outcomes included sleep diary measures; self-reported scales assessing dysfunctional beliefs about sleep, mental health, and quality of life; and smart bracelet measures. Results: Of 82 participants (mean [SD] age, 49.67 [14.49] years; 61 [74.4%] females), with 41 randomized to sleep education and 41 randomized to DCBT-I; 77 participants completed the 6-week intervention (39 participants in the sleep education group and 38 participants in the DCBT-I group; full analysis data set) and 73 completed the 6-month follow-up (per protocol data set). Mean (SD) ISI scores in the DCBT-I group were significantly lower than those in the sleep education group after the 6-week intervention (12.7 [4.8] points vs 14.9 [5.0] points; Cohen d = 0.458; P = .048) and at the 3-month follow-up (12.1 [5.4] points vs 14.8 [5.5] points; Cohen d = 0.489; P = .04). There were significant improvements from before to after the intervention for both the sleep education and DCBT-I groups, with large effect sizes(sleep education: d = 1.13; DCBT-I: d = 1.71). Some of the sleep diary measures and self-reported scales showed more improvements in the DCBT-I group than sleep education group, such as total sleep time (mean [SD]: 3 months, 403.9 [57.6] minutes vs 363.2 [72.3] minutes; 6 months, 420.3 [58.0] minutes vs 389.7 [59.4] minutes) and sleep efficiency (mean [SD]: 3 months, 87.4% [8.3%] vs 76.7% [12.1%]; 6 months, 87.5% [8.2%] vs 78.1% [10.9%]). Conclusions and Relevance: In this randomized clinical trial, the smartphone-based Chinese culture-adapted DCBT-I improved insomnia severity compared with sleep education. Future multicenter clinical trials with large sample sizes are needed to validate its effectiveness in the Chinese population. Trial Registration: ClinicalTrials.gov Identifier: NCT04779372.