In Situ Formation of Polysulfonamide Supported Poly(ethylene glycol) Divinyl Ether Based Polymer Electrolyte toward Monolithic Sodium Ion Batteries.

Sodium ion battery is one of the promising rechargeable batteries due to the low-cost and abundant sodium sources. In this work, a monolithic sodium ion battery based on a Na3 V2 (PO4 )3 cathode, MoS2 layered anode, and polyether-based polymer electrolyte is reported. In addition, a new kind of polysulfonamide-supported poly(ethylene glycol) divinyl ether based polymer electrolyte is also demonstrated for monolithic sodium ion battery via in situ preparation. The resultant polymer electrolyte exhibits relatively high ionic conductivity (1.2 mS cm-1 ) at ambient temperature, wide electrochemical window (4.7 V), and favorable mechanical strength (25 MPa). Moreover, such a monolithic Na3 V2 (PO4 )3 /MoS2 sodium ion battery using this polymer electrolyte delivers outstanding rate capability (up to 10 C) and superior cyclic stability (84%) after 1000 cycles at 0.5 C. What is more essential, such a polymer electrolyte based soft-package monolithic sodium ion cell can still power a red light emitting diode lamp and run finite times without suffering from any internal short-circuit failures, even in the case of a bended and wrinkled state. Considering these aspects, this work no doubt provides a new approach for the design of a high-performance polymer electrolyte toward monolithic sodium ion battery with exceptional rate capability and high safety.

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.

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).

Resilience in Informal Caregivers of Patients with Heart Failure in China: Exploring Influencing Factors and Identifying the Paths.

Background: In the fight against heart failure (HF), informal caregivers are an indispensable part of the team. As a protective factor against stress, resilience can help to enhance caregivers' psychological adaptation and ultimately increase the quality of care during the HF caregiving period. Recognizing its predictors and exploring how these variables interact could promote tailored strategies to enhancing caregivers' resilience of HF patients. Thus, this study aimed to identify promoting and risk factors of resilience in informal caregivers of HF patients from the Chinese context and to understand the interactions between these factors and resilience. Methods: This cross-sectional study was conducted from December, 2020 to March, 2022 among 210 caregivers in Nanjing, China. The General Information Questionnaire, the Connor-Davidson Resilience Scale, the General Self-Efficacy Scale, the Perceived Social Support Scale, the Positive and Negative Affect Scale, the Simplified Coping Style Questionnaire and the Family Hardiness Index were used in this survey. Data were analysed with Pearson's correlation analysis, the multiple linear regression model and the structural equation modeling (SEM). Results: The resilience of 210 Chinese HF caregivers was at the moderate and higher level (66.40±15.08). The SEM had a good fit (root mean square error of approximation=0.047, comparative fit index=0.994, Tucker-Lewis index=0.987). Perceived social support (ß=0.390, P<0.001), positive coping style (ß=0.159, P=0.019) and self-efficacy (ß=0.332, P<0.001) had positive direct effects on resilience among HF caregivers, separately. Both perceived social support (ß=0.04, P<0.001) and self-efficacy (ß=0.07, P<0.001) indirectly influenced resilience through positive coping style. Conclusion: We recommended that multi-dimensional and greater social support, higher self-efficacy and especially, positive coping strategies should be offered or encouraged during the caregiving period, which may contribute to enhancing HF caregivers' resilience.

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.

Prediction and Severity Ratings of COVID-19 in the United States.

OBJECTIVES: The objectives of this study is to predict the possible trajectory of coronavirus disease 2019 (COVID-19) spread in the United States. Prediction and severity ratings of COVID-19 are essential for pandemic control and economic reopening in the United States. METHOD: In this study, we apply the logistic and Gompertz model to evaluate possible turning points of the COVID-19 pandemic in different regions. By combining uncertainty and severity factors, this study constructed an indicator to assess the severity of the coronavirus outbreak in various states. RESULTS: Based on the index of severity ratings, different regions of the United States are classified into 4 categories. The result shows that it is possible to identify the first turning point in Montana and Hawaii. It is unclear when the rest of the states will reach the first peak. However, it can be inferred that 75% of regions will not reach the first peak of coronavirus before August 2, 2020. CONCLUSION: It is still essential for the majority of states to take proactive steps to fight against COVID-19 before August 2, 2020.

Cross-Linked Covalent Organic Framework-Based Membranes with Trimesoyl Chloride for Enhanced Desalination.

The rational design of continuous covalent organic framework (COF)-based membranes is challenging for desalination applications, mainly due to the larger intrinsic pore size of COFs and defects in the crystalline film, which lead to a negligible NaCl rejection ratio. In this work, we first demonstrated a COF-based desalination membrane with in situ cross-linking of a COF-TpPa layer by trimesoyl chloride (TMC) to stitch the defects between COF crystals and cross-link the COF cavity with high-cross-linking degree networks to enhance NaCl rejection. With the addition of TMC monomers, both small spherical nodules and some elongated "leaf-like" features were observed on the membrane surface due to the appearance of nanovoids during cross-linking. The resulting COF-based desalination membrane had a water permeability of approximately 0.81 L m-2 h-1 bar-1 and offered substantial enhancement of the NaCl rejection ratio from being negligible to 93.3% at 5 bar. Mechanistic analysis indicated that the amidation reaction of the secondary amine in keto COF with TMC induced the formation of a highly porous network structure both in the cavity and on the exterior of COF, thereby successfully forming a continuous and nanovoid-containing selective layer for desalination. In addition, the membrane exhibited excellent desalting performance for real industrial wastewater with both low and high salinity. This study proposed that the introduction of a cross-linker to react with the terminal amine group and secondary amine in the backbone of the keto form of COF or its derivatives could provide a facile and scalable approach to fabricate a COF-based membrane with superior NaCl rejection. This opens a new fabrication route for COF-based desalination membranes, as well as extended applications in water desalination.

Sustainable and Superior Heat-Resistant Alginate Nonwoven Separator of LiNi0.5Mn1.5O4/Li Batteries Operated at 55 °C.

High-voltage lithium-ion batteries have become a major research focus. As a major part of lithium batteries, the separator plays a critical role in the development of high-voltage lithium batteries. Herein, we demonstrated a sustainable and superior heat-resistant alginate nonwoven separator for high-voltage (5 V) lithium batteries. It was demonstrated that the resultant alginate nonwoven separator exhibited better mechanical property (37 MPa), superior thermal stability (up to 150 °C), and higher ionic conductivity (1.4 × 10-3 S/cm) as compared to commercially available polyolefin (PP) separator. More impressively, the 5 V class LiNi0.5Mn1.5O4 (LNMO)/Li cell with this alginate nonwoven separator delivered much better cycling stability (maintaining 79.6% of its initial discharge capacity) than that (69.3%) of PP separator after 200 cycles at an elevated temperature of 55 °C. In addition, the LiFePO4/Li cell assembled with such alginate nonwoven separator could still charge and discharge normally even at an elevated temperature of 150 °C. The above-mentioned fascinating characteristics of alginate separator provide great probability for its application for high-voltage (5 V) lithium batteries at elevated temperatures.

Taichi-inspired rigid-flexible coupling cellulose-supported solid polymer electrolyte for high-performance lithium batteries.

Inspired by Taichi, we proposed rigid-flexible coupling concept and herein developed a highly promising solid polymer electrolyte comprised of poly (ethylene oxide), poly (cyano acrylate), lithium bis(oxalate)borate and robust cellulose nonwoven. Our investigation revealed that this new class solid polymer electrolyte possessed comprehensive properties in high mechanical integrity strength, sufficient ionic conductivity (3 × 10(-4) S cm(-1)) at 60°C and improved dimensional thermostability (up to 160°C). In addition, the lithium iron phosphate (LiFePO4)/lithium (Li) cell using such solid polymer electrolyte displayed superior rate capacity (up to 6 C) and stable cycle performance at 80°C. Furthermore, the LiFePO4/Li battery could also operate very well even at an elevated temperature of 160°C, thus improving enhanced safety performance of lithium batteries. The use of this solid polymer electrolyte mitigates the safety risk and widens the operation temperature range of lithium batteries. Thus, this fascinating study demonstrates a proof of concept of the use of rigid-flexible coupling solid polymer electrolyte toward practical lithium battery applications with improved reliability and safety.

Sustainable, heat-resistant and flame-retardant cellulose-based composite separator for high-performance lithium ion battery.

A sustainable, heat-resistant and flame-retardant cellulose-based composite nonwoven has been successfully fabricated and explored its potential application for promising separator of high-performance lithium ion battery. It was demonstrated that this flame-retardant cellulose-based composite separator possessed good flame retardancy, superior heat tolerance and proper mechanical strength. As compared to the commercialized polypropylene (PP) separator, such composite separator presented improved electrolyte uptake, better interface stability and enhanced ionic conductivity. In addition, the lithium cobalt oxide (LiCoO2)/graphite cell using this composite separator exhibited better rate capability and cycling retention than that for PP separator owing to its facile ion transport and excellent interfacial compatibility. Furthermore, the lithium iron phosphate (LiFePO4)/lithium cell with such composite separator delivered stable cycling performance and thermal dimensional stability even at an elevated temperature of 120°C. All these fascinating characteristics would boost the application of this composite separator for high-performance lithium ion battery.

Renewable and superior thermal-resistant cellulose-based composite nonwoven as lithium-ion battery separator.

A renewable and superior thermal-resistant cellulose-based composite nonwoven was explored as lithium-ion battery separator via an electrospinning technique followed by a dip-coating process. It was demonstrated that such nanofibrous composite nonwoven possessed good electrolyte wettability, excellent heat tolerance, and high ionic conductivity. The cells using the composite separator displayed better rate capability and enhanced capacity retention, when compared to those of commercialized polypropylene separator under the same conditions. These fascinating characteristics would endow this renewable composite nonwoven a promising separator for high-power lithium-ion battery.