Effect of acupuncture on lung cancer-related fatigue: study protocol for a multi-center randomized controlled trial

BACKGROUND: Fatigue is one of the primary symptoms in lung cancer, with a prevalence of 88.0% in survivors of cancer, and an even higher prevalence post resection surgery. Effective fatigue control after lung cancer surgery is important for patient recovery and quality of life. Some studies have shown that acupuncture might be effective in treating cancer-related fatigue; however, randomized controlled trials (RCTs) of suitable sample size are limited. METHOD/DESIGN: This is a multi-center, patient-blinded RCT. A total of 320 eligible patients will be recruited in four centers and randomly assigned to either the acupuncture group or the sham acupuncture group in a 1:1 ratio. Treatment will be given twice per week for 12 sessions. Treatment will be given at acupoints GV20, GV29, CV12, CV6, CV4, and bilateral LI4, LR3, SP6, ST36. The primary outcome will be assessed using the Chinese version of The Brief Fatigue Inventory. The secondary outcomes will be measured using The European Organization for Research and The Treatment of Cancer Quality of Life Questionnaire, and the Hamilton Rating Scale for Depression. The primary outcome will be assessed at all main points (baseline, the 3rd week, the 6th week, and at follow up time points) and the secondary outcomes will be assessed at baseline and the 6th week. Intention-to-treat analysis will be used in this RCT. DISCUSSION: This trial protocol provides an example of the clinical application acupuncture treatment in the management of lung cancer-related fatigue. If the acupuncture treatment protocol confirms that acupuncture is an effective and safe option for lung cancer-related fatigue, it can be adopted as a standardized treatment. TRIAL REGISTRATION: Chinese Clinical Trial Registry, ChiCTR1900022831. Registered on 27 April 2019. URL: http://www.chictr.org.cn/showproj.aspx?proj=37823

Analysis of fruit quality and spatial distribution of soluble solids content in four new kiwifruit cultivars

[Objective] Kiwifruit has become a high-value agricultural commodity in China, where the development of new cultivars is critical for maintaining market competitiveness. Fruit quality traits such as sweetness, acidity, and nutritional composition are heavily dependent on genotype-environment interactions. Shiyan City in northwestern Hubei Province, characterized by a subtropical monsoon climate with annual rainfall of 800-1200 mm and elevations spanning 300-1500 meters, offers ideal ecological conditions for kiwifruit cultivation. Despite this potential, the region remains underutilized in terms of optimized production systems. Four new cultivars, Wudang No. 1, Hanxiang, Hanmei, and Zhongmi No. 2, bred for enhanced stress resilience and flavor profiles, require comprehensive evaluation of their phenotypic adaptability and biochemical characteristics under local conditions. This study aimed to assess the fruit quality traits of these cultivars, and investigate spatial variations in soluble solids content (SSC) across fruit segments to guide cultivar selection, harvest timing, and scientific sampling protocols. [Methods] Fruits of four cultivars were harvested when SSC levels reached 6.5%-7.0%. The single fruit mass was measured using a precision electronic scale. Fruit dimensions (longitudinal, transverse, and lateral diameters) were recorded with vernier calipers, and the shape index was calculated as the ratio of longitudinal to transverse diameter. The SSC was analyzed using a PAL-1 digital refractometer, with fruits longitudinally divided into three segments (stalk end, middle part, and beak end) prior to juice extraction. The soluble sugar content was determined via the 3, 5-dinitrosalicylic acid colorimetric method (NY/T 2742—2015), expressed as glucose equivalents. Total acidity was quantified using an automatic titrator with 0.1 mol·L-1 NaOH titrant to pH 8.2, reported as citric acid equivalents based on a modified GB/T 12456—2008 protocol. The vitamin C content was analyzed through high-performance liquid chromatography (HPLC) following GB 5009.86—2016 standards. [Results] The results revealed significant varietal differences: Hanmei and Zhongmi No. 2 exhibited the highest single fruit mass (132.99 g and 124.47 g, respectively), while Hanxiang (59.26 g) was markedly smaller. In terms of the SSC, Hanxiang (20.04%) surpassed all other cultivars, followed by Zhongmi No. 2 (18.34%), Wudang No. 1(15.78%), and Hanmei (15.51%). The soluble sugar content of Hanxiang (12.04%) and Zhongmi No. 2(11.36%) was higher than that of Hanmei (10.47%) and Wudang No. 1 (10.23%) showed no significant differences. The total acidity was nearly similar among the four cultivars (1.24%-1.41%), whereas the dry matter content varied from 17.37% (Hanmei) to 20.37% (Hanxiang). Vitamin C levels ranged narrowly from 96.67 to118.53 mg·100 g-1. The correlation analysis showed strong positive associations between fruit size parameters and negative correlations between single fruit mass and SSC, dry matter. Notably, the SSC showed strong linkages to soluble sugars and dry matter, while vitamin C exhibited no significant correlations with other metrics. The comprehensive analysis of SSC across three anatomical regions (stalk end, middle part, and beak end) revealed distinct spatial patterns among cultivars. All four kiwifruit cultivars exhibited a consistent SSC gradient, with the highest concentration at the beak end and gradual decrease toward the stalk end. However, inter-cultivar differences emerged in the magnitude of these gradients. In Zhongmi No. 2 and Wudang No. 1, the SSC remained statistically uniform across segments, with mean values ranging narrowly. In contrast, Hanmei demonstrated pronounced compartmentalization: stalk end SSC (15.05%) was significantly lower than that of middle part (15.60%) and beak end (15.89%). The most striking variation occurred in Hanxiang, which beak end SSC reached 20.50% over stalk end levels (18.8%) and middle part values (19.98%), and the difference between the beak end and the stalk end of the fruit was significant. Among all recorded SSC values, the maximum values of Zhongmi No. 2, Wudang No. 1, and Hanmei were consistently observed at the beak end, while the minimum values were uniformly detected at the stalk end. In contrast, both the maximum and minimum SSC values in Hanxiang kiwifruit were recorded from the middle part. The coefficients of variation (CV) for SSC in fruits of Zhongmi No. 2, Wudang No. 1 Hanmei, and Hanxiang exhibited a decreasing trend, measuring 5.24%, 4.73%, 4.03%, and 3.67% respectively. These spatial disparities showed the importance of sampling position for quality assessments. [Conclusion] The four cultivars demonstrated superior fruit quality in Shiyans Qinba Mountain region. Hanxiang and Zhongmi No. 2 had higher sweetness and dry matter content, while Wudang No. 1 was advantageous in vitamin C enrichment. The observed SSC spatial gradients underscored the need for cultivar-specific harvest strategies, for instance, mixed sampling of different parts (covering the whole fruit) for Hanmei and Hanxiang to ensure accurate quality assessments

Efficacy and safety of electroacupuncture on treating mild to moderate first-episode depression: a study protocol for a randomized controlled trial

IntroductionOnly 30%-40% of patients with first-episode depression recover after taking antidepressants. Acupuncture is a clinically recognized treatment for depression, but its effect on first-episode depression remains unknown. This randomized controlled trial is designed to investigate the efficacy and safety of electroacupuncture (EA) compared with escitalopram (ESC) in treating patients with mild to moderate first-episode depression.Methods and analysisThis is a multi-site, single-blind, randomized controlled trial with two parallel arms. A total of 204 eligible patients will be randomly allocated to two groups: the EA group (receiving EA treatment with placebo drugs) and the ESC group (receiving escitalopram and sham acupuncture treatment). Treatment will last 12 weeks, with 3 sessions per week for the first 8 weeks, decreasing to 2 per week for the remaining 4 weeks. The primary outcome will be the score of the 17-item Hamilton Depression Rating Scale (HAMD-17), and the secondary outcomes will include depression recovery rate, depression remission rate, Patient Health Questionnaire-9 (PHQ-9), 36-Item Short Form Survey Instrument (SF-36), and the dose and frequency of ESC. The Treatment Emergent Symptom Scale (TESS) will be used to assess all adverse effects. Full details of the statistical analysis plan for the primary and secondary outcomes will be described in this article

Efficacy of electroacupuncture on insomnia disorder in older adults: study protocol for a multicentre randomised controlled trial

IntroductionInsomnia disorder is highly prevalent among older adults and is associated with significant adverse effects on both physical and psychological health. The use of hypnotic medications in this population is often accompanied by undesirable risks, including drug tolerance, dependence, and impaired daytime functioning. While electroacupuncture has been increasingly employed as a therapeutic modality for insomnia, robust clinical evidence supporting its efficacy and safety remains limited. This multicentre randomised controlled trial is designed to evaluate the therapeutic effectiveness and safety profile of electroacupuncture in the treatment of insomnia disorder in older adults.Methods and analysisThis multi-centre, single-blind, randomised controlled trial will enrol 214 older adults with diagnosed insomnia disorder from five hospitals. Participants will be randomly assigned in a 1:1 ratio to receive either electroacupuncture or sham electroacupuncture. The electroacupuncture group will undergo treatment three times per week for 8 weeks. The sham electroacupuncture group will receive a non-penetrative placebo needle intervention at sham acupoints, with no electrical stimulation delivered despite connection to the electroacupuncture apparatus. The primary outcome will be the change in Pittsburgh Sleep Quality Index score. Secondary outcomes will include the Insomnia Severity Index, actigraphy-derived sleep parameters, sleep diaries, the Hospital Anxiety and Depression Scale, and the Mini-Mental State Examination. All outcomes will be assessed at baseline (week 0), during intervention (weeks 4 and 8), and during follow-up (weeks 12 and 20).DiscussionIf the intervention demonstrates efficacy, this study will provide important clinical evidence supporting electroacupuncture as a safe and effective non-pharmacological treatment for insomnia in older adults. The findings may influence clinical practice by expanding therapeutic options and improving sleep quality in this vulnerable population.Clinical trial registrationhttp://www.chictr.org.cn, identifier ChiCTR2400081782

Finishing the euchromatic sequence of the human genome

The sequence of the human genome encodes the genetic instructions for human physiology, as well as rich information about human evolution. In 2001, the International Human Genome Sequencing Consortium reported a draft sequence of the euchromatic portion of the human genome. Since then, the international collaboration has worked to convert this draft into a genome sequence with high accuracy and nearly complete coverage. Here, we report the result of this finishing process. The current genome sequence (Build 35) contains 2.85 billion nucleotides interrupted by only 341 gaps. It covers ∼99% of the euchromatic genome and is accurate to an error rate of ∼1 event per 100,000 bases. Many of the remaining euchromatic gaps are associated with segmental duplications and will require focused work with new methods. The near-complete sequence, the first for a vertebrate, greatly improves the precision of biological analyses of the human genome including studies of gene number, birth and death. Notably, the human enome seems to encode only 20,000-25,000 protein-coding genes. The genome sequence reported here should serve as a firm foundation for biomedical research in the decades ahead

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Correction to: Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

The original version of this article unfortunately contained a mistake