Phototherapy Research Articles

Impact of Ultraviolet radiation and 1-methylcyclopropane treatments on maintain quality and storability of Iceberg lettuce head during cold storage.

Impact of Ultraviolet radiation and 1-methylcyclopropane treatments on maintain quality and storability of Iceberg lettuce head during cold storage.

Prospective Clinical Study: Full-Body Blue Irradiation in the Treatment of Atopic Dermatitis.

Ultraviolet-free (UV-free) blue light phototherapy has emerged as a promising option due to its reported efficacy and minimal adverse effects. This study aims to evaluate the effectiveness of full-body blue light irradiation in both adult and pediatric patients with atopic dermatitis (AD), assessing its impact on skin condition and mood regulation by investigating serum concentrations of serotonin and kynurenine pathway metabolites. 20 patients (age 9-45) with moderate and severe AD were included in the study. Treatment consisted of 10 irradiations with Full Body Blue device (453nm). Serum concentrations of serotonin, quinolinic acid, kynurenic acid, tryptophan, and kynurenine were measured before and after irradiations. After 10 sessions of full blue light therapy (453nm) statistically significant improvements were observed in Eczema Area Severity Index (EASI 13.16 vs. 8.65; p = 0.00016), SCORing Atopic Dermatitis (SCORAD 44.99 vs. 23.73; p < 0.00001), Visual Analogue Scale (VAS 6.53 vs. 3.95; p = 0.00251), 10-item pruritus severity scale (13.32 vs. 7.05; p < 0.00001). Moreover, statistically significant decrease in Dermatology Life Quality Index (DLQI) was noted (14.37 vs. 7.42; p = 0.00351). Additionally, increase in the serum concentration of serotonin was observed after completing 10 irradiation sessions (median 139.77mg/ml vs. 274.92mg/ml; p < 0.00001). Blue light may be a promising and safe treatment in patients with AD. It might also positively influence mood. Further investigations are needed to confirm those findings. ClinicalTrials.gov identifier, NCT06516783.

Mitigating the Adverse Effects of Night Shifts: A Review of Strategies for Enhancing Health Outcomes in Shift Workers

Introduction and PurposeShift work, essential for continuous operation in industries like healthcare, transportation, and security, disrupts circadian rhythms and adversely affects health. This review consolidates findings on the multifaceted impacts of night shift work, emphasizing interventions to mitigate these effects and improve worker health and well-being. Brief Description of the State of KnowledgeNight shift work disrupts circadian rhythms, leading to cognitive decline, sleep disorders, mental health risks, cardiovascular issues, metabolic disturbances, and cancer susceptibility. Effective interventions include limiting shift lengths and frequency, incorporating rest breaks and napping, aligning meal times with circadian rhythms, using melatonin supplementation and light therapy to improve sleep quality, engaging in regular aerobic exercise, and employing stress management techniques. Summary Implementing proposed interventions can mitigate the adverse health effects of night shift work, enhancing worker well-being, efficiency, and job satisfaction. Tailoring strategies to different age groups optimizes effectiveness, with structured approaches beneficial for older workers and flexible options suitable for younger workers. Further research should explore long-term intervention effects and develop personalized strategies for diverse populations. This review provides comprehensive guidelines for managing the health impacts of night shift work, supporting improved patient safety, reduced accidents, and enhanced work performance across various industries.

Regenerative Retinal Laser and Light Therapies (RELITE): Proposal of a New Nomenclature, Categorization, and Trial Reporting Standard.

Numerous laser and light therapies have been developed to induce regenerative processes in the choroid/retinal pigment epithelium (RPE)/photoreceptor complex, leaving the neuroretina undamaged. These therapies are applied to the macula for the treatment of various diseases, most prominently diabetic maculopathy, retinal vein occlusion, central serous chorioretinopathy, and age-related macular degeneration. However, the abundance of technologies, treatment patterns, and dosimetry protocols has made understanding these therapies and comparing different approaches increasingly complex and challenging. To address this, we propose a new nomenclature system with a clear categorization that will allow for better understanding and comparability between different laser and light modalities. We propose this nomenclature system as an open standard that may be adapted in future toward new technical developments or medical advancements. A systematic literature review of reported macular laser and light therapies was conducted. A categorization into a standardized system was proposed and discussed among experts and professionals in the field. This paper does not aim to assess, compare, or evaluate the efficacy of different laser or dosimetry techniques or treatment patterns. The literature search yielded 194 papers describing laser techniques, 50 studies describing dosimetry, 272 studies with relevant clinical trials, and 82 reviews. Following the common therapeutic aim, we propose "regenerative retinal laser and light therapies (RELITE)" as the general header. We subdivided RELITE into four main categories that refer to the intended physical and biochemical effects of temperature increase (photothermal therapy, PTT), RPE regeneration (photomicrodisruption therapy, PMT), photochemical processes (photochemical therapy, PCT), and photobiomodulation (photobiomodulation therapy, PBT). Further, we categorized the different dosimetry approaches and treatment regimens. We propose the following nomenclature system that integrates the most important parameters to enable understanding and comparability: Pattern-Dosimetry-Exposure Time/Frequency, Duty Cycle/Irradiation Diameter/Wavelength-Subcategory-Category. Regenerative retinal laser and light therapies are widely used for different diseases and may become valuable in the future. A precise nomenclature system and strict reporting standards are needed to allow for a better understanding, reproduceable and comparable clinical trials, and overall acceptance. We defined categories for a systematic therapeutic goal-based nomenclature to facilitate future research in this field.

Induction of Endoplasmic Reticulum Stress and Aryl Hydrocarbon Receptor Pathway Expression by Blue LED Irradiation in Oral Squamous Cell Carcinoma.

Photobiomodulation therapy, as an emerging treatment modality, has been widely used in dentistry. However, reports on blue light therapy for oral cancer are scarce. This study investigated the effects of 457 and 475 nm LED irradiation on SCC-25 cells and explored the potential mechanisms underlying the impact of blue light. Both wavelengths were found to inhibit cell viability, induce oxidative stress, and cause cell cycle arrest without leading to cell death. Notably, the inhibitory effect of 457 nm blue light on cell proliferation was more sustained. Transcriptome sequencing was performed to explore the underlying mechanisms, revealing that blue light induced endoplasmic reticulum stress in SCC-25 cells, with 457 nm light showing a more pronounced effect. Moreover, 457 nm blue light upregulated the expression of the aryl hydrocarbon receptor pathway, indicating potential therapeutic prospects for the combined use of blue light and pharmacological agents.

Panuveitis after ultraviolet light treatments for light adjustable intraocular lens.

To resport a case of panuveitis after light adjustable intraocular lens (LAL) implantation and ultraviolet (UV) light treatment. Case report. A 68-year-old woman with a history of herpes zoster without ocular involvement presented with panuveitis in her right eye two weeks after a UV light lock-in treatment for a recently implanted LAL. An infectious and inflammatory workup was only notable for positive HSV-1 and VZV IgG, but the patient did not have any history of ocular HSV or VZV. Over the course of five months, the panuveitis resolved completely with topical steroids and the patient had a good visual outcome. Though causality cannot be established in this case, physicians should be aware of the possibility of uveitis after UV light treatments. Extra caution should be observed in patients with history of herpetic disease.

Efficacy and Clinical Outcome of Single and Combined Therapies for Refractory Meibomian Gland Dysfunction: Probing, Intense Pulsed Light, and Thermal Pulsation Treatments

Background: Refractory meibomian gland dysfunction (MGD) is a prevalent condition characterized by chronic functional abnormalities of the meibomian glands, leading to altered tear film and ocular discomfort despite medical treatments. Traditional management strategies include various single-modality treatments, although there is growing interest in the efficacy of combined therapies. Aim: The aim of this study was to evaluate the efficacy of regimens used individually and in combination for the treatment of refractory MGD. Methods: This retrospective study involved pre- and posttreatment evaluations of the ocular surface and symptoms in patients with refractory MGD. Treatments included meibomian gland probing (MGP), intense pulsed light (IPL) therapy, thermal pulsation (LipiFlow), IPL + MGP, and MGP + LipiFlow. Results: In total, 325 eyes of 241 patients with refractory MGD were assessed. The MGP group showed significant improvements in the ocular surface disease index (OSDI), tear meniscus height (TMH), corneal and conjunctival staining, lid wiper epitheliopathy (LWE), and meibomian gland expression (MGX) score. The IPL group showed significant improvements in OSDI, TMH, redness, conjunctival staining, and MGX score. IPL + MGP resulted in significant improvements in corneal and conjunctival staining, LWE, and MGX score, while LipiFlow significantly improved conjunctival staining, LWE, and MGX score. No significant improvements were observed in the MGP + LipiFlow group. Conclusion: IPL or MGP alone could alleviate the signs and symptoms of refractory MGD, while LipiFlow and IPL + MGP could improve the ocular surface parameters. However, no significant improvements were observed with MGP + LipiFlow. These findings provide a valuable guide for ophthalmologists for the selection of effective treatment modalities for refractory MGD, suggesting a potential advantage of combined IPL + MGP to maximize therapeutic benefits.

BBX Genes of Cymbidium ensifolium Exhibited Intense Response to Blue Light in Meristem Induction through Artificial Control.

Cymbidium ensifolium, a prominent orchid species, is both highly valued for its ornamental qualities and commercially cultivated. However, the species has a considerable challenge in its breeding efforts due to the lengthy period of 7-8 years required for it to transition from seed germination to flowering. BBXs are multifunctional proteins that modulate the actions of critical regulators including HY5 and COP1 in response to blue light, ultimately impacting photomorphogenic processes. In this study, BBX proteins, known for their essential roles in regulating developmental processes under various light conditions, were chosen as the main subject of investigation. The outcome reveals the presence of 19 BBX genes in their genome. The genes are classified into four separate clades and dispersed among 12 out of the 20 chromosomes. Located in the nuclear, physicochemical properties of proteins, analysis of the promoter region reveals the existence of almost 800 cis-acting elements, highlighting the complex regulatory mechanisms that control the expression of the CeBBXs in various organs, as well as their response to light and hormone inputs. Moreover, the examination of differential expression under blue light therapy reveals their involvement in photomorphogenic reactions. The expression of CeBBXs exhibits substantial alterations as the duration of exposure to blue light increases. These findings contribute to a deeper understanding of the roles that BBX genes serve in C. ensifolium, providing a basis for future studies on the functions and regulatory mechanisms of BBX members in the context of floral initiation and development within this species.

The effect of intense pulsed light combined with topical 0.05% Cyclosporin A eyedrops in the treatment of Sjögren’s syndrome related dry eye

ABSTRACT Objectives This study aimed to assess the effectiveness and safety of intense pulsed light (IPL) therapy plus topical 0.05% cyclosporine A (CsA) eye drops to treat Sjögren’s Syndrome-related dry eyes (SS-DE). Research design and methods In this prospective, randomized trial included, 60 individuals with SS-DE symptoms were randomized to receive topical eye drops containing either 0.1% sodium hyaluronate (Group S) or 0.05% CsA (Group C) plus IPL therapy. Before the first treatment (baseline), and at 12, 16, and 20 weeks after treatment commencement, we assessed the best corrected visual acuity (BCVA), the Ocular Surface Disease Index (OSDI) score, the Schirmer I test (SIT), noninvasive tear breakup time (NBUT), corneal fluorescein staining (CFS), meibomian gland (MG) dropout, lid margin abnormality, MG expressibility, and meibum quality. Results Both groups showed significant improvements in the OSDI, NBUT, CFS, MG expressibility, and meibum quality (all p < 0.05). Group C showed a greater increase in OSDI, NBUT, MG expressibility, and meibum quality (all p < 0.05). Moreover, SIT and lid margin abnormalities significantly improved in Group C (both p < 0.05), but not in Group S. Conclusion Treatment with 0.05% CsA eyedrops plus IPL therapy could significantly reduce the issues and physical discomfort of patients with SS-DE. Clinical Trial Registered on 20 July 2021, with the registration number ChiCTR2100049059.

Light Therapy for Myopia Prevention and Control: A Systematic Review on Effectiveness, Safety, and Implementation.

This systematic review focuses on the effectiveness, safety, and implementation outcomes of light therapy as an intervention to prevent or control myopia in children. A systematic literature search was performed in PubMed, EMBASE, CINAHL, SCOPUS, and Web of Science up to January 27, 2024. Effectiveness outcomes included myopia incidence, and changes in axial length (AL), spherical equivalent refraction (SER), and choroidal thickness (CT). Safety outcomes relating to retinal health or damage and implementation outcomes including compliance rates and loss to follow-up were extracted. ROBINS-I, ROB 2, and ROB-2 CRT were used to assess risk of bias. Nineteen interventional studies were included. Increased outdoor time (n = 3), red-light therapy (n = 13), and increased classroom lighting (n = 1) had a significant effect on myopia incidence, and changes in AL, SER, and CT. Violet-light therapy (n = 2) was only effective in children aged 8 to 10 years and children without eyeglasses with less than 180minutes of near-work time daily. Two studies using red-light therapy reported adverse effects. For all studies, only compliance rates and loss to follow-up were reported on implementation effectiveness. Evidence is compelling for the effectiveness of red-light therapy and outdoors time; more data are needed to confirm safety. Robust data are still needed to prove the effectiveness of violet-light and increased classroom lighting. Clearer implementation strategies are needed for all light therapies. Light therapy has emerged as effective for myopia prevention and control. This systematic review summarizes the state of knowledge and highlights gaps in safety and implementation for these strategies.

Assessing the efficacy of narrowband UVB phototherapy using digital patient questionnaires and patient‐reported outcome measures (PROMs): An observational cohort study of patients with psoriasis and eczema

Assessing the efficacy of narrowband UVB phototherapy using digital patient questionnaires and patient‐reported outcome measures (PROMs): An observational cohort study of patients with psoriasis and eczema

Photobiomodulation therapy for oral lesions: a bibliometric analysis

Photobiomodulation therapy is a nonthermal light therapy with therapeutic properties for pain and inflammation relief, immune modulation, and tissue regeneration. Our goal was to provide a comprehensive overview of photobiomodulation therapy for oral lesions using visual mapping techniques. We used VOSViewer to analyze publications in the “photobiomodulation” and “oral lesion” categories from PubMed, Scopus, and Dimension AI databases, allowing us to track author contributions, journal, institutional affiliations, and contributions by country. A total of 373 publications from 1991 to 2022 were gathered. Notably, Brazil, the United States, and France emerged as major contributors in this field. The College of Dentistry at the University of Florida (US) ranked first with 515 citations. Jan Magnus Bjordal was the most prolific author, receiving 207 total citations. Supportive Care in Cancer and Photomedicine and Laser Surgery were identified as the two most promising journals. The intellectual structure was divided into four clusters: cluster one for ‘lllt’, cluster two for ‘head and neck cancer’, cluster three for ‘olp’, and cluster four for ‘inflammatory mediators’. Overall, there has been a significant increase in research on photobiomodulation, particularly over the last decade. The study identified four distinct research clusters: low-level light therapy, head and neck cancer, oral lichen planus, and inflammatory mediators. These findings highlight the need for further research into photobiomodulation in the treatment of various oral diseases. This trend may indicate an increase in the use of low-level light therapy to treat oral lesions in the population, as well as the potential for alternative treatments.

An investigation into the use of incoherent UV light to augment IR nanosecond pulsed laser texturing of CFRP composites for improved adhesion

The preparation of Carbon Fibre Reinforced Polymers (CFRP) surfaces for adhesive bonding has been widely reported. Such reports include laser texturing using both near-infrared (IR) lasers and ultraviolet (UV) lasers. In this report, we present, for the first time, findings showing that surface treatment of CFRP using incoherent UV light, at 254 nm wavelength, can increase the adhesive bonding strength of CFRP by 75 % compared to non-treated samples. It is also around 10 % stronger than NIR laser-textured samples. However, combination treatments, where the UV irradiation is conducted either before or after laser texturing did not give a significant benefit over the laser-textured samples. A germicidal 46 W 254 nm UV lamp was used for the UV light treatment, while an IR nanosecond pulsed fibre laser operating at 1064 nm was used for the laser texturing treatment. The material tested was an autoclave-cured T700 CFRP composite.The wettability of the treated CFRP surfaces and the adhesive bonding were quantitatively assessed. This study concludes that low-cost incoherent UV treatment effectively reduces the water contact angle of the CFRP surface and activates CFRP surfaces. All treatments led to bonding strengths at least 50% greater than for the untreated surfaces.The predominant failure mode for UV-treated samples was Cohesive Substrate Failure (CSF), indicating that the adhesion strength exceeded the interlaminar shear strength of the CFRP material. All samples treated with the laser (including combined treatment with UV) exhibited Light Fibre Tear Failure.

Enhancing flexibility and durability of PVC with liquid epoxidized natural rubber: Innovative UV treatment to mitigate plasticizer migration

AbstractThis manuscript elucidates the preparation and utilization of liquid epoxidized natural rubber (LENR) with 50 mol% epoxidation level (LENR50) as a polymeric plasticizer for poly(vinyl chloride) (PVC), and further immobilization of the plasticizer in the plastic matrix through subsequent ultraviolet (UV)‐curing treatment. The plasticizing effect induced by LENR50 at 50 wt% loading was evident with a reduction of Tg from a high of 72.0 to 11.4°C. Positive enhancements were also documented in the mechanical properties of the LENR50‐plasticized PVC, specifically the big improvement in elongation at break and elastic modulus, from 106% to 430%, and from 646 to 7 MPa, respectively. The UV‐treated PVC/LENR film also exhibited superior resistance to migration compared with formulations with conventional plasticizers such as di‐2‐ethylhexyl phthalate (DEHP) and triethyl‐2‐acetyl citrate (ATEC). A similar outcome was recorded in the leaching resistance test, where LENR50 had the best resistance to leaching in four different solvents (water, soap solution, ethanol, and toluene). The LENR50‐plasticized PVC film recorded the lowest weight loss following 24 h immersion in both hydrophilic and lipophilic solvents. The findings from this study suggest that LENR50 could serve as an efficient bio‐based polymeric plasticizer for PVC.Highlights LENR as bio‐based polymeric plasticizer for PVC. Significant reduction in Tg and elastic modulus of PVC plasticized with LENR. UV treatment improved tensile strength and elongation at break of LENR/PVC film. UV‐treated PVC/LENR has superior plasticizer migration and leaching resistance.

The Analysis Study of Efficacy and Effectiveness of Laser and Light Therapy for The Treatment of Cutaneous Disorders of Hyperpigmentation : A Comprehensive Systematic Review

The Analysis Study of Efficacy and Effectiveness of Laser and Light Therapy for The Treatment of Cutaneous Disorders of Hyperpigmentation : A Comprehensive Systematic Review

Long-Term Impacts of Intense Pulsed Light Therapy on Ocular Surface Health and Tear Film Dynamics in Patients with Dry Eye Disease: Detailed Analysis and Observations Over a 1-Year Follow-Up Period.

To evaluate the long-term effects of intense pulsed light (IPL) therapy on patients with dry eye disease (DED) associated with meibomian gland dysfunction (MGD). A retrospective case series was performed with 110 participants undergoing IPL therapy. Assessments included the eye fitness test (EFT) to gauge subjective symptoms, along with objective measures using the Tearcheck® device (ESW Vision, Houdan, France) noninvasive first breakup time (NIFBUT), noninvasive average breakup time (NIABUT), central tear meniscus height (CTMH), thinnest tear meniscus height (TTMH), and ocular surface inflammatory risk evaluation (OSIE) assessed using the SCHWIND SIRIUS device (SCHWIND eye-tech-solutions GmbH, Kleinostheim, Germany). This study documented significant improvements in subjective and objective symptoms associated with DED and MGD. Subjective symptoms measured by the EFT showed an average increase of 9.74 points (range -10 to 28, standard deviation [SD] ± 7.54), indicating reduced symptoms. Objective measures of tear film stability, represented by NIABUT, increased by an average of 4.04s (range -15.00 to 14.40, SD ± 4.91). Tear film stability evaluation (TFSE) scores decreased by 229.12 points on average (range -1775 to 528, SD ± 384.94), suggesting enhanced tear film stability. OSIE type 1 showed a reduction in inflammation, with a percentage decrease of 4.98% (range -45 to 5, SD ± 7.33). Additionally, OSIE capture time decreased by 3.25s on average (range -27 to 22, SD ± 10.35), further indicating an improvement in ocular surface health. IPL therapy was shown to be a promising, noninvasive approach for improving quality of life in patients with DED by effectively managing symptoms and stabilizing tear film. The findings support the use of IPL as a sustainable treatment modality for DED associated with MGD.

The Usage of Different Hyaluronic-Acid-Containing Artificial Tears and the Treatment Outcome of Intense Pulsed Light Therapy for Dry Eye Disease: A Retrospective Cohort Study.

In this study, we aimed to investigate the effect of different hyaluronic acid (HA)-containing artificial tears on dry eye disease (DED) treatment in combination with intense pulsed light (IPL) therapy. A retrospective cohort study was conducted, and the participants received IPL therapy and HA-containing artificial tears. There were 42 and 40 eyes in the 0.10% and 0.15% HA groups after selection, respectively. The main outcomes were the postoperative non-invasive tear break-up time (NITBUT), Schirmer II test results, ocular surface stain, and numbers of DED-related symptoms. A generalized linear model was utilized to produce the adjusted odds ratio (aOR) and 95% confidence interval (CI) of the main outcomes between groups. At the three-month follow-up, the NITBUT was significantly higher in the 0.15% HA group (p = 0.023), and the NITBUT recovery was also significantly better in the 0.15% HA group compared to the 0.10% HA group (p = 0.039). The multiple DED-related symptoms significantly correlated with no DED symptom improvement in both the 0.10% and 0.15% HA groups (both p < 0.05), while the low pre-treatment NITBUT was marginally related to no DED symptom improvement in the 0.10% HA group (p = 0.047). A low NITBUT and Schirmer II test result correlated with no DED symptom improvement in both the groups (all p < 0.05). In conclusion, the application of 0.10% and 0.15% HA-containing artificial tears revealed similar effects to IPL therapy for DED.

Multimodal Imaging-Assisted Intravascular Theranostic Photoactivation on Atherosclerotic Plaque.

Atherosclerosis is a chronic inflammatory disease causing a fatal plaque rupture, and its key aspect is a failure to resolve inflammation. We hypothesize that macrophage-targeted near-infrared fluorescence emitting photoactivation could simultaneously assess macrophage/lipid-rich plaques in vivo and facilitate inflammation resolution. We fabricated a Dectin-1-targeted photoactivatable theranostic agent through the chemical conjugation of the near-infrared fluorescence-emitting photosensitizer chlorin e6 and the Dectin-1 ligand laminarin (laminarin-chlorin e6 [LAM-Ce6]). Intravascular photoactivation by a customized fiber-based diffuser after administration of LAM-Ce6 effectively reduced inflammation in the targeted plaques of atherosclerotic rabbits in vivo as serially assessed by dual-modal optical coherence tomography-near-infrared fluorescence structural-molecular catheter imaging after 4 weeks. The number of apoptotic macrophages peaked at 1 day after laser irradiation and then resolved until 4 weeks. Autophagy was strongly augmented 1 hour after the light therapy, with the formation of autophagolysosomes. LAM-Ce6 photoactivation increased the terminal deoxynucleotidyl transferase dUTP (deoxyuridine triphosphate) nick end labeling/RAM11 (rabbit monocyte/macrophage antibody)- and MerTK (c-Mer tyrosine kinase)-positive cells in the plaques, suggesting enhanced efferocytosis. In line with inflammation resolution, photoactivation reduced the plaque burden through fibrotic replacement via the TGF (transforming growth factor)-β/CTGF (connective tissue growth factor) pathway. Optical coherence tomography-near-infrared fluorescence imaging-guided macrophage Dectin-1-targetable photoactivation could induce the transition of macrophage/lipid-rich plaques into collagen-rich lesions through autophagy-mediated inflammation resolution and TGF-β-dependent fibrotic replacement. This novel strategy offers a new opportunity for the catheter-based theranostic strategy.

A systematic review and network meta-analysis of psychological, psychosocial, pharmacological, physical and combined treatments for adults with a new episode of depression

Various effective treatments for depression exist. We aimed to identify the most effective first-line treatments for new episodes of less and more severe depression (defined by depression scale cut-off scores), to update NICE guidance on the management of Depression in Adults in England. Systematic review and network meta-analysis of randomised controlled trials (RCTs) published up to June 2020 (PROSPERO registration number CRD42019151328). We analysed interventions by class and individually. The primary efficacy outcome was depressive symptom change (expressed as standardised mean difference [SMD]). The review for this outcome was updated in November2023. We included 676 RCTs, 105,477 participants and 63 treatment classes. For less severe depression, group cognitive/cognitive behavioural therapy (CT/CBT) class was efficacious versus treatment as usual [TAU], the reference treatment for this population [SMD-1.01 (95% Credible Interval [CrI]-1.76;-0.06)]. For more severe depression, efficacious classes versus pill placebo (reference treatment for this population) included combined individual CT/CBT with antidepressants [-1.18 (-2.07;-0.44)], individual behavioural therapies [-0.86 (-1.65;-0.16)], combined light therapy with antidepressants [-0.86 (-1.59;-0.12)], combined acupuncture with antidepressants [-0.78 (-1.12;-0.44)], individual CT/CBT [-0.78 (-1.42;-0.33)], mirtazapine [-0.35 (-0.48;-0.22)], serotonin and norepinephrine reuptake inhibitors [-0.32 (-0.43;-0.22)], tricyclic antidepressants [-0.29 (-0.50;-0.05)], and selective serotonin reuptake inhibitors [-0.24 (-0.32;-0.16)]. Additional treatments showed evidence of efficacy at the intervention level. Evidence for less and more severe depression was of low and low-to-moderate quality, respectively. In the 2023 update, group yoga and self-help without support emerged as efficacious for less severe depression. For more severe depression, combined group exercise with antidepressants emerged as efficacious, whereas combined light therapy with antidepressants failed to remain efficacious. Group CT/CBT (and possibly group yoga and self-help) appears efficacious in less severe depression, whereas antidepressants do not show evidence of effect. Combined antidepressants with individual CT/CBT, acupuncture and, possibly, group exercise, individual psychological therapies (behavioural therapies, CT/CBT) alone, and antidepressants alone appear efficacious in more severe depression. Quality of evidence, cost-effectiveness, applicability and implementation issues also need to be considered when formulating clinical practice recommendations. National Institute for Health and Care Excellence.

Self-Initiated Nano-Micelles Mediated Covalent Modification of mRNA for Labeling and Treatment of Tumors.

As a promising gene therapy strategy, controllable small molecule-mRNA covalent modification in tumor cells could be initiated by singlet oxygen (1O2) to complete the modification process. However, in vivo generation of 1O2 is usually dependent on excitation of external light, and the limited light penetration of tissues greatly interferes the development of deep tumor photo therapy. Here, we constructed a tumor-targeting nano-micelle for the spontaneous intracellular generation of 1O2 without the need for external light, and inducing a high level of covalent modification of mRNA in tumor cells. Luminol and Ce6 were chemically bonded to produce 1O2 by chemiluminescence resonance energy transfer (CRET) triggered by high levels of hydrogen peroxide (H2O2) in the tumor microenvironment (TME). The sufficient 1O2 oxidized the loaded furan to highly reactive dicarbonyl moiety, which underwent cycloaddition reaction with adenine (A), cytosine (C) or guanine (G) on the mRNA for interfering with the tumor cell protein expression, thereby inhibiting tumor progression. In vitro and in vivo experiments demonstrated that this self-initiated gene therapy nano-micelle could induce covalent modification of mRNA by 1O2 without external light, and the process could be monitored in real time by fluorescence imaging, which provided an effective strategy for RNA-based tumor gene therapy.