ABSTRACT
Background: Sleep disturbance is a common issue among rotating night shift workers and is closely related to health risks. The present study aimed to determine the effectiveness of pharmacological and non-pharmacological sleep interventions for the management of sleep disturbance among rotating night shift workers. Methods: For this systematic review and meta-analysis, we searched six electronic databases-EMBASE, CINAHL, Cochrane Library, PubMed, Scopus, and Web of Science-for randomized controlled trials and clinical trials published from January 1990 to June 2022. The quality of eligible studies was independently assessed by three authors using the Joanna Briggs Institute Critical Appraisal Checklist for randomized controlled trials and quasi-experimental studies. The meta-analysis was performed based on the random effects model using the Comprehensive Meta-Analysis software. The study was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Results: Of the 1019 studies retrieved, 30 met the inclusion criteria for the systematic review; 25 were selected for the meta-analysis. Sleep interventions were categorized as follows: pharmacological approach (n = 7), light therapy (n = 9), cognitive behavioral approach (n = 7), aroma or alternative therapy (n = 4), and shift schedule modification (n = 3). The overall mean effect size of the interventions was moderate (Hedges' g = 0.59; 95% confidence interval = 0.33-0.84, z = 4.50, p < 0.001). Conclusion: Sleep interventions were effective in promoting sleep or reducing sleep disturbance among rotating night shift workers. These findings provide evidence of the effectiveness of various pharmacological and non-pharmacological sleep interventions for managing sleep health in the work environment of rotating night shift workers.
Subject(s)
Cognitive Behavioral Therapy , Complementary Therapies , Sleep Wake Disorders , Humans , SleepABSTRACT
PURPOSE: We hypothesized that combined delivery of vascular endothelial growth factor (VEGF) and angiopoietin-1 (Ang-1) using microsphere/hydrogel hybrid systems could enhance mature vessel formation compared with administration of each factor alone. METHODS: Hybrid delivery systems composed of alginate hydrogels and poly(D,L-lactic-co-glycolic acid) (PLGA) microspheres containing angiogenic factors were prepared. The release behavior of angiogenic factors from hybrid systems was monitored in vitro. The hybrid systems were injected into an ischemic rodent model, and blood vessel formation at the ischemic site was evaluated. RESULTS: The sustained release over 4 weeks of both VEGF and Ang-1 from hybrid systems was achieved in vitro. Co-delivery of VEGF and Ang-1 was advantageous to retain muscle tissues and significantly induced vessel enlargement at the ischemic site, compared to mice treated with either VEGF or Ang-1 alone. CONCLUSIONS: Sustained and combined delivery of VEGF and Ang-1 significantly enhances vessel enlargement at the ischemic site, compared with sustained delivery of either factor alone. Microsphere/hydrogel hybrid systems may be a promising vehicle for delivery of multiple drugs for many therapeutic applications.
Subject(s)
Angiopoietin-1/administration & dosage , Delayed-Action Preparations/chemistry , Hydrogel, Polyethylene Glycol Dimethacrylate/chemistry , Vascular Endothelial Growth Factor A/administration & dosage , Alginates/chemistry , Animals , Cell Proliferation/drug effects , Female , Glucuronic Acid/chemistry , Hexuronic Acids/chemistry , Hindlimb/blood supply , Hindlimb/drug effects , Lactic Acid/chemistry , Mice , Mice, Inbred BALB C , Mice, Nude , Microspheres , Neovascularization, Physiologic/drug effects , Polyglycolic Acid/chemistry , Polylactic Acid-Polyglycolic Acid CopolymerABSTRACT
Ischemic disease is associated with high mortality and morbidity rates, and therapeutic angiogenesis via systemic or local delivery of protein drugs is one potential approach to treat the disease. In this study, we hypothesized that combined delivery of TAT-HSP27 (HSP27 fused with transcriptional activator) and VEGF could enhance the therapeutic efficacy in an ischemic mouse model, and that sequential release could be critical in therapeutic angiogenesis. Alginate hydrogels containing TAT-HSP27 as an anti-apoptotic agent were prepared, and porous PLGA microspheres loaded with VEGF as an angiogenic agent were incorporated into the hydrogels to prepare microsphere/hydrogel hybrid delivery systems. Sequential in vitro release of TAT-HSP27 and VEGF was achieved by the hybrid systems. TAT-HSP27 was depleted from alginate gels in 7 days, while VEGF was continually released for 28 days. The release rate of VEGF was attenuated by varying the porous structures of PLGA microspheres. Sequential delivery of TAT-HSP27 and VEGF was critical to protect against muscle degeneration and fibrosis, as well as to promote new blood vessel formation in the ischemic site of a mouse model. This approach to controlling the sequential release behaviors of multiple drugs could be useful in the design of novel drug delivery systems for therapeutic angiogenesis.
Subject(s)
Drug Carriers/chemistry , Gene Products, tat/administration & dosage , HSP27 Heat-Shock Proteins/administration & dosage , Hydrogels/chemistry , Ischemia/drug therapy , Neovascularization, Physiologic/drug effects , Recombinant Fusion Proteins/administration & dosage , Vascular Endothelial Growth Factor A/administration & dosage , Alginates/chemistry , Animals , Apoptosis/drug effects , Disease Models, Animal , Drug Combinations , Femoral Artery/drug effects , Femoral Artery/pathology , Gene Products, tat/pharmacology , Gene Products, tat/therapeutic use , HSP27 Heat-Shock Proteins/pharmacology , HSP27 Heat-Shock Proteins/therapeutic use , Hindlimb/blood supply , Hindlimb/drug effects , Hindlimb/pathology , In Situ Nick-End Labeling , Ischemia/metabolism , Lactic Acid/chemistry , Mice , Mice, Nude , Microscopy, Electron, Scanning , Microspheres , Particle Size , Polyglycolic Acid/chemistry , Polylactic Acid-Polyglycolic Acid Copolymer , Porosity , Recombinant Fusion Proteins/pharmacology , Recombinant Fusion Proteins/therapeutic use , Solubility , Surface Properties , Vascular Endothelial Growth Factor A/pharmacology , Vascular Endothelial Growth Factor A/therapeutic useABSTRACT
The intracellular delivery of small interfering RNA (siRNA) plays a key role in RNA interference (RNAi) and provides an emerging technique to treat various diseases, including infectious diseases. Chitosan has frequently been used in gene delivery applications, including siRNA delivery. However, studies regarding the modification of chitosan with antibodies specifically targeting T cells are lacking. We hypothesized that chitosan nanoparticles modified with T cell-specific antibodies would be useful for delivering siRNA to T cells. CD7-specific single-chain antibody (scFvCD7) was chemically conjugated to chitosan by carbodiimide chemistry, and nanoparticles were prepared by a complex coacervation method in the presence of siRNA. The mean diameter and zeta potential of the scFvCD7-chitosan/siRNA nanoparticles were approximately 320 nm and +17 mV, respectively, and were not significantly influenced by the coupling of antibody to chitosan. The cellular association of antibody-conjugated nanoparticles to CD4+ T cell lines as well as gene silencing efficiency in the cells was significantly improved compared to nonmodified chitosan nanoparticles. This approach to introducing T cell-specific antibody to chitosan nanoparticles may find useful applications for the treatment of various infectious diseases.
