The common cutworm, Spodoptera litura (F.), feeds on a wide variety of food and cash crops and is one of the most widespread and destructive agricultural pests worldwide. Migration is the biological basis of its regional population outbreaks but the seasonal movement of this pest between east and south Asia regions remains unknown. In this study, searchlight traps were used to monitor the seasonal migration of S. litura from 2019 to 2023 in Ruili City (Yunnan, China), located along the insect migratory route between China and the south Asia region. The results showed that migratory activity could occur throughout the year, with the main periods found in spring (April–May) and autumn (October–December). The ovarian development and mating status of the trapped females indicated that most individuals were in the middle or late stages of migration and that Ruili City was located in the transit area of the long-distance migration of the pest. In the migration trajectory simulation, populations of S. litura moved from northeast India, Bangladesh, and northern Myanmar to southwestern China along the southern margin of the Himalayas in spring and returned to the south Asia region in autumn. Our findings clarify the seasonal migration patterns of S. litura in China and South Asia and facilitate the development of regional cross-border monitoring and management systems for this pest. Full article

With the construction and development of the smart grid, the power business puts higher requirements on the communication capability of the network. In order to improve the energy efficiency of the space–air–ground-integrated power three-dimensional fusion communication network, we establish an optimization problem for joint air platform (AP) flight path selection, ground power facility (GPF) association, and power control. In solving the problem, we decompose the problem into two subproblems, one is the AP flight path selection subproblem and the other is the GPF association and power control subproblem. Firstly, based on the GPF distribution and throughput weights, we model the AP flight path selection subproblem as a Markov Decision Process (MDP) and propose a multi-agent iterative optimization algorithm based on the comprehensive judgment of GPF positions and workload. Secondly, we model the GPF association and power control subproblem as a multi-agent, time-varying K-armed bandit model and propose an algorithm based on multi-agent Temporal Difference (TD) learning. Then, by alternately iterating between the two subproblems, we propose a reinforcement learning (RL)-based joint optimization algorithm. Finally, the simulation results indicate that compared to the three baseline algorithms (random path, average transmit power, and random device association), the proposed algorithm improves an overall energy efficiency of the system of 16.23%, 86.29%, and 5.11% under various conditions (including different noise power levels, GPF bandwidth, and GPF quantities), respectively. Full article

Obesity is a major global health concern linked to cognitive impairment and neurological disorders. Circulating brain-derived neurotrophic factor (BDNF), a protein crucial for neuronal growth and survival, plays a vital role in brain function and plasticity. Notably, obese individuals tend to exhibit lower BDNF levels, potentially contributing to cognitive decline. Physical exercise offers health benefits, including improved circulating BDNF levels and cognitive function, but the specific impacts of acute versus regular exercise on circulating BDNF levels in obesity are unclear. Understanding this can guide interventions to enhance brain health and counter potential cognitive decline in obese individuals. Therefore, this study aimed to explore the impact of acute and regular physical exercise on circulating BDNF in individuals with obesity. The target population comprised individuals classified as overweight or obese, encompassing both acute and chronic protocols involving all training methods. A comprehensive search was conducted across computerized databases, including PubMed, Academic Search Complete, and Web of Science, in August 2022, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Initially, 98 studies were identified, from which 16 studies, comprising 23 trials, met the selection criteria. Substantial heterogeneity was observed for both acute (I² = 80.4%) and long-term effects (I² = 88.7%), but low risk of bias for the included studies. A single session of exercise increased circulating BDNF levels among obese patients compared to the control group (ES = 1.25, 95% CI = 0.19 to 2.30, p = 0.021). However, with extended periods of physical exercise, there was no significant increase in circulating BDNF levels when compared to the control group (ES = 0.49, 95% CI = −0.08 to 1.06, p = 0.089). These findings highlight the need to consider exercise duration and type when studying neurobiological responses in obesity and exercise research. The study’s results have implications for exercise prescription in obesity management and highlight the need for tailored interventions to optimize neurotrophic responses. Future research should focus on elucidating the adaptive mechanisms and exploring novel strategies to enhance BDNF modulation through exercise in this population. However, further research is needed considering limitations such as the potential age-related confounding effects due to diverse participant ages, lack of sex-specific analyses, and insufficient exploration of how specific exercise parameters (e.g., duration, intensity, type) impact circulating BDNF. Full article

Artificial coastal structures, such as seawalls, breakwaters, and groins, can exert various impacts on the fish communities in the nearby regions. This study focuses on assessing the ecological effects of coastal infrastructure on marine environments, by comparing, at different seasons, the habitat complexity and heterogeneity, as well as their effects on fish assemblages, between the artificial habitat created with the intention of constructing a marina (Puerto Amor) and the natural habitats surrounding the Cabo de la Huerta area in Alicante (Spain). Employing an asymmetric design and examining two temporal and spatial scales, we utilized visual censuses in snorkeling to gauge the abundance and size of fish species, alongside various parameters related to habitat complexity and heterogeneity. The overarching hypothesis is that fish populations associated with artificial habitats will differ in terms of abundance, biomass, species richness, and diversity compared to fish populations associated with natural habitats, due to changes in complexity and heterogeneity. The findings indicate a shift in fish assemblages; for example, the family Labridae showed differences between the two habitat types for several species. These changes were due to the influences of the Posidonia oceanica meadow and algae like Jania rubens; being influenced by biological variables such as Ellisolandia elongata, Oculina patagonica, and Sarcotragus spinosulus; as well as physical variables such as stones, gravel, and blocks. While there is evidence of alteration in fish assemblages due to changes in habitat structure, there is also an increase in richness (9 species/m²) and total abundance and biomass (1000 ind./m² and 1700 g/m², respectively) in the artificial habitat. Multivariate analyses reveal that the fish community in Puerto Amor is less homogeneous than the one in the natural habitat. However, these analyses also indicate an overlap between the communities of both habitats, suggesting substantial similarity despite the noted differences. Consequently, although the habitat alteration has impacted fish populations, it has not diminished abundance, biomass, or species richness. In conclusion, the artificial rocky habitat resulting from the construction attempt at Puerto Amor harbor has fish populations with ecological significance and its removal could lead to undesirable impacts in the area, as the fish assemblages have become well established. Full article

This paper focuses on terminal air traffic complexity indicators. By thorough analysis of previous research, the benefits and limitations of the existing terminal complexity models are identified. According to these findings, a new approach for determining terminal air traffic complexity indicators is proposed which assumes that terminal complexity could be determined based on approach air traffic controller (ATCO) tasks. The comprehensive list of general approach ATCO tasks was defined using a literature review and observation of training exercises, forming the basis for subsequent expert group workshops which enabled the acquisition of ATCOs’ knowledge data. Through these workshops, new approach ATCO tasks were additionally identified, and terminal complexity indicators were defined with airspace and traffic parameters. These new tasks and indicators present a novelty in this field of research since they incorporate ATCOs’ knowledge as the data input and consider various traffic scenarios, all types of traffic, weather conditions, and off-nominal situations. Full article

This essay reads a short narrative, “Savoir” by Hélène Cixous, to describe susceptibility as a problem organized around two lines of impingement: between subject and world and between consciousness and the wayward impulses of interior life. The young girl in Cixous’s text suffers a moment of disorientation and distress one misty morning and, against presumptions of inviolability and ideals of subjective consistency, this unhappy event comes to resonate with her disappointed trust in the generosity of the world, her anxious sense of betrayal with respect to those who ought to protect her and her insecurity about her own role in this complex of associations. The frame of susceptibility thus opens up a space for Cixous’s reader and this essay to think the subject in her inconsistency and self-strangeness. Full article

Psychological research has shown that empathy and compassion can be developed through mediation, simulation and embodiment techniques that foster benevolence and kindness, attributes and actions that play a major role in increasing subjective feelings of happiness and overall wellbeing. Our exercise of having students re-write the ending with a more positive outcome and re-draw the cover for the famous 19th century short story “The Yellow Wallpaper” serves as a model for future art education practices interested in promoting positive psychological experiences that can be used for enhanced self-care and empathy development. Full article

Single-walled carbon nanotubes (SWCNTs) loaded with magnetic iron oxide nanoparticles were prepared by the arc discharge method and air heat treatment. The nanocomposite was characterized by X-ray diffraction, scanning electron microscopy, Raman spectroscopy, vibrating sample magnetometry, etc. The results showed that the heat-treated nanocomposites (SWCNTs/Fe_xO_y) had iron oxide phases and superparamagnetic properties with a saturation magnetization of 33.32 emu/g. Compared with the non-heat-treated materials, SWCNTs/Fe_xO_y had a larger specific surface area and pore volume. Using SWCNTs/Fe_xO_y to remove the organic contaminant (bisphenol A, BPA), it was found that under the conditions of pH = 3 and adsorbent dosage of 0.2 g/L, the maximum adsorption capacity of the composite was 117 mg/g, and the adsorption could reach more than 90% in only 5 min when the BPA content was below 0.05 mmol/L. The fitting results of the Langmuir and D-R models are more consistent with the experimental data, indicating a relatively uniform distribution of the adsorption sites and that the adsorption process is more consistent with physical adsorption. The kinetic calculations showed that the SWCNTs/Fe_xO_y exhibits chemical effects on both the surface and the gap, and the adsorption process is controlled by the π-π bonds and the hydrophobicity of the SWCNTs/Fe_xO_y. Full article

Existing research in metasurface design was based on trial-and-error high-intensity iterations and requires deep acoustic expertise from the researcher, which severely hampered the development of the metasurface field. Using deep learning enabled the fast and accurate design of hypersurfaces. Based on this, in this paper, an integrated learning approach was first utilized to construct a model of the forward mapping relationship between the hypersurface physical structure parameters and the acoustic field, which was intended to be used for data enhancement. Then a dual-feature fusion model (DFCNN) based on a convolutional neural network was proposed, in which the first feature was the high-dimensional nonlinear features extracted using a data-driven approach, and the second feature was the physical feature information of the acoustic field mined using the model. A convolutional neural network was used for feature fusion. A genetic algorithm was used for network parameter optimization. Finally, generalization ability verification was performed to prove the validity of the network model. The results showed that 90% of the integrated learning models had an error of less than 3 dB between the real and predicted sound field data, and 93% of the DFCNN models could achieve an error of less than 5 dB in the local sound field intensity. Full article

This study aims to evaluate leg movement by integrating gait analysis with surface electromyography (sEMG) and accelerometer (ACC) data from the lower limbs. We employed a wireless, self-made, and multi-channel measurement system in combination with commercial GaitUp Physilog^® 5 shoe-worn inertial sensors to record the walking patterns and muscle activations of 17 participants. This approach generated a comprehensive dataset comprising 1452 samples. To accurately predict gait parameters, a machine learning model was developed using features extracted from the sEMG signals of thigh and calf muscles, and ACCs from both legs. The study utilized evaluation metrics including accuracy (R²), Pearson correlation coefficient (PCC), root mean squared error (RMSE), mean absolute percentage error (MAPE), mean squared error (MSE), and mean absolute error (MAE) to evaluate the performance of the proposed model. The results highlighted the superiority of the CatBoost model over alternatives like XGBoost and Decision Trees. The CatBoost’s average PCCs for 17 temporospatial gait parameters of the left and right legs are 0.878 ± 0.169 and 0.921 ± 0.047, respectively, with MSE of 7.65, RMSE of 1.48, MAE of 1.00, MAPE of 0.03, and Accuracy (R²-Score) of 0.91. This research marks a significant advancement by providing a more comprehensive method for detecting and analyzing gait statuses. Full article

Gait phase monitoring wearable sensors play a crucial role in assessing both health and athletic performance, offering valuable insights into an individual’s gait pattern. In this study, we introduced a simple and cost-effective capacitive gait sensor manufacturing approach, utilizing a micropatterned polydimethylsiloxane dielectric layer placed between screen-printed silver electrodes. The sensor demonstrated inherent stretchability and durability, even when the electrode was bent at a 45-degree angle, it maintained an electrode resistance of approximately 3 Ω. This feature is particularly advantageous for gait monitoring applications. Furthermore, the fabricated flexible capacitive pressure sensor exhibited higher sensitivity and linearity at both low and high pressure and displayed very good stability. Notably, the sensors demonstrated rapid response and recovery times for both under low and high pressure. To further explore the capabilities of these new sensors, they were successfully tested as insole-type pressure sensors for real-time gait signal monitoring. The sensors displayed a well-balanced combination of sensitivity and response time, making them well-suited for gait analysis. Beyond gait analysis, the proposed sensor holds the potential for a wide range of applications within biomedical, sports, and commercial systems where soft and conformable sensors are preferred. Full article

Ulcerative colitis (UC), as a chronic inflammatory disease, presents a global public health threat. However, the mechanism of Poria cocos (PC) in treating UC remains unclear. Here, LC-MS/MS was carried out to identify the components of PC. The protective effect of PC against UC was evaluated by disease activity index (DAI), colon length and histological analysis in dextran sulfate sodium (DSS)-induced UC mice. ELISA, qPCR, and Western blot tests were conducted to assess the inflammatory state. Western blotting and immunohistochemistry techniques were employed to evaluate the expression of tight junction proteins. The sequencing of 16S rRNA was utilized for the analysis of gut microbiota regulation. The results showed that a total of fifty-two nutrients and active components were identified in PC. After treatment, PC significantly alleviated UC-associated symptoms including body weight loss, shortened colon, an increase in DAI score, histopathologic lesions. PC also reduced the levels of inflammatory cytokines TNF-α, IL-6, and IL-1β, as evidenced by the suppressed NF-κB pathway, restored the tight junction proteins ZO-1 and Claudin-1 in the colon, and promoted the diversity and abundance of beneficial gut microbiota. Collectively, these findings suggest that PC ameliorates colitis symptoms through the reduction in NF-κB signaling activation to mitigate inflammatory damage, thus repairing the intestinal barrier, and regulating the gut microbiota. Full article

Cultivated grasslands are an important part of grassland ecosystems and have been proven to be major carbon sinks, then playing an important role in the global carbon balance. The effect of cultivated grassland type (Medicago sativa, Triticum aestivum, Secale cereale, and Vicia villosa grasslands) on carbon flux (including net ecosystem CO₂ exchange (NEE), ecosystem respiration (ER), and gross ecosystem productivity (GEP)) downstream of the Yellow River was studied via the static chamber technique and a portable photosynthetic system. Bare land was used as a control. The results showed that the four cultivated grassland types were mainly carbon sinks, and bare land was a carbon source. The cultivated grassland types significantly affected carbon flux. The average NEE and GEP of the grassland types were in the following order from high to low: Medicago sativa, Secale cereale, Triticum aestivum, and Vicia villosa grassland. Stepwise regression analysis showed that among all measured environmental factors, soil pH, soil bulk density (BD), soil organic carbon (SOC), and soil microbial carbon (MBC) were the main factors affecting CO₂ flux. The combined influence of soil BD, SOC, and pH accounted for 77.6% of the variations in NEE, while soil BD, SOC, and MBC collectively explained 79.8% of changes in ER and 72.9% of the changes in GEP. This finding indicates that Medicago sativa grassland is a cultivated grassland with a high carbon sink level. The changes in carbon flux were dominated by the effects of soil physicochemical properties. Full article

Acute graft-versus-host disease (aGVHD) remains a barrier to successful allogeneic hematopoietic stem cell transplantation (HSCT) outcomes. Contemporary comprehensive analyses of real-world clinical outcomes among patients who develop aGVHD post-HSCT are needed to better understand the unmet needs of this patient population. This multicenter, retrospective chart review describes treatment patterns and clinical outcomes among patients (≥18 years old) from Finland, Sweden, and France who developed grades II–IV aGVHD after their first HSCT (January 2016–June 2017). From 13 participating centers, 151 patients were included. The median (Q1, Q3) age at HSCT was 56 (45, 62) years old. One line of aGVHD treatment was received by 47.7%, and the most common first-line treatment was methylprednisolone (alone or in a combination regimen, 74.2%; monotherapy, 25.8%). Among patients treated with methylprednisolone, 79.5% achieved a complete or partial response. The median (Q1, Q3) number of treatment lines was 2.0 (1.0, 3.0). The median (Q1, Q3) time to obtain an aGVHD diagnosis from transplant was 29.5 (21.0, 44.0) days, and 14.5 (7.0, 34.0) days to achieve the best response for 110 evaluable patients. At 6 and 12 months, 53.6% and 49.0%, respectively, achieved a complete response. Chronic GVHD occurred in 37.7% of patients, and aGVHD reoccurred in 26.5%. Following aGVHD diagnosis, mortality rates were 30.0% at 6 months and 37.3% at 12 months. Findings from this study demonstrate a continuing unmet need for new therapies that control aGVHD and improve mortality. Full article

Modern chemotherapies offer a broad approach to cancer treatment but eliminate both cancer and non-cancer cells indiscriminately and, thus, are associated with a host of side effects. Advances in precision oncology have brought about new targeted therapeutics, albeit mostly limited to a subset of patients with an actionable mutation. They too come with side effects and, ultimately, ‘self-resistance’ to the treatment. There is recent interest in the modulation of ion channels, transmembrane proteins that regulate the flow of electrically charged molecules in and out of cells, as an approach to aid treatment of cancer. Phytochemicals have been shown to act on ion channels with high specificity regardless of the tumor’s genetic profile. This paper explores the use of phytochemicals in cancer symptom management and treatment. Full article

Deformation of ultra-deep pit walls and surrounding geotechnical bodies due to engineering disturbances typically shows intricate spatiotemporal patterns. In this study, deformations at critical steps of the construction process were first numerically simulated by Midas GTS NX, and this was followed by lab-scale geophysical model tests of the entire process of the pit construction. Data on deformation obtained from numerical simulations and lab-scale geophysical model tests were compared with those obtained from a dynamic monitoring scheme in the field to analyze the characteristics of the deformation and evolution of the pit wall. This was used to derive a generally applicable theoretical expression to predict variations in the horizontal displacements. Full article

Background/Objectives: Older patients are subject to a high number of Emergency Department (ED) visits and hospitalizations. Innovative strategies to manage geriatric urgencies in the community are thus needed. Methods: In this prospective observational study, we examined the case mix of a hospital-based domiciliary urgent care service tailored to older patients, called Multidisciplinary Mobile Unit (MMU), from January to September 2023. The service, activated by general practitioners or territorial specialists during workdays, provided domiciliary geriatric assessment, point-of-care diagnostics, including multi-site ultrasound and lab tests, and therapeutical measures, including intravenous treatment and insertion of invasive devices, with the goal of reaching on-site stabilization and avoiding ED referral. We collected data regarding multimorbidity, polypharmacy, and frailty according to the Clinical Frailty Scale (CFS), reasons for MMU activation, and diagnostic and therapeutical services provided. The assessed outcomes were immediate hospitalization after a visit, 30-day admission, and 30-day mortality. Results: Participants (n = 205, 102 M) were mostly aged (median age 83 years old), with multimorbidity and frailty (CFS median 6). The most frequent reasons for MMU activation were dyspnea (49%), cough (34%), and musculoskeletal pain (17%), while the commonest diagnostic test provided was thoracic ultrasound (81%). Only five patients (2.4%) were hospitalized immediately after MMU visit. The 30-day rate of hospitalization was 10.2%, with age, cancer, and abdominal pain as independent predictors on a stepwise binary logistic regression model. 30-day mortality was 4.9%. Conclusions: The MMU model is a feasible strategy to manage geriatric urgencies, especially involving the cardiorespiratory system, is associated with good outcomes and may prevent ED visits. Full article

Remote passive sonar detection with low-frequency band spectral lines has attracted much attention, while complex low-frequency non-Gaussian impulsive noisy environments would strongly affect the detection performance. This is a challenging problem in weak signal detection, especially for the high false alarm rate caused by heavy-tailed impulsive noise. In this paper, a novel matched stochastic resonance (MSR)-based weak signal detection model is established, and two MSR-based detectors named MSR-PED and MSR-PSNR are proposed based on a theoretical analysis of the MSR output response. Comprehensive detection performance analyses in both Gasussian and non-Gaussian impulsive noise conditions are presented, which revealed the superior performance of our proposed detector under non-Gasussian impulsive noise. Numerical analysis and application verification have revealed the superior detection performance with the proposed MSR-PSNR detector compared with energy-based detection methods, which can break through the high false alarm rate problem caused by heavy-tailed impulsive noise. For a typical non-Gasussian impulsive noise assumption with $\alpha =1.5$, the proposed MSR-PED and MSR-PSNR can achieve approximately 16 dB and 22 dB improvements, respectively, in the detection performance compared to the classical PED method. For stronger, non-Gaussian impulsive noise conditions corresponding to $\alpha =1$, the improvement in detection performance can be more significant. Our proposed MSR-PSNR methods can overcome the challenging problem of a high false alarm rate caused by heavy-tailed impulsive noise. This work can lay a solid foundation for breaking through the challenges of underwater passive sonar detection under non-Gaussian impulsive background noise, and can provide important guidance for future research work. Full article

Utilizing data from the 2016 Vietnam Household Living Standard Survey, we undertake an empirical investigation into the influence of energy poverty on the health expenditure of Vietnamese households. Employing a double-hurdle model, our empirical findings reveal a negative relationship between energy poverty and health expenditure. Specifically, our results indicate that for each incremental unit increase in energy poverty, there is a substantial reduction of 42.5 percentage points in the overall health expenditure of the households. Furthermore, as energy poverty deepens, we observe declines of 24.6 percentage points and 45.5 percentage points in the expenses incurred for inpatient/outpatient care and self-treatment, respectively. To validate the robustness of our results, we conduct several sensitivity analyses, including propensity score matching, double/debiased machine learning. Across all these methods, our findings consistently underscore the significant and persistent adverse impact of energy poverty on the examined outcome variables. Additionally, to examine the underlying pathways, we conduct a structural equation modeling analysis and find that the relationship between energy poverty and health expenses is mediated by household hospitalization and expenditures on essential items, such as food and daily necessities. Full article

Vitamin B₁₂ (cobalamin) is an essential nutrient for humans and animals. Metabolically active forms of B₁₂-methylcobalamin and 5-deoxyadenosylcobalamin are cofactors for the enzymes methionine synthase and mitochondrial methylmalonyl-CoA mutase. Malfunction of these enzymes due to a scarcity of vitamin B₁₂ leads to disturbance of one-carbon metabolism and impaired mitochondrial function. A significant fraction of the population (up to 20%) is deficient in vitamin B₁₂, with a higher rate of deficiency among elderly people. B₁₂ deficiency is associated with numerous hallmarks of aging at the cellular and organismal levels. Cellular senescence is characterized by high levels of DNA damage by metabolic abnormalities, increased mitochondrial dysfunction, and disturbance of epigenetic regulation. B₁₂ deficiency could be responsible for or play a crucial part in these disorders. In this review, we focus on a comprehensive analysis of molecular mechanisms through which vitamin B₁₂ influences aging. We review new data about how deficiency in vitamin B₁₂ may accelerate cellular aging. Despite indications that vitamin B₁₂ has an important role in health and healthy aging, knowledge of the influence of vitamin B₁₂ on aging is still limited and requires further research. Full article

Chemotherapy exhibits numerous side effects in anti-tumour therapy. The clinical experiments indicated that deuterium-depleted water (DDW) monotherapy or in combination with chemotherapy was beneficial in inhibiting cancer development. To further understand the potential mechanism of DDW in cancer therapy, we performed a systematic review. The data from experiments published over the past 15 years were included. PubMed, Cochrane and Web of Science (January 2008 to November 2023) were systemically searched. Fifteen studies qualified for review, including fourteen in vivo and in vitro trials and one interventional trial. The results showed that DDW alone or in combination with chemotherapy effectively inhibited cancer progression in most experiments. The combination treatment enhances the therapeutic effect on cancer compared with chemotherapeutic monotherapy. The inhibitory role of DDW in tumours is through regulating the reactive oxygen species (ROS)-related genes in Kelch-like ECH-associated protein 1 (Keap 1) and Nuclear erythroid 2-related factor 2 (Nrf2) signalling pathways, further controlling ROS production. An abnormal amount of ROS can inhibit the tumour progression. More extensive randomized controlled trials should be conducted to evaluate the accurate effect of DDW in Keap1-Nrf2 signalling pathways. Full article

Enisamium is an orally available therapeutic that inhibits influenza A virus and SARS-CoV-2 replication. We evaluated the clinical efficacy of enisamium treatment combined with standard care in adult, hospitalized patients with moderate COVID-19 requiring external oxygen. Hospitalized patients with laboratory-confirmed SARS-CoV-2 infection were randomly assigned to receive either enisamium (500 mg per dose, four times a day) or a placebo. The primary outcome was an improvement of at least two points on an eight-point severity rating (SR) scale within 29 days of randomization. We initially set out to study the effect of enisamium on patients with a baseline SR of 4 or 5. However, because the study was started early in the COVID-19 pandemic, and COVID-19 had been insufficiently studied at the start of our study, an interim analysis was performed alongside a conditional power analysis in order to ensure patient safety and assess whether the treatment was likely to be beneficial for one or both groups. Following this analysis, a beneficial effect was observed for patients with an SR of 4 only, i.e., patients with moderate COVID-19 requiring supplementary oxygen. The study was continued for these COVID-19 patients. Overall, a total of 592 patients were enrolled and randomized between May 2020 and March 2021. Patients with a baseline SR of 4 were divided into two groups: 142 (49.8%) were assigned to the enisamium group and 143 (50.2%) to the placebo group. An analysis of the population showed that if patients were treated within 4 days of the onset of COVID-19 symptoms (n = 33), the median time to improvement was 8 days for the enisamium group and 13 days for the placebo group (p = 0.005). For patients treated within 10 days of the onset of COVID-19 symptoms (n = 154), the median time to improvement was 10 days for the enisamium group and 12 days for the placebo group (p = 0.002). Our findings suggest that enisamium is safe to use with COVID-19 patients, and that the observed clinical benefit of enisamium is worth reporting and studying in detail. Full article