Special at-rich sequence-binding protein 2 and its role in healing of the experimental mandible bone tissue defect filling with a synthetic bone graft material and electrical stimulation impact.

OBJECTIVE: Aim: The purpose of the study was to identify the role of SATB2 in healing of the experimental mandible bone tissue defect filling with a synthetic bone graft material and electrical stimulation impact. PATIENTS AND METHODS: Materials and Methods: An experiment was carried out on 48 mature male rats of the WAG population, which were divided into 4 groups. Each group included 12 experimental animals. Group 1 included rats that were modeled with a perforated defect of the lower jaw body. Group 2 included animals that were modeled with a perforated defect similar to group 1. In animals, a microdevice for electrical action was implanted subcutaneously in the neck area on the side of the simulated bone defect. The negative electrode connected to the negative pole of the battery was in contact with the bone defect. The battery and electrode were insulated with plastic heat shrink material. Group 3 included rats that were modeled with a perforated defect similar to previous groups, the cavity of which was filled with synthetic bone graft "Biomin GT" (RAPID, Ukraine). Group 4 included animals that were modeled with a perforated defect similar to groups 1-3, the cavity of which was filled with synthetic bone graft "Biomin GT" (RAPID, Ukraine). The simulation of electrical stimulation was the same as in group 2. The material for the morphological study was a fragment of the body of the lower jaw from the zone of the perforated defect. Immunohistochemical study was performed using rabbit anti-human SATB2 monoclonal antibody. RESULTS: Results: In the regenerate filling the defect in the bone tissue of the lower jaw of rats, there was an increase in SATB2 expression under conditions of electrical stimulation; filling the defect with a synthetic bone graft material; simultaneous filling the defect with a synthetic bone graft material and electrical stimulation. The most pronounced expression of SATB2 was observed under conditions of simultaneous filling the defect with a synthetic bone graft material and electrical stimulation; minimally expressed - in conditions of filling the defect with a synthetic bone graft material; moderately expressed - under conditions of electrical stimulation. In the regenerate, in cases of all treatment methods, SATB2 was expressed by immune cells, fibroblastic differon cells, osteoblasts, and in case of electrical stimulation, also by adipocytes, vascular pericytes and endothelial cells, epidermis. CONCLUSION: Conclusions: The activation of SATB2 expression identified by the authors is one of the mechanisms for stimulating reparative osteogenesis under the conditions of electrical stimulation; filling the defect with a synthetic bone graft material; simultaneous filling the defect with a synthetic bone graft material and electrical stimulation.

Successful Radiofrequency Lesioning of the Pallidothalamic Tract in Paretic Form Focal Hand Dystonia With Paradoxical Unexpected Response to Intraoperative Test Electrical Stimulation: A Case Report.

We report a case with paretic focal hand dystonia, which at first glance was diagnosed as writer's cramp, with poor performance only when playing the guitar and writing but with increased muscle tension around the elbow rather than in the fingers and hands. The muscle tension was around the elbow and the pallidothalamic tract (PTT) was selected as the proximal muscle target with less permanent complications. During the operation, the PTT test electrical stimulation was impaired only for guitar playing, but not for other hand movements. Therefore, test lesioning at a lower temperature and for a shorter time improved the symptoms, so we were convinced that this was the target site and coagulated this site, i.e., the PPT, at the usual temperature and time. With only one target lesioning, the patient's symptoms disappeared for six months. Careful history taking and physical examination to identify the site of muscle tension is important in determining the target of paretic form dystonia. In addition, test lesioning at a lower temperature and for a shorter time is useful if the test electrical stimulation produces a paradoxically unexpected response.

Electrical stimulation with polypyrrole-coated polycaprolactone/silk fibroin scaffold promotes sacral nerve regeneration by modulating macrophage polarisation.

Peripheral nerve injury poses a great threat to neurosurgery and limits the regenerative potential of sacral nerves in the neurogenic bladder. It remains unknown whether electrical stimulation can facilitate sacral nerve regeneration in addition to modulate bladder function. The objective of this study was to utilise electrical stimulation in sacra nerve crush injury with newly constructed electroconductive scaffold and explore the role of macrophages in electrical stimulation with crushed nerves. As a result, we generated a polypyrrole-coated polycaprolactone/silk fibroin scaffold through which we applied electrical stimulation. The electrical stimulation boosted nerve regeneration and polarised the macrophages towards the M2 phenotype. An in vitro test using bone marrow derived macrophages revealed that the pro-regenerative polarisation of M2 were significantly enhanced by electrical stimulation. Bioinformatics analysis showed that the expression of signal transducer and activator of transcriptions (STATs) was differentially regulated in a way that promoted M2-related genes expression. Our work indicated the feasibility of electricals stimulation used for sacral nerve regeneration and provided a firm demonstration of a pivotal role which macrophages played in electrical stimulation.

Effects of simultaneous neuromuscular electrical stimulation and static stretching on flexibility and strength: a randomized controlled trial.

[Purpose] This study aimed to determine the effects of simultaneous neuromuscular electrical stimulation (NMES) and static stretching on flexibility and muscle strength. [Participants and Methods] A randomized controlled trial was conducted with 96 healthy university students equally assigned to either a simultaneous NMES and static stretching group (Group S) or an NMES-only group (Group C). The gastrocnemius muscle was the target of both NMES and static stretching. Ankle dorsiflexion angle (DFA), forward flexion distance (FFD), and ankle plantar flexor strength (PFS) were measured before and directly following intervention. Outcomes in the two groups were evaluated using two-way analysis of variance. [Results] A significant time effect was observed for both DFA and FFD, whereas a significant interaction effect was observed for FFD only. Improvements in DFA were similar between the groups; however, improvements in FFD were significantly greater in Group S. PFS showed no significant interaction between the group and the time factor. [Conclusion] Our findings suggest that simultaneous intervention enhances flexibility. Despite targeting the gastrocnemius muscle, the observed improvement in hamstring flexibility may have been because of fascial connections. These findings support the efficacy and safety of NMES combined with static stretching for increasing flexibility.

Attention improvement to transcranial alternating current stimulation at gamma frequency over the right frontoparietal network: a preliminary report.

Applying transcranial alternating current stimulation (tACS) at 40 Hz to the frontal and parietal regions, either unilaterally (left or right) or bilaterally, can improve cognitive dysfunctions. This study aimed to explore the influence of tACS at gamma frequency over right fronto-parietal (FP) region on attention. The analysis is based on retrospective data from a clinical intervention. We administered test of variables of attention (TOVA; visual mode) to 44 participants with various neuropsychiatric diagnoses before and after 12 sessions of tACS treatment. Alternating currents at 2.0 mA were delivered to the electrode positions F4 and P4, following the 10-20 EEG convention, for 20 mins in each session. We observed significant improvement across 3 indices of the TOVA, including reduction of variability in reaction time (p = 0.0002), increase in d-Prime (separability of targets and non-targets; p = 0.0157), and decrease in commission error rate (p = 0.0116). The mean RT and omission error rate largely remained unchanged. Artificial injection of tACS at 40 Hz over right FP network may improve attention function, especially in the domains of consistency in performance, target/non-target discrimination, and inhibitory control.

Research progress of piezoelectric materials in protecting oral health and treating oral diseases: a mini-review.

Piezoelectric materials, as a class of materials capable of generating electrical charges under mechanical vibration, have special piezoelectric effects and have been widely applied in various disease treatment fields. People generate vibrations in the oral cavity during daily activities such as brushing teeth, using electric toothbrushes, chewing, and speaking. These natural vibrations (or external ultrasound) provide ideal conditions for activating piezoelectric materials, leading to their high potential applications in protecting oral health and treating oral diseases. Based on this, this review reports on the research progress and trends of piezoelectric materials in the protection of oral health and the treatment of oral diseases in the past 5 years, and discusses its treatment mechanism, challenges and shortcomings, aiming to provide theoretical basis and new ideas for the future application of piezoelectric materials in the field of oral cavity. Finally, a brief outlook is provided, suggesting that the potential of piezoelectric materials may enable them to quickly move towards real clinical applications.

Electrical stimulation: a potential alternative to positively impact cerebral health?

An increasing body of evidence confirms the effectiveness of physical exercise (PE) in promoting brain health by preventing age-related cognitive decline and reducing the risk of neurodegenerative diseases. The benefits of PE are attributed to neuroplasticity processes which have been reported to enhance cerebral health. However, moderate to high-intensity PE is necessary to induce these responses and these intensities cannot always be achieved especially by people with physical limitations. As a countermeasure, electrical stimulation (ES) offers several benefits, particularly for improving physical functions, for various neurological diseases. This review aims to provide an overview of key mechanisms that could contribute to the enhancement in brain health in response to ES-induced exercise, including increases in cerebral blood flow, neuronal activity, and humoral pathways. This narrative review also focuses on the effects of ES protocols, applied to both humans and animals, on cognition. Despite a certain paucity of research when compared to the more classical aerobic exercise, it seems that ES could be of interest for improving cerebral health, particularly in people who have difficulty engaging in voluntary exercise.

Investigating the Effect of Polypyrrole-Gelatin/Silk Fibroin Hydrogel Mediated Pulsed Electrical Stimulation for Skin Regeneration.

In clinical practice to treat complex injuries, the application of electrical stimulation (ES) directly to the skin complicates the wound. In this work, the effect of a conductive hydrogel mediated electric field on skin regeneration is investigated. Polypyrrole incorporated matrices of gelatin and silk fibroin were prepared by two-step interfacial polymerization. The maximum electrical conductivity of 10-4 S cm-1 was achieved when 200 mM polypyrrole was loaded. Mechanically stable and cytocompatible hydrogels were evidenced to have antioxidant and blood compatible characteristics. Human dermal fibroblast cells responded to pulsed stimulation of 100 or 300 mV mm-1 as observed from the increased expressions of TGFß1, αSMA, and COLIAI genes. Further, the increase in the αSMA protein expression with the magnitude of electrical stimulation also suggested transdifferentiation of the fibroblast to myofibroblast. Moreover, Raman spectroscopy identified two fingerprint regions (collagen and lipid) to differentiate ES treated and nontreated samples. Therefore, the combination of hydrogels and electrical stimulation has potential therapeutic effects for accelerating the rate of skin regeneration.

The Role of Electrical Stimulation in Peripheral Nerve Regeneration: Current Evidence and Future Directions.

The role of electrical stimulation in peripheral nerve regeneration is reviewed, including a brief background and proposed mechanism of action. Studies in animal as well as human models are reviewed. Current recommendations and future directions are addressed.

A Systematic Review to Compare Electrical, Magnetic, and Optogenetic Stimulation for Peripheral Nerve Repair.

The purpose of this systematic review was to assess the currently available evidence for the use of external stimulation to modulate neural activity and promote peripheral nerve regeneration. The most common external stimulations are electrical stimulation (ES), optogenetic stimulation (OS), and magnetic stimulation (MS). Understanding the comparative effectiveness of these stimulation methods is pivotal in advancing therapeutic interventions for peripheral nerve injuries. This systematic review focused on these three external stimulation modalities as potential strategies to enhance peripheral nerve repair (PNR). We used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses framework to systematically evaluate and compare the efficiency of ES, OS, and MS in PNR. The review included studies published between 2018 and 2023 using ES, OS, or MS for PNR focused on enhancing recovery of peripheral nerve injuries in rodent models identified through PubMed and Google Scholar. The search strategies and inclusion criteria identified 19 studies (13 ES, 4 OS, and 2 MS) for detailed analysis, focusing on critical parameters such as functional recovery, histological outcomes, and electrophysiological data. Although ES demonstrated a consistent improvement in all the analyses, high-frequency repetitive MS (HFr-MS) emerged as a promising modality. HFr-MS demonstrated accelerated PNR, as histological and electrophysiological evidence indicated. In contrast, OS exhibited superior functional recovery outcomes. Notable limitations include constrained MS and OS data sets and the challenge of comparing relative improvements because of methodological diversity in evaluation techniques. Our findings underscore the potential of HFr-MS and OS in PNR while emphasizing the critical need for standardized testing protocols to facilitate meaningful cross-study comparisons. External stimulations have the potential to improve functional recovery in patients with nerve injury.

Electrical stimulation of biofidelic engineered muscle enhances myotube size, force, fatigue resistance, and induces a fast-to-slow-phenotype shift.

Therapeutic development for skeletal muscle diseases is challenged by a lack of ex vivo models that recapitulate human muscle physiology. Here, we engineered 3D human skeletal muscle tissue in the Biowire II platform that could be maintained and electrically stimulated long-term. Increasing differentiation time enhanced myotube formation, modulated myogenic gene expression, and increased twitch and tetanic forces. When we mimicked exercise training by applying chronic electrical stimulation, the "exercised" skeletal muscle tissues showed increased myotube size and a contractility profile, fatigue resistance, and gene expression changes comparable to in vivo models of exercise training. Additionally, tissues also responded with expected physiological changes to known pharmacological treatment. To our knowledge, this is the first evidence of a human engineered 3D skeletal muscle tissue that recapitulates in vivo models of exercise. By recapitulating key features of human skeletal muscle, we demonstrated that the Biowire II platform may be used by the pharmaceutical industry as a model for identifying and optimizing therapeutic drug candidates that modulate skeletal muscle function.

The Biomimetic Electrical Stimulation System Inducing Osteogenic Differentiations of BMSCs.

Electrical stimulation has been used clinically as an adjunct therapy to accelerate the healing of bone defects, and its mechanism requires further investigations. The complexity of the physiological microenvironment makes it challenging to study the effect of electrical signal on cells alone. Therefore, an artificial system mimicking cell microenvironment in vitro was developed to address this issue. In this work, a novel electrical stimulation system was constructed based on polypyrrole nanowires (ppyNWs) with a high aspect ratio. Synthesized ppyNWs formed a conductive network in the composited hydrogel which contained modified gelatin with methacrylate, providing a conductive cell culture matrix for bone marrow mesenchymal stem cells. The dual-network conductive hydrogel had improved mechanical, electrical, and hydrophilic properties. It was able to imitate the three-dimensional structure of the cell microenvironment and allowed adjustable electrical stimulations in the following system. This hydrogel was integrated with cell culture plates, platinum electrodes, copper wires, and external power sources to construct the artificial electrical stimulation system. The optimum voltage of the electrical stimulation system was determined to be 2 V, which exhibited remarkable biocompatibility. Moreover, this system had significant promotion in cell spreading, osteogenic makers, and bone-related gene expression of stem cells. RNA-seq analysis revealed that osteogenesis was correlated to Notch, BMP/Smad, and calcium signal pathways. It was proven that this biomimetic system could regulate the osteogenesis procedure, and it provided further information about how the electrical signal regulates osteogenic differentiations.

Effects of end-effector robotic arm reach training with functional electrical stimulation for chronic stroke survivors.

BACKGROUND: Upper-extremity dysfunction significantly affects dependence in the daily lives of stroke survivors, limiting their participation in the social environment and reducing their quality of life. OBJECTIVES: This study aimed to investigate the effect of end-effector robotic arm reach training (RAT) with functional electrical stimulation (FES) on upper-limb motor recovery in chronic stroke survivors. METHODS: In this single-blinded randomized controlled trial, 28 chronic stroke survivors were randomized to receive RAT-with-FES and RAT-without-FES for 40 min/day, three times per week over a 4-week period, and the data of 26 participants were used in the final analysis. Upper-limb motor recovery was measured using the Fugl-Meyer assessment (FMA), and kinematics (movement time, speed, and distance) during reaching movements toward targets placed in three directions (ipsilateral, median, and contralateral sides) were measured using a robotic arm. RESULTS: The upper-limb motor recovery (FMA and kinematics) improvement for the within-group comparisons tended to be greater in the RAT-with-FES group than in the RAT-without-FES group. However, in the between-group comparison, no significant differences were found in FMA, and significant differences were observed only for 2 distance parameters of kinematic factors: total (23.0% vs. 1.7%) and straight total (25.5% vs. 2.6%) distance on the ipsilateral side (p < 0.05). CONCLUSIONS: This study was unable to clearly reveal the positive effects of electrical stimulation combined with robotic arm training. However, we believe that it provides basic data that furthers our understanding of the role of hybrid neuroprostheses in stroke rehabilitation and the factors determining successful treatment.

Role of Piezoelectricity in Disease Diagnosis and Treatment: A Review.

Because of their unique electromechanical coupling response, piezoelectric smart biomaterials demonstrated distinctive capability toward effective, efficient, and quick diagnosis and treatment of a wide range of diseases. Such materials have potentiality to be utilized as wireless therapeutic methods with ultrasonic stimulation, which can be used as self-powered biomedical devices. An emerging advancement in the realm of personalized healthcare involves the utilization of piezoelectric biosensors for a range of therapeutic diagnosis such as diverse physiological signals in the human body, viruses, pathogens, and diseases like neurodegenerative ones, cancer, etc. The combination of piezoelectric nanoparticles with ultrasound has been established as a promising approach in sonodynamic therapy and piezocatalytic therapeutics and provides appealing alternatives for noninvasive treatments for cancer, chronic wounds, neurological diseases, etc. Innovations in implantable medical devices (IMDs), such as implantable piezoelectric energy generator (iPEG), offer significant advantages in improving physiological functioning and ability to power a cardiac pacemaker and restore the heart function. This comprehensive review critically evaluates the role of piezoelectricity in disease diagnosis and treatment, highlighting the implication of piezoelectric smart biomaterials for biomedical devices. It also discusses the potential of piezoelectric materials in healthcare monitoring, tissue engineering, and other medical applications while emphasizing future trends and challenges in the field.

Unraveling the neuroprotective potential of scalp electroacupuncture in ischemic stroke: A key role for electrical stimulation.

This study aims to explore the neuroprotective effects of scalp Electroacupuncture (EA) on ischemic stroke, with a specific focus on the role of electrical stimulation (ES). Employing a rat model of middle cerebral artery occlusion (MCAO), we used methods such as Triphenyl tetrazolium chloride staining, micro-CT scanning, Enzyme linked immunosorbent assay (ELISA), and immunofluorescence to assess the impacts of EA. We further conducted RNA-seq analysis and in vitro experiments with organotypic brain slices and cerebral organoids to explore the underlying mechanisms. Our research revealed that EA notably reduced cerebral infarct volume and improved regional cerebral blood flow in rats following MCAO. Micro-CT imaging showed improved vascular integrity in EA-treated groups. Histological analyses, including HE staining, indicated reduced brain tissue damage. ELISA demonstrated a decrease in pro-inflammatory cytokines TNF-α, IL-1ß, and IL-6, suggesting improved blood-brain barrier function. Immunofluorescence and Western blot analyses revealed that EA treatment significantly inhibited microglial and astrocytic overactivation. RNA-seq analysis of brain tissues highlighted a downregulation of immune pathways and inflammatory responses, confirming the neuroprotective role of EA. This was further corroborated by in vitro experiments using organotypic brain slices and cerebral organoids, which showcased the efficacy of electrical stimulation in reducing neuroinflammation and protecting neuronal cells. The study highlights the potential of scalp EA, particularly its ES component, in treating ischemic stroke. It provides new insights into the mechanisms of EA, emphasizing its efficacy in neuroprotection and modulation of neuroinflammation, and suggests avenues for optimized treatment strategies in stroke therapy.

Effect of easy cupping combined with pelvic floor electrical stimulation and Kegel exercise and pelvic floor muscle surface electromyography on symptoms improvement in women with stress urinary incontinence.

This study aimed to evaluate the effectiveness of easy cupping combined with pelvic floor electrical stimulation and Kegel exercises in treating female patients with stress urinary incontinence (SUI). Ninety SUI patients were randomly assigned to two groups: the control group (pelvic floor electrical stimulation + Kegel exercises) and the experimental group (easy cupping + pelvic floor electrical stimulation + Kegel exercises). Outcomes assessed included pelvic floor muscle strength, urinary incontinence, urinary leakage, pelvic floor muscle surface electromyography, adverse effects, and patient satisfaction before and after treatment. Results showed significant improvements in pelvic floor muscle strength, International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICI-Q-SF) scores, and urinary leakage in both groups, with the experimental group showing greater improvements (P < 0.05). The experimental group also had higher pelvic floor muscle potential values and a greater total effective rate (P < 0.05). No significant differences in adverse effects were noted between groups, and patient satisfaction was higher in the experimental group (P < 0.05). In conclusion, the combination of easy cupping with pelvic floor electrical stimulation and Kegel exercises effectively enhances pelvic floor muscle strength, reduces urinary leakage, and improves patient satisfaction in women with stress urinary incontinence.

Cette étude visait à évaluer l'efficacité des ventouses faciles combinées à la stimulation électrique du plancher pelvien et aux exercices de Kegel dans le traitement des patientes souffrant d'incontinence urinaire d'effort (IUE). Quatre-vingt-dix patients SUI ont été répartis au hasard en deux groupes : le groupe témoin (stimulation électrique du plancher pelvien + exercices de Kegel) et le groupe expérimental (ventouses faciles + stimulation électrique du plancher pelvien + exercices de Kegel). Les résultats évalués comprenaient la force musculaire du plancher pelvien, l'incontinence urinaire, les fuites urinaires, l'électromyographie de la surface des muscles du plancher pelvien, les effets indésirables et la satisfaction des patients avant et après le traitement. Les résultats ont montré des améliorations significatives de la force musculaire du plancher pelvien, des scores de la Consultation internationale sur l'incontinence (ICI-Q-SF) et des fuites urinaires dans les deux groupes, le groupe expérimental montrant de plus grandes améliorations (P < 0,05). Le groupe expérimental présentait également des valeurs de potentiel musculaire du plancher pelvien plus élevées et un taux effectif total plus élevé (P < 0,05). Aucune différence significative dans les effets indésirables n'a été notée entre les groupes et la satisfaction des patients était plus élevée dans le groupe expérimental (P < 0,05). En conclusion, la combinaison de ventouses faciles avec la stimulation électrique du plancher pelvien et les exercices de Kegel améliore efficacement la force musculaire du plancher pelvien, réduit les fuites urinaires et améliore la satisfaction des patientes souffrant d'incontinence urinaire d'effort.

The effect of brain-computer interface controlled functional electrical stimulation training on rehabilitation of upper limb after stroke: a systematic review and meta-analysis.

Introduction: Several clinical studies have demonstrated that brain-computer interfaces (BCIs) controlled functional electrical stimulation (FES) facilitate neurological recovery in patients with stroke. This review aims to evaluate the effectiveness of BCI-FES training on upper limb functional recovery in stroke patients. Methods: PubMed, Embase, Cochrane Library, Science Direct and Web of Science were systematically searched from inception to October 2023. Randomized controlled trials (RCTs) employing BCI-FES training were included. The methodological quality of the RCTs was assessed using the PEDro scale. Meta-analysis was conducted using RevMan 5.4.1 and STATA 18. Results: The meta-analysis comprised 290 patients from 10 RCTs. Results showed a moderate effect size in upper limb function recovery through BCI-FES training (SMD = 0.50, 95% CI: 0.26-0.73, I2 = 0%, p < 0.0001). Subgroup analysis revealed that BCI-FES training significantly enhanced upper limb motor function in BCI-FES vs. FES group (SMD = 0.37, 95% CI: 0.00-0.74, I2 = 21%, p = 0.05), and the BCI-FES + CR vs. CR group (SMD = 0.61, 95% CI: 0.28-0.95, I2 = 0%, p = 0.0003). Moreover, BCI-FES training demonstrated effectiveness in both subacute (SMD = 0.56, 95% CI: 0.25-0.87, I2 = 0%, p = 0.0004) and chronic groups (SMD = 0.42, 95% CI: 0.05-0.78, I2 = 45%, p = 0.02). Subgroup analysis showed that both adjusting (SMD = 0.55, 95% CI: 0.24-0.87, I2 = 0%, p = 0.0006) and fixing (SMD = 0.43, 95% CI: 0.07-0.78, I2 = 46%, p = 0.02). BCI thresholds before training significantly improved motor function in stroke patients. Both motor imagery (MI) (SMD = 0.41 95% CI: 0.12-0.71, I2 = 13%, p = 0.006) and action observation (AO) (SMD = 0.73, 95% CI: 0.26-1.20, I2 = 0%, p = 0.002) as mental tasks significantly improved upper limb function in stroke patients. Discussion: BCI-FES has significant immediate effects on upper limb function in subacute and chronic stroke patients, but evidence for its long-term impact remains limited. Using AO as the mental task may be a more effective BCI-FES training strategy. Systematic review registration: Identifier: CRD42023485744, https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023485744.

Letter to the editor: "Effect of electrical stimulation on the fusion rate after spinal surgery: a systematic review and meta-analysis".

This letter provides feedback on the article Effect of electrical stimulation on the fusion rate after spinal surgery: a systematic review and meta-analysis. The study highlights the clinical efficacy of electrical stimulation (ES) in enhancing fusion rates post-surgery. Future research should focus on identifying optimal ES parameters, long-term safety profiles, and its personalized application based on genetic and metabolic factors. Additionally, exploring the combination of ES with other regenerative therapies and evaluating its cost-effectiveness could further improve clinical outcomes.

"All-in-one" tea polyphenol-modified injectable hyaluronic acid-based hydrogel for diabetic wound healing.

Refractory diabetic wounds are a devastating and rapidly growing clinical problem, which is associated with high incidence rates, mortality, and recurrence rates. Therapeutic angiogenesis in wound tissues is essential to the healing of diabetic wounds. However, the presence of excessive oxidative stress in diabetic wounds hinders angiogenesis, and conventional anti-oxidative approaches are inefficient to compensate for the systematically impaired angiogenesis. Here, a multifunctional supramolecular hyaluronic acid hydrogel dressing for diabetic wounds is successfully designed and constructed (GHPM). The GHPM hydrogel features outstanding properties, including excellent tissue adhesion, antibacterial ability, conductivity, and antioxidant properties. Based on the dynamic crosslinking structure, the GHPM hydrogel also presents adequate injectable and self-healing capabilities, which play a vital role in covering irregular or deep wounds. Additionally, diabetic wounds treated with GHPM hydrogel showed a significant acceleration of wound closure by preventing wound infection, reducing oxidative stress, and accelerating collagen deposition. More interestingly, the combination of electrical stimulation and GHPM hydrogel can effectively promote angiogenesis and neurogenesis, further accelerating diabetic wound healing in an all-around way. This advanced collaborative strategy opens a new avenue in treating diabetic wounds.

Alpha transcranial alternating current stimulation as add-on to neglect training: a randomized trial.

Visuospatial neglect is a common and debilitating condition following unilateral stroke, significantly impacting cognitive functioning and daily life. There is an urgent need for effective treatments that can provide clinically relevant and sustained benefits. In addition to traditional stroke treatment, non-invasive brain stimulation, such as transcranial alternating current stimulation, shows promise as a complementary approach to enhance stroke recovery. In the current study, we aimed to evaluate the additive effects of multi-session transcranial alternating current stimulation at alpha frequency when combined with visual scanning training in chronic stroke patients with visuospatial neglect. In this double-blind randomized controlled trial, we compared the effects of active transcranial alternating current stimulation at alpha frequency to sham (placebo) transcranial alternating current stimulation, both combined with visual scanning training. Both groups received eighteen 40-minute training sessions over a 6-week period. A total of 22 chronic visuospatial neglect patients participated in the study (active group n = 12, sham group n = 10). The median age was 61.0 years, with a median time since stroke of 36.1 months. We assessed the patients at six time-points: at baseline, after the first, ninth and eighteenth training sessions, as well as 1 week and 3 months following the completion of the combined neuromodulation intervention. The primary outcome measure was the change in performance on a visual search task, specifically the star cancellation task. Secondary outcomes included performance on a visual detection task, two line bisection tasks and three tasks evaluating visuospatial neglect in daily living. We found significantly improved visual search (primary outcome) and visual detection performance in the neglected side in the active transcranial alternating current stimulation group, compared to the sham transcranial alternating current stimulation group. We did not observe stimulation effects on line bisection performance nor in daily living. Time effects were observed on all but one outcome measures. Multi-session transcranial alternating current stimulation combined with visual scanning training may be a more effective treatment for chronic visuospatial neglect than visual scanning training alone. These findings provide valuable insights into novel strategies for stroke recovery, even long after the injury, with the aim of enhancing cognitive rehabilitation outcomes and improving the overall quality of life for individuals affected by this condition. Trial registration: ClinicalTrials.gov; registration number: NCT05466487; https://clinicaltrials.gov/ct2/show/NCT05466487.