Electrical Impulses Research Articles

Extrusion-Based 3D Bioprinting of Bioactive and Piezoelectric Scaffolds as Potential Therapy for Treating Critical Soft Tissue Wounds.

Objective: This study focuses on developing bioactive piezoelectric scaffolds that could deliver bioelectrical cues to potentially treat injuries to soft tissues such as skeletal muscles and promote active regeneration. Approach: To address the underexplored aspect of bioelectrical cues in skeletal muscle tissue engineering (SMTE), we developed piezoelectric bioink based on natural bioactive materials such as sodium alginate, gelatin, and chitosan. Extrusion-based 3D bioprinting was utilized to develop scaffolds that mimic muscle stiffness and generate electrical stimulation (E-stim) when subjected to forces. The biocompatibility of these scaffolds was tested with the C2C12 muscle cell line. Results: The bioink demonstrated suitable rheological properties for 3D bioprinting, resulting in high-resolution composite sodium alginate-gelatin-chitosan scaffolds with good structural fidelity. The scaffolds exhibited a 42-60 kPa stiffness, similar to muscle. When a controlled force of 5N was applied to the scaffolds at a constant frequency of 4 Hz, they generated electrical fields and impulses (charge), indicating their suitability as a stand-alone scaffold to generate E-stim and instill bioelectrical cues in the wound region. The cell viability and proliferation test results confirm the scaffold's biocompatibility with C2C12s and the benefit of piezoelectricity in promoting muscle cell growth kinetics. Our study indicates that our piezoelectric bioink and scaffolds offer promise as autonomous E-stim-generating regenerative therapy for SMTE. Innovation: A novel approach for treating skeletal muscle wounds was introduced by developing a bioactive electroactive scaffold capable of autonomously generating E-stim without stimulators and electrodes. This scaffold offers a unique approach to enhancing skeletal muscle regeneration through bioelectric cues, addressing a major gap in the SMTE, that is, fibrotic tissue formation due to delayed muscle regeneration. Conclusion: A piezoelectric scaffold was developed, providing a promising solution for promoting skeletal muscle regeneration. This development can potentially address skeletal muscle injuries and offers a unique approach to facilitating skeletal muscle wound healing.

Energy-safety balanced composites of attractive cyclic nitramines with polyaniline

Composite microcrystals of the cyclic nitramines 2,4,6,8,10,12-hexanitro-2,4,6,8,10,12-hexaazaisowurtzitane (ε-CL-20), 1,3,5-trinitro-1,3,5-triazinane(RDX), 1,3,5,7-tetranitro-1,3,5,7-tetrazocane (β-HMX), and cis-1,3,4,6-tetranitrooctahydroimidazo-[4,5-d]imidazole (BCHMX) with polyaniline (PANi) have been prepared and thoroughly characterized in terms of morphology and phase purity. PANi outperformed other conducting polymers in terms of selectivity towards NAs due to its better interaction with NAs, low production cost, and ease of preparation. The bonding of nitramines with the polymeric PANi chain has been examined by means of Fourier transform infrared (FTIR), Raman spectroscopy methods, and fluorescence quenching; the Raman spectrum has shown the laser sensitivity of these microcrystals. Powder X-ray diffraction results have shown changes in polymorph modifications in CL20 (from ɛ to β) and HMX (from β to α) during the preparation of the composites, which have also been confirmed by spectral and differential thermal analysis techniques. The structural orientations found in these composites significantly stabilize nitramines against impact; their detonation properties have slightly deteriorated, but the PANi electrical conductivity has strongly increased their electric-spark sensitivity. The above properties of the prepared composites determine their potential use mainly as parts of the electric or laser impulse initiators, having “a green character”, for various charges.

Nanoparticle-Patch System for Localized, Effective, and Sustained miRNA Administration into Infarcted Myocardium to Alleviate Myocardial Ischemia-Reperfusion Injury.

Timely blood reperfusion after myocardial infarction (MI) paradoxically triggers ischemia-reperfusion injury (I/RI), which currently has not been conquered by clinical treatments. Among innovative repair strategies for myocardial I/RI, microRNAs (miRNAs) are expected as genetic tools to rescue damaged myocardium. Our previous study identified that miR-30d can provide protection against myocardial apoptosis and fibrosis to alleviate myocardial injury. Although common methods such as liposomes and viral vectors have been used for miRNA transfection, their therapeutic efficiencies have struggled with inefficient in vivo delivery, susceptible inactivation, and immunogenicity. Here, we establish a nanoparticle-patch system for miR-30d delivery in a murine myocardial I/RI model, which contains ZIF-8 nanoparticles and a conductive microneedle patch. Loaded with miR-30d, ZIF-8 nanoparticles leveraging the proton sponge effect enable miR-30d to escape the endocytic pathway, thus avoiding premature degradation in lysosomes. Meanwhile, the conductive microneedle patch offers a distinct advantage by intramyocardial administration for localized, effective, and sustained miR-30d delivery, and it simultaneously releases Au nanoparticles to reconstruct electrical impulses within the infarcted myocardium. Consequently, the nanoparticle-patch system supports the consistent and robust expression of miR-30d in cardiomyocytes. Results from echocardiography and electrocardiogram (ECG) revealed improved heart functions and standard ECG wave patterns in myocardial I/RI mice after implantation of a nanoparticle-patch system for 3 and 6 weeks. In summary, our work incorporated conductive microneedle patch and miR-30d nanodelivery systems to synergistically transcend the limitations of common RNA transfection methods, thus mitigating myocardial I/RI.

Study of some components of the influence and formation of blood flow in patients with "slow flow".

"Slow flow" is one very important concept in modern fundamental and clinical biomedicine. Slow coronary flow is indicative of delayed filling of the terminal coronary artery vessels, occurring in the absence of significant coronary stenosis. This group patient of patients exhibits a high incidence of disability and represents a significant financial and material burden for the state and the healthcare system in general. The primary objective of our study was to examine patients with slow coronary flow. We studied the standard parameters recommended by the international health care system (electrocardiography (by Medica QRS-12, Germany), through the electrical activity of a patient's heart by the electrical impulses (beating) of the heart; HC1(Germany); coagulogramma by Coatron M1 (Germany), troponin by AQT 90 (Germany); general blood test we used automatic human counting device HC1(Germany). Also, we investigate the original parameters (non-standard parameters, which we use in this pilot study) that we were first studied for this diagnosis and non-standard parameters. A general blood test showed that patients with slow flow had a higher blood leukocyte count than the control group, but the amount of hemoglobin was normal, the hematocrit was much higher than in the control group, and the platelet count was close to the lower limit of clinical standards.We obtained details of blood flow by coagulation situation, such as prothrombin time, prothrombin index, international normalized ratio, activated partial thromboplastin time, thrombin time, fibrinogen, and rheological properties such as index of erythrocyte aggregability, index of erythrocyte deformability, plasma viscosity, in silico blood rheological index. Blood flow can be considered as a superposition of vortices with similar frequencies and wave vectors that change after bifurcations or other obstacles in the vascular network. These factors together determine the conditions for structuring the flow of moving blood. Disruption or alteration of these factors results in slow flow. It has been found that the speed of blood flow in the coronary arteries depends on changes in the number and function of red blood cells. Slow flow is directly influenced by the aggregation and deformation of red blood cells, their number, and plasma viscosity. Consequently, the rheological status plays a crucial role in determining blood flow and its velocity.

Quantum Entanglement Enable The Mind during Lifetime to Exist Forever

The mind is one of human brain’s activities known as brain wave, which is essentially an electric impulse of neurons in brain. The mind’s characteristics are highly similar and closely correlated to the quantum entanglement’s features, such as superposition, non-local correlation, instantaneous connection, monogamy and so on. Through series conversions, including amplifying, modulation and quantum entanglement, an oscillating electric impulse in brain is converted to a quantum entangled electromagnetic wave carrying brain activity’s signals, namely a carrier wave with the mind’s activity’s signals. The carrier wave can transmit in free space and can be detected, recorded and retrieved the original brain activity data by demodulation in other places, no matter how far away, therefore the mind during lifetime can be preserved forever.

Impact of preanaesthetic electrocardiogram on decision making and modification of anaesthetic protocols in dogs.

This retrospective observational study explored the impact of preanaesthetic electrocardiogram (ECG) assessment on preoperative echocardiography requests and modifications to a standardised anaesthetic protocol in healthy dogs. A total of 228 healthy dogs with no previously diagnosed heart disease that underwent general anaesthesia at Complutense Veterinary Teaching Hospital from December 2017 to June 2018 were included. Preanaesthetic ECGs were assessed for abnormalities, and the findings were documented. The number of dogs requiring echocardiography, based on ECG findings, and the echocardiography results were recorded. All anaesthesia-related decisions were documented. Overall, 72 dogs (31.6%) exhibited ECG abnormalities. Echocardiography was requested for five dogs (2.2%). The anaesthetic protocol was changed in 11 dogs (15.3% of those with ECG abnormalities). P wave disturbances, ventricular premature complexes and impulse conduction issues were abnormalities that prompted echocardiography. Bradycardia and electrical impulse conduction abnormalities influenced protocol modifications. The limited sample size meant that it was not possible to investigate potentialcorrelations between demographics and ECG alterations. Preanaesthetic ECG screening was useful forpromoting echocardiography and influencing anaesthesia plans in a subset of dogs. Despite this, further assessment of the impact of routine use of non-targeted preoperative ECG on anaesthesia-related outcomes is warranted.

Differences in Iron Kinetics during Cardiac Load between Patients with Atrial Fibrillation and Those with Sinus Rhythm.

The prevalence of atrial fibrillation (AF) increases with age. Although most AF cases are caused by irregular electrical impulses near the pulmonary vein, not all elderly individuals develop AF. Moreover, risk factors such as hypertension and diabetes do not always lead to AF, even in severe conditions such as pneumonia. We aimed to examine iron kinetics, including ferritin, in patients with AF and individuals in normal sinus rhythm (NSR) using peripheral blood samples. This case-control study included 178 patients who visited the outpatient clinic of a cardiovascular and arrhythmia specialist at the National Center for Geriatrics and Gerontology between August and October 2023. Patients with missing iron-related blood tests and those with pacemaker implantation were excluded. Iron parameters (ferritin, free iron, transferrin saturation) were compared between AF (n = 53) and NSR (n = 125) groups. The AF group had higher log brain natriuretic peptide (BNP) levels, indicating increased cardiac load (AF 2.18 vs. NSR 1.53). However, there were no significant differences in iron parameters between the AF and NSR groups. After matching for age, sex, and coronary artery disease, the AF group showed an increasing trend in ferritin and a decreasing trend in free iron with BNP elevation, suggesting chronic inflammation. In contrast, the NSR group showed no significant changes in iron parameters with BNP elevation. Patients with AF are more likely to have elevated ferritin levels and decreased free iron levels during cardiac overload. Thus, they are more likely to present with chronic inflammation associated with cardiac overload in AF. Future studies should investigate the mechanisms underlying this phenomenon and its implications for AF treatment.

Growth mechanism of high‐voltage electric pulse rock breaking 3D plasma channel in drilling fluid environment

AbstractHigh‐voltage electric pulse rock breaking has excellent potential for exploiting deep geothermal resources. Numerous researchers have conducted experimental studies on this topic, particularly in rock mechanics, where the breakdown occurs. However, there has been limited scholarly research on drilling fluid. Therefore, the study focuses on the drilling fluid suitable for electric pulse drilling, considering the characteristics of electric pulse rock breaking, which differ from traditional rock breaking. The study focused on the impact of various drilling fluid parameters on the effectiveness of electric impulse rock breaking using red sandstone as the experimental material. This was investigated using the finite element method, and indoor electric rock‐breaking tests were conducted in a drilling fluid environment. The results indicate that the plasma channel mainly grows in the permeable layer of the drilling fluid, resulting in shallow rock breaking depth in the drilling fluid environment. The pore permeated by drilling fluid guides the growth of the plasma channel. The higher the conductivity of the drilling fluid, the closer the ion channel of rock breaking by electric pulse is to the rock surface. This results in a smaller crushing volume and shallower damage depth, which is more detrimental to rock breaking by an electric pulse. The viscosity of drilling fluid can impede the breakdown to some extent. In this paper, the influence of drilling fluid parameters on electro‐pulse rock‐breaking technology is preliminarily studied, which has significant reference value for the selection of actual drilling fluid.

Classification Intracardial Blocks from the Position of Electrophysiological Features of the Movement of Electrical Impulse: A Literature Review

Classification Intracardial Blocks from the Position of Electrophysiological Features of the Movement of Electrical Impulse: A Literature Review

Modulation instability analysis, and characterize time-dependent variable coefficient solutions in electromagnetic transmission and biological field

This study integrates the telegraph model with the traveling wave coefficient. This model characterizes planar random motion of particles in fluid flow, pressure waves from pulsatile blood flow in arteries, electrical impulses in nerve and muscle cell axons, and electromagnetic waves in superconducting media. Using the efficient and well-established Enhanced Modified Simple Equation (EMSE) method, we investigate solitary wave solution with the variable coefficient of the telegraph model. To investigate the variable coefficient solitary wave solution, we apply a transformation variable η = h(t)x + g(t), which is dependent on the time variable function. The diverse functions of h(t) and g(t) yield many novel and exclusive solutions. Numerical solutions are plotted in 3D, density, and 2D. instanton soliton, kinky periodic wave, lump wave, kink wave, anti-kink wave, double periodic wave, diverse types periodic wave, lump with bell wave periodic wave, periodic lump wave, etc. Solitary waves explain complex wave phenomena through nonlinear effects like self-interaction and dispersion. Due to the classical nonlinear telegraph model's wave dynamics, they are used in brain function and communication system design. We conclude by testing the governing model's modulation instability. Dispersive and nonlinear processes modulating the stable state cause instability in high-order nonlinear equations. Examining the wave movement role and modulation instability analysis to assess solution stability shows that all solutions are accurate and stable. The computational difficulties and results demonstrate the approaches' clarity, effectiveness, and simplicity, suggesting they can be applied to evolutionary dynamic and static nonlinear equations in computational physics, other real-world situations, and numerous academic disciplines.

AiCarePWP: Deep learning-based novel research for Freezing of Gait forecasting in Parkinson

Background and objectives:Episodes of Freezing of Gait (FoG) are among the most debilitating motor symptoms of Parkinson’s Disease (PD), leading to falls and significantly impacting patients’ quality of life. Accurate assessment of FoG by neurologists provides crucial insights into patients’ conditions and disease symptoms. This proposed strategy involves utilizing a Weighted Fuzzy Logic Controller, Kalman Filter, and Kaiser–Meyer–Olkin test to detect the gait parameters while walking, resting, and standing phases. Parameters such as neuromodulation format, intensity, duration, frequency, and velocity are computed to pre-empt freezing episodes, thus aiding their prevention. Method:The AiCarePWP is a wearable electronics device designed to identify instances when a patient is on the brink of experiencing a freezing episode and subsequently deliver a brief electrical impulse to the patient’s shank muscles to stimulate movement. The AiCarePWP wearable device aims to identify impending freezing episodes in PD patients and deliver brief electrical impulses to stimulate movement. The study validates this innovative approach using plantar insoles with a 3D accelerometer and electrical stimulator, analysing data from the inertial measuring unit and plantar-pressure foot data to detect and predict FoG. Results:Using a Convolutional Neural Network-based model, the study evaluated 47 gait features for their ability to differentiate resting, standing, and walking conditions. Variable selection was based on sensitivity, specificity, and overall accuracy, followed by Principal Component Analysis and Varimax rotation to extract and interpret factors. Factors with eigenvalues exceeding 1.0 were retained, and 37 features were retained. Conclusion:This study validates CNN’s effectiveness in detecting FoG during various activities. It introduces a novel cueing method using electrical stimulation, which improves gait function and reduces FoG incidence in PD patients. Trustworthy wearable devices, based on Artificial Intelligence of Things (AIoT) and Artificial Intelligence of Medical Things (AIoMT), have been developed to support such interventions.

A comprehensive study of machine learning-based methods to predict epileptic seizures

People with epilepsy have many difficulties as a result of this complicated brain condition, which is typified by frequent convulsions. Symptoms of these seizures include bizarre behaviors, odd sensations, and in extreme cases, loss of awareness. These seizures appear as episodes of aberrant electrical impulses in the central nervous system. Successful epilepsy management depends on early seizure detection and identification, which allows for appropriate intervention to minimize risks and improve patient outcomes. Two major reasons have contributed to the extraordinary advancements in the area of epilepsy investigations in the last few years: the explosive development of machine learning techniques and the decreasing cost of non-invasive electroencephalography (EEG) apparatus. The availability of low-cost EEG equipment has made it easier to gather information on brain activity, which has opened up new avenues for monitoring and analyzing episodes of epileptic seizures away from conventional medical settings. The abundance of data and the advancement of machine learning methods have created new opportunities for the early identification and forecasting of seizures. Machine learning algorithms can predict seizures based on EEG data, providing patients with epilepsy with more control and informed decision-making. This paper offers a current review of current methods for treating epileptic seizures. The feature extraction techniques and classification algorithms receive particular focus. The most popular EEG datasets and their accessibility are listed. The approaches that are examined range from those that use more established machine learning techniques, such as naive Bayes models, Support Vector Machines (SVM), and Linear Discriminant Analysis (LDA), to those that take advantage of more recent deep learning techniques, like (Long-Short Term Memory, or LSTM), and deep Convolutional-Neural-Networks (CNN).

Effects of Intramuscular Electrical Stimulation for Treatment of Non-Traumatic Shoulder Pain

Non-traumatic shoulder pain is the third most common cause of consultations for musculoskeletal pain in primary health care. It is one of the common musculoskeletal conditions of the shoulder which may develop sensory-motor and autonomic dysfunctions at the various level of the neuromuscular system. The objective of the study to find out the Effects of Intramuscular Electrical Stimulation for Treatment of Non-Traumatic Shoulder Pain. The pain and dysfunction caused by NSP were primarily treated with physical therapy and pharmacological agents in order to achieve pain free movements. However, in recent years intramuscular electrical stimulation (IMES) with conventional electrode placement was used by researchers to maximize therapeutic values. But, in this study an inverse electrode placement was used to deliver electrical impulses intramuscularly to achieve neuro-modulation at the various level of the nervous system. Nine patients with NSP were treated with intramuscular electrode stimulation using inversely placed electrodes for a period of three weeks. All nine subjects recovered from their shoulder pain and disability within the few weeks of intervention. So, this IMES may be more appropriate for treatment approach for Non traumatic shoulder pain management.

Diabetic Retinopathy: Current Understanding, Mechanisms and Treatment Strategies

Researchers have been assuming about the possible connection between the eye and the central nervous system (CNS) for a considerable amount of time. This is primarily due to the fact that the eye is considered to be an extension of the brain, which is a reasonable assumption. The neural tube is the beginning of both structures, and neurons are the building blocks of both structures. Retinal ganglionic cells, also known as RGCs, are a specific type of cell that are found in the retina. These cells are responsible for receiving light signals from the environment around them and then transmitting them to photoreceptors, which are involved in the process of vision. The retina, which is found inside the eye, is responsible for converting light into electrical impulses, which are then sent to the brain through the optic nerve. Glaucoma, age-related macular degeneration (AMD), and diabetic retinopathy are only few of the eye illnesses that can be caused by chronic progressive neurodegeneration of the retina, which is more prevalent in older people. It is the elderly who are most likely to be affected by these eye disorders; nevertheless, younger people are also susceptible to them and may experience permanent vision loss or a reduction in their eyesight. In most cases, neurodegenerative disorders that are characteristic of CSN are characterised by common symptoms and a cause that is only partially understood. Although certain risk factors have been identified, they do not account for all instances. On the other hand, according to a number of studies, several illnesses of the central nervous system (CNS), such as Alzheimer's disease (AD) and Parkinson's disease (PD), which are responsible for a significant amount of mortality and morbidity on a global scale, display distinctive alterations at the ocular level. It is helpful to be aware of potential linkages in order to have a better understanding of the mechanics on which onset occurs. In addition, experts have not yet reached a consensus regarding the factors that are responsible for these various disorders. In this overview, the symptoms of ocular illnesses are discussed in detail, with a particular focus on the interaction between the brain and the eye. At some point in the future, a more in-depth understanding could be of assistance in the development of innovative treatments that could help reduce or prevent blindness and improve quality of life.

A review of treatment of relapsing-remitting type of multiple sclerosis (RRMS)

Introduction Multiple sclerosis (SM) is the most common chronic inflammatory-demyelinating disease of the Central Nervous System. In its course, a multifocal damage is done to a nervous tissue - myelin sheaths surrounding axons become disintegrated. This process leads to a dysfunction of the electrical impulses passage along nerve fibers which occurs as various symptoms that hinder the functioning of the patients. Aim of the study This review aims to summarize treatment methods of relapsing-remitting type of multiple sclerosis (RRMS). Following information will be presented: groups of medications, mechanism of its action, its most important side effects and its effectiveness. Material and method This review presents the current state of knowledge about relapsing-remitting type of multiple sclerosis (RRMS) treatment - it is based on Pubmed database and was carried out using keywords concerning the issues of multiple sclerosis. Cited articles were selected in order to base on up-to-date investigation results. Summary A wide range of therapeutic options let neurologists treat their patients accurately, but the basic knowledge about each substance should be assimilated to choose the best individual therapy. Patients suffering from multiple sclerosis differ from each other and a personal approach is needed to implement appropriate treatment as soon as possible. Early start allows patients to not to lose their everyday functioning areas, as the neurodegenerative process is stopped at the initial stage. If some changes in brain tissue structure are permanently done, neurologists should know the options of symptomatic treatment to alleviate a patient's suffering.

Torque Detection Using EMG Signals for Different Walking Speed of a Person

This paper analyses the different walking speed of a person for torque detection by using the Electromyography (EMG) signals. EMG measures electrical activity and the muscle response to a nerve stimulation. The reduced ability to move due to variation in tendon structured muscle in lower limb joints of legs affects the overall activity of the human lifecycle. This defect makes it difficult to move causing severe pain resulting in disability. In order to overcome this problem, exoskeleton technology is implemented where Electromyography (EMG) signals are collected from electric impulse generated during the muscle movements. From these electric impulses, the torque present in EMG signals are detected and classified accordingly. The first step consists of pre processing EMG signals using Infinite Impulse Response (IIR) filter. Secondly features are extracted from pre processed signals by using Continuous Wavelet Transform (CWT) methods and classified using Convolutional Neural Networks (CNN) classifier. From this classification, the rotational movement of muscles named torque in processed EMG signal is detected. Form detected torque, the normal muscle system and problematic muscle system are differentiated

Literature Review on Conjugated Polymers as Light-Sensitive Materials for Photovoltaic and Light-Emitting Devices in Photonic Biomaterial Applications

Due to their extended p-orbital delocalization, conjugated polymers absorb light in the range of visible–NIR frequencies. We attempt to exploit this property to create materials that compete with inorganic semiconductors in photovoltaic and light-emitting materials. Beyond competing for applications in photonic devices, organic conjugated compounds, polymers, and small molecules have also been extended to biomedical applications like phototherapy and biodetection. Recent research on conjugated polymers has focused on bioapplications based on the absorbed light energy conversions in electric impulses, chemical energy, heat, and light emission. In this review, we describe the working principles of those photonic devices that have been applied and researched in the field of biomaterials.

An optoelectronic implantable neurostimulation platform allowing full MRI safety and optical sensing and communication

A novel programmable implantable neurostimulation platform based on photonic power transfer has been developed for various clinical applications with the main focus of being safe to use with MRI scanners. The wires usually conveying electrical current from the neurostimulator to the electrodes are replaced by optical fibers. Photovoltaic cells at the tip of the fibers convert laser light to biphasic electrical impulses together with feedback signals with 54% efficiency. Furthermore, a biocompatible, implantable and ultra-flexible optical lead was developed including custom optical fibers. The neurostimulator platform incorporates advanced signal processing and optical physiological sensing capabilities thanks to a hermetically sealed transparent nonmetallic casing. Skin transparency also allowed the development of a high-speed optical transcutaneous communication channel. This implantable neurostimulation platform was first adapted to a vagus nerve stimulator for the treatment of epilepsy. This neurostimulator has been designed to fulfill the requirements of a class III long-term implantable medical device. It has been proven compliant with standard ISO/TS10974 for 1.5 T and 3 T MRI scanners. The device poses no related threat and patients can safely undergo MRI without specific or additional precautions. Especially, the RF induced heating near the implant remains below 2 °C whatever the MRI settings used. The main features of this unique advanced neurostimulator and its architecture are presented. Its functional performance is evaluated, and results are described with a focus on optoelectronics aspects and MRI safety.

Evaluation of Change in Body Composition, including Phase Angle, in Post-Myocardial Infarction Patients Rehabilitated under the KOS-Zawał (MC-AMI) Programme.

Background: Ischaemic heart disease, including myocardial infarction, is one of the main causes leading to heart failure as a consequence of ischaemic myocardial damage. In recent years, survival in the acute phase of myocardial infarction has improved significantly, but the high mortality rate within 12 months of hospital discharge (reaching up to 9.8% in Poland) remains a challenge. Therefore, the KOS-Zawał (MC-AMI) comprehensive 12-month post-MI care programme was introduced in Poland in 2017. Aim: This study aimed to assess body composition (including, but not limited to, the phase angle, visceral fat, total body fat, redistribution between intracellular and extracellular fluid in the body, and metabolic age) using a bioelectrical impedance analysis (BIA) in post-MI patients before and after early post-MI rehabilitation who were participating in the KOS-Zawał (MC-AMI) programme. Methods: This study involved an examination (before rehabilitation) of 94 post-myocardial infarction patients who were referred to a cardiology appointment within 7-10 days of hospital discharge, during which a clinical assessment, electrocardiogram, and biochemical blood tests (complete blood count, CRP, and serum creatinine) were performed. For various reasons (death, qualification for device implantation, non-completion of rehabilitation, failure to attend a follow-up BIA), data from 55 patients who were examined twice (before and after rehabilitation) were used for the final analysis. Measurements were taken using a high-grade Tanita MC-780 BIA body composition analyser, which measured the resistance of tissues to a low-intensity electrical impulse (not perceptible to the subject). Results: Participation in rehabilitation as part of the KOS-Zawał (MC-AMI) programme was associated with a decrease in metabolic age in patients, with a reduction in visceral fat levels and levels of adipose tissue in the lower and upper limbs. Moreover, a clinically beneficial reduction in the ratio of extracellular water to total body water was also observed. These changes were statistically significant (p < 0.005). In contrast, there were no statistically significant differences in the change in phase angle values in the subjects before and after the 5-week post-infarction rehabilitation. Conclusions: Participation in early post-myocardial infarction rehabilitation as part of the KOS-Zawał (MC-AMI) programme (25 training sessions) is associated with significant improvements in body composition parameters, such as visceral adipose tissue, limb fat, and water redistribution, and, consequently, a reduction in metabolic age, despite no significant increase in phase angle values. It was hypothesised that the good baseline condition of the subjects might explain the lack of significant change in the phase angle over the short observation period. For further analysis, it would be worthwhile to increase the number of patients with baseline reduced phase angle values and monitor changes in this parameter throughout rehabilitation and the entire MC-AMI programme, because changes in the phase angle may also be influenced by other programme components such as dietary or psychological education. It is worth considering implementing a regular BIA assessment in patients in the programme as a motivating stimulus for diligent exercise and extending rehabilitation to be followed by telerehabilitation or hybrid telerehabilitation.

Peripheral Nerve Stimulation of the Shoulder: A Technical Primer.

Scapulalgia or shoulder pain accounts for 16% of all musculoskeletal complaints in the healthy adult population and becomes more common as we age. When this pain exceeds 3 months in duration, it is deemed to be chronic, and typically treated in an escalating manner. Spanning a continuum of conservative and non-conservative measures, chronic shoulder pain treatments range from rest and physical therapy to surgery. Since each patient presents with a unique spectrum of symptoms a customized treatment plan is often required. Over the lifetime of many of these patients, a variety of treatment options are required. One of these treatment options, peripheral nerve stimulation (PNS), is a minimally invasive procedure in which an electrical impulse is delivered through a percutaneously implanted, small caliber electrode to a peripheral nerve proximal to the lesion which interferes with the pain signals. Over the past several years, significant growth of PNS in the treatment of chronic neuropathic pain has been observed. However, the procedural techniques have not been well described. The foundation of long-term, minimally invasive percutaneous PNS in patients with chronic shoulder pain, and procedural techniques for stimulating the suprascapular and axillary nerves using fluoroscopy or ultrasonography will be described in this report.