Electromagnetic network-targeted field (ENTF) brain stimulation therapy is a promising approach to reduce poststroke disability. Two pilot, randomized, sham-controlled trials showed safety and signals of efficacy. The aim of this study was to perform a pooled analysis with greater statistical power to characterize with precision the effect of ENTF in promoting recovery and reducing disability. We pooled individual patient-level data from 2 double-blind, randomized, sham-controlled studies, BQ3 (BrainQ3 Trial; Unique identifier: NCT04039178) and EMAGINE 1 (Electromagnetic Field Ischemic Stroke-Novel Subacute Treatment Trial; NCT05044507). Key entry criteria in both trials were (1) 4 to 21 days post-ischemic stroke and (2) Fugl-Meyer assessment-upper extremity score of 10 to 45. For EMAGINE 1, an additional criterion was a study entry modified Rankin Scale (mRS) score of 3 to 4. The primary outcome for this pooled analysis was freedom-from-disability (mRS score, 0-1) at 8 to 12 weeks. Secondary outcomes were level of disability (ordinal mRS score distribution), disability (mRS score) change from entry to 8 to 12 weeks, and 2 focused upper extremity motor end points. Altogether, 124 patients were included (active n=65; sham n=59). The mean age was 58.2±13.1 years, 31% were female, the study entry Fugl-Meyer assessment-upper extremity score was 25.3 (±10.6), and the therapy started 14.5 (±4.9) days poststroke. The study entry mRS score was 3.9 (±0.36), and 123/124 (99.2%) had a study entry mRS score of 3 to 4. Study entry features were well-balanced across treatment groups. At 8 to 12 weeks, freedom-from-disability was higher with active ENTF than sham stimulation (33.8% versus 11.9%; P=0.005). Ordinal shift across 3 disability strata (mRS score, 0-1, 2, and >2) also favored ENTF (P=0.009). Focused upper extremity motor end points nonsignificantly favored ENTF. Safety analyses showed no device- or procedure-related serious adverse events. In pooled data from 2 randomized, sham-controlled trials, treatment with ENTF compared with sham for patients with subacute ischemic stroke with moderate-severe study entry disability yielded increased achieved freedom-from-disability, greater disability improvement from study entry, and reduced final disability level. These findings, together with an attractive safety profile, support ENTF as a promising therapy for stroke recovery.

Stroke is frequently accompanied by respiratory dysfunction, which limits ventilatory reserve and may hinder functional recovery. Respiratory muscle training (RMT) can improve selected ventilatory indices, but overall benefits remain modest. This pilot trial aimed to evaluate the clinical effects of calcium-regulating pulsed electromagnetic fields (Ca-R-PEMF) combined with RMT on poststroke respiratory function. This single-center, prospective, double-blind pilot trial was conducted at Yongsen Hospital of China Medical University, China, from July to December 2025. Thirty patients were randomly assigned to standard rehabilitation plus sham stimulation (control group), standard rehabilitation plus sham stimulation and RMT (RMT group), or standard rehabilitation plus Ca-R-PEMF stimulation and RMT (Ca-R-PEMF+RMT group; n=10 per group). The intervention lasted 4 weeks, RMT was administered 5 sessions per week (20 minutes/session), and Ca-R-PEMF stimulation was administered 2 sessions per week (15 minutes/session). Outcome measures were recorded at baseline and after 4 weeks of intervention. The primary outcome was the change rate in forced vital capacity. Secondary outcomes included forced expiratory volume in 1 second (FEV1), FEV1/forced vital capacity, peak expiratory flow, inspiratory capacity, and vital capacity. A total of 27 participants completed the 4-week follow-up (n=9 per group), and baseline characteristics were comparable across groups. The change rate in forced vital capacity differed significantly among groups (P<0.01; η2=0.47). Ca-R-PEMF+RMT showed greater improvement than both control and RMT, whereas the difference between control and RMT was not significant. For secondary outcomes, overall between-group differences were significant for FEV1 (P<0.01; η2=0.39) and peak expiratory flow (P<0.01; η2=0.41). Ca-R-PEMF+RMT was superior to control for both outcomes, and RMT was superior to control for FEV1. No significant between-group differences were observed for the change rates in the FEV1/forced vital capacity, inspiratory capacity, or vital capacity. No adverse events related to the treatment were reported. In this pilot trial, Ca-R-PEMF combined with RMT was feasible and appeared safe in patients with stroke and respiratory dysfunction. Following 4 weeks of training, Ca-R-PEMF+RMT showed more favorable signals of improvement in selected pulmonary ventilatory indices than standard rehabilitation alone and RMT alone, suggesting its potential value as a combined rehabilitation strategy. URL: https://www.chictr.org.cn; Unique identifier: ChiCTR2300078947.

Pulsed electromagnetic fields (PEMF) can be used to improve the efficacy of chemotherapeutic agents, such as doxorubicin (DOX). DOX induces mitotic slippage, leading to cell death in various cancers including breast cancer. Herein, we investigated whether PEMF exposure enhances DOX-induced mitotic slippage and subsequent cell death in breast cancer cells. DOX-treated MDA-MB-231 breast cancer cells were stimulated with a 60 min PEMF session three times daily. Cell viability was assessed using the trypan blue exclusion assay. Cell cycle distribution and polyploidy were assessed using flow cytometry, and the morphological features of mitotic slippage were observed microscopically. Western blotting and confocal microscopy were used to evaluate the key molecules involved in G2/M transition, mitotic transition, and caspase-mediated cell death. DOX treatment for three days induced mitotic slippage including cell enlargement, polyploidy, and multinucleation, which was further enhanced by PEMF exposure. DOX treatment also induced CDK1 activation, histone H3 dephosphorylation, and survivin and PLK1 downregulation, which were further increased by PEMF exposure. In addition, CDK1 inhibition reduced mitotic slippage phenotypes and suppressed caspase-2-dependent cell death, resulting in partial restoration of cell viability in the DOX+PEMF group. PEMF promotes DOX-induced mitotic slippage and subsequent caspase-2-dependent cell death in MDA-MB-231 cells by modulating cell cycle checkpoint regulators such as CDK1, survivin, and PLK1. These findings suggest that PEMF may serve as a novel adjuvant to potentiate the anticancer efficacy of DOX by increasing DOX-induced mitotic slippage.

Effects of extremely low-frequency sinusoidal electromagnetic field therapy on survival and vascularization in a rat random-pattern skin flap model.

Bone Growth Stimulators in Orthopedic Trauma: History, Mechanisms, and Clinical Applications.

A high-performance optical fiber surface plasmon resonance (SPR) biosensor for the determination of dopamine (DP) is reported based on gold nanocone arrays combined with gold nanoparticles (AuNPs). The sensor was fabricated via thermal nanoimprinting, gold sputtering, and single-stranded DNA-assisted AuNPs immobilization to form gap hotspots. Finite element simulation and experimental results verified strong electromagnetic field enhancement via extraordinary optical transmission and SPR-LSPR coupling. The sensor achieved a detection limit of 2.7 ×10-14 M for DA, with sensitivity and FOM improved by 37.4% and 54.2% relative to conventional gold film structures. It showed excellent selectivity and stability in serum, cerebrospinal fluid (CSF), and whole blood. This robust, scalable design provides a promising label-free platform for ultrasensitive DA detection in clinical point-of-care applications.

This study investigated whether pulsed electromagnetic field (PEMF) therapy enhanced recovery after fatiguing exercise. Thirty recreationally-trained participants were randomly allocated to PEMF (22:32 min:s of PEMF therapy), PLAC (placebo; held device that was not on), or CONT (control) groups. Fatigue was induced by a Yo-Yo running protocol. Recovery interventions were provided after the fatigue protocol (0 hours), and at 24, 48, and 72 hours. Recovery was measured quantitatively by a cycle ergometer peak power (PP) and cadence test, vertical jump, and leg/back dynamometer. These were measured at baseline, and after the interventions from 0-72 hours. Qualitative recovery was measured by visual analogue and Likert scales pre and post intervention. A 3 (group) x 5 (time) repeated measures ANCOVA, with sex as a covariate, derived between-group differences. Change scores relative to baseline were calculated, and analyzed by a 3x4 (0-baseline, 24-baseline, 48-baseline, 72-baseline) repeated measures ANCOVA. Paired samples t-tests compared the qualitative measures pre and post recovery intervention. A 3x8 and 3x4 repeated measures ANCOVA calculated differences in perceived recovery and change scores. There were no significant time by group ANCOVAs for any variable. The PEMF group did have 11-385% greater PP change scores at each time point. There was a significant decrease (p=0.015; d=0.949) in the PEMF group Likert scale score at 72 hours with the qualitative data indicating recovery for this group. Large standard deviations suggested variation in individual responses. Although significant differences were lacking, PEMF therapy may be beneficial for recovery from fatiguing exercise among some individuals.

Achieving precise control over nanostructure morphology is key to advancing surface-enhanced Raman spectroscopy (SERS) through the creation of highly active plasmonic hotspots. Here, we transform solid Au@Ag core-shell nano-octahedra via galvanic replacement with HAuCl4 into two distinct architectures: nano-octahedra with Au tipping on the corner at low precursor concentration and hollow Au-vertexed nanocages at higher concentration. Elemental mapping confirms a Ag-dominant octahedral body with Au-rich corners, which serve as localized plasmonic hotspots. The hollow nanocages can be further etched with hydrogen peroxide to enlarge their interior cavity, enabling systematic tuning of their plasmon resonance. These vertex-engineered nanostructures demonstrate a significantly improved SERS response, with octahedral AuAg hybrid nanocages achieving an optimal enhancement factor (EF) of 1.0 × 109 using crystal violet (CV) as a probe molecule at a concentration as low as 10-9 M. Specifically, for the 1619 cm-1 peak, the enhancement is ∼1.14× greater at 10-6 M and ∼1.69× greater at 10-9 M compared to Au-tipped octahedral Au@Ag nanocrystals. Finite-element simulations attribute this improvement to the synergistic generation of strong electromagnetic field confinement and efficient charge separation at the Au-tipped vertices. This work provides a general strategy for designing high-performance SERS substrates through precise morphological engineering of metallic nanocages.

Herein, a novel silver nanocrystal-patterned (Ag-NCP) metasurface-based electrochemiluminescence (ECL) sensor for the detection of miRNA-92a-3p in extracellular vesicles (EVs) was constructed with a luminescent 2,2'-bipyridine-5,5'-diamine (Bpy)-covalent organic framework (COF). On the basis of the soft-template and spatial confinement effects of micelles, the ordered nucleation and growth of Ag NCs finally yielded an Ag-NCP metasurface with synergistic structure characteristics of a long-range ordered arrangement and a short-range disordered morphology. Long-range order was defined as the uniform and periodic spatial arrangement of Ag NCs over macroscopic dimensions, which was characterized by a stable and regular structural organization. By comparison, short-range disorder refers to the irregularity in the size, surface morphology, and spacing of adjacent Ag NCs on the local nanoscale with random and variable features. The short-range disordered morphology of irregular Ag NCs in the metasurface generated high-density electromagnetic hotspots due to the localized surface plasmon resonance and the surface plasmon-coupling effect. It greatly enhanced the local electromagnetic field and triggered the Purcell effect, thereby accelerating the luminescence process and improving the ECL efficiency of the Bpy-COF. Moreover, the long-range-ordered arrangement of Ag NCs formed a dense electromagnetic network in the Ag-NCP metasurface to improve the stability and persistence of luminescent signals. The constructed Ag-NCP metasurface-based ECL sensor was successfully applied to the detection of miRNA-92a-3p with a linear range of 1 fM to 10 nM and a limit of detection of 0.36 fM. This biosensor was employed successfully for the detection of miRNA-92a-3p in ascites from gastric cancer patients, which can serve as an auxiliary diagnostic tool.

Strong coupling between molecular excitations and quantized electromagnetic fields in optical cavities provides a powerful means to control the physical and chemical properties of molecular systems. Here, we study electron transfer (ET) dynamics in cavity-coupled molecules using the numerically exact hierarchical equations of motion method, which captures nonperturbative and non-Markovian effects beyond standard perturbative theories. We identify distinct resonance and collective effects associated with polariton formation and show that the ET rate saturates in the strong-coupling regime, a feature not captured by perturbative approaches. We further extend the cavity-modified ET model by incorporating the nuclear-coordinate dependence of molecular electric dipole moments, which gives rise to a three-body interaction involving molecular electronic and vibrational degrees of freedom and cavity photons. This vibronic polariton formation leads to non-monotonic, oscillatory dependencies of the ET rate on the light-matter coupling strength and cavity frequency, which we attribute to quantum interference among multiple transfer pathways. These findings establish cavity-modified electron transfer as a multichannel quantum process governed by the interplay of electronic, vibrational, and photonic degrees of freedom.

As a part of an ongoing project devoted to the development of theoretical foundations and computational methods for treating systems in external electro-magnetic fields, we present a new method here for dealing with magnetic fields of arbitrary strength and for arbitrary systems. The method is based on leaving the commonly used Coulomb gauge and instead introducing an operator gauge. We show that this method avoids the obstacles related with using the Coulomb gauge in combination with GIAOs (gauge-invariant atomic orbitals) as basis functions, i.e., complicated matrix elements and oscillatory behavior for non-magnetic terms. Moreover, our approach shares many features with the "Modern Theory of Magnetization," which is based on the operator, ∇⃗k. However, our approach is not restricted to periodic systems and avoids many complications involved in the application of ∇⃗k. Our method is applicable for any system and field strength, and it readily provides an answer to the question of whether there is a surface/shape contribution to intensive magnetic responses for large systems. Test calculations on H2+ using a homemade abinitio program developed for small systems, and a simplified model for large systems, give mutually consistent and complementary results in support of our suggested approach, but not in complete agreement with results of GIAO calculations. We present a detailed analysis of this finding.

Corrigendum to "Electromagnetic field induced activation of amyloid-β degrading enzyme, neprilysin, for accelerated Alzheimer's disease therapy".

Microwave heating is widely used in daily applications but is fundamentally limited by non-uniform temperature distribution. Despite extensive efforts to manipulate energy distribution around materials, achieving uniform heating remains elusive due to the intrinsic inhomogeneity of electromagnetic fields. Here, we report a self-regulating solution that adaptively modulates the absorbance distribution using a Negative Temperature Coefficient (NTC) Metamaterial Absorber (MA). Distinct from electromagnetic field-shaping strategies, our approach intrinsically suppresses overheating in high-temperature regions and redistributes energy to cooler areas. We demonstrate, for the first time, that uniform heating-quantified by over 90% reduction in the coefficient of variation-can be achieved across diverse configurations, including planar, polyhedral, curved, and multiple objects, as well as under power variations spanning two orders of magnitude. This work not only provides a theoretical resolution to the longstanding challenge of non-uniform microwave heating but also opens new avenues for development and application of temperature-adaptive metamaterials.

Rheumatoid arthritis (RA) is a chronic inflammatory disease in which symptoms such as pain and functional limitations can persist despite pharmacological control. Balneotherapy and pelotherapy are widely used as complementary, non-pharmacological interventions, although clinical evidence remains heterogeneous. To evaluate the clinical effects of a combined balneotherapy protocol consisting of local application of low-temperature sulphurous peloids followed by partial baths in natural sulphurous mineral water, added to a standard rehabilitation program in patients with active rheumatoid arthritis (RA). Seventy patients with active RA were included. The balneotherapy group (n = 35) received local applications of sulphurous peloids (24 °C, 20 min) followed by partial baths in sulphurous mineral water (30 °C, 15 min) for 21 daily sessions. The standard group (n = 35) received four-cell galvanic baths. Both groups received identical physiotherapy and a low-frequency electromagnetic field (5 mT, 25 Hz, 30 min). Primary outcome was change in Disease Activity Score 28 (DAS28). Secondary outcomes included pain, morning stiffness, joint counts, erythrocyte sedimentation rate (ESR), and change in concomitant analgesic medication. The balneotherapy group showed a significantly greater reduction in DAS28 (6.17 ± 0.84 to 4.65 ± 0.78) than the standard group (6.00 ± 0.80 to 5.41 ± 0.92; p < 0.001). Between-group analyses also favored balneotherapy for pain reduction in hands and knees, decreases in tender and swollen joint counts, greater ESR reduction, and a more favorable pattern of analgesic dose reduction (77.1% vs. 20.0%; p < 0.001). No serious adverse events were reported. Adjunctive low-temperature sulphurous peloids plus partial baths in sulphurous mineral water were associated with greater short-term improvement in disease activity, inflammatory markers, pain, and functional outcomes than conventional thermal therapy in active RA.

Ferroptosis, an iron-dependent form of regulated cell death driven by lipid peroxidation, manifests with pronounced single-cell heterogeneity that often dictates the cell fate. Conventional bulk-scale lipidomic analyses obscure early-stage oxidative signatures and intercellular stochasticity, while current single-cell mass spectrometry (MS) workflows are frequently hampered by nonselective sampling and severe ion suppression from biological matrices, leading to substantial experimental and computational overhead. To address these limitations, we developed a fluorescence-guided surface plasmon polarization laser desorption ionization mass spectrometry (SPP-LDI-MS) platform designed for the targeted collection and high-resolution lipidomic profiling of individual cells. This synergistic approach utilizes lipid peroxidation-responsive fluorescent probes to initially screen and define the oxidative trajectories of the cell population. Targeted single cells are subsequently captured and transferred onto the apex of a copper-coated tapered capillary via a custom-designed SPP-LDI probe. Within this microinterface, the surface plasmon polarization-enhanced electromagnetic fields facilitate the direct laser soft ionization of intracellular contents. We demonstrate that the SPP-LDI configuration effectively mitigates salt- and buffer-induced ion suppression, markedly elevating lipid detection sensitivity and molecular coverage at the single-cell level beyond the limits of traditional nESI methods. Application to an RSL3-induced ferroptosis model enabled the precise identification of doubly and triply oxidized polyunsaturated phospholipids at the single-cell level, the accumulation of which was reversibly modulated by selenomethionine (SeMet) intervention. This state-guided lipidomic strategy provides a robust analytical framework for resolving stage-specific lipid remodeling, offering new insights into the molecular mechanisms underlying cellular heterogeneity in ferroptotic pathways.

The electromagnetic response of materials serves as the foundation for a broad range of vital applications, from imaging, to sensing, to classical and quantum communications. Here we demonstrate, theoretically and experimentally, a fundamentally new regime of electromagnetic material response originating from inherent material nonlocality. We show that by structuring materials on the intrinsic scale of this nonlocal response, it becomes possible to alter the electromagnetics of the composite, revealing the inherent nonlocal behavior of the constituent components. These intrinsically nonlocal metamaterials exhibit strong intrinsic (as opposed to effective) nonlocality, easily detectable at room temperatures, in realistic (lossy), macroscopic materials. Intrinsically nonlocal metamaterials open a new design space for electromagnetic composites, beyond photonic crystals, metasurfaces, and effective medium composites. This allows the control of electromagnetic fields at a deep subwavelength scale, revealing a new dimension for control of light-matter interactions.

Although there is no evidence for adverse health effects from non-ionising electromagnetic fields (EMFs) exposure below legal limits, this concern is widespread among the general population. School teachers and nursery school teachers are considered multipliers of health-related information as they impart knowledge to parents and children. However, there is a lack of knowledge about the risk perception regarding EMFs among these professional groups. The extent to which school teachers and nursery school teachers are in contact with questions concerning EMFs and health in their work has not been investigated. Nor is there any knowledge about the information level of school teachers and nursery school teachers regarding EMFs. Data on teachers' perception regarding EMFs is important though to meet information needs. A cross-sectional study among school teachers and nursery school teachers in Germany was carried out in 2024, combining an online survey (N = 1400) with focus groups (N = 29). We calculated prevalence estimates for participants' risk perception, subjective information level, and EMFs relevance in everyday work with correction for non-response. Furthermore, we conducted a latent class analysis to identify types of EMFs risk perception. A third of all participating school teachers (32%) and nursery school teachers (33%) indicated that, in their view, EMF exposure below legal limits may cause adverse health effects. Five types of risk perception concerning EMFs were identified using latent class analysis, with the high risk perception class comprising 11% of the participants. Many school teachers (56%) and nursery school teachers (77%) perceived themselves as poorly informed about EMFs. The group discussions provided deeper insights and supported these findings. The interviews revealed that both professional groups had concerns about the health effects of EMFs. Knowledge of scientific evidence concerning EMFs and health was low. Moreover, the discussions revealed a desire for more information on EMFs and health. A notable proportion of school teachers and nursery school teachers indicated considerable risk perception towards EMFs. Most participants indicated low subjective information levels, expressing a need for information on EMF health effects. Communication formats tailored to this target group should be developed and evaluated.

The detection sensitivity of surface-enhanced Raman scattering (SERS) depends on high-density electromagnetic "hotspots" within metallic nanostructures. However, conventional salt-induced aggregation often leads to uncontrolled clustering, resulting in uneven hotspot distribution and occasional macroscopic precipitation. Here, we report a Fe3+-assisted spatially confined etching strategy for precise fabrication of silver-based core-satellite nanostructures (SGSI), using silver-graphene nanoparticles (Ag@G) as a template. Finite-difference time-domain (FDTD) simulations confirm that nanogaps within the satellite architecture induce strong plasmonic coupling, generating highly localized electromagnetic fields. Benefiting from uniformly distributed intra-cavity hotspots and excellent colloidal stability, the substrate exhibits high SERS activity and signal reproducibility. The superior performance arises from two synergistic effects: (i) carboxyl inherent to the graphene shell of Ag@G imparts a negative surface potential, promoting the electrostatic adsorption of Fe3+ ions and accelerating the etching process; and (ii) the graphene shell also serves as a permeable physical barrier that provides a spatial confinement effect, guiding Ag reorganization into stable satellite structures. This satellite platform enables highly sensitive detection of the anticancer drug methotrexate (55nM) in mice serum. Overall, this work offers a new paradigm for constructing a high-performance and stable SERS sensing platform via the synergistic regulation of surface charge and spatial confinement effects.

We evaluated endoplasmic reticulum stress responses in hepatic tissues following 6GHz electromagnetic field (EMF) exposure and the protective effects of Coenzyme Q10 (CoQ10). The experimental design included 24 male Sprague-Dawley rats randomly assigned to three groups: (i) sham control group, (ii) 6GHz EMF exposure group, and (iii) 6GHz EMF exposure + CoQ10 treatment group. Rats in the exposure groups were subjected to 6GHz EMF exposure for 2h/day over 30 consecutive days. Rats in the exposure groups were subjected to 6GHz EMF exposure (0.21 mW/cm2; specific absorption rate: 0.014 W/kg) for 2h/day over 30 consecutive days. In addition, the animals in the CoQ10 treatment group received CoQ10 orally at a dose of 10mg/kg/day throughout the exposure period. After completing the experimental protocol, hepatic tissue samples were obtained for subsequent analyses. Comparative analyses revealed significant differences in TBARS, GSH, TNF-α, IL-1β, ALT, and AST levels across the control-6GHz and 6GHz -6GHz + CoQ10 groups. Exposure to 6GHz EMF increased histopathological damage and liver histopathological score values, whereas CoQ10 markedly reduced these changes and suppressed glucose-regulated protein 78, C/EBP homologous protein, oxidative 8-hydroxy-2'-deoxyguanosine, and nuclear factor kappa B p65immunoreactivitiesy. 6GHz EMF induces hepatic dysfunction via oxidative stress, endoplasmic reticulum stress, inflammation, and DNA damage, whereas CoQ10 mitigates these effects of EMF exposure.

Low-frequency radar waves, particularly in the P-band, present a significant stealth challenge due to the inherent trade‑offs among strong absorption, broad bandwidth, and ultra-thin thickness. These limitations arise from the conflict between structural thickness and wavelength, impedance-matching difficulties, andweakened loss mechanisms. To overcome these constraints, a new strategy for synergistic enhancement of the local field and electromagnetic loss field of metamaterials has been proposed. By employing metasurface structures for local‑field enhancement, strong absorption is achieved at ultra-thin thicknesses. Furthermore, dielectric, magnetic, conduction, and structural resonance losses are integrated to enable strong, broadband absorption. Herein, a double-layer metasurface array is designed and integrated onto a polydimethylsiloxane/flake carbonyl iron high‑loss dielectric substrate. The resulting composite exhibits exceptional performance in the 1.77-2.85GHz range at a thickness of only 3.78mm (~ 0.022λ), with an absorption rate exceeding 90%, and the absorption rate within the 1-6GHz range can exceed 60%. It also demonstrates good mechanical flexibility and stability. The proposed local‑field enhancement principle provides a new route to bypass the quarter-wavelength limitation of traditional absorbers, while its ultra-thin, broadband, and flexible integrable features highlight its potential for efficient conformal integration on complex curved surfaces.