Achieving Synergistic Improvement in Dielectric and Energy Storage Properties of All-Organic Poly(Methyl Methacrylate)-Based Copolymers Via Establishing Charge Traps

How to achieve synergistic improvement of permittivity(ε_(r))and breakdown strength(E_(b))is a huge challenge for polymer dielectrics.Here,for the first time,theπ-conjugated comonomer(MHT)can simultaneously promote theε_(r)and E_(b)of linear poly(methyl methacrylate)(PMMA)copolymers.The PMMA-based random copolymer films(P(MMA-co-MHT)),block copolymer films(PMMA-b-PMHT),and PMMA-based blend films were prepared to investigate the effects of sequential structure,phase separation structure,and modification method on dielectric and energy storage properties of PMMA-based dielectric films.As a result,the random copolymer P(MMA-coMHT)can achieve a maximumε_(r)of 5.8 at 1 kHz owing to the enhanced orientation polarization and electron polarization.Because electron injection and charge transfer are limited by the strong electrostatic attraction ofπ-conjugated benzophenanthrene group analyzed by the density functional theory(DFT),the discharge energy density value of P(MMA-co-PMHT)containing 1 mol%MHT units with the efficiency of 80%reaches15.00 J cm^(-3)at 872 MV m^(-1),which is 165%higher than that of pure PMMA.This study provides a simple and effective way to fabricate the high performance of polymer dielectrics via copolymerization with the monomer of P-type semi-conductive polymer.

Optimal transcorneal electrical stimulation parameters for preserving photoreceptors in a mouse model of retinitis pigmentosa

Retinitis pigmentosa is a hereditary retinal disease that affects rod and cone photoreceptors,leading to progressive photoreceptor loss.Previous research supports the beneficial effect of electrical stimulation on photoreceptor survival.This study aims to identify the most effective electrical stimulation parameters and functional advantages of transcorneal electrical stimulation(tcES)in mice affected by inherited retinal degeneration.Additionally,the study seeked to analyze the electric field that reaches the retina in both eyes in mice and post-mortem humans.In this study,we recorded waveforms and voltages directed to the retina during transcorneal electrical stimulation in C57BL/6J mice using an intraocular needle probe with rectangular,sine,and ramp waveforms.To investigate the functional effects of electrical stimulation on photoreceptors,we used human retinal explant cultures and rhodopsin knockout(Rho^(-/-))mice,demonstrating progressive photoreceptor degeneration with age.Human retinal explants isolated from the donors’eyes were then subjected to electrical stimulation and cultured for 48 hours to simulate the neurodegenerative environment in vitro.Photoreceptor density was evaluated by rhodopsin immunolabeling.In vivo Rho^(-/-)mice were subjected to two 5-day series of daily transcorneal electrical stimulation using rectangular and ramp waveforms.Retinal function and visual perception of mice were evaluated by electroretinography and optomotor response(OMR),respectively.Immunolabeling was used to assess the morphological and biochemical changes of the photoreceptor and bipolar cells in mouse retinas.Oscilloscope recordings indicated effective delivery of rectangular,sine,and ramp waveforms to the retina by transcorneal electrical stimulation,of which the ramp waveform required the lowest voltage.Evaluation of the total conductive resistance of the post-mortem human compared to the mouse eyes indicated higher cornea-to-retina resistance in human eyes.The temperature recordings during and after electrical stimulation indicated no significant temperature change in vivo and only a subtle temperature increase in vitro(~0.5-1.5°C).Electrical stimulation increased photoreceptor survival in human retinal explant cultures,particularly at the ramp waveform.Transcorneal electrical stimulation(rectangular+ramp)waveforms significantly improved the survival and function of S and M-cones and enhanced visual acuity based on the optomotor response results.Histology and immunolabeling demonstrated increased photoreceptor survival,improved outer nuclear layer thickness,and increased bipolar cell sprouting in Rho^(-/-)mice.These results indicate that transcorneal electrical stimulation effectively delivers the electrical field to the retina,improves photoreceptor survival in both human and mouse retinas,and increases visual function in Rho^(-/-)mice.Combined rectangular and ramp waveform stimulation can promote photoreceptor survival in a minimally invasive fashion.

A new electric field mill array with each of the mill’s rotor controlled precisely by a GPS module:Equipment and initial results

We have newly designed an electrostatic sensor,called an electric field mill(EFM),to simplify the estimation of the charge position and charge amount transferred by lightning discharges.It is necessary for this remote estimation of the transferred charge to measure electric field changes caused by charge loss at the time of a lightning strike at multiple locations.For multiple-station measurement of electric field changes,not only speed but also phase for exposure and shielding of the sensing plates inside each EFM of the array should be synchronized to maintain the sensitivities of the deployed instruments.Currently,there is no such EFM with specified speed and phase control performance of the rotary part.Thus,we developed a new EFM in which the rotary mechanism was controlled consistently to within 3%error by a GPS module.Five EFMs had been distributed in the Hokuriku area of Japan during the winter season of 2022-2023 for a test observation.Here we describe the design and a simple calibration method for our new EFM array.Data analysis method based on the assumption of a simple monopole charge structure is also summarized.For validation,locations of assumed point charges were compared with three-dimensional lightning mapping data estimated by radio observations in the MF-HF bands.Initial results indicated the validity to estimate transferred charge amounts and positions of winter cloud-to-ground lightning discharges with our new EFM array.

Improved YOLOv8n Model for Detecting Helmets and License Plates on Electric Bicycles

Wearing helmetswhile riding electric bicycles can significantly reduce head injuries resulting fromtraffic accidents.To effectively monitor compliance,the utilization of target detection algorithms through traffic cameras plays a vital role in identifying helmet usage by electric bicycle riders and recognizing license plates on electric bicycles.However,manual enforcement by traffic police is time-consuming and labor-intensive.Traditional methods face challenges in accurately identifying small targets such as helmets and license plates using deep learning techniques.This paper proposes an enhanced model for detecting helmets and license plates on electric bicycles,addressing these challenges.The proposedmodel improves uponYOLOv8n by deepening the network structure,incorporating weighted connections,and introducing lightweight convolutional modules.These modifications aim to enhance the precision of small target recognition while reducing the model’s parameters,making it suitable for deployment on low-performance devices in real traffic scenarios.Experimental results demonstrate that the model achieves an mAP@0.5 of 91.8%,showing an 11.5%improvement over the baselinemodel,with a 16.2%reduction in parameters.Additionally,themodel achieves a frames per second(FPS)rate of 58,meeting the accuracy and speed requirements for detection in actual traffic scenarios.

The action mechanism of the work done by the electric field force on moving charges to stimulate the emergence of carrier generation/recombination in a PN junction

It is discovered that the product of the current and the electric field in a PN junction should be regarded as the rate of work(power)done by the electric field force on moving charges(hole current and electron current),which was previously misinterpreted as solely a Joule heating effect.We clarify that it is exactly the work done by the electric field force on the moving charges to stimulate the emergence of non-equilibrium carriers,which triggers the novel physical phenomena.As regards to Joule heat,we point out that it should be calculated from Ohm’s law,rather than simply from the product of the current and the electric field.Based on this understanding,we conduct thorough discussion on the role of the electric field force in the process of carrier recombination and carrier generation.The thermal effects of carrier recombination and carrier generation followed are incorporated into the thermal equation of energy.The present study shows that the exothermic effect of carrier recombination leads to a temperature rise at the PN interface,while the endothermic effect of carrier generation causes a temperature reduction at the interface.These two opposite effects cause opposite heat flow directions in the PN junction under forward and backward bias voltages,highlighting the significance of managing device heating phenomena in design considerations.Therefore,this study possesses referential significance for the design and tuning on the performance of piezotronic devices.

On the evolution and formation of discharge morphology in pulsed dielectric barrier discharge

The discharge morphology of pulsed dielectric barrier discharge(PDBD) plays important roles in its applications. Here, we systematically investigated the effects of the voltage amplitude,discharge gap, and O_(2)content on the PDBD morphology, and revealed the possible underlying mechanism of the U-shaped formation. First, the morphological evolution under different conditions was recorded. A unique U-shaped region appears in the middle edge region when the gap is larger than 2 mm, while the entire discharge region remains columnar under a 2 mm gap in He PDBD. The width of the discharge and the U-shaped region increase with the increase in voltage, and decrease with the increase of the gap and O_(2)content. To explain this phenomenon,a two-dimensional symmetric model was developed to simulate the spatiotemporal evolution of different species and calculate the electric thrust. The discharge morphology evolution directly corresponds to the excited-state atomic reduction process. The electric thrust on the charged particles mainly determines the reaction region and strongly influences the U-shaped formation.When the gap is less than 2 mm, the electric thrust is homogeneous throughout the entire region,resulting in a columnar shape. However, when the gap is larger than 2 mm or O_(2)is added, the electric thrust in the edge region becomes greater than that in the middle, leading to the U-shaped formation. Furthermore, in He PDBD, the charged particles generating electric thrust are mainly electrons and helium ions, while in He/O_(2)PDBD those that generate electric thrust at the outer edge of the electrode surface are mainly various oxygen-containing ions.

SOLIDWORKS Electrical在通过式脚踏封口机自动化改造设计中的应用

小型企业塑封工艺中通过式脚踏封口机应用广泛,但在塑封重型工件时,工人操作非常费力且次品率高,无法保障塑封质量,为此对其进行机构优化与软硬件设计自动化改造。利用SOLIDWORKS Electrical快速建立3D虚拟电气配盘与生成各类BOM清单,大大缩短了研发周期,安装人员还可以根据虚拟电气装配路径进行准确安装。最终设计出结构合理,满足生产工艺要求的自动化装置,企业以极少改造成本提质增效,为机电一体化装置自动化设计提供了一个高效开发途径。

Self-Adaptive and Electric Field-Driven Protective Layer with Anchored Lithium Deposition Enable Stable Lithium Metal Anode

Lithium metal battery has great development potential because of its lowest electrochemical potential and highest theoretical capacity.However,the uneven deposition of Li^(+)flux in the process of deposition and stripping induces the vigorous growth of lithium dendrites,which results in severely battery performance degradation and serious safety hazards.Here,the tetragonal BaTiO3 polarized by high voltage corona was used to build an artificial protective layer with uniform positive polarization direction,which enables uniform Li^(+)flux.In contrast to traditional strategies of using protective layer,which can guide the uniform deposition of lithium metal.The ferroelectric protective layer can accurately anchor the Li^(+)and achieve bottom deposition of lithium due to the automatic adjustment of the electric field.Simultaneously,the huge volume changes caused by Li^(+)migration change of the lithium metal anode during charging and discharging is functioned to excite the piezoelectric effect of the protective layer,and achieve seamless dynamic tuning of lithium deposition/stripping.This dynamic effect can accurately anchor and capture Li^(+).Finally,the layer-modified Li anode enables reversible Li plating/stripping over 1500 h at 1 mA cm^(-2)and 50℃in symmetric cells.In addition,the assembled Li-S full cell exhibits over 300 cycles with N/P≈1.35.This work provides a new perspective on the uniform Li^(+)flux at the Li-anode interface of the artificial protective layer.

Moisture‑Electric–Moisture‑Sensitive Heterostructure Triggered Proton Hopping for Quality‑Enhancing Moist‑Electric Generator

Moisture-enabled electricity(ME)is a method of converting the potential energy of water in the external environment into electrical energy through the interaction of functional materials with water molecules and can be directly applied to energy harvesting and signal expression.However,ME can be unreliable in numerous applications due to its sluggish response to moisture,thus sacrificing the value of fast energy harvesting and highly accurate information representation.Here,by constructing a moisture-electric-moisture-sensitive(ME-MS)heterostructure,we develop an efficient ME generator with ultra-fast electric response to moisture achieved by triggering Grotthuss protons hopping in the sensitized ZnO,which modulates the heterostructure built-in interfacial potential,enables quick response(0.435 s),an unprecedented ultra-fast response rate of 972.4 mV s^(−1),and a durable electrical signal output for 8 h without any attenuation.Our research provides an efficient way to generate electricity and important insight for a deeper understanding of the mechanisms of moisture-generated carrier migration in ME generator,which has a more comprehensive working scene and can serve as a typical model for human health monitoring and smart medical electronics design.

Ultrafast Laser-Induced Excellent Thermoelectric Performance of PEDOT:PSS Films

Because poly(3,4-ethylenedioxythiophene)-poly(styrenesulfonate)(PEDOT:PSS)is water processable,thermally stable,and highly conductive,PEDOT:PSS and its composites have been considered to be one of the most promising flexible thermoelectric materials.However,the PEDOT:PSS film prepared from its commercial aqueous dispersion usually has very low conductivity,thus cannot be directly utilized for TE applications.Here,a simple environmental friendly strategy via femtosecond laser irradiation without any chemical dopants and treatments was demonstrated.Under optimal conditions,the electrical conductivity of the treated film is increased to 803.1 S cm^(-1)from 1.2 S cm^(-1)around three order of magnitude higher,and the power factor is improved to 19.0μW m^(-1)K^(-2),which is enhanced more than 200 times.The mechanism for such remarkable enhancement was attributed to the transition of the PEDOT chains from a coil to a linear or expanded coil conformation,reduction of the interplanar stacking distance,and the removal of insulating PSS with increasing the oxidation level of PEDOT,facilitating the charge transportation.This work presents an effective route for fabricating high-performance flexible conductive polymer films and wearable thermoelectric devices.

Carbon Abatement Cost-Sharing Strategy for Electric Power Sector Based on Incentive and Subsidy Mechanisms

The green and low carbon transition and development of the electricity industry is the most crucial task in realizing the“dual-carbon target”,and it is urgent to explore the incentive and subsidy mechanism to promote green electricity consumption and the cost-sharing strategy of carbon reduction,to alleviate the pressure of carbon abatement cost of each subject of the electricity supply chain.Against this background,this paper takes into account the low-carbon subsidies provided by the government and the incentive subsidies for users,and studies the optimal decision-making of each subject in the electricity supply chain,so that each of them can obtain the optimal profit and achieve carbon emission reduction at the same time.Firstly,taking into account the direct power purchase mode of large users and the electricity-selling companies emerging after the reform of the power sales side,we have established a cooperative mechanism for sharing the cost of carbon emission reduction in the electricity supply chain and clarified the relationship between the supply and demand of electricity among the main parties.Subsequently,considering government low-carbon subsidies and user incentive subsidies,the optimal decisionmaking model is established under two scenarios of decentralized and centralized cooperative games in the supply chain,respectively,with the objective of maximizing profits and carbon reduction rates.Solving for the optimal proportion of carbon abatement costs shared by each participant in the electricity supply chain in achieving game equilibrium.Finally,we analyze the role of the government’s low-carbon subsidies,users’incentive subsidies,and other factors on the profit and carbon reduction effect of the electricity industry through the example analysis and further analyze the impact of carbon abatement cost-sharing measures to provide recommendations for the electricity industry to realize low-carbon abatement and make decisions.

The bioelectrical properties of bone tissue

Understanding the bioelectrical properties of bone tissue is key to developing new treatment strategies for bone diseases and injuries,as well as improving the design and fabrication of scaffold implants for bone tissue engineering.The bioelectrical properties of bone tissue can be attributed to the interaction of its various cell lineages(osteocyte,osteoblast and osteoclast)with the surrounding extracellular matrix,in the presence of various biomechanical stimuli arising from routine physical activities;and is best described as a combination and overlap of dielectric,piezoelectric,pyroelectric and ferroelectric properties,together with streaming potential and electro-osmosis.There is close interdependence and interaction of the various electroactive and electrosensitive components of bone tissue,including cell membrane potential,voltage-gated ion channels,intracellular signaling pathways,and cell surface receptors,together with various matrix components such as collagen,hydroxyapatite,proteoglycans and glycosaminoglycans.It is the remarkably complex web of interactive cross-talk between the organic and non-organic components of bone that define its electrophysiological properties,which in turn exerts a profound influence on its metabolism,homeostasis and regeneration in health and disease.This has spurred increasing interest in application of electroactive scaffolds in bone tissue engineering,to recapitulate the natural electrophysiological microenvironment of healthy bone tissue to facilitate bone defect repair.

Clinical efficacy of magnetic vibration magnetoelectric therapy in the treatment of chronic prostatitischronic pelvic pain syndrome

BACKGROUND The prominent symptoms of chronic pelvic pain syndrome(CPPS)are urogenital pain,lower urinary tract symptoms,psychological problems,and sexual dysfunction.Traditional pharmacological treatments have poor efficacy and more untoward reaction and complications.Magnetic vibration magnetoelectric therapy is a non-invasive form of physiotherapy.Nevertheless,its effectiveness in improving urinary discomfort and relieving pain in patients requires further exploration.AIM To investigate the clinical efficacy of the magnetic vibration magnetoelectric therapy instrument in the treatment of chronic prostatitis(CP)/CPPS.METHODS Seventy patients with CP/CPPS were collected from the outpatient clinic and ward of the Department of Male Medicine,Jiangsu Province Hospital of Traditional Chinese Medicine,and were treated with magnetic vibration magnetoelectric therapy once a day for a period of 14 d.National Institutes of healthchronic prostatitis symptom index(NIH-CPSI),international index of erectile function 5(IIEF-5),premature ejaculation diagnostic tool(PEDT),generalized anxiety disorder(GAD),patient health questionnaire,the pain catastrophizing scale(PCS)and traditional Chinese medicine syndrome(TCMS)scores were performed before and after treatment.RESULTS The total effective rate of treatment was 58.5%,and the total NIH-CPSI score,pain symptoms,voiding symptoms,quality of life,IIEF-5,PEDT,GAD,PCS and TCMS scores all decreased significantly(P<0.05).CONCLUSION Magnetic vibration magnetotherapy is effective in improving urinary discomfort,relieving pain,improving quality of life,improving sexual dysfunction and relieving negative emotions such as anxiety in patients with CP/CPPS.

The Future Trend of E-Mobility in Terms of Battery Electric Vehicles and Their Impact on Climate Change: A Case Study Applied in Hungary

The transportation sector is responsible for 25% of the total Carbon dioxide (CO2) emissions, whereas 60.6% of this sector represents small and medium passenger cars. However, as noted by the European Union Long-term strategy, there are two ways to reduce the amount of CO2 emissions in the transportation sector. The first way is characterized by creating more efficient vehicles. In contrast, the second way is characterized by changing the fuel used. The current study addressed the second way, changing the fuel type. The study examined the potential of battery electric vehicles (BEVs) as an alternative fuel type to reduce CO2 emissions in Hungarys transportation sector. The study used secondary data retrieved from Statista and stata.com to analyze the future trends of BEVs in Hungary. The results showed that the percentage of BEVs in Hungary in 2022 was 0.4% compared to the total number of registered passenger cars, which is 3.8 million. The simple exponential smoothing (SES) time series forecast revealed that the number of BEVs is expected to reach 84,192 in 2030, indicating a percentage increase of 2.21% in the next eight years. The study suggests that increasing the number of BEVs is necessary to address the negative impact of CO2 emissions on society. The Hungarian Ministry of Innovation and Technologys strategy to reduce the cost of BEVs may increase the percentage of BEVs by 10%, resulting in a potential average reduction of 76,957,600 g/km of CO2 compared to gasoline, diesel, hybrid electric vehicles (HEVs), and plug-in hybrid vehicles (PHEVs).

Diffusion Equations of the Electric Charges and Magnetic Flux

Innovative definitions of the electric and magnetic diffusivities through conducting mediums and innovative diffusion equations of the electric charges and magnetic flux are verified in this article. Such innovations depend on the analogy of the governing laws of diffusion of the thermal, electrical, and magnetic energies and newly defined natures of the electric charges and magnetic flux as energy, or as electromagnetic waves, that have electric and magnetic potentials. The introduced diffusion equations of the electric charges and magnetic flux involve Laplacian operator and the introduced diffusivities. Both equations are applied to determine the electric and magnetic fields in conductors as the heat diffusion equation which is applied to determine the thermal field in steady and unsteady heat diffusion conditions. The use of electric networks for experimental modeling of thermal networks represents sufficient proof of similarity of the diffusion equations of both fields. By analysis of the diffusion phenomena of the three considered modes of energy transfer;the rates of flow of these energies are found to be directly proportional to the gradient of their volumetric concentration, or density, and the proportionality constants in such relations are the diffusivity of each energy. Such analysis leads also to find proportionality relations between the potentials of such energies and their volumetric concentrations. Validity of the introduced diffusion equations is verified by correspondence their solutions to the measurement results of the electric and magnetic fields in microwave ovens.

Pyroelectric Plate with Magnetoelectric Effect

In dynamic problems the electric and magnetic fields are inseparable. At the same time, a multitude of electrostatic and magnetostatic effects permit mutually independent description. This separation appears to be possible and thermodynamically consistent when the bulk energy density depends only on the polarization density or, alternatively, on the magnetization density. However, when the bulk energy density depends simultaneously on the both densities, then, the electrostatic and magnetostatic effects should be studied together. There appear interesting cross-effects;among those are the change of the internal electrostatic field inside a specimen under the influence of the external magnetic fields, and vice versa. Below, in the framework of thermodynamic approach the boundary value problem for magnetoelectric plate is formulated and analyzed. The exact solution is established for the isotropic pyroelectric plate.

Reducing Operation Emissions and Improving Work Efficiency Using a Pure Electric Wheel Drive Tractor

In response to the problems of excessive greenhouse-gas and particulate emissions and the low traction efficiency of conventional diesel tractors in the field,a purely electric wheel-side drive tractor was studied,including an electric motor drive system,a battery ballast system,and an electro–hydraulic suspension system.This paper develops a dynamics model of an electric tractor-ploughing unit under complex soil conditions,leading to the proposal of an active control method for drive wheel torque and a joint control method for the traction force of the suspension system and the front-and rear-axle loads of a tractor.Finally,the tractor is prototyped and assembled,and ploughing tests are carried out.The ploughing results show that the active torque-distribution control method proposed in this study reduces the tractor slip by 14.83%and increases the traction efficiency by 10.28%compared with the average torquedistribution mode.Compared with the conventional traction control mode,the joint control method for traction and ballast proposed in this paper results in a 3.7%increase in traction efficiency,a 15.05%decrease in slip,and a 4.9%reduction in total drive motor energy consumption.This study will help to improve the operation quality and traction efficiency of electric tractors in complex soil conditions.

Reliability evaluation of IGBT power module on electric vehicle using big data

There are challenges to the reliability evaluation for insulated gate bipolar transistors(IGBT)on electric vehicles,such as junction temperature measurement,computational and storage resources.In this paper,a junction temperature estimation approach based on neural network without additional cost is proposed and the lifetime calculation for IGBT using electric vehicle big data is performed.The direct current(DC)voltage,operation current,switching frequency,negative thermal coefficient thermistor(NTC)temperature and IGBT lifetime are inputs.And the junction temperature(T_(j))is output.With the rain flow counting method,the classified irregular temperatures are brought into the life model for the failure cycles.The fatigue accumulation method is then used to calculate the IGBT lifetime.To solve the limited computational and storage resources of electric vehicle controllers,the operation of IGBT lifetime calculation is running on a big data platform.The lifetime is then transmitted wirelessly to electric vehicles as input for neural network.Thus the junction temperature of IGBT under long-term operating conditions can be accurately estimated.A test platform of the motor controller combined with the vehicle big data server is built for the IGBT accelerated aging test.Subsequently,the IGBT lifetime predictions are derived from the junction temperature estimation by the neural network method and the thermal network method.The experiment shows that the lifetime prediction based on a neural network with big data demonstrates a higher accuracy than that of the thermal network,which improves the reliability evaluation of system.

Flexible and Robust Functionalized Boron Nitride/Poly(p‑Phenylene Benzobisoxazole)Nanocomposite Paper with High Thermal Conductivity and Outstanding Electrical Insulation

With the rapid development of 5G information technology,thermal conductivity/dissipation problems of highly integrated electronic devices and electrical equipment are becoming prominent.In this work,“high-temperature solid-phase&diazonium salt decomposition”method is carried out to prepare benzidine-functionalized boron nitride(m-BN).Subsequently,m-BN/poly(pphenylene benzobisoxazole)nanofiber(PNF)nanocomposite paper with nacremimetic layered structures is prepared via sol–gel film transformation approach.The obtained m-BN/PNF nanocomposite paper with 50 wt%m-BN presents excellent thermal conductivity,incredible electrical insulation,outstanding mechanical properties and thermal stability,due to the construction of extensive hydrogen bonds andπ–πinteractions between m-BN and PNF,and stable nacre-mimetic layered structures.Itsλ∥andλ_(⊥)are 9.68 and 0.84 W m^(-1)K^(-1),and the volume resistivity and breakdown strength are as high as 2.3×10^(15)Ωcm and 324.2 kV mm^(-1),respectively.Besides,it also presents extremely high tensile strength of 193.6 MPa and thermal decomposition temperature of 640°C,showing a broad application prospect in high-end thermal management fields such as electronic devices and electrical equipment.

Safety and effectiveness of neuromuscular electrical stimulation in cardiac surgery:A systematic review

BACKGROUND Lack of mobilization and prolonged stay in the intensive care unit(ICU)are major factors resulting in the development of ICU-acquired muscle weakness(ICUAW).ICUAW is a type of skeletal muscle dysfunction and a common complication of patients after cardiac surgery,and may be a risk factor for prolonged duration of mechanical ventilation,associated with a higher risk of readmission and higher mortality.Early mobilization in the ICU after cardiac surgery has been found to be low with a significant trend to increase over ICU stay and is also associated with a reduced duration of mechanical ventilation and ICU length of stay.Neuromuscular electrical stimulation(NMES)is an alternative modality of exercise in patients with muscle weakness.A major advantage of NMES is that it can be applied even in sedated patients in the ICU,a fact that might enhance early mobilization in these patients.AIM To evaluate safety,feasibility and effectiveness of NMES on functional capacity and muscle strength in patients before and after cardiac surgery.METHODS We performed a search on Pubmed,Physiotherapy Evidence Database(PEDro),Embase and CINAHL databases,selecting papers published between December 2012 and April 2023 and identified published randomized controlled trials(RCTs)that included implementation of NMES in patients before after cardiac surgery.RCTs were assessed for methodological rigor and risk of bias via the PEDro.The primary outcomes were safety and functional capacity and the secondary outcomes were muscle strength and function.RESULTS Ten studies were included in our systematic review,resulting in 703 participants.Almost half of them performed NMES and the other half were included in the control group,treated with usual care.Nine studies investigated patients after cardiac surgery and 1 study before cardiac surgery.Functional capacity was assessed in 8 studies via 6MWT or other indices,and improved only in 1 study before and in 1 after cardiac surgery.Nine studies explored the effects of NMES on muscle strength and function and,most of them,found increase of muscle strength and improvement in muscle function after NMES.NMES was safe in all studies without any significant complication.CONCLUSION NMES is safe,feasible and has beneficial effects on muscle strength and function in patients after cardiac surgery,but has no significant effect on functional capacity.