Search Results (24)

Lightning strikes pose a significant risk during outdoor activities. The connection between conventionally used rescue blankets in alpine emergencies and the risk of lightning injury is unclear. This experimental study investigated whether rescue blankets made of aluminum-coated polyethylene terephthalate increase the likelihood of lightning injuries. High-voltage experiments of up to 2.5 MV were conducted in a controlled laboratory setting, exposing manikins to realistic lightning discharges. In a balanced test environment, two conventionally used brands were investigated. Upward leaders frequently formed on the edges along the fold lines of the foils and were significantly longer in crumpled rescue blankets (p = 0.004). When a lightning strike occurred, the thin metallic layer evaporated at the contact point without igniting the blanket or damaging the underlying plastic film. The blankets diverted surface currents and prevented current flow to the manikins, indicating potentially protective effects. The findings of this experimental study suggest that upward leaders rise from the edge areas of rescue blankets, although there is no increased risk for a direct strike. Rescue blankets may even provide partial protection against exposure to electrical charges. Full article

Background: High-voltage electrical injuries (HVEIs) represent a complex and life-threatening entity, frequently involving multi-organ damage. While traditionally linked to occupational hazards, train surfing—riding on moving trains—and train climbing—scaling stationary carriages—have emerged as increasingly common causes among adolescents. Popularized via social media, these behaviors expose individuals to the invisible danger of electric arcs from 15,000-volt railway lines, often resulting in extensive burns, cardiac complications, and severe trauma. This study presents a 30-year retrospective analysis comparing cardiac biomarkers and clinical outcomes in train-surfing injuries versus work-related HVEIs. Methods: All patients with confirmed high-voltage injury (≥1000 volts) admitted to a Level 1 burn center between 1994 and 2024 were retrospectively analyzed. Exclusion criteria comprised low-voltage trauma, suicide, incomplete records, and external treatment. Clinical and laboratory parameters—including total body surface area (TBSA), Abbreviated Burn Severity Index (ABSI), electrocardiogram (ECG) findings, intensive care unit (ICU) and hospital stay, mortality, and cardiac biomarkers (creatine kinase [CK], CK-MB, lactate dehydrogenase [LDH], aspartate transaminase [AST], troponin, and myoglobin)—were compared between the two cohorts. Results: Of 81 patients, 24 sustained train-surfing injuries and 57 were injured in occupational settings. Train surfers were significantly younger (mean 16.7 vs. 35.2 years, p = 0.008), presented with greater TBSA (49.9% vs. 17.9%, p = 0.008), higher ABSI scores (7.3 vs. 5.1, p = 0.008), longer ICU stays (53 vs. 17 days, p = 0.008), and higher mortality (20.8% vs. 3.5%). ECG abnormalities were observed in 51% of all cases, without significant group differences. However, all cardiac biomarkers were significantly elevated in train-surfing injuries at both 72 h and 10 days post-injury (p < 0.05), suggesting more pronounced cardiac and muscular damage. Conclusions: Train-surfing-related high-voltage injuries are associated with markedly more severe systemic and cardiac complications than occupational HVEIs. The significant biomarker elevation and critical care demands highlight the urgent need for targeted prevention, public awareness, and early cardiac monitoring in this high-risk adolescent population. Full article

This study presents a self-powered smart wrist brace integrated with a piezoelectric sensor for real-time biomechanical monitoring during weightlifting activities. The system was designed to quantify wrist flexion across multiple loading conditions (0 kg, 0.5 kg, and 1.0 kg), leveraging mechanical strain-induced voltage generation to capture angular displacement. A flexible PVDF film was embedded within a custom-fitted wrist brace and tested on male and female participants performing controlled wrist flexion. The resulting voltage signals were analyzed to extract root-mean-square (RMS) outputs, calibration curves, and sensitivity metrics. To interpret the experimental results analytically, a lumped-parameter cantilever beam model was developed, linking wrist flexion angles to piezoelectric voltage output based on mechanical deformation theory. The model assumed a linear relationship between wrist angle and induced strain, enabling theoretical voltage prediction through simplified material and geometric parameters. Model-predicted voltage responses were compared with experimental measurements, demonstrating a good agreement and validating the mechanical-electrical coupling approach. Experimental results revealed consistent voltage increases with both wrist angle and applied load, and regression analysis demonstrated strong linear or mildly nonlinear fits with high $R^2$ values (up to 0.994) across all conditions. Furthermore, surface plots and strain sensitivity analyses highlighted the system’s responsiveness to simultaneous angular and loading changes. These findings validate the smart wrist brace as a reliable, low-power biomechanical monitoring tool, with promising applications in injury prevention, rehabilitation, and real-time athletic performance feedback. Full article

Introduction: The indication for a free flap in acute burn reconstruction is very specific. It should avoid several complications that are more common in the burned patient population. We propose an anterolateral thigh (ALT) flap as a first option for primary burn reconstruction in microvascular free flap reconstruction in burned patients. Patients and Methods: A retrospective review of all acutely burned patients treated with microvascular ALT free flap reconstruction between the years 2005 and 2022 in the Vall d’Hebron Barcelona Hospital Campus Burn Centre was conducted. Results: We performed 30 ALT flaps for primary burn reconstruction. The majority of patients were male (87.5%), with a mean age of 36.7 years, and 37% of patients were smokers. High-voltage electrical burns were the most common etiology. The mean time between burn injury and microsurgery was 22 days. The main recipient site was the lower limb. The flap survival rate was 96.6%. One patient required a meshed skin graft to cover a defect in the proximal third due to peripheral flap necrosis. One flap experienced mild congestion, which resolved spontaneously. Another flap had a local infection, which resolved with antibiotic therapy and surgical debridement. Conclusions: An ALT flap offers several advantages to a burned patient, provided that the surgical technique and postoperative management described in this study are followed. We propose it as the first option for primary burn reconstruction using free flaps in a burned patient. Full article

Background: High-voltage injuries associated with train surfing are a distinct subset of electrical injuries, yet detailed analyses remain limited. This study retrospectively reviewed train-surfing injuries admitted between 1994 and 2024, comparing their characteristics and outcomes to work-related high-voltage injuries. Methods: Medical records of 102 patients admitted for high-voltage injuries were analyzed, including 32 train-surfing and 70 work-related cases. Demographics, injury patterns, and clinical outcomes were assessed. Results: Train surfers were predominantly young males (median age 19 years), while work-related injuries involved slightly older males (median age 34 years). Train surfers sustained more severe burns (%TBSA: 47.6% vs. 25.4%, p < 0.0001) and higher ABSI scores (6.7 vs. 5.3, p < 0.01). Vertical electrical flow was predominant in train surfing (65.6%), reflecting contact with overhead lines, while work-related injuries showed varied flow patterns, with diagonal flow being most frequent (58.6%). Train surfers had longer ICU stays (38.7 vs. 17.9 days, p < 0.001) and underwent more surgeries per patient (5.3 vs. 2.8, p < 0.01). Fasciotomy rates were significantly higher among train surfers (84.4% vs. 55.7%, p < 0.01), as were amputations (53.1% vs. 25.7%, p < 0.001). Mortality rates were similar in both groups (25%). Conclusions: Train-surfing injuries represent a distinct and highly severe subgroup of high-voltage trauma, marked by greater burn extent, predominantly vertical electrical flow due to contact with overhead lines, and significantly higher surgical complexity—including increased rates of fasciotomies and amputations. Despite comparable mortality, the clinical burden for train-surfing victims is substantially higher, reflected in longer ICU stays and more operations per patient. These findings underscore the urgent need for targeted prevention strategies addressing youth engagement in train surfing. Public health campaigns, railway infrastructure modifications (e.g., deterrent systems or physical barriers), and early educational interventions could play a critical role in reducing these preventable injuries. Furthermore, trauma centers should be prepared for the specific reconstructive and critical care demands posed by this high-risk group, emphasizing the importance of specialized multidisciplinary management protocols. Full article

Background: High-voltage injuries pose severe risks, particularly among train surfers and occupational workers. This study compares current flow mechanisms and their association with cardiac failure and kidney function problems in these groups. Methods: A retrospective analysis of 102 patients treated for high-voltage injuries between 1994 and 2024 was conducted, including 32 train-surfing and 70 work-related cases. Demographics, current flow patterns, and complications were analyzed. Results: Train surfers, mostly young males (median age: 19 years), sustained more severe burns compared to older males with work-related injuries (median age: 34 years), with a %TBSA of 47.6% vs. 25.4% (p < 0.0001). Vertical electrical flow was predominant among train surfers (65.62%) and led to cardiac failure in 37.5% of cases. In contrast, diagonal flow was most common in work-related injuries (58.57%). Cardiac failure occurred in 21.57% of all patients, with vertical flow posing the highest risk (38.46%). Kidney failure affected 43.75% of train surfers and 21.43% of work-related cases, with dialysis required in 21.57% overall. Train surfers were more likely to require resuscitation (43.75% vs. 15.71%, p = 0.005), while ECG findings showed no significant differences (p = 0.325). Biomarker levels, such as CK, myoglobin, and troponin, were significantly higher in train surfers, reflecting greater muscle damage. Conclusions: Current flow mechanisms significantly influence cardiac and renal complications. Vertical flow, common in train surfers, is strongly associated with cardiac failure, while work-related injuries exhibit varied flow patterns. These findings highlight the need for targeted prevention strategies and public awareness. Full article

Pulsed field ablation (PFA) is an emerging technology that utilizes ultra-short high-voltage electric pulses to create nanopores in cell membranes, leading to cell death through irreversible electroporation (IRE). PFA is touted to be highly tissue-selective, which may mitigate the risk of collateral injury to vital adjacent structures. In the field of cardiac electrophysiology, initial studies have shown promising results for acute pulmonary vein isolation (PVI) and lesion durability, with overall freedom from recurrent atrial arrhythmia comparable to traditional thermal ablation modalities. While further large studies are required for long-term efficacy and safety data, PFA has the potential to become a preferred energy source for cardiac ablation for some indications. This review outlines the basic principles and biophysics of IRE and its application to cardiac electrophysiology through a review of the existing preclinical and clinical data. Full article

Pulsed field ablation (PFA) is a catheter-based procedure that utilizes short high voltage and short-duration electrical field pulses to induce tissue injury. The last decade has yielded significant scientific progress and quickened interest in PFA as an energy modality leading to the emergence of the clinical use of PFA technologies for the treatment of atrial fibrillation. It is generally agreed that more research is needed to improve our biophysical understanding of PFA for clinical cardiac applications as well as its potential as a potential alternative energy source to thermal ablation modalities for the treatment of other arrhythmias. In this review, we discuss the available preclinical and clinical evidence for PFA for atrial fibrillation, developments for ventricular arrhythmia (VA) ablation, and future perspectives. Full article

Electrical stimulation can be used in several applications such as fatigue reduction, muscle rehabilitation, neurorehabilitation, neuro-prosthesis and pain relief. Moreover, electrical stimulation can be used for drug delivery applications or body fluids extraction (e.g., sweat and interstitial fluid) to successively monitor several parameters, such as glucose, lactate, etc. All these applications are performed using electrical stimulator devices capable of applying constant voltage pulses or constant current pulses via electrodes to human tissues. Usually, constant current stimulators are most widely used because of their safety, stability, and repeatability. Thus, the aim of this work was to design, realize and test a mixed-signal electronic interface capable of producing current pulses with custom amplitude, duration, frequency, polarity and symmetry with extended voltage compliance. To achieve this result, we developed a high-voltage current stimulator suitable for iontophoresis applications. Current stimuli can be applied setting the intensity, frequency and duty cycle of the stimulation patterns through a µC. A custom electronic interface was designed to allow the control of the injected current in real time and to prevent electrical injuries to the patient by avoiding potential unwanted short circuits. Moreover, the system was tested in a simulated environment demonstrating its effectiveness and applicability for transdermal monitoring applications. The obtained results show that the device is able to apply monophasic and biphasic pulses, ranging from 0.1 to 10 mA, with a maximum error of about 10% at the minimum intensity; in addition, current stimuli can be applied up to a maximum frequency of 100 kHz with a voltage compliance of 120 V. Full article

Electrical burn injuries to the scalp are at risk of extensive tissue damage and neurological complications. We present the case of a patient who came into contact with a high-voltage power line while cherry picking, resulting in a large full-thickness scalp defect. Early on in his presentation, he developed progressive global weakness which remained relatively static during his admission. An incidental finding of an extradural abscess complicated his management, requiring urgent surgical intervention with definitive tissue coverage. The scalp was reconstructed using a free myocutaneous anterolateral thigh flap. There were no postoperative complications. Following rehabilitation, the patient was discharged home with limited functional recovery. He mobilises independently with a wheelchair and requires full-time carers. Full article

Electrical fires are frequently caused by low-voltage AC series arc faults, which can result in significant injuries and property damage. The installation of arc-fault detection devices is mandated or recommended in many regions and countries across the world, yet the current devices’ detection accuracy is insufficient to completely eliminate the risk posed by arc faults. The method based on artificial intelligence is a solution with high detection accuracy, but the AI model is a ‘black box’. When a misjudgment occurs, the cause of the model error cannot be found fundamentally, and the modification and light weight of the model also presents significant difficulties when using the approach. Given the aforementioned issues, this research proposes a novel lightweight low-voltage AC arc-fault detection method based on the explainability approach. By applying the attention mechanism approach and performing a visual analysis, the contribution of arc features to model detection is determined. Model input data optimization and model structure simplification are achieved at the same time as increased model detection accuracy. Ultimately, an experimental prototype for arc-fault detection is designed and validated. Test results demonstrate the effectiveness of the method by demonstrating that the lightweight model maintains 99.69% detection accuracy, even after optimizing the input data by 80% and reducing the model parameters by 51.52%. Full article

Pulsed Field Ablation (PFA) is the latest and most intriguing technology for catheter ablation of atrial fibrillation, due to its capability to generate irreversible and cardiomyocytes-selective electroporation of cell membranes by delivering microsecond-lasting high-voltage electrical fields, leading to high expectations. The first trials to assess the clinical success of PFA, reported an arrhythmia-free survival at 1-year of 78.5%, while other trials showed less enthusiastic results: 66.2% in paroxysmal and 55.1% in persistent AF. Nevertheless, real world data are encouraging. The isolation of pulmonary veins with PFA is easily achieved with 100% acute success. Systematic invasive remapping showed a high prevalence of durable pulmonary vein isolation at 75 and 90 days (range 84–96%), which were significatively lower in redo procedures (64.3%). The advent of PFA is prompting a reconsideration of the role of the autonomic nervous system in AF ablation, as PFA-related sparing of the ganglionated plexi could lead to the still undetermined effect on late arrhythmias’ recurrences. Moreover, a new concept of a blanking period could be formulated with PFA, according to its different mechanism of myocardial injury, with less inflammation and less chronic fibrosis. Finally, in this review, we also compare PFA with thermal energy. Full article

High-voltage electrical injuries, especially from lightning strikes, can cause life-threatening complications due to extreme temperature and voltage exposure. While burns and cardiac complications have been widely described, the documentation of metabolic imbalances, particularly hypokalemia, has not been as prevalent. This report focuses on a patient with profound transient hypokalemia following a lightning strike, alongside a review of three similar cases of transient hypokalemia from the literature. Our patient, a previously healthy young man, was struck by lightning and subsequently suffered transient hypokalemia with lower extremity sensory changes, which resolved after the normalization of serum potassium levels. While the exact underlying mechanisms of transient hypokalemia following high-voltage electrical injuries are unknown, we propose a multifactorial mechanism, which includes massive intracellular shifts of potassium due to elevated epinephrine levels and the prevention of potassium efflux through the electrical disruption of voltage-gated potassium channels. Our report underscores the importance of recognizing hypokalemia in patients with high-voltage electrical injuries and contributes to the understanding of the complex mechanisms involved. Further research is necessary to understand the connection between cellular changes induced by high-voltage exposure and their effects on metabolism, particularly in relation to hypokalemia. Full article

Triboelectric nanogenerators (TENGs) are a kind of mechanical energy harvester with a larger force sensing range and good energy conversion, which is often applied to human kinetic energy collection and motion sensing devices. Polymer materials are the most commonly used materials in TENGs’ triboelectric layers due to their high plasticity and good performance. Regarding the application of TENGs in insoles, research has often used brittle Teflon for high output performance together with hard materials, such as springs, for the mechanism to maintain its stability. However, these combined materials increase the weight and hardness of the insoles. Here, we propose a polyethylene terephthalate (PET)-based TENG with a micro-needle polydimethylsiloxane (PDMS) elastomer, referred to as MN-PDMS-TENG, to enhance performance and maintain comfort flexibility, and structural stability. Compared with a flat PDMS, the TENG with a microstructure enhances the output open-circuit voltage (Voc) from 54.6 V to 129.2 V, short-circuit current (Isc) from 26.16 μA to 64.00 μA, power from 684 µW to 4.1 mW, and ability to light up from 70 to 120 LEDs. A special three-layer TENG insole mechanism fabricated with the MN-PDMS-TENG and elastic materials gives the TENG insole high stability and the ability to maintain sufficient flexibility to fit in a shoe. The three-layer TENG insole transforms human stepping force into electric energy of 87.2 V, which is used as a self-powered force sensor. Moreover, with the calibration curve between voltage and force, it has a sensitivity of 0.07734 V/N with a coefficient of determination of R² = 0.91 and the function between force and output voltage is derived as F = 12.93 V − 92.10 under human stepping force (300~550 N). Combined with a micro-control unit (MCU), the three-layer TENG insole distinguishes the user’s motion force at different parts of the foot and triggers a corresponding device, which can potentially be applied in sports and on rehabilitation fields to record information or prevent injury. Full article

Irreversible electroporation (IRE) is a promising nonthermal ablation technique that uses high-voltage electrical pulses to create permanent pores in the cell membrane of target tissue. Recently, endoscopic IRE with catheter-based electrodes has attracted significant attention as a potential alternative tool for gastrointestinal tumors, but it has been challenged owing to the limited electric field distribution in an in-plane electrode configuration, in which rectangular interdigitated electrodes (IDEs) are commonly used. Herein, we report an enhanced electrical injury in tissue using triangular IDEs that cause strong electric fields to be induced at the tip of the electrode fingers. A set of 10 pulses with a duration of 100 μs and a frequency of 1 Hz were delivered to the tissue, and a finite element method was used to calculate the electrical injury in the gastrointestinal model. The probability of cell death by electrical injury at the triangular IDEs increases by approximately 10 times compared to that of conventional rectangular IDEs at the same electrode distance. These results could potentially pave the way toward designing electrodes in catheter-based IRE devices. Full article