Effect of negative pressure therapy on the treatment response to scar thickness and viscoelasticity.

Patients with scars face a grave threat to their mental and physical health. Negative pressure has been used for scar therapy in medical care and provides a microenvironment conducive to scar healing while stimulating cell regeneration. Negative pressure may disrupt scar tissue regeneration when the pressure is too high or too low, so finding a suitable negative pressure is important. We hypothesized that different negative pressure magnitudes would affect scar tissue properties differently. This research aimed to provide practical recommendations for scar therapy. This study used three negative pressures (-105 mmHg, -125 mmHg, and -145 mmHg) to compare scar material properties. We measured scar tissue thickness and viscoelasticity with a motor-driven ultrasound indentation system. According to the results of this study, scar thickness is most effectively reduced at a negative pressure of -105 mmHg. In comparison, scar viscoelasticity continuously increases at a negative pressure of -125 mmHg. Negative pressure therapy can be recommended to scar care clinics based on the results of this study.

Plantar pressure gradient and pressure gradient angle are affected by inner pressure of air insole.

Clinically, air insoles may be applied to shoes to decrease plantar pressure gradient (PPG) and increase plantar gradient angle (PGA) to reduce foot ulcers. PPG and PGA may cause skin breakdown. The effects of different inner pressures of inflatable air insoles on dynamic PPG and PGA distributions are largely unknown in non-diabetics and people with diabetes. This study aimed to explore the impact of varying inner air insole pressures on PPG and PGA to establish early mitigation strategies for people at risk of foot ulcers. A repeated measures study design, including three air insoles (80 mmHg, 160 mmHg, and 240 mmHg) and two walking durations (10 and 20 min) for a total of six walking protocols, was tested on 13 healthy participants (height, 165.8 ± 8.4 cm; age, 27.0 ± 7.3 years; and weight, 56.0 ± 7.9 kg, BMI: 20.3 ± 1.7 kg/m^2) over three consecutive weeks. PPG, a measurement of the spatial variation in plantar pressure around the peak plantar pressure (PPP) and PGA, a variation in the gradient direction values at the three plantar regions, big toe (T1), first metatarsal head (M1), and second metatarsal head (M2), were calculated. This study indicated that PPG was lower at 80 mmHg air insoles after 20 min of walking in the M1 region (p = 0.010). The PGA in the M2 increased at an air insole of 80 mmHg compared to 240 mmHg (p = 0.015). Compared to 20 min, the 10 min walking duration at 240 mmHg of air insole had the lowest PPG in the M1 (p = 0.015) and M2 (p = 0.034) regions. The 80 mmHg air insole significantly lowered the PPG compared to a 160 mmHg and 240 mmHg air insole. Moreover, the 80 mmHg air insole significantly decreased PPP and increased PGA compared to the 160 mmHg and 240 mmHg air insole. A shorter walking period (10 min) significantly lowered PPG. The findings of this study suggest that people with a higher risk of foot ulcers should wear softer air insoles to have a lower PPG, as well as an increased PGA.

The effects of different inner pressures of air insoles and walking durations on peak plantar pressure.

BACKGROUND: Exercise reduces chronic complications in individuals with diabetes and peripheral vascular diseases. In clinical practice, the use of air insole may reduce peak plantar pressure (PPP), and risk for diabetic foot ulcers (DFUs). However, there is no guideline on selecting air insole pressure for effectively reducing PPP. Therefore, this study aimed to investigate the effects of different air insole pressure on PPP at different walking durations. METHODS: We tested 13 participants using repeated measures study design, including 3 air insole pressures (80, 160, and 240 mm Hg) and 2 walking durations (10 and 20 minutes) for 6 walking conditions. PPP values at the first toe, first metatarsal head, and second metatarsal head were calculated. RESULTS: The one-way ANOVA showed significant pairwise differences of PPP at 20 minutes duration in the first metatarsal head between 80 and 240 mm Hg (P = .007) and between 160 and 240 mm Hg (P = .038); in the second metatarsal head between 80 and 240 mm Hg (P = .043). The paired t test confirmed that walking duration significantly has lower PPP at 10 minutes than 20 minutes with 240 mm Hg air insole in the first metatarsal head (P = .012) and the second metatarsal head (P = .027). CONCLUSION: People at risk of foot ulcers are suggested to wear shoes with 80 mm Hg of air insole for reducing PPP in the first metatarsal head and the second metatarsal head. Moreover, people may avoid wearing the stiffer insole (240 mm Hg) for more than 20 minutes.

Efficient Narrow-Bandgap Mixed Tin-Lead Perovskite Solar Cells via Natural Tin Oxide Doping.

Narrow-bandgap (NBG) mixed tin/lead-based (Sn-Pb) perovskite solar cells (PSCs) have attracted extensive attention for use in tandem solar cells. However, they are still plagued by serious carrier recombination due to inferior film properties resulting from the alloying of Sn with Pb elements, which leads to p-type self-doping behaviors. This work reports an effective tin oxide (SnOx ) doping strategy to produce high-quality Sn-Pb perovskite films for utilization in efficient single-junction and tandem PSCs. SnOx can be naturally oxidized from tin diiodide raw powders and successfully incorporated into Sn-Pb perovskite films. Consequently, Sn-Pb perovskite films doped with SnOx exhibit dramatically improved morphology, crystallization, absorption, and more interestingly, upward-shifted Fermi levels. The resulting narrow-bandgap Sn-Pb PSCs with natural SnOx doping have considerably reduced carrier recombination, therefore delivering a maximum power conversion efficiency (PCE) of 22.16% for single-junction cells and a remarkable PCE of 26.01% (with a steady-state efficiency of 25.33%) for two-terminal all-perovskite tandem cells. This work introduces a facile doping strategy for the manufacture of efficient single-junction narrow-bandgap PSCs and their tandem solar cells.

Boosting the Sonodynamic Cancer Therapy Performance of 2D Layered Double Hydroxide Nanosheet-Based Sonosensitizers Via Crystalline-to-Amorphous Phase Transformation.

Sonodynamic therapy (SDT) has been a promising therapeutic modality for cancer because of its superior advantages compared with other therapeutic strategies. However, the current sonosensitizers used for SDT normally exhibit low activity for ultrasound (US)-induced reactive oxygen species (ROS) generation. Herein, the crystalline-to-amorphous phase transformation is reported as a simple but powerful strategy to engineer ultrathin 2D CoW-LDH and NiW-LDH nanosheets as highly efficient sonosensitizers for SDT. The phase transformation of CoW-LDH and NiW-LDH nanosheets from polycrystalline to amorphous ones is achieved through a simple acid etching treatment. Importantly, compared with the polycrystalline one, the amorphous CoW-LDH (a-CoW-LDH) nanosheets possess higher ROS generation activity under US irradiation, which is ≈17 times of the commercial TiO2 sonosensitizer. The results suggest that the enhanced performance of ultrathin a-CoW-LDH nanosheets for US-induced ROS generation may be attributed to the phase transformation-induced defect generation and electronic structure changes. After polyethylene glycol modification, the a-CoW-LDH nanosheets can serve as a high-efficiency sonosensitizer for SDT to achieve cell death in vitro and tumor eradication in vivo under US irradiation.

Defect engineering of layered double hydroxide nanosheets as inorganic photosensitizers for NIR-III photodynamic cancer therapy.

Although two-dimensional (2D) layered double hydroxides (LDHs) have been widely used as efficient nanoagents for biological diagnosis and treatment, they have been found to be inert as photosensitizers (PSs) for photodynamic therapy (PDT). Herein, we report the defect engineering of ultrathin 2D CoMo-LDH and NiMo-LDH nanosheets as highly active inorganic PSs for PDT in the third near-infrared (NIR-III) window. Hydrothermal-synthesized 2D CoMo-LDH and NiMo-LDH nanosheets are etched via a simple acid treatment to obtain defect-rich CoMo-LDH and NiMo-LDH nanosheets. Importantly, the defect-rich CoMo-LDH nanosheets exhibit much higher activity (~97 times) for generation of reactive oxygen species than that of the pristine CoMo-LDH nanosheets under a NIR-III 1567 nm laser irradiation. Therefore, after modification with polyethylene glycol, the defect-rich CoMo-LDH nanosheets can be used as an efficient inorganic PS for PDT to efficiently induce cancer cells apoptosis in vitro and eradicate tumors in vivo under 1567 nm laser irradiation.

Effectiveness of self-management of dry and wet cupping therapy for low back pain: A systematic review and meta-analysis.

BACKGROUND: Low back pain (LBP) can significantly affect a person's quality of life. Cupping has been used to treat LBP. However, various cupping methods are typically included in evaluating the efficacy of cupping therapy. Therefore, the objectives of this study were to evaluate the evidence from the literature regarding the effects of dry and wet cupping therapy on LBP in adults. Dry and wet cupping therapy are analyzed categorically in this study. METHODS: We searched for randomized clinical trials with cupping in LBP published between 2008 and 2022. In dry or wet cupping clinical studies, pain intensity was assessed using the Visual Analogue Scale and present pain intensity, and the quality of life intensity was measured using the Oswestry disability index. RESULTS: The 656 studies were identified, of which 10 studies for 690 patients with LBP were included in the meta-analysis. There was a significant reduction in the pain intensity score with present pain intensity using wet cupping therapy (P < .01). In addition, both cupping therapy groups displayed significant Oswestry disability index score reduction compared to the control group (both P < .01). The patients with LBP have a substantial reduction by using wet cupping but have not shown a considerable decrease by using dry cupping (P = .19). In addition, only wet cupping therapy groups displayed a significantly improved quality of life compared to the control group. The study had a very high heterogeneity (I2 > 50%). It means there is no standardization in the treatment protocol in randomized clinical trials. In the meta-regression, there was statistically significant evidence that the number of treatment times and intercepts were related (P < .01). CONCLUSION: The present meta-analysis shows that wet cupping therapy effectively reduces the pain intensity of LBP. Furthermore, both dry wet cupping therapy improved patients with LBP quality of life.

A pH-responsive ultrathin Cu-based nanoplatform for specific photothermal and chemodynamic synergistic therapy.

Noninvasive tumor therapy requires a new generation of bionanomaterials towards sensitive response to the unique tumor microenvironment to achieve accurate and effective treatment. Herein, we have developed a tumor therapy nanoplatform by immobilizing natural glucose oxidase (GOD) onto Cu-based layered double hydroxide (CuFe-LDH) nanosheets, which for the first time integrates acid-enhanced photothermal therapy (PTT), and pH-responsive and heat-facilitated chemodynamic therapy (CDT) simultaneously. As demonstrated by EXAFS and HRTEM, CuFe-LDH nanosheets possess a considerable number of defects caused by different acid conditions, resulting in a significantly acid-enhanced photothermal conversion efficiency (83.2% at pH 5.4 vs. 46.0% at pH 7.4). Moreover, GOD/CuFe-LDH nanosheets can convert a cascade of glucose into hydroxyl radicals (˙OH) under tumor acid conditions, which is validated by a high maximum velocity (V max = 2.00 × 10-7 M) and low Michaelis-Menten constant (K M = 12.01 mM). With the combination of PTT and CDT, the tumor tissue in vivo is almost eliminated with low-dose drug injection (1 mg kg-1). Therefore, this novel pH-responsive Cu-based nanoplatform holds great promise in tumor-specific CDT/PTT synergistic therapy.

Recent advances in innovative strategies for enhanced cancer photodynamic therapy.

Photodynamic therapy (PDT), a non-invasive therapeutic modality, has received increasing attention owing to its high selectivity and limited side effects. Although significant clinical research progress has been made in PDT, the breadth and depth of its clinical application have not been fully realized due to the limitations such as inadequate light penetration depth, non-targeting photosensitizers (PSs), and tumor hypoxia. Consequently, numerous investigations put their emphasis on innovative strategies to overcome the aforementioned limitations and enhance the therapeutic effect of PDT. Herein, up-to-date advances in these innovative methods for PDT are summarized by introducing the design of PS systems, their working mechanisms and application examples. In addition, current challenges of these innovative strategies for clinical application, and future perspectives on further improvement of PDT are also discussed.