Communication
Beyond the Intrinsic Cardiac Conduction System: A Hypothetical Framework for Cardiocutaneous Electrical Pathways (CEP) Linking Heart to Skin in ECG Generation
Oluwadare Ogunlade*
Issue:
Volume 13, Issue 4, August 2025
Pages:
60-65
Received:
14 June 2025
Accepted:
30 June 2025
Published:
23 July 2025
Abstract: The existing paradigm of cardiac electrophysiology primarily focuses on the intracardiac conduction system and volume conduction through interstitial fluid to explain the electrocardiogram (ECG). However, this model faces limitations in fully elucidating the precise capture of phasic electrical signals at the cutaneous surface. This short communication introduces a novel anatomical and physiological framework postulating the existence of Cardiocutaneous Electrical Pathways (CEP) - a specialized, direct extracardiac electrical system connecting the heart to the skin. This framework proposes that CEP extends along the body's vascular channels, which establish the essential physiological link between the heart and the skin through cutaneous circulation. These pathways are hypothesized to extend beyond the immediate circulation to the skin surface, thus generating a comprehensive cardiac electrical field across the entire integument. Consequently, the electrocardiogram is presented as a direct bioelectrical manifestation resulting from the activity at the terminal ends of these CEP. Correlational evidence, such as the observed disappearance of ECG signals from a body region following localized blood supply severance, supports the intrinsic association of these pathways with vascular networks. The CEP framework suggests that this microscopic extracardiac electrical system functions as a direct extension of the intracardiac electrical system. This novel hypothesis challenges conventional understandings of cardiac bioelectricity, opening new avenues for research into the anatomical basis of cardiac electrical propagation and its systemic manifestations. Further exploration of CEP could revolutionize electrodiagnostic methods and offer new targets for understanding cardiovascular physiology and disease.
Abstract: The existing paradigm of cardiac electrophysiology primarily focuses on the intracardiac conduction system and volume conduction through interstitial fluid to explain the electrocardiogram (ECG). However, this model faces limitations in fully elucidating the precise capture of phasic electrical signals at the cutaneous surface. This short communica...
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Research Article
Preparation and Performance Evaluation of Antibacterial Coatings on Medical-Grade Polymer Surfaces
Issue:
Volume 13, Issue 4, August 2025
Pages:
66-72
Received:
25 June 2025
Accepted:
21 July 2025
Published:
8 August 2025
Abstract: The application of antibacterial coating technology is directly related to solving the problem of biological pollution and infection of medical devices, but the limitations of traditional modification methods are not enough to solve this problem. Therefore, the new antibacterial coating strategy pays more attention to the combined suppression of bacteria through multi-level mixing of materials and process improvement. Function. For example, the composite coating composed of chitosan derivatives and multi-metal oxides has the effect of temperature sensitivity and self-repair, which can ensure its ability to maintain antibacterial activity in various environments; the micro-absorption coating generated by two-step immersion of egg white protein and tannic acid can effectively reduce the adhesion and load-bearing of microorganisms. The continuous sterilization effect of nanosilver; the step-by-step precipitation method can form a continuous and tight chitosan coating on complex surfaces, providing physical barriers and biological activation; the superhydrophobic coating improves the anti-fouling performance through the nanometer-scale porous structure; the coating with high transmittance achieves the flatness between optical properties and antibacterial properties. Weigh. The future development direction focuses on the design of intelligent reaction, the application of environmental protection materials and the overcoming of the process standardization problem of clinical transformation, so that coating technology will develop in the direction of high efficiency, safety and multi-functional integration.
Abstract: The application of antibacterial coating technology is directly related to solving the problem of biological pollution and infection of medical devices, but the limitations of traditional modification methods are not enough to solve this problem. Therefore, the new antibacterial coating strategy pays more attention to the combined suppression of ba...
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Research Article
The Application of Kneeling Exercise, Guided by the Tendon-Bone Balance Theory, as a Public Health Strategy in the Management of Knee Osteoarthritis
Issue:
Volume 13, Issue 4, August 2025
Pages:
73-77
Received:
13 July 2025
Accepted:
4 August 2025
Published:
16 August 2025
DOI:
10.11648/j.sd.20251304.13
Downloads:
Views:
Abstract: Background：Knee osteoarthritis (KOA) is the most common degenerative joint disease in an aging world. In China, its prevalence exceeds 85 % among people aged 70 years and older. Although current guidelines recommend exercise as first-line management, they provide little detail on which forms of exercise suit specific patient phenotypes. Existing programmers often carry high costs, require professional supervision, or depend on specialized facilities, creating barriers to population-wide implementation. Traditional Chinese Medicine (TCM) proposes the “tendon–bone balance” theory, which maintains that coordinated muscle and bone function is essential for joint integrity; however, modern empirical evidence for this concept is lacking. Kneeling ambulation—an equipment-free, home-based manoeuvre rooted in traditional practice—has been proposed as a highly accessible intervention, yet its biomechanical mechanisms and clinical efficacy have never been rigorously examined. Objective：Guided by the TCM “tendon–bone balance” theory, we aimed to evaluate the biomechanical effects and clinical efficacy of kneeling ambulation in KOA patients and to explore its potential as a public-health strategy. Methods：Biomechanical study: Twenty healthy volunteers underwent three-dimensional gait analysis and surface electromyography while kneeling and while walking normally; thirteen additional volunteers completed repeat sessions to verify reliability. Clinical study: In a single-centre randomized controlled trial, 30 participants who met the 2015 OARSI/AAOS criteria for KOA were randomly assigned to a kneeling group (three 5-minute sessions daily for 12 weeks) or to a no-exercise control group. The primary endpoints were total and pain scores on the WOMAC; secondary endpoints included the isokinetic peak flexor/extensor torque ratio at 60 °/s, knee range of motion, and safety. Results：Biomechanics: Compared with walking, kneeling increased peak knee flexion range of motion (117° vs 48°, P < 0.05) and reduced the knee adduction moment toward zero, shifting the load axis from the medial to the lateral compartment. Clinical: After 12 weeks, the kneeling group showed significantly greater improvements than controls in total WOMAC score (P = 0.013) and pain score (P = 0.012), a flexor/extensor torque ratio closer to unity (P < 0.05), and a marked increase in maximum knee flexion angle (P < 0.01); no serious adverse events were reported. Conclusion：Kneeling ambulation redistributes joint load and restores balanced flexor–extensor strength, leading to clinically meaningful pain relief and functional improvement. Its low cost, lack of required equipment, and suitability for home use position it as an evidence-based, scalable adjunct for population-level KOA prevention and management.
Abstract: Background：Knee osteoarthritis (KOA) is the most common degenerative joint disease in an aging world. In China, its prevalence exceeds 85 % among people aged 70 years and older. Although current guidelines recommend exercise as first-line management, they provide little detail on which forms of exercise suit specific patient phenotypes. Existing pr...
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