A mouldable fibreglass backslab device as a novel approach to offload chronic plantar foot ulcers: A retrospective observational audit.

BACKGROUND: Pressure offloading is a critical component of plantar foot ulcer management, including diabetes-related foot ulcers (DFU). Conventional offloading options such as total contact casting and removable knee-high walkers may be unsuitable or unsuccessful in patients with morbid obesity, intermittent lower limb oedema, high exudative wounds or poor mobility. A mouldable fibreglass backslab device (BSD) may be a practical alternative to be considered in these situations. METHODS: Data were retrospectively collected on 28 patients (29 foot ulcers) with non-healing ulcers who received a BSD to offload their foot ulcer as an extension to standard offloading care. Baseline data included: patient demographics, type of offloading prior to BSD application, date of ulcer onset, days ulcer present prior to BSD application and ulcer size at BSD initiation. Measures of success included ulcer size reduction 12 weeks post-BSD application, time to complete ulcer healing in BSD, time to 50% reduction in ulcer size post-BSD application and total number of days ulcer present. RESULTS: The median (IQR) ulcer area and ulcer duration at baseline for 19 patients (20 ulcers) who used the BSD was 1.65 (0.4-3.8) cm2 and 531 (101-635) days. At 12 weeks, the median (IQR) ulcer area was 0.3 (0-0.55) cm2 with a median (IQR) reduction of 97 (80-100) %. Nine (45%) ulcers achieved complete wound healing (100% reduction in wound size) at 12 weeks post-BSD application, and the remaining 11 (55%) ulcers achieved at least 50% reduction in wound size. The median (IQR) time to complete wound healing and 50% reduction in wound size was 71 (35-134) days and 24 (15-44) days, respectively. Nine patients ceased use of the BSD and reverted to conventional offloading before their wounds had healed. Of these, four patients achieved a 50% reduction in wound size at the 12-week mark with conventional offloading. CONCLUSION: Our preliminary data suggests that a mouldable fibreglass BSD may be a practical offloading option in the management of DFUs, especially when conventional offloading methods are unsuccessful, unsuitable or unacceptable to patients. Higher level evidence is required to demonstrate suitability or efficacy of the BSD compared to current evidence-based recommended offloading methods.

Tuning Organic Electrochemical Transistor Threshold Voltage using Chemically Doped Polymer Gates.

Organic electrochemical transistors (OECTs) have shown promise as transducers and amplifiers of minute electronic potentials due to their large transconductances. Tuning the OECT threshold voltage is important to achieve low-powered devices with amplification properties within the desired operational voltage range. However, traditional design approaches have struggled to decouple channel and materials properties from threshold voltage, thereby compromising on several other OECT performance metrics, such as electrochemical stability, transconductance, and dynamic range. In this work, simple solution-processing methods are utilized to chemically dope polymer gate electrodes, thereby controlling their work function, which in turn tunes the operation voltage range of the OECTs without perturbing their channel properties. Chemical doping of initially air-sensitive polymer electrodes further improves their electrochemical stability in ambient conditions. Thus, OECTs that are simultaneously low-powered and electrochemically resistant to oxidative side reactions under ambient conditions are demonstrated. This approach shows that threshold voltage, which is once interwoven with other OECT properties, can in fact be an independent design parameter, expanding the design space of OECTs.

Conjugated Polymers for Microwave Applications: Untethered Sensing Platforms and Multifunctional Devices.

In the past two decades, organic electronic materials have enabled and accelerated a large and diverse set of technologies, from energy-harvesting devices and electromechanical actuators, to flexible and printed (opto)electronic circuitry. Among organic (semi)conductors, organic mixed ion-electronic conductors (OMIECs) are now at the center of renewed interest in organic electronics, as they are key drivers of recent developments in the fields of bioelectronics, energy storage, and neuromorphic computing. However, due to the relatively slow switching dynamics of organic electronics, their application in microwave technology, until recently, has been overlooked. Nonetheless, other unique properties of OMIECs, such as their substantial electrochemical tunability, charge-modulation range, and processability, make this field of use ripe with opportunities. In this work, the use of a series of solution-processed intrinsic OMIECs is demonstrated to actively tune the properties of metamaterial-inspired microwave devices, including an untethered bioelectrochemical sensing platform that requires no external power, and a tunable resonating structure with independent amplitude- and frequency-modulation. These devices showcase the considerable potential of OMIEC-based metadevices in autonomous bioelectronics and reconfigurable microwave optics.

Mixed Ionic-Electronic Conduction, a Multifunctional Property in Organic Conductors.

Organic mixed ionic-electronic conductors (OMIECs) have gained recent interest and rapid development due to their versatility in diverse applications ranging from sensing, actuation and computation to energy harvesting/storage, and information transfer. Their multifunctional properties arise from their ability to simultaneously participate in redox reactions as well as modulation of ionic and electronic charge density throughout the bulk of the material. Most importantly, the ability to access charge states with deep modulation through a large extent of its density of states and physical volume of the material enables OMIEC-based devices to display exciting new characteristics and opens up new degrees of freedom in device design. Leveraging the infinite possibilities of the organic synthetic toolbox, this perspective highlights several chemical and structural design approaches to modify OMIECs' properties important in device applications such as electronic and ionic conductivity, color, modulus, etc. Additionally, the ability for OMIECs to respond to external stimuli and transduce signals to myriad types of outputs has accelerated their development in smart systems. This perspective further illustrates how various stimuli such as electrical, chemical, and optical inputs fundamentally change OMIECs' properties dynamically and how these changes can be utilized in device applications.

A transparent, self-healing and high-κ dielectric for low-field-emission stretchable optoelectronics.

Stretchable optoelectronic materials are essential for applications in wearable electronics, human-machine interfaces and soft robots. However, intrinsically stretchable optoelectronic devices such as light-emitting capacitors usually require high driving alternating voltages and excitation frequencies to achieve sufficient luminance in ambient lighting conditions. Here, we present a healable, low-field illuminating optoelectronic stretchable (HELIOS) device by introducing a transparent, high permittivity polymeric dielectric material. The HELIOS device turns on at an alternating voltage of 23 V and a frequency below 1 kHz, safe operating conditions for human-machine interactions. We achieved a brightness of 1,460 cd m-2 at 2.5 V µm-1 with stable illumination demonstrated up to a maximum of 800% strain. The materials also self-healed mechanically and electronically from punctures or when severed. We further demonstrate various HELIOS light-emitting capacitor devices in environment sensing using optical feedback. Moreover, our devices can be powered wirelessly, potentially enabling applications for untethered damage-resilient soft robots.

Healable Thermoplastic for Kinesthetic Feedback in Wearable Haptic Devices.

The word "haptics" refers to technologies designed to stimulate the tactile and kinesthetic senses. Kinesthesia-the sense of motion-is triggered by imposing forces upon the joints, tendons, and muscles to recreate the geometry and stiffness of objects, as may be useful in physical therapy or virtual reality. Here, we introduce a form of kinesthetic feedback by manipulating the mechanical properties of spandex impregnated with a thermoplastic polymer. Heating or cooling this textile-thermoplastic composite just above or below its glass transition temperature (T g) dramatically changes its mechanical properties (corresponding to a decrease in storage modulus from 36 MPa to 0.55 MPa). In the form of a glove, the composite can also be healed after inadvertent overextension in its stiffened state by heating it above its T g. When fitted with thermoelectric devices for active heating and cooling, the flexible or stiffened state of a glove can be perceived by human subjects. As an example of a human-machine interface, the glove is used to control a robotic finger. When the robotic finger makes contact with a wall, a signal is sent to thermoelectric devices in the glove to cool (stiffen the finger) and thus provide kinesthetic feedback to the user.