Sensor-Assisted Wound Therapy in Plantar Diabetic Foot Ulcer Treatment: A Randomized Clinical Trial.

BACKGROUND: Offloading is the cornerstone of treatment of plantar diabetic foot ulcers. It limits mobility with consequent psychological and cardiovascular side effects, and if devices are removed, healing is delayed. METHODS: We developed three non-removable techniques with increasing offloading potential (multilayer felt sole, felt-fiberglass sole, or total contact casts with ventral windows) and sensors built within. Smartwatch and web apps displayed pressure, temperature, humidity, and steps. They alerted patients, staff, and a telemedicine center when pressure limits (125 kPa) were exceeded. Patients were advised to walk as much as they had done before the ulcer episode. To evaluate the potential of this intervention, we enrolled 20 ambulatory patients in a randomized clinical trial. The control group used the same offloading and monitoring system, but neither patients nor therapists received any information or warnings. RESULTS: Three patients withdrew consent. The median time to healing of ulcers was significantly shorter in the intervention group compared with controls, 40.5 (95% confidence interval [CI] = 28-not applicable [NA]) versus 266.0 (95% CI = 179-NA) days (P = .037), and increasing ulcer area was observed less frequently during study visits (7.9% vs 29.7%, P = .033). A reduction of wound area by 50% was reached at a median of 10.2 (95% CI = 7.25-NA) versus 19.1 (95% CI = 13.36-NA) days (P = .2). Participants walked an average of 1875 (SD = 1590) steps per day in intervention group and 1806 (SD = 1391) in the control group. CONCLUSIONS: Sensor-assisted wound therapy may allow rapid closure of plantar foot ulcers while maintaining patient's mobility during ulcer therapy.

Photochemistry with Cyanines in the Near Infrared: A Step to Chemistry 4.0 Technologies.

Cyanines covering the absorption in the near infrared (NIR) are attractive for distinct applications. They can interact either with lasers exhibiting line-shaped focus emitting at both 808 and 980 nm or bright high intensity NIR-LEDs with 805 nm emission, respectively. This is drawing attention to Industry 4.0 applications. The major deactivation occurs through a non-radiative process resulting in the release of heat into the surrounding, although a small fraction of radiative deactivation also takes place. Most of these NIR-sensitive systems possess an internal activation barrier to react in a photonic process with initiators resulting in the generation of reactive radicals and acidic cations. Thus, the heat released by the NIR absorber helps to bring the system, consisting of an NIR sensitizer and initiator, above such internal barriers. Molecular design strategies making these systems more compatible with distinct applications in a certain oleophilic surrounding are considered as a big challenge. This includes variations of the molecular pattern and counter ions derived from super acids exhibiting low coordinating properties. Further discussion focusses on the use of such systems in Chemistry 4.0 related applications. Intelligent software tools help to improve and optimize these systems combining chemistry, engineering based on high-throughput formulation screening (HTFS) technologies, and machine learning algorithms to open up novel solutions in material sciences.