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Diabetes mellitus (DM) is a chronic disease with a remarkable global burden on the affected patients and healthcare systems. Among the reported complications, the diabetic foot has been reported to be a common one, which might be disabling, resulting in related amputations. Furthermore, we will provide evidence regarding the effect of education on the awareness and knowledge of diabetic Saudis about diabetic foot risk factors and management practices. Different risk factors were reported for developing diabetic foot among patients with DM. These will be studied in the current literature review, focusing on evidence that was conducted in Saudi Arabia. Age, gender, type of diabetes, education, duration of the disease, peripheral neuropathy, erythrocyte sedimentation rate, peripheral vascular disease, ischemic heart disease, renal artery disease, having a previous history of diabetic foot, and hypertension were all reported to be significant factors that were associated with the risk of developing diabetic foot across the Kingdom. The level of knowledge was variable across the different investigations. However, there is a poor attitude in general about the appropriate care practices of diabetic foot. Although it has been demonstrated that educational campaigns are effective, further efforts are still needed to increase awareness and attitude levels among diabetic patients in Saudi Arabia.

Piezoelectric materials have attracted more attention than other materials in the field of textiles. Piezoelectric materials offer advantages as transducers, sensors, and energy-harvesting devices. Commonly, ceramics and quartz are used in such applications. However, polymeric piezoelectric materials have the advantage that they can be converted into any shape and size. In smart textiles, polyvinylidene fluoride (PVDF) and other piezoelectric polymers are used in the form of fibers, filaments, and composites. In this research, PVDF nanofibers were developed and integrated onto a knitted fabric to fabricate a piezoelectric device for human body angle monitoring. Scanning electron microscopy and X-ray diffraction analyses were used to study the morphology and to confirm the beta phase in fibers. The results reveal that the nanofibers made from solutions with high concentration were smooth and defect-free, compared to the fibers obtained from solutions with low concentration, and possess high crystallinity as well. Under high dynamic strain more output voltage is generated than under low dynamic strain. The maximum current density shown by the device is 172.5 nA/cm2. The developed piezoelectric nanofiber sensor was then integrated into a knitted fabric through stitching to be used for angle measurement. With increasing bending angle, the output voltage increased. The promising results show that the textile-based piezoelectric sensor developed in this study has a great potential to be used as an angle measuring wearable device for the human body due to its high current density output and flexibility.

Laparoscopy has been introduced as a minimally invasive approach that has been developed to achieve the intended outcomes by open surgeries but with less frequent body injuries and complications. However, evidence indicates that the reported favourable outcomes are mainly based on retrospective data and using historical controls and only a few prospective investigations and clinical trials were published. Furthermore, studies have also demonstrated that following laparoscopy, severe pain can develop similar to or equal to the pain reported during open surgeries that develop within the earliest hours due to the significant tissue trauma introduced by laparoscopy. The present literature review discussed the different causes and types of chronic pain following laparoscopy. We also shed more light on the potential mechanisms and pathophysiology that attributes to the development of pain following laparoscopy. Many studies have indicated the development of chronic pain after 3, 6 and 12 months after hysterectomy, cholecystectomy, nephrectomy, colorectal surgeries and other abdominal surgeries. The development of postoperative main might be attributed to the tissue or nerve injury and associated inflammatory status that can also aid to the development of pain in such settings. Evidence also shows that the incidental pain following laparoscopy is similar or superior to that following open surgeries. Therefore, further interventional approaches are needed to enhance the outcomes.

In backdrop of growing requirement of flexible and wearable energy storage systems, textile- based supercapacitors having good flexibility, durability, superior charging-discharging rates, high power densities, cost-effective is of crucial importance in the field of wearable electronics. Applicability of cost effective, wearable and flexible textile-based supercapacitors having both synergetic effect of electric double layer capacitance combined with pseudocapacitance of conducting polymer having good electroactivity, thermal and environmental stability, repeated usability with negligible degradation is desired. Herein, supercapacitor based upon textile fabrics will be reviewed from the perspective of electrochemical , mechanical, and thermal properties without compromising flexibility, durability, and comfort of textile fabric.

Conducting surgery might be challenging during the pandemic, especially for COVID-19 patients. This is because of the high transmissibility rate of the infection, which might lead to spreading the infection. Moreover, surgery might be associated with further risk over affected patients, a significant contributor to the operated patients' impaired immunity and generalized inflammatory state. Surgery is usually associated with an increased risk of high-stress levels and a generalized inflammatory state flare-up. The present literature review discusses the mortality rates and associated factors for COVID-19 patients during the incubation period. Our findings show that these patients have higher mortality rates as surgery influences the release of high levels of proinflammatory cytokines. Besides, surgery might impair the immune functions leading to progressive deterioration of COVID-19. On the other hand, it has been reported that COVID-19 can also worsen the outcomes and increase the risk of morbidities and mortality among patients undergoing surgery. Different factors have been identified to contribute to this risk, including old age, being male, and the presence of comorbidities. Therefore, avoiding surgery during infection is suggested to reduce the risk of mortality, especially among patients with multiple risk factors. However, it should be noted that this evidence needs further validation.

The field of surgery has been greatly affected during the pandemic due to the shift of resources to manage the huge numbers of COVID-19 cases. In this study, we aim to review the effect of the COVID-19 pandemic and lockdown measures on elective surgeries and the subsequent complications, in addition to the previously announced preparations and precautions for performing surgeries whenever indicated. Preparations include the availability of resources and performing each surgery in separate rooms away from other wards within the hospital to prevent any possibility of nosocomial infections. Moreover, limiting the number of individuals within the operation room and wearing personal protective equipment should be done. Limiting hospital visits and reducing in-hospital stays is also recommended. Regarding cancer operations, malignant tumors that were indicated for surgeries cannot be postponed. However, other non-malignant ones can be delayed depending on the pathologist's perspective and the symptomatology of the tumor. Besides, other surgeries like plastic and reconstructive ones can be re-scheduled. Additionally, most surgeries like urologic, orthopedic, and neurological operations can be delayed unless they are associated with a life-threatening lesion that can only be healed by surgical interference. On the other hand, palliative surgeries aiming to manage obstructions of the gastrointestinal tract cannot be delayed.

Practical usage of piezoelectric nanogenerators (PENGs) under heavy loading environments for high power generation, such as smart shoes, has been limited due to the low mechanical endurance of many piezoelectric materials. Durability and performance under harsh environments are a stumbling block for the practical application of PENGs. Synthesis of piezoelectrically enhanced nanofibers electrospun from nanocomposite of barium titanate nanoparticles (BT NPs) dispersed in poly(vinylidene fluoride-trifluoroethylene) (P(VDF-TrFE)) enables successful fabrication of a robust, efficient, flexible and lead-free PENG. A nanofiber PENG (nf-PENG) fabricated by embedding nanocomposite nanofibers in an elastomer film is demonstrated for biomechanical energy harvesting and storage during walking. When placed inside of a shoe, a nf-PENG loaded with 15 wt% BT NPs can generate an output of 25 V at a walking frequency of 0.6 Hz with high mechanical durability under very high loads (600 N). This can charge a 4.7 µF capacitor after approximately 72 steps. The stored charge can operate a strain sensor without any external power supply. The high performance of the nf-PENG is mainly attributed to the self-poled nanocomposite nanofibers. Additionally, embedding the nanofibers into an elastomer provided high durability by protecting the nanofibers from mechanical damage. Furthermore, the devices small form factor, flexibility, and transparency make this nf-PENG suitable for applications in wearable electronics, where aesthetics and comfort are also desired (in addition to performance). This work demonstrates the possibility of highly durable, efficient, and self-powered wearable sensing systems that can work under extreme environments.

Glass Fiber Reinforced Polymer (GFRP) composites have been widely used in advanced engineering applications, mainly in the automotive and aerospace industries. Due to its anisotropic nature, the damage and failure detection in composites under real-time loading are very complicated. Focusing on this problem, Multi-Walled Carbon Nanotubes (MWCNTs) based strain sensor for Structural Health Monitoring (SHM) of Fibre Reinforced Polymer (FRP) composites is proposed in this research. This study primarily aims to detect induced flexural strains and damages occurring in the composites in real-time for which glass fibers coated with carboxy and amide functionalized MWCNTs have been used as sensors. The interactions between MWCNTs and fiber surface were confirmed with FTIR. Carbon fiber sensors have been used for comparison. The sensors were embedded into GFRP composites which were subjected to three-point bending tests coupled with electrical resistance measurement to correlate the induced strain and damages with the fractional change in resistance across sensors. The electromechanical test results indicated that MWCNT coated sensors in GFRP composites show promising piezoresistive sensing characteristics with good cyclic reproducibility that is significant for in-situ strain monitoring and damage detection. Overall the highest strain sensitivity was observed with amide functionalized MWCNT sensors. The electrical response to temperature cycles showed a reproducible behavior with −8% relative resistance change within the temperature range of −10 °C to 80 °C which also signifies multifunctional characteristics of developed sensors.

Flexible chemical sensors utilizing chemically sensitive nanomaterials are of great interest for wearable sensing applications. However, obtaining high performance flexible chemical sensors with high sensitivity, fast response, transparency, stability, and workability at ambient conditions is still challenging. Herein, a newly designed flexible and transparent chemical sensor of reduced graphene oxide (R-GO) coupled with organic dye molecules (bromophenol blue) is introduced. This device has promising properties such as high mechanical flexibility (>5000 bending cycles with a bending radius of 0.95 cm) and optical transparency (>60% in the visible region). Furthermore, stacking the water-trapping dye layer on R-GO enables a higher response as well as workability in a large relative humidity range (up to 80%), and dual-mode detection capabilities of colorimetric and electrical sensing for NH3 gas (5–40 ppm). These advantageous attributes of the flexible and transparent R-GO sensor coupled with organic dye molecules provide great potential for real-time monitoring of toxic gas/vapor in future practical chemical sensing at room conditions in wearable electronics.

Human skin is highly stretchable at low strain but becomes self-limiting when deformed at large strain due to stiffening caused by alignment of a network of stiff collagen nanofibers inside the tissue beneath the epidermis. To imitate this mechanical behavior and the sensory function of human skin, we fabricated a skin-like substrate with highly stretchable, transparent, tough, ultrathin, mechanosensory, and self-limiting properties by incorporating piezoelectric crystalline poly((vinylidene fluoride)- co-trifluoroethylene) (P(VDF-TrFE)) nanofibers with a high modulus into the low modulus matrix of elastomeric poly(dimethylsiloxane). Randomly distributed P(VDF-TrFE) nanofibers in the elastomer matrix conferred a self-limiting property to the skin-like substrate so that it can easily stretch at low strain but swiftly counteract rupturing in response to stretching. The stretchability, toughness, and Young's modulus of the ultrathin (∼62 μm) skin-like substrate with high optical transparency could be tuned by controlling the loading of nanofibers. Moreover, the ultrathin skin-like substrate with a stretchable temperature sensor fabricated on it demonstrated the ability to accommodate bodily motion-induced strain in the sensor while maintaining its mechanosensory and thermosensory functionalities.

Flexible magnetoelectric (ME) materials have been studied for new applications such as memory, energy harvesters, and magnetic field sensors. Herein, with the widely studied and progressive advantages of ME phenomena in the multiferroic field, we demonstrate a new approach for utilizing flexible ME materials as gate dielectric layers in ME organic field-effect transistors (ME-OFET) that can be used for sensing a magnetic field and extracting the ME properties of the gate dielectric itself. The magnetoelectric nanohybrid gate dielectric layer comprises sandwiched stacks of magnetostrictive CoFe2O4 nanoparticles and a highly piezoelectric poly(vinylidene fluoride-co-trifluoroethylene) layer. While varying the magnetic field applied to the ME gate dielectric, the ME effect in the functional gate dielectric modulates the channel conductance of the ME-OFET owing to a change in the effective gate field. The clear separation of the ME responses in the gate dielectric layer of ME-OFET from those of the other parameters was demonstrated using the AC gate biasing method and enabled the extraction of the ME coefficient of ME materials. Additionally, the device shows high stability after cyclic bending of 10,000 cycles at a banding radius of 1.2 cm. The device has significant potential for not only the extraction of the intrinsic characterization of ME materials but also the sensing of a magnetic field in integrated flexible electronic systems.

Flexible supercapacitors with high electrochemical performance and stability along with mechanical robustness have gained immense attraction due to the substantial advancements and rampant requirements of storage devices. To meet the exponentially growing demand of microsized energy storage device, a cost-effective and durable supercapacitor is mandatory to realize their practical applications. Here, in this work, the fabrication route of novel electrode materials with high flexibility and charge-storage capability is reported using the hybrid structure of 1D zinc oxide (ZnO) nanorods and conductive polyvinylidene fluoride-tetrafluoroethylene (P(VDF-TrFE)) electrospun nanofibers. The ZnO nanorods are conformably grown on conductive P(VDF-TrFE) nanofibers to fabricate the light-weighted porous electrodes for supercapacitors. The conductive nanofibers acts as a high surface area scaffold with significant electrochemical performance, while the addition of ZnO nanorods further enhances the specific capacitance by 59%. The symmetric cell with the fabricated electrodes presents high areal capacitance of 1.22 mF cm-2 at a current density of 0.1 mA cm-2 with a power density of more than 1600 W kg-1 . Furthermore, these electrodes show outstanding flexibility and high stability with 96% and 78% retention in specific capacitance after 1000 and 5000 cycles, respectively. The notable mechanical durability and robustness of the cell acquire both good flexibility and high performance.

Stretchable piezoelectric nanogenerators (SPENGs) for human kinematics energy harvesting have limited use due to the low stretchability or mechanical robustness and the difficulty of structural design for omnidirectional stretchability. This study reports an efficient, omnidirectionally stretchable, and robust SPENG based on a stretchable graphite electrode on a 3D micropatterned stretchable substrate and a stacked mat of piezoelectric nanofibers. The stacked mat of free-standing nanofibers is alternatively composed of nanocomposite nanofibers of barium titanate nanoparticles embedded in polyurethane and poly(vinylidene fluoride-trifluoroethylene) nanofibers. The nanofiber SPENG (nf-SPENG) exhibits a high stretchability of 40% and high mechanical durability up to 9000 stretching cycles at 30% strain, which are attributed to the stress-relieving nature of the 3D micropattern on the substrate and the free-standing stacked hybrid nanofibers. The nf-SPENG produces a peak open circuit voltage (Voc) and short circuit current (Isc) of 9.3 V and 189 nA, respectively. The nf-SPENG is demonstrated to harvest the energy from human kinematics while walking when placed over the knee cap of a subject, generating a maximum Voc of 10.1 V. The omnidirectional stretchability, efficiency, facile fabrication process, mechanical durability, environmentally friendly lead-free components, and response to multimodal straining make this device suitable for self-powered wearable sensing systems.

Human machine interface technology is focused upon new ways of interaction between human beings and machines. Gesture recognition gloves are getting increasingly popular as human-machine interface devices. Conventionally, these gloves use electronic sensors to sense different hand gestures. As electronic sensors are bulky and uncomfortable, we propose a glove with textile based piezoresistive yarn sensors. This glove is flexible, more comfortable and cheap as compared to the conventional human machine interface gloves. We have examined that this glove can effectively sense our gestures and can be used for teleoperations, sign language to speech conversion systems and gaming.

A flexible ultraviolet (UV) photodetector based on ZnO nanorods (NRs) as nanostructure sensing materials integrated into a graphene (Gr) field-effect transistor (FET) platform is investigated with high performance. Based on the negative shift of the Dirac point (VDirac) in the transfer characteristics of a phototransistor, high-photovoltage responsivity (RV) is calculated with a maximum value of 3 × 10(8) V W(-1). The peak response at a wavelength of ∼365 nm indicated excellent selectivity to UV light. The phototransistor also allowed investigation of the photocurrent responsivity (RI) and photoconductive gain (G) at various gate voltages, with maximum values of 2.5 × 10(6) A W(-1) and 8.3 × 10(6), respectively, at a gate bias of 5 V. The UV response under bending conditions was virtually unaffected and was unchanged after 10,000 bending cycles at a bending radius of 12 mm, subject to a strain of 0.5%. The attributes of high stability, selectivity, and sensitivity of this flexible UV photodetector based on a ZnO NRs/Gr hybrid FET indicate promising potential for future flexible optoelectronic devices.

Aim To investigate the types of clinical clothing worn by dentists and how frequently dentists changed into a clean set of clinical clothing. Study Type Cross-sectional questionnaire-based survey.Sample Two hundred and fifty general dental practitioners (GDPs) in the NHS with North West of England region and 250 dentists in the Dental Defence Agency (DDA).Method A questionnaire was developed which aimed to investigate the types of clothing worn for upper and lower body protection, and how frequently it was changed. This was posted to the sample of dental surgeons. Results Ninety per cent of GDPs and 99 per cent of DDA dentists reported wearing some form of clinical clothing to protect their upper body. Twenty-nine per cent of GDPs and 93 per cent of DDA dentists wore some form of designated clinical clothing to protect their lower body. Less than 50 per cent of both groups reported changing clothing on a daily basis. Thirty-six per cent of GDPs and 96 per cent of DDA dentists removed their clinical clothing before leaving work.Conclusion Dentists generally wear appropriate clinical clothing for their upper body protection but fall short of the guidelines for lower body protection. To improve cross infection control dental surgeons need to improve the frequency of changing into a clean set of clinical clothing.

To pursue high-performance energy storage devices with both high energy density and power density, one-dimensional (1D) nanostructures play a key role in the development of functional devices including energy conversion, energy storage, and environmental devices. The polyacrylonitrile (PAN) nanofibers were obtained by the versatile electrospinning method. An ultra-thin nickel–cobalt sulfide (NiCoS) layer was conformably electrodeposited on a self-standing PAN nanofibers by cyclic voltammetry to fabricate the light-weighted porous electrodes for supercapacitors. The porous web of PAN nanofibers acts as a high-surface-area scaffold with significant electrochemical performance, while the electrodeposition of metal sulfide nanosheet further enhances the specific capacitance. The fabricated NiCoS on PAN (NiCoS/PAN) nanofibers exhibits a very high capacitance of 1513 F g−1 at 5 A g−1 in 1 M potassium chloride (KCl) aqueous electrolyte with superior rate capability and excellent electrochemical stability as a hybrid electrode. The high capacitance of the NiCoS is attributed to the large surface area of the electrospun PAN nanofibers scaffold, which has offered a large number of active sites for possible redox reaction of ultra-thin NiCoS layer. Benefiting from the compositional features and electrode architectures, the hybrid electrode of NiCoS/PAN nanofibers shows greatly improved electrochemical performance with an ultra-high capacitance (1124 F g−1 at 50 A g−1). Moreover, a binder-free asymmetric supercapacitor device is also fabricated by using NiCoS/PAN nanofibers as the positive electrode and activated carbon (MSP-20) on PAN nanofibers as the negative electrode; this demonstrates high energy density of 56.904 W h kg−1 at a power density of 1.445 kW kg−1, and it still delivers the energy density of 33.3923 W h kg−1 even at higher power density of 16.5013 kW kg−1.

For realization of wearable and smart electronics, developments of physical, chemical and biological sensors and sensor-integrated platforms are essentially required. For various applications such as smart health, cars, buildings or environments in the future, highly sensitive and reliable sensors with new functionalities such as flexibility, stretchability and/or optical transparency are to be integrated in various platforms including watch, glasses, smart phones, textiles, shoes, band, patch and etc. In this presentation, we demonstrate ultrasensitive flexible, stretchable and/or transparent physical (strain, pressure, temperature, IR, UV and visible light), chemical (gases, ions) and biological (protein, DNA, enzyme and small molecule) sensing devices based on low-dimensional nanoscale materials (0D, 1D and 2D), nanocomposites and hierarchical nanohybrids in FET, resistor and optical transducers. Some examples of patchable integrated platforms with multiple sensors or sensor-energy harvester-supercapacitor are presented for monitoring of physiological parameters, emotional expressions, body motions, daily activities of human.