Empirical BRDF model for goniochromatic materials and soft proofing with reflective inks.

The commonly used analytic bidirectional reflectance distribution functions (BRDFs) do not model goniochromatism, that is, angle-dependent material color. The material color is usually defined by a diffuse reflectance spectrum or RGB vector and a specular part based on a spectral complex index of refraction. Extension of the commonly used BRDFs based on wave theory can help model goniochromatism, but this comes at the cost of significant added model complexity. We measured the goniochromatism of structual color pigments used for additive color printing and found that we can fit the observed spectral angular dependence of the bidirectional reflectance using a simple modification of the standard microfacet BRDF model. All we need to describe the goniochromatism is an empirically-based spectral parameter, which we use in our model together with a specular reflectance spectrum instead of the spectral complex index of refraction. We demonstrate the ability of our model to fit the measured reflectance of red, green, and blue commercial structural color pigments. Our BRDF model enables straightforward implementation of a shader for interactive preview of 3D objects with printed spatially and angularly varying texture.

Diagnostic error in the pediatric hospital: a narrative review.

INTRODUCTION: Diagnostic error is a prevalent type of medical error that is associated with considerable patient harm and increased medical costs. The majority of literature guiding the current understanding of diagnostic error in the hospital setting is from adult studies. However, there is research to suggest this type of error is also prevalent in the pediatric specialty. OBJECTIVES: The primary objective of this study was to define the current understanding of diagnostic error in the pediatric hospital through a structured literature review. METHODS: We searched PubMed and identified studies focusing on three aspects of diagnostic error in pediatric hospitals: the incidence or prevalence, contributing factors, and related interventions. We used a tiered review, and a standardized electronic form to extract data from included articles. RESULTS: Fifty-nine abstracts were screened and 23 full-text studies were included in the final review. Seventeen of the 23 studies focused on the incidence or prevalence, with only 3 studies investigating the utility of interventions. Most studies took place in an intensive care unit or emergency department with very few studies including only patients on the general wards. Overall, the prevalence of diagnostic error in pediatric hospitals varied greatly and depended on the measurement technique and specific hospital setting. Both healthcare system factors and individual cognitive factors were found to contribute to diagnostic error, with there being limited evidence to guide how best to mitigate the influence of these factors on the diagnostic process. CONCLUSION: The general knowledge of diagnostic error in pediatric hospital settings is limited. Future work should incorporate structured frameworks to measure diagnostic errors and examine clinicians' diagnostic processes in real-time to help guide effective hospital-wide interventions.

How Should Risks Posed by Decision Support Be Managed?

Managing risk in cases that involve the use of clinical decision support tools is ethically complex. This article highlights some of these complexities and offers 3 considerations for risk managers to draw upon when assessing risk in cases using clinical decision support: (1) the type of decision support offered, (2) how well a decision support tool helps accomplish work that needs to be done, and (3) how well values embedded in a tool align with patients' and caregivers' professed values.

Methods for Patient-Centered Interface Design of Test Result Display in Online Portals.

OBJECTIVES: Patients have unique information needs to help them interpret and make decisions about laboratory test results they receive on web-based portals. However, current portals are not designed in a patient-centered way and little is known on how best to harness patients' information needs to inform user-centered interface design of portals. We designed a patient-facing laboratory test result interface prototype based on requirement elicitation research and used a mixed-methods approach to evaluate this interface. METHODS: After designing an initial test result display prototype, we used multiple evaluation methods, including focus group review sessions, expert consultation, and user testing, to make iterative design changes. For the user testing component, we recruited 14 patient-users to collect and analyze three types of data: comments made during testing sessions, responses to post-session questionnaires, and system usability scores. RESULTS: Our initial patient-centered interface design included visual ranges of laboratory values, nontechnical descriptions of the test and result, and access to features to help patients interpret and make decisions about their results. Findings from our evaluation resulted in 6 design iterations of the interface. Results from user testing indicate that the later versions of the interface fulfilled patient's information needs, were perceived as usable, and provided access to information and techniques that facilitated patient's ability to derive meaning from each test result. CONCLUSIONS: Requirement elicitation studies can inform the design of a patient-facing test result interface, but considerable user-centered design efforts are necessary to create an interface that patients find useful. To promote patient engagement, health information technology designers and developers can use similar approaches to enhance user-centered software design in patient portals.

Patient perceptions of receiving test results via online portals: a mixed-methods study.

Objective: Online portals provide patients with access to their test results, but it is unknown how patients use these tools to manage results and what information is available to promote understanding. We conducted a mixed-methods study to explore patients' experiences and preferences when accessing their test results via portals. Materials and Methods: We conducted 95 interviews (13 semistructured and 82 structured) with adults who viewed a test result in their portal between April 2015 and September 2016 at 4 large outpatient clinics in Houston, Texas. Semistructured interviews were coded using content analysis and transformed into quantitative data and integrated with the structured interview data. Descriptive statistics were used to summarize the structured data. Results: Nearly two-thirds (63%) did not receive any explanatory information or test result interpretation at the time they received the result, and 46% conducted online searches for further information about their result. Patients who received an abnormal result were more likely to experience negative emotions (56% vs 21%; P = .003) and more likely to call their physician (44% vs 15%; P = .002) compared with those who received normal results. Discussion: Study findings suggest that online portals are not currently designed to present test results to patients in a meaningful way. Patients experienced negative emotions often with abnormal results, but sometimes even with normal results. Simply providing access via portals is insufficient; additional strategies are needed to help patients interpret and manage their online test results. Conclusion: Given the absence of national guidance, our findings could help strengthen policy and practice in this area and inform innovations that promote patient understanding of test results.

Biomimetic surface modification of honeycomb films via a "grafting from" approach.

Hydrophobic isoporous membranes were fabricated using the "breath figure" method from polystyrene stars synthesized via ATRP. The living polymer chain ends at the surface of the films were then used, without further modification, in a "grafting-from" approach to grow surface-linked polyglycidyl methacrylate chains under conditions that maintained the regular honeycomb structure. This versatile functional surface was then used as a platform to build a small library of surfaces using a variety of simple chemistries: (i) the acid hydrolysis of the epoxide to form bis-alcohol groups and (ii) utilizing the "click-like" epoxide-amine reaction to functionalize the surface with a model biomolecule-(biotinamido)pentylamine. The successful modifications were confirmed by a combination of spectroscopic and biological means. Changes in the growth characteristics of nonmotile Psychrobacter sp. strain, SW5, on the honeycomb films, provided further evidence confirming changes in the hydrophobicity of the surface upon grafting.

Bifunctional dendrimers: from robust synthesis and accelerated one-pot postfunctionalization strategy to potential applications.

A fourth wheel: Two sets of bifunctional AB(2)C dendrimers having internal acetylene/azides and external hydroxy groups were constructed utilizing benign synthetic protocols. An in situ postfunctionalization strategy was successfully carried out to illustrate the chemoselective nature of these dendrimers. The dendrimers were also transformed into dendritic nanoparticles or utilized as dendritic crosslinkers for the fabrication hydrogels.

Superhydrophobic and self-cleaning bio-fiber surfaces via ATRP and subsequent postfunctionalization.

Superhydrophobic and self-cleaning cellulose surfaces have been obtained via surface-confined grafting of glycidyl methacrylate using atom transfer radical polymerization combined with postmodification reactions. Both linear and branched graft-on-graft architectures were used for the postmodification reactions to obtain highly hydrophobic bio-fiber surfaces by functionalization of the grafts with either poly(dimethylsiloxane), perfluorinated chains, or alkyl chains, respectively. Postfunctionalization using alkyl chains yielded results similar to those of surfaces modified by perfluorination, in terms of superhydrophobicity, self-cleaning properties, and the stability of these properties over time. In addition, highly oleophobic surfaces have been obtained when modification with perfluorinated chains was performed.

Intelligent dual-responsive cellulose surfaces via surface-initiated ATRP.

Novel thermo-responsive cellulose (filter paper) surfaces of N-isopropylacrylamide (NIPAAm) and pH-responsive cellulose surfaces of 4-vinylpyridine (4VP) have been achieved via surface-initiated ATRP. Dual-responsive (pH and temperature) cellulose surfaces were also obtained through the synthesis of block-copolymer brushes of PNIPAAm and P4VP. With changes in pH and temperature, these "intelligent" surfaces showed a reversible response to both individual triggers, as indicated by the changes in wettability from highly hydrophilic to highly hydrophobic observed by water contact angle measurements. Adjusting the composition of the grafted block-copolymer brushes allowed for further tuning of the wettability of these "intelligent" cellulose surfaces.

Dendronized hydroxypropyl cellulose: synthesis and characterization of biobased nanoobjects.

Dendronized polymers containing a cellulose backbone have been synthesized with the aim of producing complex molecules with versatile functionalization possibilites and high molecular weight from biobased starting materials. The dendronized polymers were built by attaching premade acetonide-protected 2,2-bis(methylol)propionic acid functional dendrons of generation one to three to a hydroxypropyl cellulose backbone. Deprotection or functionalization of the end groups of the first generation dendronized polymer to hydroxyl groups and long alkyl chains was performed, respectively. The chemical structures of the dendronized polymers were confirmed through analysis using (1)H NMR and FT-IR spectroscopies. From SEC analysis, the dendronized polymers were found to have an increasing polystyrene-equivalent molecular weight up to the second generation ( M n = 50 kg mol (-1)), whereas the polystyrene-equivalent molecular weight for the third generation was lower than for the second, although the same grafting density was obtained from (1)H NMR spectroscopy for the second and third generations. Tapping-mode atomic force microscopy was used to characterize the properties of the dendronized polymers in the dry state, exploring both the effect of the polar substrate mica and the less polar substrate highly oriented pyrolytic graphite (HOPG). It was found that the molecules were in the size range of tens of nanometers and that they were apt to undertake a more elongated conformation on the HOPG surfaces when long alkyl chains were attached as the dendron end-groups.

A chemoselective approach for the accelerated synthesis of well-defined dendritic architectures.

A chemoselective and layered growth approach has been developed for the synthesis of dendrimers, combining Click chemistry with traditional esterification/etherification reactions, without the need for activation steps and with excellent overall yields.

Superhydrophobic bio-fibre surfaces via tailored grafting architecture.

Superhydrophobic bio-fibre surfaces with a micro-nano-binary surface structure have been achieved via the surface-confined grafting of glycidyl methacrylate, using a branched "graft-on-graft" architecture, followed by post-functionalisation to obtain fluorinated brushes.

Self-assembly of poly(9,9'-dihexylfluorene) to form highly ordered isoporous films via blending.

Highly ordered hexagonal arrays of isoporous films prepared from poly(9,9'-dihexylfluorene) and polystyrene-grafted silica nanoparticles (Si-graft-PS) are presented. These close-packed arrays were formed in areas of many square millimeters. The pore size varied from 3.6 to 8.5 microm, depending on the concentration of Si-graft-PS and the processing conditions. Solid-state photoluminescence resulted in a significant red shift of up to 30 nm in these films compared to that in conventional processing techniques. These differences are attributed to enhanced aggregation of the polymers caused by polymer-solvent interactions. These highly ordered polymer films may find use in microelectronic and biological and/or chemical sensor applications.