Skin color-specific and spectrally-selective naked-eye dosimetry of UVA, B and C radiations.

Spectrally-selective monitoring of ultraviolet radiations (UVR) is of paramount importance across diverse fields, including effective monitoring of excessive solar exposure. Current UV sensors cannot differentiate between UVA, B, and C, each of which has a remarkably different impact on human health. Here we show spectrally selective colorimetric monitoring of UVR by developing a photoelectrochromic ink that consists of a multi-redox polyoxometalate and an e- donor. We combine this ink with simple components such as filter paper and transparency sheets to fabricate low-cost sensors that provide naked-eye monitoring of UVR, even at low doses typically encountered during solar exposure. Importantly, the diverse UV tolerance of different skin colors demands personalized sensors. In this spirit, we demonstrate the customized design of robust real-time solar UV dosimeters to meet the specific need of different skin phototypes. These spectrally-selective UV sensors offer remarkable potential in managing the impact of UVR in our day-to-day life.

Retroactive application of the new kidney allocation system to renal transplants performed in the ECD/SCD era.

The kidney allocation system (KAS) aims to improve deceased donor kidney transplant outcomes by matching of donor allografts and kidney recipients using the kidney donor risk index (KDRI) and recipient estimated post-transplant survival (EPTS) indices. In this single-center study, KAS was retroactively applied to 573 adult deceased donor kidney transplants (2004-2012) performed in the extended criteria/standard criteria donor (ECD/SCD) era. Donor KDRI and recipient EPTS were calculated, and transplants were analyzed to identify KAS fits. These were defined as allocation of top 20% allografts to top 20% recipients and bottom 80% allografts to bottom 80% recipients. On retroactive calculation, 70.2% of all transplants fit the KAS. Transplants that fit the KAS had inferior 1- and 5-yr patient survival (95.5% vs. 98.8%, p = 0.048, and 83.4% vs. 91.7%, p = 0.018) and similar 1- and 5-yr graft survival compared to transplants that did not fit the KAS (91.3% vs. 94.1%, p = 0.276, and 72.7% vs. 73.9%, p = 0.561). While EPTS correlated with recipient survival (HR = 2.96, p < 0.001), KDRI correlated with both recipient (HR = 3.56, p < 0.001) and graft survival (HR = 3.23, p < 0.001). Overall, retroactive application of the KAS to transplants performed in the ECD/SCD era did not identify superior patient survival for kidneys allocated in accordance with the KAS.

Concurrent surgical patient safety indicator evaluation results in more accurate reporting and reimbursement.

We sought to determine whether concurrent (before discharge) Agency for Healthcare Research and Quality patient safety indicator evaluation would result in a more expeditious review, accurate reporting, and improved reimbursement. We compared the period of preconcurrent (preC) coding (January 2012 to June 2012) with the period after concurrent coding (postC) began (July 2012 to December 2012) for total billing errors. There were 276 records reviewed in the preC versus 424 in the postC time periods. Overall coding errors were 225 (81.5%) preC versus 365 (86.1%) postC (P = nonsignificant), whereas documentation errors were present in 26 (9.4%) preC versus 40 (9.4%) postC (P = nonsignificant). Total charges were $3,782,024 preC and $2,011,144 postC. Recodes requiring rebilling were 21 (7.6%) preC for a total of $213,723 rebilled versus four (0.9%) postC for a total of $31,327 rebilled (P < 0.0001). Time from service to review was 98.7 preC versus 52.3 postC days (P < 0.0001). Time from service until rebill submitted averaged 100.8 preC versus 54.0 postC days (P = 0.06). Concurrent review allows for more accurate reporting because recodes are completed before discharge. Billing delays prolong time to reimbursement and results in loss of revenue.