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Abstract BackgroundIn prehospital emergency care, providers face significant challenges in making informed decisions due to factors such as limited cognitive support, high-stress environments, and lack of experience with certain patient conditions. Effective Clinical Decision Support Systems (CDSS) have great potential to alleviate these challenges. However, such systems have not yet been widely adopted in real-world practice and have been found to cause workflow disruptions and usability issues. Therefore, it is critical to investigate how to design CDSS that meet the needs of prehospital providers while accounting for the unique characteristics of prehospital workflows. MethodsWe conducted semi-structured interviews with 20 prehospital providers recruited from four Emergency Medical Services (EMS) agencies in an urban area in the northeastern U.S. The interviews focused on the decision-making challenges faced by prehospital providers, their technological needs for decision support, and key considerations for the design and implementation of a CDSS that can seamlessly integrate into prehospital care workflows. The data were analyzed using content analysis to identify common themes. ResultsOur qualitative study identified several challenges in prehospital decision-making, including limited access to diagnostic tools, insufficient experience with certain critical patient conditions, and a lack of cognitive support. Participants highlighted several desired features to make CDSS more effective in the dynamic, hands-busy, and cognitively demanding prehospital context, such as automatic prompts for possible patient conditions and treatment options, alerts for critical patient safety events, AI-powered medication identification, and easy retrieval of protocols using hands-free methods (e.g., voice commands). Key considerations for successful CDSS adoption included balancing the frequency and urgency of alerts to reduce alarm fatigue and workflow disruptions, facilitating real-time data collection and documentation to enable decision generation, and ensuring trust and accountability while preventing over-reliance when using CDSS. ConclusionThis study provides empirical insights into the challenges and user needs in prehospital decision-making and offers practical and system design implications for addressing these issues. 

Vertical eddy diffusivity (VED) in the planetary boundary layer (PBL) has a significant impact on forecasts of tropical cyclone (TC) structure and intensity. VED uncertainties in PBL parameterizations can be partly attributed to the model’s inability to represent roll vortices (RV). In this study, RV effects on turbulent fluxes derived from a large eddy simulation (LES) by Li et al. (Geophys. Res. Lett., 2021, 48, e2020GL090703) are added to the VED parameterization of the PBL scheme within the operational Hurricane Weather Research and Forecasting (HWRF) model. RV contribution to VED is parameterized through a coefficient and varies with the RV intensity and velocity scale. A modification over land has also been implemented. This modified VED parameterization is compared with the original wind-speed-dependent VED scheme in HWRF. Retrospective HWRF forecasts of Hurricanes Florence (2018) and Laura (2020) are analyzed to evaluate the impacts of the modified VED scheme on landfalling hurricane forecasts. Results show that the modified PBL scheme with the RV effect leads to an improvement in 10-m maximum wind speed forecasts of 14%–31%, with a neutral to positive improvement for track forecasts. Improved wind structure and precipitation forecasts against observations are also noted with the modified PBL scheme. Further diagnoses indicate that the revised PBL scheme enhances moist entropy in the boundary layer over land, leading to improved TC intensity prediction compared to the original scheme. 

Understanding the microscopic origin of the superior electromechanical response in relaxor ferroelectrics requires knowledge not only of the atomic-scale formation of polar nanodomains (PNDs) but also the rules governing the arrangements and stimulated response of PNDs over longer distances. Using x-ray coherent nanodiffraction, we show the staggered self-assembly of PNDs into unidirectional mesostructures that we refer to as polar laminates in the relaxor ferroelectric 0.68PbMg_1/3Nb_2/3O₃-0.32PbTiO₃(PMN-0.32PT). We reveal the highly heterogeneous electric-field–driven responses of intra- and interlaminate PNDs and establish their correlation with the local strain and the nature of the PND walls. Our observations highlight the critical role of hierarchical lattice organizations on macroscopic material properties and provide guiding principles for the understanding and design of relaxors and a wide range of quantum and functional materials. 

Self-discharge and chemically induced mechanical effects degrade calendar and cycle life in intercalation-based electrochromic and electrochemical energy storage devices. In rechargeable lithium-ion batteries, self-discharge in cathodes causes voltage and capacity loss over time. The prevailing self-discharge model centers on the diffusion of lithium ions from the electrolyte into the cathode. We demonstrate an alternative pathway, where hydrogenation of layered transition metal oxide cathodes induces self-discharge through hydrogen transfer from carbonate solvents to delithiated oxides. In self-discharged cathodes, we further observe opposing proton and lithium ion concentration gradients, which contribute to chemical and structural heterogeneities within delithiated cathodes, accelerating degradation. Hydrogenation occurring in delithiated cathodes may affect the chemo-mechanical coupling of layered cathodes as well as the calendar life of lithium-ion batteries. 

Abstract Developing novel lead‐free ferroelectric materials is crucial for next‐generation microelectronic technologies that are energy efficient and environment friendly. However, materials discovery and property optimization are typically time‐consuming due to the limited throughput of traditional synthesis methods. In this work, we use a high‐throughput combinatorial synthesis approach to fabricate lead‐free ferroelectric superlattices and solid solutions of (Ba_0.7Ca_0.3)TiO₃(BCT) and Ba(Zr_0.2Ti_0.8)O₃(BZT) phases with continuous variation of composition and layer thickness. High‐resolution x‐ray diffraction (XRD) and analytical scanning transmission electron microscopy (STEM) demonstrate high film quality and well‐controlled compositional gradients. Ferroelectric and dielectric property measurements identify the “optimal property point” achieved at the composition of 48BZT–52BCT. Displacement vector maps reveal that ferroelectric domain sizes are tunable by varying {BCT–BZT}_Nsuperlattice geometry. This high‐throughput synthesis approach can be applied to many other material systems to expedite new materials discovery and properties optimization, allowing for the exploration of a large area of phase space within a single growth. image 

Clinical documentation is a time-consuming and challenging task, especially in time-critical medical settings. Even with a dedicated scribe person, timely and accurate documentation under time constraints is never easy. In this work, we present a unique type of fast-paced medical team--emergency medical services (EMS)--which has no designated role for documentation while constantly working outside in the field to provide urgent patient care. Through interviews with 13 EMS practitioners, we reveal several interesting and prominent characteristics of EMS documentation practice as well as their associated challenges: EMS practitioners self-organize and collaborate on documentation while in the meantime being both physically and cognitively preoccupied with high-acuity patients, having limited capability to use handheld documentation systems in real-time, and being overwhelmed by strict documentation requirements and regulations. Lastly, we use our findings to discuss both technical and non-technical implications to support timely and collaborative documentation in dynamic medical contexts while accounting for care providers' physical and cognitive constraints in using computing devices. 

Background Over the past 2 decades, various desktop and mobile telemedicine systems have been developed to support communication and care coordination among distributed medical teams. However, in the hands-busy care environment, such technologies could become cumbersome because they require medical professionals to manually operate them. Smart glasses have been gaining momentum because of their advantages in enabling hands-free operation and see-what-I-see video-based consultation. Previous research has tested this novel technology in different health care settings. Objective The aim of this study was to review how smart glasses were designed, used, and evaluated as a telemedicine tool to support distributed care coordination and communication, as well as highlight the potential benefits and limitations regarding medical professionals’ use of smart glasses in practice. Methods We conducted a literature search in 6 databases that cover research within both health care and computer science domains. We used the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) methodology to review articles. A total of 5865 articles were retrieved and screened by 3 researchers, with 21 (0.36%) articles included for in-depth analysis. Results All of the reviewed articles (21/21, 100%) used off-the-shelf smart glass device and videoconferencing software, which had a high level of technology readiness for real-world use and deployment in care settings. The common system features used and evaluated in these studies included video and audio streaming, annotation, augmented reality, and hands-free interactions. These studies focused on evaluating the technical feasibility, effectiveness, and user experience of smart glasses. Although the smart glass technology has demonstrated numerous benefits and high levels of user acceptance, the reviewed studies noted a variety of barriers to successful adoption of this novel technology in actual care settings, including technical limitations, human factors and ergonomics, privacy and security issues, and organizational challenges. Conclusions User-centered system design, improved hardware performance, and software reliability are needed to realize the potential of smart glasses. More research is needed to examine and evaluate medical professionals’ needs, preferences, and perceptions, as well as elucidate how smart glasses affect the clinical workflow in complex care environments. Our findings inform the design, implementation, and evaluation of smart glasses that will improve organizational and patient outcomes.