Most high-resolution interfacial patterning approaches are restricted to crystalline inorganic interfaces. Recently, we have shown that it is possible to generate 1 nm resolution functional patterns on soft materials, such as polydimethylsiloxane (PDMS), by creating highly structured striped patterns of functional alkyldiacetylenes on a hard crystalline surface, photopolymerizing to set the molecular pattern as a striped-phase polydiacetylene (sPDA), and then covalently transferring the sPDAs to PDMS. Transfer depends on the diacetylene polymerization, making it important to understand design principles for efficient sPDA polymerization and cross-linking to PDMS. Here, we combine single-molecule and fluorescence-based metrics for sPDA polymerization and transfer, first to characterize sPDA polymerization of amine striped phases, and then to develop a probabilistic model that describes the transfer process in terms of sPDA–PDMS cross-linking reaction efficiency and number of reactions required for transfer. We illustrate that transferred patterns of alkylamines can be used to direct both adsorption of CdSe nanocrystals with alkyl ligand shells and covalent reactions with fluorescent dyes, highlighting the utility of functional patterning of the PDMS surface.

Hydrogels are broadly used in applications where polymer materials must interface with biology. The hydrogel network is amorphous, with substantial heterogeneity on length scales up to hundreds of nanometers, in some cases raising challenges for applications that would benefit from highly structured interactions with biomolecules. Here, we show that it is possible to generate ordered patterns of functional groups on polyacrylamide hydrogel surfaces. We demonstrate that, when linear patterns of amines are transferred to polyacrylamide, they pattern interactions with DNA at the interface, a capability of potential importance for preconcentration in chromatographic applications, as well as for the development of nanostructured hybrid materials and supports for cell culture.

Background and Purpose— A distinguishing feature of our Stroke Network is telestroke nurses who remotely facilitate evaluations. To enable expeditious transfer of large vessel occlusion (LVO) acute ischemic stroke patients presenting to nonthrombectomy centers, the telestroke nurses must immediately identify color thresholded computerized tomography perfusion (CTP) patterns consistent with internal carotid artery (ICA), middle cerebral artery (MCA) segment 1(M1), and MCA segment 2 (M2) LVO acute ischemic stroke. Methods— We developed a 6-month series of tutorials and tests for 16 telestroke nurses, focusing on CTP pattern recognition consistent with ICA, M1, or M2 LVO acute ischemic stroke. We simultaneously conducted a prospective cohort study to evaluate the impact of this intervention. Results— Telestroke nurses demonstrated good accuracy in detecting ICA, M1, or M2 LVO during the first 3 months of teaching (83%–94% accurate). This significantly improved during the last 3 months (99%–100%), during which the likelihood of correctly identifying the presence of any one of these LVOs exceeded that of the first 3 months ( P <0.001). There was a higher probability of correctly identifying any CTP pattern as consistent with either an ICA, M1, or M2 occlusion versus other types of occlusions or nonocclusions (odds ratio, 5.22 [95% CI, 3.2–8.5]). Over time, confidence for recognizing CTP patterns consistent with an ICA, M1, or M2 LVO did not differ significantly. Conclusions— A series of tutorials and tests significantly increased the likelihood of telestroke nurses correctly identifying CTP patterns consistent with ICA, M1, or M2 LVOs, with the benefit of these tutorials and test reviews peaking and plateauing at 4 months.

BACKGROUND: Distinguishing features of our stroke network include routine involvement of a telestroke nurse (TSRN) for code stroke activations at nonthrombectomy centers and immediate availability of neuroradiologists for imaging interpretation. On May 1, 2021, we implemented a new workflow for code stroke activations presenting beyond 4.5 hours from last known well that relied on a TSRN supported by a neuroradiologist for initial triage. Patients without a target large vessel occlusion (LVO) were managed without routine involvement of a teleneurologist, which represented a change from the preimplementation period. METHODS: We collected data 6 months before and after implementation of the new workflow. We compared preimplementation process metrics for patients managed with teleneurologist involvement with the postimplementation patients managed without teleneurologist involvement. RESULTS: With the new workflow, teleneurologist involvement decreased from 95% (n = 953) for patients presenting beyond 4.5 hours from last known well to 37% (n = 373; P < .001). Compared with patients in the preimplementation period, postimplementation patients without teleneurologist involvement experienced less inpatient hospital admission and observation (87% vs 90%; unadjusted P = .038, adjusted P = .06). Among the preimplementation and postimplementation admitted patients, there was no statistically significant difference in follow-up neurology consultation or nonstroke diagnoses. A similar percentage of LVO patients were transferred to the thrombectomy center (54% pre vs 49% post, P = .612), whereas more LVO transfers in the postimplementation cohort received thrombectomy therapy (75% post vs 39% pre, P = .014). Among LVO patients (48 pre and 41 post), no statistical significance was observed in imaging and management times. CONCLUSION: Our work shows the successful teaming of a TSRN and a neuroradiologist to triage acute stroke patients who present beyond an eligibility window for systemic thrombolysis, without negatively impacting care and process metrics. This innovative partnering may help to preserve the availability of teleneurologists by limiting their involvement when diagnostic imaging drives decision making.