Project to improve the management of the head injury patients presenting to the emergency department.

INTRODUCTION: At Sandwell General Hospital, there was no risk stratification tool or pathway for head injury (HI) patients presenting to the emergency department (ED). This resulted in significant delays in the assessment of HI patients, compromising patient safety and quality of care. AIMS: To employ quality improvement methodology to design an effective adult HI pathway that: ensured >90% of high-risk HI patients being assessed by ED clinicians within 15 min of arrival, reduce CT turnaround times, and aiming to keep the final decision making <4 hours. METHODS: SWOT analysis was performed; driver diagrams were used to set out the aims and objectives. Plan-Do-Study-Act cycle was used to facilitate the change and monitor the outcomes. Process map was designed to identify the areas for improvement. A new HI pathway was introduced, imaging and transporting the patients was modified, and early decisions were made to meet the standards. RESULTS: Data were collected and monitored following the interventions. The new pathway improved the proportion of patients assessed by the ED doctors within 15 min from 31% to 63%. The average time to CT head scan was decreased from 69 min to 53 min. Average CT scan reporting time also improved from 98 min to 71 min. Overall, the average time to decision for admission or discharge decreased from 6 hours 48 min to 4 hours 24 min. CONCLUSIONS: Following implementation of the new HI pathway, an improvement in the patient safety and quality of care was noted. High-risk HI patients were picked up earlier, assessed quicker and had CT head scans performed sooner. Decision time for admission/discharge was improved. The HI pathway continues to be used and will be reviewed and re-audited between 3 and 6 months to ensure the sustained improvement.

Corrosion behavior of SiC coated HX with MoSi2 interlayer to be utilized in iodine-sulfur cycle for hydrogen production.

In this era, renewable energy technologies are suitable to meet the challenges of fossil fuel depletion and global warming. Thus, hydrogen is gaining attention as an alternative clean energy carrier that can be produced from various methods, one of them is the iodine-sulfur (I-S) cycle which is a thermochemical process. The I-S cycle requires a material that can withstand an extremely corrosive environment at high temperatures. Immersion tests were conducted on bare superalloy Hastelloy X (HX), MoSi2, and SiC-MoSi2 coated HX, deposited in physical vapor deposition (PVD) to evaluate their corrosion resistance. Bare HX exhibited a high corrosion rate of 208.1 mm yr-1 when exposed to 98 wt% sulfuric acid at 300 °C. In contrast, HX with MoSi2 coating showed a much lower corrosion rate of 23.5 mm yr-1, and HX with SiC-MoSi2 coating demonstrated the lowest corrosion rate at 6.5 mm yr-1 under the same conditions. The coated samples were analyzed via FESEM before and after corrosion testing. The FESEM images reveal the formation of coalescent particles on the surface of the coating. The elemental analysis illustrates an increased concentration of silicon and oxygen in the corroded samples. Elemental mapping of these samples show a uniform distribution of elements over the sample. These findings contribute not only to materials science understanding but also to practical applications in hydrogen production via the I-S cycle, where corrosion-resistant materials are critical.

Fabrication of cellulose paper-based counter electrodes for flexible dye-sensitized solar cells.

Here, we introduce the synthesis and deposition of organic/inorganic composite ink on cellulose paper using a rapid ultrasonic spray deposition approach that can be incorporated as a counter electrode (CE) in flexible dye-sensitized solar cells (FDSSCs). The composite ink comprised a copper indium sulfide (CuInS2) nanostructure ink and dispersion of poly(3,4-ethylenedioxythiophene)-poly(styrenesulfonate) (PEDOT:PSS) in water. Fabricated counter electrodes are biodegradable, environment-friendly, flexible, and economical and meet the requirements for sustainable green energy. To evaluate the catalytic activities and power conversion efficiencies of DSSCs, the produced CuInS2/PEDOT:PSS composite ink-based CEs were compared with PEDOT:PSS counter electrodes. Cyclic voltammetry studies found that CuInS2/PEDOT:PSS had a greater cathodic charge transfer current density (Jc) (-1.23 mA cm-2). Moreover, it was found that the potential separation values are small, which indicate a stronger catalytic activity than PEDOT:PSS counter electrodes. The observed exchange current density (J0) was 3.98 mA cm-2, while the limiting current density (Jlim) increased to 45.7 mA cm-2, indicating a fast redox diffusion rate of the CuInS2/PEDOT:PSS CE. The photovoltaic performances of CuInS2/PEDOT:PSS and PEDOT: PSS-based DSSC's were measured and determined to be 5.66% and 4.41%, respectively, while the performance of CuInS2/PEDOT:PSS FDSSC composed of cellulose paper was 1.06%.

Investigation of Hydrothermally Stressed Silicone Rubber/Silica Micro and Nanocomposite for the Coating High Voltage Insulation Applications.

Silicone rubber is a promising insulating material that has been performing well for different insulating and dielectric applications. However, in outdoor applications, environmental stresses cause structural and surface degradations that diminish its insulating properties. This effect of degradation can be reduced with the addition of a suitable filler to the polymer chains. For the investigation of structural changes and hydrophobicity four different systems were fabricated, including neat silicone rubber, a micro composite (with 15% micro-silica filler), and nanocomposites (with 2.5% and 5% nanosilica filler) by subjecting them to various hydrothermal conditions. In general, remarkable results were obtained by the addition of fillers. However, nanocomposites showed the best resistance against the applied stresses. In comparison to neat silicone rubber, the stability of the structure and hydrophobic behavior was better for micro-silica, which was further enhanced in the case of nanocomposites. The inclusion of 5% nanosilica showed the best results before and after applying aging conditions.