The Efficacy of Traumatic Brain Injury Treatment by Neurotrauma Specialists.

Objective: Since the establishment of Regional Trauma Centers (RTCs) in Korea, significant efforts have been made to improve the quality of care for patients with trauma. Simultaneously, the Department of Neurosurgery assigned neurotrauma specialists to RTCs to provide specialized care to patients with traumatic brain injury (TBI). In this study, we sought to determine whether neurotrauma specialists, compared to general neurosurgeons, could make a significant difference in treatment outcomes of patients with TBI. Methods: In total, 156 patients with acute TBI who required decompression were included. We reviewed their records and compared the characteristics, outcomes, and prognosis of those who received surgical treatment from either neurotrauma specialists or general neurosurgeons at our institution. Results: A significant difference was observed between treatment by trauma neurosurgery specialists and general neurosurgeons in time to surgery, with trauma specialists experiencing shorter surgical delays. However, no significant differences existed in mortality rates or Extended Glasgow Outcome Scale scores. Univariate and multivariable regression analyses revealed that lower Glasgow Coma Scale scores, an abnormal pupil reflex, larger transfusion volume, and prolonged time from emergency room admission to surgery were associated with high mortality rates. Conclusion: Neurotrauma specialists can provide prompt surgical treatment to patients with TBI compared to general neurosurgeons. Our study did not reveal a significant difference in outcomes between the two groups. However, it is clear that rapid decompression is effective in patients with impending brain herniation. Therefore, the effectiveness of neurotrauma specialists needs to be confirmed through further systematic studies.

High-Performance Indoor Perovskite Solar Cells by Self-Suppression of Intrinsic Defects via a Facile Solvent-Engineering Strategy.

Lead halide perovskite solar cells have been emerging as very promising candidates for applications in indoor photovoltaics. To maximize their indoor performance, it is of critical importance to suppress intrinsic defects of the perovskite active layer. Herein, a facile solvent-engineering strategy is developed for effective suppression of both surface and bulk defects in lead halide perovskite indoor solar cells, leading to a high efficiency of 35.99% under the indoor illumination of 1000 lux Cool-white light-emitting diodes. Replacing dimethylformamide (DMF) with N-methyl-2-pyrrolidone (NMP) in the perovskite precursor solvent significantly passivates the intrinsic defects within the thus-prepared perovskite films, prolongs the charge carrier lifetimes and reduces non-radiative charge recombination of the devices. Compared to the DMF, the much higher interaction energy between NMP and formamidinium iodide/lead halide contributes to the markedly improved quality of the perovskite thin films with reduced interfacial halide deficiency and non-radiative charge recombination, which in turn enhances the device performance. This work paves the way for developing efficient indoor perovskite solar cells for the increasing demand for power supplies of Internet-of-Things devices.

Anticoagulation and Antiplatelet Agent Resumption Timing following Traumatic Brain Injury.

Traumatic brain injury (TBI) is a major global health concern. Due to the increase in TBI incidence and the aging population, an increasing number of patients with TBI are taking antithrombotic agents for their underlying disease. When TBI occurs in patients with these diseases, there is a conflict between the disease, which requires an antithrombotic effect, and the neurosurgeon, who must minimize intracranial hemorrhage. Nevertheless, there are no clear guidelines for the reversal or resumption of antithrombotic agents when TBI occurs in patients taking antithrombotic agents. In this review article, we intend to classify antithrombotic agents and provide information on them. We also share previous studies on the reversal and resumption of antithrombotic agents in patients with TBI to help neurosurgeons in this dilemma.

Dual functional WO3/BiVO4 heterostructures for efficient photoelectrochemical water splitting and glycerol degradation.

Dual functional heterojunctions of tungsten oxide and bismuth vanadate (WO3/BiVO4) photoanodes are developed and their applications in photoelectrochemical (PEC) water splitting and mineralization of glycerol are demonstrated. The thin-film WO3/BiVO4 photoelectrode was fabricated by a facile hydrothermal method. The morphology, chemical composition, crystalline structure, chemical state, and optical absorption properties of the WO3/BiVO4 photoelectrodes were characterized systematically. The WO3/BiVO4 photoelectrode exhibits a good distribution of elements and a well-crystalline monoclinic WO3 and monoclinic scheelite BiVO4. The light-absorption spectrum of the WO3/BiVO4 photoelectrodes reveals a broad absorption band in the visible light region with a maximum absorption of around 520 nm. The dual functional WO3/BiVO4 photoelectrodes achieved a high photocurrent density of 6.85 mA cm-2, which is 2.8 times higher than that of the pristine WO3 photoelectrode in the presence of a mixture of 0.5 M Na2SO4 and 0.5 M glycerol electrolyte under AM 1.5 G (100 mW cm-2) illumination. The superior PEC performance of the WO3/BiVO4 photoelectrode was attributed to the synergistic effects of the superior crystal structure, light absorption, and efficient charge separation. Simultaneously, glycerol plays an essential role in increasing the efficiency of hydrogen production by suppressing charge recombination in the water redox reaction. Moreover, the WO3/BiVO4 photoelectrode shows the total organic carbon (TOC) removal efficiency of glycerol at about 82% at 120 min. Notably, the WO3/BiVO4 photoelectrode can be a promising photoelectrode for simultaneous hydrogen production and mineralization of glycerol with a simple, economical, and environmentally friendly approach.

Risk Factors for Postoperative Contralateral Hemorrhage in Patients With Traumatic Brain Injury who Underwent Surgical Treatment: A Multicenter Study.

Objective: Patients with a contralateral intracranial hemorrhage after decompressive craniectomy have a worse prognosis than those whose recovery is uneventful. Therefore, the objective of this study was to identify risk factors for postoperative contralateral hemorrhage (PCH) in patients who underwent unilateral craniectomy or craniotomy due to a traumatic brain injury (TBI). Methods: Data were obtained from the Korean Neuro-Trauma Data Bank System and retrospectively reviewed. Patients who had a unilateral craniectomy or craniotomy for acute TBI were included in this study. Clinical outcomes of a PCH group and an uneventful group were compared and the risk factors for PCH were identified using regression analysis. Results: A total of 326 patients were included in this study. PCH was observed in 25 (7.7%) patients. The Glasgow coma scale (GCS) and Glasgow outcome scale extended (GOSE) scores at discharge were significantly lower in the PCH group than those in the uneventful group (GCS: 3.6 vs. 6.2, p=0.043; GOSE: 2.1 vs. 3.2, p=0.032). In the multivariable regression analysis, when the time from injury to surgery was shorter than 150 minutes, the risk of PCH was increased by 4.481 times (p=0.005). When the intraoperative transfusion volume was more than 1.5 L, the risk of PCH was increased by 4.843 times (p=0.003). Conclusion: The risk of PCH is increased when the time from injury to surgery is shorter than 150 minutes and when the intraoperative transfusion volume is greater than 1.5 L. Neurosurgeons must predict and be prepared for the development of PCH in high-risk patients.

Pharmacological Management of Germinal Matrix-Intraventricular Hemorrhage.

Germinal matrix-intraventricular hemorrhage (GM-IVH) is among the devastating neurological complications with mortality and neurodevelopmental disability rates ranging from 14.7% to 44.7% in preterm infants. The medical techniques have improved throughout the years, as the morbidity-free survival rate of very-low-birth-weight infants has increased; however, the neonatal and long-term morbidity rates have not significantly improved. To this date, there is no strong evidence on pharmacological management on GM-IVH, due to the limitation of well-designed randomized controlled studies. However, recombinant human erythropoietin administration in preterm infants seems to be the only effective pharmacological management in limited situations. Hence, further high-quality collaborative research studies are warranted in the future to ensure better outcomes among preterm infants with GM-IVH.

National Follow-up Survey of Preventable Trauma Death Rate in Korea.

BACKGROUND: The preventable trauma death rate survey is a basic tool for the quality management of trauma treatment because it is a method that can intuitively evaluate the level of national trauma treatment. We conducted this study as a national biennial follow-up survey project and report the results of the review of the 2019 trauma death data in Korea. METHODS: From January 1, 2019 to December 31, 2019, of a total of 8,482 trauma deaths throughout the country, 1,692 were sampled from 279 emergency medical institutions in Korea. All cases were evaluated for preventability of death and opportunities for improvement using a multidisciplinary panel review approach. RESULTS: The preventable trauma death rate was estimated to be 15.7%. Of these, 3.1% were judged definitive preventable deaths, and 12.7% were potentially preventable deaths. The odds ratio for preventable traumatic death was 2.56 times higher in transferred patients compared to that of patients who visited the final hospital directly. The group that died 1 hour after the accident had a statistically significantly higher probability of preventable death than that of the group that died within 1 hour after the accident. CONCLUSION: The preventable trauma death rate for trauma deaths in 2019 was 15.7%, which was 4.2%p lower than that in 2017. To improve the quality of trauma treatment, the transfer of severe trauma patients to trauma centers should be more focused.

Surface plasmon-driven photoelectrochemical water splitting of a Ag/TiO2 nanoplate photoanode.

A silver/titanium dioxide nanoplate (Ag/TiO2 NP) photoelectrode was designed and fabricated from vertically aligned TiO2 nanoplates (NP) decorated with silver nanoparticles (NPs) through a simple hydrothermal synthesis and electrodeposition route. The electrodeposition times of Ag NPs on the TiO2 NP were crucial for surface plasmon-driven photoelectrochemical (PEC) water splitting performance. The Ag/TiO2 NP at the optimal deposition time of 5 min with a Ag element content of 0.53 wt% demonstrated a remarkably high photocurrent density of 0.35 mA cm-2 at 1.23 V vs. RHE under AM 1.5G illumination, which was 5 fold higher than that of the pristine TiO2 NP. It was clear that the enhanced light absorption properties and PEC performance for Ag/TiO2 NP could be effectively adjusted by simply controlling the loading amounts of metallic Ag NPs (average size of 10-30 nm) at different electrodeposition times. The superior PEC performance of the Ag/TiO2 NP photoanode was attributed to the synergistic effects of the plasmonic Ag NPs and the TiO2 nanoplate. Interestingly, the plasmonic effect of Ag NPs not only increased the visible-light response (λ max = 570 nm) of TiO2 but also provided hot electrons to promote photocurrent generation and suppress charge recombination. Importantly, this study offers a potentially efficient strategy for the design and fabrication of a new type of TiO2 hybrid nanostructure with a plasmonic enhancement for PEC water splitting.

Controllable Acceleration and Deceleration of Charge Carrier Transport in Metal-Halide Perovskite Single-Crystal by Cs-Cation Induced Bandgap Engineering.

Charge carrier transport in materials is of essential importance for photovoltaic and photonic applications. Here, the authors demonstrate a controllable acceleration or deceleration of charge carrier transport in specially structured metal-alloy perovskite (MACs)PbI3 (MA= CH3 NH3 ) single-crystals with a gradient composition of CsPbI3 /(MA1- x Csx )PbI3 /MAPbI3 . Depending on the Cs-cation distribution in the structure and therefore the energy band alignment, two different effects are demonstrated: i) significant acceleration of electron transport across the depth driven by the gradient band alignment and suppression of electron-hole recombination, benefiting for photovoltaic and detector applications; and ii) decelerated electron transport and thus improved radiative carrier recombination and emission efficiency, highly beneficial for light and display applications. At the same time, the top Cs-layer results in hole localization in the top layer and surface passivation. This controllable acceleration and deceleration of electron transport is critical for various applications in which efficient electron-hole separation and suppressed nonradiative electron-hole recombination is demanded.

Nanosphere Lithography: A Versatile Approach to Develop Transparent Conductive Films for Optoelectronic Applications.

Transparent conductive films (TCFs) are irreplaceable components in most optoelectronic applications such as solar cells, organic light-emitting diodes, sensors, smart windows, and bioelectronics. The shortcomings of existing traditional transparent conductors demand the development of new material systems that are both transparent and electrically conductive, with variable functionality to meet the requirements of new generation optoelectronic devices. In this respect, TCFs with periodic or irregular nanomesh structures have recently emerged as promising candidates, which possess superior mechanical properties in comparison with conventional metal oxide TCFs. Among the methods for nanomesh TCFs fabrication, nanosphere lithography (NSL) has proven to be a versatile platform, with which a wide range of morphologically distinct nanomesh TCFs have been demonstrated. These materials are not only functionally diverse, but also have advantages in terms of device compatibility. This review provides a comprehensive description of the NSL process and its most relevant derivatives to fabricate nanomesh TCFs. The structure-property relationships of these materials are elaborated and an overview of their application in different technologies across disciplines related to optoelectronics is given. It is concluded with a perspective on current shortcomings and future directions to further advance the field.

Inner Ear Symptoms Are Prevalent in Patients with High Head Abbreviated Injury Scale Scores after Blunt Head Trauma.

INTRODUCTION: The purpose of this article was to determine the prevalence of inner ear symptoms in patients with blunt head trauma and to explore whether the severity of head trauma was associated with the incidence of such symptoms. METHODS: We performed a retrospective review of 56 patients admitted with blunt head trauma who underwent audiovestibular evaluation within 1 month after injury. Two scales were used to measure the severity of trauma; these were the Glasgow Coma Scale (GCS) and the Head Abbreviated Injury Scale (H-AIS). Patients with sensorineural-type hearing loss, or dizziness with nystagmus, were considered to have inner ear symptoms. RESULTS: About half of all patients (45%) with blunt head trauma showed trauma-related inner ear symptoms. Patients with inner ear symptoms were significantly more likely to have H-AIS scores ≥4 than those without inner ear symptoms (p = 0.004), even without concomitant temporal bone fracture (p > 0.05). Also, patients with inner ear symptoms required a statistically significantly longer time (measured from admission) before undergoing their ontological evaluations than did those without such symptoms (p = 0.002), possibly due to prolonged bed rest and use of sedatives. CONCLUSION: Thus, detailed history-taking and early evaluation using trauma scales are essential for all patients suffering from severe head trauma. It may be necessary to initiate early treatment of traumatic inner ear diseases.

National trauma system establishment based on implementation of regional trauma centers improves outcomes of trauma care: A follow-up observational study in South Korea.

Although South Korea is a high-income country, its trauma system is comparable to low- and middle-income countries with high preventable trauma death rates of more than 30%. Since 2012, South Korea has established a national trauma system based on the implementation of regional trauma centers and improvement of the transfer system; this study aimed to evaluate its effectiveness. We compared the national preventable trauma death rates, transfer patterns, and outcomes between 2015 and 2017. The review of preventable trauma deaths was conducted by multiple panels, and a severity-adjusted logistic regression model was created to identify factors influencing the preventable trauma death rate. We also compared the number of trauma patients transferred to emergency medical institutions and mortality in models adjusted with injury severity scores. The preventable trauma death rate decreased from 2015 to 2017 (30.5% vs. 19.9%, p < 0.001). In the severity-adjusted model, the preventable trauma death risk had a lower odds ratio (0.68, 95% confidence interval: 0.53-0.87, p = 0.002) in 2017 than in 2015. Regional trauma centers received 1.6 times more severe cases in 2017 (according to the International Classification of Diseases Injury Severity Score [ICISS]; 23.1% vs. 36.5%). In the extended ICISS model, the overall trauma mortality decreased significantly from 2.1% (1008/47 806) to 1.9% (1062/55 057) (p = 0.041). The establishment of the national trauma system was associated with significant improvements in the performance and outcomes of trauma care. This was mainly because of the implementation of regional trauma centers and because more severe patients were transferred to regional trauma centers. This study might be a good model for low- and middle-income countries, which lack a trauma system.

Coal beneficiation technology to reduce hazardous heavy metals in fly ash.

Fly ash emitted from the coal-fired power plant is the major contributor of the outdoor airborne particulate matters (PMs). Coal beneficiation, an industrial process to improve the quality of raw coal by removing ash-bearing components, can be a cost-effective sustainable and clean technology to reduce the emission of hazardous trace metals. As the removal efficiency of mineral matters and heavy metals within the coal is depend highly on the raw coal and the employed beneficiation process, a wide range of case studies at laboratory- and industrial-scale, published in the last 20 years, are reviewed in this study. Our review indicates that the coal beneficiation processes can effectively reduce content of heavy metals of fly ash, encouraging the use of clean coal to reduce pollutants emission.

Periodic nanostructures: preparation, properties and applications.

Periodic nanostructures, a group of nanomaterials consisting of single or multiple nano units/components periodically arranged into ordered patterns (e.g., vertical and lateral superlattices), have attracted tremendous attention in recent years due to their extraordinary physical and chemical properties that offer a huge potential for a multitude of applications in energy conversion, electronic and optoelectronic applications. Recent advances in the preparation strategies of periodic nanostructures, including self-assembly, epitaxy, and exfoliation, have paved the way to rationally modulate their ferroelectricity, superconductivity, band gap and many other physical and chemical properties. For example, the recent discovery of superconductivity observed in "magic-angle" graphene superlattices has sparked intensive studies in new ways, creating superlattices in twisted 2D materials. Recent development in the various state-of-the-art preparations of periodic nanostructures has created many new ideas and findings, warranting a timely review. In this review, we discuss the current advances of periodic nanostructures, including their preparation strategies, property modulations and various applications.

Efficient and Rapid Photocatalytic Degradation of Methyl Orange Dye Using Al/ZnO Nanoparticles.

ZnO and Aluminum doped ZnO nanoparticles (Al/ZnO NPs) were successfully synthesized by the sol-gel method. Together with the effect of calcination temperatures (200, 300 and 400 °C) and Al dosage (1%, 3%, 5% and 10%) on structural, morphological and optical properties of Al/ZnO NPs, their photocatalytic degradation of methyl orange (MO) dye was investigated. The calcination temperatures at 200, 300 and 400 °C in forming structure of ZnO NPs led to spherical nanoparticle, nanorod and nanoflake structures with a well-crystalline hexagonal wurtzite, respectively. The ZnO NPs calcined at 200 °C exhibited the highest specific surface area and light absorption property, leading to the MO removal efficiency of 80% after 4 h under the Ultraviolet (UV) light irradiation. The MO removal efficiency was approximately two times higher than the nanoparticles calcined at 400 °C. Furthermore, the 5% Al/ZnO NPs exhibited superior MO removal efficiency of 99% in only 40 min which was approximately 20 times enhancement in photocatalytic activity compared to pristine ZnO under the visible light irradiation. This high degradation performance was attributed to the extended light absorption, narrowed band gap and effective suppression of electron-hole recombination through an addition of Al metal.

Bifunctional photoelectrochemical process for humic acid degradation and hydrogen production using multi-layered p-type Cu2O photoelectrodes with plasmonic Au@TiO2.

Bifunctional photoelectrochemical (PEC) process for simultaneous hydrogen production and mineralisation of humic acid in water using TiO2-1 wt% Au@TiO2/Al2O3/Cu2O multi-layered p-type photoelectrodes is demonstrated. The newly designed bifunctional PEC system leads to a high degradation efficiency of dissolved humic compounds, the target pollutant, by up to 87% during 2 h reaction time. Simultaneously, humic acid is also served as a sacrificial electron donor in the proposed system, contributing to a high photocurrent density of the multi-layered p-type Cu2O photoelectrodes up to -6.32 mA cm-2 at 0 V vs. Reversible Hydrogen Electrode (RHE) under the AM 1.5 simulated 1-Sun solar illumination. The Z-scheme feature of this bifunctional PEC devices exhibiting a short-circuit photocurrent density of -0.45 mA cm-2 and solar-to-hydrogen conversion (STH) of 0.5 % in the presence of humic acid sheds light on the new bias-free artificial photosynthesis PEC system.

Treatment Experiences of Traumatic Brain Injury Patients using Doctor-Helicopter Emergency Medical Service: Early Data in a Regional Trauma Center.

OBJECTIVE: The purpose of this study is to analyze the results of doctor helicopter emergency medical service (HEMS) in traumatic brain injury (TBI) patients and to understand the effect and improvement of doctor HEMS. METHODS: We included TBI patients transferred by doctor HEMS of our hospital between February 2016 and December 2017. Basic characteristics, HEMS data, treatment and results data were analyzed retrospectively. We divided the patients into 3 groups as regarding severity of patient, relevance of treatment and transfer. We investigated the preventable trauma death rate (PTDR) of these groups to increase the reliability of the treatment outcome. RESULTS: TBI patients using doctor HEMS were indicated in 98 patients (18.7%) among 522 overall HEMS patients. The overall mortality was consisted in 21.4% and 43.2% was resulted in Glasgow outcome scale 4 or 5. The group of proper transport and treatment for severe TBI was consisted in 62.2% including 13 mortality cases and no preventable death. The group of delayed transport or treatment for severe TBI was 18.3% including 8 mortality cases and 1 preventable death. The PTDR of TBI after doctor HEMS was significantly lower than that of overall TBI (4.8% vs. 11.6%, p=0.045). CONCLUSION: In patients with severe TBI, doctor HEMS can improve treatment outcomes by reducing treatment delay and unnecessary examinations and this result was evidenced that the PTDR were decreased significantly after doctor HEMS transport. The appropriate treatment is mandatory for real-time communication with the emergency doctor and treatment preparation of the trauma team during the HEMS transport.