Discharge Process Research Articles

Ultrafast Tailoring Amorphous Zn0.25V2O5 with Precision‐Engineered Artificial Atomic‐Layer 1T′‐MoS2 Cathode Electrolyte Interphase for Advanced Aqueous Zinc‐Ion Batteries

AbstractVanadium (V)‐based oxides as cathode materials for aqueous zinc‐ion batteries (AZIBs) still encounter challenges such as sluggish Zn2+ diffusion kinetics and V‐dissolution, thus leading to severe capacity fading and limited life span. Here, we designed an ultrafast and facile colloidal chemical synthesis strategy based on crystalline Zn0.25V2O5 (c‐ZVO) to successfully prepare a‐ZVO@MoS2 core@shell heterostructures, where atomic‐layer MoS2 uniformly coats on the surface of amorphous a‐ZVO. The tailored amorphous structure of a‐ZVO provides more isotropic pathways and active sites for Zn2+, thus significantly enhancing the Zn2+ diffusion kinetics during charge–discharge processes. Meanwhile, as an efficient artificial cathode electrolyte interphase, the precision‐engineered atomic‐layer MoS2 with semi‐metallic 1T′ phase not only contributes to improved electron transport but also effectively inhibits the V‐dissolution of a‐ZVO. Therefore, the prepared a‐ZVO@MoS2 and conceptually validated a‐V2O5@MoS2 derived from commercial c‐V2O5 exhibit excellent cycling stability at an ultralow current density (0.05 A g−1) while maintaining good rate capability and capacity retention. This research achievement provides a new effective strategy for various amorphous cathode designs for AZIBs with superior performance.

Understanding of a Ni‐Rich O3‐Layered Cathode for Sodium‐Ion Batteries: Synthesis Mechanism and Al‐Gradient Doping

AbstractO3‐type NaNi0.8Mn0.1Co0.1O2 (NaNMC811) cathode active materials for sodium–ion batteries (SIBs), with a theoretical high specific capacity (∼ 187 mAh g−1), are in the preliminary exploration stage. This study comprehensively investigates NaNMC811 from multiple perspectives. For the first time, the phase evolution ( ‐ ‐ ) during the solid‐state synthesis is systemically investigated, which elucidates in‐depth the mechanisms of the thermal sodiation process. Furthermore, an Al‐gradient doping of NaNMC811 was successfully implemented through Al2O3 coating on the cathode active material (CAM) precursor. The modified Al−NaNi0.8Mn0.1Co0.1O2 (Al‐NaNMC811) exhibits excellent electrochemical dynamics and performance, maintaining a specific capacity above 100 mAh g−1 after 100 cycles at 0.1 C (1.5–4.1 V) while providing a promising capacity retention of 63%. Additionally, the material demonstrates excellent rate capabilities, retaining a specific capacity of 107 mAh g−1 at 5 C. Compared to pristine NaNMC811, the modified Al‐NaNMC811 is proven to have improved electrochemical kinetics with a higher Na+ diffusion coefficient due to dilated (003) interplanar spacing, and a more stable structure during the electrochemical charge–discharge processes, which is attributed to stronger Al–O bond energy. Understanding phase formations during the synthesis and comprehensive insight in the gradient doping for O3‐type NaNMC811 CAMs guides further development of next‐generation SIBs materials.

Simulation of landslide dam failure due to overtopping considering wide-graded soil erosion

Landslide dams, as a particular type of secondary geological disaster, can cause serious flood disasters. Therefore, accurately predicting potential dam failure processes is crucial for developing reasonable emergency response plans. Currently, several landslide dam failure models have been proposed, but most of these models do not appropriately consider the wide gradation of landslide dam materials, which is essential for accurate erosion calculations. Therefore, this research proposes a relative exposure formula under three-dimensional conditions to account for the concealment and exposure effects between large and small particles in wide-graded soil. Based on this, the incipient velocity of wide-graded soil is derived, and a mathematical model of overtopping failure of landslide dams is established. As part of the model, a numerical solution process is also developed to ensure convergence. To evaluate the performance of this new mathematical model, the discharge process of Tangjiashan landslide dam was used as a real-world case for dam failure calculation. The calculated results of key dam failure outcomes were compared with actual measurements, showing that the results of this model are largely consistent with actual measurements, with the error controlled within 10%. Additionally, the mathematical model proposed in this article was compared with two other existing dam failure models, revealing that the model proposed here has advantages in controlling the error of key dam failure outcomes, mainly due to the comprehensive consideration of erosion calculation in wide-graded soil. To further evaluate the stability of the model, the breach processes of the “11.3” Baige landslide dam and the Yigong landslide dam were also calculated, and the results showed reasonable consistency. Based on the model presented in this article, the influence of the grading width of landslide dam materials on key dam failure outcomes was discussed. It was found that grading width significantly affects the development process of breach flow. Specifically, wider grading width leads to smaller peak values of breach flow and later peak times. Additionally, the final size of the breach is affected by grading width, as it has a significant impact on erosion strength, although the sensitivity of this parameter is relatively weak. Given the significant impact of grading width on the dam failure process, especially for landslide dams containing wide-graded soil, it is essential to fully consider the wide grading of materials for accurate dam failure calculations.

A new optimization strategy, the influence of hollow electrode chamfers on the development of helium atmospheric pressure plasma jets

This work suggests applying chamfering treatment to the plasma generator of the empty electrode structure. Enhancing the electrodes’ physical structure can significantly improve plasma characteristics without requiring intricate control systems. Experiments have shown that changes in the electrode’s shape can lead to changes in the formation of the atmospheric pressure plasma jet. Specifically, our observations indicate that an increase in the chamfer radius leads to an increase in the ignition voltage and a greater density of reactive species inside the jet. We developed a multi-channel equivalent circuit model to describe the discharge process of a plasma jet. Then, using the mixed layer theory, we investigated the effect of the chamfer radius on the plasma jet. Our findings suggest that chamfering increases the effective discharge area, resulting in more discharge channels in the model. This leads to a higher density of reactive species. Additionally, chamfering improves the mixing of helium and air, increasing the concentration of N2 and O2. This consumes some of the avalanche electrons and raises the ignition voltages, ultimately enhancing the chemical reactivity of the plasma jet. This work provides new ideas for the optimization strategy of atmospheric pressure plasma radiation devices.

Who gets the bed: Factors influencing the intensive care exit block - A qualitative study

BackgroundPatient flow problems, including discharge delay and after-hours discharge, have been a consistently major issue, especially for intensive care units (ICUs). Evidence suggests that discharge delay and after-hours discharge are associated with increased ICU and hospital length of stay, leading to worsened patient outcomes and increased healthcare costs. They can also increase ICU readmission and post-ICU mortality. The factors influencing discharge processes are not well elucidated. ObjectiveThis study aimed to explore the barriers and facilitators to the ICU patient discharge processes in adult ICUs. MethodsThis qualitative exploratory multisite observational study was conducted in three regional adult ICUs in Queensland, Australia. We used staff interviews, fieldnotes, and document analysis as data collection techniques. Data analysis commenced with a deductive content analysis using the Structure, Process, and Outcomes framework. Following this, an inductive process was taken using the Theoretical Domains Framework. FindingsWe conducted 59 staff interviews and analysed the discharge documents across three sites. Five domains, including context and resources, beliefs about consequences, social/professional role and identity, and behaviour regulation, were strongly related to the factors that influenced the discharge processes. The findings revealed barriers to discharge, including finding the right bed, disconnected and ineffective information systems, ineffective communication and coordination within and across teams and departments, and uncertainty and inconsistency in discharge decision making. Facilitators included clarity on professional roles in ICU discharge, effective communication within the ICU team, and context specific strategies to support the discharge processes. ConclusionsThe findings provide an in-depth understanding of the barriers and facilitators to the ICU discharge processes. Multifaceted strategies should be considered to facilitate and manage ICU discharge safely and efficiently, including the use of clearer discharge criteria and guidelines, digital systems that aid communication and coordination, and early planning of ICU patient discharge.

Monitoring of insulator pollution discharge in overhead distribution network based on acoustic emission technology

Abstract During the continuous operation of the distribution network, dirt often accumulates on the surface of insulators. Once encountering a humid climate environment, it may cause accidental discharge, leading to the occurrence of flashover pollution accidents. In order to effectively monitor this issue, this study adopted a monitoring method based on acoustic emission technology. This article introduces the discharge process and acoustic emission phenomenon of insulators in overhead distribution networks under pollution conditions. By using emission signal detection devices, acoustic signals generated during insulator discharge are captured. And the wavelet denoising algorithm was used to process its signal, based on which the discharge characteristics of insulator pollution in the overhead distribution network were extracted. The emission amount of insulator pollution in the overhead distribution network was determined according to the set threshold, achieving monitoring of pollution emissions. The results indicate that the proposed method can accurately monitor the discharge of insulators in overhead distribution networks, provide scientific basis for timely maintenance measures, and improve the operational safety and reliability of distribution networks.

Study on the damage characteristics of high-temperature superconducting cable insulation under air gap discharge

This study explores the impact of small air gaps in high-temperature superconducting cables on the insulating material polypropylene-laminated paper (PPLP), and the aging rules and mechanisms of the insulating material during practical uses. An air gap discharge test platform was built to simulate air gap fault defects of superconducting cables in the real operating environment. Hierarchical clustering method was used to divide the gap discharge process of defect model into four stages. Insulation damage assessment was conducted on the intermediate layer PP of the superconducting insulation material PPLP at different discharge stages, revealing surface changes and periodic alterations in dielectric properties. The morphological features, roughness, infrared spectra, dielectric loss, surface resistivity, and other phase characteristics of the superconducting insulation layer material were analyzed at different stages of air gap defects. Molecular group cracking in PP was attributed to the bond breakage on the main chain. These findings provide insights into high-temperature superconducting cable insulation under air gap discharge and provide a guideline for practical applications in semi-conductive industries.

A two-pronged approach:Bulk-phase substitution and second-phase synergism to enhance the anion redox stability of layered oxide cathode for sodium-ion batteries

As a supplement to lithium-ion batteries, sodium-ion batteries have great application potential in large-scale energy storage equipment, vehicle start-stop power supplies, and low-speed electric vehicle power. P3-NaxLiyMn1-yO2 (NLMO), has received widespread attention due to its higher charge voltage and discharge capacity. However, poor cycle stability and rapid voltage platform decay caused by the release of oxygen during charging hinder its practical application. This paper reports a new NLMO modification strategy, which effectively improves the cycling stability of NLMO by substituting Zr4+ for Mn4+ in the bulk phase to suppress the O2−/On− redox couple activity and stabilize the ZrO2 second phase lattice. Under the combined action of substitution and second phase, the capacity retention rate of NLMO@Zr0.15 was 85.4 % after 100 cycles at a rate of 5 C. The results show that Zr4+ changes the coordination environment and electronic structure of O in the crystal lattice, prompting further splitting of Mn t2 g, thereby increasing the proportion of Mn 3d orbitals near the Fermi level. During the first discharge process, due to the charge balancing effect, Mn3+/Mn4+ replaced the electrochemical activity of O2−/On−, obtaining a specific capacity of up to 161 mAh g−1. This internal and external improvement idea provides a new direction for solving the poor cycle stability of NLMO high specific energy sodium-ion battery cathode materials and improving the specific capacity.

Hierarchical Flower Array NiCoOOH@CoLa‐LDH Nanosheets for High‐Performance Supercapacitor and Alkaline Zn Battery

AbstractNickel oxyhydroxide based energy storage materials have been largely confined by insufficient exposure of active sites which results in low energy efficiency and poor stability. In order to resolve the problems, hierarchical flower array heterostructure NiCoOOH@CoLa‐LDH (denoted as NC@CL) nanosheets are designed with NiCo oxyhydroxide (NiCoOOH, denoted as NC) being tightly covered on CoLa layered double hydroxide (CoLa‐LDH, denoted as CL) nanosheet. This rational design creates more active sites, enlarges the electrode‐electrolyte contact area, improves electron conductivity, and prevents agglomeration during the cycling charge–discharge processes. Density functional theory calculations and differential charges concurrently illustrate that heterostructure formation optimizes the reaction kinetics and promotes electron redistribution. Benefiting from the heterogeneous structure and rich electro‐active sites caused by NC, NC@CL displays outstanding reversible specific capacitance (3228 F g−1 at 1 A g−1). The aqueous rechargeable alkaline Zn battery NC@CL//Zn exhibits a high capacity of 381.1 mA h g−1 at 0.5 A g−1 and cycling durability (98% capacity retention after cycling at 5 A g−1 for 2000 cycles). The excellent electrochemical performances indicate that NC@CL has great application potential as electrode material for aqueous energy storage device.

Heterostructure Engineering of Biphase‐Coupled Ternary Transition Metal Phosphoselenide by Topological Transformation Enabling High Performance for Supercapacitors

AbstractThe exploration of promising electrode materials with structural stability and rapid interfacial reaction kinetics is highly desirable for supercapacitors toward large‐scale applications. Herein, the synthesis of biphase‐coupled CoPSe/NiP0.24Se1.76 with multiple in‐plane heterointerfaces using the in situ topological transformation approach is presented. As a novel ternary metal phosphoselenide (TMPSe) for supercapacitor cathode that is fabricated by synchronous phosphoselenization strategy, it realizes a superior lifespan with cycling compared to conventional transition metal selenides. The depleted anti‐bonding eg* orbitals of transition metal ions (Co/Ni) in the CoPSe/NiP0.24Se1.76, as proved by preliminary theoretical calculations, strengthens the chemical bonding between Co/Ni and coordinating atoms, thereby enhancing the chemical stability. Simultaneously, the CoPSe/NiP0.24Se1.76 in‐plane multi‐heterostructures can not only alleviate the volume change during the charge–discharge process but also expose more active sites, promoting the adsorption of OH− ions, which is conducive to the rapid redox reaction kinetics of the CoPSe/NiP0.24Se1.76, and consequently, it delivers a remarkable reversible capacity and excellent long‐term cycle stability with 97.7% initial capacitance retention over 16 000 cycles. Moreover, the asymmetric supercapacitors with this cathode demonstrate outstanding rate capability and high energy density. This strategy of constructing biphase‐coupled CoPSe/NiP0.24Se1.76 by topological transformation is of great potential application for the high‐performance electrode material.

Illustrating the influence of anodic/cathodic second-phases on dissolution mode via Mg–Ca–Sn alloy anodes for primary Mg-air cells

Two second-phases with an opposite potential difference to the α-Mg matrix may affect the discharge mechanism of magnesium (Mg) anodes for primary Mg-air cells through different micro-galvanic behaviors. Herein, using Mg–Ca-xSn alloys anode with Mg2Ca and CaMgSn phases, we investigated their influence on the dissolution mode of Mg-anode during discharge state via in-situ scanning vibrating electrode technique (SVET) technology. Firstly, the peak surface positive potential of Mg–1Ca alloy only containing Mg2Ca phase and Mg–1Ca–1Sn alloy with CaMgSn/Mg2Ca phase increases multiplied by 10 during the discharge process compared to that of OCP, exhibiting accelerated anodic substrate dissolution. Moreover, Mg2Ca-phases can be attacked firstly while promoting the discharge of the α-Mg matrix surrounding them, leading to the preferential dissolution of grain boundaries and “chunk effects (CE)” occurrence. More CaMgSn/α-Mg couples are activated to form dispersed micro-galvanic cell islands, which also boosts the dissolution of the α-Mg matrix but reduces the area of high-intensity dissolution reaction due to CaMgSn acting as a cathode. However, excessive CaMgSn-phase generally fails to discharge effectively to reduce anode efficiency, although it can improve the self-peeling capacity of the film layer through physical detachment; in addition, with Sn content increasing to 3 wt%, the open circuit voltage of Mg–1Ca–3Sn significantly declines. Mg–1Ca-0.2Sn exhibits the highest cell voltage and anodic efficiency by introducing a tiny amount of dispersed short rod-like CaMgSn, due to the adjusted dissolution mode, enhanced electrochemical activity and inhibited CE. Finally, our study provides a universal mechanism for fabricating Mg-anode with high performance via phase composition modulation.

Identifying factors influencing emerging innovations in hospital discharge decision making in response to system stress: a qualitative study

BackgroundThe purpose of this qualitative study was to identify emergent rehabilitation innovations and clinician perceptions influencing their implementation and outcomes related to hospital discharge decision-making during the Coronavirus 2019 pandemic.MethodsRehabilitation clinicians were recruited from the Veterans Affairs Health Care System and participated in individual semi-structured interviews guided by the integrated Promoting Action on Research Implementation in Health Services (i-PARIHS) framework. Data were analyzed using a rapid qualitative, deductive team-based approach informed by directed content analysis.ResultsTwenty-three rehabilitation clinicians representing physical (N = 11) and occupational therapy (N = 12) participated in the study. Three primary themes were generated: (1) Innovation: emerging innovations in discharge processes included perceived increases in team collaboration, shifts in caseload prioritization, and alternative options for post-acute care. (2) Recipients: innovations emerged as approaches to communicating discharge recommendations changed (in-person to virtual) and strong patient/family preferences to discharge to the home challenged collaborative goal setting; and (3) Context: the ability of rehabilitation clinicians to innovate and the form of innovations were influenced by the broader hospital system, interdisciplinary team dynamics, and policy fluctuations. Innovations described by participants included (1) use of technological modalities for interdisciplinary collaboration, (2) expansion of telehealth modalities to deliver care in the home, (3) changes in acute care case prioritization, and (4) alternative options for discharge directly to home.ConclusionsOur findings reinforce that rehabilitation clinicians developed innovative strategies to quickly adapt to multiple systems-level factors that were changing in the face of the COVID-19 pandemic. Future research is needed to assess the impact of innovations, remediate unintended consequences, and evaluate the implementation of promising innovations to respond to emerging healthcare delivery needs more rapidly.

Synthesis mechanism of TiO2 nanoparticles via high frequency electrical arc discharge

Abstract The rapid advancement of nanofabrication techniques has significantly increased the utilization of nanoparticles in recent years. This study investigates the synthesis of titanium dioxide (TiO₂) nanoparticles, highlighting their unique properties and diverse applications across scientific and industrial fields. These nanoparticles are valued for their biocompatibility and advantageous optical, electrical, and physical properties. Various synthesis methods—chemical, physical, and biological—are reviewed, with a particular focus on the electric arc discharge method. This method is distinguished by its efficiency and environmental friendliness, enabling the production of highly pure nanoparticles. Utilizing continuous and alternating sparks between two electrodes, the technique generates spherical nanoparticles with adjustable sizes, controlled by the energy of each spark. An RC circuit-based device was designed for this electrical discharge process. Dynamic light scattering (DLS) measurements revealed an average particle size of 164.51 nm with a standard deviation of 44.08 nm. Field emission scanning electron microscopy (FESEM) images showed both solid and hollow spherical TiO2 nanoparticles. Energy dispersive spectroscopy (EDS) confirmed that the TiO2 particles contained only titanium and oxygen, with no other elements detected. X-ray diffraction (XRD) analysis verified the crystal structure, predominantly identifying the anatase phase of the synthesized nanoparticles. This research enhances the understanding of TiO2 nanoparticle synthesis and characterization, providing a foundation for future innovations in their extensive applications.

Review on polymer electrolytes for lithium‐sulfurized polyacrylonitrile batteries

AbstractLithium‐sulfur (Li‐S) batteries are deemed as the next generation of energy storage devices due to high theoretical specific capacity (1675 mAh g−1) and energy density (2600 Wh kg−1). However, the commercial application has always been constrained by lithium polysulfide (LiPSs) shuttling effects and still has a long way to go. Sulfurized polyacrylonitrile (SPAN) is a promising alternative candidate to replace traditional sulfur cathode and is conducive to eliminating LiPSs by realizing “solid‐solid” direct conversion in conventional carbonate electrolytes. However, an over 25% irreversible capacity loss is exhibited inevitably in the first discharge process, the inherent structure of SPAN and the related reaction mechanism remain unclear. In this review, the structure characteristics and electrochemical behaviors of SPAN are summarized for better interpreting current knowledge and favoring the design of high performance materials. In the past few decades, many problems in traditional Li‐S batteries have been solved by improving electrolytes. Polymer electrolytes (PEs) have been widely used due to structural designability, multi‐functionality, exceptional chemical stability, and excellent processability. Surprisingly, the relevant researches on PEs compatible with SPAN remains limited currently. Therefore, the recent modification strategies of gel polymer electrolytes and solid polymer electrolytes in Li‐SPAN batteries are introduced in terms of Li+ transfer and interface engineering, the design principles are concluded, the specific challenges encountered by polymer‐based electrolytes are summarized and the instructive directions for future research on PEs are demonstrated, facilitating the commercialization of Li‐SPAN batteries.

Contextual Factors Influencing Intensive Care Patients' Discharge Processes: A Multicentre Prospective Observational Study.

To compare contextual factors influencing discharge practices in three intensive care units (ICUs). A prospective observational study. Data were collected using a discharge process report form (DPRF) between May and September 2023. Descriptive statistics were performed to analyse demographic and clinical data. One-way analysis of variance (ANOVA) was used to test the time interval differences among the three sites. Overall, 69 patients' discharge processes were observed. Among them, 41 (59%) experienced discharge delay, and 1 in 5 patients experienced after-hours discharge. There were statistically significant differences in mean hours in various time intervals during the discharge processes among the three sites. Patients in Hospital C waited the longest time (mean = 31.9 h) for the ward bed to be ready after the bed was requested and for being eventually discharged after ICU nurses to get them ready for discharge (mean = 26.7 h) compared to Hospital A and Hospital B. We found that discharge delay and after-hours discharge were common and there were significant differences in mean hours of various time intervals during the discharge processes occurred among the three sites. The influence of contextual factors in different hospitals/ICU needs to be considered to improve the ICU discharge process. Researchers and clinicians should consider targeted context-specific interventions and strategies to optimise patient discharge process from ICUs. The study findings will inform the development of tailored interventions to reduce the discharge delay and after-hours discharge and, in turn, improve the quality and safety of patient care and health service efficiency. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines. Patients' discharge processes were observed, and consumer representatives were involved in the study design.

Tailoring eco-friendly siloxane-based electrolytes for high-performance lithium–sulfur batteries

Lithium–sulfur batteries (LSBs), with their ultra-high theoretical energy density (2600 Wh kg−1), are considered one of the most attractive high-energy batteries. However, the “shuttling effect” of polysulfides and the uncontrolled growth of lithium (Li) dendrites pose significant challenges to the practical implementation of LSBs. Herein, a lightweight and eco-friendly diethoxydimethylsilane (DEMS) is chosen as a multi-functional solvent for LSBs. The low polarity of DEMS promotes the “solid–solid” conversion of sulfurized polyacrylonitrile (SPAN) during charge–discharge processes, eliminating the shuttle effect of polysulfides. Moreover, the DEMS-based electrolyte enables highly reversible Li plating/stripping processes across a wide temperature range spanning from −20 to 60 °C. As a result, the Li/SPAN batteries using the DEMS electrolyte exhibit excellent cyclic stability at 0.2 C with retainable capacities of 524.4 mAh/g after 200 cycles, 598.8 mAh/g after 100 cycles, and 318.6 mAh/g after 50 cycles at 26, 60 and −20 °C, respectively. This study aims to identify low-cost and highly stable electrolytes through solvent screening to enhance the electrochemical performance of LSBs.

A Supramolecular Deep Eutectic Electrolyte Enhancing Interfacial Stability and Solution Phase Discharge in Li−O2 Batteries

AbstractLi−O2 batteries (LOBs) have gained widespread recognition for their exceptional energy densities. However, a major challenge faced by LOBs is the lack of appropriate electrolytes that can effectively balance reactant transport, interfacial compatibility, and non‐volatility. To address this issue, a novel supramolecular deep eutectic electrolyte (DEE) has been developed, based on synergistic interaction between Li‐bonds and H‐bonds through a combination of lithium salt (LiTFSI), acetamide (Ace) and boric acid (BA). The incorporation of BA serves as an interface modification additive, acting as both Li‐bonds acceptor and H‐bonds donor/acceptor, thereby enhancing the redox stability of the electrolyte, facilitating a solution phase discharge process and improving compatibility with the Li anode. Our proposed DEE demonstrates a high oxidation voltage of 4.5 V, an ultrahigh discharge capacity of 15225 mAh g−1 and stable cycling performance of 196 cycles in LOBs. Additionally, the intrinsic non‐flammability and successful operation of a Li−O2 pouch cell indicate promising practical applications of this electrolyte. This research broadens the design possibilities for LOBs electrolytes and provides theoretical insights for future studies.

Effects of discharge parameters on plasma acceleration and transmission characteristics of a coaxial gun operated in gas-prefilled mode

The effects of discharge parameters on the discharge process and plasma transport characteristics of a coaxial gun in the gas-prefilled mode are studied. The plasma optical intensity and ejection velocity are measured by photodiodes, the optical emission spectrum is taken by a spectroscopic system, and the plasma evolution in the transport process is captured by a high-speed camera. The plasma acceleration characteristics under different discharge parameters show that the velocity and electron density of the ejection plasma are mainly determined by the pre-filled pressure and discharge current, which is consistent with the snowplow model. The kinetic energy of ejection plasma can be significantly increased by reducing the outer loop inductance, which is conducive to increasing the energy utilization efficiency. The time-varying images of plasma radiation and the plasma density at different transport locations illuminate the transmission characteristics of coaxial gun discharge plasma. The results show that the snowplow effect continues to play a role in the plasma transport process, and the plasma accumulation is induced by the combination of shock wave compression. The current-driven magneto hydrodynamics instability occurs during the transport process, and the luminous signal of the plasma current sheet oscillates periodically. In addition, the plasma impact effect is obvious and the gas retarding effect is enhanced with the increase in the gas pressure. These results give us a more comprehensive view of the coaxial gun discharge process and plasma transport and provide a certain reference for optimizing the parameters selection and physical design of coaxial gun discharge plasma characteristics.

07 Partnering with patients with living and lived experience of eating disorders to improve inpatient care on an acute paediatric medicine unit

Abstract Background Since the COVID-19 pandemic, hospitals nationally are seeing a growing number of adolescent patients with eating disorders requiring acute medical stabilization, which is often a time of crisis in the trajectory of this ego-syntonic disorder. The complexity of these admissions often lead to safety events for patients and moral distress for clinicians. Medical admissions can also be an opportunity to engage youth and families. Patient partners are a pillar in healthcare quality improvement, but historically we have not engaged adolescent patient partners in improving acute eating disorder treatment. We gathered the experience of patients and families with living and lived experience of eating disorder treatment to improve their quality of care in an acute paediatric medicine unit. Objectives We aimed to describe the experience of patients and families with living and lived experience of eating disorder treatment, specifically acute medical stabilization, through a quality improvement patient engagement project. Design/Methods We used a mixed-methods design of semi-structured interviews and a focus group with adolescents with eating disorders and their caregivers in an acute medical unit at a tertiary paediatric hospital in British Columbia. We employed opportunity sampling by distributing recruitment flyers through patient experience councils, outpatient clinics, other non-acute units, and to all patients admitted with a medically unstable eating disorder at our hospital during the study period. The interviews consisted of open-ended questions, yes/no questions, and Likert scales related to four categories: admission process, inpatient experience, team communication, and discharge process. Two reviewers analyzed the qualitative data using thematic analysis, and the quantitative data was analyzed descriptively. Quality improvement projects are exempt from Research Ethics Board approval. However, we utilized the "A Project Ethics Community Consensus Initiative" (ARECCI) Ethics Guideline and Screening Tool and presented our proposal at the hospital's quality improvement and research oversight committees. Results We completed 8 interviews with patients with current living experience admitted to our acute medical unit. We also completed 1 interview with a patient with past lived experience and 1 focus group with patients and caregivers. Primary themes identified included uncertainty about their overall treatment journey and stress due to the sudden new expectations on the inpatient unit, such as activity restriction, meal plans by the hospital, and bathroom access after meal times. Patients identified the importance of relational care, inclusion in treatment planning, acknowledgement of the demanding nature of eating disorders, and individualized care. Due to variability in training, resource allocation, and gaps in communication, these patient-identified priorities are not always met. While 100% of participants stated they understood the reasons and goals for admission, participants averaged 3.7 on a 1 (lowest) to 5 (highest) Likert scale when asked to rate their satisfaction with the information they received. Five out of eight adolescents felt that there was consistency in communication within the team. Conclusion We demonstrate the complex needs of patients with eating disorders who require acute medical stabilization. Targeted knowledge mobilization initiatives through admission orientation documents and family-centered rounds could better meet those needs. We are currently developing an admission pamphlet and journal for patients admitted with a new eating disorder to our medical unit. Patient partners exhibited a high willingness to participate in our study and readily acknowledged the importance their contributions could hold for other patients.

18 Past and current care practices for neonates with complex medical needs: A scoping review to support clinical program evaluation

Abstract Background Neonates with complex medical needs (NCMN) are a rapidly growing patient population internationally. Although NCMN are a relatively small proportion of all Neonatal Intensive Care Unit (NICU) admissions, they are high healthcare utilizers. Since 2018, a dedicated Neonatal Complex Care Team (NCCT) has cared for NCMN at a large quaternary care center. The NCCT cares for NCMN in a dedicated, single-family room, patient area within the NICU. This model of care has yet to be evaluated for its potential impact on healthcare outcomes. Objectives The objective of the scoping review is to determine the breadth of available literature on the care practices for the management of NCMN and to collate the available evidence to define outcome measures to be used in a formal program evaluation. Design/Methods The review followed the PRISMA extension for scoping reviews and utilized resources from the Joanna Briggs Institute. The two databases that were utilized include Medline via OVID and CINAHL. The dates for included publications are January 1st 1993, until July 15th 2023. Only studies published in English and primary research were included. Two independent reviewers performed the initial title and abstract screening, and the full text review. The data extraction was completed by one independent reviewer. Results 102 articles were included in the title and abstract screen, and 12 were considered for full text review. Four articles were included. Interventions discussed in the included articles ranged from discharge conferences with patient’s caregivers, to the implementation of an entirely new model of care. Multidisciplinary health care teams appear to be integral to the in-hospital care and smooth discharge of NCMN. We identified that caregiver involvement and satisfaction are important to the discharge process as they are primarily responsible for their infant’s care after discharge, and so it is important that the specifics of care are communicated and taught effectively. The outcomes of interest identified as most useful for clinical program evaluation were length of stay and readmission rate. Additionally there was limited data reported on long-term health outcomes of this patient population. Conclusion This scoping review identified few articles that reported new models of care, a lack of consistent outcomes used in evaluating existing care models and overall a gap in research in this rapidly growing patient population. There is more work to be done to improve care of NCMN and our findings will be used in designing future studies that evaluate care models.