This is a repository copy of Effectiveness of a national quality improvement programme to improve survival after emergency abdominal surgery (EPOCH) : a stepped-wedge cluster-randomised trial. Effectiveness of a national quality improvement programme to improve survival after emergency abdominal surgery (EPOCH) : a stepped-wedge cluster-randomised trial. The Lancet. ISSN 0140-6736 https://doi.org/10.1016/S0140-6736(18)32521-2 eprints@whiterose.ac.uk https://eprints.whiterose.ac.uk/
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Implications of all the available evidenceDespite the success of some smaller projects, there was no survival benefit from a national quality improvement programme to implement a care pathway for patients undergoing emergency abdominal surgery. To succeed, large national quality improvement programmes need to allow for differences between hospitals and ensure teams have both the time and resources needed to improve patient care.
Worldwide production capacities of carbon‐based chemicals and associated products are steadily increasing. At the same time the reduction of greenhouse gas emissions such as carbon dioxide is of paramount importance in order to mitigate the anthropogenic impact of climate change. In Carbon2Chem® a cross industrial network develops concepts towards the utilization of steel mill gases for the sustainable production of “green” base chemicals, including methanol. This Review describes the technological challenges emerging from the use of these alternative feedstocks, specifically in the context of methanol production processes.
Summary
The present work aims to identify critical materials in water electrolysers with potential future supply constraints. The expected rise in demand for green hydrogen as well as the respective implications on material availability are assessed by conducting a case study for Germany. Furthermore, the recycling of end‐of‐life (EoL) electrolysers is evaluated concerning its potential in ensuring the sustainable supply of the considered materials. As critical materials bear the risk of raising production costs of electrolysers substantially, this article examines the readiness of this technology for industrialisation from a material perspective. Except for titanium, the indicators for each assessed material are scored with a moderate to high (platinum) or mostly high (iridium, scandium and yttrium) supply risk. Hence, the availability of these materials bears the risk of hampering the scale‐up of electrolysis capacity. Although conventional recycling pathways for platinum, iridium and titanium already exist, secondary material from EoL electrolysers will not reduce the dependence on primary resources significantly within the period under consideration—from 2020 until 2050. Notably, the materials identified as critical are used in PEM and high temperature electrolysis, whereas materials in alkaline electrolysis are not exposed to significant supply risks.
The greatest lever for advancing climate adaptation and mitigation is the defossilization of energy systems. A key opportunity to replace fossil fuels across sectors is the use of renewable hydrogen. In this context, the main political and social push is currently on climate neutral hydrogen (H2) production through electrolysis using renewable electricity. Another climate neutral possibility that has recently gained importance is biohydrogen production from biogenic residual and waste materials. This paper introduces for the first time a novel concept for the production of hydrogen with net negative emissions. The derived concept combines biohydrogen production using biotechnological or thermochemical processes with carbon dioxide (CO2) capture and storage. Various process combinations referred to this basic approach are defined as HyBECCS (Hydrogen Bioenergy with Carbon Capture and Storage) and described in this paper. The technical principles and resulting advantages of the novel concept are systematically derived and compared with other Negative Emission Technologies (NET). These include the high concentration and purity of the CO2 to be captured compared to Direct Air Carbon Capture (DAC) and Post-combustion Carbon Capture (PCC) as well as the emission-free use of hydrogen resulting in a higher possible CO2 capture rate compared to hydrocarbon-based biofuels generated with Bioenergy with Carbon Capture and Storage (BECCS) technologies. Further, the role of carbon-negative hydrogen in future energy systems is analyzed, taking into account key societal and technological drivers against the background of climate adaptation and mitigation. For this purpose, taking the example of the Federal Republic of Germany, the ecological impacts are estimated, and an economic assessment is made. For the production and use of carbon-negative hydrogen, a saving potential of 8.49–17.06 MtCO2,eq/a is estimated for the year 2030 in Germany. The production costs for carbon-negative hydrogen would have to be below 4.30 € per kg in a worst-case scenario and below 10.44 € in a best-case scenario in order to be competitive in Germany, taking into account hydrogen market forecasts.
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