413 research outputs found
Impact of non-synchronous generation on transmission oscillations paths
The large scale penetration of non-synchronous
generation has been causing several impacts on the power systems dynamics. The low-frequency oscillations affect the power
exchanged along the transmission lines/corridors. This paper uses the Multi-Prony Analysis mode estimation technique to monitor
and suggest the dominant oscillation modes which can be useful for wide-area control purposes. Moreover, the oscillation modes
are also monitored under gradual cases of non-synchronous generation integration in the system. The methodology is applied to two different test transmission systems: i) the two area system and, ii) the Nordic 32 system. The results illustrate the similarity and differences in the scenarios proposed
Homogeneous Bubble Nucleation driven by local hot spots: a Molecular Dynamics Study
We report a Molecular Dynamics study of homogenous bubble nucleation in a
Lennard-Jones fluid. The rate of bubble nucleation is estimated using
forward-flux sampling (FFS). We find that cavitation starts with compact
bubbles rather than with ramified structures as had been suggested by Shen and
Debenedetti (J. Chem. Phys. 111:3581, 1999). Our estimate of the
bubble-nucleation rate is higher than predicted on the basis of Classical
Nucleation Theory (CNT). Our simulations show that local temperature
fluctuations correlate strongly with subsequent bubble formation - this
mechanism is not taken into account in CNT
Microbleed Prevalence and Burden in Anticoagulant-Associated Intracerebral Bleed
Prior studies suggest an association between Vitamin K antagonists (VKA) and cerebral microbleeds (CMBs); less is known about nonvitamin K oral anticoagulants (NOACs). In this observational study we describe CMB profiles in a multicenter cohort of 89 anticoagulation-related intracerebral hemorrhage (ICH) patients. CMB prevalence was 51% (52% in VKA-ICH, 48% in NOAC-ICH). NOAC-ICH patients had lower median CMB count [2(IQR:1–3) vs. 7(4–11); P \u3c 0.001]; ≥5 CMBs were less prevalent in NOAC-ICH (4% vs. 31%, P = 0.006). This inverse association between NOAC exposure and high CMB count persisted in multivariable logistic regression models adjusting for potential confounders (OR 0.10, 95%CI: 0.01–0.83; P = 0.034)
Safety of Coronary Reactivity Testing in Women With No Obstructive Coronary Artery Disease Results From the NHLBI-Sponsored WISE (Women's Ischemia Syndrome Evaluation) Study
ObjectivesThis study evaluated the safety of coronary reactivity testing (CRT) in symptomatic women with evidence of myocardial ischemia and no obstructive coronary artery disease (CAD).BackgroundMicrovascular coronary dysfunction (MCD) in women with no obstructive CAD portends an adverse prognosis of a 2.5% annual major adverse cardiovascular event (MACE) rate. The diagnosis of MCD is established by invasive CRT, yet the risk of CRT is unknown.MethodsThe authors evaluated 293 symptomatic women with ischemia and no obstructive CAD, who underwent CRT at 3 experienced centers. Microvascular function was assessed using a Doppler wire and injections of adenosine, acetylcholine, and nitroglycerin into the left coronary artery. CRT-related serious adverse events (SAEs), adverse events (AEs), and follow-up MACE (death, nonfatal myocardial infarction [MI], nonfatal stroke, or hospitalization for heart failure) were recorded.ResultsCRT-SAEs occurred in 2 women (0.7%) during the procedure: 1 had coronary artery dissection, and 1 developed MI associated with coronary spasm. CRT-AEs occurred in 2 women (0.7%) and included 1 transient air microembolism and 1 deep venous thrombosis. There was no CRT-related mortality. In the mean follow-up period of 5.4 years, the MACE rate was 8.2%, including 5 deaths (1.7%), 8 nonfatal MIs (2.7%), 8 nonfatal strokes (2.7%), and 11 hospitalizations for heart failure (3.8%).ConclusionsIn women undergoing CRT for suspected MCD, contemporary testing carries a relatively low risk compared with the MACE rate in these women. These results support the use of CRT by experienced operators for establishing definitive diagnosis and assessing prognosis in this at-risk population. (Women's Ischemia Syndrome Evaluation [WISE]; NCT00832702
Perioperative oxygen fraction – effect on surgical site infection and pulmonary complications after abdominal surgery: a randomized clinical trial. Rationale and design of the PROXI-Trial
<p>Abstract</p> <p>Background</p> <p>A high perioperative inspiratory oxygen fraction may reduce the risk of surgical site infections, as bacterial eradication by neutrophils depends on wound oxygen tension. Two trials have shown that a high perioperative inspiratory oxygen fraction (Fi<smcaps>O</smcaps><sub>2 </sub>= 0.80) significantly reduced risk of surgical site infections after elective colorectal surgery, but a third trial was stopped early because the frequency of surgical site infections was more than doubled in the group receiving Fi<smcaps>O</smcaps><sub>2 </sub>= 0.80. It has not been settled if a high inspiratory oxygen fraction increases the risk of pulmonary complications, such as atelectasis, pneumonia and respiratory failure. The aim of our trial is to assess the potential benefits and harms of a high perioperative oxygen fraction in patients undergoing abdominal surgery.</p> <p>Methods and design</p> <p>The PROXI-Trial is a randomized, patient- and assessor blinded trial of perioperative supplemental oxygen in 1400 patients undergoing acute or elective laparotomy in 14 Danish hospitals. Patients are randomized to receive either 80% oxygen (Fi<smcaps>O</smcaps><sub>2 </sub>= 0.80) or 30% oxygen (Fi<smcaps>O</smcaps><sub>2 </sub>= 0.30) during surgery and for the first 2 postoperative hours. The primary outcome is surgical site infection within 14 days. The secondary outcomes are: atelectasis, pneumonia, respiratory failure, re-operation, mortality, duration of postoperative hospitalization, and admission to intensive care unit. The sample size allows detection of a 33% relative risk reduction in the primary outcome with 80% power.</p> <p>Discussion</p> <p>This trial assesses benefits and harms of a high inspiratory oxygen fraction, and the trial may be generalizable to a general surgical population undergoing laparotomy.</p> <p>Trial registration</p> <p>ClinicalTrials.gov identifier: NCT00364741.</p
Efficacy and Safety of AmBisome in Combination with Sodium Stibogluconate or Miltefosine and Miltefosine Monotherapy for African Visceral Leishmaniasis: Phase II Randomized Trial.
BACKGROUND: SSG&PM over 17 days is recommended as first line treatment for visceral leishmaniasis in eastern Africa, but is painful and requires hospitalization. Combination regimens including AmBisome and miltefosine are safe and effective in India, but there are no published data from trials of combination therapies including these drugs from Africa. METHODS: A phase II open-label, non-comparative randomized trial was conducted in Sudan and Kenya to evaluate the efficacy and safety of three treatment regimens: 10 mg/kg single dose AmBisome plus 10 days of SSG (20 mg/kg/day), 10 mg/kg single dose AmBisome plus 10 days of miltefosine (2.5mg/kg/day) and miltefosine alone (2.5 mg/kg/day for 28 days). The primary endpoint was initial parasitological cure at Day 28, and secondary endpoints included definitive cure at Day 210, and pharmacokinetic (miltefosine) and pharmacodynamic assessments. RESULTS: In sequential analyses with 49-51 patients per arm, initial cure was 85% (95% CI: 73-92) in all arms. At D210, definitive cure was 87% (95% CI: 77-97) for AmBisome + SSG, 77% (95% CI 64-90) for AmBisome + miltefosine and 72% (95% CI 60-85) for miltefosine alone, with lower efficacy in younger patients, who weigh less. Miltefosine pharmacokinetic data indicated under-exposure in children compared to adults. CONCLUSION: No major safety concerns were identified, but point estimates of definitive cure were less than 90% for each regimen so none will be evaluated in Phase III trials in their current form. Allometric dosing of miltefosine in children needs to be evaluated. TRIAL REGISTRATION: The study was registered with ClinicalTrials.gov, number NCT01067443
Clinical characteristics of patients with suspected cardiac chest pain and angiographically normal coronary arteries in a secondary care hospital
Modeling of Intermediate Structures and Chain Conformation in Silica-Latex Nanocomposites Observed by SANS During Annealing
The evolution of the polymer structure during nanocomposite formation and
annealing of silica-latex nanocomposites is studied using contrast-variation
small angle neutron scattering. The experimental system is made of silica
nanoparticles (Rsi \approx 8 nm) and a mixture of purpose-synthesized
hydrogenated and deuterated nanolatex (Rlatex \approx 12.5 nm). The progressive
disappearance of the latex beads by chain interdiffusion and release in the
nanocomposites is analyzed quantitatively with a model for the scattered
intensity of hairy latex beads and an RPA description of the free chains. In
silica-free matrices and nanocomposites of low silica content (7%v), the
annealing procedure over weeks at up to Tg + 85 K results in a molecular
dispersion of chains, the radius of gyration of which is reported. At higher
silica content (20%v), chain interdiffusion seems to be slowed down on
time-scales of weeks, reaching a molecular dispersion only at the strongest
annealing. Chain radii of gyration are found to be unaffected by the presence
of the silica filler
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