Higher incidence of adverse events in isolated patients compared with non-isolated patients: A cohort study

Objective To determine whether isolated patients admitted to hospital have a higher incidence of adverse events (AEs), to identify their nature, impact and preventability. Design Prospective cohort study with isolated and non-isolated patients. Setting One public university hospital in the Valencian Community (southeast Spain). Participants We consecutively collected 400 patients, 200 isolated and 200 non-isolated, age =18 years old, to match according to date of entry, admission department, sex, age (±5 years) and disease severity from April 2017 to October 2018. Exclusion criteria: patients age <18 years old and/or reverse isolation patients. Primary and secondary outcome measures The primary outcome as the AE, defined according to the National Study of Adverse Effects linked to Hospitalisation (Estudio Nacional Sobre los Efectos Adversos) criteria. Cumulative incidence rates and AE incidence density rates were calculated. Results The incidence of isolated patients with AEs 16.5% (95% CI 11.4% to 21.6%) compared with 9.5% (95% CI 5.4% to 13.6%) in non-isolated (p<0.03). The incidence density of patients with AEs among isolated patients was 11.8 per 1000?days/patient (95%?CI 7.8 to 15.9) compared with 4.3 per 1000?days/patient (95%?CI 2.4 to 6.3) among non-isolated patients (p<0.001). The incidence of AEs among isolated patients was 18.5% compared with 11% for non-isolated patients (p<0.09). Among the 37 AEs detected in 33 isolated patients, and the 22 AEs detected in 19 non-isolated patients, most corresponded to healthcare-associated infections (HAIs) for both isolated and non-isolated patients (48.6% vs 45.4%). There were significant differences with respect to the preventability of AEs, (67.6% among isolated patients compared with 52.6% among non-isolated patients). Conclusions AEs were significantly higher in isolated patients compared with non-isolated patients, more than half being preventable and with HAIs as the primary cause. It is essential to improve training and the safety culture of healthcare professionals relating to the care provided to this type of patient

Power system stability analysis under increasing penetration of photovoltaic power plants with synchronous power controllers

The utilisation of renewable sources brings many benefits to electric power systems, but also some challenges such as the impact that renewable power plants employing power electronics have on the grid, which is gaining importance as the penetration of this type of generating stations increases, driven by the construction of large wind or solar photovoltaic (PV) power plants. This study analyses the impact of large-scale PV power plants on a transmission grid for different penetration levels. The analysis considers power plants formed by a number of power converters employing synchronous power controllers (SPCs), that allow them to have a harmonious interaction with the grid, and compares their performance with that of conventional power converter controllers, assuming in both cases that the power plants participate in frequency and voltage regulation. The study addresses both the small-signal stability of the system and its response to large disturbances that alter the active power balance and frequency stability. The results of the analysis show that PV power plants using SPCs are able to limit frequency deviations, improve the oscillation damping, and reduce the stress of other generating units, thus having a beneficial impact on the power system.Peer Reviewe

Efficient Model Order Reduction of Large-Scale Systems on Multi-core Platforms

We propose an efficient implementation of the Balanced Truncation (BT) method for model order reduction when the state-space matrix is symmetric (positive definite). Most of the computational effort required by this method is due to the computation of matrix inverses. Two alternatives for the inversion of a symmetric positive definite matrix on multi-core platforms are studied and evaluated, the traditional approach based on the Cholesky factorization and the Gauss-Jordan elimination algorithm. Implementations of both methods have been developed and tested. Numerical experiments show the efficiency attained by the proposed implementations on the target architecture.Supported by the CICYT project TIN2008-06570-C0