1,793 research outputs found
Multi-Agent System Control and Coordination of an Electrical Network
Multi-Agent Systems (MAS) have the potential to solve Active Network Management (ANM) problems arising from an increase in Distributed Energy Resources (DER). The aim of this research is to integrate a MAS into an electrical network emulation for the purpose of implementing ANM. Initially an overview of agents and MAS and how their characteristics can be used to control and coordinate an electrical network is presented. An electrical network comprising a real-time emulated transmission network connected to a live DER network controlled and coordinated by a MAS is then constructed. The MAS is then used to solve a simple ANM problem: the control and coordination of an electrical network in order to maintain frequency within operational limits. The research concludes that a MAS is successful in solving this ANM problem and also that in the future the developed MAS can be applied to other ANM problems. © 2012 IEEE
The ROPAC registry: a multicentre collaboration on pregnancy outcomes in women with heart disease
A low-wear onload tap changer diverter switch for frequent voltage control on distribution networks
This paper presents a fast mechanical diverter switch design suitable for new “arcless” hybrid onload tap-changing systems. In such systems, arcing at contact separation and contact closure is almost completely eliminated by the inclusion of alternate current paths incorporating semiconductor devices. This allows the use of compact, air-insulated mechanical contacts that do not need to withstand significant arc erosion or provide arc quenching. As a result, the moving mass and the drive system for the switch may be dramatically reduced in size, leading to low inertia of the moving parts and resulting in very rapid operation times. An integrated, high-torque, low-mass permanent-magnet actuator is presented that provides detent (unpowered) contact force coupled with a cantilever spring contact system sized for an 11-kV 2-MVA onload tap changer. The design delivers operation times of under 20 ms and is capable of sustaining more than operations. The complete design is experimentally verified under representative electrical conditions, and contact wear levels comparable to pure mechanical (zero current) operation are demonstrated
Ventricular arrhythmias and sudden death in adults after a Mustard operation for transposition of the great arteries
Aims To examine the prevalence of sustained ventricular tachycardia (VT) and sudden death (SD) in adults with atrial repair of transposition of the great arteries (TGA) and to determine associated risk factors. Methods and results In a single-centre review, we studied the outcome of 149 adults (mean age 28 ± 7 years) who had undergone a Mustard operation for TGA. During a mean follow-up of 9 ± 6 years, sustained VT and/or SD occurred in 9% (13/149) of the cohort. Sustained VT/SD was more likely to occur in patients with associated anatomic lesions [hazard ratio (HR) 4.9, 95% CI 1.5-16.0], with NYHA class ≥III (HR 9.8, 95% CI 3.0-31.6) and with an impaired subaortic right ventricular (RV) ejection fraction (EF) (HR 2.2, 95% CI 1.2-4.0 per 10% decrease in EF). There was an inverse correlation between the RV-EF and both age and QRS duration. Patients with a QRS duration ≥140 ms were at highest risk of sustained VT/SD (HR 13.6, 95% CI 2.9-63.4). Atrial tachyarrhythmia was detected in 66 (44%) patients, but was not a statistically significant predictor of sustained VT/SD in our adult population (HR 2.7, 95% CI 0.6-13.0). Conclusion Sustained VT/SD in adults after a Mustard operation for TGA are more common than previously described. Age, systemic ventricular function, and QRS duration are interrelated and are associated with VT/SD. A QRS duration ≥140 ms helps to identify the high risk patien
Cardiac outcomes in adults with supravalvar aortic stenosis
Aims Supravalvar aortic stenosis is a rare form of left ventricular outflow tract obstruction that is often progressive in childhood. Little data are available on outcomes in the adult population. Our aim was to define cardiac outcomes in adults with supravalvar aortic stenosis. Methods and results This is a multicentre retrospective study of cardiac outcomes in adults (≥18 years) with supravalvar aortic stenosis. We examined: (i) adverse cardiac events (cardiovascular death, myocardial infarction, stroke, heart failure, sustained arrhythmias, and infective endocarditis) and (ii) the need for cardiac surgery in adulthood. One hundred and thirteen adults (median age at first visit 19 years; 55% with Williams-Beuren syndrome; 67% with surgical repair in childhood) were identified. Adults without Williams-Beuren syndrome had more severe supravalvar aortic stenosis and more often associated left ventricular outflow tract obstructions (P < 0.001). In contrast, mitral valve regurgitation was more common in patients with Williams-Beuren syndrome. Eighty-five per cent of adults (96/113) had serial follow-up information (median follow-up 6.0 years). Of these patients, 13% (12/96) had an adverse cardiac event and 13% (12/96) had cardiac operations (7 valve repair or replacements, 4 supravalvar aortic stenosis repairs, 1 other). Cardiac surgery was more common in adults without Williams-Beuren syndrome (P = 0.007). Progression of supravalvar aortic stenosis during adulthood was rare. Conclusion Adults with supravalvar aortic stenosis remain at risk for cardiac complications and reoperations, while progression of supravalvar aortic stenosis in adulthood is rare. Valve surgery is the most common indication for cardiac surgery in adulthoo
Conservative fluid management or deresuscitation for patients with sepsis or acute respiratory distress syndrome following the resuscitation phase of critical illness: a systematic review and meta-analysis
BackgroundIt is unknown whether a conservative approach to fluid administration or deresuscitation (active removal of fluid using diuretics or renal replacement therapy) is beneficial following haemodynamic stabilisation of critically ill patients.PurposeTo evaluate the efficacy and safety of conservative or deresuscitative fluid strategies in adults and children with acute respiratory distress syndrome (ARDS), sepsis or systemic inflammatory response syndrome (SIRS) in the post-resuscitation phase of critical illness.MethodsWe searched Medline, EMBASE and the Cochrane central register of controlled trials from 1980 to June 2016, and manually reviewed relevant conference proceedings from 2009 to the present. Two reviewers independently assessed search results for inclusion and undertook data extraction and quality appraisal. We included randomised trials comparing fluid regimens with differing fluid balances between groups, and observational studies investigating the relationship between fluid balance and clinical outcomes.ResultsForty-nine studies met the inclusion criteria. Marked clinical heterogeneity was evident. In a meta-analysis of 11 randomised trials (2051 patients) using a random-effects model, we found no significant difference in mortality with conservative or deresuscitative strategies compared with a liberal strategy or usual care [pooled risk ratio (RR) 0.92, 95 % confidence interval (CI) 0.82–1.02, I2 = 0 %]. A conservative or deresuscitative strategy resulted in increased ventilator-free days (mean difference 1.82 days, 95 % CI 0.53–3.10, I2 = 9 %) and reduced length of ICU stay (mean difference −1.88 days, 95 % CI −0.12 to −3.64, I2 = 75 %) compared with a liberal strategy or standard care.ConclusionsIn adults and children with ARDS, sepsis or SIRS, a conservative or deresuscitative fluid strategy results in an increased number of ventilator-free days and a decreased length of ICU stay compared with a liberal strategy or standard care. The effect on mortality remains uncertain. Large randomised trials are needed to determine optimal fluid strategies in critical illness
Stu Davis: Canada’s Cowboy Troubadour
This essay is a profile of Stu Davis, a Canadian musical composer, performer, and radio/television host between 1939 and 1971. With his many recordings, constant on-air presence, and easy-going personality, he popularized country and western music to mainstream Canadian (as well as American and European) audiences
Genetic services and attitudes in primary care pediatrics
Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/102660/1/ajmga36339.pd
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