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 $10^{6}$ operations. The complete design is experimentally verified under representative electrical conditions, and contact wear levels comparable to pure mechanical (zero current) operation are demonstrated

Nurses' perceptions of aids and obstacles to the provision of optimal end of life care in ICU

Contains fulltext : 172380.pdf (publisher's version ) (Open Access

Effect of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker initiation on organ support-free days in patients hospitalized with COVID-19

IMPORTANCE Overactivation of the renin-angiotensin system (RAS) may contribute to poor clinical outcomes in patients with COVID-19. Objective To determine whether angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) initiation improves outcomes in patients hospitalized for COVID-19. DESIGN, SETTING, AND PARTICIPANTS In an ongoing, adaptive platform randomized clinical trial, 721 critically ill and 58 non–critically ill hospitalized adults were randomized to receive an RAS inhibitor or control between March 16, 2021, and February 25, 2022, at 69 sites in 7 countries (final follow-up on June 1, 2022). INTERVENTIONS Patients were randomized to receive open-label initiation of an ACE inhibitor (n = 257), ARB (n = 248), ARB in combination with DMX-200 (a chemokine receptor-2 inhibitor; n = 10), or no RAS inhibitor (control; n = 264) for up to 10 days. MAIN OUTCOMES AND MEASURES The primary outcome was organ support–free days, a composite of hospital survival and days alive without cardiovascular or respiratory organ support through 21 days. The primary analysis was a bayesian cumulative logistic model. Odds ratios (ORs) greater than 1 represent improved outcomes. RESULTS On February 25, 2022, enrollment was discontinued due to safety concerns. Among 679 critically ill patients with available primary outcome data, the median age was 56 years and 239 participants (35.2%) were women. Median (IQR) organ support–free days among critically ill patients was 10 (–1 to 16) in the ACE inhibitor group (n = 231), 8 (–1 to 17) in the ARB group (n = 217), and 12 (0 to 17) in the control group (n = 231) (median adjusted odds ratios of 0.77 [95% bayesian credible interval, 0.58-1.06] for improvement for ACE inhibitor and 0.76 [95% credible interval, 0.56-1.05] for ARB compared with control). The posterior probabilities that ACE inhibitors and ARBs worsened organ support–free days compared with control were 94.9% and 95.4%, respectively. Hospital survival occurred in 166 of 231 critically ill participants (71.9%) in the ACE inhibitor group, 152 of 217 (70.0%) in the ARB group, and 182 of 231 (78.8%) in the control group (posterior probabilities that ACE inhibitor and ARB worsened hospital survival compared with control were 95.3% and 98.1%, respectively). CONCLUSIONS AND RELEVANCE In this trial, among critically ill adults with COVID-19, initiation of an ACE inhibitor or ARB did not improve, and likely worsened, clinical outcomes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT0273570

GHOST Commissioning Science Results: Identifying a New Chemically Peculiar Star in Reticulum II

The Gemini High-resolution Optical SpecTrograph (GHOST) is the newest high-resolution spectrograph to be developed for a large-aperture telescope, recently deployed and commissioned at the Gemini-South telescope. In this paper, we present the first science results from the GHOST spectrograph taking during its commissioning runs. We have observed the bright metal-poor benchmark star HD 122563, along with two stars in the ultrafaint dwarf galaxy Reticulum II (Ret ii ), one of which was previously identified as a candidate member, but did not have a previous detailed chemical abundance analysis. We find that this candidate (GDR3 0928) to be a bona fide member of Ret ii , and from a spectral synthesis analysis it is also revealed to be a CEMP- r star, with significant enhancements in several light elements (C, N, O, Na, Mg, and Si), in addition to featuring an r -process enhancement like many other Ret ii stars. The light-element enhancements in this star resemble the abundance patterns seen in the CEMP-no stars of other ultrafaint dwarf galaxies, and are thought to have been produced by an independent source from the r -process. These unusual abundance patterns are thought to be produced by faint supernovae, which may be produced by some of the earliest generations of stars