Grid Voltages Estimation for Three-Phase PWM Rectifiers Control Without AC Voltage Sensors

This paper proposes a new ac voltage sensorless control scheme for the three-phase pulse-width modulation rectifier. A new startup process to ensure a smooth starting of the system is also proposed. The sensorless control scheme uses an adaptive neural (AN) estimator inserted in voltage-oriented control to eliminate the grid voltage sensors. The developed AN estimator combines an AN network in series with an AN filter. The AN estimator structure leads to simple, accurate, and fast grid voltages estimation, and makes it ideal for low-cost digital signal processor implementation. Lyapunov-based stability and parameters tuning of the AN estimator are performed. Simulation and experimental tests are carried out to verify the feasibility and effectiveness of the AN estimator. Obtained results show that the proposed AN estimator presented faster convergence and better accuracy than the second-order generalized integrator-based estimator; the new startup procedure avoided the overcurrent and reduced the settling time; and the AN estimator presented high performances even under distorted and unbalanced grid voltages

Epidemiology and outcomes of hospital-acquired bloodstream infections in intensive care unit patients: the EUROBACT-2 international cohort study

Purpose In the critically ill, hospital-acquired bloodstream infections (HA-BSI) are associated with significant mortality. Granular data are required for optimizing management, and developing guidelines and clinical trials. Methods We carried out a prospective international cohort study of adult patients (≥ 18 years of age) with HA-BSI treated in intensive care units (ICUs) between June 2019 and February 2021. Results 2600 patients from 333 ICUs in 52 countries were included. 78% HA-BSI were ICU-acquired. Median Sequential Organ Failure Assessment (SOFA) score was 8 [IQR 5; 11] at HA-BSI diagnosis. Most frequent sources of infection included pneumonia (26.7%) and intravascular catheters (26.4%). Most frequent pathogens were Gram-negative bacteria (59.0%), predominantly Klebsiella spp. (27.9%), Acinetobacter spp. (20.3%), Escherichia coli (15.8%), and Pseudomonas spp. (14.3%). Carbapenem resistance was present in 37.8%, 84.6%, 7.4%, and 33.2%, respectively. Difficult-to-treat resistance (DTR) was present in 23.5% and pan-drug resistance in 1.5%. Antimicrobial therapy was deemed adequate within 24 h for 51.5%. Antimicrobial resistance was associated with longer delays to adequate antimicrobial therapy. Source control was needed in 52.5% but not achieved in 18.2%. Mortality was 37.1%, and only 16.1% had been discharged alive from hospital by day-28. Conclusions HA-BSI was frequently caused by Gram-negative, carbapenem-resistant and DTR pathogens. Antimicrobial resistance led to delays in adequate antimicrobial therapy. Mortality was high, and at day-28 only a minority of the patients were discharged alive from the hospital. Prevention of antimicrobial resistance and focusing on adequate antimicrobial therapy and source control are important to optimize patient management and outcomes