Plos One
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Conventional generators in power grids are steadily substituted with new renewable sources of electric power. The latter are connected to the grid via inverters and as such have little, if any rotational inertia. The resulting reduction of total inertia raises important issues of power grid stability, especially over short-time scales. ⋯ We find that procedure (iii) has little effect on disturbance propagation, while procedure (i) leads to the strongest increase of RoCoF and frequency deviations. This shows that, beyond absorbing frequency disturbances following nearby faults, inertia also mitigates frequency disturbances from distant power losses, provided both the fault and the inertia are located on the support of the slowest modes of the grid Laplacian. These results for our model of the European transmission grid are corroborated by numerical investigations on the ERCOT transmission grid.
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Primary appraisals of pain as a potential threat influence pain perception and coping but comparatively less is known about related effects of challenge appraisals or causal effects of primary appraisals on secondary appraisals of perceived pain coping capacities (e.g., pain self-efficacy). ⋯ Through examining particular theory-based pain appraisal and coping processes, this experiment is the first to identify both perceived coping capacities (pain self-efficacy) and coping responses as factors that explain why appraisals of pain as a challenge or threat have differential effects on pain tolerance.
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If interprofessional collaborative practice is to be an important component of healthcare reform, then an evidentiary base connecting interprofessional education to interprofessional practice with significantly improved health and healthcare outcomes is an unconditional necessity. This study is a scoping review of the current peer reviewed literature linking interprofessional collaborative care and interprofessional collaborative practice to clearly identified healthcare and/or patient health-related outcomes. The research question for this review was: What does the evidence from the past decade reveal about the impact of Interprofessional collaborative practice on patient-related outcomes in the US healthcare system? ⋯ The results suggest a need for more research on the measurable impact of interprofessional collaborative practice and/or care on patient health-related outcomes to further document its benefits and to explore the models, systems and nature of collaborations that best improve population health, increase patient satisfaction, and reduce cost of care.
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We evaluated the safety and feasibility of ultrasound-guided peripherally-inserted central venous catheters (PICC) by a neurointensivist at the bedside compared to fluoroscopy-guided PICC and conventional central venous catheter (CCVC). This was a retrospective study of adult patients who underwent central line placement and were admitted to the neurosurgical intensive care unit (ICU) between January 2014 and March 2018. In this study, the primary endpoint was central line-induced complications. ⋯ There was no significant difference in procedure time between the three groups. However, incidence of insertional injuries was higher in CCVC group compared to PICC groups (p = 0.038). Ultrasound-guided PICC placement by a neurointensivist may be safe and feasible compared to fluoroscopy-guided PICC placement by interventional radiologists and CCVC placement for neurocritically ill patients.
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A previously published pilot study assessed energy expenditure (EE) of participants with overweight and obesity after they were switched from a baseline high-carbohydrate diet (BD) to an isocaloric low-carbohydrate ketogenic diet (KD). EE measured using metabolic chambers increased transiently by what was considered a relatively small extent after the switch to the KD, whereas EE measured using doubly labeled water (EEDLW) increased to a greater degree after the response in the chambers had waned. Using a publicly available dataset, we examined the effect of housing conditions on the magnitude of the increase in EEDLW after the switch to the KD and the role of physical activity in that response. ⋯ Switching from the BD to the KD substantially increased EEDLW, but apparently only on days subjects were living in the ward outside the metabolic chamber. Increased physical activity as measured by accelerometry did not appear to account for this effect.