Nurse-determined assessment of cardiac output. Comparing a non-invasive cardiac output device and pulmonary artery catheter: a prospective observational study.

Background The accurate measurement of Cardiac output (CO) is vital in guiding the treatment of critically ill patients. Invasive or minimally invasive measurement of CO is not without inherent risks to the patient. Skilled Intensive Care Unit (ICU) nursing staff are in an ideal position to assess changes in CO following therapeutic measures. The USCOM (Ultrasonic Cardiac Output Monitor) device is a non-invasive CO monitor whose clinical utility and ease of use requires testing. Objectives To compare cardiac output measurement using a non-invasive ultrasonic device (USCOM) operated by a non-echocardiograhically trained ICU Registered Nurse (RN), with the conventional pulmonary artery catheter (PAC) using both thermodilution and Fick methods. Design Prospective observational study. Setting and participants Between April 2006 and March 2007, we evaluated 30 spontaneously breathing patients requiring PAC for assessment of heart failure and/or pulmonary hypertension at a tertiary level cardiothoracic hospital. Methods SCOM CO was compared with thermodilution measurements via PAC and CO estimated using a modified Fick equation. This catheter was inserted by a medical officer, and all USCOM measurements by a senior ICU nurse. Mean values, bias and precision, and mean percentage difference between measures were determined to compare methods. The Intra-Class Correlation statistic was also used to assess agreement. The USCOM time to measure was recorded to assess the learning curve for USCOM use performed by an ICU RN and a line of best fit demonstrated to describe the operator learning curve. Results In 24 of 30 (80%) patients studied, CO measures were obtained. In 6 of 30 (20%) patients, an adequate USCOM signal was not achieved. The mean difference (±standard deviation) between USCOM and PAC, USCOM and Fick, and Fick and PAC CO were small, −0.34 ± 0.52 L/min, −0.33 ± 0.90 L/min and −0.25 ± 0.63 L/min respectively across a range of outputs from 2.6 L/min to 7.2 L/min. The percent limits of agreement (LOA) for all measures were −34.6% to 17.8% for USCOM and PAC, −49.8% to 34.1% for USCOM and Fick and −36.4% to 23.7% for PAC and Fick. Signal acquisition time reduced on average by 0.6 min per measure to less than 10 min at the end of the study. Conclusions In 80% of our cohort, USCOM, PAC and Fick measures of CO all showed clinically acceptable agreement and the learning curve for operation of the non-invasive USCOM device by an ICU RN was found to be satisfactorily short. Further work is required in patients receiving positive pressure ventilation.

On analysing and interpreting variability in motor output

A recent article in the Journal of Science and Medicine in Sport by Chapman et al.1 reported data from an empirical investigation comparing lower extremity joint motions, joint coordination and muscle recruitment in expert and novice cyclists. 3D kinematic and intramuscular electromyographic (EMG) analyses revealed no differences between expert and novice cyclists for normalised joint angles and velocities of the pelvis, hip, knee and ankle. However, significant differences in the strength of sagittal plane kinematics for hip–ankle and knee–ankle joint couplings were reported, with expert cyclists displaying tighter coupling relationships than novice cyclists. Furthermore, significant differences between expert and novice cyclists for all muscle recruitment parameters, except timing of peak EMG amplitude, were also reported.

Application of Dynamic Hysteresis Band Height Control to Improve Output Voltage Transient in Boost and Positive Buck-Boost Converters

This paper presents dynamic hysteresis band height control to reduce the overshoot and undershoot issue on output voltage caused by load change. The converters in this study are Boost and Positive Buck-Boost (PBB) converters. PBB has been controlled to work in a step up conversion and avoid overshoot when load is changed. Simulation and experimental results have been presented to verify the proposed method.

Particle emissions, volatility, and toxicity from an ethanol fumigated compression ignition engine

Particle emissions, volatility, and the concentration of reactive oxygen species (ROS) were investigated for a pre-Euro I compression ignition engine to study the potential health impacts of employing ethanol fumigation technology. Engine testing was performed in two separate experimental campaigns with most testing performed at intermediate speed with four different load settings and various ethanol substitutions. A scanning mobility particle sizer (SMPS) was used to determine particle size distributions, a volatilization tandem differential mobility analyzer (V-TDMA) was used to explore particle volatility, and a new profluorescent nitroxide probe, BPEAnit, was used to investigate the potential toxicity of particles. The greatest particulate mass reduction was achieved with ethanol fumigation at full load, which contributed to the formation of a nucleation mode. Ethanol fumigation increased the volatility of particles by coating the particles with organic material or by making extra organic material available as an external mixture. In addition, the particle-related ROS concentrations increased with ethanol fumigation and were associated with the formation of a nucleation mode. The smaller particles, the increased volatility, and the increase in potential particle toxicity with ethanol fumigation may provide a substantial barrier for the uptake of fumigation technology using ethanol as a supplementary fuel.

Are combination forecasts of S&P 500 volatility statistically superior?

Forecasting volatility has received a great deal of research attention, with the relative performances of econometric model based and option implied volatility forecasts often being considered. While many studies find that implied volatility is the pre-ferred approach, a number of issues remain unresolved, including the relative merit of combining forecasts and whether the relative performances of various forecasts are statistically different. By utilising recent econometric advances, this paper considers whether combination forecasts of S&P 500 volatility are statistically superior to a wide range of model based forecasts and implied volatility. It is found that a combination of model based forecasts is the dominant approach, indicating that the implied volatility cannot simply be viewed as a combination of various model based forecasts. Therefore, while often viewed as a superior volatility forecast, the implied volatility is in fact an inferior forecast of S&P 500 volatility relative to model-based forecasts.

Effects of switching time on output voltages of a multilevel inverter used in high frequency applications

Employing multilevel inverters is a proper solution to reduce harmonic content of output voltage and electromagnetic interference in high power electronic applications. In this paper, a new pulse width modulation method for multilevel inverters is proposed in which power devices’ on-off switching times have been considered. This method can be surveyed in order to analyse the effect of switching time on harmonic contents of output voltage in high frequency applications when a switching time is not negligible compared to a switching cycle. Fast Fourier transform calculation and analysis of output voltage waveforms and harmonic contents with regard to switching time variation are presented in this paper for a single phase (3, 5)-level inverters used in high voltage and high frequency converters. Mathematical analysis and MATLAB simulation results have been carried out to validate the proposed method.

Cross voltage control with inner hysteresis current control for multi-output boost converter

Multi-output boost (MOB) converter is a novel DC-DC converter unlike the regular boost converter, has the ability to share its total output voltage and to have different series output voltage from a given duty cycle for low and high power applications. In this paper, discrete voltage control with inner hysteresis current control loop has been proposed to keep the simplicity of the control law for the double-output MOB converter, which can be implemented by a combination of analogue and logical ICs or simple microcontroller to constrain the output voltages of MOB converter at their reference voltages against variation in load or input voltage. The salient features of the proposed control strategy are simplicity of implementation and ease to extend to multiple outputs in the MOB converter. Simulation and experimental results are presented to show the validity of control strategy.

Multi-output DC-DC converters based on diode-clamped converters configuration : topology and control strategy

This paper presents a new DC-DC Multi-Output Boost (MOB) converter which can share its total output between different series of output voltages for low and high power applications. This configuration can be utilised instead of several single output power supplies. This is a compatible topology for a diode-clamed inverter in the grid connection systems, where boosting low rectified output-voltage and series DC link capacitors is required. To verify the proposed topology, steady state and dynamic analysis of a MOB converter are examined. A simple control strategy has been proposed to demonstrate the performance of the proposed topology for a double-output boost converter. The topology and its control strategy can easily be extended to offer multiple outputs. Simulation and experimental results are presented to show the validity of the control strategy for the proposed converter.

Yield-factor volatility models

The term structure of interest rates is often summarized using a handful of yield factors that capture shifts in the shape of the yield curve. In this paper, we develop a comprehensive model for volatility dynamics in the level, slope, and curvature of the yield curve that simultaneously includes level and GARCH effects along with regime shifts. We show that the level of the short rate is useful in modeling the volatility of the three yield factors and that there are significant GARCH effects present even after including a level effect. Further, we find that allowing for regime shifts in the factor volatilities dramatically improves the model’s fit and strengthens the level effect. We also show that a regime-switching model with level and GARCH effects provides the best out-of-sample forecasting performance of yield volatility. We argue that the auxiliary models often used to estimate term structure models with simulation-based estimation techniques should be consistent with the main features of the yield curve that are identified by our model.

A new family of multi-output DC-DC converter topologies to supply an asymmetrical four-level diode-clamped inverter

Purpose Multi-level diode-clamped inverters have the challenge of capacitor voltage balancing when the number of DC-link capacitors is three or more. On the other hand, asymmetrical DC-link voltage sources have been applied to increase the number of voltage levels without increasing the number of switches. The purpose of this paper is to show that an appropriate multi-output DC-DC converter can resolve the problem of capacitor voltage balancing and utilize the asymmetrical DC-link voltages advantages. Design/methodology/approach A family of multi-output DC-DC converters is presented in this paper. The application of these converters is to convert the output voltage of a photovoltaic (PV) panel to regulate DC-link voltages of an asymmetrical four-level diode-clamped inverter utilized for domestic applications. To verify the versatility of the presented topology, simulations have been directed for different situations and results are presented. Some related experiments have been developed to examine the capabilities of the proposed converters. Findings The three-output voltage-sharing converters presented in this paper have been mathematically analysed and proven to be appropriate to improve the quality of the residential application of PV by means of four-level asymmetrical diode-clamped inverter supplying highly resistive loads. Originality/value This paper shows that an appropriate multi-output DC-DC converter can resolve the problem of capacitor voltage balancing and utilize the asymmetrical DC-link voltages advantages and that there is a possibility of operation at high-modulation index despite reference voltage magnitude and power factor variations.