A Smart Energy Recovery System to Avoid Preheating in Gas Grid Pressure Reduction Stations

Preheating is often required to prevent hydrate formation during the pressure reduction process in a natural gas distribution network’s pressure reduction station. This paper examines an energy recovery method to avoid the cost and energy consumption of this preheating. The primary aim is to assess the techno-economic feasibility of an energy recovery system based on the Ranque–Hilsch vortex tube coupled to a heat exchanger for large-scale application to the gas grid. To this end, a techno-economic model of the entire energy recovery system was included in an optimisation procedure. The resulting design minimises the payback period (PP) when the system is applied to the pressure reduction stations belonging to a particular gas grid. The pressure reduction stations always operate at an outlet pressure above atmospheric pressure. However, available performance models for the Ranque–Hilsch vortex tube do not permit prediction at backpressure operation. Therefore, a novel empirical model of the device is proposed, and a cost function derived from several manufacturer quotations is introduced for the first time, to evaluate the price of the Ranque–Hilsch vortex tubes. Finally, a nearly complete set of pressure reduction stations belonging to the Italian natural gas grid was chosen as a case study using actual operating parameters collected by each station’s grid manager. The results indicate that the environmental temperature strongly affects the technical and economic feasibility of the proposed energy recovery system. In general, pressure reduction stations operating at an ambient temperature above 0 °C are economically desirable candidates. In addition, the higher the energy recovery system convenience, the higher the flow rate and pressure drop managed by the station. In the Italian case study, 95% of preheating costs could be eliminated with a PP of fewer than 20 years. A 40% preheating cost saving is still possible if the maximum PP is limited to 10 years, and a small but non-negligible 3% of preheating costs could be eliminated with a PP of fewer than 4.5 years.

J-shape relation of blood pressure reduction and outcome in acute intracerebral hemorrhage: A pooled analysis of INTERACT2 and ATACH-II individual participant data

Objective: The aim of this study was to better define the shape of association between the degree (“magnitude”) of early (< 1 h) reduction in systolic blood pressure (SBP) and outcomes in patients with acute intracerebral hemorrhage (ICH) through pooled analysis of the second Intensive Blood Pressure Reduction in Acute Cerebral Hemorrhage Trial (INTERACT2) and second Antihypertensive Treatment of Acute Cerebral Hemorrhage (ATACH-II) datasets. Methods: Association of the continuous magnitude of SBP reduction described using cubic splines and an ordinal measure of the functional outcome on the modified Rankin scale (mRS) scores at 90 days were analyzed in generalized linear mixed models. Models were adjusted for achieved (mean) and variability (standard deviation, SD) of SBP between 1 and 24 h, various baseline covariates, and trial as a random effect. Results: Among 3796 patients (mean age 63.1 (SD = 13.0) years; female 37.4%), with a mean magnitude (< 1 h) of SBP reduction of 28.5 (22.8) mmHg, those with larger magnitude were more often non-Asian and female, had higher baseline SBP, received multiple blood pressure (BP) lowering agents, and achieved lower SBP levels in 1–24 h. Compared to those patients with no SBP reduction within 1 h (reference), the adjusted odds of unfavorable functional outcome, according to a shift in mRS scores, were lower for SBP reductions up to 60 mmHg with an inflection point between 32 and 46 mmHg, but significantly higher for SBP reductions > 70 mmHg. Similar J-shape associations were evident across various time epochs across 24 h and consistent according to baseline hematoma volume and SBP and history of hypertension. Interpretation: A moderate degree of rapid SBP lowering is associated with improved functional outcome after ICH, but large SBP reductions over 1 h (e.g. from > 200 to target < 140 mmHg) were associated with reduction, or reversal, of any such benefit.

Comparative Study on Pressure Reduction of Sprinkler Piping Systems with an Orifice

The recent increase in the number of high-rise buildings has led to increased pressure on sprinkler piping systems. This overpressure results in the supply of large quantities of water to a small number of open sprinkler heads due to the aging of buildings or malfunctioning of sprinkler heads. This induces significant water damage during incidents such as fires, resulting in long-term restoration needs of electrical and infrastructure facilities. Therefore, this study intends to mitigate this damage by introducing an orifice in sprinkler piping systems to reduce the water pressure at sprinkler head openings. Various types of data values were calculated by increasing the pressure and simultaneously varying the orifice specifications for each type of pipe. Currently, there are no test data of this kind, rendering the obtained data useful in the design and construction of orifices for pressure reduction in sprinkler piping systems.

Implementing a Goal-Directed Care Bundle after Acute Intracerebral Haemorrhage: Process Evaluation for the Third INTEnsive Care Bundle with Blood Pressure Reduction in Acute Cerebral Haemorrhage Trial Study in China

<b><i>Background:</i></b> The third INTEnsive care bundle with blood pressure Reduction in Acute Cerebral Haemorrhage Trial is an ongoing international, multicentre, stepped wedge, cluster-randomized trial to determine the effectiveness of a goal-directed care bundle (early intensive blood pressure [BP] lowering, glycaemic control, treatment of pyrexia, and reversal of anticoagulation), as compared to standard of care, on patient-centred outcomes after acute intracerebral haemorrhage (ICH). An embedded process evaluation aims to identify factors related to the uptake and implementation of the intervention. Herein, we present the process evaluation results for hospital sites in China. <b><i>Methods/Design:</i></b> A mixed methods approach, including surveys, focused group discussions and interviews with clinicians, routine monitoring, and recruitment logs were used to collect data across purposively sampled hospitals. Medical Research Council guidance and normalization process theory were used as theoretical frameworks for design, data analysis, and synthesis. <b><i>Results:</i></b> Twenty quantitative surveys were completed with clinicians, and 26 interviews and 2 focus group discussions were conducted during 2019–2020. The care bundle was generally delivered as planned and acceptable by doctors and nurses, but difficulties were reported in achieving the protocol-defined target levels of BP and glycaemic control. Resistance to implementing the care bundle occurred for patients perceived to be at high risk of adverse effects. Common organizational contextual factors that impeded implementation included delayed processes and limited medication supply, while established background care procedures, expertise, and capacity influenced its integration into routine practice. Areas to facilitate implementation included optimizing workflow within available resources, having a dedicated team, and recognizing the potential benefits of the intervention. <b><i>Conclusions:</i></b> Varied established care protocols across sites, different levels of background expertise, and lack of staff capacity impeded the integration of goal-directed care bundle into routine practice for ICH patients in China. Ready identification, and efforts to address, these barriers could facilitate uptake of future guideline-recommended interventions for the management of patients with ICH.

THE EFFECT OF ISOMETRIC EXERCISE ON BLOOD PRESSURE REDUCTION IN HYPERTENSION: A LITERATURE REVIEW

Background: Hypertension is a major factor contributing to cardiovascular disease, which is the number one cause of death globally. Basic Health Research Indonesian Ministry of Health data for 2018 showed that hypertension in East Java Province increased in 2018 by 36.32. So, the authors want to know the effect of isometrics on reducing blood pressure. Objective: The authors want to know the effect of isometrics on reducing blood pressure. Design: This study design is a systematic review to search and review article from database and the theory underlying this study or guidance in this systematic literature review using PRISMA. Data Sources: Based on the results of the literature search through six databases, such as EBSCO, Springer, MedPub, Elsevier, Science Direct, and National Nursing Journal with keywords: Hypertension, High Blood Pressure, Resting Blood Pressure, Isometric Training, Isometric Exercise. The data was search since June 2020. Review Methods: The method used in the preparation of the Literature review using the PRISMA checklist and PICOS. Secondary data obtained from the journal with a predetermined discussion. Results: Based on 18 articles in the literature review, it can be concluded that the results for the research is Isometric exercises that are performed are very effective in reducing blood pressure. Conclusion: Isometric exercises that are performed are very effective in reducing blood pressure. The exercise is doing in 3-4 weeks with 4x2 minutes of exercise with a rest duration of 3 minutes.