Study on the Impacts of Peaking Factors on a Water Distribution System in Germany

This paper aims to explore the impacts of peaking factors on a water distribution system designed for a small city in Germany through model-based analysis. As a case study, the water distribution network was modelled by EPANET and then two specific studies were carried out. The first study tested corresponding system-wide influences on water age and energy consumption if the peaking factors used at design stage are inconsistent with ones in real situation. The second study inspected the possible relationship between the choice of peaking factors and budgets by comparing several different pipe configurations of the distribution system, obtained according to variety of peaking factors. Given the analysis results, the first study reveals that average water age will increase if peaking factors estimated at design stage are larger than real values in that specific system, and vice versa. In contrast, energy consumption will increase if peaking factors defined for system design are smaller than ones in real case, and vice versa. According to the second study, it might be possible to amplify peaking factors for design dramatically by a slight increase in the investment on this system. However, further study on budget estimation with more factors and detailed information considered should be carried out

Predictors of clinically relevant differences between noninvasive versus arterial blood pressure

Objective: Blood pressure (BP) measurements are important for managing patients with hypertensive emergen-cies (HE). Previous studies showed that there was significant difference between IABP and NIBP but no informa-tion whether these differences changed management. Our study investigated the factors associated with the differences affecting BP management of patients with HE. Methods: This was a retrospective study involving adult patients admitted to a resuscitation unit. We screened all patients who received IABP upon admission between 06/01/2017 and 12/31/2017 as sample size calculation rec-ommended 64 patients. Primary outcome was the clinical relevance of the difference of IABP vs. NIBP, which was defined as having both: a) difference of 10 mm of mercury (mmHg), and b) resulting in possible change of blood pressure managements according to treatment guidelines. We performed backward stepwise multivariable lo-gistic regression to measure associations. Results: We analyzed 147 patients whose mean age was 69 (+/- 16) years and included 69 (47%) patients with spontaneous intracerebral hemorrhage (sICH). Mean difference between IABP and NIBP was 21 (+/- 16) mmHg while 41 (28%) patients who had difference affecting managements. In multivariable regression, sICH (Odd Ra -tios 13.5, 95%CI 2.3-79.5, p-value b 0.001) was significantly associated with clinically relevant difference between the two modalities of BP monitoring. Conclusions: There was a large difference between IABP and NIBP among patients with hypertensive emergen-cies. Up to 30% of patients had clinically relevant differences. Patients with sICH were more likely to have differ-ences affecting BP management. Further studies are needed to confirm our observation. (c) 2020 Elsevier Inc. All rights reserved