scholarly journals Association of British Clinical Diabetologists (ABCD) position statement on the use of biosimilar insulin

2018 ◽  
Vol 18 (4) ◽  
pp. 171-174 ◽  
Author(s):  
Vijay Jayagopal ◽  
Russell Drummond ◽  
Dinesh Nagi
Keyword(s):  
Cost Saving ◽  
Position Statement ◽  
Healthcare Staff ◽  
Advantages And Disadvantages ◽  
Considerable Cost ◽  
Published Evidence ◽  
Considerable Cost Saving

Biosimilar insulins have the potential to offer the NHS a considerable cost saving. The acceptability and use of biosimilar insulin by clinicians and patients may, however, be limited by lack of experience, understanding and concerns about safety and tolerability. This article summarises information on the advantages and disadvantages of using biosimilar insulins and an overview of the published evidence in relation to efficacy, tolerability and safety of current and expected Biosimilar Insulins. The position of the ABCD on the use of Biosimilar Insulin is stated along with the key practical considerations for healthcare staff involved in insulin prescription and administration.

Controlling sand placement during the building of artificial islands

1984 ◽  
Vol 21 (2) ◽  
pp. 371-375 ◽  
Author(s):  
D. H. Shields ◽  
L. Domaschuk ◽  
D. W. Corkal ◽  
J. R. McCutchon
Keyword(s):  
Cost Saving ◽  
Low Cost ◽  
Model Tests ◽  
Scale Model ◽  
Small Scale ◽  
Considerable Cost ◽  
Environmentally Safe ◽  
Considerable Cost Saving ◽  
Small Scale Model

A new way to construct artificial islands of sand is described. The method shows promise of considerable cost saving. The present high cost of island building is due to the difficulty of making underwater sand slopes steep. Simply dumping sand into the ocean results in slopes of from 12 to 15 horizontal to 1 vertical. These shallow slopes have enormous implications in terms of sand volume and cost. The sand can be tremied into place to form a steep-sided ring or bund. Handling large quantities of sand in this way is expensive. Small-scale model tests show that if the sand is mixed with certain chemicals the resulting 'cohesion' enables the sand to fall through seawater as a block, with little dispersion. Steep underwater slopes result. Low-cost, nontoxic (environmentally safe) chemicals were used in the experiment. Keywords: construction, artificial islands, sand, oceans, dredging.

An Audit of the Impact of Introducing Microacupuncture into Primary Care

2001 ◽  
Vol 19 (1) ◽  
pp. 43-45 ◽  
Author(s):  
Juliette Ross
Keyword(s):  
Primary Care ◽  
General Practice ◽  
Cost Saving ◽  
Computer System ◽  
Patient Records ◽  
Considerable Cost ◽  
Considerable Cost Saving ◽  
The Impact

In 1997, one of the partners in a general practice in NW London comprising 6700 patients began using microacupuncture - a very brief form of treatment described by Felix Mann. The computer system used for patient records was modified to allow easy recording of details of acupuncture treatments; the latter being performed opportunistically in standard 10-minute consultations. Over the course of three years, during which time a second partner began using acupuncture, referrals to acute physiotherapy (conditions present for < 3 months) fell by 86%, and referrals to outpatient rheumatology fell by 51%. This is likely to represent a considerable cost saving to the NHS.

scholarly journals UK Vessel Health and Preservation (VHP) Framework: a commentary on the updated VHP 2020

2020 ◽  
pp. 175717742097680
Author(s):  
Carole Hallam ◽  
Andrea Denton ◽  
Valya Weston ◽  
Helen Dunn ◽  
Tim Jackson ◽  
...  
Keyword(s):  
Vascular Access ◽  
Good Practice ◽  
Venous Access ◽  
Expert Consensus ◽  
Evidence Based ◽  
Healthcare Staff ◽  
Vascular Access Devices ◽  
Published Evidence ◽  
Randomised Control Trials ◽  
Peripheral Intravenous Catheter

Background: In 2016, a UK vessel health and preservation (VHP) framework was developed to support healthcare staff to select the most appropriate vascular access device for patients requiring intravenous therapy. The VHP framework was based on available evidence and expert consensus. The VHP was based on available evidence and expert consensus. Development of the VHP 2020 Framework: A multidisciplinary team reviewed the original UK VHP framework and considered new published evidence, national and international guidelines and expert opinion. A literature search was performed using Cinahl and Medline, incorporating a variety of terms linked to vascular access devices, assessment and selection. Articles published in and after 2014 in English were included. Twelve articles were found to be relevant including three evidence-based guidelines, two randomised control trials and one systematic review. Findings: Three main studies provided the evidence for the update: the MAGIC study that assessed the appropriateness of peripherally inserted central catheters in patients; a study that utilised the ‘A-DIVA scale’ to predict the likelihood of difficult venous access; and a study that incorporated an ‘I-DECIDED tool’ for peripheral intravenous catheter assessment and decision-making for device removal. In addition, published guidelines provided evidence that the original advice on appropriate osmolarity of medicines for peripheral administration needed updating. Conclusion: The 2020 UK VHP framework reflects latest evidence-based research and guidelines, providing healthcare staff updated guidance to assist in maintaining good practice in vascular access assessment and device selection and patient safety.

scholarly journals Single-Use and Reusable Flexible Bronchoscopes in Pulmonary and Critical Care Medicine

Diagnostics ◽  
2022 ◽  
Vol 12 (1) ◽  
pp. 174
Author(s):  
Elliot Ho ◽  
Ajay Wagh ◽  
Kyle Hogarth ◽  
Septimiu Murgu
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Time Use ◽  
Critical Role ◽  
Cost Effective ◽  
Viral Transmission ◽  
Advantages And Disadvantages ◽  
Published Evidence ◽  
Single Use ◽  
And Storage

Flexible bronchoscopy plays a critical role in both diagnostic and therapeutic management of a variety of pulmonary disorders in the bronchoscopy suite and the intensive care unit. In the set-ting of the ongoing viral pandemic, single-use flexible bronchoscopes (SUFB) have garnered attention as various professional pulmonary societies have released guidelines regarding uses for SUFB given the concern for risk of viral transmission when using reusable flexible bronchoscopes (RFB). In addition to offering sterility, SUFBs are portable, easily accessible, and may be more cost-effective than RFB when considering the potential costs of treating bronchoscopy-related infections. Furthermore, since SUFBs are one time use, they do not require reprocessing after use, and therefore may translate to reduced cleaning and storage costs. Despite these advantages, RFBs are still routinely used to perform advanced diagnostic and therapeutic bronchoscopic procedures given the need for optimal maneuverability, handling, angle of deflection, image quality, and larger channel size for passing of ancillary instruments. Here, we review the published evidence on the applications of single-use and reusable bronchoscopes in bronchoscopy suites and intensive care units. Specifically, we will discuss the advantages and disadvantages of these devices as pertinent to fundamental, advanced, and therapeutic bronchoscopic interventions.

A Novel Subsea Actuator to Electrify Small-Bore Valve

2021 ◽  
Author(s):  
Alexandre Orth ◽  
Gottfried Hendrix ◽  
Markus Kubacki ◽  
Pedro Joao Duarte da Silva ◽  
Juliano Victor De Negri
Keyword(s):  
Lean Manufacturing ◽  
Design Methodology ◽  
Economic Benefits ◽  
Design Team ◽  
Electric Actuator ◽  
Considerable Cost ◽  
Considerable Cost Saving ◽  
Safe Mechanism ◽  
Fail Safe ◽  
New System

Abstract This paper presents the development and qualification of a novel Subsea Electric Actuator, especially designed for rotary small-bore valves. One of the main challenges was to design an electric actuator which is as compact as the existing hydraulic actuators, but able to provide a fail-safe mechanism by field-proven springs and full integration of all necessary components, including the electric drive and controls, inside of a compact enclosure. Furthermore, the design team had to considerably reduce its power consumption and weight in comparison to existing solutions. Finally, the system was designed for lean manufacturing, allowing considerable cost-saving benefits for all the partners due to extensive standardization work. The paper shows the engineering requirements obtained by interviewing different users, the design methodology applied and the qualification of the new system up to TRL 3 with Digital Twin and Rapid Prototyping. Finally, an outlook is presented with the planned TRL 4 and TRL 5 qualification tests and a summary of the technical and economic benefits for the users of this novel Subsea Valve Actuator.

scholarly journals International Society of Oncology Pharmacy Practitioners global position on the use of biosimilars in cancer treatment and supportive care

2020 ◽  
Vol 26 (3_suppl) ◽  
pp. 3-10 ◽  
Author(s):  
Morgan B Frazer ◽  
Joseph Bubalo ◽  
Himanshu Patel ◽  
Jim Siderov ◽  
Milagros Cubilla ◽  
...  
Keyword(s):  
International Society ◽  
Position Statement ◽  
Biological Molecules ◽  
Healthcare Staff ◽  
Cancer Treatments ◽  
Local Implementation ◽  
Originator Product ◽  
Outcome Monitoring ◽  
Medicines Use ◽  
The Cost

With the development of innovative cancer treatments over recent decades, the cost of cancer care has risen exponentially, limiting patient access to patented originator biotherapeutics in many countries. The introduction of biosimilars to the market has created new opportunities as well the need for changes in practice within healthcare institutions. A ‘biosimilar’ is a biotherapeutic product which is highly similar in terms of quality, safety and efficacy to an already licensed originator product. Although biosimilars lack clinically meaningful differences in therapeutic activity as compared to the originator product, these complex biological molecules are not considered identical chemical copies, unlike generics, and minor differences in molecular structure and inactive compounds may exist. A thorough understanding of these differences and their clinical implications is necessary for optimising medicines-use practices involving biosimilars. This position statement, developed by the International Society of Oncology Pharmacy Practitioners Biosimilars Taskforce, aims to provide the global oncology pharmacy community with guidance to support decisions around biosimilar use. The 11 statements cover the regulation and evaluation of biosimilars, practical issues around local implementation, the education of healthcare staff and patients, and the requirement for ongoing pharmacovigilance and outcome monitoring.

A Correctional Model for Multiperiod Optimization of Steam Power Systems with Consideration of Startup/Shutdown Expenses

2010 ◽  
Vol 40-41 ◽  
pp. 298-303
Author(s):  
Wen Zhi Dai ◽  
Hong Chao Yin
Keyword(s):  
Power Systems ◽  
Control Strategy ◽  
Energy Use ◽  
Pso Algorithm ◽  
Optimal Operation ◽  
Optimal Control Strategy ◽  
Steam Power ◽  
Considerable Cost ◽  
Considerable Cost Saving ◽  
Operation Cost

In order to meet varied requirements of gas and electricity in petrochemical enterprises, as well as reducing the operation cost and minimizing energy use, optimal operation of steam power systems is a must. Based on previous work, this research proposes a mixed integral non-linear planning model (MILNP), which accounts for expenses of operation, maintenance, depreciation, and changeover cost in between startup and shutdown stage. The model is validated against operative data. The results show optimal control strategy can be quickly obtained with improved PSO algorithm, accompanied with considerable cost saving.

Minimum-Cost Well Drilling Strategy Using Dynamic Programming

1993 ◽  
Vol 115 (4) ◽  
pp. 239-246 ◽  
Author(s):  
A. K. Wojtanowicz ◽  
E. Kuru
Keyword(s):  
Minimum Cost ◽  
Cost Effective ◽  
Drilling Process ◽  
Well Drilling ◽  
Planning And Control ◽  
Considerable Cost ◽  
Drilling Optimization ◽  
Considerable Cost Saving ◽  
And Control ◽  
Conventional Drilling

This paper presents an advanced concept in drilling optimization—the dynamic drilling strategy. The dynamic drilling strategy is a new methodology of drilling process planning and control; it combines theory of single-bit control with an optimal multi-bit drilling program for a well. In the simulation study, the dynamic drilling strategy was compared to conventional drilling optimization and typical field practices; the considerable cost-saving potential of 25 and 60 percent, respectively, was estimated. The method also appeared to be the most cost-effective for expensive and long-lasting PDC bits through better utilization of their performance and reduction in the number of bits needed for the hole.

Optimal Operational Planning of Utility Systems of Petrochemical Industry

2012 ◽  
Vol 619 ◽  
pp. 143-146
Author(s):  
Wen Zhi Dai ◽  
Yang Liu ◽  
Xin Le Yang
Keyword(s):  
Petrochemical Industry ◽  
Energy Use ◽  
Pso Algorithm ◽  
Optimal Operation ◽  
Operational Planning ◽  
Optimal Control Strategy ◽  
Considerable Cost ◽  
Utility Systems ◽  
Considerable Cost Saving ◽  
Operation Cost

In order to meet varied requirements of gas and electricity in petrochemical enterprises, as well as reducing the operation cost and minimizing energy use, optimal operation of utility systems is a must. This paper establishes a model, which accounts for expenses of operation, maintenance, depreciation, and changeover cost. The model is validated against operative data. The results show optimal control strategy can be quickly obtained with improved PSO algorithm, accompanied with considerable cost saving.

Cryogenic atomic force microscopy

1991 ◽  
Vol 49 ◽  
pp. 54-55
Author(s):  
K. A. Fisher ◽  
M. G. L. Gustafsson ◽  
M. B. Shattuck ◽  
J. Clarke
Keyword(s):  
Room Temperature ◽  
Rapid Freezing ◽  
Cryogenic Temperatures ◽  
Soft Or ◽  
Electrically Conductive ◽  
Force Microscopy ◽  
Flexible Molecules ◽  
Advantages And Disadvantages ◽  
Atomic Force ◽  
Chemical Perturbation

The atomic force microscope (AFM) is capable of imaging electrically conductive and non-conductive surfaces at atomic resolution. When used to image biological samples, however, lateral resolution is often limited to nanometer levels, due primarily to AFM tip/sample interactions. Several approaches to immobilize and stabilize soft or flexible molecules for AFM have been examined, notably, tethering coating, and freezing. Although each approach has its advantages and disadvantages, rapid freezing techniques have the special advantage of avoiding chemical perturbation, and minimizing physical disruption of the sample. Scanning with an AFM at cryogenic temperatures has the potential to image frozen biomolecules at high resolution. We have constructed a force microscope capable of operating immersed in liquid n-pentane and have tested its performance at room temperature with carbon and metal-coated samples, and at 143° K with uncoated ferritin and purple membrane (PM).

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