Free and Total Digoxin in Serum During Treatment of Acute Digoxin Poisoning With Fab Fragments: Case Study

2010 ◽  
Vol 19 (4) ◽  
pp. 391-387 ◽  
Author(s):  
Florian Eyer ◽  
Werner Steimer ◽  
Christine Müller ◽  
Thomas Zilker
Keyword(s):  
Continuous Infusion ◽  
Bolus Dose ◽  
Clinical Signs ◽  
Cost Effective ◽  
Total Serum ◽  
Antidotal Therapy ◽  
Initial Bolus ◽  
Digoxin Poisoning ◽  
Glycoside Intoxication

A woman ingested 10 mg of methyldigoxin in a suicide attempt and presented 19 hours after ingestion with clinical signs of glycoside intoxication. Her serum level of digoxin was 7.4 ng/mL, and antidotal therapy with Fab antibody fragments was started. The manufacturer’s recommended dosing scheme was modified, with 80 mg Fab administered intravenously within 15 minutes followed by a continuous infusion at 30 mg/h. Total serum concentration of digoxin increased markedly within minutes after Fab therapy was started, while the level of free digoxin immediately decreased into the nontoxic range without recrudescent toxic effects of digoxin. The cumulative amounts of free and bound digoxin that were excreted in urine within 30 hours after ingestion were 900 μg and 1600 μg, respectively. Half-life of bound digoxin in urine was 9.9 hours; mean rate of clearance of bound digoxin in the urine was 7.0 mL/min. On the basis of these kinetic data, a smaller initial bolus dose of Fab followed by a continuous infusion may be a more tailored, cost-effective, and relatively safe therapy for patients who have overdosed on cardiac glycosides.

Sonographically guided, transcatheter foam sclerotherapy of the great saphenous vein

Phlebologie ◽  
2007 ◽  
Vol 36 (06) ◽  
pp. 309-312 ◽  
Author(s):  
T. Schulz ◽  
M. Jünger ◽  
M. Hahn
Keyword(s):  
Saphenous Vein ◽  
Great Saphenous Vein ◽  
Clinical Stage ◽  
Clinical Signs ◽  
Cost Effective ◽  
Duplex Sonography ◽  
Foam Sclerotherapy ◽  
Average Loss ◽  
One Year ◽  
The Cost

Summary Objective: The goal of the study was to assess the effectiveness and patient tolerability of single-session, sonographically guided, transcatheter foam sclerotherapy and to evaluate its economic impact. Patients, methods: We treated 20 patients with a total of 22 varicoses of the great saphenous vein (GSV) in Hach stage III-IV, clinical stage C2-C5 and a mean GSV diameter of 9 mm (range: 7 to 13 mm). We used 10 ml 3% Aethoxysklerol®. Additional varicoses of the auxiliary veins of the GSV were sclerosed immediately afterwards. Results: The occlusion rate in the treated GSVs was 100% one week after therapy as demonstrated with duplex sonography. The cost of the procedure was 207.91 E including follow-up visit, with an average loss of working time of 0.6 days. After one year one patient showed clinical signs of recurrent varicosis in the GSV; duplex sonography showed reflux in the region of the saphenofemoral junction in a total of seven patients (32% of the treated GSVs). Conclusion: Transcatheter foam sclerotherapy of the GSV is a cost-effective, safe method of treating varicoses of GSV and broadens the spectrum of therapeutic options. Relapses can be re-treated inexpensively with sclerotherapy.

Clinical signs in free-ranging Guiana dolphins Sotalia guianensis during a morbillivirus epidemic: case study in Sepetiba Bay, Brazil

2019 ◽  
Vol 133 (3) ◽  
pp. 175-180 ◽  
Author(s):  
L Flach ◽  
MB Alonso ◽  
T Marinho ◽  
K Van Waerebeek ◽  
MF Van Bressem
Keyword(s):  
Clinical Signs ◽  
Sepetiba Bay ◽  
Sotalia Guianensis ◽  
Free Ranging

The socio-spatial politics of royalties and their distribution: A case study of the Surat Basin, Queensland

2021 ◽  
pp. 0308518X2110266
Author(s):  
Neil Argent ◽  
Sean Markey ◽  
Greg Halseth ◽  
Laura Ryser ◽  
Fiona Haslam-McKenzie
Keyword(s):  
Cost Effective ◽  
Indigenous Communities ◽  
Energy Extraction ◽  
Grant Application ◽  
Coal Seam Gas ◽  
Spatial Politics ◽  
Developmental Needs ◽  
Development Fund ◽  
Effective Use

This paper is concerned with the socio-spatial and ethical politics of redistribution, specifically the allocation of natural resources rents from political and economic cores to the economic and geographical peripheries whence the resource originated. Based on a case study of the coal seam gas sector in Queensland's Surat Basin, this paper focuses on the operation of the Queensland State Government's regional development fund for mining and energy extraction-affected regions. Employing an environmental justice framework, we critically explore the operation of these funds in ostensibly helping constituent communities in becoming resilient to the worst effects of the ‘staples trap’. Drawing on secondary demographic and housing data for the region, as well as primary information collected from key respondents from mid-2018 to early 2019, we show that funds were distributed across all of the local government areas, and allocated to projects and places primarily on a perceived economic needs basis. However, concerns were raised with the probity of the funds’ administration. In terms of recognition justice, the participation of smaller and more remote towns and local Indigenous communities was hampered by their structural marginalisation. Procedurally, the funds were criticised for the lack of local consultation taken in the development and approval of projects. While spatially concentrated expenditure may be the most cost-effective use of public monies, we argue that grant application processes should be open, transparent and inclusive, and the outcomes cognisant of the developmental needs of smaller communities, together with the need to foster regional solidarity and coherence.

scholarly journals Toward Decentralised Sanitary Sewage Collection Systems: A Multiobjective Approach for Cost-Effective and Resilient Designs

Water ◽  
2021 ◽  
Vol 13 (14) ◽  
pp. 1886
Author(s):  
Arezoo Zahediasl ◽  
Amin E. Bakhshipour ◽  
Ulrich Dittmer ◽  
Ali Haghighi
Keyword(s):  
Treatment Plant ◽  
Drainage System ◽  
Cost Effective ◽  
Optimization Approach ◽  
Hydraulic Design ◽  
Multiobjective Approach ◽  
Layout Generation ◽  
Plant Allocation ◽  
Problem Solving Process

In recent years, the concept of a centralized drainage system that connect an entire city to one single treatment plant is increasingly being questioned in terms of the costs, reliability, and environmental impacts. This study introduces an optimization approach based on decentralization in order to develop a cost-effective and sustainable sewage collection system. For this purpose, a new algorithm based on the growing spanning tree algorithm is developed for decentralized layout generation and treatment plant allocation. The trade-off between construction and operation costs, resilience, and the degree of centralization is a multiobjective problem that consists of two subproblems: the layout of the networks and the hydraulic design. The innovative characteristics of the proposed framework are that layout and hydraulic designs are solved simultaneously, three objectives are optimized together, and the entire problem solving process is self-adaptive. The model is then applied to a real case study. The results show that finding an optimum degree of centralization could reduce not only the network’s costs by 17.3%, but could also increase its structural resilience significantly compared to fully centralized networks.

An application of Austrian legal requirements for CSO emissions

2011 ◽  
Vol 64 (5) ◽  
pp. 1081-1088 ◽  
Author(s):  
Manfred Kleidorfer ◽  
Wolfgang Rauch
Keyword(s):  
Model Calibration ◽  
Model Building ◽  
Treatment Plant ◽  
Cost Effective ◽  
Combined Sewer Overflows ◽  
Sewer System ◽  
Legal Requirements ◽  
Innovative Methods ◽  
Combined Sewer

The Austrian standard for designing combined sewer overflow (CSO) detention basins introduces the efficiency of the combined sewer overflows as an indicator for CSO pollution. Additionally criteria for the ambient water quality are defined, which comprehend six kinds of impacts. In this paper, the Austrian legal requirements are described and discussed by means of hydrological modelling. This is exemplified with the case study Innsbruck (Austria) including a description for model building and model calibration. Furthermore an example is shown in order to demonstrate how – in this case – the overall system performance could be improved by implementing a cost-effective rearrangement of the storage tanks already available at the inflow of the wastewater treatment plant. However, this guideline also allows more innovative methods for reducing CSO emissions as measures for better usage of storage volume or de-centralised treatment of stormwater runoff because it is based on a sewer system simulation.

scholarly journals GPU-Enabled Serverless Workflows for Efficient Multimedia Processing

2021 ◽  
Vol 11 (4) ◽  
pp. 1438
Author(s):  
Sebastián Risco ◽  
Germán Moltó
Keyword(s):  
Video Processing ◽  
Cost Effective ◽  
Multimedia Processing ◽  
Computing Services ◽  
Video Frames ◽  
Open Source Framework ◽  
Cloud Infrastructures ◽  
Aws Lambda ◽  
Runtime Environments

Serverless computing has introduced scalable event-driven processing in Cloud infrastructures. However, it is not trivial for multimedia processing to benefit from the elastic capabilities featured by serverless applications. To this aim, this paper introduces the evolution of a framework to support the execution of customized runtime environments in AWS Lambda in order to accommodate workloads that do not satisfy its strict computational requirements: increased execution times and the ability to use GPU-based resources. This has been achieved through the integration of AWS Batch, a managed service to deploy virtual elastic clusters for the execution of containerized jobs. In addition, a Functions Definition Language (FDL) is introduced for the description of data-driven workflows of functions. These workflows can simultaneously leverage both AWS Lambda for the highly-scalable execution of short jobs and AWS Batch, for the execution of compute-intensive jobs that can profit from GPU-based computing. To assess the developed open-source framework, we executed a case study for efficient serverless video processing. The workflow automatically generates subtitles based on the audio and applies GPU-based object recognition to the video frames, thus simultaneously harnessing different computing services. This allows for the creation of cost-effective highly-parallel scale-to-zero serverless workflows in AWS.

scholarly journals Cost-Effectiveness of Investigations for Invasive Bladder Cancer

1987 ◽  
Vol 80 (3) ◽  
pp. 143-144 ◽  
Author(s):  
M T Hunt ◽  
C R J Woodhouse
Keyword(s):  
Transitional Cell ◽  
Clinical Signs ◽  
Cost Effective ◽  
Intravenous Urography ◽  
Liver Scan ◽  
Chest X Ray ◽  
Carcinoma Of The Bladder ◽  
Disseminated Disease ◽  
Positive Results ◽  
Diagnostic Investigations

The results of diagnostic and staging investigations in consecutive cases of invasive transitional cell carcinoma of the bladder are reviewed. Urine culture, urine cytology and intravenous urography had positive results in a high percentage of cases. As diagnostic investigations they are cost-effective but certainly do not remove the obligation to perform cystoscopy and examination under anaesthetic. Isotopic bone scan and liver scan showed metastases in 4 and one cases respectively and only when there were clinical signs of disseminated disease. Chest X-ray showed metastases in one case. These investigations are not cost-effective. Lymphangiography was positive in 12 of the 94 cases and, although expensive (£70), is still a staging investigation of value in planning treatment.

The potential cost of environmental certification to vegetation management in plantation forests: a New Zealand case study

2011 ◽  
Vol 41 (5) ◽  
pp. 986-993 ◽  
Author(s):  
Carol A. Rolando ◽  
Michael S. Watt ◽  
Jerzy A. Zabkiewicz
Keyword(s):  
New Zealand ◽  
Cost Effective ◽  
Vegetation Management ◽  
Rate Of Return ◽  
Internal Rate Of Return ◽  
Mechanical Control ◽  
Vegetation Control ◽  
High Productivity ◽  
Plantation Forests

Plantation forests certified by the Forest Stewardship Council have restrictions on herbicide use. Since certified plantations are dependant on herbicides for cost-effective vegetation management, compliance requires a shift from current chemical practices. Using New Zealand plantation forests as a case study, discounted cash flow analyses were used to estimate the cost of certification-compliant vegetation control regimes compared with current non-compliant methods. We examined methods that (i) reduce the quantity of herbicides by using spot control and (ii) avoid the use of herbicides by using weed mats, manual, and mechanical control. Cost analyses were undertaken for low-, medium-, and high-productivity sites. The internal rate of return of the non-compliant regime was between 5% and 5.8% across the productivity range. Spot control was cheaper than current non-compliant practice. However, spot control is limited by site suitability and the availability of labour. Non-chemical control methods were expensive relative to other regimes. Reductions in the internal rate of return varied across low- and high-productivity sites between 0.8% and 0.5% for manual control, 1.3% and 0.8% for mechanical control, and 1.7% and 1.0% for weed mats. Meeting the goals of certification while retaining cost-effective vegetation control presents a challenge to the plantation forestry sector.

The Use of Photogrammetry in Piping Design

1983 ◽  
Vol 197 (2) ◽  
pp. 125-138 ◽  
Author(s):  
P A Bracewell ◽  
U R Klement
Keyword(s):  
Information Retrieval ◽  
Mathematical Formulation ◽  
Three Dimensional ◽  
Cost Effective ◽  
Process Industry ◽  
Process Plant ◽  
Definition Of ◽  
High Degree ◽  
Positional Data

Piping design for ‘revamp’ projects in the process industry requires the retrieval of large amounts of ‘as-built’ data from existing process plant installations. Positional data with a high degree of accuracy are required. Photogrammetry, the science of measurement from photographs, was identified in Imperial Chemical Industries plc (ICI) as a suitable tool for information retrieval. The mathematical formulation enabling the definition of three-dimensional positions from photographic information is described. The process of using ICI's photogrammetric system for the definition of complete objects such as structures and pipes is illustrated. The need for specialized photogrammetric software for design purposes is explained. A case study describing how the photogrammetric system has been applied is described and graphical outputs from this exercise are shown. It is concluded that this particular photogrammetric system has proved to be a cost effective and accurate tool for the retrieval of ‘as-built’ information.

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