Cost-benefit analysis of abatement measures for nutrient emission from agriculture

In intensive animal husbandry areas surface water N and P concentrations often remain too high. The Water Framework Directive calls for additional nutrient emission abatement measures. Therefore, costs and benefits for possible agricultural measures in Flanders were first analysed in terms of soil balance surplus. Finally, abatement measures for agriculture, households and industry were set off against each other and ranked according to their cost-efficiency by the Environmental Costing Model. Increased dairy cattle efficiency, winter cover crops and increased pig feed efficiency turn out very cost efficient. Other agricultural measures are less cost efficient than for instance collective treatment for households and industry.nitrogen and phosphorus abatement, surface water, cost efficiency, Environmental Economics and Policy, Livestock Production/Industries,

Pressure and Flow Properties of Cannulae for Extracorporeal Membrane Oxygenation II: Drainage (Venous) Cannulae

The use of extracorporeal life support devices such as extracorporeal membrane oxygenation in adults requires cannulation of the patient's vessels with comparatively large diameter cannulae to allow circulation of large volumes of blood (>5 L/min). The cannula diameter and length are the major determinants for extracorporeal membrane oxygenation flow. Manufacturing companies present pressure-flow charts for the cannulae; however, these tests are performed with water. Aims of this study were 1. to investigate the specified pressure-flow charts obtained when using human blood as the circulating medium and 2. to support extracorporeal membrane oxygenation providers with pressure-flow data for correct choice of the cannula to reach an optimal flow with optimal hydrodynamic performance. Eighteen extracorporeal membrane oxygenation drainage cannulae, donated by the manufacturers (n = 6), were studied in a centrifugal pump driven mock loop. Pressure-flow properties and cannula features were described. The results showed that when blood with a hematocrit of 27% was used, the drainage pressure was consistently higher for a given flow (range 10%-350%) than when water was used (data from each respective manufacturer's product information). It is concluded that the information provided by manufacturers in line with regulatory guidelines does not correspond to clinical performance and therefore may not provide the best guidance for clinicians.info:eu-repo/semantics/publishedVersio

Cost-benefit analysis of abatement measures for nutrient emission from agriculture

In intensive animal husbandry areas surface water N and P concentrations often remain too high. The Water Framework Directive calls for additional nutrient emission abatement measures. Therefore, costs and benefits for possible agricultural measures in Flanders were first analysed in terms of soil balance surplus. Finally, abatement measures for agriculture, households and industry were set off against each other and ranked according to their cost-efficiency by the Environmental Costing Model. Increased dairy cattle efficiency, winter cover crops and increased pig feed efficiency turn out very cost efficient. Other agricultural measures are less cost efficient than for instance collective treatment for households and industry

Extracorporeal life support provision in COVID-19 patients-An international EuroELSO 2022 update survey

Introduction An analysis on the ECLS use for patients with respiratory or cardiac support in COVID-19 based on an international response to EuroELSO survey, aims to generate a more comprehensive understanding of ECLS role during the recent viral pandemic. Methods EuroELSO announced the survey at the 10th annual congress in London, May 2022. The survey covered 26 multiple-choice questions. Results The survey returned 69 questionnaires from 62 centers across 22 European countries and seven centers across five non-European countries. Most of the centers providing ECLS for COVID-19 patients had more than 30 runs for respiratory support since December 2019. In the same period, at least 31 runs in adult COVID-19 patients have been performed in 48 of 69 centers (69.6%). The reported pediatric data from 18 centers is limited to less than the patients per center. Conclusion Majority of the COVID-19 patients received respiratory ECLS support and adult patients dominated. The indications and contraindications are broadly aligned with available guidelines. Most of the centers considered age >65 or biological age as a relative or absolute contraindication for ECLS in COVID-19. ECLS withdrawal criteria in COVID-19 are controversial because the long-term outcomes after ECLS in COVID-19 and the impact of critical illness and the impact of long-COVID are still not known