Economic and Technical Evaluation of Flexible Power GenerationScenarios for a Biogas Plant

Biogas plants can contribute significantly to the integration of renewable energy sources in the energy system due to their flexible operability. The storability of the energy carrier enables them to generate power in a demand-oriented way and to participate in electricity markets that focus on balancing power supply and demand. In this study process simulation was used to investigate the economic and technical effects of flexible power generation on an Austrian biogas plant that focuses on biomethane production. Three different power generation scenarios were evaluated considering participation in the electricity spot market and markets for control energy reserves, while continuously producing biomethane. The results show that no major technical adaptions are needed for flexible power generation but an appropriate support scheme (premium system) is required to make demand-oriented power generation economically viable. The determined required premium was 37.3-99.9 EUR/MWh depending on the power generation scenario

Effect of Steam Explosion Pretreatment on the Specific Methane Yield of Miscanthus x giganteus

A highly promising energy crop for biogas production can be Miscanthus x giganteus. It has multiple advantages, which include low soil requirements and the existence of genotypes adapted to dry conditions in comparison to other energy crops. Miscanthus cannot be used in the biogas plant without a pretreatment due to the recalcitrant nature of lignocelluloses. One of the most efficient pretreatment methods for lignocellulosic biomass is steam explosion. This includes heating the biomass at high temperature values, followed by mechanical disruption of the biomass fibres by a rapid pressure drop. The objective of this study is to analyse the effect of the steam explosion pretreatment on the specific biogas and methane production of miscanthus. In addition methane hectare yields are calculated and compared to those of maize. Steam explosion pretreatment was carried out in a laboratory scale facility in Ĺs, Norway. The miscanthus was mixed with water and heated up to the desired temperature. After a defined pretreatment time the pressure in the reaction vessel was reduced rapidly, which caused the liquid water to vaporize immediately. The material was cooled down in a flushing tank and was then stored at 5°C until further analytical procedures. Pretreatment temperatures were 190°C and 210°C; holding times were 5, 10 and 15 minutes. Determination of the specific methane yield was done in triplicate using batch tests according to VDI 4630. The material was inoculated with the liquid fermentation residue of a biogas plant. The produced gas was collected in eudiometers and then analysed for the CH4 and CO2 content

Insights into Early Stage of Antibiotic Development in Small and Medium-Sized Enterprises: A Survey of Targets, Costs, and Durations

Antibiotic innovation has dwindled to dangerously low levels in the past 30 years. Since resistance continues to evolve, this innovation deficit can have perilous consequences on patients. A number of new incentives have been suggested to stimulate greater antibacterial drug innovation. To design effective solutions, a greater understanding is needed of actual antibiotic discovery and development costs and timelines. Small and medium-sized enterprises (SMEs) undertake most discovery and early phase development for antibiotics and other drugs. This paper attempts to gather a better understanding of SMEs’ targets, costs, and durations related to discovery and early phase development of antibacterial therapies

Nitrofurantoin revisited: a systematic review and meta-analysis of controlled trials

The available evidence supports first-line treatment of lower urinary tract infections with nitrofurantoin as clinical efficacy is similar to that seen for trimethoprim/sulfamethoxazole, ciprofloxacin and amoxicillin, rates of microbiological cure are good, short- term toxicity is generally mild and acquired resistance is still relatively rar

Variability of Voriconazole Trough Levels in Haematological Patients: Influence of Comedications with cytochrome P450(CYP) Inhibitors and/or with CYP Inhibitors plus CYP Inducers

Voriconazole plasma exposure greatly varies among haematological patients. The purpose of this study was to identify the magnitude of influence of comedications with CYP inhibitors and/or with CYP inhibitors plus CYP inducers on voriconazole trough level (Cmin). Voriconazole Cmin was retrospectively assessed among haematological patients who underwent therapeutic drug monitoring (TDM). Univariate and multivariate linear mixed-effect regression analyses were performed to identify the independent predictors of normalized Cmin. Of the 83 included patients, 35 had comedications with CYP inhibitors (omeprazole or pantoprazole) and 21 with CYP inhibitors (omeprazole or pantoprazole) plus CYP inducers (methylprednisolone, dexamethasone, phenobarbital, rifampin or carbamazepine). Median Cmin value (n = 199) was 2.4 mg/L with a wide range of distribution (<0.2-13.5 mg/L). Median (IQR) normalized voriconazole Cmin value was significantly higher in the presence of CYP inhibitors (4.20 mg/L, 3.23-5.51 mg/L) than either in the absence of interacting cotreatments (2.55 mg/L, 1.54-3.47 mg/L) or in the presence of CYP inhibitors plus CYP inducers (2.16 mg/L, 1.19-3.09 mg/L). The presence of CYP inhibitors was highly significantly associated with Cmin >5.5 mg/L (OR: 23.22, 95% CI: 3.01-179.09, p = 0.003). No significant association emerged when CYP inhibitors were coadministered with CYP inducers (OR: 3.53, 95% CI: 0.36-34.95, p = 0.280). The amount of expected Cmin increase was significantly influenced by both the type and the dose of the administered proton pump inhibitor. The study highlights that the benefit from TDM of voriconazole may be maximal in those patients who are cotreated with CYP inhibitors and/or with CYP inhibitors plus CYP inducers, especially when receiving proton pump inhibitors (PPIs) at very high dosages intravenously

Impact of availability of guidelines and active surveillance in reducing the incidence of ventilator-associated pneumonia in Europe and worldwide

Background: To analyse whether the availability of written standards for management of mechanically ventilated patients and/or the existence of a surveillance system for cases of ventilation-associated pneumonia (VAP) are positively associated with compliance with 6 well-established VAP prevention measures. Methods: Ecological study based on responses to an online-questionnaire completed by 1730 critical care physicians. Replies were received from 77 different countries, of which the majority, i.e. 1351, came from 36 European countries. Results: On a cross-country level, compliance with VAP prevention measures is higher in countries with a large number of prevention standards and/or VAP surveillance systems in place at ICU level., Likewise, implementation of standards and VAP surveillance systems has a significant impact on self-reported total compliance with VAP prevention measures (both p < 0.001). Moreover, predictions of overall prevention measure compliance show the effect size of the availability of written standards and existence of surveillance system. For instance, a female physician with 10 years of experience in critical care working in a 15-bed ICU in France has a predicted baseline level of VAP prevention measure compliance of 63 per cent. This baseline level increases by 9.5 percentage points (p < 0.001) if a written clinical VAP prevention standard is available in the ICU, and by another 4 percentage points (p < 0.001) if complemented by a VAP surveillance system. Conclusions: The existence of written standards for management of mechanically ventilated patients in an ICU and the availability of VAP surveillance systems have shown to be positively associated with compliance with VAP prevention measures and should be fostered on a policy level

Population pharmacokinetics of colistin and the relation to survival in critically ill patients infected with colistin susceptible and carbapenem-resistant bacteria

Objectives: The aim was to analyse the population pharmacokinetics of colistin and to explore the relationship between colistin exposure and time to death. Methods: Patients included in the AIDA randomized controlled trial were treated with colistin for severe infections caused by carbapenem-resistant Gram-negative bacteria. All subjects received a 9 million units (MU) loading dose, followed by a 4.5 MU twice daily maintenance dose, with dose reduction if creatinine clearance (CrCL) 2 mg/L in 94% (195/208) and 44% (38/87) of patients with CrCL ≤120 mL/min, and >120 mL/min, respectively. Colistin methanesulfonate sodium (CMS) and colistin clearances were strongly dependent on CrCL. High colistin exposure to MIC ratio was associated with increased hazard of death in the multivariate analysis (adjusted hazard ratio (95% CI): 1.07 (1.03–1.12)). Other significant predictors included SOFA score at baseline (HR 1.24 (1.19–1.30) per score increase), age and Acinetobacter or Pseudomonas as index pathogen. Discussion: The population pharmacokinetic model predicted that >90% of the patients had colistin concentrations