Parasympathetic Tone Activity Evaluation to Discriminate Ketorolac and Ketorolac/Tramadol Analgesia Level in Swine.

BACKGROUND: Evaluation of nociceptive-antinociceptive balance during general anesthesia is still challenging and routinely based on clinical criteria. Analgesic drug delivered may be optimized with parasympathetic tone activity (PTA) monitor. This study compares ketorolac and ketorolac/tramadol balance analgesia using a PTA monitor. METHODS: Pain intensity response was assessed using a 0-100 numerical state scale (PTA) after nociceptive stimuli in pigs under stable sevoflurane anesthesia. Bispectral index, heart rate, noninvasive blood pressure, and respiratory parameters were also measured. Animals were divided into 3 groups: without analgesia, ketorolac, and ketorolac/tramadol. Mean values or mean areas under the curve (AUC) in selected time periods were compared over time and between groups through a mixed-model repeated measures analysis of variance and nonparametric Kruskal-Wallis tests, followed by Bonferroni or Dunn's multiple comparisons. RESULTS: It was observed a significant decrease in the PTA AUC mean value after application of the stimulus in animals treated without analgesia and only with ketorolac. The PTA AUC mean value in the control group was significantly lower than the corresponding mean in ketorolac group. The ketorolac/tramadol group showed the highest PTA AUC mean values, significantly different from those obtained for the other 2 groups, with no significant differences detected over time. Bispectral index means showed no statistically significant differences either over time periods or between different treatment groups. Heart rate showed only a statistically significant increase in AUC mean between without analgesia and ketorolac/tramadol group, in the time period after the stimulus application. Noninvasive blood pressure means showed no statistically significant differences over time and between treatment groups. CONCLUSIONS: This study shows that a low dose combination of ketorolac and tramadol is sufficient to block the pain responses induced with a needle holder in pigs 20 minutes after its administration. The PTA monitor was able to clearly recognize the analgesic level between treatments and may be used to optimize analgesic drug delivered.

Environmental and administrative EVIAVE-based approach for landfill siting.

Landfill site selection is a relevant and necessary issue for waste management. However, it is an extremely complex task since it must take into account different environmental, economic and socio-political criteria that need to comply with strict regulations and meet different opinions. Accordingly, in this paper we propose a multi-criteria EVIAVE-(Evaluación del impacto ambiental en vertederos) based approach to evaluate the suitability of a set of possible landfill locations and rationally provide an optimal location for a landfill. The approach requires a comprehensive analysis to identify the best feasible site(s) that minimize a Global Landfill Risk Index (GRI), focused on environmental, economic and administrative impacts, and simultaneously comply with governmental regulations and constraints. This GRI is based on the Environmental Landfill Index, Administrative Landfill Index, Environmental Risk Index, Environmental Value, Probability of Contamination and Contamination Risk Index. An innovative feature of this approach lies in incorporating a mathematical model that combines weighted environmental and administrative issues. The model not only provides an optimal landfill location but also establishes landfill location ranks according to indexes of interest. This methodology reveals flexibility and high adaptability, being a useful and effective tool in the decision-making process. The methodology presented was tested with data available from a preliminary study developed in the municipalities of Oporto Metropolitan Area, Portugal, for the implementation of a multi-municipal landfill, which considers nine different locations for analysis.

Assessment strategies for municipal selective waste collection schemes.

An important strategy to promote a strong sustainable growth relies on an efficient municipal waste management, and phasing out waste landfilling through waste prevention and recycling emerges as a major target. For this purpose, effective collection schemes are required, in particular those regarding selective waste collection, pursuing a more efficient and high quality recycling of reusable materials. This paper addresses the assessment and benchmarking of selective collection schemes, relevant to guide future operational improvements. In particular, the assessment is based on the monitoring and statistical analysis of a core-set of performance indicators that highlights collection trends, complemented with a performance index that gathers a weighted linear combination of these indicators. This combined analysis underlines a potential tool to support decision makers involved in the process of selecting the collection scheme with best overall performance. The presented approach was applied to a case study conducted in Oporto Municipality, with data gathered from two distinct selective collection schemes.

Statistical analysis in MSW collection performance assessment.

The increase of Municipal Solid Waste (MSW) generated over the last years forces waste managers pursuing more effective collection schemes, technically viable, environmentally effective and economically sustainable. The assessment of MSW services using performance indicators plays a crucial role for improving service quality. In this work, we focus on the relevance of regular system monitoring as a service assessment tool. In particular, we select and test a core-set of MSW collection performance indicators (effective collection distance, effective collection time and effective fuel consumption) that highlights collection system strengths and weaknesses and supports pro-active management decision-making and strategic planning. A statistical analysis was conducted with data collected in mixed collection system of Oporto Municipality, Portugal, during one year, a week per month. This analysis provides collection circuits' operational assessment and supports effective short-term municipality collection strategies at the level of, e.g., collection frequency and timetables, and type of containers.