THE GENERAL IMPACT OF OBESITY Sample Clauses

THE GENERAL IMPACT OF OBESITY. ON THE PHARMACOKINETICS OF DRUGS The pharmacokinetics of a specific drug depend on the physiochemical properties of that drug and the biological environment of the patient. The independent pharmacokinetic parameters: volume of distribution (Vd) and total clearance (CL) determine the drug elimination half-life (t1/2), which, in turn, determines the maintenance dose for that drug. (Xxxxxx et al., 2010) The Vd describes the extent to which a drug distributes into extravascular tissues and is dependent on the physiochemical properties of that drug. (Xxxxx et al., 2011) Drug clearance is determined by hepatic and renal physiology, which are both influenced by body weight. Certain metabolic processes may be more active in obese patients, such as glucoronidation, sulphation, increased cytochrome P450-2E1 activity and phase II conjugation, resulting in increased drug clearance. Additionally, non-diabetic obese patients have been shown to have increased glomerular filtration as a result of structural renal changes and increased renal plasma flow, resulting in increased renal clearance. (Xxxxxxx et al., 2000) However, one study suggests that obesity-related liver lipodystrophy may result in hepatic dysfunction, thus, decreased drug clearance. (Xxxxxx et al., 2010) The main factors which affect the tissue distribution of drugs are: body composition, regional blood flow and the affinity of the drug for plasma proteins and/or tissue components. (Xxxxxx et al., 2010) Obese individuals have a lower cardiac output and decreased blood supply to the adipose tissue. There are uncertain differences in drug plasma protein binding with reports of increased binding to alpha-1 acid glycoprotein in obese patients. (Xxxxxxx et al., 1983) Obese individuals have an increased percentage of fat per kilogram of total body weight and decreased lean tissue compared to normally-weighted individuals of the same age, height and gender. (Xxxxxxx, 2000) Xxx explains that since 99% of the body’s metabolic processes occur within lean tissues. It is this compartment which should be used when quantifying changes in clearance for individuals of all body weights. Han and colleagues critically evaluated drug dosing in obesity, making three crucial observations: absolute drug clearance is greater in obese individuals; clearance increases non-linearly with weight; and clearance correlates linearly with lean body weight. (Han et al., 2007) Lean body weight closely represents fat free mass, which has bee...
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Related to THE GENERAL IMPACT OF OBESITY

  • Standard Hazard and Flood Insurance Policies For each Mortgage Loan (other than a Cooperative Loan), the Master Servicer shall maintain, or cause to be maintained by each Servicer, standard fire and casualty insurance and, where applicable, flood insurance, all in accordance with the provisions of this Agreement and the related Servicing Agreement, as applicable. It is understood and agreed that such insurance shall be with insurers meeting the eligibility requirements set forth in the applicable Servicing Agreement and that no earthquake or other additional insurance is to be required of any Mortgagor or to be maintained on property acquired in respect of a defaulted loan, other than pursuant to such applicable laws and regulations as shall at any time be in force and as shall require such additional insurance. Pursuant to Section 4.01, any amounts collected by the Master Servicer, or by any Servicer, under any insurance policies maintained pursuant to this Section 9.16 or any Servicing Agreement (other than amounts to be applied to the restoration or repair of the property subject to the related Mortgage or released to the Mortgagor in accordance with the applicable Servicing Agreement) shall be deposited into the Collection Account, subject to withdrawal pursuant to Section 4.02. Any cost incurred by the Master Servicer or any Servicer in maintaining any such insurance if the Mortgagor defaults in its obligation to do so shall be added to the amount owing under the Mortgage Loan where the terms of the Mortgage Loan so permit; provided, however, that the addition of any such cost shall not be taken into account for purposes of calculating the distributions to be made to Certificateholders and shall be recoverable by the Master Servicer or such Servicer pursuant to Section 4.02.

  • Standard Hazard Insurance and Flood Insurance Policies (a) For each Mortgage Loan, the Master Servicer shall enforce any obligation of the Servicers under the related Servicing Agreements to maintain or cause to be maintained standard fire and casualty insurance and, where applicable, flood insurance, all in accordance with the provisions of the related Servicing Agreements. It is understood and agreed that such insurance shall be with insurers meeting the eligibility requirements set forth in the applicable Servicing Agreement and that no earthquake or other additional insurance is to be required of any Mortgagor or to be maintained on property acquired in respect of a defaulted loan, other than pursuant to such applicable laws and regulations as shall at any time be in force and as shall require such additional insurance. (b) Pursuant to Section 4.01 and 4.02, any amounts collected by the Servicers or the Master Servicer, or by any Servicer, under any insurance policies (other than amounts to be applied to the restoration or repair of the property subject to the related Mortgage or released to the Mortgagor in accordance with the applicable Servicing Agreement) shall be deposited into the Master Servicer Collection Account, subject to withdrawal pursuant to Section 4.02 and 4.03. Any cost incurred by the Master Servicer or any Servicer in maintaining any such insurance if the Mortgagor defaults in its obligation to do so shall be added to the amount owing under the Mortgage Loan where the terms of the Mortgage Loan so permit; provided, however, that the addition of any such cost shall not be taken into account for purposes of calculating the distributions to be made to Certificateholders and shall be recoverable by the Master Servicer or such Servicer pursuant to Section 4.02 and 4.03.

  • Deductibles and Self-Insurance Retentions Any deductibles or self-insured retentions must be declared to and approved by the City. The City may require the Consultant to provide proof of ability to pay losses and related investigation, claims administration and defense expenses within the deductible or self-insured retention. The deductible or self-insured retention may be satisfied by either the named insured or the City.

  • Additional Provisions Respecting Insurance (a) All insurance required by this Tenant Agency Compliance Agreement shall be procured and maintained in financially sound and generally recognized responsible insurance companies authorized to write such insurance in the State and selected by the entity required to procure the same. The company issuing the policies required by Section 2.1(a) hereof shall be rated “A” or better by A.M. Best Co., Inc. in Best’s Key Rating Guide. Such insurance may be written with deductible amounts comparable to those on similar policies carried by other companies engaged in businesses similar in size, character and other respects to those in which the procuring entity is engaged. All policies of insurance required by Section 2.1 hereof shall provide for at least thirty (30) days prior written notice to the Agency of the restriction, cancellation or modification thereof. The policy evidencing the insurance required by Section 2.1(c) hereof shall name the Agency as an additional insured. All policies evidencing the insurance required by Section 2.1 (d)(ii) and (iv) shall name the Agency and the Tenant as additional insureds. (b) The certificate of insurance required by Section 2.1(c) hereof shall be delivered to the Agency on or before the date hereof. A copy of the certificates of insurance required by Section 2.1(d)(ii) and (iv) hereof shall be delivered to the Agency on or before the commencement of any construction or renovation of the Demised Premises. The Tenant shall deliver to the Agency before the first Business Day of each calendar year thereafter a certificate dated not earlier than the immediately preceding month reciting that there is in full force and effect, with a term covering the current year of the Tenant’s insurance policy, insurance of the types and in the amounts required by Section 2.1 hereof and complying with the additional requirements of Section 2.2(a) hereof. Prior to the expiration of each such policy or policies, the Tenant shall furnish to the Agency and any other appropriate Person a new policy or policies of insurance or evidence that such policy or policies have been renewed or replaced or are no longer required by this Tenant Agency Compliance Agreement. The Tenant shall provide such further information with respect to the insurance coverage required by this Tenant Agency Compliance Agreement as the Agency may from time to time reasonably require.

  • Terms of obligatory insurances The Borrower shall procure that each Owner shall effect such insurances: (a) in Dollars; (b) in the case of fire and usual marine risks and war risks, in an amount on an agreed value basis at least the greater of (i) an amount, which when aggregated with the insured value of the other Ships at the relevant time subject to a Mortgage, is equal to 120 per cent. of the Loan and (ii) the Market Value of the Ship owned by it; and (c) in the case of oil pollution liability risks, for an aggregate amount equal to the highest level of cover from time to time available under basic protection and indemnity club entry (with the international group of protection and indemnity clubs) and the international marine insurance market (currently $1,000,000,000); (d) in relation to protection and indemnity risks, in respect of the full value and tonnage of the Ship owned by it; (e) on approved terms; and (f) through approved brokers and with approved insurance companies and/or underwriters or, in the case of war risks and protection and indemnity risks, in approved war risks and protection and indemnity risks associations.

  • General Insurance Requirements During the Term of this Lease, Lessor and Lessee shall at all times keep the Leased Property insured with the kinds and amounts of insurance described below, or such other insurance coverage(s) as may be required by the Franchise Agreement. This insurance shall be written by companies authorized to issue insurance in the State. The policies must name Lessor and/or Lessee, as applicable, as the insured or as an additional named insured, as the case may be. Losses shall be payable to Lessor or Lessee as provided in this Lease. Any loss adjustment shall require the written consent of Lessor and Lessee, each acting reasonably and in good faith. Evidence of insurance shall be deposited with Lessor. The policies on the Leased Property, including the Leased Improvements, Fixtures and Lessee’s Personal Property, shall include the following: (a) Lessor shall obtain and maintain, at its own expense: (i) Building insurance on the “Special Form” (formerly “All Risk” form) (including earthquake and flood in reasonable amounts as determined by Lessor) in an amount not less than 100% of the then full replacement cost thereof (as defined in Section 13.2) or such other amount which is acceptable to Lessor and Lessee, and personal property insurance (on other than Lessee’s Personal Property) on the “Special Form” in the full amount of the replacement cost thereof; (ii) Insurance for loss or damage (direct and indirect) from steam boilers, pressure vessels or similar apparatus, now or hereafter installed in the Hotel, in the minimum amount of $5,000,000 or in such greater amounts as are then customary; and (iii) Loss of income insurance on the “Special Form”, in the amount of one year of Base Rent and Additional Charges (to the extent quantifiable) for the benefit of Lessor. (b) Lessee shall obtain and maintain, at its own expense: (i) Personal property insurance on Lessee’s Personal Property on the “Special Form” in the full amount of the replacement cost thereof; (ii) Comprehensive general liability insurance, with amounts not less than $10,000,000 covering each of the following: bodily injury, death, or property damage liability per occurrence, personal and advertising injury, general aggregate, products and completed operations, with respect to Lessor, and “all risk legal liability” (including liquor law or “dram shop” liability, if liquor or alcoholic beverages are served on the Leased Property) with respect to Lessor and Lessee; (iii) Insurance covering such other hazards and in such amounts as may be customary for comparable properties in the area of the Leased Property and is available from insurance companies, insurance pools or other appropriate companies authorized to do business in the State at rates which are economically practicable in relation to the risks covered, as may be reasonably requested by Lessor; (iv) Fidelity bonds with limits and deductibles as may be reasonably requested by Lessor, covering Lessee’s employees in job classifications normally bonded under prudent hotel management practices in the United States or otherwise required by law; (v) Worker’s compensation insurance coverage for all persons, if any, employed by Lessee on the Leased Premises, to the extent necessary to protect Lessor and the Leased Property against Lessee’s worker’s compensation claims, such worker’s compensation insurance to be in accordance with the requirements of applicable local, state and federal law; (vi) Vehicle liability insurance for owned, non-owned, and hired vehicles, in the amount of $5,000,000; and (vii) Such other insurance as Lessor may reasonably request for facilities such as the Leased Property and the operation thereof.

  • Boiler and Machinery Insurance The Owner shall have the option of purchasing and maintaining boiler and machinery insurance required by the Contract Documents or by law, which shall specifically cover such insured objects during installation and until final acceptance by the Owner. If purchased this insurance shall include interests of the Owner, Contractor, Subcontractors and Sub-subcontrators in the Work.

  • Renewal of obligatory insurances The Borrower shall procure that each Owner shall: (a) at least 21 days before the expiry of any obligatory insurance: (i) notify the Security Trustee of the brokers (or other insurers) and any protection and indemnity or war risks association through or with whom that Owner proposes to renew that insurance and of the proposed terms of renewal; and (ii) in case of any substantial change in insurance cover, obtain the Security Trustee’s approval to the matters referred to in paragraph (i) above; (b) at least 14 days before the expiry of any obligatory insurance, renew the insurance in accordance with the Security Trustee’s approval pursuant to paragraph (a); and (c) procure that the approved brokers and/or the war risks and protection and indemnity associations with which such a renewal is effected shall promptly after the renewal notify the Security Trustee in writing of the terms and conditions of the renewal.

  • Fire and Casualty Insurance Developer shall obtain and keep in full force adequate fire and casualty insurance with coverage in an amount equal to the assessed value of such improvements. In the event of loss the Developer shall use the proceeds of such insurance to promptly reconstruct the damaged or lost improvements.

  • Workplace Safety Insurance 20.1 Each member covered by this Agreement who is absent on account of injuries received while on duty and who is receiving a pension, salary or wage award from the Workplace Safety and Insurance Board shall be entitled to be paid the difference between the pension wage and salary award from the Workplace Safety and Insurance Board and his or her current net salary as long as such member remains in the employ of the Niagara Police Board. This shall be applied such that the combination of any WSIB salary or wage award plus the employer top-up shall, in total, equal the net pay of the member's current salary. The non- economic loss portion of any WSIB pension payments shall not be considered as being a salary or wage award, and hence shall not form part of these calculations. Any member who does not comply with the provisions of the Workplace Safety & Insurance Act or Regulations thereto and subsequently receives a salary or wage award or an amount less than the prevailing maximum payable, due to such non-compliance, shall not receive from the Niagara Police Board the difference between the wage or salary award paid by the Workplace Safety & Insurance Board and his or her current net salary. For the purpose of this Clause, net pay shall be the pay for the rank of the member as shown in Appendix "A" less those deductions required under Government Statutes, pension plans and as provided for in this Agreement. 20.2 Subject to the terms of this Article, each member covered by this Agreement who is injured as a result of carrying out his/her duties shall not be deprived of his/her vacations or statutory holidays as a result thereof, and shall accumulate such vacation credits and statutory holidays as he/she might otherwise receive. 20.2.1 Each member shall be entitled to accumulate the float time that he/she might otherwise receive for a period of three (3) months following the injury. 20.2.2 In respect of members who have been off work and receiving WSIB benefits for less than two

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