Czy globalizacja sprzyja rozwojowi energii odnawialnej? Globalna makro-perspektywa

The contemporary world has become increasingly interdependent in terms of economic, social and political development. These various forms of interdependence, usually termed globalization, help disseminate ideas, information, products, and services around the world. Increase in globalization has also increased path-dependence, affecting economic, social, and institutional development and completing some industries, products and technologies to grow in line with the global demand and changing standards.  While the role of globalization in economic growth, technology transfer and institutional development is established in literature, the role of globalization in reversing environmental deterioration is not explored yet. The current study looks at how globalization has affected renewable energy use in high, upper middle and lower middle income countries. The empirical results based on a fixed effects model show that countries differ in terms of taking advantage of different types of globalization, i.e., economic, social and political, while transitioning towards renewable energy (RE) projects. Economic globalization has a positive influence on RE usage in the case of high and lower middle income countries, Social globalization in case of high and upper middle income countries. Contrary to the positive impacts of economic and social globalization, political globalization has a negative impact on RE usage in the case of high income countries. In addition to globalization, the effect of government effectiveness, GDP per capita and CO2 vary across the groups of countries.Współczesny świat staje się coraz bardziej współzależny pod względem rozwoju gospodarczego, społecznego i politycznego. Te różne formy współzależności, zwykle nazywane globalizacją, pomagają rozpowszechniać idee, informacje, produkty i usługi na całym świecie. Wzrost globalizacji zwiększył również inne współzależności, wpływając na rozwój gospodarczy, społeczny i instytucjonalny oraz ukończenie niektórych gałęzi przemysłu, produktów i technologii, tak aby rozwijały się zgodnie z globalnym popytem i zmieniającymi się standardami. Chociaż rola globalizacji we wzroście gospodarczym, transferze technologii i rozwoju instytucjonalnym jest ustalona w literaturze, rola globalizacji w odwracaniu degradacji środowiska nie jest jeszcze zbadana. Obecne badanie dotyczy wpływu globalizacji na wykorzystanie energii odnawialnej w krajach o wysokim, średnim i niskim średnim dochodzie. Wyniki empiryczne oparte na modelu efektów stałych pokazują, że kraje różnią się pod względem wykorzystania różnych rodzajów globalizacji, tj. gospodarczej, społecznej i politycznej, podczas przechodzenia na projekty związane z energią odnawialną (OZE). Globalizacja gospodarcza ma pozytywny wpływ na wykorzystanie OZE w przypadku krajów o wysokim i niskim średnim dochodzie, Globalizacja społeczna w przypadku krajów o wysokim i wyższym średnim dochodzie. W przeciwieństwie do pozytywnych skutków globalizacji gospodarczej i społecznej, globalizacja polityczna ma negatywny wpływ na wykorzystanie OZE w przypadku krajów o wysokich dochodach. Oprócz globalizacji wpływ skuteczności rządów, PKB na mieszkańca i CO2 jest różny w poszczególnych grupach krajów

An integrated assessment model for food security under climate change for South Asia

The present study develops an integrated assessment model (IAM) for food security under climate change for South Asia. For IAM, initially, an econometric model is estimated that identifies the impact of climate change on crop yields, using the historical relationships between temperature, precipitation, and the production of cereals. Subsequently, future projections have been collected for temperature and precipitation from climate models of the Coupled Model Inter-comparison Project Phase 5 (CMIP5), and the previous econometric model is applied to obtain the implied future cereal yields changes. Then, the yield variations are fed into a multiregional Global Trade Analysis Project (GTAP) model, calibrated to the GTAP 9 database, taking the form of decreases in factor-augmenting productivity of the grains sector. Further, the present study evaluates the effects of climate change on an individual South Asian country. The results indicate that change in climate decreases food production, increases food prices, decreases food consumption, and thus affects the welfare. Trade and fiscal policy responses are investigated to combat the problem of food security. It is revealed that these two policies fail to compensate climate change damage in all the selected South Asian countries

Do Farmers Adapt to Climate Change? A Macro Perspective

Greenhouse gas emissions cause climate change, and agriculture is the most vulnerable sector. Farmers do have some capability to adapt to changing weather and climate, but this capability is contingent on many factors, including geographical and socioeconomic conditions. Assessing the actual adaptation potential in the agricultural sector is therefore an empirical issue, to which this paper contributes by presenting a study examining the impacts of climate change on cereal yields in 55 developing and developed countries, using data from 1991 to 2015. The results indicate that cereal yields are affected in all regions by changes in temperature and precipitation, with significant differences in certain macro-regions in the world. In Southern Asia and Central Africa, farmers fail to adapt to climate change. The findings suggest that the world should focus more on enhancing adaptive capacity to moderate potential damage and on coping with the consequences of climate change

Factors ssociated with complicated appendicitis: view from a low-middle income country

Introduction Factors associated with complicated appendicitis have been inconsistently identified. Moreover, studies are lacking from low and low-middle countries where access to surgical care is limited. Our objective was to identify factors predicting complicated appendicitis as diagnosed intraoperatively in a low-middle income country hospital. Methodology Retrospective case-control study of patients who underwent laparoscopic appendectomy from 01/2008 to 12/2015 was completed. Based on intraoperative diagnosis of complicated appendicitis, patients were divided into two groups; those with complicated appendicitis (CA) and those who had non-complicated appendicitis (NCA). CT scans were further reviewed to identify presence of appendicolith. Result Of the 442 patients included, 88 (20%) patients were in the CA group while 354 (80%) patients were in the NCA group. Patients in the CA group were older [CA vs. NCA: 34.6 ± 14 vs. 30.4 ± 11.5; p-value \u3c 0.001], had symptoms for longer duration [CA vs. NCA: 2 ± 1.2 vs. 1.5 ± 0.8; p-value: 0.001] and had a greater proportion of patients with appendicoliths [CA vs. NCA: 37 (42%) vs. 84 (23.7%); p-value: 0.001]. On multivariable regression analysis, patients with complicated appendicitis had greater odds of having appendicoliths (OR: 2.4, 95% CI: 1.4-4.07; p-value \u3c 0.001) and symptoms for a longer duration (OR: 1.57, 95% CI: 1.25-1.97; p-value \u3c 0.001). Conclusion Patients with complicated appendicitis had greater odds of having appendicoliths and symptoms for a longer duration. Further studies are warranted in low and low-middle income countries to gauge the impact delay in presentation and intervention has on appendicitis and its outcomes

A Weighted Linear Combining Scheme for Cooperative Spectrum Sensing

AbstractCooperative spectrum sensing exploits spatial diversity of secondary-users (SUs), to reliably detect the availability of a spectrum. Soft energy combining schemes have optimal detection performance at the cost of high cooperation overhead, since actual sensed data is required at the fusion center. To reduce cooperation overhead, in hard combining only local decisions are shared; however the detection performance is suboptimal due to the loss of information. In this paper, a weighted linear combining scheme is proposed in which a SU performs a local sensing test based on two threshold levels. If local test result lies between the two thresholds then the SU report neither its local decision nor sequentially estimated unknown SNR parameter values, to the fusion center. Thereby, uncertain decisions about the presence/absence of the primary-user signal are suppressed. Simulation results suggest that the detection performance of the proposed scheme is close to optimal soft combining schemes yet its overhead is similar to hard combining techniques

Template operative note: A better documentation

Operative notes are a valuable part of patient\u27s medical record, and carry the medico-legal significance. One way of improving it is to introduce the template form operative notes. Only few studies have been done worldwide to compare both the forms of operative notes. This cross-sectional study was conducted in the department of General Surgery, AKUH. This included the patients who underwent Laparoscopic cholecystectomy (Complying with inclusion criteria) from August 2013 till March 2014. Out of 24 patients, 19 were females. The completeness of data in template group was significantly better than traditional group (79.2% vs. 8.3%). There was no significant difference among the residents of different level (writing the notes) and the completeness of data in both the groups. Similarly the timing of day did not affect significantly on the completeness

The characteristics of appendicoliths associated with acute appendicitis

Introduction: Differences between appendicoliths associated with appendicitis and those found incidentally have not been studied. The objective of this study was to determine the characteristics of appendicoliths that are associated with acute appendicitis. Methods: A cross-sectional study of patients with appendicoliths identified on computed tomographic (CT) scan from January 2008 till December 2014 was conducted. Patients were divided into two group: appendicitis and appendicoliths (AA) and incidentally discovered appendicoliths (IA). Results: Overall, 321 patients were included in the study. Of these, 103 (32%) patients were in the AA group while 218 (68%) patients were in the IA group. Both groups were similar in age and gender distribution. Significantly greater proportion of patients in the AA group had more than one appendicolith [AA vs. IA: 63 (62%) vs. 82 (38%), p \u3c 0.001], appendicolith location at the base [AA vs. IA: 34 (33%) vs. 33 (15%), p \u3c 0.001] and appendicolith diameter of 5 mm or more [AA vs. IA: 71 (69%) vs. 28 (13%), p \u3c 0.001]. On multivariate analysis, more than one appendicolith [Odds ratio (OR): 1.9, 95% CI: 1.1-3.4; p = 0.02] and diameter of 5 mm or more (OR: 13, 95% CI: 7.1-23.6; p \u3c 0.001) were independently associated with acute appendicitis. Conclusion: Multiple appendicoliths and appendicoliths larger than 5 mm are associated with acute appendicitis

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication