Factors Associated with Revision Surgery after Internal Fixation of Hip Fractures

Background: Femoral neck fractures are associated with high rates of revision surgery after management with internal fixation. Using data from the Fixation using Alternative Implants for the Treatment of Hip fractures (FAITH) trial evaluating methods of internal fixation in patients with femoral neck fractures, we investigated associations between baseline and surgical factors and the need for revision surgery to promote healing, relieve pain, treat infection or improve function over 24 months postsurgery. Additionally, we investigated factors associated with (1) hardware removal and (2) implant exchange from cancellous screws (CS) or sliding hip screw (SHS) to total hip arthroplasty, hemiarthroplasty, or another internal fixation device. Methods: We identified 15 potential factors a priori that may be associated with revision surgery, 7 with hardware removal, and 14 with implant exchange. We used multivariable Cox proportional hazards analyses in our investigation. Results: Factors associated with increased risk of revision surgery included: female sex, [hazard ratio (HR) 1.79, 95% confidence interval (CI) 1.25-2.50; P = 0.001], higher body mass index (fo

Using a Strategic Environmental Assessment Framework to quantify the environmental impact of bioenergy plans

Renewable energy and GHG reduction targets are driving an acceleration in the use of bioenergy resources. The environmental impact of national and regional development plans must be assessed in compliance with the EU Strategic Environmental Assessment (SEA) Directive (2001/42/EC). Here, we quantify the environmental impact of an Irish Government bioenergy plan to replace 30% of peat used in three peat-burning power stations, located within the Midlands region, with biomass. Four plan alternatives for supplying biomass to the power plant were considered in this study; (1) importation of palm kernel shell from south-east Asia, (2) importation of olive cake pellets from Spain and (3) growing either willow or (4) Miscanthus in the vicinity of the power stations. The impact of each alternative on each of the environmental receptors proposed in the SEA Directive was first quantified before the data were normalised on either an Irish, regional or global scale. Positive environmental impacts were very small compared to the negative environmental impacts for each of the plan alternatives considered. Comparison of normalised indicator values confirmed that the adverse environmental consequences of each plan alternative are concentrated at the location where the biomass is produced. The analysis showed that the adverse environmental consequences of biomass importation are substantially greater than those associated with the use of willow and Miscanthus grown on former grassland. The use of olive cake pellets had a greater adverse environmental effect compared to the use of peat whereas replacement of peat with either willow or Miscanthus feedstocks led to a substantial reduction in environmental pressure. The proposed assessment framework combines the scope of SEA with the quantitative benefits of life cycle analysis and can be used to evaluate the environmental consequences of bioenergy plans.JRC.J.5-Sustainable Production and Consumptio

Receptor binding studies on lipid vesicles using the BIAcore

NRC publication: Ye

Bioenergy from “surplus” land: environmental and socio-economic implications

The increasing demand for biomass for the production of bioenergy is generating land-use conflicts. These conflicts might be solved through spatial segregation of food/feed and energy producing areas by continuing producing food on established and productive agricultural land while growing dedicated energy crops on so called “surplus” land. Ambiguity in the definition and characterization of surplus land as well as uncertainty in assessments of land availability and of future bioenergy potentials is causing confusion about the prospects and the environmental and socio-economic implications of bioenergy development in those areas. The high level of uncertainty is due to environmental, economic and social constraints not yet taken into account and to the potentials offered by those novel crops and their production methods not being fully exploited. This paper provides a scientific background in support of a reassessment of land available for bioenergy production by clarifying the terminology, identifying constraints and options for an efficient bioenergy-use of surplus land and providing policy recommendations for resolving conflicting land-use demands. A serious approach to factoring in the constraints, combined with creativity in utilizing the options provided, in our opinion, would lead to a more sustainable and efficient development of the bioenergy sector. Unless the sustainability challenge is mastered, the interdependent policy objectives of mitigating climate change, obtaining independence from fossil fuels, feeding and fuelling a growing human world population and maintaining biodiversity and ecosystem services will not be met. Despite the advanced developments of bioenergy, we still see regional solutions for designing and establishing sustainable bioenergy production systems with optimized production resulting in social, economic and ecological benefits. Where bioenergy production has been identified as the most suitable option to overcome the given problems of energy security and climate change mitigation, we need to determine which bioenergy cultivation systems are most suitable for the respective types of surplus land, by taking into account issues such as yields, inputs and costs, as well as potential environmental and socio-economic impacts