Concentrating solar power in Europe, the Middle East and North Africa: Achieving its potential

Concentrating solar power (CSP) is a commercially available renewable energy technology capable of harnessing the immense solar resource in Southern Europe, the Middle East and North Africa (the MENA region), and elsewhere. This paper summarises the findings of a study by the European Academies Science Advisory Council which has examined the current status and development challenges of CSP, and consequently has evaluated the potential contribution of CSP in Europe and the MENA region to 2050. It identifies the actions that will be required by scientists, engineers, policy makers, politicians, business and investors alike, to enable this vast solar resource to make a major contribution to establishing a sustainable energy system. The study concludes that cost reductions of 50-60% in CSP electricity may reasonably be expected in the next 10-15 years, enabling the technology to be cost competitive with fossil-fired power generation at some point between 2020 and 2030. Incorporation of storage delivers added value in enabling CSP to deliver dispatchable power. Incentive schemes will be needed in Europe and MENA countries to enable this point to be achieved. Such schemes should reflect the true value of electricity to the grid, effectively drive R&D, and ensure transparency of performance and cost data

Clinical Predictive Model of Multidrug Resistance in Neutropenic Cancer Patients with Bloodstream Infection Due to Pseudomonas aeruginosa

We aimed to assess the rate and predictive factors of bloodstream infection (BSI) due to multidrug-resistant (MDR) Pseudomonas aeruginosa in neutropenic cancer patients. We performed a multicenter, retrospective cohort study including oncohematological neutropenic patients with BSI due to P. aeruginosa conducted across 34 centers in 12 countries from January 2006 to May 2018. A mixed logistic regression model was used to estimate a model to predict the multidrug resistance of the causative pathogens. Of a total of 1,217 episodes of BSI due to P. aeruginosa, 309 episodes (25.4%) were caused by MDR strains. The rate of multidrug resistance increased significantly over the study period (P 0.033). Predictors of MDR P. aeruginosa BSI were prior therapy with piperacillin-tazobactam (odds ratio [OR], 3.48; 95% confidence interval [CI], 2.29 to 5.30), prior antipseudomonal carbapenem use (OR, 2.53; 95% CI, 1.65 to 3.87), fluoroquinolone prophylaxis (OR, 2.99; 95% CI, 1.92 to 4.64), underlying hematological disease (OR, 2.09; 95% CI, 1.26 to 3.44), and the presence of a urinary catheter (OR, 2.54; 95% CI, 1.65 to 3.91), whereas older age (OR, 0.98; 95% CI, 0.97 to 0.99) was found to be protective. Our prediction model achieves good discrimination and calibration, thereby identifying neutropenic patients at higher risk of BSI due to MDR P. aeruginosa. The application of this model using a web-based calculator may be a simple strategy to identify high-risk patients who may benefit from the early administration of broad-spectrum antibiotic coverage against MDR strains according to the local susceptibility patterns, thus avoiding the use of broad-spectrum antibiotics in patients at a low risk of resistance development