Prosthetic joint infections

Objectives: To review the available literature on prosthetic joint infections and provide recommendations on management particularly the importance of identifying the causative organism and starting the most appropriate antimicrobial therapy. Methods: The medical literature was searched using PubMed, employing the key words prosthetic joint infections. There appears to be no UK consensus guidelines on the management of prosthetic joint infections or the use of prophylactic antibiotics to prevent them. There is however a number of key documents and trust policies which deal with the subject extensively. We also made use of ‘The Sanford Guide to Antimicrobial therapy 2012’ for the latest recommendations on the correct antimicrobial therapy. Conclusion: Although diagnosis is often difficult, there are a number of investigations which can help us identify the organism. We recommend that the local prevalence of such infections is studied together with identification of the commonest organisms. Work is already underway between the infectious disease team and orthopaedic surgeons to devise locally adapted protocols for the identification and management of such infections. They should work in close liaison to implement the correct treatment which often involves a combination of both surgical and antimicrobial therapy.peer-reviewe

Designing Adaptive Engagement Approaches for Audience-bounded Online Communities

Audience-bounded online communities require innovative user engagement techniques. Without special efforts focus- ing on engagement, the contribution volume will likely to be insufficient to maintain a sustainable community-driven sys- tem. This paper presents an adaptive approach for user en- gagement that aims to apply alternative engagement strate- gies to users with different behavior in the online community. We report the results of the first experiments testing the fea- sibility of such approach. We discuss further design options that can be explored and the implications of the approach

Credit and information in universal banking : a clinical study

We studied information and interaction processes in six lending relationships between a universal bank and medium sized firms. The study is based on the credit files of the respective firms. If no problems occur in these lending relationships, bank monitoring is based mainly on cheap, retrospective and internal data. In case of distress, more expensive, prospective and external information is used. The level of monitoring and the willingness to renegotiate the lending relationship depends on what the lending officers can learn about the future prospects of the firm from the behaviour of the debtors. We identify both signalling and bonding activities. Such learning from past behaviour seems to allow monitoring at low cost, whereas the direct observation of the firm's investment outlook seems to be very costly. Also, too much knowledge about the firm's investments might leave the bank in a very strong bargaining position and distort investment incentives. Therefore, the traditional view of credit assessment as observation of the quality of a borrower's investment programme needs to be reconsidered

Trade, competitiveness and employment in Jordan

Jordan has realized the necessity to pursue opportunities through integration into international production networks and cross-border trade. The country has recently undertaken ambitious reforms of its trade regime. These initiatives comprise the accession to the WTO in 2000, the signing of several preferential trade agreements, notably with the European Union and the United States in 2001, and the pursuit of unilateral border policy reforms. This paper discusses Jordan’s recent trade performance, with special attention to the impact of trade reforms and the country’s special economic zones on employment. Moreover, a set of indicators of economic competitiveness will be examined to highlight Jordan’s position vis-à-vis a group of comparator countries. And finally, some recommendations for the attention of policy makers will be derived on how trade-related growth could be made more job-rich.Tariffs, services trade, incentives, special economic zones, regional integration

State space mixed models for longitudinal obsservations with binary and binomial responses

We propose a new class of state space models for longitudinal discrete response data where the observation equation is specified in an additive form involving both deterministic and random linear predictors. These models allow us to explicitly address the effects of trend, seaonal or other time-varying covariates while preserving the power of state space models in modeling serial dependence in the data. We develop a Markov Chain Monte Carlo algorithm to carry out statistical inferene for models with binary and binomial responses, in which we invoke de Jong and Shephard's (1995) simulaton smoother to establish an efficent sampling procedure for the state variables. To quantify and control the sensitivity of posteriors on the priors of variance parameters, we add a signal-to-noise ratio type parmeter in the specification of these priors. Finally, we ilustrate the applicability of the proposed state space mixed models for longitudinal binomial response data in both simulation studies and data examples

Power from the Desert: Not a Mirage

Energy policy is confronted by two major challenges. First, fossil fuels will become ever more scarce and expensive in coming years, a trend which will intensify conflicts for the control of natural resources. Second, the burning of fossil fuels-particularly coal-is leading to an increase in harmful greenhouse gas emissions. To address these challenges, the share of renewable energy in total energy consumption must be considerably increased. In sharp contrast to fossil fuels, which are becoming ever more depleted, renewable energy sources are essentially inexhaustible. Furthermore, renewable energy produces hardly any greenhouse gases. The large-scale exploitation of solar energy for power generation offers enormous potential. In theory, solar-thermal collectors installed in North Africa over an area roughly the size of New Jersey could meet all of Europe's electricity needs. The construction of high-voltage direct current (HVDC) lines would be necessary to import power from the Mediterranean region without excessive transmission losses. An expansion of European electricity networks could also yield supplementary benefits, including enhanced integration of domestic renewable energy (such as wind power), and improved competition in electricity markets.Electricity trade, Solar energy, DESERTEC

Mitigation of Methane Emissions: A Rapid and Cost-Effective Response to Climate Change

Methane is a major anthropogenic greenhouse gas, second only to carbon dioxide (CO2) in its impact on climate change. Methane (CH4) has a high global warming potential that is 25 times as large as the one of CO2 on a 100 year time horizon according to the latest IPCC report. Thus, CH4 contributes significantly to anthropogenic radiative forcing, although it has a relatively short atmospheric perturbation lifetime of 12 years. CH4 has a variety of sources that can be small, geographically dispersed, and not related to energy sectors. In this report, we analyze methane emission abatement options in five different sectors and identify economic mitigation potentials for different CO2 prices. While mitigation potentials are generally large, there are substantial potentials at low marginal abatement costs. Drawing on different assumptions on the social costs of carbon, we calculate benefit/cost ratios for different sectors and mitigation levels. We recommend an economically efficient global methane mitigation portfolio for the year 2020 that includes the sectors of livestock and manure, rice management, solid waste, coal mine methane and natural gas. Depending on assumptions of social costs of carbon, this portfolio leads to global CH4 mitigation levels of 1.5 or 1.9 GtCO2-eq at overall costs of around $14 billion or$30 billion and benefit/cost ratios of 1.4 and 3.0, respectively. We also develop an economically less efficient alternative portfolio that excludes cost-effective agricultural mitigation options. It leads to comparable abatement levels, but has higher costs and lower benefit/cost ratios. If the global community wanted to spend an even larger amount of money - say, $250 billion - on methane mitigation, much larger mitigation potentials could be realized, even such with very high marginal abatement costs. Nonetheless, this approach would be economically inefficient. If the global community wanted to spend such an amount, we recommend spreading the effort cost-effectively over different greenhouse gases. While methane mitigation alone will not suffice to solve the climate problem, it is a vital part of a cost-effective climate policy. Due to the short atmospheric lifetime, CH4 emission reductions have a rapid effect. Methane mitigation is indispensable for realizing ambitious emission scenarios like IPCC's "B1", which leads to a global temperature increase of less than 2°C by the year 2100. Policy makers should put more emphasis on methane mitigation and aim for realizing low-cost methane mitigation potentials by providing information to all relevant actors and by developing appropriate regulatory and market frameworks. We also recommend including methane in emissions trading schemes.Methane, mitigation, climate change, cost-benefit analysis

Methane: A Neglected Greenhouse Gas

Methane is a greenhouse gas that gets far less public attention than carbon dioxide. This is entirely unwarranted. Being 25 times more potent than carbon dioxide in trapping heat in the atmosphere, methane accounts for about one-sixth of all anthropogenic (i.e. human-induced) greenhouse gas emissions. Methane is also overlooked when it comes to taking concrete measures for climate protection, despite the fact that reducing methane emissions is potentially cheap. Major sources of methane emissions are livestock farming, the natural gas sector, landfills, wetland rice cultivation and coal mining. In many cases, it is possible to mitigate substantial amounts of methane in a cost-effective way. Moreover, captured methane can be used for generating heat and power. In other words, abating one ton of methane emissions is sometimes cheaper than abating an equivalent amount of carbon dioxide. The challenge is to effectively incorporate cutbacks of methane gas emissions into climate policy strategies.Methane, Mitigation, Climate policy

Tropical Cyclone Losses in the USA and the Impact of Climate Change: A Trend Analysis Based on a New Dataset

Economic losses caused by tropical cyclones have increased dramatically. It can be assumed that most losses are due to increased prosperity and a greater tendency for people to settle in exposed areas, but also that the growing incidence of severe cyclones is due to climate change. This paper aims to isolate the socio-economic effects and ascertain the potential impact of climate change on this trend. Storm losses for the period 1950-2005 have been adjusted to 2005 socio-economic values so that any remaining trend cannot be ascribed to socio-economic developments. In the period 1971-2005, losses excluding socio-economic effects show an annual increase of 4% per annum.Climate change, tropical cyclones, loss trends