Patient selection for bilateral total knee replacement needs improvement

ScienceDaily (Sep. 28, 2012) ? Because there are more risks with having a total knee replacement in both legs at the same time than having a knee replacement in one leg, doctors in recent years have been selecting younger and healthier patients for the bilateral procedure. Now a new study by researchers at Hospital for Special Surgery has revealed that although patients are younger and healthier than those undergoing only one-sided surgery, they are becoming sicker and some complication rates have risen.

"Although we are selecting younger people, we can't ignore the fact that the population in general is getting sicker," said Stavros Memtsoudis, M.D., Ph.D., director of Critical Care Services at Hospital for Special Surgery (HSS) in New York City, who led the study. "Many of the complications that we studied didn't decrease over time as you would expect with younger patients and better health care, and some of the complications even increased." The study is published online ahead of print in the journal Clinical Orthopaedics and Related Research.

Rising levels of obesity appear to be driving the complication rates, as well as the increase in the utilization of total knee replacements. Obesity puts extra stress on joints and bones and can cause premature osteoarthritis.

To conduct their research into trends regarding bilateral total knee replacements, researchers at HSS turned to the Nationwide Inpatient Survey, sponsored by the Agency for Healthcare Research and Quality (AHRQ). This is the largest inpatient database available in the United States that includes information on patients of all ages. It collects data from about 20% of all hospitalizations in the U.S. The study investigators identified 258,524 bilateral total knee replacements performed between 1999 and 2008. The number of annual bilateral procedures increased by 75%. In 1999, bilateral procedures accounted for 3.7% of all knee replacement operations and in 2008, they accounted for 6% of the operations.

The average age of patients undergoing bilateral knee replacement decreased by 2.5 years from 1999 to 2008. As the years marched on, patients presented with higher rates of comorbidities, including renal failure, neurologic disease, liver disease, diabetes, and chronic obstructive pulmonary disease. Obesity increased by 131% during the study period. The only comorbidity that decreased was congestive heart failure.

Over the time period studied, the researchers identified a 3% increase in pneumonia, a 6% increase in pulmonary embolism, and a 3% increase in nonmyocardial infarction cardiac complications.

"The take home message of this paper is that we are fighting an uphill battle, because people are getting sicker, despite us attempting to limit risk by choosing younger people to do these procedures in," said Dr. Memtsoudis. "We have to start thinking of other interventions other than patient selection that we can implement in order to reduce these complications."

On a positive note, the investigators also found that absolute in-hospital mortality rates decreased at an average rate of 10% per year. The researchers attribute this decrease to advances in medicine and increased use of telemetry and observation in the last 10 to 15 years. "With advances in medicine and monitoring, we have been able to counteract this extreme event of mortality. If you get a complication and it is not recognized, you may die from it," said Dr. Memtsoudis. "If you observe people more thoroughly, you may not be able to prevent the complication, but you may be able to prevent a mortal event resulting from it."

The researchers also identified a cost shifting landscape. Patients stayed in the hospital an average of five days after their procedure in 1999 and an average of four days in 2008, but the proportion of discharges to a home or customary residence without home health care decreased at an average rate of 5.5% per year.

"Before this study, we were under the assumption that patient complications were steadily decreasing after bilateral knee arthroplasty, because of better patient selection and improvements in medical care," said Dr. Memtsoudis. "Now we understand that the picture is more complex. Patients being selected for the procedure may be getting younger, but they are not getting healthier and maybe that is why we don't see a drastic drop in complications."

Before embarking on a bilateral knee replacement, he said, patients should "critically look at themselves and talk to their physicians about how their health status plays into the choice of surgery."

More work is needed to identify ways to prevent complications in patients undergoing bilateral knee replacement and a recent conference sponsored by the Hospital for Special Surgery is aiming to do just that. The Consensus Conference on the Creation of Guidelines for Bilateral Knee Arthroplasty involved 40 experts from 16 institutions. The guidelines coming out of this conference, which are expected to be published within the next six months, address issues such as determining the appropriate workup and management for a patient undergoing bilateral knee replacement, and how long doctors should wait between procedures if a patient undergoes two operations.

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Story Source:

The above story is reprinted from materials provided by Hospital for Special Surgery, via EurekAlert!, a service of AAAS.

Note: Materials may be edited for content and length. For further information, please contact the source cited above.

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Journal Reference:

1. Stavros G. Memtsoudis, Carlos B. Mantilla, Javad Parvizi, Ottokar Stundner, Madhu Mazumdar. Have Bilateral Total Knee Arthroplasties Become Safer?: A Population-Based Trend Analysis. Clinical Orthopaedics and Related Research?, 2012; DOI: 10.1007/s11999-012-2608-9

Note: If no author is given, the source is cited instead.

Disclaimer: This article is not intended to provide medical advice, diagnosis or treatment. Views expressed here do not necessarily reflect those of ScienceDaily or its staff.

Source: http://feeds.sciencedaily.com/~r/sciencedaily/most_popular/~3/aTlkoVATYFQ/120929140401.htm

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Backpacking to Perth day 3 - Backpacking travel & Outdoor adventure

Backpacking to Perth

Cape to Cape of Margaret River Valley
07 Sep. to 18 Sep. 2012

Day 03 Sun. (09.09.2012) ? Boating at Canning River a tributary of the Swan River

Dave prepared the morning breakfast of toasted bread, eggs, noodle, baked beans and coffee. While waiting for my high school friend, Jenny Chuah to come over to meet us, Dave and Gerard took the boat out into the Canning River. We spent the day of family picnicking and boating by the Canning River together with Dave?s brother, sister-in-law, children and grandchildren.

As usual, Dave?s spirit session started at 4.30 pm and followed by wine. For another good dinner it was grilled beef and sausages. I too helped out to cook a prawn dish. Monica invited my friend Jenny Chuah and hubby Kelvin Tan for dinner. Jenny Chuah is from Teluk Intan, Perak and Kelvin Tan is from Malacca, Malaysia ? both migrated to Perth in the late seventies.

Sleeping: Seah?s Haven
Temperature: Sunny 26?C/13?C

Backpacking to Perth WA day 1, 2
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click here to continue day 4

Source: http://chingnengbin.blogspot.com/2012/09/2012-backpacking-to-perth-day-3.html

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Fox News Apologizes For Airing Live Suicide

Source: http://www.thehollywoodgossip.com/2012/09/fox-news-apologizes-for-airing-live-suicide/

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iPhone 5, Galaxy S III cost lower than $1 per year to charge

iPhone 5, Galaxy S III cost lower than $1 per year to charge

If you?re ordering an iPhone 5, you?re possibly paying a great deal of cash for the handset. That?s specifically true when you?re getting the telephone straight from Apple without a two-year contract, because the expense of the 16GB model is set at $ 649 ? plus that?s the smallest pricey model about provide. That absolutely isn?t inexpensive, however, there?s 1 aspect of the iPhone 5 which isn?t pricey at all: the expense to charge it.

The people at Opower ran several tests plus determined which the iPhone 5 just costs an estimated 41 cents per year to charge. Getting a little more certain, they utilized the Watts Up Pro Consumption Power Meter to figure out how much electricity the iPhone 5 consumes whenever charging from 0% to 100%. When they had those results, it just took a little of math to figure out how much it may expense customers to charge their iPhone 5 per year.

The test assumes which these iPhone 5 consumers are charging their shiny new handset when daily, that isn?t unreasonable considering the iPhone 5?s beefier power compared to previous iPhones. Simply for kicks, the Opower team additionally tested the Galaxy S III plus determined it costs 53 cents per year to charge Samsung?s flagship. Why the discrepancy involving the 2 handsets? The Galaxy S III attributes a bigger power than the iPhone 5, meaning it takes a little more electricity to totally charge it.

Still, the difference amongst the 2 is negligible, particularly because the expense is spread out over an whole year. It?s somewhat surprising which the expense to charge a mobile is really low, nevertheless Opower equally reminds you which the force use is very substantial whenever you take all smartphone consumers into account. That?s set to strengthen a lot inside the close future too, because it?s estimated which by 2016, a whopping 1 billion persons all over the world can have smartphones. Should you have a few minutes, make sure to read by Opower?s whole report, because it?s all fairly fascinating. What do we think of the small test?

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Source: http://www.dailygadgets.net/iphone-5-galaxy-s-iii-cost-lower-than-1-per-year-to-charge/13864/

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Economy is the name of the game in Mass. Senate race

As Massachusetts voters?scrutinize Republican Sen. Scott Brown and challenger Democratic Elizabeth Warren the candidates may be have to tackle issues like foreign policy and national security.?

By Bob Salsberg,?Associated Press / September 30, 2012

Massachusetts Democrat Elizabeth Warren, (l.), who is challenging incumbent U.S. Sen. Scott Brown, R-Mass., in the November 2012 general election.

AP Photos

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Foreign policy and national security issues have largely taken a backseat to economic concerns in the hard-fought and expensive US Senate race in Massachusetts, and barring a monumental international event, that dynamic is unlikely to change in the final weeks of the campaign.

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But with continued instability in the Middle East and other global challenges, the positions of Republican incumbent Scott Brown and Democratic challenger Elizabeth Warren may well come into sharper focus. Both will be asked to provide voters with a sense of how ? as a US senator for the next six years ? they would view America's role in the world and vote on key questions from national defense and trade policy.

The candidates' written responses to a series of questions on foreign affairs posed by The Associated Press reveal contrasts both stark and subtle, yet also some striking similarities in approach.

On the threat posed by Iran, both Brown and Warren indicated all options up to and including military action must be considered if diplomacy and sanctions fail to end the regime's pursuit of nuclear capability. Calling Iran the "most serious threat to world peace and stability," Brown criticized Warren's use during the campaign's first televised?debate?of the word "nuanced" to describe the preferred U.S. approach.

"President Obama attempted a more nuanced approach to Iran early in his term, and he quickly discovered it didn't work," Brown said.

Diplomacy and sanctions had merely slowed Iran's nuclear program and bought some time, he added, and the administration now needed to apply "severe pressure" on Iran's government and economy.

Warren said she supported Obama's strategy for preventing Iran from becoming a nuclear power.

"We have the toughest sanctions we have ever had against Iran, and I will work to make them even tougher," she said.

The candidates ended their response on Iran with similar language: Brown said the "US must keep every option on the table;" Warren said she "wouldn't take any options off the table," while also cautioning that "we must not rush to war."

Commenting on another Middle East hotspot, both declared that Syrian President Bashir Assad must go, but they differed on how the US should respond to the government's violent crackdown on dissidents.

"It is appropriate to identify moderate elements within the opposition and provide them with weapons so they can fight back against Assad and the Syrian army," Brown said. The senator made clear he did not, at this time, support sending in US ground troops or imposing a no-fly zone.

"Options such as providing lethal support such as weapons, establishing humanitarian zones, or setting up a no-fly zone must be carefully considered," Warren said. "Because lethal assistance can have complex and unintended consequences, we should not act unless we are confident that we can do more good than harm and that we have a clear plan and achievable goals."

Neither Brown nor Warren offered a specific opinion on Obama's timetable for withdrawing troops from Afghanistan by the end of 2014. Brown said he was less concerned about the precise timing as with the need to defeat the enemy and place Afghan forces in position to assume control of the country's security.

Warren said the US should leave Afghanistan as "quickly as possible," while ensuring the safety of troops, so that the $2 billion spent weekly on the war can be used for domestic needs.

The nation's budget woes and the winding down of the wars in Iraq and Afghanistan are likely to renew pressure on Congress to rein in military spending. Here, both candidates advocated a smart approach to any defense reductions, with Warren opposing "across-the-board" cuts and Brown warning that defense programs should not be trimmed indiscriminately.

The Republican, a member of the Senate Armed Services Committee, said he backed the panel's $634.4 billion defense authorization while also supporting the Pentagon's goal of finding $500 million in savings. Warren did not cite a savings target, but said the ending of the wars could permit downsizing of the US Army. She also called for greater investment in cybersecurity.

Source: http://rss.csmonitor.com/~r/feeds/csm/~3/HTVueCxcTtg/Economy-is-the-name-of-the-game-in-Mass.-Senate-race

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Starbucks to open first store in India in South Mumbai by October?end this year

Description: An unhandled exception occurred during the execution of the current web request. Please review the stack trace for more information about the error and where it originated in the code.

Exception Details: System.NullReferenceException: Object reference not set to an instance of an object.

Source Error:

An unhandled exception was generated during the execution of the current web request. Information regarding the origin and location of the exception can be identified using the exception stack trace below.

Stack Trace:

[NullReferenceException: Object reference not set to an instance of an object.] detailNews.Page_Load(Object sender, EventArgs e) +133 System.Web.Util.CalliHelper.EventArgFunctionCaller(IntPtr fp, Object o, Object t, EventArgs e) +14 System.Web.Util.CalliEventHandlerDelegateProxy.Callback(Object sender, EventArgs e) +35 System.Web.UI.Control.OnLoad(EventArgs e) +99 System.Web.UI.Control.LoadRecursive() +50 System.Web.UI.Page.ProcessRequestMain(Boolean includeStagesBeforeAsyncPoint, Boolean includeStagesAfterAsyncPoint) +627

---

Version Information:?Microsoft .NET Framework Version:2.0.50727.3634; ASP.NET Version:2.0.50727.3634

Source: http://www.hospitalitybizindia.com/detailNews.aspx?aid=14755&sid=1

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Copy This Romantic Dior Makeup For A Fall Wedding

Wedding Day Glow

Wedding day makeup is all about a natural flush and romantic gaze, no ?matter the season. Look at this Christian Dior Fall 2012 runway beauty look ? it?s perfect wedding makeup, no? We agree. The makeup artist behind this look used a palette of pearly vanilla, pale fawn, rosy pale pink and nude to evoke a youthful, serene makeup look. We want to wear this makeup to our wedding ? and we?re not even engaged! This look, while perfect for the bride or wedding party, can work for guests too and complements every skintone.

Related: Use Expert Eye Makeup Tips Work For This Wedding Look

Do?s And Don?ts For The Day

Summer weddings can draw on a more bronzed, dewy makeup look, while an autumn wedding day calls for a shine-free, flushed face like the Dior look here. Though some autumn brides opt for deeper tones on lips and eyes, we think overdoing the dark makeup is a no-no ofor any wedding. To achieve a perfect balance between a natural look in person and a photo-ready face, go for this soft, subtle, feature-enhancing makeup.

Related: What?s Trending For The Future Of Makeup

How To Get It

If you?ll be having your makeup done for the big day simply bring us along to your appointment on your smart phone. If you?re doing your makeup yourself, here?s how to copy this easy makeup look. First, you must use a photo ready primer like this Revlon version before you apply any foundation or powder. For lucky flawless ladies, opt for primer and sheer mineral powder atop an otherwise nude face. Lightly dust Dior Rosy Glow blush from cheekbones to temples upwards for the illusion of naturally rosy cheeks and defined cheekbones. Eyes rely on only two shades, so use this bareMinerals duo ? it?s perfect! (And the colour is called ?The Promise?. Hello!) Cover lids right up to brow bone with the pale vanilla shade, followed by a soft, fluffy application of the fawn shade into crease and softly curved outwards. Using an angle brush, apply this shade under lower lashline. Lips call for a kiss-the-bride pout in a smoochable, matte nude hue. We love this h.wood.beauty Semi Matte shade for a subtle wash of matte colour. Finally- Dior inspired looks are never complete (actually, no makeup look is) without lush Diorshow mascara in chestnut or black.

Shop The Look: Revlon Photo Ready Perfecting Primer, $13, Ulta
Shop The Look: bareMinerals Duo in the Promise, $20, Sephora
Shop The Look: h.wood.beauty Semi Matte Lipstick In Toni, $20, dermstore.com
Shop The Look: Diorshow Mascara, $25, Nordstrom
Shop The Look: Dior Rosy Glow Blush, $45, Saks Fifth Avenue

[Photos via Style.com]

Tags: autumn wedding makeup, bridal makeup, bridal makeup ideas, fall 2012 makeup trends, fall wedding makeup, how to do makeup for a wedding, wedding makeup, wedding makeup inspiration

This entry was posted on Saturday, September 29th, 2012 at 10:00 am and is filed under Makeup. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.

Source: http://www.realstylenetwork.com/blogs/beauty/2012/09/copy-this-romantic-dior-makeup-for-a-fall-wedding/

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Top Comments From Mashable Readers This Week

Facebook Users Say Private Messages Appear Publicly

Even if you take care to keep your Facebook messages private, privacy settings can change in an instant. Although Facebook denied any changes to its settings, our readers claimed they had private messages posted to their timeline.

Click here to view this gallery.

[More from Mashable: Voice-Guided Directions Dispute Torpedoed Google Maps for iOS 6]

Here at Mashable, the week kicked off with conversations about social good with the Social Good Summit serving as the platform for a three-day global conversation. Activists, humanitarians, entrepreneurs and CEOs all discussed how social media can affect positive change on a global scale. The conversation even broke a world record: It was the largest conversation around a single topic to ever occur in one day.

As 92nd Street Y President Stuart J. Ellman pointed out, one important message from the summit was that "social media and technology are not agents of change. They are just tools. We the connected people are the agents of change." This week on Mashable we saw different examples of how we can use these tools. While technology can bring beautiful innovation, it can also promote the rapid dissemination of prejudice. Our community provided insightful commentary around the disparate ways social media can both bring us together and drive us apart.

[More from Mashable: Google?s New Maps App for iPhone Won?t Come for Months [REPORT]]

Even though we are more globally connected than ever before, some old rivalries continue to keep readers engaged in debate. Google and Apple products continue to face off, while the struggling underdogs Blackberry and Myspace are throwing their hats back in the ring.

Adding insult to injury, Google Maps this week unveiled an underwater "street view" feature which met an overwhelmingly positive response.

Facebook caused a social media malestrom when some users reported that private messages prior to 2010 had become publicly visible. Although Facebook claimed that no such leak had occurred, our readers had a different opinion. We also discovered a bug on Facebook that keeps post from being erased. While Facebook combatted accusations that it was releasing private information, Justin Timberlake was bringing Myspace back with a redesign for the social networking website that once reigned supreme.

But no matter the platform you're using, ultimately the greatest social media blunders are purely the result of human failings. Our readers shared some of the most memorable social media gaffes of the past few years.

However, in addition to providing us with a platform on which to screw up, the Internet also gives us a chance to learn from our mistakes. This week, the Reddit community was schooled by a Sikh woman who responded to a photo someone had posted of her as a joke. The original poster saw her response, reconsidered his original post and publicly apologized for his actions. See the gallery above for our community's reactions.

Our readers are a vital part of the Mashable experience. We encourage you to be a part of the ongoing conversation by joining Mashable Follow and brushing up on our community guidelines. Next week you might be featured in our weekly rundown of the top discussions!

Image courtesy of Flickr, ntr23

This story originally published on Mashable here.

Source: http://news.yahoo.com/top-comments-mashable-readers-week-152544015.html

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Maggot guts help police identify body

Police in Mexico recently discovered a body burned beyond recognition in a remote patch of woods just off a country road. The hands and feet were missing. There was no physical evidence nearby except a school graduation ring. The body was in such bad shape that investigators couldn't even determine the gender. The only soft tissue available for genetic analysis was a burned fragment of liver, but attempts to get a DNA profile from this bit of evidence proved futile.

However, forensic investigators were able to find useful genetic material in an unusual place ? inside the guts of the maggots infesting the corpse's neck and face.

"This is the first reported case of analysis of human DNA isolated from the gastrointestinal tract of maggots used to identify a victim in a criminal case," a group of researchers from Monterrey, Mexico, wrote in a report this month in the Journal of Forensic Sciences.

1. Science news from NBCNews.com

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Ten days before the body was found, a man claimed his daughter had been abducted. He recognized the ring, but couldn't tell if the badly burned corpse was his daughter. The investigators took a DNA sample from the man and then looked at the gut contents of three blowfly maggots from the dead body. They found traces of human DNA in the bugs' stomachs. With this evidence, they found that the victim was female, and they were able to run a paternity test, which came back with a 99.68-percent match to the man, confirming that this was his abducted daughter.

Maggots are commonly used to construct timelines for crimes, as larval development can indicate how long a victim has been dead. Attracted by gases escaping from a decomposing corpse, blowflies often show up within minutes of death, infesting parts of the body and laying their eggs there. It's the larvae that result from these eggs that serve as a timestamp; depending on the temperature they develop from egg to winged adult in a matter of 10 or so days.

But the researchers say this grim case shows how else the insects might be used as clues.

"If maggots are encountered in association with human remains, investigators could utilize this approach if the extraction of DNA from other sources is not possible," wrote the researchers, led by Marta Ortega-Mart?nez, of Universidad Aut?noma de Nuevo Le?n.

Follow LiveScience on Twitter @livescience. We're also on Facebook? and Google+.

? 2012 LiveScience.com. All rights reserved.

Source: http://www.msnbc.msn.com/id/49218951/ns/technology_and_science-science/

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Liver cells, insulin-producing cells, thymus can be grown in lymph nodes

Friday, September 28, 2012

Lymph nodes can provide a suitable home for a variety of cells and tissues from other organs, suggesting that a cell-based alternative to whole organ transplantation might one day be feasible, according to researchers at the University of Pittsburgh School of Medicine and its McGowan Institute for Regenerative Medicine. In a report recently published online in Nature Biotechnology, the research team showed for the first time that liver cells, thymus tissue and insulin-producing pancreatic islet cells, in an animal model, can thrive in lymph nodes despite being displaced from their natural sites.

Hepatitis virus infection, alcoholic cirrhosis and other diseases can cause so much damage that liver transplantation is the only way to save the patient, noted senior investigator Eric Lagasse, Pharm. D., Ph.D., associate professor, Department of Pathology, Pitt School of Medicine. Children with DiGeorge syndrome lack functional thymus glands to produce essential immune cells, and diabetes can be cured with a pancreas transplant.

"However, the scarcity of donor organs means many people will not survive the wait for transplantation," said Dr. Lagasse, whose lab is at the McGowan Institute. "Cell therapies are being explored, but introducing cells into tissue already ravaged by disease decreases the likelihood of successful engraftment and restoration of function."

In the study, his team tested the possibility of using lymph nodes, which are abundant throughout the body and have a rich blood supply, as a new home for cells from other organs in what is called an "ectopic" transplant.

They injected healthy liver cells from a genetically-identical donor animal into lymph nodes of mice at various locations. The result was an enlarged, liver-like node that functioned akin to the liver; in fact, a single hepatized lymph node rescued mice that were in danger of dying from a lethal metabolic liver disease. Likewise, thymus tissue transplanted into the lymph node of mice that lacked the organ generated functional immune systems, and pancreatic islet cell transplants restored normal blood sugar control in diabetic animals.

"Our goal is not necessarily to replace the entire liver, for example, but to provide sufficient cell mass to stabilize liver function and sustain the patient's life," Dr. Lagasse said. "That could buy time until a donor organ can be transplanted. Perhaps, in some cases, ectopic cell transplantation in the lymph node might allow the diseased organ to recover."

###

University of Pittsburgh Schools of the Health Sciences: http://www.upmc.com/Pages/default.aspx

Thanks to University of Pittsburgh Schools of the Health Sciences for this article.

This press release was posted to serve as a topic for discussion. Please comment below. We try our best to only post press releases that are associated with peer reviewed scientific literature. Critical discussions of the research are appreciated. If you need help finding a link to the original article, please contact us on twitter or via e-mail.

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Source: http://www.labspaces.net/123964/Liver_cells__insulin_producing_cells__thymus_can_be_grown_in_lymph_nodes

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Google, Microsoft, Apple, Facebook: Please, Will The Regulators Stop Worrying About Monopolies?

One of my favourite economists, Lynne Kiesling, has written on why the regulators and bureaucracies really should worry a great deal less about the possibility of monopolies in the tech space. A basic point is that the whole field is simply changing too quickly. She also links to this well argued piece on the fleeting nature of the monopolies that are being worried about.

No one actually gets a monopoly for long enough to be able to fleece consumers through having that monopoly. This is as true of Facebook as it is of Google, Microsoft or Apple.

I would go further on two points. The first is that given the speed with which these markets move bureaucracy and the law just isn?t the correct method of dealing with the problem even if it does exist. It is almost impossible to imagine any governmental organisation spotting a problem, working out what to do about it and then crafting the solution in a period under two or three years. Do recall that this is about the period of time since the release of the iPad itself. Quite: if the iPad had been noted as a monopolistic product right on the day of first issue we?d be expecting a bureaucracy to be just about ready to do something about it today. Which does suggest that bureaucracy isn?t the way to deal with any problems we might have in this sort of technological space.

The second point is slightly more theoretical. The current government and legal attitude towards monopoly is that if you?ve got great market power then you might indeed be a monopoly and thus you?re subject to special rules. Investigations, constraints on how you can leverage that market power and so on come into play. The argument being that if you?ve this market power you might deploy it to the detriment of the consumer.

There?s a slight problem with this though: economists have gone one stage further in considering monopolies. It?s not a wholly agreed point but there?s a decent level of consensus. Having market power, even having a monopoly, isn?t sufficient to induce firms to act against consumer interests. Having uncontestable market power, an uncontestable monopoly, might well be: but the crucial point is whether they are contestable or not. Possessors of contestable market power or monopoly can be assumed to either not act against consumer interest or to be about to lose said market power or monopoly.

Think of it this way. Assume that one company, just for the sake of argument we?ll call it Apple, had all the patents necessary to stop anyone else making a smartphone of any kind at all. They launch the iPhone and no one is allowed to produce anything even remotely similar: there?s no Android, Windows Phone, Firefox cannot even play with their OS and so on. We would indeed be worried about Apple creaming monopoly profits off the top of that market for the next decade or so that those patents are valid. We might indeed want to curtail what they can do.

Now consider our actual world: yes, there are still patent fights. But they are about minor details of the implementation of how you build and operate a smartphone (well, OK, rectangles with rounded corners aside) not about the very concept of one at all. There are a number of operating systems for smartphones, there is a larger number of manufacturers of them. We do see Apple with great market power (which is why they?re making the vast majority of the profits in the sector) but it is obviously true that Apple?s position is contestable. Given this contestability Apple cannot simply rest on its laurels and bleed the consumers dry. It must continue to develop the iPhone, improve the consumer experience or it will lose that predominant position. If they stumble for a year or two Microsoft and Nokia, or maybe Google and Samsung, or some as yet unknown competitor, will come and eat their lunch.

So we don?t really need to worry about Apple?s market position because the contestability of it, the precariousness of it, means that they cannot act like a monopoly and hope to hold on to that position. And it is not market power, nor even monopoly, that we are actually worried about but the misuse of it.

The same logic applies to Microsoft and browsers. To Facebook and social networking. Amazon and e-books and yes, even to Google and search engine placement. Anyone who tries to abuse a dominant market position is very quickly going to lose that position. Simply because all of these monopolies are contestable. There are enough other firms vying for the space (and it?s never been easier to raise the VC money to attack such spaces if you want to create a new rival) that even those who have achieved market dominance cannot exploit it. And given that it?s the exploitation, not the market dominance, which is the potential problem there isn?t in fact much of a problem.

There are economists who would say that a true monopoly without government action to support it is impossible. I wouldn?t go as far as that hardline position. I think there can indeed be monopolies for other reasons like network effects, to say nothing of patent rules. But I do think that some of the current worries about monopolies in the tech space are overdone. Purely and simply because they?re contestable monopolies and thus not really exploitable in the sense that we worry about when considering the very idea of monopoly.

Source: http://www.forbes.com/sites/timworstall/2012/09/29/google-microsoft-apple-facebook-please-will-the-regulators-stop-worrying-about-monopolies/?utm_source=allactivity&utm_medium=rss&utm_campaign=20120929

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Chair, Department of Community Health - Public Health CareerMart

Chair, Department of Community Health Job Code: 67054 POSTED: Sep 28 Salary: Open Location: Statesboro, Georgia Employer: Georgia Southern University Type: Full Time - Experienced Sector: College / University Discipline: Academic / Research Required Education: Doctorate ? ?

About Georgia Southern University Georgia Southern University, a member institution of the University System of Georgia, is classified as a Doctoral/Research University. Accredited by the Commission on Colleges of the Southern Association of Colleges and Schools, Georgia Southern offers more than 100 academic majors in a comprehensive array of baccalaureate degrees and selected master's and doctoral programs. The University has earned a reputation for providing all of the benefits of a major university with the feeling of a much....more info View all our jobs

Reporting to the Dean, the Associate/Full Professor position requires administration, teaching, advisement, service, and research/scholarship responsibilities. The position requires a terminal degree. The successful applicant will provide leadership to the department, teach graduate-level courses, be actively involved in extramurally funded research, provide service/outreach to the public health community, serve on committees, and participate in official activities at the college and university levels. The position is a 12-month tenure-track or tenured appointment. Screening of applications begins October 31st, 2012 and continues until the position is filled. The preferred position starting date is July 1st, 2013. A complete application consists of a letter addressing the qualifications cited above; curriculum vitae; and the names, addresses, telephone numbers, and email addresses of at least three professional references. Other documentation may be requested. Only complete applications and applications submitted electronically will be considered. Finalists will be required to submit to a background investigation. Applications and nominations with the subject entitled ?Application for Community Health #67054 position? should be e-mailed to: Dr. Moya Alfonso, Assistant Professor and Search Chair Search # 67054 Community Health Georgia Southern University P. O. Box 8015 Statesboro GA 30460-8015 Electronic mail: malfonso@georgiasouthern.edu Telephone: 912-478-0966 Georgia is an Open Records state. Georgia Southern University is an AA/EO institution. Individuals who need reasonable accommodations under the ADA to participate in the search process should contact the Associate Provost. NOTES: Additional Salary Information: The salary is competitive and commensurate with qualifications and experience.

Required Qualifications: ? Earned doctorate (PhD, DrPH, ScD, MD or other relevant doctoral degree) in Community Health/Health Education or other field appropriate for the expertise offered ? Commitment to leadership, teaching, academic program development, research, and service that is consistent with the College?s vision and mission ? Proven record for securing extramural research funding ? Commitment to service within the University, the profession, and community ? Ability to contribute to a positive work environment in the College and University ? Minimum of four years full-time college or university teaching experience at the assistant professor rank required for appointment at the associate professor rank in addition to a strong record of research and service with publications and presentations in professional venues. ? Minimum of five years full-time college or university teaching experience at the associate professor rank required for appointment at the professor rank along with a strong record of research and service with substantial publications and presentations in professional venues.

Georgia Southern University

Statesboro GA

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Source: http://careers.apha.org/jobs/4934586/chair-department-of-community-health

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Video: McCaskill fights to hold onto Senate seat

No-hitter! Reds' Bailey brilliant against Pirates

??Homer Bailey of the Cincinnati Reds threw the season's seventh no-hitter, beating the Pittsburgh Pirates 1-0 on Friday night. The seven no-hitters matches the modern record for most in a season, tying 1990 and 1991. There were eight no-hitters in 1884.

Source: http://www.msnbc.msn.com/id/3036697/vp/49217926#49217926

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Advertising and Marketing Tricks for Commercial Real Estate Agents ...

Posted on Thursday, September 27th, 2012

With regards to being successful being an agent in this commercial property market, the large factor that may have impact on the agency final results will be advertising and marketing; that is the advertising and marketing of your latest listings towards the prospects which can be active. Not just any advertising and marketing will do; you want to do it the right way for the best final results.

Here are some tips to assist you connect with the proper people in a concentrated marketing campaign to trade or book commercial as well as retail property Simi Valley real estate .

Check out the property fully prior to deciding to move to an inventory. Understanding the local area and just what hurdles you happen to be up against will allow you to list with the right price and seek the correct quantity of vendor paid out marketing cash (Yes, it is essential to get supplier paid advertising and marketing funds).

Contending properties will probably exist in the area area that could frustrate the marketing endeavours, your moment of the campaign, and the method of sale as well as lease. Enter into your local area to understand just where other properties tend to be today, how long they have been in the marketplace, and on just what terms and conditions.

Several properties offer or book for certain reasons. Marketplace intelligence will allow you to with comprehending those details. Local age can also possess something to do with the sale as well as lease of a property. Enter into your area and appear around to determine the ?good and bad? aspects of all areas. Any buyer or actuel will do a similar thing, so be a step ahead of the market.

Just who or what exactly is your target market of customers and owners of the house? Are they energetic today within looking for property of this type? There is no point in listing a thing publicly in the event the property is gonna be a challenge to trade or book. Any difficult listings should be directly sold to specific tenants as well as buyers because case could possibly be. In this way you?ll get more suggestions and something to work with, rather than expecting enquiry to come through very general public advertising instead of getting virtually any prospects call or contact you Simi Valley real estate . Several properties shouldn?t be openly sold in newspaper publishers and the world wide web simply because the property is so exclusive.

For the common properties that may be taken to industry openly, choose the best methods of sale or book that are feasible for your property customers or owners of the house to act using. Do not result in the method of sale or book too hard on their behalf. Timing and due diligence should all have been examined.

Look for 4 or 5 key facts regarding attraction that the property list offers to the target market. These types of points will need to feature inside your advertising. A similar facts as well as points regarding attraction ought to feature through the marketing materials so you obtain the consistent information across.

Be sure to use advertising and marketing tools which reach the targeted market. That will contain direct phone calls, newspaper, world wide web, brochures, correspondence, email, and signboards. Get the property message out to the local world of business first since many buyers and tenants range from local area.
It is not hard to industry a commercial as well as retail property for sale as well as lease. It is extremely much the truth however, that the results will probably be driven through your marketing strategy and efforts. On this slower and tougher professional property industry you should make every effort to take the exclusive item listings personally towards the prospects which exist.

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Source: http://www.destinationraleigh.com/random-thoughts/advertising-and-marketing-tricks-for-commercial-real-estate-agents-today/

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Diagnosis of rare brain disorder may take months

NEW YORK (Reuters Health) - Doctors often initially misdiagnose people with Jakob-Creutzfeldt disease, a rare brain disorder caused by misfolded, infectious prion proteins, according to new research.

Jakob-Creutzfeldt disease, or CJD, is marked by rapid brain wasting and dementia and typically kills patients within a year after symptoms appear. According to the National Institutes of Health, there are about 200 cases each year in the United States.

In the new study, researchers found 97 people with CJD received an average of almost four different diagnoses each before doctors made the correct call. Those alternate diagnoses included autoimmune disorders, Alzheimer's and depression.

Researchers said the early symptoms of CJD can vary widely, depending on where in the brain infected proteins accumulate.

"There's a lot of other things it could be, literally any disease that could affect the brain in a relatively rapid way," said Dr. Richard Caselli, a neurologist from the Mayo Clinic Arizona in Scottsdale, who wrote a commentary accompanying the study in the Archives of Neurology.

He said the search for a correct diagnosis, with multiple failed attempts along the way, is "obviously a very traumatic thing for families to endure." It can also be expensive.

CJD is not treatable, so although catching it early prevents patients from having to undergo more tests, it won't change the course of the disease.

On the other hand, Caselli said a number of other conditions that may come with similar symptoms, such as infectious meningitis, can be treated if they're diagnosed quickly. That's why neurologists try to exhaust every possible curable option before landing on a diagnosis of CJD.

Dr. Michael Geschwind of the University of California, San Francisco, and colleagues found it took CJD patients almost eight months from the onset of symptoms until they were correctly diagnosed, on average. By then, most only had a few months left to live.

The study included 97 people, age 26 to 83, referred to the UCSF Memory and Aging Center between 2001 and 2007. Seventeen of them had been correctly diagnosed with CJD at their first assessment - but it took much longer for others.

Caselli said that because symptoms of different brain-related disorders often overlap, magnetic resonance imaging, or MRI, is typically the best way to see what's going on in the brain and make a diagnosis. But even so, that doesn't always work.

"The challenge comes when the MRI findings are not as definitive as you'd like them to be," he told Reuters Health.

Some other invasive tests, such as spinal taps, can differentiate meningitis from CJD.

Geschwind said he often tests for infections such as syphilis and HIV in people with early symptoms similar to CJD. Dementia that comes on quickly can also be caused by cancer antibodies that attack the nervous system, he said.

A small fraction of CJD cases are passed down in families and the disease can be transmitted through infected brain tissue. But most cases occur when normal proteins in the brain spontaneously become infectious, for no clear reason.

"Any time there's a patient with a rapidly progressing dementia, I mean going from completely normal function to not being able to function in a few months to less than a year, I think CJD should be (considered)," Geschwind told Reuters Health.

"But so should many of these other conditions, some of which are treatable."

"It still is true that one should not accept the diagnosis without being sure that one has had a thorough evaluation," Caselli said.

"The more definitive one can be, the more one can save the patient who's pretty oblivious through all this from getting dragged from one doctor to another," he added.

"Once the diagnosis is credibly established, it really probably is best to start thinking about palliative care hospice, the comfort of the patient and the family so that people can start to deal with this diagnosis and the time they have left."

SOURCE: http://bit.ly/UOQT2p Archives of Neurology, online September 24, 2012.

Source: http://news.yahoo.com/diagnosis-rare-brain-disorder-may-months-190111623.html

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Full Moon and Bugs, Bugs, Bugs... | Fighting Autism and Winning!

Diatomacious Earth (often referred to as "DE") is an off white talc-like powder that is the fossilized remains of marine phytoplankton. When sprinkled on a bug that has an exoskeleton (such as bed bugs, ants or fleas) it gets caught between their little exoskeleton joints. As they move, the diatomaceous earth acts like razor blades and cuts them up. But it doesn't hurt mammals. We can eat it. We do eat it! It's in lots of grain based foods because lots of grains are stored with diatomaceous earth to keep the bugs from eating

Diatomacious Earth (often referred to as "DE") is an off white talc-like powder that is the fossilized remains of marine phytoplankton. When sprinkled on a bug that has an exoskeleton (such as bed bugs, ants or fleas) it gets caught between their little exoskeleton joints. As they move, the diatomaceous earth acts like razor blades and cuts them up. But it doesn't hurt mammals. We can eat it. We do eat it! It's in lots of grain based foods because lots of grains are stored with diatomaceous earth to keep the bugs from eating the grain!

Die bugs! Die! Die! Die!

I have heard two explanations of how diatomaceous earth works.

One is that on a microscopic level, the diatomaceous earth particles are very sharp looking. These particles stick to an insect and get stuck between its exoskeleton joints. As the insect moves, it gets physically cut up.

The other explanation is that diatomaceous earth sticks to the insect and somehow causes them to dry out. I think this approach involves scratching the insects waxy layer which then allows precious moisture within the insect to get out. So their teeny tiny bug-innards turn into teeny tiny bug-innards-jerky.

A reader, Sue, in Washington state writes:

Both are true and connected. DE is almost pure silica (with some beneficial trace minerals); under a microscope, it looks like shards of glass (glass is made from silica). On any beetle-type insect that has a carapace, like fleas and cockroaches, the DE works under the shell and punctures the body, which then dehydrates and the insect dies. DE is totally nontoxic. There is no buildup of tolerance like there is to poisons because the method of killing is PHYSICAL, not chemical.

The important thing to us is that if an insect with an exoskeleton gets diatomaceous earth on them, they die. At the same time, we can rub it all over our skin, rub it in our hair, eat it .... whatever ... and we are unharmed.

Diatomaceous earth kills all bugs. It has been reported to be the most effective solution when fighting pests like fleas, ants and bed bugs.

Farmers dump food grade diatomaceous earth by big scoops in with grains when the grains are stored. It kills the insects that want to feast on the grain. This is a great improvement over the stuff they used to put in with the grain.

Farmers feed gobs of diatomaceous earth (food grade) to animals in the hopes that it will cure whatever ails them. Many farmers swear that the stuff kills all sorts of worms in their critters.

Many people eat a quarter cup of food grade diatomaceous earth every day. They mix it into juice. I have visited with several people that are keen on living past 100 years that believe that eating lots diatomaceous earth every day will help them with that goal. I have found references where it is cited for colon cleansing, parasite control and detox.

One strange thing about diatomaceous earth is that for it to work on killing bugs, you have to keep it dry. Even morning dew can make diatomaceous earth ineffective.

I have encountered over a dozen ignorant boobs that have proclaimed "Diatomaceous Earth does NOT work!" I have read this statement in all caps. In extra big fonts. With italics. And I've even had it screamed at me. I'm gonna stick with "ignorant boobs". On closer inspection of each case there is always a flaw. Usually the problem is that it was not used correctly. Diatomaceous earth is not a bait. If you put a little bit in a pile somewhere, the bugs are not drawn to it and invite all their friends. I kinda wonder if the pesticide companies pay people to go to internet forums and say this sort of thing. Diatomaceous earth is super cheap, non toxic, and generally more effective than anything the pesticide companies have to offer - so it kinda cuts into their profit margins a bit. I've been meaning to create an experiment to set the record straight on this topic, but a participant in the diatomaceous earth discussion, Stephanie, beat me to it:

I tried my own experiment with the diatomaceous earth to see how quickly it kills the fleas; I caught a few fleas and put them in a jar with a pinch of diatomaceous earth - all were dead within just a couple of hours.

It just doesn't get any more clear than that.

How safe is diatomaceous earth?

The only known problem for people, mammals and birds that I have ever been able to find any reference to is breathing it in. For food grade diatomaceous earth, there is only the bother of breathing in any dust. There exists another variety of diatomaceous earth that has been fiddled with so it can be used for pool filters. The pool grade stuff would be bad for you because it contains up to 70% "crystalline silica". My understanding is that if you work with the pool grade stuff all day, every day, for years, you could get cancer. Don't mess with the pool grade stuff. Food grade diatomaceous earth will contain less than 1% crystalline silica.

This article is really about the pure, food grade diatomaceous earth. I have to say "food grade" over and over or some nitwit will quote a small slice and then bring up the pool grade issues.

I have heard from two people that said that they won't use diatomaceous earth anymore because "the tiny particles cut my lungs!" --- (deep sigh goes here) All I can say is "Did you actually examine your lung with a microscope and watch the diatomaceous earth cut into it?" - of course, they did not. I think the truth behind these reports is that these folks heard how diatomaceous earth works, and when they would breathe in the dust, it would make them cough - just as breathing in flour or corn starch would make you cough. And then they thought of the sharpness at a microscopic level. My understanding is that when diatomaceous earth becomes moist, the sharp thing is no longer happening. That's why you have to keep it dry when you use it.

I have heard that people working in the diatomaceous earth (food grade) mines have no greater health problems than the people working in any other mines. (I would like to get some sources for this info - if anybody has a link, please email me)

As long as you are using food grade diatomaceous earth, you are perfectly safe. Even if you breathe in gobs of it. Of course, if you are asthmatic or have lung problems of any kind, I would think breathing in big gobs of any kind of dust would be a bad idea.

gimmie gimmie gimmie!

There are a lot of varieties of diatomaceous earth, so when you are shopping, be sure to get the right stuff!

Make sure that you get food grade diatomaceous earth. Some people make 3% of the food they eat be diatomaceous earth. There are claims at parasite control, longevity and all sorts of perks. I know that food grade diatomaceous earth is used heavily in storing grains - so you are probably already eating lots of diatomaceous earth every time you eat any bread, pasta or other grain based food.

Farmers feed food grade diatomaceous earth to their animals to reduce parasites and provide other benefits.

Some places sell the diatomaceous earth (food grade) mixed with other stuff. And that is something I do not recommend. When I see a label that says "97% diatomaceous earth" I have to wonder what the other 3% is. If the packaging is about killing bugs, is it some sort of toxin? Did they add something like borates or pyrethrin for a little extra kick? I don't want that!

Some places sell diatomaceous earth that is for swimming pool filters - that is definitely what you do NOT want.

Some places sell an 8 ounce shaker. I think it is wise to get at least a few pounds of the stuff. It keeps well (it's already millions of years old) and is useful for so many things. And if you get too little, you are likely to not use enough.

So I've done a lot of research on this .... and I've used diatomaceous earth from about eight different sources ... and here is what I'm recommending: This is food grade diatomateous earth guaranteed to be "less than 0.5% crystaline silica". After a long talk with the guy that runs this outfit, I found out that most of this diatomaceous earth runs about 0.1% to 0.2% crystaline silica. By far the best I've ever heard of.

This next one is food grade diatomaceous earth where all they would tell me is that it has less than 0.5% crystalline silica. Not as good as the stuff above, but still way better than the others I could find:

?

http://www.richsoil.com

Source: http://www.chicagonow.com/fighting-autism-and-winning/2012/09/full-moon-and-bugs-bugs-bugs/

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Recognition at last for Alfred Russel Wallace, who lived in Darwin's shadow

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Knowing The Various Types Of Affiliate Software Program ...

Affiliate marketing is considered one of the most profitable businesses on the internet. Many people are joining the bandwagon by establishing their own affiliate marketing business, in order to boost the efficiency of their goods or services. In reality, starting an affiliate program is fairly easy but the challenging part is to effectively advertise your affiliate program. Marketing your affiliate program is tougher than you think, due to the amount of competition on the market. There are so many internet entrepreneurs, so many advertisements internet, and every one of them is proclaiming that their affiliate program is the most effective.

Fortunately, you will find a number of methods to successfully advertise your affiliate program. If you currently have your own affiliate web site, offering free eBooks could be a very powerful statement concerning your website. You can also have your own emailing list on your website or blog; this can offer you an opportunity to inform your subscribers on the most recent news, sales notices, and updates. Another great technique would be to use web-based message boards or forums that is related to your products or services and posting relevant topics is a beneficial way of advertising your affiliate program.

Today, there are many types of software and resources on the internet. Many of the established net marketers are trying to persuade folks that it?s important to have affiliate marketing software to be successful in their online company. But somehow it?s true simply because it makes life easy and the tasks more automated. One thing every online business owner needs to remember is that not all tools or application in the marketplace are that useful. So it is necessary to study and know all the features of the software program you wish to buy for your affiliate marketing business.

Affiliate marketing software program should offer you the chance to efficiently handle your affiliates. It ought to automate much of your tasks, so you don?t need to sit in front of your pc for long amounts of time. Affiliate marketing software program must also be precise in providing you the needed reports that you can use to further improve your company.

As an affiliate marketer, it is important that you have an affiliate tracking software. It is possible to learn about this revolutionary solution by visiting the various sites on the internet and discovering the numerous benefits it can provide your affiliate business.

GillianCuervo is a seasoned affiliate execute of many web-based marketing programs as well as a renown internet business person . She wants to impart her knowledge and you can read more about affiliate marketing online on her blog site as well as important advice on internet business .

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Source: http://affiliatemarketingonlinebusiness.com/knowing-the-various-types-of-affiliate-software-program/

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