That makes for a total effective rate on investment income of 45%.

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Investors also must cover the manager's fixed hedging costs of 0.077% a week, which push total expenses up to an effective annual rate of 5.35%.

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Metal on metal hip resurfacing is considered to be a much better option because it has a lower failure rate and is more cost effective since it does not need to be repeated as often as a total hip replacement.

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