Better energy indicators for sustainable development

The UN Sustainable Development Goal 7 aims to deliver affordable, reliable, sustainable and modern energy for all. Tracking progress towards the targets under this goal can spur better energy statistics and data gathering capacity, and will require new indicators that also consider the interplay with other goals

BeppoSAX/PDS serendipitous detections at high galactic latitudes

At a flux limit of ~10^(-11) erg/cm2/s in the 20-100 keV band, the PDS instrument on-board BeppoSAX offers the opportunity to study the extragalactic sky with an unprecedented sensitivity. In this work we report on the results of a search in the BeppoSAX archive for serendipitous high energy sources at high galactic latitudes (|b| > 13 deg). We have defined a set of twelve regions in which the PDS/MECS cross-calibration constant is higher than the nominal value. We attribute this mismatch to the presence of a serendipitous source in the PDS field of view.In four cases the likely high energy emitter is also present in the MECS field of view. In these cases, we have performed a broad band spectral analysis (1.5-100 keV) so as to understand the source spectral behaviour and compare it with previous BeppoSAX observations when available. In eight cases the identification of the source likely to provide the PDS spectrum is based on indirect evidence (extrapolation to lower energies and/or comparison to previous observations). This approach leads to the discovery of six new hard X-ray emitting objects (PKS 2356-611, 2MASX J14585116-1652223, NGC 1566, NGC 7319, PKS 0101-649 and ESO 025-G002) and to the presentation the PDS spectrum of NGC 3227 for the first time. In the remaining five cases we provide extra BeppoSAX observations that can be compared with measurements which are already published and/or in the archive.Comment: 16 pages, 9 figures, accepted for publication in A&A, main journa

Palliative care in interstitial lung disease: living well

Progressive fibrotic interstitial lung diseases (ILDs) are characterised by major reductions in quality of life and survival and have similarities to certain malignancies. However, palliative care expertise is conspicuously inaccessible to many patients with ILD. Unmet patient and caregiver needs include effective pharmacological and psychosocial interventions to improve quality of life throughout the disease course, sensitive advanced care planning, and timely patient-centred end-of-life care. The incorrect perception that palliative care is synonymous with end-of-life care, with no role earlier in the course of ILD, has created a culture of neglect. Interventions that aim to improve life expectancy are often prioritised without rigorous assessment of the individual's health and psychosocial needs, thereby inadvertently reducing quality of life. As in malignant disorders, radical interventions to slow disease progression and palliative measures to improve quality of life should both be prioritised. Efficient patient-centred models of palliative care must be validated, taking into account religious and cultural differences, as well as variability of resources. Effective implementation of palliative care for ILD will require multidisciplinary participation from clinicians, specialist nurses, psychologists, social workers, and, in some countries, non-governmental faith and community-based organisations with access to palliative care expertise

Kinetic and economic analysis of reactive capture of dilute carbon dioxide with Grignard reagents

Carbon Dioxide Utilisation (CDU) processes face significant challenges, especially in the energetic cost of carbon capture from flue gas and the uphill energy gradient for CO2 reduction. Both of these stumbling blocks can be addressed by using alkaline earth metal compounds, such as Grignard reagents, as sacrificial capture agents. We have investigated the performance of these reagents in their ability to both capture and activate CO2 directly from dried flue gas (essentially avoiding the costly capture process entirely) at room temperature and ambient pressures with high yield and selectivity. Naturally, to make the process sustainable, these reagents must then be recycled and regenerated. This would potentially be carried out using existing industrial processes and renewable electricity. This offers the possibility of creating a closed loop system whereby alcohols and certain hydrocarbons may be carboxylated with CO2 and renewable electricity to create higher-value products containing captured carbon. A preliminary Techno-Economic Analysis (TEA) of an example looped process has been carried out to identify the electrical and raw material supply demands and hence determine production costs. These have compared broadly favourably with existing market values

Crystal-Size Effects on Carbon Dioxide Capture of a Covalently Alkylamine-Tethered Metal-Organic Framework Constructed by a One-Step Self-Assembly

To enhance the carbon dioxide (CO2) uptake of metal-organic frameworks (MOFs), amine functionalization of their pore surfaces has been studied extensively. In general, amine-functionalized MOFs have been synthesized via post-synthetic modifications. Herein, we introduce a one-step construction of a MOF ([(NiLethylamine)(BPDC)]=MOFNH2; [NiLethylamine]2+=[Ni(C12H32N8)]2+; BPDC2-=4,4???-biphenyldicarboxylate) possessing covalently tethered alkylamine groups without post-synthetic modification. Two-amine groups per metal centre were introduced by this method. MOFNH2 showed enhanced CO2 uptake at elevated temperatures, attributed to active chemical interactions between the amine groups and the CO2 molecules. Due to the narrow channels of MOFNH2, the accessibility to the channel of CO2 is the limiting factor in its sorption behaviour. In this context, only crystal size reduction of MOFNH2 led to much faster and greater CO2 uptake at low pressures.open

Reference values for methacholine reactivity (SAPALDIA study)

BACKGROUND: The distribution of airway responsiveness in a general population of non-smokers without respiratory symptoms has not been established, limiting its use in clinical and epidemiological practice. We derived reference equations depending on individual characteristics (i.e., sex, age, baseline lung function) for relevant percentiles of the methacholine two-point dose-response slope. METHODS: In a reference sample of 1567 adults of the SAPALDIA cross-sectional survey (1991), defined by excluding subjects with respiratory conditions, responsiveness during methacholine challenge was quantified by calculating the two-point dose-response slope (O'Connor). Weighted L1-regression was used to estimate reference equations for the 95(th ), 90(th ), 75(th )and 50(th )percentiles of the two-point slope. RESULTS: Reference equations for the 95(th ), 90(th ), 75(th )and 50(th )percentiles of the two-point slope were estimated using a model of the form a + b* Age + c* FEV(1 )+ d* (FEV(1))(2 ), where FEV(1 )corresponds to the pre-test (or baseline) level of FEV(1). For the central half of the FEV(1 )distribution, we used a quadratic model to describe the dependence of methacholine slope on baseline FEV(1). For the first and last quartiles of FEV(1), a linear relation with FEV(1 )was assumed (i.e., d was set to 0). Sex was not a predictor term in this model. A negative linear association with slope was found for age. We provide an Excel file allowing calculation of the percentile of methacholine slope of a subject after introducing age – pre-test FEV(1 )– and results of methacholine challenge of the subject. CONCLUSION: The present study provides equations for four relevant percentiles of methacholine two-point slope depending on age and baseline FEV(1 )as basic predictors in an adult reference population of non-obstructive and non-atopic persons. These equations may help clinicians and epidemiologists to better characterize individual or population airway responsiveness

Acute exacerbation of idiopathic pulmonary fibrosis: International survey and call for harmonisation.

AIM Acute exacerbation of idiopathic pulmonary fibrosis (AE-IPF) is an often deadly complication of IPF. No focused international guidelines for the management of AE-IPF exist. The aim of this international survey was to assess the global variability in prevention, diagnostic and treatment strategies for AE-IPF. MATERIAL AND METHODS Pulmonologists with ILD expertise were invited to participate in a survey designed by an international expert panel. RESULTS 509 pulmonologists from 66 countries responded. Significant geographical variability in approaches to manage AE-IPF was found. Common preventive measures included antifibrotic drugs and vaccination. Diagnostic differences were most pronounced regarding use of KL-6 and viral testing, while HRCT, BNP and D-Dimer are generally applied. High dose steroids are widely administered (94%); the use of other immunosuppressant and treatment strategies is highly variable. Very few (4%) responders never use immunosuppression. Antifibrotic treatments are initiated during AE-IPF by 67%. Invasive ventilation or extracorporeal membrane oxygenation are mainly used as a bridge to transplantation. Most physicians educate patients comprehensively on the severity of AE-IPF (82%) and consider palliative care (64%). CONCLUSION Approaches to the prevention, diagnosis and treatment of AE-IPF vary worldwide. Global trials and guidelines to improve the prognosis of AE-IPF are needed

Socioeconomic status and hospitalization in the very old: a retrospective study

<p>Abstract</p> <p>Background</p> <p>Socioeconomic status could affect the demand for hospital care. The aim of the present study was to assess the role of age, socioeconomic status and comorbidity on acute hospital admissions among elderly.</p> <p>Methods</p> <p>We retrospectively examined the discharge abstracts data of acute care hospital admissions of residents in Rome aged 75 or more years in the period 1997–2000. We used the Hospital Information System of Rome, the Tax Register, and the Population Register of Rome for socio-economic data. The rate of hospitalization, modified Charlson's index of comorbidity, and level of income in the census tract of residence were obtained. Rate ratios and 95% confidence limits were computed to assess the relationship between income deciles and rate of hospitalization. Cross-tabulation was used to explore the distribution of the index of comorbidity by deciles of income. Analyses were repeated for patients grouped according to selected diseases.</p> <p>Results</p> <p>Age was associated with a marginal increase in the rate of hospitalization. However, the hospitalization rate was inversely related to income in both sexes. Higher income was associated with lower comorbidity. The same associations were observed in patients admitted with a principal diagnosis of chronic condition (diabetes mellitus, heart failure, chron obstructive pulmonary disease) or stroke, but not hip fracture.</p> <p>Conclusion</p> <p>Lower social status and associated comorbidity, more than age per se, are associated with a higher rate of hospitalization in very old patients.</p

Integrating Clinical Probability into the Diagnostic Approach to Idiopathic Pulmonary Fibrosis: An International Working Group Perspective

Background. When considering the diagnosis of idiopathic pulmonary fibrosis (IPF), experienced clinicians integrate clinical features that help to differentiate IPF from other fibrosing interstitial lung diseases, thus generating a “pre-test” probability of IPF. The aim of this international working group perspective was to summarize these features using a tabulated approach similar to chest HRCT and histopathologic patterns reported in the international guidelines for the diagnosis of IPF, and to help formally incorporate these clinical likelihoods into diagnostic reasoning to facilitate the diagnosis of IPF. Methods. The committee group identified factors that influence the clinical likelihood of a diagnosis of IPF, which was categorized as a pre-test clinical probability of IPF into “high” (70-100%), “intermediate” (30-70%), or “low” (0-30%). After integration of radiological and histopathological features, the post-test probability of diagnosis was categorized into “definite” (90-100%), “high confidence” (70-89%), “low confidence” (51-69%), or “low” (0-50%) probability of IPF. Findings. A conceptual Bayesian framework was created, integrating the clinical likelihood of IPF (“pre-test probability of IPF”) with the HRCT pattern, the histopathology pattern when available, and/or the pattern of observed disease behavior into a “post-test probability of IPF”. The diagnostic probability of IPF was expressed using an adapted diagnostic ontology for fibrotic interstitial lung diseases. Interpretation. The present approach will help incorporate the clinical judgement into the diagnosis of IPF, thus facilitating the application of IPF diagnostic guidelines and, ultimately improving diagnostic confidence and reducing the need for invasive diagnostic techniques

Targeted emission reductions from global super-polluting power plant units

There are more than 30,000 biomass- and fossil-fuel-burning power plants now operating worldwide, reflecting a tremendously diverse infrastructure, which ranges in capacity from less than a megawatt to more than a gigawatt. In 2010, 68.7% of electricity generated globally came from these power plants, compared with 64.2% in 1990. Although the electricity generated by this infrastructure is vital to economic activity worldwide, it also produces more CO2 and air pollutant emissions than infrastructure from any other industrial sector. Here, we assess fuel- and region-specific opportunities for reducing undesirable air pollutant emissions using a newly developed emission dataset at the level of individual generating units. For example, we find that retiring or installing emission control technologies on units representing 0.8% of the global coal-fired power plant capacity could reduce levels of PM2.5 emissions by 7.7–14.2%. In India and China, retiring coal-fired plants representing 1.8% and 0.8% of total capacity can reduce total PM2.5 emissions from coal-fired plants by 13.2% and 16.0%, respectively. Our results therefore suggest that policies targeting a relatively small number of ‘super-polluting’ units could substantially reduce pollutant emissions and thus the related impacts on both human health and global climate