A systematic review of key challenges of CO2 transport via pipelines

Transport of carbon dioxide (CO2) via pipeline from the point of capture to a geologically suitable location for either sequestration or enhanced hydrocarbon recovery is a vital aspect of the carbon capture and storage (CCS) chain. This means of CO2 transport has a number of advantages over other means of CO2 transport, such as truck, rail, and ship. Pipelines ensure continuous transport of CO2 from the capture point to the storage site, which is essential to transport the amount of CO2 captured from the source facilities, such as fossil fuel power plants, operating in a continuous manner. Furthermore, using pipelines is regarded as more economical than other means of CO2 transport The greatest challenges of CO2 transport via pipelines are related to integrity, flow assurance, capital and operating costs, and health, safety and environmental factors. Deployment of CCS pipeline projects is based either on point-to-point transport, in which case a specific source matches a specific storage point, or through the development of pipeline networks with a backbone CO2 pipeline. In the latter case, the CO2 streams, which are characterised by a varying impurity level and handled by the individual operators, are linked to the backbone CO2 pipeline for further compression and transport. This may pose some additional challenges. This review involves a systematic evaluation of various challenges that delay the deployment of CO2 pipeline transport and is based on an extensive survey of the literature. It is aimed at confidence-building in the technology and improving economics in the long run. Moreover, the knowledge gaps were identified, including lack of analyses on a holistic assessment of component impurities, corrosion consideration at the conceptual stage, the effect of elevation on CO2 dense phase characteristics, permissible water levels in liquefied CO2, and commercial risks associated with project abandonment or cancellation resulting from high project capital and operating costs

Linkage to HIV care, postpartum depression, and HIV-related stigma in newly diagnosed pregnant women living with HIV in Kenya: a longitudinal observational study

BACKGROUND: While studies have suggested that depression and HIV-related stigma may impede access to care, a growing body of literature also suggests that access to HIV care itself may help to decrease internalized HIV-related stigma and symptoms of depression in the general population of persons living with HIV. However, this has not been investigated in postpartum women living with HIV. Furthermore, linkage to care itself may have additional impacts on postpartum depression beyond the effects of antiretroviral therapy. We examined associations between linkage to HIV care, postpartum depression, and internalized stigma in a population with a high risk of depression: newly diagnosed HIV-positive pregnant women. METHODS: In this prospective observational study, data were obtained from 135 HIV-positive women from eight antenatal clinics in the rural Nyanza Province of Kenya at their first antenatal visit (prior to testing HIV-positive for the first time) and subsequently at 6 weeks after giving birth. RESULTS: At 6 weeks postpartum, women who had not linked to HIV care after testing positive at their first antenatal visit had higher levels of depression and internalized stigma, compared to women who had linked to care. Internalized stigma mediated the effect of linkage to care on depression. Furthermore, participants who had both linked to HIV care and initiated antiretroviral therapy reported the lowest levels of depressive symptoms. CONCLUSIONS: These results provide further support for current efforts to ensure that women who are newly diagnosed with HIV during pregnancy become linked to HIV care as early as possible, with important benefits for both physical and mental health

A systematic review of the effects of residency training on patient outcomes

<p>Abstract</p> <p>Background</p> <p>Residents are vital to the clinical workforce of today and tomorrow. Although in training to become specialists, they also provide much of the daily patient care. Residency training aims to prepare residents to provide a high quality of care. It is essential to assess the patient outcome aspects of residency training, to evaluate the effect or impact of global investments made in training programs. Therefore, we conducted a systematic review to evaluate the effects of relevant aspects of residency training on patient outcomes.</p> <p>Methods</p> <p>The literature was searched from December 2004 to February 2011 using MEDLINE, Cochrane, Embase and the Education Resources Information Center databases with terms related to residency training and (post) graduate medical education and patient outcomes, including mortality, morbidity, complications, length of stay and patient satisfaction. Included studies evaluated the impact of residency training on patient outcomes.</p> <p>Results</p> <p>Ninety-seven articles were included from 182 full-text articles of the initial 2,001 hits. All studies were of average or good quality and the majority had an observational study design.Ninety-six studies provided insight into the effect of 'the level of experience of residents' on patient outcomes during residency training. Within these studies, the start of the academic year was not without risk (five out of 19 studies), but individual progression of residents (seven studies) as well as progression through residency training (nine out of 10 studies) had a positive effect on patient outcomes. Compared with faculty, residents' care resulted mostly in similar patient outcomes when dedicated supervision and additional operation time were arranged for (34 out of 43 studies). After new, modified or improved training programs, patient outcomes remained unchanged or improved (16 out of 17 studies). Only one study focused on physicians' prior training site when assessing the quality of patient care. In this study, training programs were ranked by complication rates of their graduates, thus linking patient outcomes back to where physicians were trained.</p> <p>Conclusions</p> <p>The majority of studies included in this systematic review drew attention to the fact that patient care appears safe and of equal quality when delivered by residents. A minority of results pointed to some negative patient outcomes from the involvement of residents. Adequate supervision, room for extra operation time, and evaluation of and attention to the individual competence of residents throughout residency training could positively serve patient outcomes. Limited evidence is available on the effect of residency training on later practice. Both qualitative and quantitative research designs are needed to clarify which aspects of residency training best prepare doctors to deliver high quality care.</p

Banks Technological Advancement and Financial Inclusion in Nigeria

This study examined the impact of deposit money banks technological advancement on financial inclusion in Nigeria covering the period 2013Q1 to 2019Q4. Data were sourced from the Central Bank of Nigeria (CBN) Statistical bulletin 2020. Data collected were interpolated and pre-estimation tests done using  Augmented Dickey-Fuller(ADF) unit root and cointegration tests. The Error Correction Mechanism (ECM) was applied in  estimating the structural parameters of the model. The findings showed that POS and FD had negative effect on financial inclusion in Nigeria while other variables such as ATM, WP and MOP had positive impact.  The t-statistic and the probability values of the variables in the model showed that all the variables were statistically significant. The result of the Granger Causality test showed unidirectional causality flowing from financial inclusion to the use of Automated Teller Mathine (ATM). The results further showed that there was presence of causality flowing from financial inclusion to Automated Teller Machine. The paper also found that there no sign of causality between POS and FI, FI and WP, FI and MOP, and FI and FD. The researcher recommended that a sound policy that will enhance the performance of banking technological advancement should be made by the apex regulator of the Nigerian banking system. Keywords: Banks; Financial Inclusion; Technological Advancement, Model; computer DOI: 10.7176/EJBM/16-6-04 Publication date: July 30th 202

Associations between self-perception of weight, food choice intentions, and consumer response to calorie information: a retrospective investigation of public health center clients in Los Angeles County before the implementation of menu-labeling regulation.

BackgroundAlthough obesity continues to rise and remains a great public health concern in the U.S., a number of important levers such as self-perception of weight and calorie postings at point-of-purchase in restaurants are still not well-characterized in the literature, especially for low-income and minority groups in Los Angeles County (LAC). To study this gap, we examined the associations of self-perception of weight (as measured by body weight discrepancy) with food choice intentions and consumer response to calorie information among low-income adults residing in LAC during the pre-menu labeling regulation era.MethodsDescriptive and multivariable logistic regression analyses were performed to examine the aforementioned associations utilizing data from the 2007-2008 Calorie and Nutrition Information Survey (CNIS). The CNIS was a local health department study of 639 low-income adults recruited from five large, multi-purpose public health centers in LAC.ResultsSurvey participants who reported that their desired weight was less than their current weight (versus desired weight the same as current weight) had (i) higher odds of intending to select lower-calorie foods under the scenario that calorie information was available at point-of-purchase (aOR = 2.0; 95 % CI: 1.0-3.9); and (ii) had higher odds of reporting that it is "very important" to have these calorie postings on food items in grocery stores (aOR = 3.1; 95 % CI: 0.90-10.7) and in fast-food restaurants (aOR = 3.4; 95 % CI: 1.0-11.4).ConclusionsSelf-perception of weight was found to be associated with the intention to select lower-calorie foods under the scenario that calorie information was available at point-of-purchase. Future public health efforts to support menu labeling implementation should consider these and other findings to inform consumer education and communications strategies that can be tailored to assist restaurant patrons with this forthcoming federal law

Associations between self-perception of weight, food choice intentions, and consumer response to calorie information: a retrospective investigation of public health center clients in Los Angeles County before the implementation of menu-labeling regulation.

BackgroundAlthough obesity continues to rise and remains a great public health concern in the U.S., a number of important levers such as self-perception of weight and calorie postings at point-of-purchase in restaurants are still not well-characterized in the literature, especially for low-income and minority groups in Los Angeles County (LAC). To study this gap, we examined the associations of self-perception of weight (as measured by body weight discrepancy) with food choice intentions and consumer response to calorie information among low-income adults residing in LAC during the pre-menu labeling regulation era.MethodsDescriptive and multivariable logistic regression analyses were performed to examine the aforementioned associations utilizing data from the 2007-2008 Calorie and Nutrition Information Survey (CNIS). The CNIS was a local health department study of 639 low-income adults recruited from five large, multi-purpose public health centers in LAC.ResultsSurvey participants who reported that their desired weight was less than their current weight (versus desired weight the same as current weight) had (i) higher odds of intending to select lower-calorie foods under the scenario that calorie information was available at point-of-purchase (aOR = 2.0; 95 % CI: 1.0-3.9); and (ii) had higher odds of reporting that it is "very important" to have these calorie postings on food items in grocery stores (aOR = 3.1; 95 % CI: 0.90-10.7) and in fast-food restaurants (aOR = 3.4; 95 % CI: 1.0-11.4).ConclusionsSelf-perception of weight was found to be associated with the intention to select lower-calorie foods under the scenario that calorie information was available at point-of-purchase. Future public health efforts to support menu labeling implementation should consider these and other findings to inform consumer education and communications strategies that can be tailored to assist restaurant patrons with this forthcoming federal law

Value of Baseline Serum Thyrotropin as a Predictor of Hypothyroidism in Patients with Diabetes Mellitus

Objective: To determine whether serum thyrotropin measurement performed at diagnosis of diabetes mellitus or at initial patient contact predicts subsequent development of hypothyroidism. Methods: We retrospectively reviewed the computerized records of patients attending annual visits between January 2008 and December 2008 at a hospital diabetes mellitus clinic. Serum free thyroxine and thyrotropin at current and baseline annual visits were documented. A Cox regression model was used to analyze the relationship between development of thyroid dysfunction and patient characteristics including age, sex, type of diabetes, and baseline serum thyrotropin concentration. Kaplan-Meier survival curves were generated for predictors of hypothyroidism. Results: Clinical records of 1101 patients were reviewed (595 men [54%] and 506 women [46%]). Mean age was 60.0 ±17 years. Two hundred twenty-three patients (20.3%) had type 1 DM and 878 (79.7%) had type 2 diabetes. Thyroid dysfunction was present in 136 patients (12.4%) at baseline and developed in 71 patients (6.4%) at follow-up (median duration, 37 months). Overt and subclinical hypothyroidism developed in 28 (2.5%) and 38 (3.5%) patients, respectively. Incident hypothyroidism was associated with baseline thyrotropin concentration greater than 2.2 mIU/L (relative risk, 10.4; confidence interval, 5.6-19.6; P<.001) and female sex (relative risk, 1.8; confidence interval, 1.1-2.9; P = .007). The predictive influence of sex was abolished in patients with a thyrotropin value greater than 2.2 mIU/L. This TSH threshold yielded an optimal sensitivity and specificity of 83% and 72%, respectively, for predicting hypothyroidism. Conclusions: Baseline serum thyrotropin predicted hypothyroidism in patients with diabetes mellitus even at thyrotropin concentrations within the reference range. Selective annual thyroid screening in diabetic patients with baseline thyrotropin concentrations greater than 2.2 mIU/L may be more cost-effective than universal screening

Sex Differences in Hospitalizations with Maintenance Hemodialysis.

Hospitalization is a major source of morbidity among patients with ESRD undergoing maintenance hemodialysis and is a significant contributor to health care costs. To identify subgroups at the highest risk of hospitalization, we analyzed by sex, age, and race, adjusting for demographic and clinical characteristics, the hospitalization rates, and 30-day readmissions for 333,756 hospitalizations among 111,653 patients undergoing maintenance hemodialysis in facilities operated by a large dialysis organization in the United States (2007-2011). The overall hospitalization rate was 1.85 hospitalizations per person-year and was much higher among women than among men (2.08 versus 1.68 hospitalizations per year for women versus men, P&lt;0.001). Age group-specific hospitalization rates were consistently higher for women than for men of the same race, and the differences were greatest in younger age groups (for example, women aged 18-34 years and ≥75 years had 54% [95% confidence interval, 42% to 67%] and 14% [95% confidence interval, 11% to 18%] higher hospitalization rates, respectively, than did men of respective ages). Women also had substantially higher risk for 30-day readmission, with the largest differences at younger ages. Women had a significantly lower serum albumin level than men, and stratification by serum albumin level attenuated sex differences in the age group-specific hospitalization and 30-day readmission rates. These findings suggest that women undergoing maintenance hemodialysis have substantially higher risks for hospitalization and 30-day readmission than men. In this cohort, the sex differences were greatest in the younger age groups and were attenuated by accounting for differences in health status reflected by serum albumin level