Carbon footprint and cost reduction by endoscopic grading of gastric intestinal metaplasia using narrow-band imaging.

BACKGROUND AND AIM: Gastric intestinal metaplasia (GIM) is a high-risk factor for the development of gastric cancer. Narrow-band imaging (NBI) enables endoscopic grading of GIM (EGGIM). In the era of climate change, gastrointestinal endoscopists are expected to reduce greenhouse gas emissions and medical waste. Based on the diagnostic performance of NBI endoscopy, this study measured the environmental impact and reduced cost of implementing EGGIM during gastroscopy. METHODS: Using NBI endoscopy in 242 patients, EGGIM classification and operative link on GIM (OLGIM) staging were prospectively performed in five different areas (lesser and greater curvatures of the corpus and antrum, and the incisura angularis). We estimated the environmental impact and cost reduction of the biopsy procedures and pathological processing if EGGIM were used instead of OLGIM. RESULTS: The diagnostic accuracy of NBI endoscopy for GIM was 93.0-97.1% depending on the gastric area. When a high EGGIM score ≥ 5 was the cut-off value for predicting OLGIM stages III-IV, the area under the curve was 0.862, sensitivity was 81.9%, and specificity was 90.4%. The reduction in the carbon footprint by EGGIM was -0.4059 kg carbon dioxide equivalents per patient, equivalent to 1 mile driven by a gasoline-powered car. The cost savings were calculated to be $47.36 per patient. CONCLUSIONS: EGGIM is a reliable method for identifying high-risk gastric cancer patients, thereby reducing the carbon footprint and medical costs in endoscopy practice.

Economics of Biofuel Production: A Case of Sorghum and Pearl Millet in India.

Reduction of fossil fuels at an alarming rate has attracted increasing attention to blending biofuels worldwide. India's energy demand is expected to grow at an annual rate of 4-5 times over the next couple of decades. With self-sufficiency levels in crude oil becoming a distant dream, there is growing interest to look out for alternative fuels and the biofuels are an important option for policy makers in India. In this context, this paper reviews the experiences in India in the last two decades with respect to biofuel cultivation and its impact on land use, environment, and the livelihoods of rural communities. The objective of this paper is to assess the economics of biofuel production using Sorghum and Pearl millet feedstocks in India using a Life Cycle Analysis (LCA) approach. Baseline study was conducted during the year 2013 in the Madhya Pradesh state of India covering five districts and 333 sample farmers to understand the farmers perception about the various issues related to the production of biofuels using Indian staple food crops Sorghum and Pearl millet. Empirical data from the multi-locational trials conducted during the years 2014-2015 and 2015-2016 in farmers' fields was used to conduct the LCA analysis. Sorghum and Pearl millet feedstocks which are rain-fed crops are considered for bioethanol production with different pretreatment methods. Net Energy Ratio (NER), Net Energy Balance (NEB), Net Carbon Balance (NCB), and % Carbon reduction were some of the key parameters used for analysis and the results are evaluated based on the environmental impacts through the Life Cycle Assessment at 5% blending. Findings reveal that, dilute alkali pretreatment process is most energy intensive due to consumption of alkali consumption. Whereas dilute acid pretreatment has higher conversion efficiency than the other pretreatment processes which is due to higher glucan and xylan conversion efficiencies.The study concludes that Sorghum feedstock is more energy intensive than Pearl millet feedstock due to higher water requirement and yield. Biofuels, either conventional or advanced, should not been couraged without a comprehensive outlook on the overall impact that will ultimately have on the society, environment, or on the countries' energy security. Efforts should be made toward encouragement of research and development in the field as well as in formulating a comprehensive and effective biofuel policy for India.

The dairy sector in the Azores Islands: possibilities and main constraints towards increased added value.

The Azores archipelago is the most suitable region for dairy production in Portugal, representing 30% of the overall Portuguese dairy production. It has a production system characterized by an average milk yield of 6216 kg/cow/year, and the predominance of pasture-based feeding and cows that have longer productive lives and lower incidence of metabolic/production diseases, such as acidosis or mastitis. The biggest problem with the Azores Islands dairy sector is the cost of transport, as the main markets are located in continental Portugal, over 1500 km away, and local dairy products have to compete with dairy products produced in mainland Portugal and in the rest of the European Union. Herein, the evolution of the dairy sector in the Azores Islands from 2007 to 2017 is presented. A SWOT (Strength, Weakness, Opportunity, and Threat) analysis was performed to find potential solutions to increase the value of the Azorean dairy sector. The most relevant solution considered was the valorization of the dairy production through three major aspects: higher milk quality, namely, better organoleptic properties; lower carbon footprint (not considering transport costs); and higher levels of animal welfare. Three examples are shown of such valorization: protected denomination of origin (PDO) cheeses, the "happy cows" program, and the production of an organic milk, from the Terceira Island. Some of these programs are relatively recent, so, it will be interesting to see how their sales and acceptance by consumers evolve, particularly under the current economic framework.

Energy carbon emission structure and reduction potential focused on the supply-side and demand-side.

In recent years, the environmental problems caused by excessive carbon emissions from energy sources have become increasingly serious, which not only aggravates the climate change caused by the greenhouse effect but also seriously restricts the sustainable development of Chinese economy. An attempt is made in this paper to use energy consumption method and input-output method to study the carbon emission structure of China's energy system and industry in 2015 from two perspectives, namely China's energy supply side and energy demand side, by taking into account the two factors of energy invest in gross capital formation and export. The results show that neglecting these two factors will lead to underestimation of intermediate use carbon emissions and overestimation of final use carbon emissions. On energy supply side, the carbon emission structure of China's energy system is still dominated by high-carbon energy (raw coal, coke, diesel, and fuel oil, etc.), accounting for more than 70% of total energy carbon emissions; on the contrary, the natural gas such as clean energy accounts for only 3.45% of total energy carbon emissions, indicating that the energy consumption structure optimization and emission reduction gap of China's energy supply side are still substantial. On energy demand side, the final use (direct consumption by residents and government) produces less carbon emissions, while the intermediate use (production by enterprises) produces more than 90% of the total energy carbon emissions. Fossil energy, power sector, heavy industry, chemical industry, and transportation belong to industries with larger carbon emissions and lower carbon emission efficiency, while agriculture, construction, light industry, and service belong to industries with fewer carbon emissions and higher carbon emission efficiency. This means that the optimization of industrial structure is conducive to slowing down the growth of energy carbon emissions on the demand side.

Carbon footprint of the RSNA annual meeting.

PURPOSE: To determine the airplane travel-related carbon footprint of the Radiological Society of North America (RSNA) annual meeting, the associated health burden, and the costs to offset these greenhouse gas emissions (i.e. compensation of emissions by funding an equivalent CO2 saving elsewhere). METHODS: The RSNA's website was used to determine the reported country of origin of attendees to the 2017 meeting that took place in Chicago from November 26 to December 1. It was assumed that attendees had traveled from the airport nearest to the largest city in their country or state to Chicago's O'Hare international airport. The total amount of air travel-related CO2-equivalent emission (based on round-trip economy class travel), the imposed health burden in terms of disability-adjusted life years (DALYs) in the global population, the total CO2 offsets costs, and the CO2 offsets costs per DALY were calculated. RESULTS: The calculated airplane travel-related CO2-equivalent emissions of 11,223 attendees from the United States and 10,684 attendees from other countries were 7,067,618 kg and 32,438,420 kg, totaling 39,506,038 kg. This caused an estimated 51.4-79.0 DALYs. The calculated amount of Total CO2 offset costs were calculated to be $474,072, which corresponds to $6,001-9,223 per DALY averted. CONCLUSIONS: The airplane travel-related carbon footprint of the RSNA annual meeting and the associated disease burden are relevant, and potential attendees and organizers should take measures to overcome this undesired side effect. Offsetting this carbon footprint is cost-effective and this initiative should be taken by the radiological community.

Costs of switching to low global warming potential inhalers. An economic and carbon footprint analysis of NHS prescription data in England.

OBJECTIVES: Metered-dose inhalers (MDIs) contain propellants which are potent greenhouse gases. Many agencies propose a switch to alternative, low global warming potential (GWP) inhalers, such as dry powder inhalers (DPIs). We aimed to analyse the impact on greenhouse gas emissions and drug costs of making this switch. SETTING: We studied National Health Service prescription data from England in 2017 and collated carbon footprint data on inhalers commonly used in England. DESIGN: Inhalers were separated into different categories according to their mechanisms of action (eg, short-acting beta-agonist). Within each category we identified low and high GWP inhalers and calculated the cost and carbon impact of changing to low GWP inhalers. We modelled scenarios for swapping proportionally according to the current market share of each equivalent DPI (model 1) and switching to the lowest cost pharmaceutically equivalent DPI (model 2). We also reviewed available data on the carbon footprint of inhalers from scientific publications, independently certified reports and patents to provide more accurate carbon footprint information on different types of inhalers. RESULTS: If MDIs using HFA propellant are replaced with the cheapest equivalent DPI, then for every 10% of MDIs changed to DPIs, drug costs decrease by £8.2M annually. However if the brands of DPIs stay the same as 2017 prescribing patterns, for every 10% of MDIs changed to DPIs, drug costs increase by £12.7M annually. Most potential savings are due to less expensive long-acting beta-agonist (LABA)/inhaled corticosteroids (ICS) inhalers. Some reliever inhalers (eg, Ventolin) have a carbon footprint over 25 kg CO2e per inhaler, while others use far less 1,1,1,2-tetrafluoroethane (HFA134a) (eg, Salamol) with a carbon footprint of <10 kg CO2e per inhaler. 1,1,1,2,3,3,3-Heptafluoropropane (HFA227ea) LABA/ICS inhalers (eg, Flutiform) have a carbon footprint over 36 kg CO2e, compared with an equivalent HFA134a combination inhaler (eg, Fostair) at <20 kg CO2e. For every 10% of MDIs changed to DPIs, 58 kt CO2e could be saved annually in England. CONCLUSIONS: Switching to DPIs would result in large carbon savings and can be achieved alongside reduced drug costs by using less expensive brands. Substantial carbon savings can be made by using small volume HFA134a MDIs, in preference to large volume HFA134a MDIs, or those containing HFA227ea as a propellant.

Carbon footprint accounts of Pakistan: an input-output life cycle assessment model.

The Paris agreement (2015) seems a significant achievement towards a global mitigation policy to climate change. However, implementing the promised Intended Nationally Determined Contribution (INDC) targets by the participating countries has become a real challenge. In this aspect, the input-output life cycle assessment (IO-LCA) model provides an important assessment mechanism to design suitable abatement policies limiting the rising greenhouse gas (GHG) emissions. The present paper develops an IO-LCA model for Pakistan and estimates all the direct and indirect GHG emissions caused by all the production activities during all the stages of production. This task is achieved in three phases. In phase 1, the Pakistan input-output table (IOT) is constructed. In phase 2, the GHG environmental satellite accounts are created for each sector in the economy. In phase 3, the GHG emissions are linked to different categories of final demand.

Clinical, fiscal and environmental benefits of a specialist-led virtual ureteric colic clinic: a prospective study.

OBJECTIVES: To evaluate the clinical, fiscal and environmental impact of a specialist-led acute ureteric colic virtual clinic (VC) pathway. PATIENTS AND METHODS: All patients with uncomplicated acute ureteric colic, referred to a single tertiary centre, were prospectively entered into the study over a 4-year period (January 2015-December 2018). Inclusion criteria were: low-dose non-contrast computed tomography of kidneys, ureters and bladder; white blood cell count <16 × 109/L; pain controlled; normal renal function; and no clinical concern. Primary outcomes were: time (days) from referral to VC outcome; VC outcome (discharge, further VC, face-to-face [FTF] clinic, extracorporeal shockwave lithotripsy [ESWL], ureterorenoscopy [URS], percutaneous nephrolithotomy [PCNL]); and adverse events (sepsis or obstruction). Secondary outcomes were patient and stone demographics, cost and environmental analysis. The minimum follow-up was 3 months. RESULTS: A total of 1008 patients entered the study, of whom 91.5% (n = 922) were of working age. The median (interquartile range) time from presentation to VC outcome was 2 (4) days. VC outcomes were as follows: 16.3% of patients (n = 164) were discharged; 18.2% (n = 183) were discharged after further VC; 17.2% (n = 173) underwent an intervention; and 48.4% (n = 488) were referred to an FTF clinic. Interventions comprised: PCNL 0.5% (n = 5); ESWL 7.7% (n = 78); and URS 8.9% (n = 90). Stone demographics were as follows: 570 patients (56.5%) had lower, 157 (15.6%) had upper, 96 (9.5%) had mid-ureteric and 163 (16.2%) had renal calculi, and in 22 patients (2.2%) the stones had recently passed. The mean (sd) stone size was 3.5  (2.3) mm. Two adverse events (0.2%) were reported. Introducing a VC saved £145,152 for Clinical Commissioning Groups, the equivalent NHS tariff payment of performing 106 URS procedures or 211 ureteric stent insertions. Overall, 15,085 patient journey kilometres were avoided, equal to 0.70-2.93 metric tonnes of carbon dioxide equivalent production and the need to plant 14.7 trees to achieve carbon balance. CONCLUSION: A specialist-led acute ureteric colic VC reduced time to treatment decision to a median of 2 days. This creates additional clinic capacity and reduces the fiscal burden of traditional clinics and their associated carbon footprint.

Does globalization increase the ecological footprint? Empirical evidence from Malaysia.

This study focuses to investigate the relationship between globalization and the ecological footprint for Malaysia from 1971 to 2014. The results of the Bayer and Hanck cointegration test and the ARDL bound test show the existence of cointegration among variables. The findings disclose that globalization is not a significant determinant of the ecological footprint; however, it significantly increases the ecological carbon footprint. Energy consumption and economic growth stimulate the ecological footprint and carbon footprint in Malaysia. Population density reduces the ecological footprint and carbon footprint. Further, financial development mitigates the ecological footprint. The causality results disclose the feedback hypothesis between energy consumption and economic growth in the long run and short run.

Cradle-to-grave carbon footprint of dried organic pasta: assessment and potential mitigation measures.

BACKGROUND: In several Environmental Product Declarations, the business-to-business carbon footprint (CFCDC ) of durum wheat semolina dried pasta ranged from 0.57 to 1.72 kg carbon dioxide equivalent (CO2e ) kg-1 . In this work, the business-to-consumer carbon footprint (CFCG ) of 1 kg of dry decorticated organic durum wheat semolina pasta, as packed in 0.5 kg polypropylene bags by a South Italian medium-sized pasta factory in the years 2016 and 2017, was assessed in compliance with the Publicly Available Specification 2050 standard method. RESULTS: Whereas CFCDC was mostly conditioned by the greenhouse gases emitted throughout durum wheat cultivation (0.67 vs 1.12 kg CO2e kg-1 ), CFCG was mainly dependent on the use and post-consume phases (0.68 vs 1.81 kg CO2e kg-1 ). CFCG was more or less affected by the pasta types and packing formats used, since it varied from +0.3 to +14.8% with respect to the minimum score estimated (1.74 kg CO2e kg-1 ), which corresponded to long goods packed in 3 kg bags for catering service. Once the main hotspots had been identified, CFCG was stepwise reduced by resorting to a series of mitigation actions. CONCLUSION: Use of more eco-sustainable cooking practices, organic durum wheat kernels resulting from less impacting cultivation techniques, and renewable resources to generate the thermal and electric energy needs reduced CFCG by about 58% with respect to the above reference case. Finally, by shifting from road to rail freight transport and shortening the supply logistics of dry pasta and grains, a further 5% reduction in CFCG was achieved. © 2019 Society of Chemical Industry.

Reducing the carbon footprint per unit of economic benefit is a new method to accomplish low-carbon agriculture. A case study: adjustment of the planting structure in Zhangbei County, China.

BACKGROUND: The development of low-carbon agriculture is promising for mitigating climate change. This study used adjustments to the planting structure in Zhangbei County, China, as an example to evaluate whether the carbon footprint per unit of economic benefit is a suitable indicator of low-carbon agriculture and to determine if low-carbon agriculture is not necessarily low-input non-intensive agriculture. RESULTS: The results showed that total greenhouse gas emissions increased; therefore, the adjustments to the planting structure were ostensibly not a low-carbon process. However, if we obtain the same economic benefit as the actual distribution of the planting industry by adopting the scenario of planting only grain crops, then the annual greenhouse gas emissions would be 1608.00 × 103  t CO2 eq, and 5769.94 × 103  ha of farmland would be required. However, if we adopt the scenario of planting only vegetable crops, then only 82.52 × 103  ha of farmland would be required, and the annual greenhouse gas emissions would be 323.52 × 103  t CO2 eq. CONCLUSIONS: These results indicated that the carbon footprint per unit of economic benefit is a suitable indicator to assess agricultural sustainability and that intensive agriculture with high input and high output is a form of low-carbon agriculture if the carbon footprint per unit of economic benefit is low. © 2019 Society of Chemical Industry.

Decisions of the Dual-Channel Supply Chain under Double Policy Considering Remanufacturing.

Considering the preference of green consumers for remanufactured products, a dual-sale-channel supply chain model with government non-intervention, government remanufacturing subsidy policy, and carbon tax policy is constructed, respectively. The difference of the optimal decision between the firm and the government under the two policies is discussed in this paper. Meanwhile, we analyze the influence of green consumers on the government's optimal decision, based on social welfare maximization. It is found that without government intervention, social welfare is the lowest. The carbon tax policy is better when the proportion of green consumers and the environmental coefficient are extreme or moderate at the same time. Otherwise, the subsidy policy is better. The carbon tax policy is more effective than the subsidy policy in controlling carbon emissions. Profit-sharing contracts should be established by enterprises and governments to achieve win⁻win results.

Inequality in carbon intensity in EU-28: analysis based on club convergence.

This study examines the convergence properties of CO2 intensity in EU-28 countries, using panel data for the period 1990 to 2016. We use Phillips and Sul's (2007) approach to test for CO2 intensity convergence and identify convergence clubs. In addition to the EU-28 members, we analyze the EU-15, and the new EU members (EU-new) that joined after 2004, as distinct groups for the periods 1990-2016, 1990-2004, and 2005-2016. Our results show no convergence to a single group among the EU countries during the full and two subsample periods. However, the convergence takes place within five to seven clubs for the EU-28 and within three to five clubs for the EU-15 and EU-new. There is no evidence of all members converging to a single club in either group or the three sub-periods examined. This study highlights the need for adopting new strategies considering club properties and for sustainable growth, which meets the EU-28 environmental regulation standards.

Incentive Strategies for Low-Carbon Supply Chains with Asymmetric Information of Carbon Reduction Efficiency.

Information concerning carbon reduction efficiency is of great significance to supply chain operations. Considering the impact of information asymmetry on the performance of low-carbon supply chain, we therefore analyze a chain system with a single product designer and a single manufacturer. The manufacturer owns information on carbon reduction efficiency, whereas the product designer only knows that the carbon reduction efficiency of the manufacturer is either high or low. To induce the manufacturer to reveal his true private information of carbon-reduction efficiency to the product designer, we devise the pooling and separating equilibrium models to compare the impacts of these two models on supply chain performance, respectively. We find that the high-efficiency manufacturer gets his first-best choice at the equilibrium decision in the separating model, and obtains the information rent in the pooling model. The information rent increases in the efficiency difference between the two emission-reduction types. Additionally, we examine how the probability of the high (or low)-efficiency manufacturer being chosen impacts on both the profits of chain members and carbon-reduction levels. The research provides a reference for companies about how to cooperate with partner who possess private information of carbon emissions.

A Dual-Channel Supply Chain Coordination under Carbon Cap-and-Trade Regulation.

We consider a dual-channel supply chain coordination under a carbon cap-and-trade regulation. The dual-channel refers to the traditional retail channel and the network direct channel, and both two channels' selling prices can affect the market demand. We formulate the problem as a supplier-Stackelberg game model and obtain the optimal pricing decisions and corresponding profits in centralized and decentralized systems. We explore the effects of cap-and-trade regulation on optimal decisions and profits. To improve the performance of the decentralized system, we propose online channel price discount and offline channel price discount contracts to coordinate dual-channel supply chain and provide a transfer payment mechanism to make win-win of both sides. Moreover, we investigate how carbon regulation affects the coordination performance. Numerical examples illustrate the process to find the appropriate price discount coefficient and show the coordination effects of two contracts.