Modelling the impact of sublingual immunotherapy versus subcutaneous immunotherapy on patient travel time and CO2 emissions in Sweden.

In Sweden, allergy immunotherapy (AIT) is available as either subcutaneous immunotherapy (SCIT) injections or sublingual immunotherapy (SLIT) tablets and is used to treat moderate-severe allergic rhinitis (AR). This study sought to determine treatment-related CO2 emissions and travel times in Swedish patients receiving either SCIT or SLIT-tablets. A list of specialized Swedish AR clinics that administer AIT was determined, and respective co-ordinates retrieved. Swedish municipality population data were obtained from a national database. The mean distance from each Swedish municipality to the nearest AR clinic was calculated, adjusted using a detour index, and weighted by estimated patient population size. Transport modality data were obtained from a Swedish urban transport study and CO2 emissions were obtained from Government sources. The mean number of annual SLIT-tablets and SCIT doses required were calculated based on product labels and clinical expert input. The annual number of healthcare professional interactions were layered into the model to estimate changes in mean patient travel time, distance, and travel-related CO2 emissions associated with using SCIT versus SLIT-tablets. Mean annual travel-related CO2 emissions were 410 tonnes (to two significant figures [s.f.]; standard deviation [SD] 90) with SLIT-tablets, versus 1700 tonnes (SD 380) for SCIT, resulting in mean annual savings of approximately 1300 tonnes (SD 290) of CO2 if all AIT patients were to receive SLIT-tablets instead of SCIT, over 380 times greater than 2021 average Swedish CO2 emissions per capita. Approximate mean annual travel times for patients taking SLIT-tablets were 66,500 h (three s.f.; SD 14,400), and 278,000 h (SD 60,200) for SCIT, resulting in mean annual savings of 211,000 h (SD 45,800) if all AIT patients were to receive SLIT-tablets instead of SCIT. Compared with SCIT injections, SLIT-tablets led to substantial reductions in treatment-related CO2 emissions and travel times for Swedish patients.

Perceptions of the seriousness of major public health problems during the COVID-19 pandemic in seven middle-income countries.

INTRODUCTION: Public perception of the seriousness of the COVID-19 pandemic compared to six other major public health problems (alcoholism and drug use, HIV/AIDS, malaria, tuberculosis, lung cancer and respiratory diseases caused by air pollution and smoking, and water-borne diseases like diarrhea) is unclear. We designed a survey to examine this issue using YouGov's internet panels in seven middle-income countries in Africa, Asia, and Latin America in early 2022. METHODS: Respondents rank ordered the seriousness of the seven health problems using a repeated best-worst question format. Rank-ordered logit models allow comparisons within and across countries and assessment of covariates. RESULTS: In six of the seven countries, respondents perceived other respiratory illnesses to be a more serious problem than COVID-19. Only in Vietnam was COVID-19 ranked above other respiratory illnesses. Alcoholism and drug use was ranked the second most serious problem in the African countries. HIV/AIDS ranked relatively high in all countries. Covariates, particularly a COVID-19 knowledge scale, explained differences within countries; statistics about the pandemic were highly correlated with differences in COVID-19's perceived seriousness. CONCLUSIONS: People in the seven middle-income countries perceived COVID-19 to be serious (on par with HIV/AIDS) but not as serious as other respiratory illnesses. In the African countries, respondents perceived alcoholism and drug use as more serious than COVID-19. Our survey-based approach can be used to quickly understand how the threat of a newly emergent disease, like COVID-19, fits into the larger context of public perceptions of the seriousness of health problems.

We were curious what people in different countries thought about the seriousness of COVID-19 compared to other health problems. We designed a survey, and hired YouGov, a survey research firm, to administer it in seven countries in Africa, Asia, and Latin America in early 2022. Respondents answered the questions on their computer, tablets, or smart phones. Their answers revealed that in most countries respiratory illnesses were perceived to be a more serious problem than COVID-19. In Africa people felt that alcoholism and drug use were also more serious than COVID-19. These findings are important because they show that people still care about the health problems they were facing before the pandemic, which is useful information for healthcare providers.

Restoring areas after a radioactive fallout: A multidisciplinary study on decontamination.

Land remediation is an important part of restoration measures after a radioactive fallout containing long-lived fission products such as 137Cs. In this multidisciplinary study, we focused on three main issues related to remediation of contaminated urban areas. First, we assessed how much decontamination contributes to reducing resident radiation exposure and how much this reduction depends on the timing of implemented measures. Second, we calculated direct and indirect costs of decontamination in an industrialized country such as Sweden. Finally, in a survey study, we considered reactions of Swedish citizens to being given the hypothetical option of moving to a site decontaminated after radioactive fallout and how this predicted response might influence the design of contingency plans. The main findings are that clean-up operations must be done within the first few years after a fallout to contribute significantly to reducing residual dose. If conducted within 1-2 years, large-scale decontamination can, on average, avert 20-200 manSv per km2 residential area and unit ground deposition of 137Cs (1 MBq). The estimated direct costs (in 2020 purchasing power) would amount to 100 million Euro per km2 decontaminated residential area (comparable to Japanese estimates after the Fukushima accident), generating 39,000 m3 of radioactive waste on average, mainly in the form of 137Cs-contaminated topsoil. In our survey study of 2291 Swedish respondents about their willingness to return to decontaminated homes, women, families with resident children, and high-income earners exhibited more skepticism about returning, even if authorities were to deem it safe. The demographic pattern in attitudes was similar to that found among evacuees in the Fukushima prefecture after 2011. We conclude that predefined ranges of measured 137Cs ground deposition can be used as guidance for rescue leaders in the early post-accident phase in long-term planning for affected areas. This planning should include timing and intensity of decontamination measures, duration of evacuation, and risk communication to citizens. Because some citizens expressed both high risk perception and risk aversion, however, timely and dialogic communication is unlikely to limit a shift after the incident to an older and more male-dominated population composition. There is a risk that those who can afford to do so will move away, whereas people whose wealth is locked in property (houses or businesses) will feel stuck. Perceptions of unfairness may fray the social fabric and complicate resettlement, which in some cases may mean inefficient outlay of decontamination costs. We believe that the issue of monetary compensation to affected residents requires priority in future work.

China's adaptive response to climate change through air-conditioning.

Studies have shown that the soaring demand for air conditioners in recent years is closely related to the worsening global warming; however, little evidence has been provided for China. This study uses weekly data of 343 Chinese cities to investigate how air conditioner sales respond to climate variability. We detected a U-shaped relationship between air-conditioning and temperature. An additional day with average temperature above 30°C increases weekly sales by 16.2%. Heterogeneity analysis shows that the adoption of air-conditioning is different for south and north China. By combining our estimates with shared socioeconomic pathway scenarios, we project China's mid-century air conditioner sales and the resulting electricity demand. Under the fossil-fueled development scenario, air conditioner sales in the Pearl River Delta would rise by 71% (65.7%-87.6%) in summer. On average, the per capita electricity demand for air-conditioning will surge by 28% (23.2%-35.4%) in China by mid-century.

Improving biodiversity protection through artificial intelligence.

Over a million species face extinction, urging the need for conservation policies that maximize the protection of biodiversity to sustain its manifold contributions to people. Here we present a novel framework for spatial conservation prioritization based on reinforcement learning that consistently outperforms available state-of-the-art software using simulated and empirical data. Our methodology, CAPTAIN (Conservation Area Prioritization Through Artificial INtelligence), quantifies the trade-off between the costs and benefits of area and biodiversity protection, allowing the exploration of multiple biodiversity metrics. Under a limited budget, our model protects substantially more species from extinction than areas selected randomly or naively (such as based on species richness). CAPTAIN achieves substantially better solutions with empirical data than alternative software, meeting conservation targets more reliably and generating more interpretable prioritization maps. Regular biodiversity monitoring, even with a degree of inaccuracy characteristic of citizen science surveys, substantially improves biodiversity outcomes. Artificial intelligence holds great promise for improving the conservation and sustainable use of biological and ecosystem values in a rapidly changing and resourcelimited world.

Saving energy in residential buildings: the role of energy pricing.

A zero-carbon society requires dramatic change everywhere including in buildings, a large and politically sensitive sector. Technical possibilities exist but implementation is slow. Policies include many hard-to-evaluate regulations and may suffer from rebound mechanisms. We use dynamic econometric analysis of European macro data for the period 1990-2018 to systematically examine the importance of changes in energy prices and income on residential energy demand. We find a long-run price elasticity of -0.5. The total long-run income elasticity is around 0.9, but if we control for the increase in income that goes towards larger homes and other factors, the income elasticity is 0.2. These findings have practical implications for climate policy and the EU buildings and energy policy framework. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s10584-021-03164-3.

Charting a "Green Path" for Recovery from COVID-19.

Should the economic recovery from the 2019 novel coronavirus disease (COVID-19) be green? The current crisis is so severe that we should not take the answer for granted. It requires serious thought and we start by reviewing some arguments for and against a green approach. A crucial element is of course to see how different industries fare in the current crisis. Our empirical contribution is to examine daily stock returns for firms from the STOXX Europe 600 index. We find that firms with higher carbon intensities experienced significantly large decreases in stock values particularly those within the crude petroleum extraction, air transport and coke and refined petroleum industries. Our tentative conclusion is that efforts to revitalize the economy should avoid subsidizing stranded assets and instead target the industries of the future. However, identifying these will not necessarily be easy. We find, for example, that having an official ESG "climate change policy" has no effect on firm performance during the pandemic. We suggest possible ways of designing a new form of more informative index.

Gender and life-stage dependent reactions to the risk of radioactive contamination: A survey experiment in Sweden.

This article proposes and examines gender and life-stage factors as determinants of public worry and risk avoidance in a nuclear fallout scenario. Drawing on a survey (N 2,291) conducted in Sweden, the article demonstrates statistically significant results that women as well as parents with children at home are more likely to express high levels of worry for radiation exposure and have a preference to move away from a fallout area despite assurance of successful remediation. Moreover, a negative relationship is shown between age and both worry for radiation exposure and preference to move. These novel results from Northern Europe thus support a life-stage framing of public risk attitudes. As radiation physicists develop new methods showing that women and children are at higher risk of cancer than other groups at the same radiation exposure, we may actually see the precaution among women and parents as a regulating mechanism for the higher objective risk they face. The results are moreover in agreement with studies of public risk reactions in Japan, creating a strong knowledge base that human-induced radiation pollution is largely an intolerable risk to the public. Considering the public opinion, managing an intolerable risk through risk mitigation by remediation alone is likely insufficient in many cases. A viable strategy would offer a range of social support options that enable individual decision-making and the protection of risk groups.

Influence of methane emissions and vehicle efficiency on the climate implications of heavy-duty natural gas trucks.

While natural gas produces lower carbon dioxide emissions than diesel during combustion, if enough methane is emitted across the fuel cycle, then switching a heavy-duty truck fleet from diesel to natural gas can produce net climate damages (more radiative forcing) for decades. Using the Technology Warming Potential methodology, we assess the climate implications of a diesel to natural gas switch in heavy-duty trucks. We consider spark ignition (SI) and high-pressure direct injection (HPDI) natural gas engines and compressed and liquefied natural gas. Given uncertainty surrounding several key assumptions and the potential for technology to evolve, results are evaluated for a range of inputs for well-to-pump natural gas loss rates, vehicle efficiency, and pump-to-wheels (in-use) methane emissions. Using reference case assumptions reflecting currently available data, we find that converting heavy-duty truck fleets leads to damages to the climate for several decades: around 70-90 years for the SI cases, and 50 years for the more efficient HPDI. Our range of results indicates that these fuel switches have the potential to produce climate benefits on all time frames, but combinations of significant well-to-wheels methane emissions reductions and natural gas vehicle efficiency improvements would be required.

Short-run allocation of emissions allowances and long-term goals for climate policy.

We use economic analysis to evaluate grandfathering, auctioning, and benchmarking approaches for allocation of emissions allowances and then discuss practical experience from European and American schemes. In principle, auctions are superior from the viewpoints of efficiency, fairness, transparency, and simplicity. In practice, auctions have been opposed by important sectors of industry, which argue that carbon pricing without compensation would harm international competitiveness. In the European Union's Emissions Trading System, this concern led to grandfathering that is updated at various intervals. Unfortunately, updating gives industry an incentive to change behavior to influence future allocation. Furthermore, the wealth transferred to incumbent firms can be significantly larger than the extra costs incurred, leading to windfall profits. Meanwhile, potential auction revenues are not available to reduce other taxes. By circumscribing free allocation, benchmarking can target competitiveness concerns, incur less wealth transfer, and provide a strategy consistent with transitioning to auctions in the long run.

How should support for climate-friendly technologies be designed?

Stabilizing global greenhouse gas concentrations at levels to avoid significant climate risks will require massive "decarbonization" of all the major economies over the next few decades, in addition to the reduced emissions from other GHGs and carbon sequestration. Achieving the necessary scale of emissions reductions will require a multifaceted policy effort to support a broad array of technological and behavioral changes. Change on this scale will require sound, well-thought-out strategies. In this article, we outline some core principles, drawn from recent social science research, for guiding the design of clean technology policies, with a focus on energy. The market should be encouraged to make good choices: pricing carbon emissions and other environmental damage, removing distorting subsidies and barriers to competition, and supporting RD&D broadly. More specific policies are required to address particular market failures and barriers. For those technologies identified as being particularly desirable, some narrower RD&D policies are available.

To trade or not to trade: firm-level analysis of emissions trading in Santiago, Chile.

Whether tradable permits are appropriate for use in transition and developing economies--given special social and cultural circumstances, such as the lack of institutions and lack of expertise with market-based policies--is much debated. We conducted interviews and surveyed a sample of firms subject to emissions trading programs in Santiago, Chile, one of the first cities outside the OECD that has implemented such trading. The information gathered allows us to study what factors affect the performance of the trading programs in practice and the challenges and advantages of applying tradable permits in less developed countries.

Alumina ceramic particles, in comparison with titanium particles, hardly affect the expression of RANK-, TNF-alpha-, and OPG-mRNA in the THP-1 human monocytic cell line.

Particle-induced osteolysis is the most frequent cause of aseptic loosening after total joint replacement. We performed a study to illuminate the effect of ceramic particles with different diameters and concentrations on the mRNA expression of certain key regulators in particle-induced aseptic osteolysis (RANK, RANKL, OPG, and TNF-alpha) in THP-1 macrophage-like cells. Titanium particles were used as a positive control. RNA was analyzed by quantitative RTPCR. Our results demonstrate that alumina ceramic particles, regardless of particle size, caused only slight upregulations of RANK, TNF-alpha, and OPG mRNA, whose levels were significantly lower in comparison with those of titanium particles (p < 0.05). The continuous increasing tendency to time and particle-dependent mRNA expression of all the parameters stimulated by titanium particles was not found after stimulation with ceramic materials. Even after the concentration of ceramic particles was increased, only a mild upregulation of mRNA expression was found. Furthermore, we observed that the bioinert properties of ceramic particles did not change much in diameters ranging from 0.5 to 1.5 microm. At most of the measuring time points, there was no significant difference between the reactions of the large and small particles in this range. Our results support the theory about the relative bioinert properties of alumina ceramic particles.

Synergistic effects of mixed TiAlV and polyethylene wear particles on TNFalpha response in THP-1 macrophages.

TNFalpha is a potent osteoclastogenic cytokine that has a fundamental role in the pathogenesis of wear particle-induced osteolysis. Wear particles of one composition and their biological effects are well characterised. In contrast, little is known about the effects of mixed particles with respect to mix ratio and particle concentration. We evaluated the effects of different mix ratios of polyethylene and TiAlV particles on TNFalpha response. We used a human monocytic cell line (THP-1) in this in vitro study. THP-1 monocytes were differentiated to macrophage-like cells and exposed to different mixtures of lipopolysaccharide-detoxified polyethylene and TiAlV particles. TNFalpha was analysed in culture supernatants using ELISAs. Both polyethylene and TiAlV particles induced a dose- and time-related release of TNFalpha, with maximum levels after 6 h. A PE/TiAlV mix ratio of 36:1 at 10(8) particles/ml induced significantly higher TNFalpha concentrations compared to equal particle concentrations of isolated TiAlV (p=0.047) or PE (p=0.044), indicating the synergistic effect of mixed particles. These results provide evidence that TiAlV and polyethylene particles have significant synergistic effects, depending on the mix ratio and particle concentrations. This supra-additive effect can contribute substantially to the pathogenesis of implant particle-induced osteolysis.

Suppression of polyethylene particle-induced osteolysis by exogenous osteoprotegerin.

Alterations of the key regulators of osteoclastogenesis, receptor activator of NF-kappaB (RANK), RANK ligand (RANKL), and osteoprotegerin (OPG) have been implicated in wear particle-induced osteolysis, the most common cause for implant failure in total joint replacements. This study investigated the effect of exogenous OPG on ultra-high-molecular-weight polyethylene (UHMWPE) particle-induced osteolysis. The murine calvarial osteolysis model was utilized in 28 C57BL/6J mice randomized to four groups. Group I underwent sham surgery only, group II received UHMWPE particles, and group III and IV particles and subcutaneous OPG starting from day 0 (group III) or day 5 (group IV) until sacrifice. After 2 weeks, calvaria were prepared for histology and histomorphometry. Bone resorption was measured within the midline suture using Giemsa staining and osteoclast numbers were determined using TRAP staining. UHMWPE particle implantation resulted in grossly pronounced osteoclastogenesis and bone resorption. Both immediate and delayed treatment with OPG counteracted these particle-induced effects significantly, suppressing osteoclast formation and bone resorption (p < 0.001 and p < 0.001, respectively). In conclusion, exogenous OPG markedly suppressed UHMWPE particle-induced osteolysis in a murine calvarial model. This important finding underscores the crucial significance of the OPG-RANKL-RANK signaling in wear particle-induced osteolysis. Exogenous OPG may prove an effective treatment modality for wear debris-mediated periprosthetic osteolysis after total joint arthroplasty.

A net loss: policy instruments for commercial cod fishing in Sweden.

This paper describes the overfishing of the seas, in particular for cod in Sweden. It discusses policy instruments such as individual quotas, labelling and marine reserves. A tentative conclusion is that something needs to be done to the very structure of the policy instruments used. Information on stock depletion is available but goes unheeded and is counteracted by fishermen who want to fish more and who are routinely supported by "the political establishment" who appear to be most concerned about (short-term) employment. The whole debate is taking place before the eyes of a general public that does not care sufficiently and difficult international bureaucracy. In this situation, the most important changes may be to strengthen both the rights and the duties of the fishermen. The integrity of fish stocks must be given absolute priority, but it is also important to motivate the fishermen with a greater stake and interest in the stock by giving them quotas that have, as far as possible, the characteristics of property.