Methodological approaches for incorporating the external effects resulting from climate impacts into health economic evaluation (HEE) are a vivid field of research. Combining established standards for reporting HEE and climate footprints (CF), our aim is to develop a structured list of points to consider for reporting full HEE that combines the two methodologies, referred to as climate-extended HEE METHODS: We mapped a transparency catalogue with methodological items for estimating CF to the reporting items described in the Consolidated Health Economic Evaluation Reporting Standards (CHEERS). We identified synergies and developed a proposal of methodological points to report for climate-extended HEE, structured by the CHEERS items. The proposal was validated using three published climate-extended HEEs and a hypothetical case study.. We proposed extensions to 18 reporting items of CHEERS, for example, adding more detail to the measurement and valuation of resources and costs to facilitate a process- or cost-based estimation of CF. Using three identified publications and a hypothetical case study, examples on how all items could be addressed are provided, including a presentation of climate-extended versions of the standard summary measures of HEE. The proposed catalogue can be used for reporting and reviewing climate-extended HEEs. Further work is necessary to include planetary boundaries beyond climate change. Future steps could be, first, to develop a reporting standard within a formal Delphi process of all relevant stakeholders. Second, the catalogue can be used to develop standards of analytic choices for specific decision makers or problems.

Abstract The chemical industry’s reliance on fossil raw materials has significantly contributed to increased CO 2 levels. To reduce the climate footprint, renewable resources must replace fossil ones. Biotechnical production of industrial chemicals using renewable resources is a promising approach. However, many biotechnical processes require yeast extract, a costly nutrient source. Inexpensive, protein-rich substitutes like agricultural residues can be used instead. To improve fermentation results, a hydrolysis process was developed and tested. This paper describes the optimization of chemical hydrolysis for protein-rich agricultural raw materials like Distillers’ Dried Grains with Solubles (DDGS) and rapeseed meal (RM). The hydrolysates were used as a nitrogen source in bioprocesses to verify their usability. The results show that the amount of free amino nitrogen increases with increasing molarity of the acid. In order to achieve acceptable amino nitrogen concentrations with reduced sulfuric acid molarity, the temperature was raised up to 160 °C. This temperature increase resulted in 81.3% of the amino nitrogen concentration with 1 M sulfuric acid compared to using 3 M sulfuric acid. As a result of this optimization, the costs of the hydrolysated rapeseed meal are reduced to only 8–13% of the original costs of yeast extract with the same nitrogen content. Graphical Abstract

ABSTRACT Using a sample of US publicly listed firms from 2002 to 2023, our findings reveal a significant association between CEO tenure and a firm's exposure to climate change risk. Specifically, we show that a firm's climate risk exposure tends to increase during the early stages of a CEO's tenure and declines as their tenure progresses. Our results are robust across multiple model specifications and alternative proxies, confirming the validity of our findings. The concave (inverse‐U‐shaped) relationship between CEO tenure and climate risk is especially pronounced in firms facing higher environmental litigation risk and those with strong environmental, social, and governance (ESG) performance. Notably, we find that this concave relationship is more evident in firms led by lower ability CEOs and those with higher CEO compensation. Moreover, CEOs in firms with lower efficiency in conventional input–output measures, as well as those operating in more transparent environments, are more effective at shifting their firms' climate risk exposure from positive to negative. By examining the influence of corporate governance mechanisms on firm‐level climate change risk, our study contributes to the ongoing discourse on the CEO's role in managing corporate climate footprints.

Climate regime shifts (CRSs), characterized by abrupt and persistent transitions between alternative stable states in the climate system, pose serious threats to ecosystems and human well-being. Understanding the potential drivers of CRSs is crucial, particularly in a warming world where CRSs are becoming more frequent. Here, using multiple observations and model simulations, we find that the likelihood of CRS occurrence significantly increases in the context of super El Niño events due to their remarkable climate perturbations. This higher probability is detected across various climate elements, such as surface air temperature, sea surface temperature, and surface soil moisture. In addition, we suggest that this boost effect of super El Niño events on CRSs will be greatly amplified under future greenhouse warming. Our findings underscore a deeper and more persistent climate footprint of super El Niño events, suggesting that early warnings and proactive measures are crucial for mitigating their escalating risks.

Global aviation hascontributed ∼3.5% to the anthropogenicclimate forcing in 2018, of which around two-thirds (with substantialuncertainty) were due to non-CO2 effects dominated by contrailcirrus. To be sustainable, the aviation industry faces a great challengein reducing its climate footprint. There are ongoing efforts towardcontrail avoidance via rerouting flights to avoid ice supersaturatedregions, but serious reservations have been voiced against it becauseof extra fuel burning and resultant increased CO2 emissions,among other issues. Based on simulations with a state-of-the-art aerosoland contrail microphysics model, we show that the aviation non-CO2 climate effect associated with contrail cirrus may be significantlyreduced via controlled seeding of a small amount of ice-nucleatingparticles (INPs). The optimized amount of INPs seeded will consumewater vapor and minimize the peak relative humidity reached in theplume. In turn, this reduces the number of exhaust particles activatingand forming contrail ice particles by up to 1–2 orders of magnitude,resulting in larger contrail ice particles that fall faster and shortercontrail lifetimes, which is expected to diminish the warming effectof contrail cirrus to a very small level. This novel approach maysolve some of the issues associated with the proposed navigationalcontrail avoidance, but further research is needed to assess its feasibilityand environmental impacts.

Conference travel contributes to the climate footprint of academic research. Here, we provide a quantitative estimate of the carbon emissions associated with conference attendance by analyzing travel data from participants of 10 international conferences in the field of magnetic resonance, namely EUROMAR, ENC and ICMRBS. We find that attending a EUROMAR conference produces, on average, more than 1 t . For the analyzed conferences outside Europe, the corresponding value is about 2–3 times higher, on average, with intercontinental trips amounting to up to 5 t. We compare these conference-related emissions to other activities associated with research and show that conference travel is a substantial portion of the total climate footprint of a researcher in magnetic resonance. We explore several strategies to reduce these emissions, including the impact of selecting conference venues more strategically and the possibility of decentralized conferences. Through a detailed comparison of train versus air travel – accounting for both direct and infrastructure-related emissions – we demonstrate that train travel offers considerable carbon savings. These data may provide a basis for strategic choices of future conferences in the field and for individuals deciding on their conference attendance.

Dairy cow longevity affects production economy, climate footprint, and cow welfare. Based on data from the Danish Cattle Database, this research paper evaluates the relationship between early-life risk factors associated with the period before first calving and cow longevity, including data from all Danish dairy cows culled in 2019-2023. Explanatory variables for linear mixed models included calf size, twinning, and age at first calving. Information about the length of productive life (LPL) (mean: 1,074days) and lifetime milk yield (mean: 32,088kg energy-corrected milk) was available for 767,305 and 716,120 cows, respectively. Milk yield per day of life increased from 7kg in cows culled during the first lactation to more than 20kg in cows culled in their fifth or later lactations. For cows born as singletons, LPL was one month longer for cows born as large calves than for medium-sized calves, and 2 months longer than for small calves. Cows born as twins had 2 to 3 months shorter productive lives compared to cows born as singletons. For singletons, lifetime milk yield was 1,200kg higher for large calves than for medium-sized calves, and 2,100kg higher than for small calves. Lifetime milk yield was 1,500 to 3,500kg lower in cows born as twins. Cows being among the third quartile of age at first calving had an estimated productive life 2.5months longer, and a lifetime milk yield more than 2,600kg higher than cows calving among the first quartile of age. The results from this study clearly demonstrate the importance of 'a good start'.

Abstract Inspired by a discourse-centred commodity chain analysis (Thurlow 2020), this study investigates beefy landscapes materialized in three organic grocery store chains in Germany. Organic food stores produce meat-intensive texts that may contradict their widely promoted and mediatized claims to sustainability, complicating the pleas for reducing meat consumption which is essential to limit global warming. Focusing on organic beef, with the largest climate footprint of any protein source, the study looks into semiotic material detached from scientific findings on environmental issues and composing an alarming part of the globalized clean food discourse that masks unsustainable realities. By putting forward cows as icons of organic cattle farming and the effortless convenience of preparation, while erasing environment-related impact categories, beef consumption is perpetuated. The article ultimately shows that our ‘meaty routines’ (Sundet, Hansen, & Wethal 2023) are deeply rooted in environmental escapism as we follow the hype to eat right. (Organic beef, Anthropocene discourse, semiotic landscape, discourse-centred commodity chain analysis, (Social) Life Cycle Assessment)

Abstract Climate change action and sustainability are gaining importance in the health policy discourse. This concerns both anticipating and managing the potential impact of climate change on population health and health systems, but also understanding and mitigating the climate footprint of healthcare itself. The health sector alone is responsible for around 5% of global greenhouse gas emissions, of which 17% directly related to activities in health care facilities. There are a range of ways in which the sector and health care facilities specifically can implement change, while also generating co-benefits for population health, including redesigning procurement practices to consider environmental criteria, transforming the physical spaces in which health care is delivered, improving recycling and waste management practices, promoting green mobility options for patients and staff, and empowering the health workforce to embed decarbonization principles in their daily practice, just to name a few. This session aims to showcase existing initiatives that highlight the types of activities that can be implemented to facilitate the greening of health facilities and reduce the climate impact of health care, bringing together a range of perspectives from actors at different levels. This will include a discussion of the support instruments, including funding and technical support, made available by the European Union, which can be accessed by different actors in the sector to facilitate the greening of health facilities. Two relevant examples, the EU-funded initiatives BeWell and Caring Nature, will be featured to demonstrate how European partners are collaborating to reduce the impact of the healthcare sector on the environment. The session will also zoom in to look at initiatives from different national and regional contexts and the lessons they have learnt: presenting the work of the Competence Centre for Climate and Health based at the Austrian National Public Health Institute, which has been working closely with health care facilities towards reaching climate neutrality, and Austria's participation in a multicountry EU project to leverage EU resources for the greening of Austrian health facilities; and discussing a regional good practice example of the health facility group Mutua Terrassa in Catalonia (Spain), which has collaborated with regional authorities and developed a Green Commitment strategy to reduce the environmental impact of its estates. The session foresees active audience participation in discussion with the panel to reflect on enablers and barriers of sustainable action in health care, exploring the different options that policy makers can make use of to drive action at different levels and the role of international support and cross-country learning in making change happen at a time when health systems face many competing challenges and demands. Key messages • Mobilisation is needed across the entire sector and at all levels: from the top down to the health care facility. • A broad range of options and resources exist that can be pursued by decision-makers at different levels to make health care facilities more sustainable.

Climate impact and land use of processing grass-clover biomass cultivated under different nitrogen fertilization rates in green biorefinery.

Tracing the global climate footprint: four decades of evolving air temperature and ozone dynamics (1980–2024) using satellite-based MERRA-2 data

Climate transition has not been as prominent in healthcare as in other sectors of society. It is crucial to recognize the part and potential of healthcare in the climate transition, both as part of the problem and of the solution. Healthcare professionals globally are aware of the negative consequences of climate change for patients but have insufficient knowledge and experience to be able to act. This overview aims to provide insight into how the environmental and climate footprint footprint from clinical activity can be reduced while increasing resilience against extreme weather and other climate-related health effects that risk affecting our activities. It also highlights the unique role of healthcare professionals in the climate transition of society.

IntroductionThe healthcare sector has significant environmental impacts, particularly through greenhouse gas emissions. Reducing its climate footprint is therefore essential for achieving political goals such as net-zero and climate-friendly healthcare. While health economic evaluation (HEE) methods compare the costs and consequences of two or more interventions, these analyses rarely consider climate impacts. Some studies have begun to determine climate impacts parallel to or integrated into HEEs. Life cycle assessment (LCA) could be used to integrate climate impacts by considering these results as effects or monetised climate footprints. However, a reporting standard is needed for using these climate-extended economic evaluations in evidence-based decision-making. This protocol describes using an online Delphi process to incorporate climate impacts into the Consolidated Health Economic Evaluation Reporting Standard (CHEERS), called CHEERS Climate Extension (CHEERS ClimatE).Methods and analysisThe development of CHEERS ClimatE will proceed through five key stages. First, the preliminary steering group develops in consultation with an advisory board a proposal for the CHEERS ClimatE reporting standard based on a transparency checklist that combines three standards for carbon footprint calculations into the CHEERS framework. The mapping was complemented by reviewing studies that incorporate climate impacts in HEE. Second, for the Delphi process, international experts in HEE and LCA with at least one year of academic experience will be invited to participate in an online pre-survey. We aim to recruit at least 40 participants. Expecting various drop-outs, we aim to reach a consensus with at least 20 participants per Delphi round. Third, an expected three-round Delphi process will be conducted to validate and refine the proposed elements. Participants will rate each item using a 9-point Likert scale and will have the opportunity to comment on each item and propose new items. Consensus is defined with the target of a 70% agreement. Unless consensus is reached, a moderated video conference may be held as a fourth round. Fourth, following other CHEERS extensions, the consented checklist will be piloted using thematically relevant case studies. While substantial changes are not anticipated, minor revisions to individual items may be considered and ratified by the steering group and advisory board. The fifth stage is the publication of the final checklist.Ethics and disseminationThis study has been approved by the ethics committee of the University of Bremen (2024–25). The findings of the Delphi study will be published in a peer-reviewed journal and presented at conferences.

Abstract Grass production with subsequent green biorefining into value-added products is developing fast in Denmark. Environmental assessments indicate promising performance, two full-scale plants are in operation, and R&D-focus is substantial. Currently, the fibrous pulp fraction from grass refining is used to boost manure digestion in biogas plants. Recently, it has been investigated experimentally if the grass pulp is suitable for pyrolysis, and previous work has shown its usefulness as cattle feed. In this study, the climate footprint of grass pulp management in both single-use and cascade use systems encompassing anaerobic digestion, cattle feed, and thermal pyrolysis is investigated. A total of seven approaches for grass pulp and manure co-management are modelled, and differences in GHG emissions are compared. Results show that all investigated management options offer substantial climate benefits ranging from around 700 to almost 1300 kg CO2e pr ton grass pulp solids co-managed with cattle manure in a GWP100 perspective. Integrating biomass pyrolysis in grass pulp and cattle manure co-management systems encompassing fodder use and/or anaerobic digestion is found to have substantial climate benefits in all cases, averaging at a 30% higher climate benefit from co-management of these resources.

Exploring the role of urban nature in mitigating the climate footprint of urbanization in Ethiopia

Circulating fluidized bed fly ash (CFBFA) stockpiles release alkaline dust, high-pH leachate, and secondary CO2/SO2—an environmental burden that exceeds 240 Mt yr−1 in China alone. Yet, barely 25% is recycled, because the high f-CaO/SO3 contents destabilize conventional cementitious products. Here, we presents a pressurized flue gas heat curing (FHC) route to bridge this scientific deficit, converting up to 85 wt% CFBFA into structural lightweight gravel. The gypsum dosage was optimized, and a 1:16 (gypsum/CFBFA) ratio delivered the best compromise between early ettringite nucleation and CO2-uptake capacity, yielding the highest overall quality. The optimal mix reaches 9.13 MPa 28-day crushing strength, 4.27% in situ CO2 uptake, 1.75 g cm−3 bulk density, and 3.59% water absorption. Multi-technique analyses (SEM, XRD, FTIR, TG-DTG, and MIP) show that FHC rapidly consumes expansive phases, suppresses undesirable granular-ettringite formation, and produces a dense calcite/needle-AFt skeleton. The FHC-treated CFBFA composite gravel demonstrates 30.43% higher crushing strength than JTG/TF20-2015 standards, accompanied by a water absorption rate 28.2% lower than recent studies. Its superior strength and durability highlight its potential as a low-carbon lightweight aggregate for structural engineering. A life-cycle inventory gives a cradle-to-gate energy demand of 1128 MJ t−1 and a process GWP of 226 kg CO2-eq t−1. Consequently, higher point-source emissions paired with immediate mineral sequestration translate into a low overall climate footprint and eliminate the need for CFBFA landfilling.

Abstract Purpose (stating the main purposes and research question) Anthropogenic resource use contributes to pollution, violent conflict over scarce resources, loss of biodiversity, and diminished quality of life for humans. Moreover, the “safe” amount of carbon dioxide—350 parts per million—has been exceeded. The health care industry is responsible for 4–5% of total world emissions,[i] which is similar to the global food sector.[ii] Health care carbon emissions come from health care infrastructures, supply chains and health care delivery. Increasingly, health care delivery is reliant on technologies which require the use of artificial intelligence to provide supportive care, such as triage algorithms, electronic patient records, and robotics.[iii] While these technological innovations have advanced health care significantly, they also contribute to the negative effects on the environment, among others, through carbon emissions. The environmental impacts of artificial intelligence (AI) in health care—in particular—are understudied. This research seeks to fill this gap. Methods Our team ran an exploratory search in Scopus and PubMed to identify studies that integrate environmental sustainability, artificial intelligence, and health. Results Our research initially yielded 735 studies. 77 of these studies focused on an environmental concern of a health technology or AI-application in a health care setting, but most of the articles in this subset addressed lowering energy consumption of a specific technology, such as a sensor or monitoring technology. Conclusions While there have been studies looking at AI in health care; sustainability in AI; and sustainability in health care, little attention has been paid to the interface between all three. [i] Karliner, J., Slotterback, S., Boyd, R., Ashby, B., & Steele, K. 2019. Health Care’s Climate Footprint: How the Health Sector Contributes to the Global Climate Crisis and Opportunities for Action Healthcare Without HarmARUP; September. [ii] Pichler, P. P., Jaccard, I. S., Weisz, U., & Weisz, H. 2019 International Comparison of Health Care Carbon Footprints, Environmental Research Letters 14, no. 6: 064004. [iii] Khaliq, Abdul, Ali Waqas, Qasim Ali Nisar, Shahbaz Haider, and Zunaina Asghar. 2022. Application of AI and robotics in hospitality sector: A resource gain and resource loss perspective. Technology in Society 68: 101807.

Climate assessments of civil aviation1,2 have consistently quantified the dominant climate-forcing components: (1) CO2 emissions, (2) NOx (NO + NO2) emissions and (3) persistent contrails. All three components exert a positive radiative forcing (RF) and lead to climate warming of similar magnitudes. The aviation community is actively seeking to reduce its climate footprint through advanced engine technologies, more sustainable aviation fuel and optimal routing plans3-12. These approaches usually involve a trade-off of CO2 against NOx or contrails (non-CO2), such as burning 1% more fuel to decrease contrail RF by 4%. Here, we show that a climate-trade-off risk curve derived from uncertainties in the RF components2,13-16 can give the probability that a specified trade-off ratio will produce a climate benefit. For each component, we calculate the integrated effective RF resulting from 1 year of flights: global warming per activity (GWA). The complementary cumulative probability distribution of the GWA(non-CO2) to GWA(CO2) ratio results in a climate-trade-off risk curve giving the likelihood of a positive climate outcome as a function of the trade-off-CO2 to trade-off-non-CO2 ratio, because the product, GWA × trade-off, should be the same for both. We find a likely (67%) chance of climate mitigation on a 100-year time horizon for the above suggested ratio of 1:4, favouring proposed non-CO2 mitigation efforts3-12 with ratios smaller than this.

Rapid and significant reductions in global carbon emissions are needed to remain within Earth’s limits. The construction and operation of buildings account for the largest share of the global consumption of raw materials, and they yield around 40% of global carbon emissions. Leading climate researchers therefore recommend adapting housing needs to existing building stock instead of constructing new buildings. This requires shifting the focus from what we desire to how we can adapt our needs to existing spaces. This paper, a work in progress, examines the misalignment between sustainability ambitions and tourism strategy in a Danish municipality. This municipality has yet to fully integrate the potential of its existing building stock into its tourism plans. This oversight is striking, given the municipality’s ambitious goal of achieving CO₂ neutrality and availability of surplus building stock, including vacant retail spaces in shopping streets. Building on this observation, we propose a conceptual framework for incorporating existing buildings into the municipality’s tourism strategies. Rather than expanding their climate footprint by constructing new accommodations for tourists, we suggest a solution centered on using vacant spaces and renovating existing structures. Specifically, we envision repurposing vacant retail spaces into holiday apartments, boutique hotels, or other types of housing. This paper lays a foundation for further research to increase awareness of this issue and to test and refine our proposal. The overarching goals are to support sustainable urban development, promote climate-friendly behavior, and strengthen local community and economic vitality in small and medium-sized towns through longer-lasting buildings.

The demand for plant-based proteins has grown significantly due to their sustainability and lower environmental impact compared to animal proteins. Shifting from animal-based to plant-based diets, particularly those incorporating protein-rich legumes like beans and peas, can substantially reduce the climate footprint of food production. Underutilized legumes, which are often critical in resource-poor regions, hold immense potential for enhancing food security, nutrition, and agricultural development. Despite their importance, information about these legumes remains limited and region-specific. The shift towards plant proteins is further driven by the growing popularity of vegetarian and vegan diets, alongside mounting concerns over the environmental impacts of livestock farming. Consequently, plant proteins are increasingly favored over their animal-based counterparts in the food industry. Scientists are now exploring novel plant protein sources and developing superior-quality proteins with enhanced functional and nutritional characteristics using cutting-edge technologies. While traditional plant protein sources like wheat and soy present challenges such as allergenicity, pulses like peas, beans, chickpeas, and lentils are gaining prominence due to their agronomic and nutritional advantages. It is anticipated that ongoing research will address the existing knowledge gaps regarding the nutritional and health benefits of fodder seeds such as field bean and field pea seeds, broadening their application across diverse food industries. In this context, the present review focuses on the potential of field bean and field pea as valuable sources of food and functional ingredients. Despite their benefits, current knowledge about these crops is limited to specific geographic areas where they hold cultural or local significance.