Saturday, April 05, 2025

 BITUMIN* IS A BITCH

Study: Burning heavy fuel oil with scrubbers is the best available option for bulk maritime shipping



Researchers analyzed the full lifecycle of several fuel options and found this approach has a comparable environmental impact, overall, to burning low-sulfur fuels



Massachusetts Institute of Technology

Hedwig Oldendorff vessel 

image: 

Pictured here is the Hedwig Oldendorff vessel at the Port of Taicang, China, prior to the start of the emission monitoring voyage.

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Credit: Courtesy of Patricia Stathatou




CAMBRIDGE, MA – When the International Maritime Organization enacted a mandatory cap on the sulfur content of marine fuels in 2020, with an eye toward reducing harmful environmental and health impacts, it left shipping companies with three main options.

They could burn low-sulfur fossil fuels, like marine gas oil, or install cleaning systems to remove sulfur from the exhaust gas produced by burning heavy fuel oil. Biofuels with lower sulfur content offer another alternative, though their limited availability makes them a less feasible option.

While installing exhaust gas cleaning systems, known as scrubbers, is the most feasible and cost-effective option, there has been a great deal of uncertainty among firms, policymakers, and scientists as to how “green” these scrubbers are.

Through a novel lifecycle assessment, researchers from MIT, Georgia Tech, and elsewhere have now found that burning heavy fuel oil with scrubbers in the open ocean can match or surpass using low-sulfur fuels, when a wide variety of environmental factors is considered.

The scientists combined data on the production and operation of scrubbers and fuels with emissions measurements taken onboard an oceangoing cargo ship.

They found that, when the entire supply chain is considered, burning heavy fuel oil with scrubbers was the least harmful option in terms of nearly all 10 environmental impact factors they studied, such as greenhouse gas emissions, terrestrial acidification, and ozone formation.

“In our collaboration with Oldendorff Carriers to broadly explore reducing the environmental impact of shipping, this study of scrubbers turned out to be an unexpectedly deep and important transitional issue,” says Neil Gershenfeld, an MIT professor, director of the Center for Bits and Atoms (CBA), and senior author of the study.

“Claims about environmental hazards and policies to mitigate them should be backed by science. You need to see the data, be objective, and design studies that take into account the full picture to be able to compare different options from an apples-to-apples perspective,” adds lead author Patricia Stathatou, an assistant professor at Georgia Tech, who began this study as a postdoc in the CBA.

Stathatou is joined on the paper by Michael Triantafyllou, the Henry L. and Grace Doherty and others at the National Technical University of Athens in Greece and the maritime shipping firm Oldendorff Carriers. The research appears today in Environmental Science and Technology.

Slashing sulfur emissions

Heavy fuel oil, traditionally burned by bulk carriers that make up about 30 percent of the global maritime fleet, usually has a sulfur content around 2 to 3 percent. This is far higher than the International Maritime Organization’s 2020 cap of 0.5 percent in most areas of the ocean and 0.1 percent in areas near population centers or environmentally sensitive regions.

Sulfur oxide emissions contribute to air pollution and acid rain, and can damage the human respiratory system.

In 2018, fewer than 1,000 vessels employed scrubbers. After the cap went into place, higher prices of low-sulfur fossil fuels and limited availability of alternative fuels led many firms to install scrubbers so they could keep burning heavy fuel oil.

Today, more than 5,800 vessels utilize scrubbers, the majority of which are wet, open-loop scrubbers.

“Scrubbers are a very mature technology. They have traditionally been used for decades in land-based applications like power plants to remove pollutants,” Stathatou says.

A wet, open-loop marine scrubber is a huge, metal, vertical tank installed in a ship’s exhaust stack, above the engines. Inside, seawater drawn from the ocean is sprayed through a series of nozzles downward to wash the hot exhaust gases as they exit the engines.

The seawater interacts with sulfur dioxide in the exhaust, converting it to sulfates — water-soluble, environmentally benign compounds that naturally occur in seawater. The washwater is released back into the ocean, while the cleaned exhaust escapes to the atmosphere with little to no sulfur dioxide emissions.

But the acidic washwater can contain other combustion byproducts like heavy metals, so scientists wondered if scrubbers were comparable, from a holistic environmental point of view, to burning low-sulfur fuels.

Several studies explored toxicity of washwater and fuel system pollution, but none painted a full picture.

The researchers set out to fill that scientific gap.

A “well-to-wake” analysis

The team conducted a lifecycle assessment using a global environmental database on production and transport of fossil fuels, such as heavy fuel oil, marine gas oil, and very-low sulfur fuel oil. Considering the entire lifecycle of each fuel is key, since producing low-sulfur fuel requires extra processing steps in the refinery, causing additional emissions of greenhouse gases and particulate matter.

“If we just look at everything that happens before the fuel is bunkered onboard the vessel, heavy fuel oil is significantly more low-impact, environmentally, than low-sulfur fuels,” she says.

The researchers also collaborated with a scrubber manufacturer to obtain detailed information on all materials, production processes, and transportation steps involved in marine scrubber fabrication and installation.

“If you consider that the scrubber has a lifetime of about 20 years, the environmental impacts of producing the scrubber over its lifetime are negligible compared to producing heavy fuel oil,” she adds.

For the final piece, Stathatou spent a week onboard a bulk carrier vessel in China to measure emissions and gather seawater and washwater samples. The ship burned heavy fuel oil with a scrubber and low-sulfur fuels under similar ocean conditions and engine settings.

Collecting these onboard data was the most challenging part of the study.

“All the safety gear, combined with the heat and the noise from the engines on a moving ship, was very overwhelming,” she says.

Their results showed that scrubbers reduce sulfur dioxide emissions by 97 percent, putting heavy fuel oil on par with low-sulfur fuels according to that measure. The researchers saw similar trends for emissions of other pollutants like carbon monoxide and nitrous oxide.

In addition, they tested washwater samples for more than 60 chemical parameters, including nitrogen, phosphorus, polycyclic aromatic hydrocarbons, and 23 metals.

The concentrations of chemicals regulated by the IMO were far below the organization’s requirements. For unregulated chemicals, the researchers compared the concentrations to the strictest limits for industrial effluents from the U.S. Environmental Protection Agency and European Union.

Most chemical concentrations were at least an order of magnitude below these requirements.

In addition, since washwater is diluted thousands of times as it is dispersed by a moving vessel, the concentrations of such chemicals would be even lower in the open ocean.

These findings suggest that the use of scrubbers with heavy fuel oil can be considered as equal to or more environmentally friendly than low-sulfur fuels across many of the impact categories the researchers studied.

“This study demonstrates the scientific complexity of the waste stream of scrubbers. Having finally conducted a multiyear, comprehensive, and peer-reviewed study, commonly held fears and assumptions are now put to rest,” says Scott Bergeron, managing director at Oldendorff Carriers and co-author of the study.

Ultimately, this study shows the importance of incorporating lifecycle assessments into future environmental impact reduction policies, Stathatou says.

“There is all this discussion about switching to alternative fuels in the future, but how green are these fuels? We must do our due diligence to compare them equally with existing solutions to see the costs and benefits,” she adds.

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Patricia Stathatou, pictured, spent a week onboard a bulk carrier vessel in China to measure emissions and gather seawater and washwater samples. This image shows, from left to right: measuring emissions upstream of the scrubber, Stathatou downstream of the scrubber, and the engine room aboard the bulk carrier vessel.

Stathatou (center) aboard the Hedwig Oldendorff vessel with, (from left) Zaytsev Serhiy, the vessel's Second Engineer, Liashko Igor, the vessel's Chief Officer, Konfederatov Evgeni, the vessel's Master, Iengenii Petrunia, Senior Technical Manager at Oldendorff, and Omelyanenko Ivan, vessel's Chief Engineer.

Credit

Courtesy of Patricia Stathatou

This study was supported, in part, by Oldendorff Carriers.

 

Study reveals worse patient outcomes in Black-serving hospitals





University of Pennsylvania School of Nursing

Penn Nursing's Eileen Lake 

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Eileen T. Lake, PhD, RN, FAAN, the Edith Clemmer Steinbright Professor in Gerontology; Professor of Nursing in the Department of Biobehavioral Health Sciences; and Associate Director of CHOPR

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Credit: Penn Nursing




PHILADELPHIA (April 4, 2025) – A new study – just published in Nursing Research – has uncovered concerning disparities in patient outcomes, specifically related to nursing care, within hospitals that predominantly serve Black communities. The research, which analyzed data from over 3,000 hospitals across the United States, reveals that these Black-serving hospitals (BSHs) exhibit significantly higher rates of specific adverse patient events.

The study from Penn Nursing’s Center for Health Outcomes and Policy Research (CHOPR), utilizing data from 2019 to 2022, examined four key nursing-sensitive indicators: pressure ulcers, perioperative pulmonary embolus/deep vein thrombosis, postoperative sepsis, and “failure to rescue,” which refers to death following serious surgical complications. These distressing, uncomfortable, or grave conditions are directly influenced by nursing care. Their occurrence can affect a patient’s ability to go home, their comfort during recovery, and their overall healing process. Researchers categorized hospitals into high, medium, and low BSHs based on the percentage of Black patients they served.

The findings painted a stark picture. While the overall average rates for these indicators were 0.59 for pressure ulcers, 3.38 for perioperative pulmonary embolus/deep vein thrombosis, 4.12 for sepsis, and 143.58 for failure to rescue, the study revealed a significant divergence when comparing BSH categories.

"We observed a clear trend," said lead-author Eileen T. Lake, PhD, RN, FAAN, the Edith Clemmer Steinbright Professor in Gerontology; Professor of Nursing in the Department of Biobehavioral Health Sciences; and Associate Director of CHOPR. "Hospitals serving a higher proportion of Black patients demonstrated significantly elevated rates of pressure ulcers, postoperative sepsis, and perioperative pulmonary embolus/deep vein thrombosis." The failure-to-rescue rates did not show significant differences across the BSH categories.

The study, encompassing 3,101 predominantly urban, non-teaching hospitals, also revealed a paradox: BSHs were more likely to have Magnet designation, a recognition of nursing excellence, than other hospitals (14% vs. 12%). This suggests that despite potential strengths in nursing infrastructure, patient outcomes remain compromised in BSHs.

These findings underscore the urgent need to address systemic factors contributing to these disparities. Further research is crucial to understand the underlying mechanisms, particularly the relationship between nursing resources, such as staffing and the work environment, and patient outcomes in these hospitals. The researchers emphasized that the poorer nursing-sensitive indicators observed in high BSHs and previously documented poorer nurse staffing necessitate immediate policy and management interventions.

Co-authors include Celsea Tibbitt, PhD, RN, John F. Rizzo MSN, CRNP, FNP-BC, and Christin Iroegbu, PhD, RN, all Postdoctoral Fellows (Tibbitt; Iroegbu) or former Predoctoral Fellow (Rizzo) at the University of Pennsylvania; Jessica G. Smith, PhD, RN, Associate Professor at the University of Texas at Arlington; Douglas O. Staiger, PhD, John Sloan Dickey Third Century Professor at Dartmouth College; and Jeannette A. Rogowski, PhD, Professor at The Pennsylvania State University. The research was supported by a grant of T32NR007104 from the National Institutes of Health.

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About the University of Pennsylvania School of Nursing

The University of Pennsylvania School of Nursing (Penn Nursing) is one of the world’s leading nursing schools. It has been ranked the #1 nursing school in the U.S. by QS University for a decade. Our Bachelor of Science in Nursing (BSN) is among the top-ranked programs in the nation, according to the 2025 U.S. News & World Report’s Best Colleges rankings. Penn Nursing also consistently earns high rankings in U.S. News & World Report’s annual list of best graduate schools and is a top recipient of National Institutes of Health (NIH) funding for nursing research. Penn Nursing prepares nurse scientists and nurse leaders to meet the health needs of a global society through innovation in research, education, and practice. Follow Penn Nursing on: FacebookXLinkedInYouTube, & Instagram.

WHY DEI?!

Gender inequity in institutional leadership roles in US academic medical centers




JAMA Network Open




About The Study: 

This systematic scoping review suggests that even though emphasis has been placed on addressing gender inequities in academic medicine, considerable disparities remain at the leadership level. While certain positions and specialties have been observed to have more female leaders, niches of academic medicine almost or completely exclude women from their leadership ranks. Importantly, even female-dominated specialties, such as obstetrics and gynecology, have substantial inequity in leadership roles. It is past time for organizational and systems-level changes to ensure equitable gender representation in academic leadership.


Corresponding Author: To contact the corresponding author, Marilyn Huang, MD, MS, email msh8f@uvahealth.org.

To access the embargoed study: Visit our For The Media website at this link https://media.jamanetwork.com/

(doi:10.1001/jamanetworkopen.2025.2829)

Editor’s Note: Please see the article for additional information, including other authors, author contributions and affiliations, conflict of interest and financial disclosures, and funding and support.

#  #  #

Embed this link to provide your readers free access to the full-text article This link will be live at the embargo time https://jamanetwork.com/journals/jamanetworkopen/fullarticle/10.1001/jamanetworkopen.2025.2829?guestAccessKey=c0957767-f5eb-4d6d-88a4-15c747418b57&utm_source=for_the_media&utm_medium=referral&utm_campaign=ftm_links&utm_content=tfl&utm_term=040425

About JAMA Network Open: JAMA Network Open is an online-only open access general medical journal from the JAMA Network. On weekdays, the journal publishes peer-reviewed clinical research and commentary in more than 40 medical and health subject areas. Every article is free online from the day of publication. 

 

Study assesses U.S. image amid weakening of democracy


Survey finds global partners' views of U.S. dimmed but policy support remained



Dartmouth COLLEGE 





The erosion of democracy in the U.S. has been a topic of concern in recent years, especially after protesters stormed the U.S. Capitol on Jan. 6, 2021, in an attempt to block the certification of Joe Biden's election as president. Most of the academic studies on democratic backsliding, however, have focused on public opinion within the U.S. and have not looked at global public opinion.

How favorably others view the U.S. is part of the country's "soft power"—a term coined by Joseph Nye at Harvard University in the 1980s. It refers to a country's ability to influence other countries’ policy decisions toward them through attraction rather than coercion. According to Nye, one of a country's soft power resources is democracy, so how others view U.S. democracy may affect how willing they are to cooperate with the U.S. on foreign policy.

A team of researchers from Dartmouth, the Australian National University, and Florida State University set out to examine how democratic backsliding in the U.S. may affect people's views toward the U.S. Through a series of survey experiments conducted in 2023 and 2024—all before Donald Trump won a second term in office—they obtained data from more than 11,800 participants in 12 other democracies throughout North America, Europe, Asia, and Oceania. The findings are published in PNAS Nexus.

In the spring of 2023, participants in Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway, Sweden, and the United Kingdom evaluated how unfavorably or favorably they viewed the U.S. on a four-point scale. Half of the respondents received an overview of a hypothetical report on how democracy is declining in the U.S. before they were asked to rate how favorably they viewed the U.S. while the other half received no information beforehand. While the summary of the report mentioned the Jan. 6 attack at the U.S. Capitol without mentioning Trump by name, the report also included other concerns about U.S. democratic backsliding, such as new laws that could make it harder for some groups of people to vote. 

The researchers intentionally designed this hypothetical report to evaluate how information about democratic backsliding affects people's attitudes, independent of who the president is. In other words, their goal was to understand how people respond to negative views of U.S. democracy, not those of a particular president.

The second and third surveys were administered in New Zealand in July 2023 and in Japan, India, and South Korea in February 2024. The research team selected the four countries because they are key U.S. partners in the Indo-Pacific. In these studies, respondents in the "treatment" group received either the democratic backsliding information, the same as the report used in the first study, or a summary of a hypothetical report on how the U.S. economy is declining. Respondents in the control group received neither. All participants were then asked to evaluate their favorability toward the U.S. In addition, they also answered questions about their policy preferences toward the U.S.

Across all three surveys, the results showed that respondents who received the information about the democratic backsliding report had a less favorable view of the U.S.

Yet, contrary to the research team's expectations, democratic backsliding did not reduce public support for cooperation policies with the U.S., a stark contradiction to Nye's theory of soft power.

"Our findings demonstrate that when it comes to international public opinion, a country's attractiveness does not necessarily change people's policy preferences," says co-author Yusaku Horiuchi, a professor of government and the Mitsui Professor of Japanese Studies at Dartmouth. "If the study, however, were to be repeated now under President Trump's second term, it would be interesting to see if the results may be any different." 

However, the co-authors add that in the current context, it would be especially difficult to distinguish between how global public opinion has changed due to U.S. democratic backsliding or the Trump administration’s policies. "Our study is unique because we show the effects of changes in American democracy before the leadership change," says Horiuchi. 

The results also showed that participants' favorability toward the U.S. was not reduced when they received hypothetical information reporting on the U.S. economy's declining performance. This finding demonstrates that an economic downturn does not influence global public opinion while U.S. democratic decline does. 

"Understanding how citizens of democracies view each other—or in this case view the U.S.—holds relevance for the future of U.S. foreign policy," says co-author Kathleen Powers, an associate professor of government and faculty coordinator for the War & Peace Fellows Program at the Dickey Center for International Understanding. "We did not find evidence that democratic backsliding reduced support for international cooperation, but the declining image of the U.S. could be an early indicator of whether there will be sustained support."

Horiuchi's long-time collaborators Benjamin Goldsmith at the Australia National University and Kelly Matush, a former post-doctoral fellow at the Dickey Center now at Florida State University, also contributed equally to the study.

The researchers have other studies underway examining democratic solidarity—whether democracies support another democracy in conflict—and how foreign policy opinion shifts when major political change occurs within a country.

Horiuchi is available for comment at: Yusaku.Horiuchi@dartmouth.edu.

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U$ Political beliefs affect patients’ trust in doctors, study finds


After the pandemic, patients on the left trusted their doctors more than those on the right



University of Oregon





Democrats are more likely to trust their personal doctors and follow their doctors’ advice than Republicans, new research from the University of Oregon finds.

UO political scientist and 2024 Andrew Carnegie Fellow Neil O’Brian co-authored the paper with independent researcher Thomas Bradley Kent. It recently appeared in the British Journal of Political Science.

The findings have implications for personal and public health, as well as the practice of medicine in the United States.

Patients who trust their doctors are more likely to follow their doctor’s guidance on everything from managing diabetes to getting regular colon screenings, which improves health, various studies have shown.

“The big takeaway from our research is that after the COVID-19 pandemic, not only are the left and right divided on COVID-19 health matters, they're also divided on trust in their own doctor and following their doctor’s advice about their health conditions,” O’Brian said. “This broader polarization about trust in medicine has trickled down to trust in your personal doctor to treat, in some cases, your chronic illnesses.”

That’s alarming because life expectancy has stagnated in the United States and declined in the early 2020s, O’Brian said.

Between 2001 and 2019, scholars also identified a growing gap in death rates between people living in Republican and Democratic-leaning counties. Residents of Democratic counties were living longer.  

“If people don’t trust medical institutions or health professionals, then it makes it harder to solve health problems and could potentially exacerbate them,” O’Brian said.

Historically, politics has influenced health policy debates on topics like reproductive rights or government-sponsored health insurance. But the doctor-patient relationship stayed above the political fray, according to the survey data. Trust in one’s doctor was bipartisan. Republicans had just as much trust in their personal doctors as Democrats.

When the COVID-19 pandemic emerged in 2020, O’Brian saw people take sides along party lines on public health measures like vaccines and masking. He wondered if the division also affected people’s trust in their own doctors and their willingness to follow their doctors’ recommendations on a range of health conditions. So he began to investigate.

O’Brian and Kent examined cross-sectional data, a survey of a slice of the U.S. electorate at various points in time. They found that Republicans and Democrats shared a trust in their doctors until 2020, when Democrats began to show more trust in their doctors than Republicans.

The researchers then sought to better understand why people’s attitudes had shifted.

To test the role the pandemic may have played in shifting attitudes, the researchers simulated the divisiveness of the pandemic in an experiment involving 1,150 survey participants.

They randomly showed a group of respondents a New York Post headline charging that Dr. Anthony Fauci, the head of the National Institute of Allergy and Infectious Diseases, was a Democrat. Then they asked the respondents about their trust in their personal doctor.

The group that saw the headline was more polarized along party lines, with Democrats reporting more trust and Republicans reporting less trust, compared to the control group that didn’t see the headline.

Surveys of public trust in major institutions like the press, business and labor unions identified a division along party lines in the 2010s. One exception was medicine, but in 2020 a similar partisan divide also emerged in that institution, O’Brian said.

“We argue that the partisan divide in trust in personal doctors was a response to COVID-19, a COVID spillover effect,” O’Brian said.

Next, the researchers investigated how much a doctor’s political affiliation mattered to patients. It turned out to carry a lot of weight.

In their first experiment, the researchers created two fictitious profiles of dermatologists and randomly varied different attributes, such as race, gender, school attended, online ratings and political affiliation. Asked which dermatologist they were more likely to visit, both Republican and Democratic respondents preferred a doctor who shared their political beliefs.

In the second experiment, the researchers observed how 777 study participants responded when they saw doctors’ profiles in Zocdoc.com, a directory of doctors, or profiles in conservativeprofessionals.com, a directory of conservative professionals, including doctors. Conservative respondents who saw conservativeprofessionals.com were more likely to seek health care from that website compared to those who saw Zocdoc.com

O’Brian’s future research will explore the factors that inspire patients’ trust in their doctors. He also will investigate what the trust gap in doctors means for health outcomes and if the data show different health outcomes for Republicans and Democrats.

Last May, O’Brian, an assistant professor of political science in the UO’s College of Arts and Sciences,  was honored as a 2024 Andrew Carnegie Fellow. The fellowship’s $200,000 grant will help fund his future research on trust in doctors.

— By Sherri Buri McDonald, University Communications

his work was supported by faculty research funds from the University of Oregon.