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2022年のG7ドイツサミットでは、石炭火力を単独にして最大の地球温暖化の原因であると共同宣言で述べている。 G7の中で唯一脱石炭を表明していない日本が、石炭火力存続の切り札にしているのがアンモニアとの混焼だ。 アンモニアは燃やしてもCO2を出さないため、石炭に混ぜて燃やせばCO2を削減できる。 そしてアンモニアを100％（専焼）にすれば、CO2を一切出さないゼロエミッション火力となる。 理論上はそうなるが、これにはいくつかの課題がある。 日本が2050年のカーボンニュートラルを達成するためには、こうした課題を克服していかなければならない。

UN Secretary-General Guterres said “Phasing out coal from the electricity sector is the single most important step to get in line with the 1.5 degree goal.” At the COP 26, the world was divided into the coal phase-out countries and the phase-down countries. On the other hand, Japan adopts “fade-out” policy and maintains “highly efficient” coal power. In addition, the government of Japan promotes ammonia as carbon-free fuel and tries to make a switch from coal. This material explores challenges and difficulties behind the coal-ammonia co-firing policy.

Hydrogen is a potentially transformative multi-functional fuel that could help many countries achieve ambitious decarbonisation targets. High concentrations of heavy industries and rising transport emissions make hydrogen’s potential particularly enticing in Asia. However, hydrogen’s widespread deployment requires assessing multiple dimensions of its feasibility. This paper analyses the environmental, economic and geopolitical feasibility of making hydrogen mainstream in Asia. That analysis suggests that relevant policies in Asia need to prioritise green hydrogen over blue and grey hydrogen; create financial incentives that facilitate transitions from grey and blue to green hydrogen; and commit to infrastructure that eases the import and export of fuels, raw materials and related technologies. A regional cooperative framework that is led by Japan and places a mutually beneficial co-innovation process at its core could also help make the hydrogen economy a reality in Asia.

Objective We investigated a novel diagnostic scoring system to differentiate Legionella pneumophila pneumonia from Streptococcus pneumoniae pneumonia. Methods We retrospectively reviewed the clinical data of 62 patients with L. pneumophila pneumonia (L-group) and 70 patients with S. pneumoniae pneumonia (S-group). Results The serum sodium (Na) levels tended to be lower according to the severity [age, dehydration, respiratory failure, orientation disturbance, low blood pressure (A-DROP)] score in the L-group. On a multivariate analysis, we found that four factors were independent predictive markers for inclusion in the L-group: relative bradycardia [hazard ratio (HR) 5.177, 95% confidence interval (CI): 1.072-24.993, p=0.041], lactate dehydrogenase (LDH) levels ≥292 IU/L (HR 6.804, 95% CI: 1.629-28.416, p=0.009), C-reactive protein (CRP) levels ≥21 mg/dL (HR 28.073, 95% CI: 5.654-139.462, p

Objective To compare the radiological and laboratory data of children and adults with Mycoplasma pneumoniae pneumonia (MPP) and to evaluate the correlation between the total affected lung area and the clinical findings. Methods We retrospectively examined the data from MPP patients who visited our hospital during the period from April 2006 to July 2014. All data were retrieved at the time of the diagnosis of MPP and were analyzed to investigate the correlation between the clinical findings and the total affected lung area using a chest X-ray scoring system. Results We identified 71 children and 54 adults with MPP. The incidence of consolidation, which was the most common chest X-ray finding in both groups, was similar (children: n = 62, 87.3%; adults: n = 45, 83.3%). In contrast, air bronchogram, bronchial thickening, and atelectasis were observed significantly more frequently among children than among adults. In both groups, a chest X-ray scoring system revealed a zonal predominance of the affected area (middle-to-lower lung fields). The body temperature and serum data such as the C-reactive protein level, white blood cell count, and lactate dehydrogenase level were significantly higher in the child group than in the adult group. The total score did not significantly correlate with the above-mentioned inflammatory markers or the presence of hypoxemia in either group. Conclusion This study showed the first evidence of a correlation between the extent of lung abnormalities on chest X-ray (calculated as a total score) and the clinical findings, including the presence of hypoxemia, in children and adults with MPP.

A 58‐year‐old man presented with a two‐month history of facial erythema and dry cough. Physical examination revealed typical cutaneous manifestations of dermatomyositis (DM), including heliotrope rash and shawl sign. A chest X‐ray revealed a 4‐cm mass in the right middle lung. After bronchoscopy and investigation of auto‐antibodies, he was diagnosed with co‐occurring transcriptional intermediary factor 1‐gamma (TIF1‐γ) positive DM and lung adenocarcinoma. He was administered oral prednisolone for subsequent muscle weakness, but developed TIF1‐γ positive DM‐associated oropharyngeal dysphagia complicated by spontaneous oesophageal rupture and died from progression of chemoresistant lung cancer.

A 62‐year‐old healthy man presented to our hospital due to a persistent fever of up to 38°C for one week. Thoracic computed tomography showed right pleural effusion with multiple large nodules up to 7 cm in diameter composed of numerous discrete small nodules like fireworks, the so‐called “cluster” signs. Some of the large nodules had a hyper‐dense portion centrally surrounded by partially discrete small nodules, not as densely assembled, suggestive of the “galaxy” sign. The repeated acid‐fast sputum smears and both bronchial washings were all negative for Mycobacterium tuberculosis, but the acid‐fast culture of sputum taken soon after the first bronchoscopy, and pleural fluid, turned out to be positive for M. tuberculosis at six weeks after admission. The present case clearly demonstrates that the “galaxy” and “cluster” signs are red herring signs of the low rates of isolating M. tuberculosis, which should be differentiated from pulmonary sarcoidosis.

A 17‐year‐old woman was referred to our hospital due to cough on exertion and right chest pain over the previous two months, together with bloody sputum over the previous week. Chest X‐ray demonstrated a nodule measuring 3 cm in diameter in the right middle lung field. On repeated bronchoscopy, the tumour was recognized as a rapidly growing intra‐bronchial protruded tumour at the orifice of the right B8. Based on a tentative diagnosis of lung cancer, right lower lobectomy was performed. She was diagnosed with mixed squamous cell and glandular papilloma of the bronchus without smoking history and human papillomavirus infection. Solitary endobronchial papillomas are rare but should be considered a differential diagnosis for solitary lung nodule with the potential to develop into carcinoma.

A 64‐year‐old man was referred to our hospital because of persistent dyspnoea for the past 1 month. He had recurrent brain anaplastic meningioma after two operations and irradiation. He suffered from right pleural effusion in the previous few months and was diagnosed with malignant mesothelioma via pleural biopsy 1 month prior to coming to our hospital. At his first visit to our hospital, thoracic computed tomography demonstrated rapidly developed large inhomogeneously enhancing pleural thickening up to 3 cm, which surrounded the right hemithorax, together with left‐sided pleural effusion. After re‐evaluation of the pathological specimens retrieved from the local hospital, he was finally diagnosed with pleural metastasis secondary to anaplastic meningioma (WHO classification, grade 3). Generally, brain meningiomas are believed to be benign and seldom metastasize to other organs. However, the present case clearly demonstrated the unique clinical presentation of anaplastic meningioma, also known as malignant meningioma, which mimicked the pathological and radiological findings of a malignant mesothelioma.

Table S1. The exacerbation scores and their predictive values for worsening asthma. Figure S1. Relationship between oral corticosteroid usage and biomarkers. (DOCX 387 kb)