Transformationsszenarien für das deutsche Energiesystem

Szenarien spielten und spielen eine zentrale Rolle für die Gestaltung der Energiewende. Sie beschreiben dabei auf konsistente Weise die mögliche zukünftige Entwicklung des Systems unter bestmöglicher Berücksichtigung des aktuellen Wissens bezüglich des Systems, d.h. der internen Abhängigkeiten und Wechselwirkungen der Systemkomponenten, aber auch die Abhängigkeit der Systementwicklung von äußeren Faktoren. Damit liefern Szenarien Leitplanken für zentrale technisch-strukturelle, energiepolitische, ökonomische und gesellschaftliche Weichenstellungen, die einen zielgerichteten Transformationsprozess flankieren müssen

Dose-intensified stereotactic body radiotherapy for painful vertebral metastases : a randomized phase 3 trial

Abstract: BackgroundThe purpose of this randomised study was to determine whether dose-intensified stereotactic body radiotherapy (SBRT) for painful vertebral metastases results in increased rates of pain improvement compared with conventional external beam radiotherapy (cEBRT) (control) 6 months after treatment.MethodsThis randomized, controlled phase 3 trial was conducted between November 2016 and January 2023, when it was stopped early. Patients were eligible if they were aged 18 years or older; had one or two painful, stable, or potentially unstable vertebral metastases; and had a life expectancy of 1 year or longer according to the investigator's estimates. Patients received 48.5 grays (Gy) in 10 fractions (with epidural involvement) or 40 Gy in five fractions (without epidural involvement) in the SBRT group and 30 Gy in 10 fractions or 20 Gy in five fractions in the cEBRT group, respectively. The primary end point was an improvement in the pain score at the treated site by at least 2 points (on a visual analog scale from 0 to 10 points) at 6-month follow-up. Data were analyzed on an intention-to-treat and per-protocol basis.ResultsOf 214 patients who were screened for eligibility, 63 were randomized 1:1 between SBRT (33 patients with 36 metastases) and cEBRT (30 patients with 31 metastases). The median age of all patients was 66 years, and 40 patients were men (63.5%). In the intention-to-treat analysis, the 6-month proportion of patients who had metastases with pain reduction by 2 or more points was significantly higher in the SBRT group versus the control group (69.4% vs. 41.9%, respectively; two-sided p = .02). Changes in opioid medication intake relative to baseline were nonsignificant between the groups. No differences were observed in vertebral compression fracture or adverse event rates between the groups.ConclusionsDose-intensified SBRT improved pain score more effectively than cEBRT at 6 months. In this randomized clinical trial that included 63 patients with 67 painful vertebral metastases, the proportion of those who had metastases with pain improvement at 6-month follow-up was 69% in the stereotactic body radiotherapy group versus 42% in the conventional external beam radiotherapy group: a significant difference. Changes in opioid medication intake relative to baseline between the groups were not significant, and dose-intensified stereotactic body radiotherapy was not associated with increased risks of adverse events

Achieving the Paris Climate Agreement Goals - Global and Regional 100% Renewable Energy Scenarios with Non-Energy GHG Pathways for +1.5°C and +2°C

This open access book presents detailed pathways to achieve 100% renewable energy by 2050, globally and across ten geographical regions. Based on state-of-the-art scenario modelling, it provides the vital missing link between renewable energy targets and the measures needed to achieve them. Bringing together the latest research in climate science, renewable energy technology, employment and resource impacts, the book breaks new ground by covering all the elements essential to achieving the ambitious climate mitigation targets set out in the Paris Climate Agreement. For example, sectoral implementation pathways, with special emphasis on differences between developed and developing countries and regional conditions, provide tools to implement the scenarios globally and domestically. Non-energy greenhouse gas mitigation scenarios define a sustainable pathway for land-use change and the agricultural sector. Furthermore, results of the impact of the scenarios on employment and mineral and resource requirements provide vital insight on economic and resource management implications. The book clearly demonstrates that the goals of the Paris Agreement are achievable and feasible with current technology and are beneficial in economic and employment terms. It is essential reading for anyone with responsibility for implementing renewable energy or climate targets internationally or domestically, including climate policy negotiators, policy-makers at all levels of government, businesses with renewable energy commitments, researchers and the renewable energy industry