Exploring the transition potential of renewable energy communities

Renewable energy communities are grassroots initiatives that invest in ‘clean energy’ in order to meet consumption needs and environmental goals and thereby – often unwittingly – conduce to the spread of renewables. Our aim in the present study is to explore the potential of renewable energy communities in the Netherlands, as social niches, to contribute to transitions in the energy system. To do so, we propose three proxies for measuring the transition potential of social niches, based on proxies for technological innovations derived from the literature. In addition, we reinterpret the notion of niches and the way transition occurs by arguing that niches are complex systems in which both technological and social innovations develop simultaneously and that during a transition entire niches link up with the regime. Furthermore, we make a distinction between internally and externally oriented niches based on their orientation and application focus. We use a comparative case study analysis complemented by a systematic literature and documentary review to show that these communities are already changing the Dutch energy system, by connecting to regime actors. Their further advancement depends on strengthening their links to established actors, but also on providing a favorable regulatory framework

Concurrent cisplatin, continuous infusion fluorouracil and radiotherapy followed by tailored consolidation treatment in non metastatic anal squamous cell carcinoma

BACKGROUND: To evaluate efficacy and feasibility of chemo-radiotherapy in patients with non-metastatic anal squamous-cell-cancer. METHODS: TNM staged anal squamous-cell cancer patients were treated with pelvic radiotherapy concomitant to continuous infusion fluorouracil plus cisplatin for at least 2 cycles. In T3-T4 or any T - N+ tumours or in "slow-responder" cases, 1-2 chemotherapy courses were subsequently administered. Tumour assessment was performed at baseline and 6-8 weeks after radiotherapy to evaluate response. RESULTS: 29 patients were enrolled: 4 males, 25 females; median age 57 years; baseline T1/T2/T3/T4 2/12/7/8; N involvement 17. Median dose pelvic radiotherapy was 59.4 Gy (range: 54-74). In 5 patients 2 chemotherapy courses, in 12 patients three and in 12 patients four courses were performed. At first evaluation, 27 CR (93.1%; 95% CI: 78% - 98%) and 2 SD were observed. Main grade (G) 3 toxic events were neutropenia (8%), diarrhoea (8%) and dermatitis (62%). Most frequent late events G3-G4 occurred in 14 patients: proctitis (5), dermatitis (4), bladder dysfunctions (2), sexual dysfunctions (9), lower extremity venous thromboses (2), dysuria (1), stenosis (1) and tenesmus (1). Five patients reported G1 leucopoenia. The rate of colostomy was 14%. After a median follow up of 42 months (range: 4-81), 20 patients are still alive without relapse and 3 died due to PD. The estimated 7-year DFS was 83.4% (C.I.: 68.3%-98.5%) and the estimated 7-year OS was 85.7% (C.I.: 70% - 100%). The 1-year and the estimated 7-year colostomy-free survivals were 85.9% (C.I.: 73.1% - 98.7%). CONCLUSIONS: Concurrent cisplatin plus fluorouracil and radiotherapy is associated with favourable local control rates and acute toxicity. Future investigations will be directed towards research into molecular biomarkers related to disease progression and resistance to chemo-radiotherapy and to the evaluation of new cytotoxic agents or targeted drugs, such as anti-epidermal growth factor receptor, concomitant to RT and to determining the role of intensity-modulated radiotherap

Chemo-radiation with or without mandatory split in anal carcinoma: experiences of two institutions and review of the literature

BACKGROUND: The split-course schedule of chemo-radiation for anal cancer is controversial. METHODS: Eighty-four patients with invasive anal cancer treated with definitive external beam radiotherapy (RT) with a mandatory split of 12 days (52 patients, Montreal, Canada) or without an intended split (32 patients, Zurich, Switzerland) were reviewed. Total RT doses were 52 Gy (Montreal) or 59.4 Gy (Zurich) given concurrently with 5-FU/MMC. RESULTS: After a mean follow-up of 40 +/- 27 months, overall survival and local tumor control at 5 years were 57% and 78% (Zurich) compared to 67% and 82% (Montreal), respectively. Split duration of patients with or without local relapse was 15 +/- 7 d vs. 14 +/- 7 d (Montreal, NS) and 11 +/- 11 d vs. 5 +/- 7 d (Zurich; P or = 7 d) had impaired cancer-specific survival compared with patients with only minor interruption (<7 d) (P = 0.06). Bowel toxicity was associated with prolonged RT (P = 0.03) duration as well as increased relapse probability (P = 0.05). Skin toxicity correlated with institution and was found in 79% (Montreal) and 28% (Zurich) (P < 0.0001). CONCLUSIONS: The study design did not allow demonstrating a clear difference in efficacy between the treatment regimens with or without short mandatory split. Cause-specific outcome appears to be impaired by unplanned prolonged interruption

Treatment of hepatocellular carcinoma with major portal vein thrombosis by combined therapy with subcutaneous interferon-α and intra-arterial 5-fluorouracil; role of type 1 interferon receptor expression

We previously reported the beneficial effects of combination therapy of interferon (IFN)-α/5-fluorouracil (FU) for advanced hepatocellular carcinoma (HCC) with tumour thrombi in the major portal branches. This report describes the results of longer follow-up and includes more than double the number of patients relative to the original report, and evaluates the role of IFN-α/type 2 interferon receptor (IFNAR2) expression on the response to the combination therapy. The study subjects were 55 patients with advanced HCC and tumour thrombi in the major branches of the portal vein (Vp3 or 4). They were treated with at least two courses of IFN-α/5-FU without major complication. In the 55 patients, 24 (43.6%) showed objective response (eight (14.5%) showed complete response, 16 (29.1%) partial response), four (7.3%) showed no response, and 27 (49.1%) showed progressive disease. Immunohistochemically, IFNAR2 expression was detected in nine out of 13 (69.2%) patients. There was significant difference in the time-to-progression survival (P=0.0002) and the overall survival (P<0.0001) between IFNAR2-positive and -negative cases. There was a significant correlation between IFNAR2 expression and response to IFN-α/5-FU combination therapy in univariate analysis (P=0.0070). IFN-α/5-FU combination therapy is a promising modality for advanced HCC with tumour thrombi in the major portal branches and could significantly depend on IFNAR2 expression

Exploring the transition potential of renewable energy communities

Renewable energy communities are grassroots initiatives that invest in ‘clean energy’ in order to meet consumption needs and environmental goals and thereby – often unwittingly – conduce to the spread of renewables. Our aim in the present study is to explore the potential of renewable energy communities in the Netherlands, as social niches, to contribute to transitions in the energy system. To do so, we propose three proxies for measuring the transition potential of social niches, based on proxies for technological innovations derived from the literature. In addition, we reinterpret the notion of niches and the way transition occurs by arguing that niches are complex systems in which both technological and social innovations develop simultaneously and that during a transition entire niches link up with the regime. Furthermore, we make a distinction between internally and externally oriented niches based on their orientation and application focus. We use a comparative case study analysis complemented by a systematic literature and documentary review to show that these communities are already changing the Dutch energy system, by connecting to regime actors. Their further advancement depends on strengthening their links to established actors, but also on providing a favorable regulatory framework

"Let's do it ourselves" : Individual motivations for investing in renewables at community level

Renewable energy communities have multiplied the last years in many countries, even in contexts that the structural conditions are not favorable. The paper analyses individual motivations for partaking in local renewable projects and generating energy jointly in an investment community, in order to inform policy debates on how to support such communities. To do so, we applied a socio-psychological approach for studying renewable energy communities in Germany and the Netherlands. Our results show that mainly gain (such as decreasing energy costs) and normative (such as addressing climate change) considerations played a role in the decision, but in the background hedonic motivations were also present, such as having fun and integrating in a community. Each of the groups examined emerged in already existing strong communities, where trust was relatively high, which seems to be an important condition for the realization of local energy projects. Consequently, we argue that tailor-made incentives addressing the different types of motivations can be more effective for the support and spread of renewable energy communities

Let's do it ourselves : individual motivations for investing in renewables at community level

The paper analyses individual motivations for partaking in local renewable projects and generating energy jointly in an investment community. To do so, we applied a socio-psychological approach for studying renewable energy communities in Germany and the Netherlands. Our results show that mainly gain and normative considerations played a role in the decision, but in the background hedonic motivations were also present. Although, these considerations were driven mostly from the individual’s perspective we also found group motivations, such as strengthening the local community and improving the neighborhood’s condition. Each of the groups examined were formed in already existing strong communities, where trust was relatively high, which seems to be an important condition for the realization of local energy projects. Consequently, we argue that tailor-made incentives addressing the dominant motivations can help the most effectively the operation and spread of renewable energy communities

Percutaneous transhepatic biliary drainage in malignant obstructive jaundice

Results obtained in 70 patients with neoplastic (primary or metastatic) biliary obstruction and submitted to percutaneous transhepatic biliary drainage indicate the effectiveness of the technique in relieving jaundice, improving general conditions and restoring liver function. In 25.4% of cases, the drainage allowed the patients to undergo surgical treatment of the neoplasm. In 74.6%, the drainage was left in place as definitive palliation. The complication rate was very low and similar to that described in the literature. At this time it is difficult to identify prognostic factors and foresee the results of percutaneous transhepatic biliary drainage, but the procedure is always indicated in patients at high operative risk or inoperable