Adaptation Planning Research Articles

Climate Justice and Climate Adaptation in California: Indigenous Community Climate Adaptation Leadership and Opportunities for Scientific Collaboration

Abstract Climate and weather-related disasters in California illustrate the need for immediate climate change action—both mitigation to reduce impacts and adaptation to protect our communities, relatives, and the ecosystems we depend upon. Indigenous frontline communities face even greater threats from climate impacts due to historical and political legacies of environmental injustice. Climate change adaptation actions have proven challenging to implement as communities struggle to access necessary climate data at appropriate scales, identify effective strategies that address community priorities, and obtain resources to act at a whole-community level. In this paper, we present three examples of Indigenous communities in California that have used a climate justice approach to climate change adaptation. These communities are drawing upon community knowledge and expertise to address the challenges of adaptation planning and taking actions that center community priorities. The three cases address emergency preparation and response, cultural burning and fire management, and community organizing and social cohesion. Across these spheres, they illustrate the ways in which a community-based and climate justice-focused approach to adaptation can be effective in addressing current threats while also addressing the legacy of imposed, socially constructed vulnerability and environmental injustices. Because we recognize the need for multiple knowledges and skills in adaptation actions, we include recommendations that have emerged based on what has been learned through these long-standing and engaged participatory research collaborations for climate scientists who wish to contribute to climate justice-focused adaptation efforts by using scientific data to support—not supplant—community efforts, target funding toward genuine community engagement and adaptation actions, and become aware of the historical and political legacies that created the climate vulnerabilities and injustices evident today.

Exploring Summer Variations of Driving Factors Affecting Land Use Zoning Based on the Surface Urban Heat Island in Chiang Mai, Thailand

Numerous studies have examined land surface temperature (LST) changes in Thailand using remote sensing, but there has been little research on LST variations within urban land use zones. This study addressed this gap by analyzing summer LST changes in land use zoning (LUZ) blocks in the 2012 Chiang Mai Comprehensive Plan and their relationship with surface biophysical parameters (NDVI, NDBI, MNDWI). The approach integrated detailed zoning data with remote sensing for granular LST analysis. Correlation and stepwise regression analyses (SRA) revealed that NDBI significantly impacted LST in most block types, while NDVI and MNDWI also influenced LST, particularly in 2023. The findings demonstrated the complexity of LST dynamics across various LUZs in Chiang Mai, with SRA results explaining 45.7% to 53.2% of summer LST variations over three years. To enhance the urban environment, adaptive planning strategies for different block categories were developed and will be considered in the upcoming revision of the Chiang Mai Comprehensive Plan. This research offers a new method to monitor the urban heat island phenomenon at the block level, providing valuable insights for adaptive urban planning.

Farmers' intention to adopt low-carbon agricultural technologies to mitigate climate change

Climate change is one of the main crises in the world primarily due to greenhouse gas emissions. The agricultural sector is a key factor in reducing greenhouse gas emissions. Therefore, this study aims to analyze farmers' intentions to use low-carbon agricultural technologies. Based on a theoretical framework adapted from the comprehensive action determination model, data were collected through questionnaires distributed among 373 farmers in the southern region of West Azarbaijan province, Iran. Factors influencing farmers' intentions were identified using a structural equation model. The results indicated that attitude (β = 0.532), habits (β = 0.282), and objective constraints (β = 0.105) significantly influenced farmers’ intentions to adopt low-carbon agricultural technologies. The model predicted 68.4% of the variance in farmers' intentions. All predictors in the comprehensive action determination model demonstrated robustness and significant positive relationships, except for subjective constraints. Additionally, the model effectively explained normative processes, habitual processes, situational influences, and intentional processes among farmers. This research suggests policy solutions to promote the adoption of low-carbon agricultural technologies by farmers in response to climate change, thereby fostering sustainable agriculture in the region. When developing future plans for climate change adaptation, planners should use the comprehensive action determination model as a fundamental guideline. This model is essential for both mitigating climate change and enhancing behavioral intentions, which are critical objectives.

Role of Surface Energy Fluxes in Urban Overheating Under Buoyancy‐Driven Atmospheric Conditions

AbstractUrbanization alters land surface properties in absorbing, reflecting and emitting radiation as well as infiltrating, evaporating and storing water. This consequently modifies surface energy and water fluxes and, thus, urban climates. Weak synoptic flow, clear sky conditions and higher surface temperatures in cities compared to their rural surroundings create a buoyancy‐driven atmospheric circulation, in which surface energy fluxes become the main determinants of urban daytime overheating. Here, we demonstrate the role of surface energy fluxes for warming and cooling processes in the urban canopy layer under buoyancy‐driven atmospheric conditions. We improve and apply an integrated CFD‐GIS modeling approach to provide a detailed analysis of fine‐scale land‐atmosphere interactions and assess the surfaces' profound implications on energy and water exchange. We show that variations in the ratios of the surface energy fluxes to the net radiation can be separated from meteorological conditions (wind speed, air temperature and incoming solar radiation) and emissivity values, varying explicitly with changes in land surface type and water availability for vegetated areas. Based on the energy flux ratios, we introduce an approach to assess the surface‐induced warming and cooling effect and its contribution to urban overheating in the urban canopy layer, under buoyancy‐driven atmospheric conditions, directly applicable to strategic urban planning for climate change adaptation. Independent of meteorological conditions, this approach can be used to evaluate different surface materials (both natural and artificial) and climate adaptation measures, such as urban nature‐based solutions and blue‐green infrastructures, and to monitor changes in the energy and water balance.

Impact of Asian aerosols on the summer monsoon strongly modulated by regional precipitation biases

Abstract. Reliable attribution of Asian summer monsoon variations to aerosol forcing is critical to reducing uncertainties in future projections of regional water availability, which is of utmost importance for risk management and adaptation planning in this densely populated region. Yet, simulating the monsoon remains a challenge for climate models that suffer from long-standing biases, undermining their reliability in attributing anthropogenically forced changes. We analyze a suite of climate model experiments to identify a link between model biases and monsoon responses to Asian aerosols and associated physical mechanisms, including the role of large-scale circulation changes. The aerosol impact on monsoon precipitation and circulation is strongly influenced by a model's ability to simulate the spatio-temporal variability in the climatological monsoon winds, clouds, and precipitation across Asia, which modulates the magnitude and efficacy of aerosol–cloud–precipitation interactions, an important component of the total aerosol response. There is a strong interplay between South Asia and East Asia monsoon precipitation biases and their relative predominance in driving the overall monsoon response. We found a striking contrast between the early- and late-summer aerosol-driven changes ascribable to opposite signs and seasonal evolution of the biases in the two regions. A realistic simulation of the evolution of the large-scale atmospheric circulation is crucial to realize the full extent of the aerosol impact over Asia. These findings provide important implications for better understanding and constraining the diversity and inconsistencies of model responses to aerosol changes over Asia in historical simulations and future projections.

The climate change adaptation readiness of co‐operative housing in Nova Scotia, Canada

AbstractClimate adaptation policy in Canada is emerging in the context of another major challenge: the diminishing availability of affordable housing. Housing is a well‐known driver of social vulnerability to environmental risks, so as governments respond to these challenges, it will be essential to understand how housing is being situated within adaptation, particularly with respect to differences in housing tenure and how decisions around equity and social vulnerability are factored into planning and policy processes. This research examines how adaptation plans and policies in Nova Scotia are addressing the needs of the non‐profit co‐operative housing sector and assesses the adaptation readiness of housing co‐operatives in the province. Two methods are employed: a systematic content analysis of municipal and provincial climate policy documents, and interviews with key informants across the co‐operative housing sector and government agencies. Using a modified adaptation readiness framework, we consider the potential for co‐operative adaptation and complimentary public policy to address vulnerability at the intersection of housing and climate change. Findings indicate that non‐market forms of tenure have been largely neglected by adaptation planners and state policymakers. Several barriers which contribute to a low level of adaptation readiness for co‐ops are highlighted, notably a lack of usable science and funding to facilitate adaptation. Characteristics such as affordability and a propensity for collective action position housing co‐ops to be agents of equitable and systemic adaptation, but this potential will only be realized in Canada if key barriers are overcome through targeted governmental rt for non‐profit housing organizations.

Intrafraction organ movement in adaptive MR-guided radiotherapy of abdominal lesions – dosimetric impact and how to detect its extent in advance

IntroductionMagnetic resonance guided radiotherapy (MRgRT) allows daily adaptation of treatment plans to compensate for positional changes of target volumes and organs at risk (OARs). However, current adaptation times are relatively long and organ movement occurring during the adaptation process might offset the benefit gained by adaptation. The aim of this study was to evaluate the dosimetric impact of these intrafractional changes. Additionally, a method to predict the extent of organ movement before the first treatment was evaluated in order to have the possibility to compensate for them, for example by adding additional margins to OARs.Materials & methodsTwenty patients receiving adaptive MRgRT for treatment of abdominal lesions were retrospectively analyzed. Magnetic resonance (MR) images acquired at the start of adaptation and immediately before irradiation were used to calculate adapted and pre-irradiation dose in OARs directly next to the planning target volume. The extent of organ movement was determined on MR images acquired during simulation sessions and adaptive treatments, and their agreement was evaluated. Correlation between the magnitude of organ movement during simulation and the duration of simulation session was analyzed in order to assess whether organ movement might be relevant even if the adaptation process could be accelerated in the future.ResultsA significant increase in dose constraint violations was observed from adapted (6.9%) to pre-irradiation (30.2%) dose distributions. Overall, OAR dose increased significantly by 4.3% due to intrafractional organ movement. Median changes in organ position of 7.5 mm (range 1.5–10.5 mm) were detected within a median time of 17.1 min (range 1.6–28.7 min). Good agreement was found between the range of organ movement during simulation and adaptation (66.8%), especially if simulation sessions were longer and multiple MR images were acquired. No correlation was determined between duration of simulation sessions and magnitude of organ movement.ConclusionIntrafractional organ movement can impact dose distributions and lead to violations of OAR tolerance doses, which impairs the benefit of daily on-table plan adaptation. By application of simulation images, the extent of intrafractional organ movement can be predicted, which possibly allows to compensate for them.

A framework for physically consistent storylines of UK future mean sea level rise

We present a framework for developing storylines of UK sea level rise to aid risk communication and coastal adaptation planning. Our approach builds on the UK national climate projections (UKCP18) and maintains the same physically consistent methods that preserve component correlations and traceability between global mean sea level (GMSL) and local relative sea level (RSL). Five example storylines are presented that represent singular trajectories of future sea level rise drawn from the underlying large Monte Carlo simulations. The first three storylines span the total range of the Intergovernmental Panel on Climate Change (IPCC) Sixth Assessment Report (AR6) likely range GMSL projections across the SSP1-2.6 and SSP5-8.5 scenarios. The final two storylines are based upon recent high-end storylines of GMSL presented in AR6 and the recent literature. Our results suggest that even the most optimistic sea level rise outcomes for the UK will require adaptation of up to 1 m of sea level rise for large sections of coastline by 2300. For the storyline most consistent with current international greenhouse gas emissions pledges and a moderate sea level rise response, UK capital cities will experience between about 1 and 2 m of sea level rise by 2300, with continued rise beyond 2300. The storyline based on the upper end of the AR6 likely range sea level projections yields much larger values for UK capital cities that range between about 3 and 4 m at 2300. The two high-end scenarios, which are based on a recent study that showed accelerated sea level rise associated with ice sheet instability feedbacks, lead to sea level rise for UK capital cities at 2300 that range between about 8 m and 17 m. These magnitudes of rise would pose enormous challenges for UK coastal communities and are likely to be beyond the limits of adaptation at some locations.

Climate Change Adaptation in Ecuador: Analysis of the Regulatory Framework and its Alignment with International Standards

INTRODUCTION. Climate change poses one of the most critical challenges of the 21st century, impacting all sectors of society. OBJECTIVE. To characterize Ecuador's political, normative, and regulatory framework for climate change adaptation in accordance with international standards. METHOD. A review of relevant secondary and documentary sources was conducted at international, regional, and national levels. This process involved examining secondary literature, identifying current regulatory frameworks, and synthesizing the theoretical framework across these levels. RESULTS. Ecuador has ratified the Paris Agreement and adopted the 2030 Agenda, integrating climate adaptation into national policies such as the National Climate Change Strategy (ENCC) and the National Adaptation Plan (PNA). Challenges include limited financial resources, accurate climate information, and inter-institutional coordination. DISCUSSION AND CONCLUSIONS. The review underscores the necessity of embedding adaptation measures into national policies to enhance the country's resilience, ensuring alignment with international commitments. Normative coherence from local to global scales is crucial for effective climate change adaptation.

Coastal Adaptation Pathways and Tipping Points for Typical Mediterranean Beaches under Future Scenarios

Coastal zones experience increasing climatic and human pressures, which lead to growing risks and tipping points (TPs) under future scenarios and natural resource scarcity. To avoid crossing TPs with irreversible coastal losses, this paper proposes the development of adaptation pathways based on advanced coastal oceanography and engineering knowledge that enables a comprehensive assessment of evolving coastal risks. These pathways feature sequential interventions steered by simulations and observations as a function of available coastal resources (mainly space and sediment) and risks for infrastructure and socioeconomic assets. Such an adaptation has been developed for urban and peri-urban Mediterranean beaches, considering conventional coastal engineering together with nature-based solutions (NbS). Both types of interventions are assessed in terms of key physical variables, which serve to evaluate performance and estimate TPs. This analysis supports the new coastal protection and management plan promoted by the regional government of Catalonia and the coastal adaptation plan of the central government of Spain. The approach and results illustrate the potential of adaptation pathways for beach sustainability, enhancing the compatibility between short-/long-term coastal protection objectives under present/future climate and management scenarios. The development of adaptation pathways underpins increasing stakeholder cooperation to achieve shared decisions for coastal sustainability.

Global exposure to climate change at a subnational jurisdiction level

In the context of climate change, there is a need to identify the most vulnerable "hotspots" to the various risks that should attract the most attention from analysts and decision-makers. In this paper, we focus on territories’ exposure to the main consequences of climate change, considering both intensity and the level of physical exposure to main climate change hazards. We propose a composite indicator that can be computed globally but at the sub-national level, covering 47,138 administrative units in the World (all land but Antarctica). It should be helpful as a first step to assess risks for countries characterized by high geoclimatic diversity but also transboundary risks. It would help identify the most vulnerable subnational administrative units and serve as one tool for adaptation planning.

Nexus between Indigenous Knowledge Systems and Adaptation to Climate Change Strategies by Farmers in Kajiado County, Kenya

Indigenous knowledge (IK) has played an important role in adaptation to climate change in traditional agricultural communities. These approaches have been shown to be more effective when integrated with scientifically developed strategies. In this study, a perception survey questionnaire was used to find out whether there is a nexus between IK systems and the uptake of modern Climate Change Adaptation Strategies (CCAS) among farmers in Kajiado County, Kenya. A mixed research approach that involved the use of household questionnaire surveys, key informant interviews, focus group discussions (FGD), and observations was used to obtain data. The two theories, namely the Situated Learning Theory (SLT) and the Theory of Planned Behavior (TPB), formed the basis for illustrating the relationship between variables, while the Model of Private Proactive Adaptation to Climate Change (MPPACC) was the key theoretical model employed. A total of 382 small-scale rural household representatives randomly selected from 3 Kajiado sub-counties were the principal respondents. The key informants included officers in the departments of agriculture, environment, meteorology, trade, and industry, as well as local administration and village elders. Statistical tools such as chi-square, correlation, and binary logistic regression analysis were used to determine associations. Thematic analysis of data collected from key informants and focus group discussions (FGD) was conducted to triangulate the survey results. Farmers' awareness of climate change, risk perceptions of impacts, existing locally developed approaches to climate change adaptation, and perceptions of CCAS were the main areas of investigation. The majority of farmers (85%) indicated that prolonged drought was the main extreme event that affected their farming activities. Of the indicators observed, drought (X2 = 13.861, p =.000) was perceived as the greatest risk associated with climate change to their agricultural productivity. Their IK adaptation strategies resulted from their interactions with the effects of drought on their livelihoods over the years. Farmers who were nomadic (IK practitioners) were not willing to apply for CCAS. For example, they were 72% less likely to increase their irrigated cropped area and 79% less likely to increase the number of better livestock breeds. Among the CCAS approaches, water resource management was the only preferred strategy. This particular finding shows that climate change policies can be easily adopted by indigenous farming communities if they are developed around an issue that matches their socio-ecological priorities. Without taking into account the prevailing social, cultural, and geo-environmental context of specific communities, the adoption of CCAS by farmers would be significantly affected. The study recommends that integrating indigenous agricultural knowledge into climate change adaptation policies enhances community resilience. Aligning adaptation strategies with local responses enriches farmer knowledge and boosts resilience against climate change impacts. Effective climate change adaptation plans should incorporate local weather prediction, environmental conservation, and proven community-based strategies, especially in water resource management for arid and semi-arid pastoralist communities.

Forecasting urban temperatures through crowdsourced data from Citizen Weather Stations

This work explores the potential of using crowdsourced data from Citizen Weather Stations (CWS) to forecast urban temperatures. Five case studies were selected (Madrid, London, Rome, Paris and Berlin), using data from the manufacturer Netatmo to gather the hourly temperatures of the years 2021 and 2022 for 776 CWS. A quality-control process was implemented to enhance data accuracy, and heat maps were generated. Multiple linear regression models were created for each CWS and month using only reference weather data as input, resulting in the development of accurate models (RMSE lower than 1.5 °C) for an average of 374 CWS. Then, reference weather predictions were used on the 2nd of April 2023 to forecast the hourly temperatures of those CWS for the period from the 3rd to the 9th of April (168 h). The outcomes showed that accurate CWS data and precise prediction models for the reference weather are crucial to improve the accuracy of the forecasts using crowdsourced data. The study demonstrates the potential benefits of using CWS data and simple models to forecast urban temperatures in a cost-efficient way even 168 h ahead, with implications for various sectors such as urban planning, energy consumptions, health impacts, or climate change adaptation strategies.

The association between climate variables and tuberculosis in Kolaka District, Southeast Sulawesi Province, Indonesia, 2013-2020: a Bayesian autoregressive model.

Tuberculosis is one of the diseases that requires comprehensive treatment. This disease is highly contagious and can be transmitted through the air. Climate factors play a role in the increasing cases of tuberculosis. This study aimed to determine the correlation between climatic variables and TB in Kolaka District, Southeast Sulawesi Province, Indonesia. This research was modeled using an autoregressive (AR) Bayesian model with three possible likelihoods; Gaussian, Poisson and Negative Binomial responses. Minimum temperature and average temperature, a coefficient of 4.234 suggests that for every 1 degree increase in minimum temperature, there is an estimated increase of approximately four cases, assuming other variables remain constant. Maximum temperature, a coefficient of 17.851 suggests that for every 1 degree increase in maximum temperature, there is an estimated increase of around 17-18 cases, assuming other variables remain constant. Humidity, a coefficient of -13.413 suggests that for every 1% increase in humidity, there is an estimated decrease of around 13 cases, assuming other variables remain constant. Rainfall, a coefficient of -0.327 suggests that for every 1 mm increase in rainfall, there is an estimated decrease of around 0.327 cases, assuming other variables remain constant. Light, a coefficient of -4.322 suggests that for every 1-hour increase in light duration, there is an estimated decrease of around four cases, assuming other variables remain constant. Climate change has a significant impact on tuberculosis through temperature-related factors. These factors influence the prevalence, spread, and vulnerability to TB. Addressing these challenges requires a holistic approach involving adaptation planning. Strong public health systems and healthcare infrastructure can help mitigate the risks and impacts of climate change-related tuberculosis.

Unequal considerations of justice in municipal adaptation planning: an assessment of US climate plans over time and by context

ABSTRACT Climate adaptation planning is increasingly approached locally through a social justice lens to ensure the needs of the most vulnerable are addressed. This study aims to identify trends in how recognitional, distributional, and procedural justice are considered within climate adaptation plans over time and across socio-demographic contexts. We coded these forms of justice in 101 climate adaptation plans and related documents published in the United States between 2010 and 2021 and conducted a series of regressions to understand patterns over time and across contexts. Newer plans more commonly addressed each type of justice, with a marked shift in plans published after 2017. More recent plans addressed new elements of recognitional justice (e.g. historical marginalisation, racial justice), a broader scope of distributional justice approaches (e.g. more strategies related to greenspaces, food, and green jobs), and more procedural justice-related initiatives to engage marginalised residents in adaptation. Plans from more Republican-leaning communities considered recognitional and distributional justice to a lesser degree than those from more Democratic-leaning areas. Plans by larger communities were more likely to address procedural justice and include strategies for monitoring the impacts to marginalised people. Plans from communities with a larger percentage of residents living in poverty addressed distributional justice more often and acknowledged more injustices faced by marginalised groups more often. We observed no trends in the treatment of procedural justice related to racial demographics or income. We discuss potential reasons for these trends and their implications.

Widespread flooding dynamics under climate change: characterising floods using grid-based hydrological modelling and regional climate projections

Abstract. An event-based approach has been used to explore the potential effects of climate change on the spatial and temporal coherence of widespread flood events in Great Britain. Time series of daily mean river flow were generated using a gridded national-scale hydrological model (Grid-to-Grid) driven by a 12-member ensemble of regional climate projections from UK Climate Projections 2018 (UKCP18), for 30-year baseline (1980–2010) and future (2050–2080) time slices. From these, sets of widespread extreme events were extracted. The question of what defines a “widespread flood event” is discussed; here it was defined as an event exceeding an at-site 99.5th percentile (equivalent to 2 d per year) simultaneously over an area of at least 20 km2, with a maximum duration of 14 d. This resulted in a set of 14 400 widespread events: approximately 20 events per year, per ensemble member, per time slice. Overall, results have shown that events are more temporally concentrated in winter in the future time slice compared to the baseline. Distributions of event area were similar in both time slices, but the distribution of at-site return periods showed some heavier tails in the future time slice. Such information could be useful for adaptation planning and risk management for floods under climate change, but the potential future changes have to be interpreted in the context of some differences in event characteristics between the baseline climate-projection-driven model runs and an observation-driven model run. While the focus here is Great Britain, the methods and analyses described could be applied to other regions with hydrological models and climate projections of appropriate resolution.

Patterns of practice of image guided particle therapy for cranio-spinal irradiation: A site specific multi-institutional survey of European Particle Therapy Network

PurposeTo investigate the current practice patterns in image-guided particle therapy (IGPT) for cranio-spinal irradiation (CSI). MethodsA multi-institutional survey was distributed to European particle therapy centres to analyse all aspects of IGPT. Based on the survey results, a Delphi consensus analysis was developed to define minimum requirements and optimal workflow for clinical practice. The centres participating in the institutional survey were invited to join the Delphi process. ResultsEleven centres participated in the survey. Imaging for treatment planning was rather similar among the centres with Computed Tomography (CT) being the main modality. For positioning verification, 2D IGPT was more commonly used than 3D IGPT. Two centres performed routinely imaging for plan adaptation, by the rest ad hoc. Eight centres participated in the Delphi consensus analysis. The full consensus was reached on the use of CT imaging without contrast for treatment planning and the role of magnetic resonance imaging (MRI) in target and organs-at-risk delineation. There was an agreement on the necessity to perform patient position verification and correction before each isocentre. The most important outcome was the clear need for standardization and harmonization of the workflow. ConclusionThere were differences in CSI IGPT clinical practice among the European particle therapy centres. Moreover, the optimal workflow as identified by experts was not yet reached. There is a strong need for consensus guidelines. The state-of-the-art imaging technology and protocols need to be implemented into clinical practice to improve the quality of IGPT for CSI.

MU variability in CBCT-guided online adaptive radiation therapy.

CBCT-guided online-adaptive radiotherapy (oART) systems have been made possible by using artificial intelligence and automation to substantially reduce treatment planning time during on-couch adaptive sessions. Evaluating plans generated during an adaptive session presents significant challenges to the clinical team as the planning process gets compressed into a shorter window than offline planning. We identified MU variations up to 30% difference between the adaptive plan and the reference plan in several oART sessions that caused the clinical team to question the accuracy of the oART dose calculation. We investigated the cause of MU variation and the overall accuracy of the dose delivered when MU variations appear unnecessarily large. Dosimetric and adaptive plan data from 604 adaptive sessions of 19 patients undergoing CBCT-guided oART were collected. The analysis included total MU per fraction, planning target volume (PTV) and organs at risk (OAR) volumes, changes in PTV-OAR overlap, and DVH curves. Sessions with MU greater than two standard deviations from the mean were reoptimized offline, verified by an independent calculation system, and measured using a detector array. MU variations relative to the reference plan were normally distributed with a mean of -1.0% and a standard deviation of 11.0%. No significant correlation was found between MU variation and anatomic changes. Offline reoptimization did not reliably reproduce either reference or on-couch total MUs, suggesting that stochastic effects within the oART optimizer are likely causing the variations. Independent dose calculation and detector array measurements resulted in acceptable agreement with the planned dose. MU variations observed between oART plans were not caused by any errors within the oART workflow. Providers should refrain from using MU variability as a way to express their confidence in the treatment planning accuracy. Clinical decisions during on-couch adaptive sessions should rely on validated secondary dose calculations to ensure optimal plan selection.

Clinical Outcomes of Online Adaptive Magnetic Resonance-Guided Stereotactic Body Radiotherapy of Adrenal Metastases from a Single Institution.

(1) Background: Recent publications foster stereotactic body radiotherapy (SBRT) in patients with adrenal oligometastases or oligoprogression. However, local control (LC) after non-adaptive SBRT shows the potential for improvement. Online adaptive MR-guided SBRT (MRgSBRT) improves tumor coverage and organ-at-risk (OAR) sparing. Long-term results of adaptive MRgSBRT are still sparse. (2) Methods: Adaptive MRgSBRT was performed on a 0.35 T MR-Linac. LC, overall survival (OS), progression-free survival (PFS), overall response rate (ORR), and toxicity were assessed. (3) Results: 35 patients with 40 adrenal metastases were analyzed. The median gross tumor volume was 30.6 cc. The most common regimen was 10 fractions at 5 Gy. The median biologically effective dose (BED10) was 75.0 Gy. Plan adaptation was performed in 98% of all fractions. The median follow-up was 7.9 months. One local failure occurred after 16.6 months, resulting in estimated LC rates of 100% at one year and 90% at two years. ORR was 67.5%. The median OS was 22.4 months, and the median PFS was 5.1 months. No toxicity > CTCAE grade 2 occurred. (4) Conclusions: LC and ORR after adrenal adaptive MRgSBRT were excellent, even in a cohort with comparably large metastases. A BED10 of 75 Gy seems sufficient for improved LC in comparison to non-adaptive SBRT.

Beneficial effect of residential greenness on sperm quality and the role of air pollution: A multicenter population-based study

BackgroundPoor sperm quality is a major cause of male infertility. However, evidence remains scarce on how greenness affects male sperm quality. ObjectivesTo assess the associations of residential greenness with male sperm quality and the modification effect of air pollution exposure on the relationship. MethodsA total of 78,742 samples from 33,184 sperm donors from 6 regions across China during 2014–2020 were included and analyzed. Individual residential greenness exposures of study subjects were estimated using the Normalized Difference Vegetation Index (NDVI) during the entire (0–90 lag days) and two key stages (0–37, and 34–77 lag days) of sperm development. Contemporaneous personal exposure levels to air pollutants were estimated using a spatio-temporal deep learning method. Linear mixed models were employed to assess the impact of greenspace in relation to sperm quality. The modification effect of air pollution on the greenspace-sperm quality relationship was also estimated. ResultsPer IQR increment in NDVI exposure throughout spermatogenesis were statistically associated with increasing sperm count by 0.0122 (95 % CI: 0.0007, 0.0237), progressive motility by 0.0162 (95 % CI: 0.0045, 0.0280), and total motility by 0.0147 (95 % CI: 0.0014, 0.0281), respectively. Similar results were observed when the model added air pollutants (PM1, PM2.5 or O3) for adjustment. Additionally, specific air pollutants, including PM1, PM2.5, and O3, were found to modify this association. Notably, the protective effects of greenness exposure were more pronounced at higher concentrations of PM1 and PM2.5 and lower concentrations of O3 (all Pinteraction < 0.05). Statistically significant positive effects of NDVI were observed on sperm motility in early spermatogenesis and sperm count in late spermatogenesis. ConclusionsExposure to residential greenness may have beneficial effects on sperm quality and air pollution modifies their relationship. These findings highlight the importance of adopting adaptable urban greenspace planning and policies to safeguard male fertility against environmental factors.