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La prise en charge standard des cancers bronchiques non à petites cellules de stade I repose actuellement sur la chirurgie. Chez les patients inopérables, la radiothérapie stéréotaxique est le traitement de référence. Cette technique non invasive s'est considérablement développée et ses excellents résultats en termes de contrôle carcinologique et de tolérance amènent à se poser la question de son indication pour les patients opérables, notamment chez les patients âgés et/ou ayant des comorbidités. Cet article détaille les données disponibles dans la littérature de la place de la radiothérapie stéréotaxique chez les patients atteints de cancer bronchique non à petites cellules de stade I opérables. Standard treatment stage of non-small cell lung cancer is currently surgery. For inoperable patients, stereotactic body radiotherapy is the reference treatment. This non-invasive technique has developed considerably and its excellent results in terms of carcinological control and tolerance raise the question of its indication for operable patients, especially for old patients and/or with comorbidities. This article reviews the available data in the literature of the place of stereotactic body radiotherapy for medically operable patients with stage I non-small cell lung cancer. [ABSTRACT FROM AUTHOR]

Abstract: The integration of wind power in power systems results in a reduction in greenhouse gas emissions. Thus, it has a positive environmental impact. However, the operation of these power systems becomes increasingly complex, owing mainly to random behaviour of the wind. In the case of island power systems, this problem is even more difficult. The traditional solution is to use diesel generators as an alternative power supply. For a wind-only power supply, an energy storage system is required. If the topography of the island makes possible the use of pumped storage hydropower plants, this is, nowadays, the most suitable energy storage system. This paper presents a novel method of Pelton turbine operation with no water flow, as a way to provide fast power injection in the case of an abrupt wind power decrease, or a wind-generator trip. This operation mode allows maximizing wind power penetration in a reliable and efficient way. This method has been validated by computer simulations, and will be tested during the commissioning of a combined wind-pumped storage power plant in an autonomous power system, on a small island. [Copyright &y& Elsevier]

• Hydro inertia is a solution for solving future frequency stability issues. • In hydro, synchronous inertia is superior to synthetic inertia for frequency control. • Var-speed enables hydro units to perform fast frequency control. • FCR is superior to the Nordic FFR for frequency control with var-speed hydropower. • RoCoF control with the Nordic FFR is strongly deteriorated with inertia increase. This paper presents a comprehensive assessment of the large-scale deployment of hydropower on the provision of frequency regulation services, when equipped with the extended flexibility solutions being developed and/or tested within the scope of the XFLEX HYDRO project. The current analysis is performed on the Iberian Peninsula (IP) power grid considering its interconnection to the Continental Europe (CE) system, since this power system zone is expected to have the most severe frequency transient behaviour in future scenarios with increased shares of variable renewable energies. For this purpose, prospective scenarios with increased shares of time variable renewable generation were identified and analysed. To assess the impacts of the hydropower flexibility solutions on frequency dynamics after a major active power loss, extensive time domain simulations were performed of the power system, including reliable reduced order dynamic models for the hydropower flexibility solutions under evaluation. This research assesses the effects of synchronous and synthetic inertia, and of the Frequency Containment Reserve (FCR) and Fast Frequency Response (FFR) services as specified in European grid codes. The main findings highlight the potential of hydropower inertia and of adopting a variable speed technology for enhancing frequency stability, while contribute to better understand the role of hydropower plants in future power systems. [ABSTRACT FROM AUTHOR]

PURPOSE: The aim of this study was to compare the presurgical and postsurgical electromyographic (EMG) activities of the lips in patients with skeletal Class III treated with combined orthognathic surgery and contrast these data with those obtained from a control group with skeletal Class I. PATIENTS AND METHODS: Ten patients with skeletal Class III underwent the registration of EMG activity before an orthognathic surgical procedure and 4 months after surgery. The results were compared with a control group of 11 healthy patients with skeletal Class I and clinical and EMG lip competence. EMG activity was recorded from the upper orbicularis oris and mentalis muscles during swallowing, lips in contact (LC), and lips apart (LA) using bipolar surface electrodes. The competence condition was assessed by determining the difference in the EMG activity of the mentalis muscle (LC-LA <=0 for lip competence). RESULTS: Patients with skeletal Class III showed greater EMG activity than the control group before and after surgery. Patients with skeletal Class III showed a significantly greater difference in LC-LA than the control group before surgery for the 2 muscles (P < .05). No significant difference was found between the skeletal Class III group after surgery and the control group for the mentalis muscle (P > .05). CONCLUSIONS: Four months after treatment with orthognathic surgery, patients with skeletal Class III and an initial muscle activity pattern of lip incompetence different from the control group (P < .05) showed EMG values compatible with lip competence. These values were similar to the control group. [ABSTRACT FROM AUTHOR]

Purpose/objective(s): Surface imaging systems are becoming a reference in radiotherapy treatments to improve patient setup. Thanks to an important database of patient positioning, a clinical retrospective evaluation of the system has been realized. For this evaluation, three relevant endpoints have been identified and analyzed: the time-saving setup, the accuracy setup, the number of additional X-Ray images performed to validate the patient setup.Materials/methods: Two groups of patients have been defined including all localizations except head & neck treatments. Patients have been all treated on the same Linac following the same positioning and imaging protocol. The first group, the reference one, includes 700 patients with a treatment positioning based on skin marks using lasers. The second group includes 250 patients with treatment positioning based on surface imaging system. In parallel, clinical data (BMI, age, localization etc.) and treatment data (immobilizing system, treatment technique etc.) have been extracted from the Hospital Information System (HIS) and Treatment Planning System (TPS) databases thanks to homemade program. Afterwards, statistical analyses have been carried out for both groups in order to correlate the clinical and technical data with the three defined endpoints.Results: Different correlations have been pointed out. First results confirm that the surface imaging system gives relevant and better set-up information for different sub-groups (breast, skinny pelvis etc.). Nevertheless, for others sub-groups, no correlation nor improvements have been observed (pelvic high BMI etc.) in comparison to laser positioning.Conclusion: Different changes in our patient positioning practices have been defined with the help of surface imaging system. For many patients, we improved our imaging workflow efficiency. For several sub-groups of patients, we still have to investigate the system and its best use. [ABSTRACT FROM AUTHOR]

According to Leventhal's Self-Regulatory Model of Illness, patients have ideas and action plans related to the management of their disease. The aim of this study is to examine whether ideas and action plans relating to hypertension change as a result of general practitioner's (GP's) discussing them during consultation, and whether these changed ideas and actions plans affect adherence. The study employed an experimental design, highlighting three conditions: (0) care-as-usual consultation; (1) discussing patient's ideas about their disorder; and (2) discussing patient's action plans. Ten GP-trainees performed care-as-usual consultations, were subsequently assigned to a training in either Condition 1 or 2, and performed the trained conversations. Hundred and eight patients with hypertension were consecutively assigned to the conditions, and completed questionnaires a week before, immediately after the consultation, and 1 month later. The training resulted in two new, feasible and different types of conversations that managed to affect some of the patient's ideas and action plans. It is concluded that the study provided GPs with a tool to discuss illness representations and actions plan of patients with hypertension. Implications for the management of hypertension adherence in primary care are discussed. [ABSTRACT FROM AUTHOR]