Clinical implementation of a Monte Carlo based treatment plan QA platform for validation of Cyberknife and Tomotherapy treatments.

PURPOSE: The main focus of the current paper is the clinical implementation of a Monte Carlo based platform for treatment plan validation for Tomotherapy and Cyberknife, without adding additional tasks to the dosimetry department. METHODS: The Monte Carlo platform consists of C++ classes for the actual functionality and a web based GUI that allows accessing the system using a web browser. Calculations are based on BEAMnrc/DOSXYZnrc and/or GATE and are performed automatically after exporting the dicom data from the treatment planning system. For Cyberknife treatments of moving targets, the log files saved during the treatment (position of robot, internal fiducials and external markers) can be used in combination with the 4D planning CT to reconstruct the actually delivered dose. The Monte Carlo platform is also used for calculation on MRI images, using pseudo-CT conversion. RESULTS: For Tomotherapy treatments we obtain an excellent agreement (within 2%) for almost all cases. However, we have been able to detect a problem regarding the CT Hounsfield units definition of the Toshiba Large Bore CT when using a large reconstruction diameter. For Cyberknife treatments we obtain an excellent agreement with the Monte Carlo algorithm of the treatment planning system. For some extreme cases, when treating small lung lesions in low density lung tissue, small differences are obtained due to the different cut-off energy of the secondary electrons. CONCLUSIONS: A Monte Carlo based treatment plan validation tool has successfully been implemented in clinical routine and is used to systematically validate all Cyberknife and Tomotherapy plans.

Hierarchical TiO2 photoanode for dye-sensitized solar cells.

Hierarchical or one-dimensional architectures are among the most exciting developments in material science these recent years. We present a nanostructured TiO(2) assembly combining these two concepts and resembling a forest composed of individual, high aspect-ratio, treelike nanostructures. We propose to use these structures for the photoanode in dye-sensitized solar cells, and we achieved 4.9% conversion efficiency in combination with C101 dye. We demonstrate this morphology beneficial to hamper the electron recombination and also mass transport control in the mesopores when solvent-free ionic liquid electrolyte is used.

[Relevance of a driving simulator in the assessment of handicapped individuals]. / Intérêt du simulateur de conduite pour la reprise de la conduite automobile en situation de handicap.

AIMS: To evaluate the value of our driving simulator in deciding whether or not to allow patients with physical and/or cognitive deficits to resuming driving and to analyze whether or not the medical expert's final decision is based more on the results of the driving simulator than those of the neuropsychological examination. METHODS: One hundred and twenty-three patients were evaluated with the driving simulator. Thirty-five of those with cognitive deficits also underwent a neuropsychological examination prior to the medical expert's decision on driving aptitude. In cases of uncertainty or disagreement, a driving assessment in real conditions was performed by a driving instructor. RESULTS: In cases of physical handicap, the medical expert's decision concurred with that of the occupational therapist. For brain-injured patients, there was a significant correlation between the neuropsychologist's opinion and that of the occupational therapist (kappa=0.33; P=0.01). However, the sensibility and specificity were only 55 and 80%, respectively. The correlation between an occupational therapy decision based on the driving simulator and that of the medical expert was very significant (kappa=0.81; P<0.0001) and the sensibility and specificity were 84 and 100%, respectively. In contrast, these values were lower (63 and 71%, respectively) for the correlation between the neuropsychologist's opinion and that of the medical expert. CONCLUSION: Our driving simulator enables the danger-free evaluation of driving aptitude. The results mirror an in situ assessment and are more sensitive than neuropsychological examination. In fact, the neuropsychologist's opinion often is more negative or uncertain with respect to the patient's real driving aptitude. When taking a decision on a patient's driving aptitude, the medical expert is more inclined to trust the results of the driving simulator.

Synthesis, characterization, and DFT-TDDFT computational study of a ruthenium complex containing a functionalized tetradentate ligand.

A ruthenium complex trans-[Ru(L)(NCS)2], L = 4,4' ''-di-tert-butyl-4',4' '-bis(carboxylic acid)-2,2':6',2' ':6' ',2' ''-quaterpyridine (N886), was synthesized and characterized by spectroscopic and electrochemical methods. The absorption spectrum of the N886 complex shows metal-to-ligand charge-transfer transitions in the entire visible region and quasi-reversible oxidation and reduction potentials at E(1/2) = +0.38 and -1.92 V vs ferrocene, respectively. The electronic spectra of the N886 complex were calculated by density functional theory (DFT)-time-dependent DFT, which qualitatively reproduces the experimental absorption spectra for both the protonated and deprotonated species. From the analysis of the computed optical transitions of N886, we assign its absorption bands as mixed Ru/SCN-to-quaterpyridine charge-transfer transitions, which extend from the near-IR to the UV regions. The panchromatic response of the N886 complex renders it as a suitable sensitizer for solar energy conversion applications based on titanium dioxide mesoporous electrodes. The preliminary results using the N886 complex as a sensitizer in a dye-sensitized solar cell, with an electrolyte containing 0.60 M butylmethylimidazolium iodide, 0.03 M I2, and 0.50 M tert-butylpyridine in a mixture of acetonitrile and valeronitrile (volume ratio 1:1), show 40% incident photon-to-current efficiencies, yielding under standard AM 1.5 sunlight a short-circuit photocurrent density of 11.8 +/- 0.2 mA/cm(2), an open-circuit voltage of 680 +/- 30 mV, and a fill factor of 0.73 +/- 0.03, corresponding to an overall conversion efficiency of 5.85%.

A swift dye uptake procedure for dye sensitized solar cells.

Solar cells based on swift self-assembled sensitizer bis(tetrabutylammonium)-cis-di(thiocyanato)-N,N'-bis(4-carboxylato-4'-carboxylic acid-2,2'-bipyridine)ruthenium(II) (N719) on double layers of 12 + 4 microm thick nanocrystalline TiO2 films exhibit the incident monochromatic photon-to-current conversion efficiency (IPCE) 90% and show a short circuit current density of 17 mA cm(-2), 750 mV open circuit potential and 0.72 fill factor yielding power conversion efficiencies over 9.18% under AM 1.5 sun. For the first time highest power conversion efficiencies are obtained for dye sensitized solar cells using a swift self-assembled procedure.

[Functional assessment of the hand in neurologic rehabilitation]. / Evaluation fonctionnelle de la main en réadaptation neurologique.

Functional evaluation of hand is essential in neurorehabilitation because it provides crucial information about capacities/incapacities of patients during their daily activities. Then therapists can plan realistic aims. This evaluation is usually devoted to occupational therapists, who have different tests and scales to measure the functions of hand. The movements and gestures of hands are so various and complex that no test is better than another. Here we select a few specific tests to evaluate hand functions and we present their advantages and interest in neurorehabilitation.

[Assessment of car driving skills in brain injured individuals]. / Evaluation des aptitudes à la conduite automobile chez le cérébrolésé.

Independent driving is considered as very important for a full independence and social integration of disabled people. In these patient with disabilities or handicaps, the driving skills must be carefully assessed, especially in presence of a moderate dysexecutive syndrome. A precise neurological and neuropsychological examination is usually necessary to evaluate aptitudes for driving. Standard neuropsychological tests are often limited to value the brain injury patients. At the moment, assessment on driving simulators really improves the opinion of medical experts, as they give qualitative and quantitative data on reproducible conditions. In fact, in more than 80% of cases, the tests on driving simulators allow to determine if the patient is able to drive or no, with or without a specially adapted vehicle. However, in a small percentage of cases, the evaluation of open-road driving by a driving instructor is necessary, proving that driving simulators will never take over from reality.

Engineering of efficient panchromatic sensitizers for nanocrystalline TiO(2)-based solar cells.

A new series of panchromatic ruthenium(II) sensitizers derived from carboxylated terpyridyl complexes of tris-thiocyanato Ru(II) have been developed. Black dye containing different degrees of protonation [(C(2)H(5))(3)NH][Ru(H(3)tcterpy)(NCS)(3)] 1, [(C(4)H(9))(4)N](2)[Ru(H(2)tcterpy)(NCS)(3)] 2, [(C(4)H(9))(4)N](3)[Ru(Htcterpy)(NCS)(3)] 3, and [(C(4)H(9))(4)N](4)[Ru(tcterpy)(NCS)(3)] 4 (tcterpy = 4,4',4' '-tricarboxy-2,2':6',2' '-terpyridine) have been synthesized and fully characterized by UV-vis, emission, IR, Raman, NMR, cyclic voltammetry, and X-ray diffraction studies. The crystal structure of complex 2 confirms the presence of a Ru(II)N6 central core derived from the terpyridine ligand and three N-bonded thiocyanates. Intermolecular H-bonding between carboxylates on neighboring terpyridines gives rise to 2-D H-bonded arrays. The absorption and emission maxima of the black dye show a bathochromic shift with decreasing pH and exhibit pH-dependent excited-state lifetimes. The red-shift of the emission maxima is due to better pi-acceptor properties of the acid form that lowers the energy of the CT excited state. The low-energy metal-to-ligand charge-transfer absorption band showed marked solvatochromism due to the presence of thiocyanate ligands. The Ru(II)/(III) oxidation potential of the black dye and the ligand-based reduction potential shifted cathodically with decreasing number of protons and showed more reversible character. The adsorption of complex 3 from methoxyacetonitrile solution onto transparent TiO(2) films was interpreted by a Langmuir isotherm yielding an adsorption equilibrium constant, K(ads), of (1.0 +/- 0.3) x 10(5) M(-1). The amount of dye adsorbed at monolayer saturation was (n(alpha) = 6.9 +/- 0.3) x 10(-)(8) mol/mg of TiO(2), which is around 30% less than that of the cis-di(thiocyanato)bis(2,2'-bipyridyl-4,4'-dicarboxylate)ruthenium(II) complex. The black dye, when anchored to nanocrystalline TiO(2) films achieves very efficient sensitization over the whole visible range extending into the near-IR region up to 920 nm, yielding over 80% incident photon-to-current efficiencies (IPCE). Solar cells containing the black dye were subjected to analysis by a photovoltaic calibration laboratory (NREL, U.S.A.) to determine their solar-to-electric conversion efficiency under standard AM 1.5 sunlight. A short circuit photocurrent density obtained was 20.5 mA/cm(2), and the open circuit voltage was 0.72 V corresponding to an overall conversion efficiency of 10.4%.

Efficient Lateral Electron Transport inside a Monolayer of Aromatic Amines Anchored on Nanocrystalline Metal Oxide Films.

A monolayer of a phosphonated triarylamine adsorbed on nanocrystalline TiO2, ZrO2, or Al2O3 film deposited on conducting glass displays reversible electrochemical and electrochromic behavior although the redox potential of the electroactive molecules (0.80 V vs NHE) lies in the forbidden band of the semiconducting or insulating oxides. The mechanism of charge transport was found to involve hole injection from the conducting support followed by lateral electron hopping within the monolayer. The apparent diffusion coefficient ranged from 2.8 × 10(-12) m(2) s(-1) in the neat 1-ethyl-2-methylimidazolium bis(trifluoromethylsulfonyl)imide (EtMeIm(+)Tf2N(-)) to 1.1 × 10(-11) m(2) s(-1) in acetonitrile + 2 M EtMeIm(+)Tf2N(-). A percolation threshold for electronic conductivity was found at a surface coverage corresponding to 50% of a full monolayer.

A fibrin sealant for perforated and preperforated corneal ulcers.

Fibrin sealant is used to close perforated or preperforated corneal ulcers. In addition to the usual advantages of cyanoacrylates it is degraded physiologically and provides a good support for corneal healing. Corneal grafting can be avoided when contraindicated or postponed when conditions allow. This technique has been successful in nine eyes of eight patients.

[Treatment of recurrent congenital ocular toxoplasmosis. Our initial experience with Fansidar]. / Traitement de la toxoplasmose oculaire congénitale à rechutes. Notre première expérience du Fansidar.

Congenital ocular toxoplasmosis with recurrences must be treated by Spiramycin destroys trophozoites when they escape from the true cysts. Fansidar (Pyrimethamine + Sulfadoxine) seems to have less efficacity than Pyrimethamine with Sulfadiazine.