Subpleural pulmonary nodule marking with patent blue V dye prior to surgical resection.

Background and objective: Subpleural located pulmonary nodules are perioperatively invisible to the surgeon. Their precise identification is conventionally possible by palpation, but often at the cost of performing a thoracotomy. The aim of the study was to evaluate the success rate and feasibility of the pre-operative CT-guided marking subpleural localized nodule using a mixture of Patent Blue V and an iodine contrast agent prior to the extra-anatomical video-assisted thoracoscopic surgery (VATS) resection in patients for whom the primary anatomical resection in terms of segmentectomy or lobectomy was not indicated. Methods: The data of consecutive patients with pulmonary nodules located ≤ 30 mm from the parietal pleura, who were indicated for VATS extra-anatomical resection between 2017 to 2023, were retrospectively reviewed and analyzed. All patients indicated for VATS resection underwent color marking of the area with the pulmonary lesion under CT-guided control immediately before the surgery. The primary outcome was the marking success. Morphological lesion characteristics, time from marking to the surgery, procedure related complications, final histology findings and 30day mortality were analyzed. Additionally, we assessed the association of the successful marking and the patient's smoking history. Results: A total of 62 lesions were marked. The successful marking was observed in 56/62 (90.3%) patients. The median time from the lesion marking to the beginning of surgery was 75.0 (IQR 65.0-85.0) minutes. The procedure related pneumothorax was observed in 6 (9.7%) patients, intraparenchymal hematoma in 1 (1.6%) patient. No statistically significant association of the depth of the subpleural lesion's location, occurrence of complications or time from the marking to surgery and the successful marking was observed. The 30day mortality was zero. No association of smoking and successful marking was observed. Conclusions: The method of marking the subpleural pulmonary lesions under CT-guided control with a mixture of Patent Blue V and iodine contrast agent is a safe and effective method with minimal complications. It provides surgeons the precise visualization of the affected pulmonary parenchyma before the planned extra-anatomical VATS resection.

Hippocampal subfield volumetric changes after radiotherapy for brain metastases.

Background: Changes in the hippocampus after brain metastases radiotherapy can significantly impact neurocognitive functions. Numerous studies document hippocampal atrophy correlating with the radiation dose. This study aims to elucidate volumetric changes in patients undergoing whole-brain radiotherapy (WBRT) or targeted stereotactic radiotherapy (SRT) and to explore volumetric changes in the individual subregions of the hippocampus. Method: Ten patients indicated to WBRT and 18 to SRT underwent brain magnetic resonance before radiotherapy and after 4 months. A structural T1-weighted sequence was used for volumetric analysis, and the software FreeSurfer was employed as the tool for the volumetry evaluation of 19 individual hippocampal subregions. Results: The volume of the whole hippocampus, segmented by the software, was larger than the volume outlined by the radiation oncologist. No significant differences in volume changes were observed in the right hippocampus. In the left hippocampus, the only subregion with a smaller volume after WBRT was the granular cells and molecular layers of the dentate gyrus (GC-ML-DG) region (median change -5 mm3, median volume 137 vs. 135 mm3; P = .027), the region of the presumed location of neuronal progenitors. Conclusions: Our study enriches the theory that the loss of neural stem cells is involved in cognitive decline after radiotherapy, contributes to the understanding of cognitive impairment, and advocates for the need for SRT whenever possible to preserve cognitive functions in patients undergoing brain radiotherapy.

Finite-temperature vibronic spectra from the split-operator coherence thermofield dynamics.

We present a numerically exact approach for evaluating vibrationally resolved electronic spectra at finite temperatures using the coherence thermofield dynamics. In this method, which avoids implementing an algorithm for solving the von Neumann equation for coherence, the thermal vibrational ensemble is first mapped to a pure-state wavepacket in an augmented space, and this wavepacket is then propagated by solving the standard, zero-temperature Schrödinger equation with the split-operator Fourier method. We show that the finite-temperature spectra obtained with the coherence thermofield dynamics in a Morse potential agree exactly with those computed by Boltzmann-averaging the spectra of individual vibrational levels. Because the split-operator thermofield dynamics on a full tensor-product grid is restricted to low-dimensional systems, we briefly discuss how the accessible dimensionality can be increased by various techniques developed for the zero-temperature split-operator Fourier method.

High-order geometric integrators for the local cubic variational Gaussian wavepacket dynamics.

Gaussian wavepacket dynamics has proven to be a useful semiclassical approximation for quantum simulations of high-dimensional systems with low anharmonicity. Compared to Heller's original local harmonic method, the variational Gaussian wavepacket dynamics is more accurate, but much more difficult to apply in practice because it requires evaluating the expectation values of the potential energy, gradient, and Hessian. If the variational approach is applied to the local cubic approximation of the potential, these expectation values can be evaluated analytically, but they still require the costly third derivative of the potential. To reduce the cost of the resulting local cubic variational Gaussian wavepacket dynamics, we describe efficient high-order geometric integrators, which are symplectic, time-reversible, and norm-conserving. For small time steps, they also conserve the effective energy. We demonstrate the efficiency and geometric properties of these integrators numerically on a multidimensional, nonseparable coupled Morse potential.

How to Find Molecules with Long-lasting Charge Migration?

Under certain conditions, the ionization of a molecule may create a superposition of electronic states, leading to ultrafast electron dynamics. If controlled, this motion could be used in attochemistry applications, but it has been shown that the decoherence induced by the nuclear motion typically happens in just a few femtoseconds. We recently developed an efficient algorithm for finding molecules exhibiting long-lasting electronic coherence and charge migration across the molecular structure after valence ionization. Here, we first explain why the but-3-ynal molecule is a promising candidate to study this type of ultrafast electron dynamics. Then, we use the 3-oxopropanenitrile molecule, which does not induce long-lasting charge migration in any of three different ionization scenarios, as an example demonstrating that several different properties must be fulfilled simultaneously to make the attochemistry applications possible.

High-order geometric integrators for the variational Gaussian approximation.

Among the single-trajectory Gaussian-based methods for solving the time-dependent Schrödinger equation, the variational Gaussian approximation is the most accurate one. In contrast to Heller's original thawed Gaussian approximation, it is symplectic, conserves energy exactly, and may partially account for tunneling. However, the variational method is also much more expensive. To improve its efficiency, we symmetrically compose the second-order symplectic integrator of Faou and Lubich and obtain geometric integrators that can achieve an arbitrary even order of convergence in the time step. We demonstrate that the high-order integrators can speed up convergence drastically compared to the second-order algorithm and, in contrast to the popular fourth-order Runge-Kutta method, are time-reversible and conserve the norm and the symplectic structure exactly, regardless of the time step. To show that the method is not restricted to low-dimensional systems, we perform most of the analysis on a non-separable twenty-dimensional model of coupled Morse oscillators. We also show that the variational method may capture tunneling and, in general, improves accuracy over the non-variational thawed Gaussian approximation.

Color Doppler ultrasound versus CT angiography for DIEP flap planning: A randomized controlled trial.

BACKGROUND: Identifying relevant perforators is crucial in planning a deep inferior epigastric perforator (DIEP) flap. Color Doppler ultrasonography (CDU) has gained popularity for localizing perforators; however, current evidence on its efficiency is still inconclusive. This study aimed to compare the efficiency of CDU with that of computed tomography angiography (CTA) in localizing and selecting the relevant perforators. METHODS: In this randomized controlled trial, 60 patients undergoing DIEP flap breast reconstruction (uni- or bilateral) were randomly assigned to the CDU group (i.e., CDU was performed to map and select the relevant perforators preoperatively) or the CTA+CDU group (i.e., mapping was based on CTA and supplemented by CDU). CDU was performed by the same surgeon with a well-defined sonography experience from our previous study. The reference XY coordinates of the dissected perforators were measured intraoperatively, and deviations from preoperatively deducted coordinates were calculated (ΔCDU or ΔCTA+CDU). The flaps were categorized according to the number of dissected perforators, and adherence to the preoperative strategy was evaluated. RESULTS: Overall, 22 patients (30 flaps) in the CTA+CDU group and 27 (39 flaps) patients in the CDU group were evaluated. The average ΔCDU (0.6 cm) was significantly lower than the average ΔCTA+CDU (1.0 cm) (p < 0.001). Adherence to the mapping-based dissection strategy was higher in the CDU group; however, the difference was insignificant (p = 0.092). CONCLUSION: CDU is not inferior to CTA + CDU in localizing and selecting relevant DIEA perforators. Therefore, CDU mapping is a possible complementary or substitute modality for CTA mapping.

Isotope Effects on the Electronic Spectra of Ammonia from Ab Initio Semiclassical Dynamics.

Despite its simplicity, the single-trajectory thawed Gaussian approximation has proven useful for calculating the vibrationally resolved electronic spectra of molecules with weakly anharmonic potential energy surfaces. Here, we show that the thawed Gaussian approximation can capture surprisingly well even more subtle observables, such as the isotope effects in the absorption spectra, and we demonstrate it on the four isotopologues of ammonia (NH3, NDH2, ND2H, and ND3). The differences in their computed spectra are due to the differences in the semiclassical trajectories followed by the four isotopologues, and the isotope effects─narrowing of the transition band and reduction of the peak spacing─are accurately described by this semiclassical method. In contrast, the adiabatic harmonic model shows a double progression instead of the single progression seen in the experimental spectra. The vertical harmonic model correctly shows only a single progression but fails to describe the anharmonic peak spacing. Analysis of the normal-mode activation upon excitation provides insight into the elusiveness of the symmetric stretching progression in the spectra.

Family of Gaussian wavepacket dynamics methods from the perspective of a nonlinear Schrödinger equation.

Many approximate solutions of the time-dependent Schrödinger equation can be formulated as exact solutions of a nonlinear Schrödinger equation with an effective Hamiltonian operator depending on the state of the system. We show that Heller's thawed Gaussian approximation, Coalson and Karplus's variational Gaussian approximation, and other Gaussian wavepacket dynamics methods fit into this framework if the effective potential is a quadratic polynomial with state-dependent coefficients. We study such a nonlinear Schrödinger equation in full generality: we derive general equations of motion for the Gaussian's parameters, demonstrate time reversibility and norm conservation, and analyze conservation of energy, effective energy, and symplectic structure. We also describe efficient, high-order geometric integrators for the numerical solution of this nonlinear Schrödinger equation. The general theory is illustrated by examples of this family of Gaussian wavepacket dynamics, including the variational and nonvariational thawed and frozen Gaussian approximations and their special limits based on the global harmonic, local harmonic, single-Hessian, local cubic, and local quartic approximations for the potential energy. We also propose a new method by augmenting the local cubic approximation with a single fourth derivative. Without substantially increasing the cost, the proposed "single-quartic" variational Gaussian approximation improves the accuracy over the local cubic approximation and, at the same time, conserves both the effective energy and symplectic structure, unlike the much more expensive local quartic approximation. Most results are presented in both Heller's and Hagedorn's parametrizations of the Gaussian wavepacket.

Preoperative percutaneous Onyx embolization of carotid body paragangliomas with balloon test occlusion.

Objectives: The study aims to analyze our first experience with direct percutaneous embolization of carotid body tumors (CBTs) using ethylene-vinyl alcohol copolymer (Onyx) along with balloon test occlusion (BTO). Methods: A retrospective preliminary single-center study was conducted at the Otorhinolaryngology and Head and Neck Surgery Department and the Medical Imaging Department of the University Teaching Hospital. A consecutive series of three patients with CBTs was treated at the local institution between October 2018 and June 2019. All three patients underwent preoperative percutaneous embolization using ethylene-vinyl alcohol copolymer (Onyx 18) with the addition of BTO. Outcome measures were the percentage of tumor devascularization, intraoperative blood losses, and operation times. BTO was evaluated by clinical neurological examination and neurosonological transcranial Doppler examination of the middle cerebral artery (MCA). Results: Devascularization of all three tumors was complete or near complete. All three tumors were surgically extirpated with excellent surgical outcomes. The blood losses were minimal, and the average operation time was 2 h and 8 min. BTO was positive in one patient, which was valuable additional information on carotid branches ligation limitations. The other two patients showed negative BTOs with the result of safety of eventual carotid arteries ligations. Conclusion: Preoperative direct percutaneous embolization of CBT with Onyx is a highly effective procedure that significantly facilitates surgery. BTO provides valuable additional information on the most appropriate and safe surgical approach.

Safety and Efficacy of Baseline Antiplatelet Treatment in Patients Undergoing Mechanical Thrombectomy for Ischemic Stroke: Antiplatelets Before Mechanical Thrombectomy.

PURPOSE: To investigate the safety and efficacy of baseline antiplatelet treatment in patients with acute ischemic stroke (AIS) undergoing mechanical thrombectomy (MT). MATERIALS AND METHODS: Baseline use of antiplatelet medication before MT for (AIS) may provide benefit on reperfusion and clinical outcome but could also carry an increased risk of intracranial hemorrhage (ICH). All consecutive patients with AIS and treated with MT with and without intravenous thrombolysis (IVT) between January 2012 and December 2019 in all centers performing MT nationwide were reviewed. Data were prospectively collected in national registries (eg, SITS-TBY and RES-Q). Primary outcome was functional independence (modified Rankin Scale 0-2) at 3 months; secondary outcome was ICH. RESULTS: Of the 4,351 patients who underwent MT, 1,750 (40%) and 666 (15%) were excluded owing to missing data from the functional independence and ICH outcome cohorts, respectively. In the functional independence cohort (n = 2,601), 771 (30%) patients received antiplatelets before MT. Favorable outcome did not differ in any antiplatelet, aspirin, and clopidogrel groups when compared with that in the no-antiplatelet group: odds ratio (OR), 1.00 (95% CI, 0.84-1.20); OR, 1.05 (95% CI, 0.86-1.27); and OR, 0.88 (95% CI, 0.55-1.41), respectively. In the ICH cohort (n = 3,685), 1095 (30%) patients received antiplatelets before MT. The rates of ICH did not increase in any treatment options (any antiplatelet, aspirin, clopidogrel, and dual antiplatelet groups) when compared with those in the no-antiplatelet group: OR, 1.03 (95% CI, 0.87-1.21); OR, 0.99 (95% CI, 0.83-1.18); OR, 1.10 (95% CI, 0.82-1.47); and OR, 1.43 (95% CI, 0.87-2.33), respectively. CONCLUSIONS: Antiplatelet monotherapy before MT did not improve functional independence or increase the risk of ICH.

Applicability of the Thawed Gaussian Wavepacket Dynamics to the Calculation of Vibronic Spectra of Molecules with Double-Well Potential Energy Surfaces.

Simulating vibrationally resolved electronic spectra of anharmonic systems, especially those involving double-well potential energy surfaces, often requires expensive quantum dynamics methods. Here, we explore the applicability and limitations of the recently proposed single-Hessian thawed Gaussian approximation for the simulation of spectra of systems with double-well potentials, including 1,2,4,5-tetrafluorobenzene, ammonia, phosphine, and arsine. This semiclassical wavepacket approach is shown to be more robust and to provide more accurate spectra than the conventional harmonic approximation. Specifically, we identify two cases in which the Gaussian wavepacket method is especially useful due to the breakdown of the harmonic approximation: (i) when the nuclear wavepacket is initially at the top of the potential barrier but delocalized over both wells, e.g., along a low-frequency mode, and (ii) when the wavepacket has enough energy to classically go over the low potential energy barrier connecting the two wells. The method is efficient and requires only a single classical ab initio molecular dynamics trajectory, in addition to the data required to compute the harmonic spectra. We also present an improved algorithm for computing the wavepacket autocorrelation function, which guarantees that the evaluated correlation function is continuous for arbitrary size of the time step.

Search for long-lasting electronic coherence using on-the-fly ab initio semiclassical dynamics.

Using a combination of high-level ab initio electronic structure methods with efficient on-the-fly semiclassical evaluation of nuclear dynamics, we performed a massive scan of small polyatomic molecules searching for a long-lasting oscillatory dynamics of the electron density triggered by the outer-valence ionization. We observed that in most of the studied molecules, either the sudden removal of an electron from the system does not lead to the appearance of the electronic coherence or the created coherences become damped by the nuclear rearrangement on a time scale of a few femtoseconds. However, we report several so far unexplored molecules with the electronic coherences lasting up to 10 fs, which can be good candidates for experimental studies. In addition, we present the full-dimensional simulations of the electronic coherences coupled to nuclear motion in several molecules which were studied previously only in the fixed nuclei approximation.

Efficient Semiclassical Evaluation of Electronic Coherences in Polyatomic Molecules.

Exposing a molecule to intense light pulses may bring this molecule to a nonstationary quantum state, thus launching correlated dynamics of electronic and nuclear subsystems. Although much had been achieved in the understanding of fundamental physics behind the electron-nuclear interactions and dynamics, accurate numerical simulations of light-induced processes taking place in polyatomic molecules remain a formidable challenge. Here, we review a recently developed theoretical approach for evaluating electronic coherences in molecules, in which the ultrafast electronic dynamics is coupled to nuclear motion. The presented technique, which combines accurate ab initio on-the-fly simulations of electronic structure with efficient semiclassical procedure to compute the dynamics of nuclear wave packets, is not only computationally efficient, but also can help shed light on the underlying physical mechanisms of decoherence and revival of the electronic coherences driven by nuclear rearrangement.

An implicit split-operator algorithm for the nonlinear time-dependent Schrödinger equation.

The explicit split-operator algorithm is often used for solving the linear and nonlinear time-dependent Schrödinger equations. However, when applied to certain nonlinear time-dependent Schrödinger equations, this algorithm loses time reversibility and second-order accuracy, which makes it very inefficient. Here, we propose to overcome the limitations of the explicit split-operator algorithm by abandoning its explicit nature. We describe a family of high-order implicit split-operator algorithms that are norm-conserving, time-reversible, and very efficient. The geometric properties of the integrators are proven analytically and demonstrated numerically on the local control of a two-dimensional model of retinal. Although they are only applicable to separable Hamiltonians, the implicit split-operator algorithms are, in this setting, more efficient than the recently proposed integrators based on the implicit midpoint method.

Core-Valence Attosecond Transient Absorption Spectroscopy of Polyatomic Molecules.

Tracing ultrafast processes induced by interaction of light with matter is often very challenging. In molecular systems, the initially created electronic coherence becomes damped by the slow nuclear rearrangement on a femtosecond timescale which makes real-time observations of electron dynamics in molecules particularly difficult. In this work, we report an extension of the theory underlying the attosecond transient absorption spectroscopy (ATAS) for the case of molecules, including a full account for the coupled electron-nuclear dynamics in the initially created wave packet, and apply it to probe the oscillations of the positive charge created after outer-valence ionization of the propiolic acid molecule. By taking advantage of element-specific core-to-valence transitions induced by x-ray radiation, we show that the resolution of ATAS makes it possible to trace the dynamics of electron density with atomic spatial resolution.

High-order geometric integrators for representation-free Ehrenfest dynamics.

Ehrenfest dynamics is a useful approximation for ab initio mixed quantum-classical molecular dynamics that can treat electronically nonadiabatic effects. Although a severe approximation to the exact solution of the molecular time-dependent Schrödinger equation, Ehrenfest dynamics is symplectic, is time-reversible, and conserves exactly the total molecular energy as well as the norm of the electronic wavefunction. Here, we surpass apparent complications due to the coupling of classical nuclear and quantum electronic motions and present efficient geometric integrators for "representation-free" Ehrenfest dynamics, which do not rely on a diabatic or adiabatic representation of electronic states and are of arbitrary even orders of accuracy in the time step. These numerical integrators, obtained by symmetrically composing the second-order splitting method and exactly solving the kinetic and potential propagation steps, are norm-conserving, symplectic, and time-reversible regardless of the time step used. Using a nonadiabatic simulation in the region of a conical intersection as an example, we demonstrate that these integrators preserve the geometric properties exactly and, if highly accurate solutions are desired, can be even more efficient than the most popular non-geometric integrators.

Corrigendum: RAFF-4, Magnetization Transfer and Diffusion Tensor MRI of Lysophosphatidylcholine Induced Demyelination and Remyelination in Rats.

[This corrects the article DOI: 10.3389/fnins.2021.625167.].

How important are the residual nonadiabatic couplings for an accurate simulation of nonadiabatic quantum dynamics in a quasidiabatic representation?

Diabatization of the molecular Hamiltonian is a standard approach to remove the singularities of nonadiabatic couplings at conical intersections of adiabatic potential energy surfaces. In general, it is impossible to eliminate the nonadiabatic couplings entirely-the resulting "quasidiabatic" states are still coupled by smaller but nonvanishing residual nonadiabatic couplings, which are typically neglected. Here, we propose a general method for assessing the validity of this potentially drastic approximation by comparing quantum dynamics simulated either with or without the residual couplings. To make the numerical errors negligible to the errors due to neglecting the residual couplings, we use the highly accurate and general eighth-order composition of the implicit midpoint method. The usefulness of the proposed method is demonstrated on nonadiabatic simulations in the cubic Jahn-Teller model of nitrogen trioxide and in the induced Renner-Teller model of hydrogen cyanide. We find that, depending on the system, initial state, and employed quasidiabatization scheme, neglecting the residual couplings can result in wrong dynamics. In contrast, simulations with the exact quasidiabatic Hamiltonian, which contains the residual couplings, always yield accurate results.

Time-reversible and norm-conserving high-order integrators for the nonlinear time-dependent Schrödinger equation: Application to local control theory.

The explicit split-operator algorithm has been extensively used for solving not only linear but also nonlinear time-dependent Schrödinger equations. When applied to the nonlinear Gross-Pitaevskii equation, the method remains time-reversible, norm-conserving, and retains its second-order accuracy in the time step. However, this algorithm is not suitable for all types of nonlinear Schrödinger equations. Indeed, we demonstrate that local control theory, a technique for the quantum control of a molecular state, translates into a nonlinear Schrödinger equation with a more general nonlinearity, for which the explicit split-operator algorithm loses time reversibility and efficiency (because it only has first-order accuracy). Similarly, the trapezoidal rule (the Crank-Nicolson method), while time-reversible, does not conserve the norm of the state propagated by a nonlinear Schrödinger equation. To overcome these issues, we present high-order geometric integrators suitable for general time-dependent nonlinear Schrödinger equations and also applicable to nonseparable Hamiltonians. These integrators, based on the symmetric compositions of the implicit midpoint method, are both norm-conserving and time-reversible. The geometric properties of the integrators are proven analytically and demonstrated numerically on the local control of a two-dimensional model of retinal. For highly accurate calculations, the higher-order integrators are more efficient. For example, for a wavefunction error of 10-9, using the eighth-order algorithm yields a 48-fold speedup over the second-order implicit midpoint method and trapezoidal rule, and a 400 000-fold speedup over the explicit split-operator algorithm.