Haemorrhagic Complications After Microsurgical Treatment for Intracranial Aneurysms Under Acetylsalicylic Acid: An Impact Analysis.

BACKGROUND: Patients with intracranial aneurysms often have comorbidities that require them to take acetylsalicylic acid (ASA). In recent years, many patients with aneurysms have been prescribed ASA to prevent aneurysm enlargement. ASA is also prescribed to patients with intracranial aneurysms in preparation for surgical revascularization. METHODS: From 2016 to 2021, 64 patients underwent microsurgical aneurysm clipping without revascularization, and an additional 20 patients underwent extracranial to intracranial (EC-IC) bypass. The following parameters were analysed: the frequency of hemorrhagic complications, the blood loss volume, the duration of surgery and inpatient treatment, the change in hemoglobin level (Hb), hematocrit (Ht), erythrocytes, and clinical outcomes according to the modified Rankin scale (mRS). RESULTS: At the time of surgery, laboratory-confirmed effect of the ASA was registered in 22 patients (main group). In 42 patients, the ASA was not functional on assay (control group). Hemorrhagic complications were noted in two patients in the ASA group. In both cases, the hemorrhagic component did not exceed 15 ml in volume and did not require additional surgical interventions. Statistical analysis showed no significant differences in hemorrhagic postoperative complications. CONCLUSION: Taking low doses of acetylsalicylic acid during planned microsurgical clipping of cerebral aneurysms does not affect intraoperative blood loss volume, risk of postoperative hemorrhagic complications, length of stay in the hospital, or functional outcomes.

Optimal photoelectron circular dichroism of a model chiral system.

We optimize the internuclear geometry and electronic structure of a model chiral system to achieve a maximal photoelectron circular dichroism (PECD) in its one-photon ionization by circularly polarized light. The electronic structure calculations are performed by the single center method, while the optimization is done using quantum alchemy employing a Taylor series expansion. Thereby, the effect of bond lengths and uncompensated charge distributions on the chiral response of the model is investigated theoretically in some detail. It is demonstrated that manipulating a chiral asymmetry of the ionic potential may enhance the dichroic parameter (i.e., the PECD) of the randomly oriented model system well beyond ß1 = 25%. Furthermore, we demonstrate that quantum alchemy is applicable to PECD despite the unusually strong coupling of spatial and electronic degrees of freedom and discuss the relative impact of the individual degrees of freedom in this model system. We define the necessary conditions for the computational design of PECD for real (non-model) chiral molecules using our approach.

A Systematic Review and Case Illustrations of Misdiagnosing Intracranial Aneurysms.

Modern neuroimaging methods do not completely rule out false diagnoses of intracranial aneurysms which can lead to an unwarranted operation associated with risks of complications. However, surgical interventions for falsely diagnosed aneurysms are quite rare. The purpose of this study is to demonstrate two clinical cases of false-positive aneurysms and a systematic review of the literature dedicated to the incidence and etiology of false-positive aneurysms, identifying risk factors associated with false-positive aneurysms. A literature search in two databases (PubMed and Web of Science) using keywords "mimicking an intracranial aneurysm", "presenting as an intracranial aneurysm", "false positive intracranial aneurysms", and "neurosurgery" was conducted. A total of 243 papers were found in the initial search in two databases. Sixteen papers (including 20 patients) were included in the final analysis. There were 10 women and 10 men. The most common location of false-positive aneurysms was the bifurcation of the middle cerebral artery (MCA). In the posterior circulation, false-positive aneurysms were identified either on the basilar artery, or at the vertebro-basilar junction. The main causes of false intracranial aneurysm diagnosis included artery occlusion with vascular stump formation, infundibular widening, fenestration, arterial dissection, contrast extravasation, and venous varix. In conclusion, summarizing the results of our analysis, we can say that surgical interventions for false-positive aneurysms are an underestimated problem in vascular neurosurgery. Despite extremely rare published clinical observations, the actual frequency of erroneous surgical interventions for false-positive aneurysms is unknown.

Real-time laser speckle contrast imaging for intraoperative neurovascular blood flow assessment: animal experimental study.

The use of various blood flow control methods in neurovascular interventions is crucial for reducing postoperative complications. Neurosurgeons worldwide use different methods, such as contact Dopplerography, intraoperative indocyanine videoangiography (ICG) video angiography, fluorescein angiography, flowmetry, intraoperative angiography, and direct angiography. However, there is no noninvasive method that can assess the presence of blood flow in the vessels of the brain without the introduction of fluorescent substances throughout the intervention. The real-time laser-speckle contrast imaging (LSCI) method was studied for its effectiveness in controlling blood flow in standard cerebrovascular surgery cases in rat common carotid arteries, such as proximal occlusion, trapping, reperfusion, anastomosis, and intraoperative vessel thrombosis. The real-time LSCI method is a promising method for use in neurosurgical practice. This approach allows timely diagnosis of intraoperative disturbance of blood flow in vessels in cases of clip occlusion or thrombosis. Additionally, LSCI allows us to reliably confirm the functioning of the anastomosis and reperfusion after removal of the clips and thrombolysis in real time. An unresolved limitation of the method is noise from movements, but this does not reduce the value of the method. Additional research is required to improve the quality of the data obtained.

Theoretical study of spin polarization in multiphoton ionization of Xe.

Spin polarization in the multiphoton above-threshold ionization of 5p3/2- and 5p1/2-electrons of Xe with intense 395nm, circularly polarized laser pulses, is investigated theoretically. For this purpose, we solve the time-dependent Schrödinger equation on the basis of spherical spinors. We, thus, simultaneously propagate the spin-up and spin-down single-active-electron wave packets, driven by the laser pulses in the ionic potential, which includes the spin-orbit interaction explicitly. The present theoretical results are in good agreement with the recent experimental results [D. Trabert et al., Phys. Rev. Lett. 120, 043202 (2018)].

Amplitude Dependence of Nonlinear Precipitation Blocking of Relativistic Electrons by Large Amplitude EMIC Waves.

Recent work has shown that ElectroMagnetic Ion Cyclotron (EMIC) waves tend to occur in four distinct regions, each having their own characteristics and morphology. Here, we use nonlinear test-particle simulations to examine the range of energetic electron scattering responses to two EMIC wave groups that occur at low L-shells and overlap the outer radiation belt electrons. The first group consists of low-density, H-band region b waves, and the second group consists of high-density, He-band region c waves. Results show that while low-density EMIC waves cannot precipitate electrons below ∼16 MeV, the high density EMIC waves drive a range of linear and nonlinear behaviors including phase bunching and trapping. In particular, a nonlinear force bunching effect can rapidly advect electrons at low pitch-angles near the minimum resonant energy to larger pitch angles, effectively blocking precipitation and loss. This effect contradicts conventional expectations and may have profound implication for observational campaigns.

Nonresonant Scattering of Relativistic Electrons by Electromagnetic Ion Cyclotron Waves in Earth's Radiation Belts.

Electromagnetic ion cyclotron waves are expected to pitch-angle scatter and cause atmospheric precipitation of relativistic (>1 MeV) electrons under typical conditions in Earth's radiation belts. However, it has been a long-standing mystery how relativistic electrons in the hundreds of keV range (but <1 MeV), which are not resonant with these waves, precipitate simultaneously with those >1 MeV. We demonstrate that, when the wave packets are short, nonresonant interactions enable such scattering of hundred-keV electrons by introducing a spread in wave number space. We generalize the quasilinear diffusion model to include nonresonant effects. The resultant model exhibits an exponential decay of the scattering rates extending below the minimum resonant energy depending on the shortness of the wave packets. This generalized model naturally explains observed nonresonant electron precipitation in the hundreds of keV concurrent with >1 MeV precipitation.

Superfast precipitation of energetic electrons in the radiation belts of the Earth.

Energetic electron precipitation from Earth's outer radiation belt heats the upper atmosphere and alters its chemical properties. The precipitating flux intensity, typically modelled using inputs from high-altitude, equatorial spacecraft, dictates the radiation belt's energy contribution to the atmosphere and the strength of space-atmosphere coupling. The classical quasi-linear theory of electron precipitation through moderately fast diffusive interactions with plasma waves predicts that precipitating electron fluxes cannot exceed fluxes of electrons trapped in the radiation belt, setting an apparent upper limit for electron precipitation. Here we show from low-altitude satellite observations, that ~100 keV electron precipitation rates often exceed this apparent upper limit. We demonstrate that such superfast precipitation is caused by nonlinear electron interactions with intense plasma waves, which have not been previously incorporated in radiation belt models. The high occurrence rate of superfast precipitation suggests that it is important for modelling both radiation belt fluxes and space-atmosphere coupling.

Electron Dynamics and Correlations During High-Order Harmonic Generation in Be.

We investigate theoretically the high-order harmonic generation in beryllium atom irradiated by a short 1850 nm linearly polarized laser pulse in the intermediate strong-field ionization regime with the Keldysh parameter of 0.85. To this end, the respective time-dependent Schrödinger equation is solved by the time-dependent restricted-active-space configuration-interaction (TD-RASCI) method. By systematically increasing the active space of included configurations, we demonstrate an individual effect of different physical processes evoked by the pulse, which, all together, significantly enrich and extend the computed high-order harmonic generation spectrum.

Photoelectron circular dichroism of a model chiral anion.

Photoelectron circular dichroism (PECD) in the one-photon detachment of a model chiral anionic system is studied theoretically by the single center method. The computed chiral asymmetry, characterized by the dichroic parameter ß1 of up to about ±3%, is in good accord with the first experimental observations of the effect in photodetachment of amino acid anions [P. Krüger and K. M. Weitzel, Angew. Chem., Int. Ed. 60, 17861 (2021)]. Our findings confirm a general assumption that the magnitude of PECD is governed by the ability of an outgoing photoelectron wave packet to accumulate characteristic chiral asymmetry from the short-range part of the molecular potential.

Spacecraft Observations and Theoretical Understanding of Slow Electron Holes.

We present Magnetospheric Multiscale observations showing large numbers of slow electron holes with speeds clustered near the local minimum of double-humped velocity distribution functions of background ions. Theoretical computations show that slow electron holes can avoid the acceleration that otherwise prevents their remaining slow only under these same circumstances. Although the origin of the slow electron holes is still elusive, the agreement between observation and theory about the conditions for their existence is remarkable.

Self-consistent kinetic model of nested electron- and ion-scale magnetic cavities in space plasmas.

NASA's Magnetospheric Multi-Scale (MMS) mission is designed to explore the proton- and electron-gyroscale kinetics of plasma turbulence where the bulk of particle acceleration and heating takes place. Understanding the nature of cross-scale structures ubiquitous as magnetic cavities is important to assess the energy partition, cascade and conversion in the plasma universe. Here, we present theoretical insight into magnetic cavities by deriving a self-consistent, kinetic theory of these coherent structures. By taking advantage of the multipoint measurements from the MMS constellation, we demonstrate that our kinetic model can utilize magnetic cavity observations by one MMS spacecraft to predict measurements from a second/third spacecraft. The methodology of "observe and predict" validates the theory we have derived, and confirms that nested magnetic cavities are self-organized plasma structures supported by trapped proton and electron populations in analogous to the classical theta-pinches in laboratory plasmas.

Photoelectron circular dichroism in the multiphoton ionization by short laser pulses. III. Photoionization of fenchone in different regimes.

Photoelectron circular dichroism (PECD) in different regimes of multiphoton ionization of fenchone is studied theoretically using the time-dependent single center method. In particular, we investigate the chiral response to the one-color multiphoton or strong-field ionization by circularly polarized 400 nm and 814 nm optical laser pulses or 1850 nm infrared pulse. In addition, the broadband ionization by short coherent circularly polarized 413-1240 nm spanning pulse is considered. Finally, the two-color ionization by the phase-locked 400 nm and 800 nm pulses, which are linearly polarized in mutually orthogonal directions, is investigated. The present computational results on the one-color multiphoton ionization of fenchone are in agreement with the available experimental data. For the ionization of fenchone by broadband and bichromatic pulses, the present theoretical study predicts substantial multiphoton PECDs.

Remarkable charged particle dynamics near magnetic field null lines.

The study of charged-particle motion in electromagnetic fields is a rich source of problems, models, and new phenomena for nonlinear dynamics. The case of a strong magnetic field is well studied in the framework of a guiding center theory, which is based on conservation of an adiabatic invariant-the magnetic moment. This theory ceases to work near a line on which the magnetic field vanishes-the magnetic field null line. In this paper, we show that the existence of these lines leads to remarkable phenomena which are new both for nonlinear dynamics in general and for the theory of charged-particle motion. We consider the planar motion of a charged particle in a strong stationary perpendicular magnetic field with a null line and a strong electric field. We show that particle dynamics switch between a slow guiding center motion and the fast traverse along a segment of the magnetic field null line. This segment is the same (in the principal approximation) for all particles with the same total energy. During the phase of a guiding center motion, the magnetic moment of particle's Larmor rotation stays approximately constant, i.e., it is an adiabatic invariant. However, upon each traversing of the null line, the magnetic moment changes in a random fashion, causing the particle to choose a new trajectory of the guiding center motion. This results in a stationary distribution of the magnetic moment, which only depends on the particle's total energy. The jumps in the adiabatic invariant are described by Painlevé II equation.

Controlling Dynamics of Postcollision Interaction.

A general scheme to get insight and to control postcollision interaction (PCI) by means of sequential double ionization with two high-frequency pulses is discussed. In particular, we propose to consider PCI of a slow photoelectron released by the pump pulse from a neutral atom with a fast photoelectron released by the time-delayed probe pulse from the created ion. This scheme is exemplified by the ab initio calculations performed for the prototypical helium atom. In order to visualize PCI effects in real time and real space, the corresponding time-dependent Schrödinger equation is solved by propagating two-electron wave packets in terms of essential stationary eigenstates of the unperturbed Hamiltonian. It is demonstrated that the exchange of energy between the slow and fast photoelectron wave packets in continuum, as well as the recapture of threshold photoelectrons owing to the PCI, can be controlled by the properties of the ionizing pulses and the time delay between them.

Nonlinear resonances generate large-scale convection cells in phase space.

It is well known that resonance phenomena can destroy adiabatic invariance and cause chaos and mixing. In the present Rapid Communication, we show that a nonlinear wave-particle resonant interaction may do the opposite-generate large-scale coherent structures in phase space. The combined action of the drift due to nonlinear scattering on resonance and trapping (capture) into resonance creates a convection cell-like structure, where the areas of particle acceleration and deceleration are macroscopically separated. At the same time, nonlinear scattering also creates a diffusion that cause mixing on and between the energy levels.

Circular Dichroism in Fluorescence Emission Following the C 1s→π* Excitation and Resonant Auger Decay of Carbon Monoxide.

Dichroism in angle-resolved spectra of circularly polarized fluorescence from freely-rotating CO molecules was studied experimentally and theoretically. For this purpose, carbon monoxide in the gas phase was exposed to circularly polarized soft X-ray synchrotron radiation. The photon energy was tuned across the C 1s→π* resonant excitation, which decayed via the participator Auger transition into the CO⁺ A ²Π state. The dichroic parameter ß1 of the subsequent CO⁺ (A ²Π → X ²Σ⁺) visible fluorescence was measured by photon-induced fluorescence spectroscopy. Present experimental results are explained with the ab initio electronic structure and dynamics calculations performed by the single center method. Our results confirm the possibility to perform partial wave analysis of the emitted photoelectrons in closed-shell molecules.

Multiscale Currents Observed by MMS in the Flow Braking Region.

We present characteristics of current layers in the off-equatorial near-Earth plasma sheet boundary observed with high time-resolution measurements from the Magnetospheric Multiscale mission during an intense substorm associated with multiple dipolarizations. The four Magnetospheric Multiscale spacecraft, separated by distances of about 50 km, were located in the southern hemisphere in the dusk portion of a substorm current wedge. They observed fast flow disturbances (up to about 500 km/s), most intense in the dawn-dusk direction. Field-aligned currents were observed initially within the expanding plasma sheet, where the flow and field disturbances showed the distinct pattern expected in the braking region of localized flows. Subsequently, intense thin field-aligned current layers were detected at the inner boundary of equatorward moving flux tubes together with Earthward streaming hot ions. Intense Hall current layers were found adjacent to the field-aligned currents. In particular, we found a Hall current structure in the vicinity of the Earthward streaming ion jet that consisted of mixed ion components, that is, hot unmagnetized ions, cold E × B drifting ions, and magnetized electrons. Our observations show that both the near-Earth plasma jet diversion and the thin Hall current layers formed around the reconnection jet boundary are the sites where diversion of the perpendicular currents take place that contribute to the observed field-aligned current pattern as predicted by simulations of reconnection jets. Hence, multiscale structure of flow braking is preserved in the field-aligned currents in the off-equatorial plasma sheet and is also translated to ionosphere to become a part of the substorm field-aligned current system.

Photoelectron circular dichroism in the multiphoton ionization by short laser pulses. II. Three- and four-photon ionization of fenchone and camphor.

Angle-resolved multiphoton ionization of fenchone and camphor by short intense laser pulses is computed by the time-dependent single center method. Thereby, the photoelectron circular dichroism (PECD) in the three-photon resonance enhanced ionization and four-photon above-threshold ionization of these molecules is investigated in detail. The computational results are in satisfactory agreement with the available experimental data, measured for randomly oriented fenchone and camphor molecules at different wavelengths of the exciting pulses. We predict a significant enhancement of the multiphoton PECD for uniaxially oriented fenchone and camphor.