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We report on the pediatric block practice digitized due to the COVID-19 pandemic. Nineteen seminars were recorded, which represent the broad spectrum of pediatrics as comprehensively as possible, and made available on the learning platform ILIAS in a learning sequence. In order to increase attention and learning success formative questions were interspersed into the seminars. The evaluation of the students showed a high acceptance of this course. Especially the formative questions and the high time flexibility were appreciated. A major point of criticism was that not all questions were resolved immediately afterwards. The resolutions were inserted in the meantime. Parts of the digitized block practical course should therefore be used in the pediatric block practical course after the end of the corona restrictions after appropriate revision.

An oncology chaplain illustrates The Discipline for Pastoral Care Giving by recalling interactions with a breast cancer patient. [ABSTRACT FROM AUTHOR]

Previous research has indicated that health care workers, including those in mental health, have negative attitudes toward people living with HIV and AIDS and may be unwilling to work with them in a professional capacity. Ajzen's theory of planned behavior (1985) was used as a model for better understanding the specific components of these attitudes. In this project doctoral students in clinical psychology read a vignette describing a person who is HIV positive and then completed a set of measures regarding willingness to interact professionally, level of knowledge and attitudes toward HIV and AIDS, and attitudes regarding drug abusers and promiscuity. Results indicated that participants were generally willing to provide therapy for an HIV positive client, although some participants indicated that they would experience some anxiety in doing so. Level of anxiety could be predicted by attitudes toward AIDS and whether the participants believed that accepting an infected client would have negative effects for them personally or professionally. [ABSTRACT FROM AUTHOR]

BackgroundObesity is the leading cause of preventable death costing the health care system billions of dollars. Combining self-monitoring technology with personalized behavior change strategies results in clinically significant weight loss. However, there is a lack of real-world outcomes in commercial weight-loss program research. ObjectiveRetrofit is a personalized weight management and disease-prevention solution. This study aimed to report Retrofit’s weight-loss outcomes at 6, 12, and 24 months and characterize behaviors, age, and sex of high-performing participants who achieved weight loss of 10% or greater at 12 months. MethodsA retrospective analysis was performed from 2011 to 2014 using 2720 participants enrolled in a Retrofit weight-loss program. Participants had a starting body mass index (BMI) of >25 kg/m² and were at least 18 years of age. Weight measurements were assessed at 6, 12, and 24 months in the program to evaluate change in body weight, BMI, and percentage of participants who achieved 5% or greater weight loss. A secondary analysis characterized high-performing participants who lost ≥10% of their starting weight (n=238). Characterized behaviors were evaluated, including self-monitoring through weigh-ins, number of days wearing an activity tracker, daily step count average, and engagement through coaching conversations via Web-based messages, and number of coaching sessions attended. ResultsAverage weight loss at 6 months was −5.55% for male and −4.86% for female participants. Male and female participants had an average weight loss of −6.28% and −5.37% at 12 months, respectively. Average weight loss at 24 months was −5.03% and −3.15% for males and females, respectively. Behaviors of high-performing participants were assessed at 12 months. Number of weigh-ins were greater in high-performing male (197.3 times vs 165.4 times, P=.001) and female participants (222 times vs 167 times, P

Background: Alexander disease is a rare, progressive leukodystrophy, which predisposes patients to complications under general anesthesia due to clinical manifestations including developmental delay, seizures, dysphagia, vomiting, and sleep apnea. However, study of anesthetic outcomes is limited., Aims: Our aim was to describe patient characteristics, anesthetic techniques, and anesthesia-related complications for Alexander disease patients undergoing magnetic resonance imaging and/or lumbar puncture at a quaternary-care children's hospital., Methods: We performed a retrospective review of anesthetic outcomes in patients with Alexander disease enrolled in a prospective observational study. Included patients had diagnosed Alexander disease and underwent magnetic resonance imaging and/or lumbar puncture at our institution. We excluded anesthetics for other procedures or at outside institutions. Collected data included patient characteristics, anesthetic techniques, medications, and complications under anesthesia and in the subsequent 24 h. We performed descriptive statistics as appropriate., Results: Forty patients undergoing 64 procedures met inclusion criteria. Fifty-six procedures (87.5%) required general anesthesia or monitored anesthesia care (MAC) and eight (12.5%) did not. The general anesthesia/MAC group tended to be younger than nonanesthetized patients (median age 6 years [IQR 3.8; 9] vs. 14.5 years [IQR 12.8; 17.5]). In both groups, dysphagia (78.6% vs. 87.5%, respectively), seizures (62.5% vs. 25%), and recurrent vomiting (17.9% vs. 25%) were frequently reported preprocedure symptoms. Inhalational induction was common (N = 48; 85.7%), and two (3.6%) underwent rapid sequence induction. Serious complications were rare, with no aspiration or seizures. Hypotension resolving with ephedrine occurred in eight cases (14.3%). One patient each (1.8%) experienced postprocedure emergence agitation or vomiting. Fifty-three (94.6%) were ambulatory procedures. No inpatients required escalation in acuity of care., Conclusions: In this single-center study, patients with Alexander disease did not experience frequent or irreversible complications while undergoing general anesthesia/MAC. Co-morbid symptoms were not increased postanesthesia. Some patients may not require anesthesia to complete short procedures., (© 2024 The Author(s). Pediatric Anesthesia published by John Wiley & Sons Ltd.)

At very low density, the electrons in a uniform electron gas spontaneously break symmetry and form a crystalline lattice called a Wigner crystal. But which type of crystal will the electrons form? We report a numerical study of the density profiles of fragments of Wigner crystals from first principles. To simulate Wigner fragments, we use Clifford periodic boundary conditions and a renormalized distance in the Coulomb potential. Moreover, we show that high-spin restricted open-shell Hartree-Fock theory becomes exact in the low-density limit. We are thus able to accurately capture the localization in two-dimensional Wigner fragments with many electrons. No assumptions about the positions where the electrons will localize are made. The density profiles we obtain emerge naturally when we minimize the total energy of the system. We clearly observe the emergence of the hexagonal crystal structure, which has been predicted to be the ground-state structure of the two-dimensional Wigner crystal.

Introduction: Micrognathic neonates are at risk for upper airway obstruction, and many require intubation in the delivery room. Ex-utero intrapartum treatment is one technique for managing airway obstruction but poses substantial maternal risks. Procedure requiring a second team in the operating room is an alternative approach to secure the obstructed airway while minimizing maternal risk. The aim of this study was to describe the patient characteristics, airway management, and outcomes for micrognathic neonates and their mothers undergoing a procedure requiring a second team in the operating room at a single quaternary care children's hospital., Methods: This was a retrospective descriptive study. Subjects had prenatally diagnosed micrognathia and underwent procedure requiring a second team in the operating room between 2009 and 2021. Collected data included infant characteristics, delivery room airway management, critical events, and medications. Follow-up data included genetic testing and subsequent procedures within 90 days. Maternal data included type of anesthetic, blood loss, and incidence of transfusion., Results: Fourteen deliveries were performed via procedure requiring a second team in the operating room during the study period. 85.7% were male, and 50% had a genetic syndrome. Spontaneous respiratory efforts were observed in 93%. Twelve patients (85.7%) required an endotracheal tube or tracheostomy. Management approaches varied. Medications were primarily a combination of atropine, ketamine, and dexmedetomidine. Oxygen desaturation was common, and three patients experienced bradycardia. There were no periprocedural deaths. Follow-up at 90 days revealed that 78% of patients underwent at least one additional procedure, and one patient died due to an unrelated cause. All mothers underwent cesarean deliveries under neuraxial anesthesia. Median blood loss was 700 mL [IQR 700 mL, 800 mL]. Only one mother required a blood transfusion for pre-procedural placental abruption., Discussion: Procedure requiring a second team in the operating room is a safe and effective approach to manage airway obstruction in micrognathic neonates while minimizing maternal morbidity., Conclusions: Though shown to be safe and effective, more data are needed to support the use of procedure requiring a second team in the operating room as an alternative to ex-utero intrapartum treatment for micrognathia outside of highly specialized maternal-fetal centers., (© 2023 John Wiley & Sons Ltd.)

We present the multichannel Dyson equation that combines two or more many-body Green's functions to describe the electronic structure of materials. In this work we use it to model photoemission spectra by coupling the one-body Green's function with the three-body Green's function. We demonstrate that, unlike methods using only the one-body Green's function, our approach puts the description of quasiparticles and satellites on an equal footing. We propose a multichannel self-energy that is static and only contains the bare Coulomb interaction, making frequency convolutions and self-consistency unnecessary. Despite its simplicity, we demonstrate with a diagrammatic analysis that the physics it describes is extremely rich. Finally, we present a framework based on an effective Hamiltonian that can be solved for any many-body system using standard numerical tools. We illustrate our approach by applying it to the Hubbard dimer and show that it is exact both at 1/4 and 1/2 filling.

In its original version, the Thomson problem consists of the search for the minimum-energy configuration of a set of point-like electrons that are confined to the surface of a two-dimensional sphere ( S 2 ) that repel each other according to Coulomb's law, in which the distance is the Euclidean distance in the embedding space of the sphere, i.e., R 3 . In this work, we consider the analogous problem where the electrons are confined to an n -dimensional flat Clifford torus T n with n = 1, 2, 3. Since the torus T n can be embedded in the complex manifold C n , we define the distance in the Coulomb law as the Euclidean distance in C n , in analogy to what is done for the Thomson problem on the sphere. The Thomson problem on a Clifford torus is of interest because supercells with the topology of a Clifford torus can be used to describe periodic systems such as Wigner crystals. In this work, we numerically solve the Thomson problem on a square Clifford torus. To illustrate the usefulness of our approach, we apply it to Wigner crystals. We demonstrate that the equilibrium configurations we obtain for large numbers of electrons are consistent with the predicted structures of Wigner crystals. Finally, in the one-dimensional case, we analytically obtain the energy spectrum and the phonon dispersion law.

The electric polarizability and the spread of the total position tensors are used to characterize the metallic vs insulator nature of large (finite) systems. Finite clusters are usually treated within the open boundary condition formalism. This introduces border effects, which prevent a fast convergence to the thermodynamic limit and can be eliminated within the formalism of periodic boundary conditions. Recently, we introduced an original approach to periodic boundary conditions, named Clifford boundary conditions. It considers a finite fragment extracted from a periodic system and the modification of its topology into that of a Clifford torus. The quantity representing the position is modified in order to fulfill the system periodicity. In this work, we apply the formalism of Clifford boundary conditions to the case of carbon nanotubes, whose treatment results in a particularly simple zigzag geometry. Indeed, we demonstrate that at the Hückel level, these nanotubes, either finite or periodic, are formally equivalent to a collection of non-interacting dimerized linear chains, thus simplifying their treatment. This equivalence is used to describe some nanotube properties as the sum of the contributions of the independent chains and to identify the origin of peculiar behaviors (such as conductivity). Indeed, if the number of hexagons along the circumference is a multiple of three, a metallic behavior is found, namely a divergence of both the (per electron) polarizability and total position spread of at least one linear chain. These results are in agreement with those in the literature from tight-binding calculations., (© 2023 Author(s). Published under an exclusive license by AIP Publishing.)

In this work, we study the Wigner localization of interacting electrons that are confined to a quasi-one-dimensional harmonic potential using accurate quantum chemistry approaches. We demonstrate that the Wigner regime can be reached using small values of the confinement parameter. To obtain physical insight in our results, we analyze them with a semi-analytical model for two electrons. Thanks to electronic-structure properties such as the one-body density and the particle-hole entropy, we are able to define a path that connects the Wigner regime to the Fermi-gas regime by varying the confinement parameter. In particular, we show that the particle-hole entropy, as a function of the confinement parameter, smoothly connects the two regimes. Moreover, it exhibits a maximum that could be interpreted as the transition point between the localized and delocalized regimes.

The Extended Koopman's Theorem (EKT) provides a straightforward way to compute charged excitations from any level of theory. In this work we make the link with the many-body effective energy theory (MEET) that we derived to calculate the spectral function, which is directly related to photoemission spectra. In particular, we show that at its lowest level of approximation the MEET removal and addition energies correspond to the so-called diagonal approximation of the EKT. Thanks to this link, the EKT and the MEET can benefit from mutual insight. In particular, one can readily extend the EKT to calculate the full spectral function, and choose a more optimal basis set for the MEET by solving the EKT secular equation. We illustrate these findings with the examples of the Hubbard dimer and bulk silicon., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Di Sabatino, Koskelo, Prodhon, Berger, Caffarel and Romaniello.)

The localization spread gives a criterion to decide between metallic and insulating behavior of a material. It is defined as the second moment cumulant of the many-body position operator, divided by the number of electrons. Different operators are used for systems treated with open or periodic boundary conditions. In particular, in the case of periodic systems, we use the complex position definition, which was already used in similar contexts for the treatment of both classical and quantum situations. In this study, we show that the localization spread evaluated on a finite ring system of radius R with open boundary conditions leads, in the large R limit, to the same formula derived by Resta and co-workers [C. Sgiarovello, M. Peressi, and R. Resta, Phys. Rev. B 64, 115202 (2001)] for 1D systems with periodic Born-von Kármán boundary conditions. A second formula, alternative to Resta's, is also given based on the sum-over-state formalism, allowing for an interesting generalization to polarizability and other similar quantities.

In this work, we investigate the Wigner localization of two interacting electrons at very low density in two and three dimensions using the exact diagonalization of the many-body Hamiltonian. We use our recently developed method based on Clifford periodic boundary conditions with a renormalized distance in the Coulomb potential. To accurately represent the electronic wave function, we use a regular distribution in space of Gaussian-type orbitals and we take advantage of the translational symmetry of the system to efficiently calculate the electronic wave function. We are thus able to accurately describe the wave function up to very low density. We validate our approach by comparing our results to a semi-classical model that becomes exact in the low-density limit. With our approach, we are able to observe the Wigner localization without ambiguity.

Background: Marfan syndrome and Loeys-Dietz syndrome are connective tissue disorders associated with cardiac and vascular disease. Patients often require surgical repair, but limited data exist to describe their perioperative management., Aims: Our goals were to review the perioperative features of patients with Marfan and Loeys-Dietz syndrome that may affect anesthesia care and to describe the differences in preoperative clinical characteristics and intra-operative anesthetic management., Methods: We conducted a retrospective cohort study of patients with Marfan and Loeys-Dietz syndrome who underwent cardiac surgery at a single institution. We collected demographic and perioperative data from the electronic medical record and performed descriptive statistics to characterize the patient populations and describe their anesthetic management., Results: In 71 patients (40 Marfan, 31 Loeys-Dietz), we found significant differences between the Marfan and Loeys-Dietz patients in airway difficulty, preoperative weight, blood utilization, valvular disease, and age at first cardiac surgery. Patients with Loeys-Dietz syndrome had higher preoperative rates of severe noncardiac comorbidities, including gastroesophageal reflux and asthma that required chronic medical therapy., Conclusions: Despite undergoing similar surgical procedures, patients with Marfan and Loeys-Dietz syndrome have different intrinsic patient characteristics and comorbidities that may affect their perioperative care. This retrospective cohort study identified some factors, but additional collection and reporting of patient data based on multicenter experience are essential for the ongoing optimization of perioperative care in these patient populations., (© 2021 The Authors. Pediatric Anesthesia published by John Wiley & Sons Ltd.)

A local optimization algorithm for solving the Kohn-Sham equations is presented. It is based on a direct minimization of the energy functional under the equality constraints representing the Grassmann Manifold. The algorithm does not require an eigendecomposition, which may be advantageous in large-scale computations. It is optimized to reduce the number of Kohn-Sham matrix evaluations to one per iteration to be competitive with standard self-consistent field (SCF) approach accelerated by direct inversion of the iterative subspace (DIIS). Numerical experiments include a comparison of the algorithm with DIIS. A high reliability of the algorithm is observed in configurations where SCF iterations fail to converge or find a wrong solution corresponding to a stationary point different from the global minimum. The local optimization algorithm itself does not guarantee that the found minimum is global. However, a randomization of the initial approximation shows a convergence to the right minimum in the vast majority of cases., (© 2020 Wiley Periodicals LLC.)

In this work, we show the advantages of using the Coulomb hole plus screened exchange (COHSEX) approach in the calculation of potential energy surfaces (PES). In particular, we demonstrate that, unlike perturbative GW and partial self-consistent GW approaches, such as eigenvalue self-consistent GW and quasi-particle (QP) self-consistent GW , the COHSEX approach yields smooth PES without irregularities and discontinuities. Moreover, we show that the ground-state PES obtained from the Bethe-Salpeter equation (BSE), within the adiabatic connection fluctuation dissipation theorem, built with QP energies obtained from perturbative COHSEX on top of Hartree-Fock (BSE@COHSEX@HF) yield very accurate results for diatomic molecules close to their equilibrium distance. When self-consistent COHSEX QP energies and orbitals are used to build the BSE equation, the results become independent of the starting point. We show that self-consistency worsens the total energies but improves the equilibrium distances with respect to BSE@COHSEX@HF. This is mainly due to the changes in the screening inside the BSE.

The optical spectra of two-dimensional (2D) periodic systems provide a challenge for time-dependent density-functional theory (TDDFT) because of the large excitonic effects in these materials. In this work we explore how accurately these spectra can be described within a pure Kohn-Sham time-dependent density-functional framework, i.e., a framework in which no theory beyond Kohn-Sham density-functional theory, such as GW, is required to correct the Kohn-Sham gap. To achieve this goal we adapted a recent approach we developed for the optical spectra of 3D systems [S. Cavo, J. A. Berger and P. Romaniello, Phys. Rev. B, 2020, 101, 115109] to those of 2D systems. Our approach relies on the link between the exchange-correlation kernel of TDDFT and the derivative discontinuity of ground-state density-functional theory, which guarantees a correct quasi-particle gap, and on a generalization of the polarization functional [J. A. Berger, Phys. Rev. Lett., 2015, 115, 137402], which describes the excitonic effects. We applied our approach to two prototypical 2D monolayers, h-BN and MoS2. We find that our protocol gives a qualitatively good description of the optical spectrum of h-BN, whereas improvements are needed for MoS2 to describe the intensity of the excitonic peaks.

We propose a simple direct-sum method for the efficient evaluation of lattice sums in periodic solids. It consists of two main principles: (i) the creation of a supercell that has the topology of a Clifford torus, which is a flat, finite, and borderless manifold; (ii) the renormalization of the distance between two points on the Clifford torus by defining it as the Euclidean distance in the embedding space of the Clifford torus. Our approach does not require any integral transformations nor any renormalization of the charges. We illustrate our approach by applying it to the calculation of the Madelung constants of ionic crystals. We show that the convergence toward the system of infinite size is monotonic, which allows for a straightforward extrapolation of the Madelung constant. We are able to recover the Madelung constants with a remarkable accuracy, and at an almost negligible computational cost, i.e., a few seconds on a laptop computer.

In this work, we explore the performance of a recently derived many-body effective energy theory for the calculation of photoemission spectra in the regime of strong electron correlation. We apply the theory to paramagnetic MnO, FeO, CoO, and NiO, which are typical examples of strongly correlated materials and, therefore, a challenge for standard theories. We show that our method opens a correlation gap in all of the oxides studied without breaking the symmetry. Although the materials seem similar, we show that an analysis of the occupation numbers reveals that the nature of the gap is not the same for these materials. Overall, the results are very promising, although improvements are clearly required, since the band gap is overestimated for all of the systems studied. We indicate some possible strategies to further develop the theory.

We report unphysical irregularities and discontinuities in some key experimentally measurable quantities computed within the GW approximation of many-body perturbation theory applied to molecular systems. In particular, we show that the solution obtained with partially self-consistent GW schemes depends on the algorithm one uses to self-consistently solve the quasiparticle (QP) equation. The main observation of the present study is that each branch of the self-energy is associated with a distinct QP solution and that each switch between solutions implies a significant discontinuity in the quasiparticle energy as a function of the internuclear distance. Moreover, we clearly observe "ripple" effects, i.e., when a discontinuity in one of the QP energies induces (smaller) discontinuities in the other QP energies. Going from one branch to another implies a transfer of weight between two solutions of the QP equation. The cases of occupied, virtual, and frontier orbitals are separately discussed on distinct diatomics. In particular, we show that multisolution behavior in frontier orbitals is more likely if the HOMO-LUMO gap is small.