Spectral properties of a short-range impurity in a quantum dot

The spectral properties of the quantum mechanical system consisting of a quantum dot with a short-range attractive impurity inside the dot are investigated in the zero-range limit. The Green function of the system is obtained in an explicit form. In the case of a spherically symmetric quantum dot, the dependence of the spectrum on the impurity position and the strength of the impurity potential is analyzed in detail. It is proven that the confinement potential of the dot can be recovered from the spectroscopy data. The consequences of the hidden symmetry breaking by the impurity are considered. The effect of the positional disorder is studied.Comment: 30 pages, 6 figures, Late

A Note on the Discrete Spectrum of Gaussian Wells (I): The Ground State Energy in One Dimension

The ground state energy is computed for small values of by means of an approximation of an integral operator in momentum space. Such an approximation leads to a transcendental equation for which 0 ( ) = | 0 ( )

Surgical resection is superior to TACE in the treatment of HCC in a well selected cohort of BCLC-B elderly patients—A retrospective observational study

Simple Summary Hepatocellular carcinoma (HCC) is the most common primary liver malignancy. Liver transplantation (LT) and surgical resection (SR) are currently the primary treatments with curative intent. Nevertheless, more than two-thirds of patients are elderly and, therefore, excluded from LT; while, according to the Barcelona Clinic Liver Cancer (BCLC) system, SR should only be offered to a small group of patients with early stage HCC. The identification in stage B of an intermediate subgroup of patients that fulfill the criteria for surgery may play an important role in the implementation of potentially curative treatments. Hepatocellular carcinoma (HCC) usually develops in cirrhotic liver, with high recurrence rates. However, considering its increasing detection in non-cirrhotic liver, the choice of treatment assumes particular relevance. This study aimed to investigate outcomes of patients among BCLC stages and enrolled for surgical resection (SR) according to a more complex evaluation, to establish its safety and efficacy. A total of 186 selected HCC patients (median age 73.2 yrs), submitted to SR between January 2005 and January 2021, were retrospectively analyzed. Of which, 166 were staged 0, A, B according to the BCLC system, while 20 with a single large tumor (>5 cm) were classified as stage AB. No perioperative mortality was recorded; complications occurred in 48 (25.80%) patients, and all but two were Clavien-Dindo grade I-II. Median follow-up was 9.2 years. Subsequently, 162 recurrent patients (87,1%) were selected for new treatments. Comparable overall survival rates (OS) were observed at 1, 3, 5, and 10 years in 0, A, B and AB stages (p = 0.2). Eventually, the BCLC-B group was matched to 40 BCLC-B patients treated (2015-2021) with TACE. Significant differences in baseline characteristics (p <0.0001) and in OS were observed at 1 and 3 years (p <0.0001); a significant difference was also observed in oncological outcomes, in terms of the absence, residual, or relapse of disease (p <0.05). Surgery might be a valid treatment in HCC for patients affected by chronic liver disease in a condition of compensation, up to BCLC-B stage. Surgical indication for liver resection in case of HCC should be extensively revised

The weekend effect on the provision of Emergency Surgery before and during the COVID-19 pandemic: case–control analysis of a retrospective multicentre database

Introduction: The concept of “weekend effect”, that is, substandard healthcare during weekends, has never been fully demonstrated, and the different outcomes of emergency surgical patients admitted during weekends may be due to different conditions at admission and/or different therapeutic approaches. Aim of this international audit was to identify any change of pattern of emergency surgical admissions and treatments during weekends. Furthermore, we aimed at investigating the impact of the COVID-19 pandemic on the alleged “weekend effect”. Methods: The database of the CovidICE-International Study was interrogated, and 6263 patients were selected for analysis. Non-trauma, 18+ yo patients admitted to 45 emergency surgery units in Europe in the months of March–April 2019 and March–April 2020 were included. Demographic and clinical data were anonymised by the referring centre and centrally collected and analysed with a statistical package. This study was endorsed by the Association of Italian Hospital Surgeons (ACOI) and the World Society of Emergency Surgery (WSES). Results: Three-quarters of patients have been admitted during workdays and only 25.7% during weekends. There was no difference in the distribution of gender, age, ASA class and diagnosis during weekends with respect to workdays. The first wave of the COVID pandemic caused a one-third reduction of emergency surgical admission both during workdays and weekends but did not change the relation between workdays and weekends. The treatment was more often surgical for patients admitted during weekends, with no difference between 2019 and 2020, and procedures were more often performed by open surgery. However, patients admitted during weekends had a threefold increased risk of laparoscopy-to-laparotomy conversion (1% vs. 3.4%). Hospital stay was longer in patients admitted during weekends, but those patients had a lower risk of readmission. There was no difference of the rate of rescue surgery between weekends and workdays. Subgroup analysis revealed that interventional procedures for hot gallbladder were less frequently performed on patients admitted during weekends. Conclusions: Our analysis revealed that demographic and clinical profiles of patients admitted during weekends do not differ significantly from workdays, but the therapeutic strategy may be different probably due to lack of availability of services and skillsets during weekends. The first wave of the COVID-19 pandemic did not impact on this difference

Intraperitoneal drain placement and outcomes after elective colorectal surgery: international matched, prospective, cohort study

Despite current guidelines, intraperitoneal drain placement after elective colorectal surgery remains widespread. Drains were not associated with earlier detection of intraperitoneal collections, but were associated with prolonged hospital stay and increased risk of surgical-site infections.Background Many surgeons routinely place intraperitoneal drains after elective colorectal surgery. However, enhanced recovery after surgery guidelines recommend against their routine use owing to a lack of clear clinical benefit. This study aimed to describe international variation in intraperitoneal drain placement and the safety of this practice. Methods COMPASS (COMPlicAted intra-abdominal collectionS after colorectal Surgery) was a prospective, international, cohort study which enrolled consecutive adults undergoing elective colorectal surgery (February to March 2020). The primary outcome was the rate of intraperitoneal drain placement. Secondary outcomes included: rate and time to diagnosis of postoperative intraperitoneal collections; rate of surgical site infections (SSIs); time to discharge; and 30-day major postoperative complications (Clavien-Dindo grade at least III). After propensity score matching, multivariable logistic regression and Cox proportional hazards regression were used to estimate the independent association of the secondary outcomes with drain placement. Results Overall, 1805 patients from 22 countries were included (798 women, 44.2 per cent; median age 67.0 years). The drain insertion rate was 51.9 per cent (937 patients). After matching, drains were not associated with reduced rates (odds ratio (OR) 1.33, 95 per cent c.i. 0.79 to 2.23; P = 0.287) or earlier detection (hazard ratio (HR) 0.87, 0.33 to 2.31; P = 0.780) of collections. Although not associated with worse major postoperative complications (OR 1.09, 0.68 to 1.75; P = 0.709), drains were associated with delayed hospital discharge (HR 0.58, 0.52 to 0.66; P < 0.001) and an increased risk of SSIs (OR 2.47, 1.50 to 4.05; P < 0.001). Conclusion Intraperitoneal drain placement after elective colorectal surgery is not associated with earlier detection of postoperative collections, but prolongs hospital stay and increases SSI risk

Spectral properties of a symmetric three-dimensional quantum dot with a pair of identical attractive delta-impurities symmetrically situated around the origin

In this presentation, we wish to provide an overview of the spectral features for the self-adjoint Hamiltonian of the three-dimensional isotropic harmonic oscillator perturbed by either a single attractive delta-interaction centered at the origin or by a pair of identical attractive delta-interactions symmetrically situated with respect to the origin. Given that such Hamiltonians represent the mathematical model for quantum dots with sharply localized impurities, we cannot help having the renowned article by Bruning, Geyler and Lobanov [1] as our key reference. We shall also compare the spectral features of the aforementioned three-dimensional models with those of the self-adjoint Hamiltonian of the harmonic oscillator perturbed by an attractive delta'-interaction in one dimension, fully investigated in [2, 3], given the existence in both models of the remarkable spectral phenomenon called "level crossing". The rigorous definition of the self-adjoint Hamiltonian for the singular double well model will be provided through the explicit formula for its resolvent (Green's function). Furthermore, by studying in detail the equation determining the ground state energy for the double well model, it will be shown that the concept of "positional disorder", introduced in [1] in the case of a quantum dot with a single delta-impurity, can also be extended to the model with the twin impurities in the sense that the greater the distance between the two impurities is, the less localized the ground state will be. Another noteworthy spectral phenomenon will also be determined; for each value of the distance between the two centers below a certain threshold value, there exists a range of values of the strength of the twin point interactions for which the first excited symmetric bound state is more tightly bound than the lowest antisymmetric bound state. Furthermore, it will be shown that, as the distance between the two impurities shrinks to zero, the 3D-Hamiltonian with the singular double well (requiring renormalization to be defined) does not converge to the one with a single delta-interaction centered at the origin having twice the strength, in contrast to its one-dimensional analog for which no renormalization is required. It is worth stressing that this phenomenon has also been recently observed in the case of another model requiring the renormalization of the coupling constant, namely the one-dimensional Salpeter Hamiltonian perturbed by two twin attractive delta-interactions symmetrically situated at the same distance from the origin