Singular Structure and Enhanced Friedel Oscillations in the Two-Dimensional Electron Gas

We calculate the leading order corrections (in $r_s$) to the static polarization $\Pi^{*}(q,0,)$, with dynamically screened interactions, for the two-dimensional electron gas. The corresponding diagrams all exhibit singular logarithmic behavior in their derivatives at $q=2 k_F$ and provide significant enhancement to the proper polarization particularly at low densities. At a density of $r_s=3$, the contribution from the leading order {\em fluctuational} diagrams exceeds both the zeroth order (Lindhard) response and the self-energy and exchange contributions. We comment on the importance of these diagrams in two-dimensions and make comparisons to an equivalent three-dimensional electron gas; we also consider the impact these finding have on $\Pi^{*}(q,0)$ computed to all orders in perturbation theory

Direct mass measurements beyond the proton drip-line

First on-line mass measurements were performed at the SHIPTRAP Penning trap mass spectrometer. The masses of 18 neutron-deficient isotopes in the terbium-to-thulium region produced in fusion-evaporation reactions were determined with relative uncertainties of about $7\cdot 10^{-8}$, nine of them for the first time. Four nuclides ($^{144, 145}$Ho and $^{147, 148}$Tm) were found to be proton-unbound. The implication of the results on the location of the proton drip-line is discussed by analyzing the one-proton separation energies

Exact integral equation for the renormalized Fermi surface

The true Fermi surface of a fermionic many-body system can be viewed as a fixed point manifold of the renormalization group (RG). Within the framework of the exact functional RG we show that the fixed point condition implies an exact integral equation for the counterterm which is needed for a self-consistent calculation of the Fermi surface. In the simplest approximation, our integral equation reduces to the self-consistent Hartree-Fock equation for the counterterm.Comment: 5 pages, 1 figur

Renormalized perturbation theory for Fermi systems: Fermi surface deformation and superconductivity in the two-dimensional Hubbard model

Divergencies appearing in perturbation expansions of interacting many-body systems can often be removed by expanding around a suitably chosen renormalized (instead of the non-interacting) Hamiltonian. We describe such a renormalized perturbation expansion for interacting Fermi systems, which treats Fermi surface shifts and superconductivity with an arbitrary gap function via additive counterterms. The expansion is formulated explicitly for the Hubbard model to second order in the interaction. Numerical soutions of the self-consistency condition determining the Fermi surface and the gap function are calculated for the two-dimensional case. For the repulsive Hubbard model close to half-filling we find a superconducting state with d-wave symmetry, as expected. For Fermi levels close to the van Hove singularity a Pomeranchuk instability leads to Fermi surfaces with broken square lattice symmetry, whose topology can be closed or open. For the attractive Hubbard model the second order calculation yeilds s-wave superconductivity with a weakly momentum dependent gap, whose size is reduced compared to the mean-field result.Comment: 18 pages incl. 6 figure

Spontaneous breaking of four-fold rotational symmetry in two-dimensional electronic systems explained as a continuous topological transition

The Fermi liquid approach is applied to the problem of spontaneous violation of the four-fold rotational point-group symmetry ($C_4$) in strongly correlated two-dimensional electronic systems on a square lattice. The symmetry breaking is traced to the existence of a topological phase transition. This continuous transition is triggered when the Fermi line, driven by the quasiparticle interactions, reaches the van Hove saddle points, where the group velocity vanishes and the density of states becomes singular. An unconventional Fermi liquid emerges beyond the implicated quantum critical point.Comment: 6 pages, 4 figure

Increased prevalence of potential right-to-left shunting in children with sickle cell anaemia and stroke

'Paradoxical' embolization via intracardiac or intrapulmonary right-to-left shunts (RLS) is an established cause of stroke. Hypercoagulable states and increased right heart pressure, which both occur in sickle cell anaemia (SCA), predispose to paradoxical embolization. We hypothesized that children with SCA and overt stroke (SCA + stroke) have an increased prevalence of potential RLS. We performed contrasted transthoracic echocardiograms on 147 children (aged 2-19 years) with SCA + stroke) mean age 12·7 ± 4·8 years, 54·4% male) and a control group without SCA or stroke (n = 123; mean age 12·1 ± 4·9 years, 53·3% male). RLS was defined as any potential RLS detected by any method, including intrapulmonary shunting. Echocardiograms were masked and adjudicated centrally. The prevalence of potential RLS was significantly higher in the SCA+stroke group than controls (45·6% vs. 23·6%, P < 0·001). The odds ratio for potential RLS in the SCA + stroke group was 2·7 (95% confidence interval: 1·6-4·6) vs controls. In post hoc analyses, the SCA + stroke group had a higher prevalence of intrapulmonary (23·8% vs. 5·7%, P < 0·001) but not intracardiac shunting (21·8% vs. 18·7%, P = 0·533). SCA patients with potential RLS were more likely to report headache at stroke onset than those without. Intrapulmonary and intracardiac shunting may be an overlooked, independent and potentially modifiable risk factor for stroke in SCA

Optical symmetries and anisotropic transport in high-Tc superconductors

A simple symmetry analysis of in-plane and out-of-plane transport in a family of high temperature superconductors is presented. It is shown that generalized scaling relations exist between the low frequency electronic Raman response and the low frequency in-plane and out-of-plane conductivities in both the normal and superconducting states of the cuprates. Specifically, for both the normal and superconducting state, the temperature dependence of the low frequency $B_{1g}$ Raman slope scales with the $c-$axis conductivity, while the $B_{2g}$ Raman slope scales with the in-plane conductivity. Comparison with experiments in the normal state of Bi-2212 and Y-123 imply that the nodal transport is largely doping independent and metallic, while transport near the BZ axes is governed by a quantum critical point near doping $p\sim 0.22$ holes per CuO$_{2}$ plaquette. Important differences for La-214 are discussed. It is also shown that the $c-$ axis conductivity rise for $T\ll T_{c}$ is a consequence of partial conservation of in-plane momentum for out-of-plane transport.Comment: 16 pages, 8 Figures (3 pages added, new discussion on pseudogap and charge ordering in La214

Balancing influence between actors in healthcare decision making

<p>Abstract</p> <p>Background</p> <p>Healthcare costs in most developed countries are not clearly linked to better patient and public health outcomes, but are rather associated with service delivery orientation. In the U.S. this has resulted in large variation in healthcare availability and use, increased cost, reduced employer participation in health insurance programs, and reduced overall population health outcomes. Recent U.S. healthcare reform legislation addresses only some of these issues. Other countries face similar healthcare issues.</p> <p>Discussion</p> <p>A major goal of healthcare is to enhance patient health outcomes. This objective is not realized in many countries because incentives and structures are currently not aligned for maximizing population health. The misalignment occurs because of the competing interests between "actors" in healthcare. In a simplified model these are individuals motivated to enhance their own health; enterprises (including a mix of nonprofit, for profit and government providers, payers, and suppliers, etc.) motivated by profit, political, organizational and other forces; and government which often acts in the conflicting roles of a healthcare payer and provider in addition to its role as the representative and protector of the people. An imbalance exists between the actors, due to the resources and information control of the enterprise and government actors relative to the individual and the public. Failure to use effective preventive interventions is perhaps the best example of the misalignment of incentives. We consider the current Pareto efficient balance between the actors in relation to the Pareto frontier, and show that a significant change in the healthcare market requires major changes in the utilities of the enterprise and government actors.</p> <p>Summary</p> <p>A variety of actions are necessary for maximizing population health within the constraints of available resources and the current balance between the actors. These actions include improved transparency of all aspects of medical decision making, greater involvement of patients in shared medical decision making, greater oversight of guideline development and coverage decisions, limitations on direct to consumer advertising, and the need for an enhanced role of the government as the public advocate.</p

Engaging Caregivers and Providers of Children With Sickle Cell Anemia in Shared Decision Making for Hydroxyurea: Protocol for a Multicenter Randomized Controlled Trial

BACKGROUND: Sickle cell anemia (SCA) is a genetic blood disorder that puts children at a risk of serious medical complications, early morbidity and mortality, and high health care utilization. Until recently, hydroxyurea was the only disease-modifying treatment for this life-threatening disease and has remained the only option for children younger than 5 years. Evidence-based guidelines recommend using a shared decision-making (SDM) approach for offering hydroxyurea to children with SCA (HbSS or HbS/β0 thalassemia) aged as early as 9 months. However, the uptake remains suboptimal, likely because caregivers lack information about hydroxyurea and have concerns about its safety and potential long-term side effects. Moreover, clinicians do not routinely receive training or tools, especially those that provide medical evidence and consider caregivers' preferences and values, to facilitate a shared discussion with caregivers. OBJECTIVE: The aim of this study is to understand how best to help parents of young children with sickle cell disease and their clinicians have a shared discussion about hydroxyurea (one that considers medical evidence and parent values and preferences). METHODS: We designed our study to compare the effectiveness of two methods for disseminating hydroxyurea guidelines to facilitate SDM: a clinician pocket guide (ie, usual care) and a clinician hydroxyurea SDM toolkit (H-SDM toolkit). Our primary outcomes are caregiver reports of decisional uncertainty and knowledge of hydroxyurea. The study also assesses the number of children (aged 0-5 years) who were offered and prescribed hydroxyurea and the resultant health outcomes. RESULTS: The Ethics Committee of the Cincinnati Children's Hospital Medical Center approved this study in November 2017. As of February 2021, we have enrolled 120 caregiver participants. CONCLUSIONS: The long-term objective of this study is to improve the quality of care for children with SCA. Using multicomponent dissemination methods developed in partnership with key stakeholders and designed to address barriers to high-quality care, caregivers of patients with SCA can make informed and shared decisions about their health. TRIAL REGISTRATION: ClinicalTrials.gov NCT03442114; https://clinicaltrials.gov/ct2/show/NCT03442114. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/27650