Perturbation Theory of Schr\"odinger Operators in Infinitely Many Coupling Parameters

In this paper we study the behavior of Hamilton operators and their spectra which depend on infinitely many coupling parameters or, more generally, parameters taking values in some Banach space. One of the physical models which motivate this framework is a quantum particle moving in a more or less disordered medium. One may however also envisage other scenarios where operators are allowed to depend on interaction terms in a manner we are going to discuss below. The central idea is to vary the occurring infinitely many perturbing potentials independently. As a side aspect this then leads naturally to the analysis of a couple of interesting questions of a more or less purely mathematical flavor which belong to the field of infinite dimensional holomorphy or holomorphy in Banach spaces. In this general setting we study in particular the stability of selfadjointness of the operators under discussion and the analyticity of eigenvalues under the condition that the perturbing potentials belong to certain classes.Comment: 25 pages, Late

Knowledge Gaps in Anesthetic Gas Utilization in a Large Academic Hospital System: A Multicenter Survey

Inhaled anesthetics account for a significant portion of the greenhouse gases generated by perioperative services within the healthcare systems. This cross-sectional study aimed to identify knowledge gaps and practice patterns related to carbon dioxide (CO2) absorbents and intraoperative delivery of fresh gas flows (FGF) for future sustainability endeavors. Secondary aims focused on differences in these knowledge gaps based on the level of training. Surveys were distributed at five large academic medical centers. In addition to site-specific CO2 absorbent use and practice volume and experience, respondents at each institution were queried about individual practice with FGF rates during anesthetic maintenance as well as the cost-effectiveness and environmental impact of different volatile anesthetics. Results were stratified and analyzed by the level of training. In total, 368 (44% physicians, 30% residents, and 26% nurse anesthetists) respondents completed surveys. Seventy-six percent of respondents were unaware or unsure about which type of CO2 absorbent was in use at their hospital. Fifty-nine percent and 48% of respondents used sevoflurane and desflurane with FGF ≥1 L/min, respectively. Most participants identified desflurane as the agent with the greatest environmental impact (89.9%) and a greater proportion of anesthesiologists correctly identified isoflurane as a cost-effective anesthetic (78.3%, p=0.02). Knowledge gaps about in-use CO2 absorbent and optimal FGF usage were identified within the anesthesia care team. Educational initiatives to increase awareness about the carbon emissions from anesthesia and newer CO2 absorbents will impact the environmental and economic cost per case and align anesthesia providers toward healthcare decarbonization