2 research outputs found
Analysis of the magnetic coupling in binuclear systems. III. The role of the ligand to metal charge transfer excitations revisited
In magnetic coordination compounds and solids the magnetic orbitals are essentially located on
metallic centers but present some delocalization tails on adjacent ligands. Mean field variational
calculations optimize this mixing and validate a single band modelization of the intersite magnetic
exchange. In this approach, due to the Brillouinâs theorem, the ligand to metal charge transfer
LMCT excitations play a minor role. On the other hand the extensive configuration interaction
calculations show that the determinants obtained by a single excitation on the top of the LMCT
configurations bring an important antiferromagnetic contribution to the magnetic coupling.
Perturbative and truncated variational calculations show that contrary to the interpretation given in
a previous article C. J. Calzado et al., J. Chem. Phys. 116, 2728 2002 the contribution of these
determinants to the magnetic coupling constant is not a second-order one. An analytic development
enables one to establish that they contribute at higher order as a correlation induced increase in the
LMCT components of the wave function, i.e., of the mixing between the ligand and the magnetic
orbitals. This larger delocalization of the magnetic orbitals results in an increase in both the ferroand
antiferromagnetic contributions to the coupling constan
Evaluation of Nutritional Practices in the Critical Care patient (The ENPIC study) : Does nutrition really affect ICU mortality?
The importance of artificial nutritional therapy is underrecognized, typically being considered an adjunctive rather than a primary therapy. We aimed to evaluate the influence of nutritional therapy on mortality in critically ill patients. Methods: This multicenter prospective observational study included adult patients needing artificial nutritional therapy for >48 h if they stayed in one of 38 participating intensive care units for â„72 h between April and July 2018. Demographic data, comorbidities, diagnoses, nutritional status and therapy (type and details for â€14 days), and outcomes were registered in a database. Confounders such as disease severity, patient type (e.g., medical, surgical or trauma), and type and duration of nutritional therapy were also included in a multivariate analysis, and hazard ratios (HRs) and 95% confidence intervals (95%CIs) were reported. We included 639 patients among whom 448 (70.1%) and 191 (29.9%) received enteral and parenteral nutrition, respectively. Mortality was 25.6%, with non-survivors having the following characteristics: older age; more comorbidities; higher Sequential Organ Failure Assessment (SOFA) scores (6.6 ± 3.3 vs 8.4 ± 3.7; P < 0.001); greater nutritional risk (Nutrition Risk in the Critically Ill [NUTRIC] score: 3.8 ± 2.1 vs 5.2 ± 1.7; P < 0.001); more vasopressor requirements (70.4% vs 83.5%; P=0.001); and more renal replacement therapy (12.2% vs 23.2%; P=0.001). Multivariate analysis showed that older age (HR: 1.023; 95% CI: 1.008-1.038; P=0.003), higher SOFA score (HR: 1.096; 95% CI: 1.036-1.160; P=0.001), higher NUTRIC score (HR: 1.136; 95% CI: 1.025-1.259; P=0.015), requiring parenteral nutrition after starting enteral nutrition (HR: 2.368; 95% CI: 1.168-4.798; P=0.017), and a higher mean Kcal/Kg/day intake (HR: 1.057; 95% CI: 1.015-1.101; P=0.008) were associated with mortality. By contrast, a higher mean protein intake protected against mortality (HR: 0.507; 95% CI: 0.263-0.977; P=0.042). Old age, higher organ failure scores, and greater nutritional risk appear to be associated with higher mortality. Patients who need parenteral nutrition after starting enteral nutrition may represent a high-risk subgroup for mortality due to illness severity and problems receiving appropriate nutritional therapy. Mean calorie and protein delivery also appeared to influence outcomes. ClinicaTrials.gov NCT: 03634943