Ab initio study of the CE magnetic phase in half-doped manganites: Purely magnetic versus double exchange description

The leading electronic interactions governing the local physics of the CE phase of half-doped manganites are extracted from correlated ab initio calculations performed on an embedded cluster. The electronic structure of the low-energy states is dominated by double exchange configurations and O-2$p_{\sigma}$ to Mn-3d charge transfer configurations. The model spectra of both a purely magnetic non-symmetric Heisenberg Hamiltonian involving a magnetic oxygen and two non-symmetric double exchange models are compared to the \textit{ab initio} one. While a satisfactory agreement between the Heisenberg spectrum and the calculated one is obtained, the best description is provided by a double exchange model involving excited non-Hund atomic states. This refined model not only perfectly reproduces the spectrum of the embedded cluster in the crystal geometry, but also gives a full description of the local double-well potential energy curve of the ground state (resulting from the interaction of the charge localized electronic configurations) and the local potential energy curves of all excited states ruled by the double exchange mechanism

On the applicability of multireference second-order perturbation theory to study weak magnetic coupling in molecular complexes.

The performance of multiconfigurational second-order perturbation techniques is established for the calculation of small magnetic couplings in heterobinuclear complexes. Whereas CASPT2 gives satisfactory results for relatively strong magnetic couplings, the method shows important deviations from the expected Heisenberg spectrum for couplings smaller than 15-20 cm-1. The standard choice of the zeroth-order CASPT2 Hamiltonian is compared to alternative definitions published in the literature and the stability of the results is tested against increasing level shifts. Furthermore, we compare CASPT2 with an alternative implementation of multiconfigurational perturbation theory, namely NEVPT2 and with variational calculations based on the difference dedicated CI technique

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 ≥72 h between April and July 2018. Demographic data, comorbidities, diagnoses, nutritional status and therapy (type and details for ≤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