Differing Strategies to Meet Information‐Sharing Needs: Publicly Supported Community Health Information Exchanges Versus Health Systems’ Enterprise Health Information Exchanges

POLICY POINTS: Community health information exchanges have the characteristics of a public good, and they support population health initiatives at the state and national levels. However, current policy equally incentivizes health systems to create their own information exchanges covering more narrowly defined populations. Noninteroperable electronic health records and vendors' expensive custom interfaces are hindering health information exchanges. Moreover, vendors are imposing the costs of interoperability on health systems and community health information exchanges. Health systems are creating networks of targeted physicians and facilities by funding connections to their own enterprise health information exchanges. These private networks may change referral patterns and foster more integration with outpatient providers. CONTEXT: The United States has invested billions of dollars to encourage the adoption of and implement the information technologies necessary for health information exchange (HIE), enabling providers to efficiently and effectively share patient information with other providers. Health care providers now have multiple options for obtaining and sharing patient information. Community HIEs facilitate information sharing for a broad group of providers within a region. Enterprise HIEs are operated by health systems and share information among affiliated hospitals and providers. We sought to identify why hospitals and health systems choose either to participate in community HIEs or to establish enterprise HIEs. METHODS: We conducted semistructured interviews with 40 policymakers, community and enterprise HIE leaders, and health care executives from 19 different organizations. Our qualitative analysis used a general inductive and comparative approach to identify factors influencing participation in, and the success of, each approach to HIE. FINDINGS: Enterprise HIEs support health systems' strategic goals through the control of an information technology network consisting of desired trading partners. Community HIEs support obtaining patient information from the broadest set of providers, but with more dispersed benefits to all participants, the community, and patients. Although not an either/or decision, community and enterprise HIEs compete for finite organizational resources like time, skilled staff, and money. Both approaches face challenges due to vendor costs and less-than-interoperable technology. CONCLUSIONS: Both community and enterprise HIEs support aggregating clinical data and following patients across settings. Although they can be complementary, community and enterprise HIEs nonetheless compete for providers' attention and organizational resources. Health policymakers might try to encourage the type of widespread information exchange pursued by community HIEs, but the business case for enterprise HIEs clearly is stronger. The sustainability of a community HIE, potentially a public good, may necessitate ongoing public funding and supportive regulation

Far-ultraviolet signatures of the 3He(n,tp) reaction in noble gas mixtures

Previous work showed that the 3He(n,tp) reaction in a cell of 3He at atmospheric pressure generated tens of far-ultraviolet photons per reacted neutron. Here we report amplification of that signal by factors of 1000 and more when noble gases are added to the cell. Calibrated filter-detector measurements show that this large signal is due to noble-gas excimer emissions, and that the nuclear reaction energy is converted to far-ultraviolet radiation with efficiencies of up to 30%. The results have been placed on an absolute scale through calibrations at the NIST SURF III synchrotron. They suggest possibilities for high-efficiency neutron detectors as an alternative to existing proportional counters

Quantum Coherence Preservation in Extremely Dispersive Plasmonic Media

Quantum plasmonics experiments have on multiple occasions resulted in the observation of quantum coherence of discrete plasmons, which exhibit remarkable preservation of quantum interference visibility, a seemingly surprising feature for systems mixing light and matter with high Ohmic losses during propagation. However, most experiments to date used essentially weakly confined plasmons, which experience limited light-matter hybridization, thus limiting the potential for decoherence. In this paper, we investigate experimentally the robustness of coherence preservation in a plasmonic system: our setup is based on a hole-array chip supporting plasmons near the surface plasma frequency, where plasmonic dispersion and confinement are much stronger than in previous experiments, making the plasmons much more susceptible for decoherence processes. We, however, report preservation of quantum coherence even in these extreme conditions. We generate polarization-entangled pairs of photons using type-I spontaneous parametric down-conversion and transmit one of the photons through a plasmonic hole array that is numerically designed to convert incident single photons into highly dispersive single surface-plasmon polaritons. Our results show that the quality of photon entanglement after the plasmonic channel is unperturbed by the introduction of a highly dispersive plasmonic element. Our findings provide a lower bound of 100 fs for the pure dephasing time for dispersive plasmons in gold, and show that even in a highly dispersive regime surface plasmons preserve quantum mechanical correlations, making possible harnessing of the power of extreme light confinement for integrated quantum photonics

Patenting and licensing of university research: promoting innovation or undermining academic values?

Since the 1980s in the US and the 1990s in Europe, patenting and licensing activities by universities have massively increased. This is strongly encouraged by governments throughout the Western world. Many regard academic patenting as essential to achieve 'knowledge transfer' from academia to industry. This trend has far-reaching consequences for access to the fruits of academic research and so the question arises whether the current policies are indeed promoting innovation or whether they are instead a symptom of a pro-intellectual property (IP) culture which is blind to adverse effects. Addressing this question requires both empirical analysis (how real is the link between academic patenting and licensing and 'development' of academic research by industry?) and normative assessment (which justifications are given for the current policies and to what extent do they threaten important academic values?). After illustrating the major rise of academic patenting and licensing in the US and Europe and commenting on the increasing trend of 'upstream' patenting and the focus on exclusive as opposed to non-exclusive licences, this paper will discuss five negative effects of these trends. Subsequently, the question as to why policymakers seem to ignore these adverse effects will be addressed. Finally, a number of proposals for improving university policies will be made

Faraday waves on a viscoelastic liquid

We investigate Faraday waves on a viscoelastic liquid. Onset measurements and a nonlinear phase diagram for the selected patterns are presented. By virtue of the elasticity of the material a surface resonance synchronous to the external drive competes with the usual subharmonic Faraday instability. Close to the bicriticality the nonlinear wave interaction gives rise to a variety of novel surface states: Localised patches of hexagons, hexagonal superlattices, coexistence of hexagons and lines. Theoretical stability calculations and qualitative resonance arguments support the experimental observations.Comment: 4 pages, 4figure

Search for squarks and gluinos with the ATLAS detector in final states with jets and missing transverse momentum using √s=8 TeV proton-proton collision data

A search for squarks and gluinos in final states containing high-p T jets, missing transverse momentum and no electrons or muons is presented. The data were recorded in 2012 by the ATLAS experiment in s√=8 TeV proton-proton collisions at the Large Hadron Collider, with a total integrated luminosity of 20.3 fb−1. Results are interpreted in a variety of simplified and specific supersymmetry-breaking models assuming that R-parity is conserved and that the lightest neutralino is the lightest supersymmetric particle. An exclusion limit at the 95% confidence level on the mass of the gluino is set at 1330 GeV for a simplified model incorporating only a gluino and the lightest neutralino. For a simplified model involving the strong production of first- and second-generation squarks, squark masses below 850 GeV (440 GeV) are excluded for a massless lightest neutralino, assuming mass degenerate (single light-flavour) squarks. In mSUGRA/CMSSM models with tan β = 30, A 0 = −2m 0 and μ > 0, squarks and gluinos of equal mass are excluded for masses below 1700 GeV. Additional limits are set for non-universal Higgs mass models with gaugino mediation and for simplified models involving the pair production of gluinos, each decaying to a top squark and a top quark, with the top squark decaying to a charm quark and a neutralino. These limits extend the region of supersymmetric parameter space excluded by previous searches with the ATLAS detector

Measurement of the production of a W boson in association with a charm quark in pp collisions at √s = 7 TeV with the ATLAS detector

The production of a W boson in association with a single charm quark is studied using 4.6 fb−1 of pp collision data at s√ = 7 TeV collected with the ATLAS detector at the Large Hadron Collider. In events in which a W boson decays to an electron or muon, the charm quark is tagged either by its semileptonic decay to a muon or by the presence of a charmed meson. The integrated and differential cross sections as a function of the pseudorapidity of the lepton from the W-boson decay are measured. Results are compared to the predictions of next-to-leading-order QCD calculations obtained from various parton distribution function parameterisations. The ratio of the strange-to-down sea-quark distributions is determined to be 0.96+0.26−0.30 at Q 2 = 1.9 GeV2, which supports the hypothesis of an SU(3)-symmetric composition of the light-quark sea. Additionally, the cross-section ratio σ(W + +c¯¯)/σ(W − + c) is compared to the predictions obtained using parton distribution function parameterisations with different assumptions about the s−s¯¯¯ quark asymmetry