Primary Care Practices’ Progress of Using Electronic Health Information Exchange (HIE)

Now that EHRs are purportedly fully implemented in the healthcare industry, it is important to evaluate the electronic Health Information Exchange (HIE) between primary care facilities, laboratories, hospitals, specialists, regional coops, and public health authorities. Meaningful Use Stage 3 implementation is to begin this year, 2018. Complementing this implementation, the Medicare Access and CHIP Reauthorization Act, MACRA, was signed into law on April 16, 2015. MACRA removes eligible clinicians from EHR Incentive Programs that were previously established by the HITECH Act. MACRA also creates the Quality Payment Program that the CMS will use for Medicare and Medicaid reimbursement to primary care providers. This payment program rewards clinicians for value over volume. The amount of reimbursement the CMS pays out is dependent on performance markers deemed as quality patient care. Electronic HIE directly affects a clinicians ability to achieve these performance markers. This research study assesses the progress that primary care practices have had in reaching full spectrum industry electronic health information exchange. It will answer the question; does primary care practices electronically connect with their local laboratories, hospitals and regional data collecting entities. Additionally, the barriers that prevent electronic health information exchanged and interoperability between primary care practices and other medical professionals outside their organization will be analyzed. This study focus is limited to primary care providers

Shape evolution and shape coexistence in Pt isotopes: comparing interacting boson model configuration mixing and Gogny mean-field energy surfaces

The evolution of the total energy surface and the nuclear shape in the isotopic chain $^{172-194}$Pt are studied in the framework of the interacting boson model, including configuration mixing. The results are compared with a self-consistent Hartree-Fock-Bogoliubov calculation using the Gogny-D1S interaction and a good agreement between both approaches shows up. The evolution of the deformation parameters points towards the presence of two different coexisting configurations in the region 176 $\leq$ A $\leq$ 186.Comment: Submitted to PR

The Motion-Lab: A Virtual Reality Laboratory for Spatial Updating Experiments

The main question addressed in the Motion-Lab is: How do we know where we are? Normally, humans know where they are with respect to the immediate surround. The overall perception of this environment results from the integration of multiple sensory modalities. Here we use Virtual Reality to study the interaction of visual, vestibular, and proprioceptive senses and explore the way these senses might be integrated into a coherent perception of spatial orientation and location. This Technical Report describes a Virtual Reality laboratory, its technical implementation as a distributed network of computers and discusses its usability for experiments designed to investigate questions of spatial orientation

Solution of the Bohr hamiltonian for soft triaxial nuclei

The Bohr-Mottelson model is solved for a generic soft triaxial nucleus, separating the Bohr hamiltonian exactly and using a number of different model-potentials: a displaced harmonic oscillator in $\gamma$, which is solved with an approximated algebraic technique, and Coulomb/Kratzer, harmonic/Davidson and infinite square well potentials in $\beta$, which are solved exactly. In each case we derive analytic expressions for the eigenenergies which are then used to calculate energy spectra. Here we study the chain of osmium isotopes and we compare our results with experimental information and previous calculations.Comment: 13 pages, 9 figure

What can be learned from binding energy differences about nuclear structure: the example of delta V_{pn}

We perform an analysis of a binding energy difference called delta V_{pn}(N,Z) =- 1/4(E(Z,N)-E(Z,N-2)-E(Z-2,N)+ E(Z-2,N-2) in the framework of a realistic nuclear model. Using the angular-momentum and particle-number projected generator coordinate method and the Skyrme interaction SLy4, we analyze the contribution brought to delta V_{pn} by static deformation and dynamic fluctuations around the mean-field ground state. Our method gives a good overall description of delta V_{pn} throughout the chart of nuclei with the exception of the anomaly related to the Wigner energy along the N=Z line. The main conclusions of our analysis are that (i) the structures seen in the systematics of delta V_{pn} throughout the chart of nuclei can be easily explained combining a smooth background related to the symmetry energy and correlation energies due to deformation and collective fluctuations; (ii) the characteristic pattern of delta V_{pn} around a doubly-magic nucleus is a trivial consequence of the asymmetric definition of delta V_{pn}, and not due to a the different structure of these nuclei; (iii) delta V_{pn} does not provide a very reliable indicator for structural changes; (iv) \delta V_{pn} does not provide a reliable measure of the proton-neutron interaction in the nuclear EDF, neither of that between the last filled orbits, nor of the one summed over all orbits; (v) delta V_{pn} does not provide a conclusive benchmark for nuclear EDF methods that is superior or complementary to other mass filters such as two-nucleon separation energies or Q values.Comment: 19 pages and 12 figure

Shell-model description of monopole shift in neutron-rich Cu

Variations in the nuclear mean-field, in neutron-rich nuclei, are investigated within the framework of the nuclear shell model. The change is identified to originate mainly from the monopole part of the effective two-body proton-neutron interaction. Applications for the low-lying states in odd-$A$ Cu nuclei are presented. We compare the results using both schematic and realistic forces. We also compare the monopole shifts with the results obtained from large-scale shell-model calculations, using the same realistic interaction, in order to study two-body correlations beyond the proton mean-field variations.Comment: Phys. Rev. C (in press

Two-dimensional silica: Crystalline and vitreous

Two-dimensional SiO₂ films may be grown on metal single crystal surfaces. It is possible to grow crystalline and vitreous (glassy) films and study their structural, vibrational, and electronic properties. In particular, the structures of a crystalline and a vitreous film may be imaged with atomic resolution side by side which opens avenues to study long standing problems of real space imaging of a crystal to glass transition

Modelling the atomic arrangement of amorphous 2D silica: a network analysis

The recent experimental discovery of a semi two-dimensional silica glass has offered a realistic description of the random network theory of a silica glass structure, initially discussed by Zachariasen. To study the structure formation of silica in two dimensions, we introduce a two-body force field, based on a soft core Yukawa potential. The different configurations, sampled via Molecular dynamics simulations, can be directly compared with the experimental structures, which have been provided in the literature. The parameters of the force field are obtained from comparison of the nearest-neighbor distances between experiment and simulation. Further key properties such as angle distributions, distribution of ring sizes and triplets of rings are analyzed and compared with the experiment. Of particular interest is the spatial correlation of ring sizes. In general, we observe a very good agreement between experiment and simulation. Additional insight from the simulations is provided about the temporal and spatial stability of the rings in dependence of their size

Pairing-excitation versus intruder states in 68Ni and 90Zr

A discussion on the nature of the 0+ states in 68Ni (Z=28, N=40) is presented and a comparison is made with its valence counterpart 90Zr (Z=40, N=50). Evidence is given for a 0+ proton intruder state at only ~2.2 MeV excitation energy in 68Ni, while the analogous neutron intruder states in 90Zr reside at 4126 keV and 5441 keV. The application of a shell-model description of 0+ intruder states reveals that many pair-scattered neutrons across N=40 have to be involved to explain the low excitation energy of the proton-intruder configuration in 68Ni.Comment: 10 pages, 2 figures, 1 tabl