Orders of Magnitude Improved Cyclotron-Mode Cooling for Nondestructive Spin Quantum Transition Spectroscopy with Single Trapped Antiprotons.

We demonstrate efficient subthermal cooling of the modified cyclotron mode of a single trapped antiproton and reach particle temperatures T_{+}=E_{+}/k_{B} below 200 mK in preparation times shorter than 500 s. This corresponds to the fastest resistive single-particle cyclotron cooling to subthermal temperatures ever demonstrated. By cooling trapped particles to such low energies, we demonstrate the detection of antiproton spin transitions with an error rate <0.

Image-Current Mediated Sympathetic Laser Cooling of a Single Proton in a Penning Trap Down to 170 mK Axial Temperature.

We demonstrate a new temperature record for image-current mediated sympathetic cooling of a single proton in a cryogenic Penning trap by laser-cooled ^{9}Be^{+}. An axial mode temperature of 170 mK is reached, which is a 15-fold improvement compared to the previous best value. Our cooling technique is applicable to any charged particle, so that the measurements presented here constitute a milestone toward the next generation of high-precision Penning-trap measurements with exotic particles.

More Tethered to the EHR: EHR Workload Trends Among Academic Primary Care Physicians, 2019-2023.

Purpose: The purpose of this study is to evaluate recent trends in primary care physician (PCP) electronic health record (EHR) workload.

Methods: This longitudinal study observed the EHR use of 141 academic PCPs over 4 years (May 2019 to March 2023). Ambulatory full-time equivalency (aFTE), visit volume, and panel size were evaluated.

Trap-integrated fluorescence detection with silicon photomultipliers for sympathetic laser cooling in a cryogenic Penning trap.

We present a fluorescence-detection system for laser-cooled 9Be+ ions based on silicon photomultipliers (SiPMs) operated at 4 K and integrated into our cryogenic 1.9 T multi-Penning-trap system. Our approach enables fluorescence detection in a hermetically sealed cryogenic Penning-trap chamber with limited optical access, where state-of-the-art detection using a telescope and photomultipliers at room temperature would be extremely difficult.

BASE-STEP: A transportable antiproton reservoir for fundamental interaction studies.

Currently, the world's only source of low-energy antiprotons is the AD/ELENA facility located at CERN. To date, all precision measurements on single antiprotons have been conducted at this facility and provide stringent tests of fundamental interactions and their symmetries. However, magnetic field fluctuations from the facility operation limit the precision of upcoming measurements.

Ultra-thin polymer foil cryogenic window for antiproton deceleration and storage.

We present the design and characterization of a cryogenic window based on an ultra-thin aluminized biaxially oriented polyethylene terephthalate foil at T < 10 K, which can withstand a pressure difference larger than 1 bar at a leak rate <1×10-9 mbar l/s. Its thickness of ∼1.7 μm makes it transparent to various types of particles over a broad energy range.

BASE-high-precision comparisons of the fundamental properties of protons and antiprotons.

Abstract: The BASE collaboration at the antiproton decelerator/ELENA facility of CERN compares the fundamental properties of protons and antiprotons with ultra-high precision. Using advanced Penning trap systems, we have measured the proton and antiproton magnetic moments with fractional uncertainties of 300 parts in a trillion (p.p.

Refining Vendor-Defined Measures to Accurately Quantify EHR Workload Outside Time Scheduled With Patients.

Accurately quantifying clinician time spent on electronic health record (EHR) activities outside the time scheduled with patients is critical for understanding occupational stress associated with ambulatory clinic environments. We make 3 recommendations regarding EHR workload measures that are intended to capture time working in the EHR outside time scheduled with patients, formally defined as work outside of work (WOW): (1) separate all time working in the EHR outside of time scheduled with patients from time working in the EHR during time scheduled with patients, (2) do not exclude any time before or after scheduled time with patients, and (3) encourage the EHR vendor and research communities to develop and standardize validated, vendor-agnostic methods for measuring active EHR use. Attributing all EHR work outside time scheduled with patients to WOW, regardless of when it occurs, will produce an objective and standardized measure better suited for use in efforts to reduce burnout, set policy, and facilitate research.

Management of Locally Advanced or Metastatic Combined Hepatocellular Cholangiocarcinoma.

Combined hepatocellular cholangiocarcinoma (cHCC-CC) is a rare primary liver malignancy that comprises features of hepatocellular carcinoma (HCC) and cholangiocarcinoma (CC). Due to the rarity of this tumor, the treatment of choice has not yet been defined. For resectable disease, liver resection is the mainstay treatment.

Adsorption of oleic acid on magnetite facets.

The microscopic understanding of the atomic structure and interaction at carboxylic acid/oxide interfaces is an important step towards tailoring the mechanical properties of nanocomposite materials assembled from metal oxide nanoparticles functionalized by organic molecules. We have studied the adsorption of oleic acid (CHCOOH) on the most prominent magnetite (001) and (111) crystal facets at room temperature using low energy electron diffraction, surface X-ray diffraction and infrared vibrational spectroscopy complemented with molecular dynamics simulations used to infer specific hydrogen bonding motifs between oleic acid and oleate. Our experimental and theoretical results give evidence that oleic acid adsorbs dissociatively on both facets at lower coverages.

Primary Care Patients' and Staff's Perceptions of Self-Rooming as Alternative to Waiting Rooms.

Purpose: Most patients are escorted to exam rooms (escorted rooming) although patients directing themselves to their exam room (self-rooming) saves patient and staff time while increasing patient satisfaction. This study assesses patient and staff perceptions after pragmatic implementation of self-rooming.

Methods: In October-December 2020, we surveyed patients and staff in 25 primary care clinics after our institution expanded self-rooming from 4 specially built clinics during the COVID-19 pandemic.

Does a Change in Physician Compensation Lead to Changes in Care Delivery in Family Medicine Clinics?

Background And Objectives: Many highly capitated systems still pay physicians based on relative value units (RVU), which may lead to excessive office visits. We reviewed electronic health records from the family medicine clinic panel members of 97 physicians and 42 residents to determine if a change from RVUs to panel-based compensation influenced care delivery as defined by the number of office visits and telephone contacts per panel member per month.

Methods: A retrospective analysis of the electronic health records of patients seen in 4 residency training clinics, 10 community clinics, and 4 regional clinics was conducted.

The effect of remote scribes on primary care physicians' wellness, EHR satisfaction, and EHR use.

Background: Physician burnout is a major problem in the United States. Small studies suggest scribes can improve clinician satisfaction, but scribe programs have not been evaluated using separate control groups or structured measures of electronic health record (EHR) use.

Methods: We conducted a pre-post, non-randomized controlled evaluation of a remote scribe pilot program introduced in September 2019 in an academic primary care practice.

Disparities in Use of Patient Portals Among Adults in Family Medicine.

Objective: This study examined patient portal utilization by analyzing the pattern of time and feature use of patients, and thus to identify functionalities of portal use and patient characteristics that may inform future strategies to enhance communication and care coordination through online portals.

Methods: We conducted a retrospective study of patients at 18 family medicine clinics over a 5-year period using access log records in the electronic health record database. Dimensionality reduction analysis was applied to group portal functionalities into 4 underlying feature domains: messaging, health information management, billing/insurance, and resource/education.

Surface structure of magnetite (111) under oxidizing and reducing conditions.

We report on differences in the magnetite (111) surface structure when prepared under oxidizing and reducing conditions. Both preparations were done under UHV conditions at elevated temperatures, but in one case the sample was cooled down while keeping it in an oxygen atmosphere. Scanning tunneling microscopy after each of the preparations showed a different apparent morphology, which is discussed to be an electronic effect and which is reflected in the necessity of using opposite bias tunneling voltages in order to obtain good images.

Reduction in Medication Refill Encounters Through Primary Care Redesign Workflow Changes.

With a goal of improving efficiency and reducing workload outside of visits, we sought to examine a primary care redesign process aimed at reducing refill requests made outside of office visits. Data on the number of refill encounters per panel member were collected at 17 clinics before, during, and after the implementation of a redesign process. There was an initial reduction in the number of medication refill encounters, and the rate of refill encounters continued to decline following implementation.

Hydrogen Solubility and Atomic Structure of Graphene Supported Pd Nanoclusters.

We investigated the atomic structure of graphene supported Pd nanoclusters and their interaction with hydrogen up to atmospheric pressures at room temperature by surface X-ray diffraction and scanning tunneling microscopy. We find that Ir seeded Pd nanocluster superlattices with 1.2 nm cluster diameters can be grown on the graphene/Ir(111) moiré template with high structural perfection.

Temperature-dependent near-surface interstitial segregation in niobium.

Niobium's superconducting properties are affected by the presence and precipitation of impurities in the near-surface region. A systematic wide-temperature range x-ray diffraction study is presented addressing the effect of low temperatures (108 K-130 K) and annealing treatments (523 K in nitrogen atmosphere, 400 K in UHV) on the near-surface region of a hydrogen-loaded Nb(100) single-crystal. Under these conditions, the response of the natural surface oxides (NbO, NbO, and NbO) and the changes in the subsurface concentration of interstitial species in Nb are explored, thereby including the cryogenic temperature regime relevant for device operation.

Role of hydroxylation for the atomic structure of a non-polar vicinal zinc oxide.

From the catalytic, semiconducting, and optical properties of zinc oxide (ZnO) numerous potential applications emerge. For the physical and chemical properties of the surface, under-coordinated atoms often play an important role, necessitating systematic studies of their influence. Here we study the vicinal ZnO([Formula: see text]) surface, rich in under-coordinated sites, using a combination of several experimental techniques and density functional theory calculations.

Expansion and Evaluation of Pharmacist Services in Primary Care.

Challenges with primary care access and overextended providers present opportunities for pharmacists as patient care extenders for chronic disease management. The primary objective was to align primary care pharmacist services with organizational priorities and improve patient clinical outcomes. The secondary objective was to develop a technological strategy for service evaluation.

Order-disorder phase transition of the subsurface cation vacancy reconstruction on FeO(001).

We present surface X-ray diffraction and fast scanning tunneling microscopy results to elucidate the nature of the surface phase transition on magnetite (001) from a reconstructed to a non-reconstructed surface around 720 K. In situ surface X-ray diffraction at a temperature above the phase transition, at which long-range order is lost, gives evidence that the subsurface cation vacancy reconstruction still exists as a local structural motif, in line with the characteristics of a 2D second-order phase transition. Fast scanning tunneling microscopy results across the phase transition underpin the hypothesis that the reconstruction lifting is initiated by surplus Fe ions occupying subsurface octahedral vacancies.