Tackling Future CMS Requirements—FDCCI, Shared Services, Big Data and Mobility by Tony Trenkle, Chief Information Officer and the Director of the Office of Information Services in the Centers for Medicare and Medicaid Services, Department of Health and Human Services
Totus Communications is a powerful Sales Force Automation tool that allows your sales force
and marketing department to quickly and effectively communicate with your prospects and
customers. Totus combines multiple communication mediums like E-mail, Print-on-Demand,
Electronic Greeting Cards, Premium Fulfillment, and Direct Mail Campaigns through one, easy-touse
user interface.
Mark Daniel
Vanick Group
mark.daniel@vanick.com
615-349-1983
Totus Communications is a powerful Sales Force Automation tool that allows your sales force
and marketing department to quickly and effectively communicate with your prospects and
customers. Totus combines multiple communication mediums like E-mail, Print-on-Demand,
Electronic Greeting Cards, Premium Fulfillment, and Direct Mail Campaigns through one, easy-touse
user interface.
Mark Daniel
Vanick Group
mark.daniel@vanick.com
615-349-1983
Cloud computing is a flexible, cost-effective and proven delivery platform for providing business or
consumer IT services over the Internet. Cloud resources can be rapidly deployed and easily scaled, with all
processes, applications and services provisioned “on demand,” regardless of user location or device.
Welcome to International Journal of Engineering Research and Development (IJERD)IJERD Editor
call for paper 2012, hard copy of journal, research paper publishing, where to publish research paper,
journal publishing, how to publish research paper, Call For research paper, international journal, publishing a paper, IJERD, journal of science and technology, how to get a research paper published, publishing a paper, publishing of journal, publishing of research paper, reserach and review articles, IJERD Journal, How to publish your research paper, publish research paper, open access engineering journal, Engineering journal, Mathemetics journal, Physics journal, Chemistry journal, Computer Engineering, Computer Science journal, how to submit your paper, peer reviw journal, indexed journal, reserach and review articles, engineering journal, www.ijerd.com, research journals,
yahoo journals, bing journals, International Journal of Engineering Research and Development, google journals, hard copy of journal,
ARMnet Integrated Financial Product Management solution is a CRM based software toolset that allows us to create and manage any type of loan, mortgage origination or servicing or wealth management product and service it through it\'s life cycle. The unique Service Oriented Architecture of the application is defined in the article.
With the increasing usage of smartphones and other devices, digitization of banking sector is expected to catch up the increasing expectations of the customer. Banks have a significant role in our lives. Every one of us will execute at least a single financial transaction in a day. Hence, it becomes necessary for banks to enrich customer experience. Digitization becomes mandate feature for banks since it is being adopted in all industries in day to day life. Banks love mainframes because only mainframes can provide a single, unified, efficient solution to a host of different problems. Most of the banks uses Mainframe because of it robust, reliable and secured processing power. It also supports the new technologies like mobile, cloud etc., A business case is presented in this paper to explain Micro service and API framework for existing legacy system. Existing architecture is tightly coupled services with less standardization and fair performance. The aim of this paper is to provide solutions to convert the existing architecture to flexible service to support business for time-to-market, increase in performance and operational efficiency and improve customer experience.
In this paper, we summarize and outline some of the big challenges in addressing performance, scalability, and availability of web applications with large and complex backend database systems. We present some of the limitations imposed by the CAP theorem on distributed DB development and identify some approaches that can be used to effectively address these limitations. We propose the adoption of an effective Cloud architecture approach that pushes adoption of principles supported by loosely-coupled SPU based design, which can support incremental development and rapid scalability of such complex and dynamic applicative need.
SELECTION MECHANISM OF MICRO-SERVICES ORCHESTRATION VS. CHOREOGRAPHY IJwest
ABSTRACT Web services is a special case of a service-oriented architecture (SOA), which is, basically, a representation of web application‘s functionality. Web service is more of a generalized concept that implies whole functionality as a whole but Microservice handles only the single specific task. MSA is emerging as an excellent architecture style enabling the division of large and complex applications into micro-scale yet many services, each runs in its own process, has its own APIs, and communicates with one another using lightweight mechanisms such as HTTP. Microservices are built around business capabilities, loosely coupled and highly cohesive, horizontally scalable, independently deployable, technology-agnostic, etc. On the other side for the business dynamic requirement these microservices need to be composed for the realization of enterprise-scale, and business-critical applications. Service composition is combining various services together to provide the solution for the user dynamic queries. There are two methods for the microservice composition i.e. orchestration and choreography. In this paper,a health case study is performed for the selection mechanism of orchestration method and choreography method in various situation.
Overview of Cogent Company. Cogent is a consulting firm based in Dallas with Offices in Chicago and Oklahoma City. Learn about our Microsoft-based consulting practice.
Accelerate Digital Transformation with Data Virtualization in Banking, Financ...Denodo
Watch full webinar here: https://bit.ly/38uCCUB
Banking, Financial Services and Insurance (BFSI) organizations are globally accelerating their digital journey, making rapid strides with their digitization efforts, and adding key capabilities to adapt and innovate in the new normal.
Many companies find digital transformation challenging as they rely on established systems that are often not only poorly integrated, but also highly resistant to modernization without downtime. Hear how the BFSI industry is leveraging data virtualization that facilitates digital transformation via a modern data integration / data delivery approach to gain greater agility, flexibility, and efficiency.
In this joint live webinar session from Denodo and Wipro, you will learn:
- Industry key trends and challenges driving the digital transformation mandate and platform modernization initiatives
- Key concepts of Data Virtualization, and how it can enable BFSI customers to develop critical capabilities for real-time / near real-time data integration
- Success Stories on organizations who already use data virtualization to differentiate themselves from the competition
- Wipro’s role in helping enterprises define the business case, end-to-end services and operating model for the successful data virtualization implementations
Schedule a Discovery Session to learn more about Wipro and Denodo joint solutions for Banking, Financial Services, and Insurance.
Netmagic solutions, leading IT Managed service provider with Data centers & Cloud Computing in India fulfills your entire IT infrastructure requirements: from collocation services to dedicated hosting, diaster recovery & data Storage solutions.
Accelerating Cognitive Business with Hybrid CloudDenny Muktar
IBM Indonesia BusinessConnect Events, March 22nd, 2016.
Disruptors are reinventing business processes and leading their industries with digital transformations. Cognitive Business extends digital business with cognitive computing - both of which exist in and are built using the cloud. This presentation covers an IBM approach of building and starting the Hybrid Cloud Journey.
Cloud computing is a flexible, cost-effective and proven delivery platform for providing business or
consumer IT services over the Internet. Cloud resources can be rapidly deployed and easily scaled, with all
processes, applications and services provisioned “on demand,” regardless of user location or device.
Welcome to International Journal of Engineering Research and Development (IJERD)IJERD Editor
call for paper 2012, hard copy of journal, research paper publishing, where to publish research paper,
journal publishing, how to publish research paper, Call For research paper, international journal, publishing a paper, IJERD, journal of science and technology, how to get a research paper published, publishing a paper, publishing of journal, publishing of research paper, reserach and review articles, IJERD Journal, How to publish your research paper, publish research paper, open access engineering journal, Engineering journal, Mathemetics journal, Physics journal, Chemistry journal, Computer Engineering, Computer Science journal, how to submit your paper, peer reviw journal, indexed journal, reserach and review articles, engineering journal, www.ijerd.com, research journals,
yahoo journals, bing journals, International Journal of Engineering Research and Development, google journals, hard copy of journal,
ARMnet Integrated Financial Product Management solution is a CRM based software toolset that allows us to create and manage any type of loan, mortgage origination or servicing or wealth management product and service it through it\'s life cycle. The unique Service Oriented Architecture of the application is defined in the article.
With the increasing usage of smartphones and other devices, digitization of banking sector is expected to catch up the increasing expectations of the customer. Banks have a significant role in our lives. Every one of us will execute at least a single financial transaction in a day. Hence, it becomes necessary for banks to enrich customer experience. Digitization becomes mandate feature for banks since it is being adopted in all industries in day to day life. Banks love mainframes because only mainframes can provide a single, unified, efficient solution to a host of different problems. Most of the banks uses Mainframe because of it robust, reliable and secured processing power. It also supports the new technologies like mobile, cloud etc., A business case is presented in this paper to explain Micro service and API framework for existing legacy system. Existing architecture is tightly coupled services with less standardization and fair performance. The aim of this paper is to provide solutions to convert the existing architecture to flexible service to support business for time-to-market, increase in performance and operational efficiency and improve customer experience.
In this paper, we summarize and outline some of the big challenges in addressing performance, scalability, and availability of web applications with large and complex backend database systems. We present some of the limitations imposed by the CAP theorem on distributed DB development and identify some approaches that can be used to effectively address these limitations. We propose the adoption of an effective Cloud architecture approach that pushes adoption of principles supported by loosely-coupled SPU based design, which can support incremental development and rapid scalability of such complex and dynamic applicative need.
SELECTION MECHANISM OF MICRO-SERVICES ORCHESTRATION VS. CHOREOGRAPHY IJwest
ABSTRACT Web services is a special case of a service-oriented architecture (SOA), which is, basically, a representation of web application‘s functionality. Web service is more of a generalized concept that implies whole functionality as a whole but Microservice handles only the single specific task. MSA is emerging as an excellent architecture style enabling the division of large and complex applications into micro-scale yet many services, each runs in its own process, has its own APIs, and communicates with one another using lightweight mechanisms such as HTTP. Microservices are built around business capabilities, loosely coupled and highly cohesive, horizontally scalable, independently deployable, technology-agnostic, etc. On the other side for the business dynamic requirement these microservices need to be composed for the realization of enterprise-scale, and business-critical applications. Service composition is combining various services together to provide the solution for the user dynamic queries. There are two methods for the microservice composition i.e. orchestration and choreography. In this paper,a health case study is performed for the selection mechanism of orchestration method and choreography method in various situation.
Overview of Cogent Company. Cogent is a consulting firm based in Dallas with Offices in Chicago and Oklahoma City. Learn about our Microsoft-based consulting practice.
Accelerate Digital Transformation with Data Virtualization in Banking, Financ...Denodo
Watch full webinar here: https://bit.ly/38uCCUB
Banking, Financial Services and Insurance (BFSI) organizations are globally accelerating their digital journey, making rapid strides with their digitization efforts, and adding key capabilities to adapt and innovate in the new normal.
Many companies find digital transformation challenging as they rely on established systems that are often not only poorly integrated, but also highly resistant to modernization without downtime. Hear how the BFSI industry is leveraging data virtualization that facilitates digital transformation via a modern data integration / data delivery approach to gain greater agility, flexibility, and efficiency.
In this joint live webinar session from Denodo and Wipro, you will learn:
- Industry key trends and challenges driving the digital transformation mandate and platform modernization initiatives
- Key concepts of Data Virtualization, and how it can enable BFSI customers to develop critical capabilities for real-time / near real-time data integration
- Success Stories on organizations who already use data virtualization to differentiate themselves from the competition
- Wipro’s role in helping enterprises define the business case, end-to-end services and operating model for the successful data virtualization implementations
Schedule a Discovery Session to learn more about Wipro and Denodo joint solutions for Banking, Financial Services, and Insurance.
Netmagic solutions, leading IT Managed service provider with Data centers & Cloud Computing in India fulfills your entire IT infrastructure requirements: from collocation services to dedicated hosting, diaster recovery & data Storage solutions.
Accelerating Cognitive Business with Hybrid CloudDenny Muktar
IBM Indonesia BusinessConnect Events, March 22nd, 2016.
Disruptors are reinventing business processes and leading their industries with digital transformations. Cognitive Business extends digital business with cognitive computing - both of which exist in and are built using the cloud. This presentation covers an IBM approach of building and starting the Hybrid Cloud Journey.
Digital innovation being demanded by every business unit is transforming IT’s role to that of the main driver of new growth initiatives, prompting a shift in perspective and strategy for CIOs that begins with a well-planned and executed approach to managing customer identities. While legacy IAM might seem like a natural starting point for meeting this challenge, customer identity and access management (CIAM) has significantly different requirements and outcomes when compared to employee-facing IAM.
Denodo DataFest 2017: The Need for Speed and Agility in BusinessDenodo
Watch the live presentation here: https://goo.gl/c3sbGY
Speed is everything. Businesses that move fast leave their competition in the dust. But one needs high performance architecture to enable it.
Watch this Denodo DataFest 2017 session to discover:
• How businesses can move faster than their competitors with the right architecture.
• The critical technology component that enables speed and agility.
• How to build a data services layer to protect the data sources from corruption.
Join our webinar to learn how BMC enables enterprise customers to transform their organization to a digital DevOps model. In this webinar, NICE InContact will share their story of transforming from a physical data center to a hybrid environment, including data center and cloud infrastructure. They'll talk about strategies, challenges, best practices, and navigating an acquisition. Learn how NICE InContact improved service management and capacity management as well as resolution time for incidents using BMC TrueSight and AWS DevOps solutions. Join us to learn from a peer in the enterprise space to help you plan your own IT infrastructure transformation.
By leveraging Dell Boomi #Integration and Master Data Management the biotech business was in a position to glue #cloud-based applications with database instances across about nine distinct application platforms...bit.ly/2Nx0Feu
CIS13: Cloud, Identity Bridges, and ITSM: Three is Not a CrowdCloudIDSummit
Halim Cho, Director of Product Marketing, Covisint
The rapid adoption of cloud-based services and the increasingly compelling business advantages of a hybrid cloud strategy are presenting IT with new and unforeseen challenges around ITSM. In this session, Halim Cho will discuss these trends, technologies and challenges, plus he’ll share his thoughts on how identity bridges can help transform ITSM in a hybrid cloud environment. His presentation will cover three main topics:
1. The challenges: an overview of the most common architectural patterns seen in cloud adoption and the technical and operational challenges that each pattern raises.
2. The future: technical and operational reasons why the hybrid cloud is the most likely path enterprises will take.
3. The technology: a technical overview of the top technologies that identity bridges will be required to manage and integrate in order to meet the ITSM challenges of hybrid cloud adoption.
AIIM Info 2011 Increasing mobile worker productivityZia Consulting
This session describes how education, healthcare and government organizations can implement a collaborative mobile ECM and Project management strategy for their workforce. Attend as we cover the benefits of using CMIS, mobile applications and devices, and best practices for a mobile ECM delivery strategy.
• The value of writing content rich mobile CMIS applications that work against multiple ECM repositories.
• How to build a strategy to enable increased mobile worker productivity by created task-oriented ECM and project management related activities delivered on mobile devices.
• Mobile ECM best practices that utilize a variety of free and widely available software packages on the iPhone and iPad.
• Examples of mobile content delivery and how it has saved local governments time and money.
Cloud computing holds the promise of elevating IT within the enterprise by addressing the need for rapid service delivery.
Today, clouds can be implemented in a variety of ways: private, public, and hybrid.
This combination places IT in the unique role of being a service broker, enabling it to provide a range of service delivery options. This allows applications and data to be placed in the appropriate locations based on unique business requirements.
The proposed Trusted Exchange Framework supports ONC’s goals of achieving nationwide interoperability:
Patient Access - Patients must be able to access their health information electronically without any special effort;
Population-level Data Exchange - Providers and payer organizations accountable for managing benefits can receive population level health information allowing them to analyze population health trends, outcomes, and costs; identify at-risk populations; and track progress on quality improvement initiatives; and
Open and Accessible APIs – The health information technology (health IT) community should have open and accessible application programming interfaces (APIs) to encourage entrepreneurial, user-focused innovation to make health information more accessible and to improve electronic health record (EHR) usability.
2015 Edition Proposed RuleModifications to the ONC Health IT Certification ...Brian Ahier
Presentation to April 7, 2015 Health IT Policy Committee:
2015 Edition Proposed RuleModifications to the ONC Health IT Certification Program and 2015 Edition Health IT Certification Criteria
Remarks to Public Forum on National Health IT PolicyBrian Ahier
On February 4, 2010 there was a public forum on the rollout of national HIT policy under HITECH, including "meaningful use," EHR certification, and HIE. Aneesh Chopra, at the time serving as Chief Technology Office (CTO) of the United States made some remarks.
FTC Spring Privacy Series: Consumer Generated and Controlled Health DataBrian Ahier
Increasingly, consumers are taking a more active role in managing and generating their own health data. For example, consumers are researching their health conditions and diagnosing themselves online. Consumers are also uploading their information into personal health records and apps that allow them to manage and analyze their data, and utilizing connected health and fitness devices that regularly collect information about them and transmit this information to other entities.
The movement of health data outside the traditional medical provider context has many potential benefits; however, it also raises potential privacy concerns. The seminar will address questions such as:
What types of websites, products, and services are consumers using to generate and control their health data, and how are consumers using them?
Who are the companies behind these websites, products, and services, what are their business models, and what does the current marketplace look like?
How can consumers benefit from these companies’ websites, products, and services?
What actions are these companies taking to protect consumers’ privacy and security?
What do consumers expect from these companies regarding privacy and security protections?
Do consumers differentiate between these companies and those that offer traditional medical products and services that are covered by HIPAA?
What restrictions, if any, do advertising networks and others impose on tracking of health data?
On February 19, 2014, the Federal Trade Commission staff hosted a seminar on Mobile Device Tracking.
The speakers discussed how retailers and other businesses have been tracking consumers’ movements throughout and around retail stores and other attractions using technologies that identify signals emitted by their mobile devices. While the technologies differ, many work by identifying and collecting the MAC address – which is unique to a particular device – broadcast when a mobile device searches for Wi-Fi networks. Companies can use these technologies to reveal information about consumers including the path taken throughout a location, length of time in one location, whether a visitor is new or returning, and the frequency of visits to a location. According to media reports, major retailers in the United States are using or have tested the technology in their stores in order to gain insights into the behavior of their customers.
In most cases, this tracking is invisible to consumers and occurs with no consumer interaction. As a result, the use of these technologies raises a number of potential privacy concerns and questions.
Big Data and VistA Evolution, Theresa A. Cullen, MD, MSBrian Ahier
Presentation to Open Source Electronic Health Record Alliance (OSEHRA) Architecture Work Group by Theresa A. Cullen, MD, MS
Chief Medical Information Officer
Director, Health Informatics
Office of Informatics and Analytics
Veterans Health Administration
Department of Veterans Affairs
Basavarajeeyam is a Sreshta Sangraha grantha (Compiled book ), written by Neelkanta kotturu Basavaraja Virachita. It contains 25 Prakaranas, First 24 Chapters related to Rogas& 25th to Rasadravyas.
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
Basavarajeeyam is an important text for ayurvedic physician belonging to andhra pradehs. It is a popular compendium in various parts of our country as well as in andhra pradesh. The content of the text was presented in sanskrit and telugu language (Bilingual). One of the most famous book in ayurvedic pharmaceutics and therapeutics. This book contains 25 chapters called as prakaranas. Many rasaoushadis were explained, pioneer of dhatu druti, nadi pareeksha, mutra pareeksha etc. Belongs to the period of 15-16 century. New diseases like upadamsha, phiranga rogas are explained.
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
263778731218 Abortion Clinic /Pills In Harare ,sisternakatoto
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4. CMS Operations
• More than 98 million beneficiaries (not counting additional potential
30+ million Americans that will be added through health care reform).
• CMS expends approximately 1 trillion dollars annually on Medicare,
Medicaid, and CHIP programs.
• More than 900 million Medicare fee-for-service claims
• More than 1.6 billion claims for Medicaid beneficiaries
• More than 11 million home health assessment records
• More than 13 million nursing home assessment records
4
5. CMS IT
• Counting payments to the states the FY12 operating plan
was $3.8 billion.
• If CMS were a separate agency, that would make us the
third largest IT budget behind only DoD and DHS.
• CMS’s IT infrastructure is very decentralized and funded
mostly on a programmatic basis.
5
6. Critical IT Challenges …CMS IT Transformation Goals
CHALLENGES TRANSFORMATION GOALS
• Huge ACA IT Requirements • Meet Legislative Mandates with
Enterprise IT Shared Services
• Successful Health Reform depends on
more and better data • Create the Data Infrastructure to
maximize CMS Data and Information
• IT funding from multiple budgets Product Use
• Complex and Old IT infrastructure • Transform IT Portfolio Management
and Governance
• Decentralized IT infrastructure
• Transform CMS IT Operations
• Rapid Technological change
• Improve CMS’ Information Security
• Heavy Contractor Presence/Aging and Privacy Posture
Federal workforce • Identify and Adopt Innovative
Technologies
• Improve Organizational Effectiveness
6
8. Enterprise Shared Services
• What: Scalable, reusable business/technical solutions that
serve multiple business processes
• Why: Tight budgets, need to leverage solutions across
business lines and enhance interoperability
• Four initial “big hitters” selected to be implemented
– Enterprise Identity Management (EIDM)
– Enterprise Portal
– Master Data Management (MDM)
– Business Rules Engine
8
9. Stages of Shared Services
FY2014
FY2013 Showing
real ROI
Supporting for
major programs
FY2012
programs
Foundation
work
9
10. CMS Enterprise Shared Services: EIDM
Business Rules Enterprise Master Data
Engine Service Portal Management
Individuals will have a single identity for
engaging in business with CMS that meets
all federal security requirements
Enterprise Remote Identity Proofing (RIDP)
Identity User Identification, Verification and
Authentication
Management
Enterprise Identity Management (EIDM)
Shared Service
Managing connections from user to a CMS
application
10
11. What do we deliver to business?
• Reduce overall CMS access management costs by combining existing
authentication and authorization systems
– Over 175 CMS applications with 135,000+ users currently using seven different access management systems
• Meet the requirements to support the ACA Health Insurance Exchange
– Exchanges will potentially add 30 – 50 million users
– Legislation requires a simple and clear path for customer experience
• Improved experience for external users that access multiple CMS systems (e.g.,
providers) that currently have different proofing
• Future: Ability to rely on other identity proofers (federated identity)
• Current Status
– Contracts have been awarded for remote ID proofing and enterprise ID management
– First application uses will begin to be implemented over the next several months
11
12. CMS Enterprise Shared Services: Portal
Enterprise
Master Data Business Rules
Identity
Management Engine Service
Management
A central preferred channel for beneficiaries,
providers, organizations and States to receive
CMS information, products, and services
Secure access to
Enterprise Portal enumeration, e-enrollment,
e-Registration, status checking, and reporting
Shared Service services
Improved usability and higher customer
satisfaction
12
13. What do we deliver to business?
• Consistent user interface design to support a “single face of CMS”
• Integrated access to multiple CMS websites/portals reduces need
for users to access multiple URLs to access the information or
applications they need
• Ability for users to customize/personalize their portal experience.
• Current Status
– Initial portal capability has been implemented.
– Additional portlets will be added in the next several months
13
14. CMS Enterprise Shared Services: MDM
Enterprise Business Rules Enterprise
Identity Engine Service Portal
Management
A suite of data records and services that
will allow CMS to link and synchronize
beneficiary, provider and organization data
to multiple disparate sources
Master Data Provider and beneficiary profiles (book of
Management record) will be obtainable through a singe
call to a trusted, authoritative data service
Shared Service that is part of the MDM system
Relationships between beneficiaries,
providers and organizations can be tracked
across all CMS programs
14
15. What do we deliver to business?
• Foundational, centralized source of reference data for Providers,
Beneficiaries, Organizations/Plans, and Programs and
relationships between these entities
• Integrated data from many disparate data sources (including
Medicaid)
• Data services and BI tools that applications can consume to
access the data
• Current Status:
– Initial support provider and beneficiary alignment/assignment for ACO SSP and
Pioneer demos was implemented in May
– Other capabilities will be implemented in the next several months
15
16. CMS Enterprise Shared Services: BRES
Enterprise
Enterprise Master Data
Identity
Portal Management
Management
A software tool that can execute one or more
business rules within CMS IT application code
Establish business rules governance policies
Business Rules for creating and enhancing business rules
Engine Management of all enterprise rules, define the
Shared Service relationships between different rules and relate
some rules to the IT applications accessing the
service
16
17. What do we deliver to business?
• “Rules engine” tool that supports rule development and translation
to consumable code that applications can call
• Centralized repository of business rules that new applications can
use as-is or modify
• Standardized complex logic currently embedded in many different
systems (e.g., what is a dual eligible)
• Current Status:
– Support ACO Pioneer processing with beneficiary and provider cross-check
rules 9/2012
– Discussions underway to capture cross-program precedence rules for
coordinated care programs
17
18. Medicare Provider Experience – Today at
CMS
Provider Enrolment National Plan and
Chain and Provider
Ownership System Enumeration
(PECOS) System
(NPPES)
18
19. Future State – Increased Automation and
Self-Service
Provider
Portal Automated Provider
Verification & Book of
1 Record
Enumerate Screening
Automated
Data Capture,
2
Self Service Used by
Enroll Updates
A, B MACs
3 Register
Demos, Medicaid
PQRS, etc..
1. Iden(ty
7. Tax
and
Business
2. Licensure
8. Provider
Death
No(ce
Program
3. Legal
9. Provider
Financial
Integrity
4. Criminal
Informa(on
5. Geo-‐Spa(al
10. State
Provider
Enrollment
6. Exclusion
Data
&
Eligibility
ACOs
19
22. Data Trends
World’s Data Kaiser’s Data
80% 90%
STRUCTURED
STRUCTURED
UNSTRUCTURED DATA
UUNSTRUCTURED
NSTRUCTURED
DATA
DATA DDATA
ATA
Ø 80% of world’s data is unstructured (Rise of Ø 90% of Kaiser’s data is unstructured (80%
Mobility devices, and machine generated data) of EHR and Image data)
Ø 44x as much data over the coming decade (35
zettabytes by 2020) Ø 25x as much data over the coming decade.
(One exabyte by 2020)
Ø Majority of data growth is driven by
unstructured data (Active archives, Medical Ø Majority of data growth is driven by
images, Online movies and storage, Pictures) unstructured data (Medical Images, Videos,
Text, Voice)
Ø Information is centric to new wave of
opportunities (Retail, Financing, Insurance,
Manufacturing, Healthcare,…) Ø Information is centric to providing Real
time Personalized Healthcare. (Requires
Contextual – device, environment, spatial,
Ø Industry is employing Big Data Technologies Demographics, Social, and Behavioral
for Information extraction. profiles in addition to medical information)
Source:
Intel
Developers
Forum,
September
2012
Ø Kaiser is evaluating Big Data
Co-‐presenta(on
by
Rajiv
Synghal,
Principal,
Kaiser
Permanente;
“Big
Data
and
Analy(cs
in
Healthcare
and
Life
Sciences.”
Technologies…
h[p://intelstudios.edgesuite.net/idf/2012/sf/aep/HLCS002/HLCS002.html
22
23. Big Data at CMS
• Currently, we store and maintain:
– ½ a terabyte of data each month
(roughly 1.7 million pieces of 8 1/2 x 11 paper)
– 370 terabytes of Medicare data
– 30 terabytes of Medicaid data
– 10 terabytes of unstructured data
– Quality data
– Encounter data
– Other
• By the end of 2015:
– Medicare Claims Data will reach approximately 700 terabytes
– Medicaid Claims Data will reach approximately 100 terabytes
23
24. Payment Mechanisms are Shifting
Risk to Payor Current Future Risk to Provider
Traditional Traditional Fee-For-Service Global
Episodic Bundling
Fee-For-Service Capitation Shared Savings Payment
Care Models
Episodes of Clinical Service
Accountable Care Patient Centered
Care (CABG, Centers (Retail
Organizations Medical Homes
AMI etc.) Clinics etc..)
IT and Data are the lynchpins
24
25. Data Warehousing Vision
Maximize the full potential of CMS’ vast data resources to realize an enterprise
data warehouse environment that can support the internal and external analytics for
CMS’s future business model and to help transform the national healthcare sector.
• Goal #1: Design a scalable, sustainable data warehouse environment that
supports integration of new data sources such as encounter, quality and clinical
data to the traditional claims, beneficiary, and provider data sources.
• Goal #2: Provide an easily accessible, efficient, and secure environment for
analyzing and extracting the vast sums of CMS data.
• Goal #3: Enable business use of data without the need to understand
underlying technologies, evolving to a self-service model.
• Goal #4: Provide CMS user communities with the tools and information
required to make timely informed decisions and drive innovation (including but
not limited to internal and external users, such as analysts, researchers, states,
provider organizations, and Accountable Care Organizations).
25
26. Data Warehousing Business Drivers
• CMS’s role is changing from paying claims to defining quality of care,
supporting multiple payment models, and driving national healthcare
improvements. This will require quicker, easier answers to broader, more
complex questions using more data.
• Legislative mandates require increased coordination with other agencies and
with external parties, driving CMS to standardize data definitions and formats and
to embrace industry best practices.
• CMS is becoming an information clearing house to support external
researchers doing increasingly sophisticated analytics that will drive innovation in
the national healthcare sector.
• Budget and operational pressures require CMS to improve efficiency, reduce
costs, provide quicker time to market and to provide better return on
investment.
26
27. The Current Environment
2011 Environment
CMS
Feedback Reports States
Raw
Researchers
Data Multiple Data
Repositories/
Public Use Files
END USER
Streams Analytics/ Plans
Knowledge Creation 7000 DUAs / Data Cuts
Providers
Feedback Loop
• Mostly unidirectional communication
• Several differing points of entry into CMS Phone/Fax
• Multiple accounts for CMS customers for
various programs eMail
• Corrections, Alterations, Clarifications take time
• Costly USPS END USER
• Cumbersome, yet manageable... For now.
Help Desk
27
28. Near Future Environment If There is No Change
2013-2014 Environment If There is No Change
Increasing Demands for CMS
Information from:
CMS
• ACO Smart Reports
• 10332 (Availability of
Raw Medicare Data for Perf.
Measurement
States
Data Multiple Data
• 3002 (PQRS Improvements)
• 6002 (Physician Sunshine ) Researchers
Repositories/
Streams Analytics/
• 3003 (Quality Resource
Utilization Reports) END USER
• 3007 (Physician Value Plans
Knowledge Creation
Modifier)
• CBRs for Non-Physician, Non- Providers
Hospital Providers
• 10331 (Physician Compare)
Will lead to:
• Hundreds of thousands of new DUAs and data cuts
• Large increase in feedback reports, public use files and DUAs
• Increasingly inefficient transfer of data/knowledge
• Increased costs
28
29. Desired Future CMS Data Environment
States
Researchers
Dissemination
Collection EXTERNAL Plans
Data Enclave USER
Providers
Health 2.0
Organizing
Program CMS marketplace
data
Data Streams Gateway
Maximizing Use Contractors
of Data Portal
Fed Partners
INTERNAL
USER
Operations
Web Services
CMS Data
BENEFITS Products
• Improved business • Easy, timely and secure • Reduced cost of
intelligence access to information operations
29
30. Key 2012 Activities
• Partnered with Oak Ridge National Laboratories to test new
ways of faster and more efficient data management
(Knowledge Discovery Infrastructure). Follow up activities
will be conducted in Baltimore to test scalability and
applicability.
• Created new office to focus on data management and analysis to
partner with the Office of Information Services.
• Beginning analysis for data warehouse consolidation as part of
DW strategy
• Virtual Data Center work will help with providing more
flexible environments
30
32. Current CMS Data Center Environment
Baltimore Data
Center
• MAPD Apps
Mixture of Development • HITECH
EDC 1, Inefficient
• Data Warehouses
Direct and Contractors • Medicare FFS Claims use of
• Public Websites
Indirect Contracts • CWF Hosts computing
resources
EDC 2
Research Data Over 80 • Medicare FFS Claims
Centers operational data • HITECH NLR
• 1-800-Medicare-
centers have been NDW
identified by the Inconsistent
OMB Data requirements
Center IBM Boulder for security,
MAC Data
Varying pricing Centers Consolidation • HIGLAS
architecture and
and ownership Initiative Software
models across Development
data centers Medicare Program Buccaneer
Integrity • Quality Net
Life Cycle
• PSCs, RACs, & ZPICs • CCW (SDLC)
UC San Diego
• MIG Data Engine
(Medicaid) 32
33. CMS Data Center Consolidation Strategy
Will award a multi-billion dollar Virtual Data Center (VDC) IDIQ
contract in 2012 that will:
• Support Federal and HHS data center consolidation strategies
• Consolidate the CMS data center footprint across 6-8 data centers.
• Reduce overall energy consumption by improving server virtualization, IT
equipment utilization and environmental control devices
• Eliminate redundant spending and solutions on software, infrastructure and
operations
• Leverages shared resources, reduces time to market for new initiatives and
provides high availability to mission critical applications
• Improve security, disaster recovery times, and effectively employ cloud and
virtualization technologies.
33
34. VDC and Energy Use
• Partnered with the Department of Energy and Lawrence Berkeley Laboratories to
have VDC Contractors to provide an Energy Conservation Measures Plan that will
be evaluated as part of their overall technical solution which will include but not be
limited to:
• Current Power Usage Effectiveness (PUE) of contractor owned and contractor operated
VDC facilities.
• Minimum baseline for PUE improvement that will be monitored and reported
periodically after the initial baseline report.
• Energy consumption as it relates to CMS system’s resources, both dedicated and shared.
• Technical solution alternatives that will improve PUE, adhere to security standards and
achieve performance objectives.
• Return on investment, realized by CMS, over a specific task orders period of
performance.
34
36. HHS Mobility Strategy
• Identifying the user and business requirements for mobile
technologies;
• Identifying the security and privacy requirements for mobile
technologies;
• Developing configuration baselines for mobile technologies;
and
• Providing recommendations on identified mobile technologies
for implementation
36
37. CMS Strategy for Mobility
Internal Users
• Work with HHS through the CTO Council and CIO Council to ensure that CMS policies and
initiatives are in line with the overall Department approach and the Federal Digital
Government Strategy
• CMS has engaged in an effort to continually investigate technologies that position us to deliver
services via a more mobile and agile framework.
• The following technologies are being implemented to the CMS support population:
– Mobile Workforce – 100% mobile capability –currently being implemented, will complete
early next year
• Windows 7/Office 2010
• Dell 6320/HP 2760P Convertible Tablets
• Cisco Virtual Private Network for remote access
• 67% work remotely on a consistent basis with as much as 85% working episodic
• 100% Telework - 120 day pilot
– Mobile Device Management-being piloted for full implementation in the next 1-2 years
• Replace RIM devices with selection options for iOS and Android
• Deploy iPads – manage with MDM enterprise system
• Bring your own device
37
38. Unified Communications
Anywhere, Anytime, Any Medium
Voice
Over IP
Wi-Fi
Softphone
Converged Network
Desktop
Instant
Messaging Unified Desktop VTC
& Presence
Enriched experience for CMS employees through integrated data, voice, video & services
38
39. Supporting Mobility Needs of Stakeholders
• Optimize websites for mobile users
– Engage with customers to identify at least two existing priority customer-facing
services to optimize for mobile use.
• CMS has worked with Medicare beneficiaries and 1-800-MEDICARE customer
service representatives (CSRs) to identify Medicare.gov top tasks. This feedback
was incorporated into the redesign and drove the design of the Medicare.gov mobile
site's navigation structure.
– Optimize at least two existing priority customer-facing services for mobile use
and publish a plan for improving additional existing services.
• CMS has launched a redesign of the Medicare.gov website which uses responsive
design. This means that the website fully supports access on smartphones and
tablets
• Looking to mobile optimize other priority public websites within the next 12
months.
• Ensure that shared services support mobility
40. What Does it all mean?
• Creative tensions abound
– Rise of end user tools vs. centralized IT management
– Growing need for data and data analytics vs. maintaining
appropriate security and privacy
– Budget controls vs. more diverse IT needs
• Policy/business requirements and technology solutions are
becoming harder to align
• Skill set needs are becoming more complicated
• New and different partnerships will be needed
40