Federal Tax Law of Hospitals: Basic Principles and Current Developments, The

Federal tax laws with respect to nonprofit organizations are evolving rapidly, indeed daily, and no set of institutions are being more dramatically affected by this ongoing surge of developing law than the nation\u27s hospitals and other health care organizations. This article provides a summary of the general tax law framework as it relates to tax-exempt health care entities. Following that analysis, the authors provide an issue-by-issue explanation of the current developments in this field of tax law. The tax issues discussed in both the general summary and the current developments portions of the article include those involving application of unrelated income, private foundations and reorganizations, as well as those pertaining to the participation of hospitals in general partnerships and joint ventures

Development and Evaluation of an Open Source Software Tool for Deidentification of Pathology Reports

Background: Electronic medical records, including pathology reports, are often used for research purposes. Currently, there are few programs freely available to remove identifiers while leaving the remainder of the pathology report text intact. Our goal was to produce an open source, Health Insurance Portability and Accountability Act (HIPAA) compliant, deidentification tool tailored for pathology reports. We designed a three-step process for removing potential identifiers. The first step is to look for identifiers known to be associated with the patient, such as name, medical record number, pathology accession number, etc. Next, a series of pattern matches look for predictable patterns likely to represent identifying data; such as dates, accession numbers and addresses as well as patient, institution and physician names. Finally, individual words are compared with a database of proper names and geographic locations. Pathology reports from three institutions were used to design and test the algorithms. The software was improved iteratively on training sets until it exhibited good performance. 1800 new pathology reports were then processed. Each report was reviewed manually before and after deidentification to catalog all identifiers and note those that were not removed. Results: 1254 (69.7 %) of 1800 pathology reports contained identifiers in the body of the report. 3439 (98.3%) of 3499 unique identifiers in the test set were removed. Only 19 HIPAA-specified identifiers (mainly consult accession numbers and misspelled names) were missed. Of 41 non-HIPAA identifiers missed, the majority were partial institutional addresses and ages. Outside consultation case reports typically contain numerous identifiers and were the most challenging to deidentify comprehensively. There was variation in performance among reports from the three institutions, highlighting the need for site-specific customization, which is easily accomplished with our tool. Conclusion: We have demonstrated that it is possible to create an open-source deidentification program which performs well on free-text pathology reports

Optical/IR from ground

Optical/infrared (O/IR) astronomy in the 1990's is reviewed. The following subject areas are included: research environment; science opportunities; technical development of the 1980's and opportunities for the 1990's; and ground-based O/IR astronomy outside the U.S. Recommendations are presented for: (1) large scale programs (Priority 1: a coordinated program for large O/IR telescopes); (2) medium scale programs (Priority 1: a coordinated program for high angular resolution; Priority 2: a new generation of 4-m class telescopes); (3) small scale programs (Priority 1: near-IR and optical all-sky surveys; Priority 2: a National Astrometric Facility); and (4) infrastructure issues (develop, purchase, and distribute optical CCDs and infrared arrays; a program to support large optics technology; a new generation of large filled aperture telescopes; a program to archive and disseminate astronomical databases; and a program for training new instrumentalists

Tadpole Galaxies in the Hubble Ultra Deep Field

Tadpole galaxies have a head-tail shape with a large clump of star formation at the head and a diffuse tail or streak of stars off to one side. We measured the head and tail masses, ages, surface brightnesses, and sizes for 66 tadpoles in the Hubble Ultra Deep Field (UDF), and we looked at the distribution of neighbor densities and tadpole orientations with respect to neighbors. The heads have masses of 10^7-10^8 Msun and photometric ages of ~0.1 Gyr for z~2. The tails have slightly larger masses than the heads, and comparable or slightly older ages. The most obvious interpretation of tadpoles as young merger remnants is difficult to verify. They have no enhanced proximity to other resolved galaxies as a class, and the heads, typically less than 0.2 kpc in diameter, usually have no obvious double-core structure. Another possibility is ram pressure interaction between a gas-rich galaxy and a diffuse cosmological flow. Ram pressure can trigger star formation on one side of a galaxy disk, giving the tadpole shape when viewed edge-on. Ram pressure can also strip away gas from a galaxy and put it into a tail, which then forms new stars and gravitationally drags along old stars with it. Such an effect might have been observed already in the Virgo cluster. Another possibility is that tadpoles are edge-on disks with large, off-center clumps. Analogous lop-sided star formation in UDF clump clusters are shown.Comment: 19 pages, 16 figures, ApJ in press, vol 722, October 10, 201

Experimental Design for the Gemini Planet Imager

The Gemini Planet Imager (GPI) is a high performance adaptive optics system being designed and built for the Gemini Observatory. GPI is optimized for high contrast imaging, combining precise and accurate wavefront control, diffraction suppression, and a speckle-suppressing science camera with integral field and polarimetry capabilities. The primary science goal for GPI is the direct detection and characterization of young, Jovian-mass exoplanets. For plausible assumptions about the distribution of gas giant properties at large semi-major axes, GPI will be capable of detecting more than 10% of gas giants more massive than 0.5 M_J around stars younger than 100 Myr and nearer than 75 parsecs. For systems younger than 1 Gyr, gas giants more massive than 8 M_J and with semi-major axes greater than 15 AU are detected with completeness greater than 50%. A survey targeting young stars in the solar neighborhood will help determine the formation mechanism of gas giant planets by studying them at ages where planet brightness depends upon formation mechanism. Such a survey will also be sensitive to planets at semi-major axes comparable to the gas giants in our own solar system. In the simple, and idealized, situation in which planets formed by either the "hot-start" model of Burrows et al. (2003) or the core accretion model of Marley et al. (2007), a few tens of detected planets are sufficient to distinguish how planets form.Comment: 15 pages, 9 figures, revised after referee's comments and resubmitted to PAS

Bulge and Clump Evolution in Hubble Ultra Deep Field Clump Clusters, Chains and Spiral Galaxies

Clump clusters and chain galaxies in the Hubble Ultra Deep Field are examined for bulges in the NICMOS images. Approximately 50% of the clump clusters and 30% of the chains have relatively red and massive clumps that could be young bulges. Magnitudes and colors are determined for these bulge-like objects and for the bulges in spiral galaxies, and for all of the prominent star-formation clumps in these three galaxy types. The colors are fitted to population evolution models to determine the bulge and clump masses, ages, star-formation rate decay times, and extinctions. The results indicate that bulge-like objects in clump cluster and chain galaxies have similar ages and 2 to 5 times larger masses compared to the star-formation clumps, while the bulges in spirals have ~6 times larger ages and 20 to 30 times larger masses than the clumps. All systems appear to have an underlying red disk population. The masses of star-forming clumps are typically in a range from 10^7 to 10^8 Msun; their ages have a wide range around ~10^2 Myr. Ages and extinctions both decrease with redshift. Star formation is probably the result of gravitational instabilities in the disk gas, in which case the large clump mass in the UDF is the result of a high gas velocity dispersion, 30 km/s or more, combined with a high gas mass column density, ~100 Msun/pc^2. Because clump clusters and chains dominate disk galaxies beyond z~1, the observations suggest that these types represent an early phase in the formation of modern spiral galaxies, when the bulge and inner disk formed.Comment: ApJ in press February 2009, vol. 691, 23 pages and 20 figure

Risk Factors for End Stage Renal Disease in Non-WT1-Syndromic Wilms Tumor

PURPOSE: We assessed risk factors for end stage renal disease in patients with Wilms tumor without known WT1 related syndromes. We hypothesized that patients with characteristics suggestive of a WT1 etiology (early onset, stromal predominant histology, intralobar nephrogenic rests) would have a higher risk of end stage renal disease due to chronic renal failure. We predicted a high risk of end stage renal disease due to progressive bilateral Wilms tumor in patients with metachronous bilateral disease. MATERIALS AND METHODS: End stage renal disease was ascertained in 100 of 7,950 nonsyndromic patients enrolled in a National Wilms Tumor Study during 1969 to 2002. Risk factors were evaluated with cumulative incidence curves and proportional hazard regressions. RESULTS: The cumulative incidence of end stage renal disease due to chronic renal failure 20 years after Wilms tumor diagnosis was 0.7%. For end stage renal disease due to progressive bilateral Wilms tumor the incidence was 4.0% at 3 years after diagnosis in patients with synchronous bilateral Wilms tumor and 19.3% in those with metachronous bilateral Wilms tumor. For end stage renal disease due to chronic renal failure stromal predominant histology had a HR of 6.4 relative to mixed (95% CI 3.4, 11.9; p<0.001), intralobar rests had a HR of 5.9 relative to no rests (95% CI 2.0, 17.3; p=0.001), and Wilms tumor diagnosis at less than 24 months had a HR of 1.7 relative to 24 to 48 months and 2.8 relative to greater than 48 months (p=0.003 for trend). CONCLUSIONS: Metachronous bilateral Wilms tumor is associated with high rates of end stage renal disease due to surgery for progressive Wilms tumor. Characteristics associated with a WT1 etiology markedly increased the risk of end stage renal disease due to chronic renal failure despite the low risk in non-WT1 syndromic cases overall

Development and evaluation of an open source software tool for deidentification of pathology reports

BACKGROUND: Electronic medical records, including pathology reports, are often used for research purposes. Currently, there are few programs freely available to remove identifiers while leaving the remainder of the pathology report text intact. Our goal was to produce an open source, Health Insurance Portability and Accountability Act (HIPAA) compliant, deidentification tool tailored for pathology reports. We designed a three-step process for removing potential identifiers. The first step is to look for identifiers known to be associated with the patient, such as name, medical record number, pathology accession number, etc. Next, a series of pattern matches look for predictable patterns likely to represent identifying data; such as dates, accession numbers and addresses as well as patient, institution and physician names. Finally, individual words are compared with a database of proper names and geographic locations. Pathology reports from three institutions were used to design and test the algorithms. The software was improved iteratively on training sets until it exhibited good performance. 1800 new pathology reports were then processed. Each report was reviewed manually before and after deidentification to catalog all identifiers and note those that were not removed. RESULTS: 1254 (69.7 %) of 1800 pathology reports contained identifiers in the body of the report. 3439 (98.3%) of 3499 unique identifiers in the test set were removed. Only 19 HIPAA-specified identifiers (mainly consult accession numbers and misspelled names) were missed. Of 41 non-HIPAA identifiers missed, the majority were partial institutional addresses and ages. Outside consultation case reports typically contain numerous identifiers and were the most challenging to deidentify comprehensively. There was variation in performance among reports from the three institutions, highlighting the need for site-specific customization, which is easily accomplished with our tool. CONCLUSION: We have demonstrated that it is possible to create an open-source deidentification program which performs well on free-text pathology reports

Monitoring Healthy Metabolic Trajectories with Nutritional Metabonomics

Metabonomics is a well established analytical approach for the analysis of physiological regulatory processes via the metabolic profiling of biofluids and tissues in living organisms. Its potential is fully exploited in the field of “nutrimetabonomics” that aims at assessing the metabolic effects of active ingredients and foods in individuals. Yet, one of the greatest challenges in nutrition research is to decipher the critical interactions between mammalian organisms and environmental factors, including the gut microbiota. “Nutrimetabonomics” is today foreseen as a powerful approach for future nutritional programs tailored at health maintenance and disease prevention

Hubble Space Telescope WFC3 Early Release Science: Emission-Line Galaxies from Infrared Grism Observations

We present grism spectra of emission-line galaxies (ELGs) from 0.6-1.6 microns from the Wide Field Camera 3 on the Hubble Space Telescope. These new infrared grism data augment previous optical Advanced Camera for Surveys G800L 0.6-0.95 micron grism data in GOODS-South from the PEARS program, extending the wavelength covereage well past the G800L red cutoff. The ERS grism field was observed at a depth of 2 orbits per grism, yielding spectra of hundreds of faint objects, a subset of which are presented here. ELGs are studied via the Ha, [OIII], and [OII] emission lines detected in the redshift ranges 0.2<z<1.4, 1.2<z<2.2 and 2.0<z<3.3 respectively in the G102 (0.8-1.1 microns; R~210) and G141 (1.1-1.6 microns; R~130) grisms. The higher spectral resolution afforded by the WFC3 grisms also reveals emission lines not detectable with the G800L grism (e.g., [SII] and [SIII] lines). From these relatively shallow observations, line luminosities, star-formation rates, and grism spectroscopic redshifts are determined for a total of 48 ELGs to m(AB)~25 mag. Seventeen GOODS-South galaxies that previously only had photometric redshifts now have new grism-spectroscopic redshifts, in some cases with large corrections to the photometric redshifts (Delta(z)~0.3-0.5). Additionally, one galaxy had no previously-measured redshift but now has a secure grism-spectroscopic redshift, for a total of 18 new GOODS-South spectroscopic redshifts. The faintest source in our sample has a magnitude m(AB)=26.9 mag. The ERS grism data also reflect the expected trend of lower specific star formation rates for the highest mass galaxies in the sample as a function of redshift, consistent with downsizing and discovered previously from large surveys. These results demonstrate the remarkable efficiency and capability of the WFC3 NIR grisms for measuring galaxy properties to faint magnitudes and redshifts to z>2.Comment: Accepted for publication in AJ. Updated to include referee comments. Updated sample using improved reduction contains 23 new galaxies (Table 1; Figures 2 & 3