Using the Atacama Large Millimeter/submillimeter Array, we have conducted a blind redshift survey in the 3 mm atmospheric transmission window for 26 strongly lensed dusty star-forming galaxies (DSFGs) selected with the South Pole Telescope. The sources were selected to have S 1.4 mm > 20 mJy and a dust-like spectrum and, to remove low-z sources, not have bright radio (S 843 MHz < 6 mJy) or far-infrared counterparts (S 100 μm < 1 Jy, S 60 μm < 200 mJy). We robustly detect 44 line features in our survey, which we identify as redshifted emission lines of 12 CO, 13 CO, C i, H 2 O, and H 2 O +. We find one or more spectral features in 23 sources yielding a ∼90% detection rate for this survey; in 12 of these sources we detect multiple lines, while in 11 sources we detect only a single line. For the sources with only one detected line, we break the redshift degeneracy with additional spectroscopic observations if available, or infer the most likely line identification based on photometric data. This yields secure redshifts for ∼70% of the sample. The three sources with no lines detected are tentatively placed in the redshift desert between 1.7 < z < 2.0. The resulting mean redshift of our sample isz = 3.5. This finding is in contrast to the redshift distribution of radio-identified DSFGs, which have a significantly lower mean redshift ofz = 2.3 and for which only 10%-15% of the population is expected to be at z > 3. We discuss the effect of gravitational

Stringent de-identification methods can remove all identifiers from text radiology reports. DICOM de-identification of images does not remove all identifying information and needs special attention to images scanned from film. Adding manual coding to the radiologist narrative reports significantly improved relevancy of the retrieved clinical documents. The de-identified Indiana chest X-ray collection is available for searching and downloading from the National Library of Medicine (http://openi.nlm.nih.gov/).

Background Transition to nursing facilities is often viewed as the final stage of care for persons with dementia in a progression toward dependency Objectives Describe transitions in care among persons with dementia with attention to nursing facility transitions Design prospective cohort Setting public health system Participants 4,197 community-dwelling older adults Measurements Subjects’ electronic medical records were merged with Medicare claims, Medicaid claims, the Minimum Dataset (MDS), and the Outcome and Assessment Information Set (OASIS) from 2001–2008 with a mean follow-up of 5.2 years Results Compared to subjects never diagnosed (n=2,674), older adults with prevalent (n=524) or incident dementia (n=999) had greater Medicare (11.4% v. 44.7% v. 44.8%, p=<.0001) and Medicaid (1.4% v. 21.0% v. 16.8%, p<.0001) nursing facility use, greater hospital (51.2% v. 76.2% v. 86.0%, p< .0001) and home health use (27.3% v. 55.7%, 65.2%, p< .0001), more transitions in care per person year of follow-up (1.4 v. 2.6 v. 2.7, p<.0001), and more mean total transitions (3.8 v. 11.2 v. 9.2, p<.0001). Among the 1,523 subjects with dementia, 74.5% of transitions to nursing facilities were transfers from hospitals. Among transitions from nursing facilities, the conditional probability was 41.0% for a return home without home health care, 10.7% for home health care, and 39.8% for a hospital transfer. Among subjects with dementia with a ≤30-day rehospitalization, 45% had been discharged to nursing facilities from the index hospitalization. At time of death, 46% of subjects with dementia were at home, 35% in the hospital, and 19% in a nursing facility. Conclusion Patients with dementia live and frequently die in community settings. Nursing facilities are part of a dynamic network of care characterized by frequent transitions.

We present high-resolution maps of stars, dust, and molecular gas in a strongly lensed submillimeter galaxy (SMG) at z = 3.259. HATLAS J114637.9−001132 is selected from the Herschel-Astrophysical Terahertz Large Area Survey (H-ATLAS) as a strong lens candidate mainly based on its unusually high 500 μm flux density (∼300 mJy). It is the only high-redshift Planck detection in the 130 deg 2 H-ATLAS Phase-I area. Keck Adaptive Optics images reveal a quadruply imaged galaxy in the K band while the Submillimeter Array and the Jansky Very Large Array show doubly imaged 880 μm and CO(1→0) sources, indicating differentiated distributions of the various components in the galaxy. In the source plane, the stars reside in three major kpc-scale clumps extended over ∼1.6 kpc, the dust in a compact (∼1 kpc) region ∼3 kpc north of the stars, and the cold molecular gas in an extended (∼7 kpc) disk ∼5 kpc northeast of the stars. The emissions from the stars, dust, and gas are magnified by ∼17, ∼8, and ∼7 times, respectively, by four lensing galaxies at z ∼ 1. Intrinsically, the lensed galaxy is a warm (T dust ∼ 40-65 K), hyperluminous (L IR ∼ 1.7 × 10 13 L ; star formation rate (SFR) ∼ 2000 M yr −1 ), gas-rich (M gas /M baryon ∼ 70%), young (M stellar /SFR ∼ 20 Myr), and short-lived (M gas /SFR ∼ 40 Myr) starburst. With physical properties similar to unlensed z > 2 SMGs, HATLAS J114637.9−001132 offers a detailed view of a typical SMG through a powerful cosmic microscope.

BackgroundTo realize potential public health benefits from genetic and genomic innovations, understanding how best to implement the innovations into clinical care is important. The objective of this study was to synthesize data on challenges identified by six diverse projects that are part of a National Human Genome Research Institute (NHGRI)-funded network focused on implementing genomics into practice and strategies to overcome these challenges.MethodsWe used a multiple-case study approach with each project considered as a case and qualitative methods to elicit and describe themes related to implementation challenges and strategies. We describe challenges and strategies in an implementation framework and typology to enable consistent definitions and cross-case comparisons. Strategies were linked to challenges based on expert review and shared themes.ResultsThree challenges were identified by all six projects, and strategies to address these challenges varied across the projects. One common challenge was to increase the relative priority of integrating genomics within the health system electronic health record (EHR). Four projects used data warehousing techniques to accomplish the integration. The second common challenge was to strengthen clinicians’ knowledge and beliefs about genomic medicine. To overcome this challenge, all projects developed educational materials and conducted meetings and outreach focused on genomic education for clinicians. The third challenge was engaging patients in the genomic medicine projects. Strategies to overcome this challenge included use of mass media to spread the word, actively involving patients in implementation (e.g., a patient advisory board), and preparing patients to be active participants in their healthcare decisions.ConclusionsThis is the first collaborative evaluation focusing on the description of genomic medicine innovations implemented in multiple real-world clinical settings. Findings suggest that strategies to facilitate integration of genomic data within existing EHRs and educate stakeholders about the value of genomic services are considered important for effective implementation. Future work could build on these findings to evaluate which strategies are optimal under what conditions. This information will be useful for guiding translation of discoveries to clinical care, which, in turn, can provide data to inform continual improvement of genomic innovations and their applications.