Candida parapsilosis infection in very low birthweight infants

In a UK national surveillance study, we found that Candida parapsilosis accounted for one quarter of all cases of invasive fungal infection in very low birthweight infants. C parapsilosis was associated with fewer deep-seated infections than C albicans, but mortality was similar. Ongoing surveillance is needed to monitor the epidemiology of invasive fungal infection in very low birthweight infants.This study was partly supported by an educational grant provided by Pfizer UK

The impact of changing provider remuneration on clinical activity and quality of care: evaluation of a pilot NHS contract in Northern Ireland

Objectives A pilot NHS dental contract was introduced in Northern Ireland between 2015 and 2016, which involved changing the method for paying general dental practitioners working in the NHS from Fee-For-Service (FFS) to capitation-based payments, providing an opportunity for a robust evaluation. We investigated the impact of a change in payment methods on clinical activity and the quality of care provided. Design A difference-in-difference (DiD) evaluation was applied to clinical activity data from pilot NHS dental practices in Northern Ireland compared to matched control NHS practices, and applied to a questionnaire survey of patient-rated outcomes of health outcomes and care quality. We estimated the impact on access to care, treatment activity levels, practice finances and patient-rated outcomes of care of a change from FFS to a capitation-based system for one year, as well as the impact of a reversion back to FFS at the end of the pilot period. Results The monthly number of registered patients in the pilot practices increased more than the control practices during the capitation period, by 1.5 registrations per 1,000 registered patients. The monthly reductions in the volumes of all treatments in the pilot practices during the capitation period was much larger than the control practices, with 175 fewer treatment items. All measures rapidly returned to baseline levels following reversion from capitation back to FFS. NHS income per month increased in pilot practices, by £5,920 per month (calculated on FFS item cost basis) more than controls in the capitation period. The analysis of patient questionnaires suggest found that patients notices differences only in waiting times, skill-mix and number of radiographs, but not on other measures of healthcare process and quality. Conclusion General dental practitioners working in the NHS respond rapidly and consistently to changes in provider payment methods. A move from FFS to a capitation-based system had little impact on access to care, but did produce large reductions in clinical activity and patient charge income. Patients noticed little change in the service they received. This shows that changes in remuneration contracts have the potential to meet policy goals, such as meeting the expectations of patients within a predictable cost envelope. However, it is unlikely that all policy goals can be met simply by changing payment methods. Therefore, work is also needed to identify and evaluate interventions that can complement changes in remuneration to achieve desirable outcomes

Star formation rate indicators in the Sloan Digital Sky Survey

The Sloan Digital Sky Survey (SDSS) first data release provides a database of 106000 unique galaxies in the main galaxy sample with measured spectra. A sample of star-forming (SF) galaxies are identified from among the 3079 of these having 1.4 GHz luminosities from FIRST, by using optical spectral diagnostics. Using 1.4 GHz luminosities as a reference star formation rate (SFR) estimator insensitive to obscuration effects, the SFRs derived from the measured SDSS Halpha, [OII] and u-band luminosities, as well as far-infrared luminosities from IRAS, are compared. It is established that straightforward corrections for obscuration and aperture effects reliably bring the SDSS emission line and photometric SFR estimates into agreement with those at 1.4 GHz, although considerable scatter (~60%) remains in the relations. It thus appears feasible to perform detailed investigations of star formation for large and varied samples of SF galaxies through the available spectroscopic and photometric measurements from the SDSS. We provide herein exact prescriptions for determining the SFR for SDSS galaxies. The expected strong correlation between [OII] and Halpha line fluxes for SF galaxies is seen, but with a median line flux ratio F_[OII]/F_Halpha=0.23, about a factor of two smaller than that found in the sample of Kennicutt (1992). This correlation, used in deriving the [OII] SFRs, is consistent with the luminosity-dependent relation found by Jansen et al. (2001). The median obscuration for the SDSS SF systems is found to be A_Halpha=1.2 mag, while for the radio detected sample the median obscuration is notably higher, 1.6 mag, and with a broader distribution.Comment: Accepted for publication in ApJ, 40 pages, 26 figure

The Early Evolution of Massive Stars: Radio Recombination Line Spectra

Velocity shifts and differential broadening of radio recombination lines are used to estimate the densities and velocities of the ionized gas in several hypercompact and ultracompact HII regions. These small HII regions are thought to be at their earliest evolutionary phase and associated with the youngest massive stars. The observations suggest that these HII regions are characterized by high densities, supersonic flows and steep density gradients, consistent with accretion and outflows that would be associated with the formation of massive stars.Comment: ApJ in pres

Dense Ionized and Neutral Gas Surrounding Sgr A*

We present high resolution H41a hydrogen recombination line observations of the 1.2' (3 pc) region surrounding Sgr A* at 92 GHz using the OVRO Millimeter Array with an angular resolution of 7" x 3" and velocity resolution of 13 km/s. New observations of H31a, H35a, H41a, and H44a lines were obtained using the NRAO 12-m telescope, and their relative line strengths are interpreted in terms of various emission mechanisms. These are the most extensive and most sensitive observations of recombination line to date. Observations of HCO+ (1 - 0) transition at 89 GHz are also obtained simultaneously with a 40% improved angular resolution and 4-15 times improved sensitivity over previous observations, and the distribution and kinematics of the dense molecular gas in the circumnuclear disk (CND) are mapped and compared with those of the ionized gas. The line brightness ratios of the hydrogen recombination lines are consistent with purely spontaneous emission from 7000 K gas with n_e = 20,000 cm$^{-3}$ near LTE condition. A virial analysis suggests that the most prominent molecular gas clumps in the CND have mean densities of 10^7 cm^{-3}, sufficient to withstand the tidal shear in the Galactic Center region. Therefore, these clumps may survive over several dynamical times, and the CND may be a dynamically stable structure. We estimate a total gas mass of 3 x 10^5 solar mass for the CND. \Comment: 34 pages including 11 figures (4 jpgs), Latex, uses aastex. The full pdf format file including high resolution figures is available at http://www.astro.umass.edu/~myun/papers/SgrA.pdf . To appear in the 20 November 2004 (V616) issue of the Astrophysical Journa

Physical Conditions in the Narrow-Line Region of M51

We have investigated the physical conditions in the narrow-line region (NLR) of M51 using long-slit spectra obtained with the Space Telescope Imaging Spectrograph (STIS) aboard the Hubble Space Telescope (HST) and 3.6 cm radio continuum observations obtained with the Very Large Array (VLA). Emission-line diagnostics were employed for nine NLR clouds, which extend 2.5" (102 pc) from the nucleus, to examine the electron density, temperature, and ionization state of the NLR gas. The emission-line ratios are consistent with those typically found in Seyfert nuclei and indicate that within the inner near-nuclear region (r ~< 1") the ionization decreases with increasing radius. Upper-limits to the [O III] electron temperature (T ~< 11,000 K) for the inner NLR clouds indicate that photoionization is the dominant ionization mechanism close to the nucleus. The emission-line fluxes for most of the NLR clouds can be reproduced reasonably well by simple photoionization models using a central power-law continuum source and supersolar nitrogen abundances. Shock+precursor models, however, provide a better fit to the observed fluxes of an NLR cloud ~2.5" south of the nucleus that is identified with the extra-nuclear cloud (XNC). The large [O III] electron temperature of this cloud (T = 24,000 K) further suggests the presence of shocks. This cloud is straddled by two radio knots and lies near the location where a weak radio jet, ~2.5" (102pc) in extent, connects the near-nuclear radio emission with a diffuse lobe structure spanning \~4" (163 pc). It is plausible that this cloud represents the location where the radio jet impinges on the disk ISM.Comment: 25 pages, 26 figures (9 color), 7 tables. Accepted for publication in the Astrophysical Journa

Spectroscopy of i-Dropout Galaxies with an NB921-Band Depression in the Subaru Deep Field

We report new spectroscopy of two star-forming galaxies with strong Ly_alpha emission at z=6.03 and z=6.04 in the Subaru Deep Field. These two objects are originally selected as i'-dropouts (i'-z' > 1.5) showing an interesting photometric property, the ``NB921 depression''. The NB921-band (centered at 9196A) magnitude is significantly depressed with respect to the z'-band magnitude. The optical spectra of these two objects exhibit asymmetric emission-lines at lambda_obs ~ 8540A and ~ 8560A, suggesting that these objects are Ly_alpha emitters at z~6. The rest-frame equivalent widths of the Ly_alpha emission of the two objects are 94A and 236A; the latter one is the Ly_alpha emitter with the largest Ly_alpha equivalent width at z > 6 ever spectroscopically confirmed. The spectroscopically measured Ly_alpha fluxes of these two objects are consistent with the interpretation that the NB921 depression is caused by the contribution of the strong Ly_alpha emission to the z'-band flux. Most of the NB921-depressed i'-dropout objects are thought to be strong Ly_alpha emitters at 6.0 < z < 6.5; Galactic L and T dwarfs and NB921-dropout galaxies at z > 6.6 do not dominate the NB921-depressed i'-dropout sample. Thus the NB921-depression method is very useful for finding high-z Ly_alpha emitters with a large Ly_alpha equivalent width over a large redshift range, 6.0 < z < 6.5. Although the broadband-selected sample at z ~ 3 contains only a small fraction of objects with a Ly_alpha equivalent width larger than 100A, the i'-dropout sample of the Subaru Deep Field contains a much larger fraction of such strong Ly_alpha emitters. This may imply a strong evolution of the Ly_alpha equivalent width from z > 6 to z ~ 3.Comment: 21 pages, 6 figures, to appear in The Astrophysical Journa