Long-Term Acute Care Hospitals and Georgia Medicaid: Utilization, Outcomes, and Cost

Because most research on long-term acute care hospitals has focused on Medicare, the objective of this research is to describe the Georgia Medicaid population who received care at a long-term acute care hospital, the type and volume of services provided by these long-term acute care hospitals, and the costs and outcomes of these services. For those with select respiratory conditions, we descriptively compare costs and outcomes to those of patients who received care for the same services in acute care hospitals

Linking the Metallicity Distribution of Galactic Halo Stars to the Enrichment History of the Universe

We compare the metallicity distribution of Galactic Halo stars with 3D realizations of hierarchical galaxy formation. Outflows from dwarf galaxies enrich the intergalactic medium inhomogeneously, at a rate depending on the local galaxy density. Consequently, the first stars created in small early-forming galaxies are less metal-rich that the first stars formed in more massive galaxies which typically form later. As most halo stars are likely to originate in accreted dwarfs, while disk stars formed out of outflow-enriched gas, this scenario naturally generates a ``metallicity floor'' for old disk stars, which we find to be roughly coincident with the higher end of our predicted metallicity distribution of halo stars, in agreement with observations. The broad and centrally peaked distribution of halo star metallicities is well reproduced in our models, with a natural dispersion depending on the exact accretion history. Our modeling includes the important ``baryonic stripping'' effect of early outflows, which brush away the tenuously held gas in neighboring pre-virialized density perturbations. This stripping process does not significantly modify the predicted shape of the halo star metal distribution but inhibits star-formation and hence the number of accreted stars, helping to reproduce the observed total Galactic halo luminosity and also the lack of low-luminosity local dwarf galaxies relative to N-body predictions.Comment: 5 pages, 1 figure, ApJ Letters, accepte

Deep Hubble Space Telescope Imaging of IC 1613 II. The Star Formation History

We present deep HST WFPC2 imaging of the Local Group dwarf irregular galaxy IC 1613. The photometry is the deepest to date for an isolated dwarf irregular galaxy. The resulting color-magnitude diagram (CMD) is analyzed using three different methods to derive a star formation history (SFH). All three find an enhanced star formation rate (SFR), from 3 to 6 Gyr ago, and similar age-metallicity relationships (AMR). A comparison of the newly observed outer field with an earlier studied central field of IC 1613 shows that the SFR in the outer field has been significantly depressed during the last Gyr. This implies that the optical scale length of the galaxy has been decreasing with time and that comparison of galaxies at intermediate redshift with present day galaxies should take this effect into account. We find strong similarities between IC 1613 and the more distant Milky Way dSph companions in that all are dominated by star formation at intermediate ages. In particular, the SFH and AMR for IC 1613 and Leo I are indistinguishable. This implies that dIrr galaxies cannot be distinguished from dSphs by their intermediate age stellar populations. This type of a SFH may also be evidence for slower or suppressed early star formation in dwarf galaxies due to photoionization after the reionization of the universe by background radiation. Assuming that IC 1613 is typical of a dIrr evolving in isolation, since most of the star formation occurs at intermediate ages, these dwarf systems cannot be responsible for the fast chemical enrichment of the IGM which is seen at high redshift. There is no evidence for any large amplitude bursts of star formation in IC 1613, and we find it highly unlikely that analogs of IC 1613 have contributed to the excess of faint blue galaxies in existing galaxy redshift surveys.Comment: 32 pages, including 1 table and 17 figures, accepted for publication in the Astrophysical Journal October 10, 2003 issu

Structural basis of nSH2 regulation and lipid binding in PI3Kα

We report two crystal structures of the wild-type phosphatidylinositol 3-kinase α (PI3Kα) heterodimer refined to 2.9 Å and 3.4 Å resolution: the first as the free enzyme, the second in complex with the lipid substrate, diC4-PIP2, respectively. The first structure shows key interactions of the N-terminal SH2 domain (nSH2) and iSH2 with the activation loop that suggest a mechanism by which the enzyme is inhibited in its basal state. In the second structure, the lipid substrate binds in a positively charged pocket adjacent to the ATP-binding site, bordered by the P-loop, the activation loop and the iSH2 domain. An additional lipid-binding site was identified at the interface of the ABD, iSH2 and kinase domains. The ability of PI3Kα to bind an additional PIP2 molecule was confirmed in vitro by fluorescence quenching experiments. The crystal structures reveal key differences in the way the nSH2 domain interacts with wild-type p110α and with the oncogenic mutant p110αH1047R. Increased buried surface area and two unique salt-bridges observed only in the wild-type structure suggest tighter inhibition in the wild-type PI3Kα than in the oncogenic mutant. These differences may be partially responsible for the increased basal lipid kinase activity and increased membrane binding of the oncogenic mutant

Leo A: A Late-Blooming Survivor of the Epoch of Reionization in the Local Group

As part of a major program to use isolated Local Group dwarf galaxies as near-field probes of cosmology, we have obtained deep images of the dwarf irregular galaxy Leo A with the Advanced Camera for Surveys aboard the Hubble Space Telescope. From these images we have constructed a color-magnitude diagram (CMD) reaching apparent [absolute] magnitudes of (M475, M814) > (29.0 [+4.4], 27.9 [+3.4]), the deepest ever achieved for any irregular galaxy beyond the Magellanic Clouds. We derive the star-formation rate (SFR) as a function of time over the entire history of the galaxy. We find that over 90% of all the star formation that ever occurred in Leo A happened more recently than 8 Gyr ago. The CMD shows only a very small amount of star formation in the first few billion years after the Big Bang; a possible burst at the oldest ages cannot be claimed with high confidence. The peak SFR occurred ~1.5-4 Gyr ago, at a level 5-10 times the current value. Our modelling indicates that Leo A has experienced very little metallicity evolution; the mean inferred metallicity is consistent with measurements of the present-day gas-phase oxygen abundance. We cannot exclude a scenario in which ALL of the ancient star formation occurred prior to the end of the era of reionization, but it seems unlikely that the lack of star formation prior to ~8 Gyr ago was due to early loss or exhaustion of the in situ gas reservoir.Comment: Accepted for publication in the Astrophysical Journal Letters; 5 pages, 3 figures (2 in color); uses emulateapj.st

Deep HST Imaging of Sextans A I. The Spatially Resolved Recent Star Formation History

We have measured stellar photometry from deep Cycle 7 Hubble Space Telescope/WFPC2 imaging of the dwarf irregular galaxy Sextans A. The imaging was taken in three filters: F555W ($V$; 8 orbits), F814W ($I$; 16 orbits), and F656N (H$\alpha$; 1 orbit). Combining these data with Cycle 5 WFPC2 observations provides nearly complete coverage of the optically visible portion of the galaxy. The Cycle 7 observations are nearly 2 magnitudes more sensitive than the Cycle 5 observations, which provides unambiguous separation of the faint blue helium burning stars (BHeB stars) from contaminant populations. The depth of the photometry allows us to compare recent star formation histories recovered from both the main sequence (MS) stars and the BHeB stars for the last 300 Myr. The excellent agreement between these independent star formation rate (SFR) calculations is a resounding confirmation for the legitimacy of using the BHeB stars to calculate the recent SFR. Using the BHeB stars we have calculated the global star formation history over the past 700 Myr. The history calculated from the Cycle 7 data is remarkably identical to that calculated from the Cycle 5 data, implying that both halves of the galaxy formed stars in concert. We have also calculated the spatially resolved star formation history, combining the fields from the Cycle 5 and Cycle 7 data. Our interpretation of the pattern of star formation is that it is an orderly stochastic process.Comment: 27 pages, 14 figures, 2 mpeg movies, accepted in the Astronomical Journa

Star formation at the edge of the Local Group: a rising star formation history in the isolated galaxy WLM

We present the star formation history (SFH) of the isolated (D~970 kpc) Local Group dwarf galaxy WLM measured from color-magnitude diagrams constructed from deep Hubble Space Telescope imaging. Our observations include a central (0.5 $r_h$) and outer field (0.7 $r_h$) that reach below the oldest main sequence turnoff. WLM has no early dominant episode of star formation: 20% of its stellar mass formed by ~12.5 Gyr ago (z~5). It also has an SFR that rises to the present with 50% of the stellar mass within the most recent 5 Gyr (z<0.7). There is evidence of a strong age gradient: the mean age of the outer field is 5 Gyr older than the inner field despite being only 0.4 kpc apart. Some models suggest such steep gradients are associated with strong stellar feedback and dark matter core creation. The SFHs of real isolated dwarf galaxies and those from the the Feedback In Realistic Environment suite are in good agreement for $M_{\star}(z=0) \sim 10^7-10^9 M_{\odot}$, but in worse agreement at lower masses ($M_{\star}(z=0) \sim 10^5-10^7 M_{\odot}$). These differences may be explainable by systematics in the models (e.g., reionization model) and/or observations (HST field placement). We suggest that a coordinated effort to get deep CMDs between HST/JWST (crowded central fields) and WFIRST (wide-area halo coverage) is the optimal path for measuring global SFHs of isolated dwarf galaxies.Comment: 13 pages, 13 Figures, 4 Tables. Re-submitted to MNRAS after addressing the referee's comment

The ACS Nearby Galaxy Survey Treasury

The ACS Nearby Galaxy Survey Treasury (ANGST) is a systematic survey to establish a legacy of uniform multi-color photometry of resolved stars for a volume-limited sample of nearby galaxies (D<4 Mpc). The survey volume encompasses 69 galaxies in diverse environments, including close pairs, small & large groups, filaments, and truly isolated regions. The galaxies include a nearly complete range of morphological types spanning a factor of ~10^4 in luminosity and star formation rate. The survey data consists of images taken with ACS on HST, supplemented with archival data and new WFPC2 imaging taken after the failure of ACS. Survey images include wide field tilings covering the full radial extent of each galaxy, and single deep pointings in uncrowded regions of the most massive galaxies in the volume. The new wide field imaging in ANGST reaches median 50% completenesses of m_F475W=28.0 mag, m_F606W=27.3 mag, and m_F814W=27.3 mag, several magnitudes below the tip of the red giant branch (TRGB). The deep fields reach magnitudes sufficient to fully resolve the structure in the red clump. The resulting photometric catalogs are publicly accessible and contain over 34 million photometric measurements of >14 million stars. In this paper we present the details of the sample selection, imaging, data reduction, and the resulting photometric catalogs, along with an analysis of the photometric uncertainties (systematic and random), for both the ACS and WFPC2 imaging. We also present uniformly derived relative distances measured from the apparent magnitude of the TRGB.Comment: 54 pages, including 24 pages of figures and 16 pages of tables. Project website and data available at http://www.nearbygalaxies.org/ . Data is also available through MAST. Scheduled to appear in the Astrophysical Journal Supplements. (Replaced to fix several figures that were damaged during compression

The Milky Way's dark matter halo appears to be lopsided

The atomic hydrogen gas (HI) disk in the outer region (beyond ~10 kpc from the centre) of Milky Way can provide valuable information about the structure of the dark matter halo. The recent 3-D thickness map of the outer HI disk from the all sky 21-cm line LAB survey, gives us a unique opportunity to investigate the structure of the dark matter halo of Milky Way in great detail. A striking feature of this new survey is the North-South asymmetry in the thickness map of the atomic hydrogen gas. Assuming vertical hydrostatic equilibrium under the total potential of the Galaxy, we derive the model thickness map of the HI gas. We show that simple axisymmetric halo models, such as softened isothermal halo (producing a flat rotation curve with V_c ~ 220 km/s) or any halo with density falling faster than the isothermal one, are not able to explain the observed radial variation of the gas thickness. We also show that such axisymmetric halos along with different HI velocity dispersion in the two halves, cannot explain the observed asymmetry in the thickness map. Amongst the non-axisymmetric models, it is shown that a purely lopsided (m=1, first harmonic) dark matter halo with reasonable HI velocity dispersion fails to explain the North-South asymmetry satisfactorily. However, we show that by superposing a second harmonic (m=2) out of phase onto a purely lopsided halo e.g. our best fit and more acceptable model A (with parameters \epsilon_{h}^{1}=0.2, \epsilon_{h}^{2}=0.18 and \sigma_{HI}=8.5 km/s) can provide an excellent fit to the observation and reproduce the North-South asymmetry naturally. The emerging picture of the asymmetric dark matter halo is supported by the \Lambda CDM halos formed in the cosmological N-body simulation.Comment: 37 pages, 8 figures, accepted for publication in Ap