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Large galaxies grow through the accumulation of dwarf galaxies 1 , 2 . In principle it is possible to trace this growth history via the properties of a galaxy’s stellar halo 3 – 5 . Previous investigations of the galaxy Messier 31 (M31, Andromeda) have shown that outside a galactocentric radius of 25 kiloparsecs the population of halo globular clusters is rotating in alignment with the stellar disk 6 , 7 , as are more centrally located clusters 8 , 9 . The M31 halo also contains coherent stellar substructures, along with a smoothly distributed stellar component 10 – 12 . Many of the globular clusters outside a radius of 25 kiloparsecs are associated with the most prominent substructures, but some are part of the smooth halo 13 . Here we report an analysis of the kinematics of these globular clusters. We find two distinct populations rotating perpendicular to each other. The rotation axis for the population associated with the smooth halo is aligned with the rotation axis for the plane of dwarf galaxies 14 that encircles M31. We interpret these separate cluster populations as arising from two major accretion epochs, probably separated by billions of years. Stellar substructures from the first epoch are gone, but those from the more recent second epoch still remain. There are two distinct kinematic populations of globular clusters in Messier 31 (M31, the Andromeda galaxy) with rotation axes perpendicular to each other, suggesting that they arose from merger events separated by billions of years.

About half of the satellites in the Andromeda galaxy (M 31), all with the same sense of rotation about their host, form a planar subgroup that is extremely wide but also very thin. The Andromeda galaxy's orbiting companions Giant spiral galaxies are assembled from smaller systems through a process known as hierarchical clustering. In orbit around these giants are dwarf galaxies, which are presumably remnants of the galactic progenitors. Recent studies of the dwarf galaxies of the Milky Way have led some astronomers to suspect that their orbits are not randomly distributed. This suspicion, which challenges current theories of galaxy formation, is now bolstered by the discovery of a plane of dwarf galaxies corotating as a coherent pancake-like structure around the Andromeda galaxy, the Milky Way's close neighbour and in many respects its 'twin'. The structure is extremely thin yet contains about half of the dwarf galaxies in the Andromeda system. The authors report that 13 of the 15 satellites in the plane share the same sense of rotation. Dwarf satellite galaxies are thought to be the remnants of the population of primordial structures that coalesced to form giant galaxies like the Milky Way 1 . It has previously been suspected 2 that dwarf galaxies may not be isotropically distributed around our Galaxy, because several are correlated with streams of H  i emission, and may form coplanar groups 3 . These suspicions are supported by recent analyses 4 , 5 , 6 , 7 . It has been claimed 7 that the apparently planar distribution of satellites is not predicted within standard cosmology 8 , and cannot simply represent a memory of past coherent accretion. However, other studies dispute this conclusion 9 , 10 , 11 . Here we report the existence of a planar subgroup of satellites in the Andromeda galaxy (M 31), comprising about half of the population. The structure is at least 400 kiloparsecs in diameter, but also extremely thin, with a perpendicular scatter of less than 14.1 kiloparsecs. Radial velocity measurements 12 , 13 , 14 , 15 reveal that the satellites in this structure have the same sense of rotation about their host. This shows conclusively that substantial numbers of dwarf satellite galaxies share the same dynamical orbital properties and direction of angular momentum. Intriguingly, the plane we identify is approximately aligned with the pole of the Milky Way’s disk and with the vector between the Milky Way and Andromeda.

Feedback to the interstellar medium from ionizing radiation, stellar winds and supernovae is central to regulating star formation in galaxies. Owing to their low mass (<10 9 solar masses), dwarf galaxies are particularly susceptible to such processes, making them ideal sites for studying the detailed physics of feedback. In this Perspective, we summarize the latest observational evidence for feedback from star-forming regions and how this feedback drives the formation of ‘superbubbles’ and galaxy-wide winds. We discuss the important role of external ionizing radiation—reionization—for the smallest galaxies, and the observational evidence that this feedback directly impacts galaxy properties such as their star formation histories, metal contents, colours, sizes, morphologies and even their inner dark matter densities. We conclude with a look to the future, summarizing the key questions that remain to be answered and listing some of the outstanding challenges for galaxy formation theories. This Perspective summarizes the latest observational evidence for star formation feedback and the important role of external ionizing radiation for the smallest galaxies, showing how this feedback directly impacts their properties, including their dark matter distribution.

BACKGROUND:Under value-based purchasing, Medicare withholds reimbursements for hospital-acquired pressure ulcer occurrence and rewards hospitals that meet performance standards. With little evidence of a validated prevention process, nurse managers are challenged to find evidence-based interventions. OBJECTIVE:The aim of this study was to reduce the unit-acquired pressure ulcer (UAPU) rate on targeted intensive care and step-down units by 15% using Lean Six Sigma (LSS) methodology. METHODS:An interdisciplinary team designed a pilot program using LSS methodology to test 4 interventionsstandardized documentation, equipment monitoring, patient out-of-bed–to–chair monitoring, and a rounding checklist. RESULTS:During the pilot, the UAPU rate decreased from 4.4% to 2.8%, exceeding the goal of a 15% reduction. The rate remained below the goal through the program control phase at 2.9%, demonstrating a statistically significant reduction after intervention implementation. CONCLUSIONS:The program significantly reduced UAPU rates in high-risk populations. LSS methodologies are a sustainable approach to reducing hospital-acquired conditions that should be broadly tested and implemented.

As part of the Z-PAndAS Keck II DEIMOS survey of resolved stars in our neighboring galaxy, Andromeda (M31), we have built up a unique data set of measured velocities and chemistries for thousands of stars in the Andromeda stellar halo, particularly probing its rich and complex substructure. In this contribution, we will discuss the structural, dynamical and chemical properties of Andromeda's dwarf spheroidal galaxies, and how there is no observational evidence for a difference in the evolutionary histories of those found on and off M31's vast plane of satellites. We will also discuss a possible extension to the most significant merger event in M31 - the Giant Southern Stream - and how we can use this feature to refine our understanding of M31's mass profile, and its complex evolution.

Galactic detritus around M31 A panoramic survey of the region around our nearest galactic neighbour, the well known Andromeda galaxy M31, has detected stars and coherent structures that are almost certainly remnants of dwarf galaxies destroyed by M31's tidal field. The brightest companion, the Triangulum galaxy (M33), is surrounded by a previously unknown prominent stellar structure that provides evidence for a recent encounter with M31. This new view of galactic structures is consistent with hierarchical cosmological models in which galaxies grow in mass by the accretion of smaller ones. In hierarchical cosmological models, galaxies grow in mass through the continual accretion of smaller ones. The tidal disruption of these systems is expected to result in loosely bound and distant stars surrounding the galaxy. A panoramic survey of the Andromeda galaxy (M31) now reveals stars and coherent structures that are almost certainly remnants of dwarf galaxies destroyed by the tidal field of M31. In hierarchical cosmological models 1 , galaxies grow in mass through the continual accretion of smaller ones. The tidal disruption of these systems is expected to result in loosely bound stars surrounding the galaxy, at distances that reach 10–100 times the radius of the central disk 2 , 3 . The number, luminosity and morphology of the relics of this process provide significant clues to galaxy formation history 4 , but obtaining a comprehensive survey of these components is difficult because of their intrinsic faintness and vast extent. Here we report a panoramic survey of the Andromeda galaxy (M31). We detect stars and coherent structures that are almost certainly remnants of dwarf galaxies destroyed by the tidal field of M31. An improved census of their surviving counterparts implies that three-quarters of M31’s satellites brighter than M v = -6 await discovery. The brightest companion, Triangulum (M33), is surrounded by a stellar structure that provides persuasive evidence for a recent encounter with M31. This panorama of galaxy structure directly confirms the basic tenets of the hierarchical galaxy formation model and reveals the shared history of M31 and M33 in the unceasing build-up of galaxies.

We have previously shown that the secreted M. tuberculosis complex proteins CFP-10 and ESAT-6 form a tight, 1:1 complex, which may represent their functional form. In the work reported here a combination of yeast two-hybrid and biochemical analysis has been used to characterise complex formation between two other pairs of CFP-10/ESAT-6 family proteins (Rv0287/Rv0288 and Rv3019c/Rv3020c) and to determine whether complexes can be formed between non-genome paired members of the family. The results clearly demonstrate that Rv0287/Rv0288 and Rv3019c/3020c form tight complexes, as initially observed for CFP-10/ESAT-6. The closely related Rv0287/Rv0288 and Rv3019c/Rv3020c proteins are also able to form non-genome paired complexes (Rv0287/Rv3019c and Rv0288/Rv3020c), but are not capable of binding to the more distantly related CFP-10/ESAT-6 proteins.

Feedback to the interstellar medium (ISM) from ionising radiation, stellar winds and supernovae is central to regulating star formation in galaxies. Due to their low mass (\\(M_{*} < 10^{9}\\)\\,M\\(_\\odot\\)), dwarf galaxies are particularly susceptible to such processes, making them ideal sites to study the detailed physics of feedback. In this perspective, we summarise the latest observational evidences for feedback from star forming regions and how this drives the formation of 'superbubbles' and galaxy-wide winds. We discuss the important role of external ionising radiation -- 'reionisation' -- for the smallest galaxies. And, we discuss the observational evidences that this feedback directly impacts galaxy properties such as their star formation histories, metal content, colours, sizes, morphologies and even their inner dark matter densities. We conclude with a look to the future, summarising the key questions that remain unanswered and listing some of the outstanding challenges for galaxy formation theories.

We present deep imaging of the ultra-diffuse Andromeda XIX dwarf galaxy from the Advance Camera for Surveys on the Hubble Space Telescope which resolves its stellar populations to below the oldest main sequence turn-off. We derive a full star formation history for the galaxy using MATCH, and find no evidence of star formation in the past 8 Gyr. We calculate a quenching time of \\(\\tau_{90}=9.7\\pm0.2\\)~Gyr, suggesting Andromeda~XIX ceased forming stars very early on. This early quenching, combined with its extremely large half-light radius, low density dark matter halo and lower than expected metallicity make it a unique galaxy within the Local Group and raises questions about how it formed. The early quenching time allows us to rule out feedback from bursty star formation as a means to explain its diffuse stellar population and low density dark matter halo. We find that the extended stellar population, low density halo and star formation could be explained by either tidal interactions (such as tidal shocking) or by late dry mergers, with the latter also explaining its low metallicity. Proper motions and detailed abundances would allow us to distinguish between these two scenarios.

We report the discovery of an ultra-faint dwarf in the constellation of Pegasus. Pegasus~V (Peg~V) was initially identified in the public imaging data release of the DESI Legacy Imaging Surveys and confirmed with deep imaging from Gemini/GMOS-N. The colour-magnitude diagram shows a sparse red giant branch (RGB) population and a strong over-density of blue horizontal branch stars. We measure a distance to Peg~V of \\(D=692^{+33}_{-31}\\)~kpc, making it a distant satellite of Andromeda with \\(M_V=-6.3\\pm0.2\\) and a half-light radius of \\(r_{\\rm half}=89\\pm41\\)~pc. It is located \\(\\sim260\\)~kpc from Andromeda in the outskirts of its halo. The RGB is well-fit by a metal-poor isochrone with [Fe/H]\\(=-3.2\\), suggesting it is very metal poor. This, combined with its blue horizontal branch could imply that it is a reionisation fossil. This is the first detection of an ultra-faint dwarf outside the deep Pan-Andromeda Archaeological Survey area, and points to a rich, faint satellite population in the outskirts of our nearest neighbour.