Asthma diagnosis and treatment - 1012. The efficacy of budesonide in the treatmetn of acute asthma in children: a double-blind, randomized, controlled trial.

Background Current evidence suggests that inhaled glucocorticoids (IGC) have a more profound topical none genomic effect on bronchial airways as compared to systemic glucocorticoids. The value of adding IGC to current therapy of acute asthma is not well established. Methods We conducted a double-blind, randomized, two-arm, parallel groups, controlled clinical trial to compare the addition of budesonide 1500 mcg or placebo (normal saline) to standard acute asthma treatment (albuterol and ipratropium bromide) administered in 3 divided mixed doses within 1 hour in the emergency department (ED). Children 2-12 years of age with moderate or severe acute asthma, scoring 8-15/15 on a well-validated scoring system were included. Both groups received a single dose of prednisone 2 mg/kg/day (max. 60 mg) at the beginning of therapy. The primary outcome was admission rate within 2-4 hours from starting therapy. Results A total of 723 children were enrolled in the study over 17 months duration, of whom 139 were allowed to re-enroll and be randomized to constitute 906 randomization assignments (458 on the treatment group and 448 on the control group); with baseline mean + SD asthma score of 10.63 + 1.73; age 5.52 + 2.76 years; 35% girls; 30.8% (16.5%) with baseline severe asthma score of ≥12 (≥ 13). Statistical Analysis plan allowed for the potential dependency in response due to reenrollments of a subset of children, using Generalized Linear Mixed Modeling (GLMM) techniques. Baseline demographic and clinical characteristics were not significantly different between the two randomized groups. Seventy-five out of 458 (16.4%) of the treatment group vs. 82/448 (18.3%) of the control group were admitted, (OR 0.85, CI: 0.59-1.23, p-value=0.39). Among the severe asthmatics with baseline score ≥13, treatment vs. placebo group, GLMM adjusted admission rate was 30% vs. 47%, indicating a 17% difference in admission rate in favor of the treatment group (adjusted OR of 0.49, CI: 0.25-0.95; p-value= 0.035) that indicated a 51% reduction in the risk of admission for the treatment vs. control group. Conclusions Children with baseline severe asthma score ≥13 who were treated with budesonide had a significant reduction in their admission rate

A Free-Form Lensing Grid Solution for A1689 with New Mutiple Images

Hubble Space Telescope imaging of the galaxy cluster Abell 1689 has revealed an exceptional number of strongly lensed multiply-imaged galaxies, including high-redshift candidates. Previous studies have used this data to obtain the most detailed dark matter reconstructions of any galaxy cluster to date, resolving substructures ~25 kpc across. We examine Abell 1689 (hereafter, A1689) non-parametrically, combining strongly lensed images and weak distortions from wider field Subaru imaging, and we incorporate member galaxies to improve the lens solution. Strongly lensed galaxies are often locally affected by member galaxies, however, these perturbations cannot be recovered in grid based reconstructions because the lensing information is too sparse to resolve member galaxies. By adding luminosity-scaled member galaxy deflections to our smooth grid we can derive meaningful solutions with sufficient accuracy to permit the identification of our own strongly lensed images, so our model becomes self consistent. We identify 11 new multiply lensed system candidates and clarify previously ambiguous cases, in the deepest optical and NIR data to date from Hubble and Subaru. Our improved spatial resolution brings up new features not seen when the weak and strong lensing effects are used separately, including clumps and filamentary dark matter around the main halo. Our treatment means we can obtain an objective mass ratio between the cluster and galaxy components, for examining the extent of tidal stripping of the luminous member galaxies. We find a typical mass-to-light ratios of M/L_B = 21 inside the r<1 arcminute region that drops to M/L_B = 17 inside the r<40 arcsecond region. Our model independence means we can objectively evaluate the competitiveness of stacking cluster lenses for defining the geometric lensing-distance-redshift relation in a model independent way.Comment: 23 pages with 25 figures Replced with MNRAS submitted version. Some figures have been corrected and minor text edit

The Cluster Lensing and Supernova Survey with Hubble (CLASH): Strong Lensing Analysis of Abell 383 from 16-Band HST WFC3/ACS Imaging

We examine the inner mass distribution of the relaxed galaxy cluster Abell 383 in deep 16-band HST/ACS+WFC3 imaging taken as part of the CLASH multi-cycle treasury program. Our program is designed to study the dark matter distribution in 25 massive clusters, and balances depth with a wide wavelength coverage to better identify lensed systems and generate precise photometric redshifts. This information together with the predictive strength of our strong-lensing analysis method identifies 13 new multiply-lensed images and candidates, so that a total of 27 multiple-images of 9 systems are used to tightly constrain the inner mass profile, $d\log \Sigma/d\log r\simeq -0.6\pm 0.1$ (r<160 kpc). We find consistency with the standard distance-redshift relation for the full range spanned by the lensed images, 1.01<z<6.03, with the higher redshift sources deflected through larger angles as expected. The inner mass profile derived here is consistent with the results of our independent weak-lensing analysis of wide-field Subaru images, with good agreement in the region of overlap. The overall mass profile is well fitted by an NFW profile with M_{vir}=(5.37^{+0.70}_{-0.63}\pm 0.26) x 10^{14}M_{\odot}/h and a relatively high concentration, c_{vir}=8.77^{+0.44}_{-0.42}\pm 0.23, which lies above the standard c-M relation similar to other well-studied clusters. The critical radius of Abell 383 is modest by the standards of other lensing clusters, r_{E}\simeq16\pm2\arcsec (for z_s=2.55), so the relatively large number of lensed images uncovered here with precise photometric redshifts validates our imaging strategy for the CLASH survey. In total we aim to provide similarly high-quality lensing data for 25 clusters, 20 of which are X-ray selected relaxed clusters, enabling a precise determination of the representative mass profile free from lensing bias. (ABRIDGED)Comment: 15 pages, 14 figures, 2 tabels; V3 matches the submitted version later published in Ap

Combined strong and weak lensing analysis of 28 clusters from the Sloan Giant Arcs Survey

We study the mass distribution of a sample of 28 galaxy clusters using strong and weak lensing observations. The clusters are selected via their strong lensing properties as part of the Sloan Giant Arcs Survey (SGAS) from the Sloan Digital Sky Survey (SDSS). Mass modelling of the strong lensing information from the giant arcs is combined with weak lensing measurements from deep Subaru/Suprime-cam images to primarily obtain robust constraints on the concentration parameter and the shape of the mass distribution. We find that the concentration c_vir is a steep function of the mass, c_vir \propto M_vir^-0.59\pm0.12, with the value roughly consistent with the lensing-bias-corrected theoretical expectation for high mass (10^15 h^-1 M_sun) clusters. However, the observationally inferred concentration parameters appear to be much higher at lower masses (10^14 h^-1 M_sun), possibly a consequence of the modification to the inner density profiles provided by baryon cooling. The steep mass-concentration relation is also supported from direct stacking analysis of the tangential shear profiles. In addition, we explore the two-dimensional shape of the projected mass distribution by stacking weak lensing shear maps of individual clusters with prior information on the position angle from strong lens modelling, and find significant evidence for a large mean ellipticity with the best-fit value of e = 0.47 \pm 0.06 for the mass distribution of the stacked sample. We find that the luminous cluster member galaxy distribution traces the overall mass distribution very well, although the distribution of fainter cluster galaxies appears to be more extended than the total mass.Comment: 29 pages, 15+9 figures, 7 tables, accepted for publication in MNRA

Evidence for Ubiquitous, High-EW Nebular Emission in z~7 Galaxies: Towards a Clean Measurement of the Specific Star Formation Rate using a Sample of Bright, Magnified Galaxies

Growing observational evidence now indicates that nebular line emission has a significant impact on the rest-frame optical fluxes of z~5-7 galaxies observed with Spitzer. This line emission makes z~5-7 galaxies appear more massive, with lower specific star formation rates. However, corrections for this line emission have been very difficult to perform reliably due to huge uncertainties on the overall strength of such emission at z>~5.5. Here, we present the most direct observational evidence yet for ubiquitous high-EW [OIII]+Hbeta line emission in Lyman-break galaxies at z~7, while also presenting a strategy for an improved measurement of the sSFR at z~7. We accomplish this through the selection of bright galaxies in the narrow redshift window z~6.6-7.0 where the IRAC 4.5 micron flux provides a clean measurement of the stellar continuum light. Observed 4.5 micron fluxes in this window contrast with the 3.6 micron fluxes which are contaminated by the prominent [OIII]+Hbeta lines. To ensure a high S/N for our IRAC flux measurements, we consider only the brightest (H_{160}<26 mag) magnified galaxies we have identified in CLASH and other programs targeting galaxy clusters. Remarkably, the mean rest-frame optical color for our bright seven-source sample is very blue, [3.6]-[4.5]=-0.9+/-0.3. Such blue colors cannot be explained by the stellar continuum light and require that the rest-frame EW of [OIII]+Hbeta be greater than 637 Angstroms for the average source. The bluest four sources from our seven-source sample require an even more extreme EW of 1582 Angstroms. Our derived lower limit for the mean [OIII]+Hbeta EW could underestimate the true EW by ~2x based on a simple modeling of the redshift distribution of our sources. We can also set a robust lower limit of >~4 Gyr^-1 on the specific star formation rates based on the mean SED for our seven-source sample. (abridged)Comment: 9 pages, 6 figures, 1 table, submitted to the Astrophysical Journa

CLASH: A Census of Magnified Star-Forming Galaxies at z ~ 6-8

We utilize 16 band Hubble Space Telescope (HST) observations of 18 lensing clusters obtained as part of the Cluster Lensing And Supernova survey with Hubble (CLASH) Multi-Cycle Treasury program to search for $z\sim6-8$ galaxies. We report the discovery of 204, 45, and 13 Lyman-break galaxy candidates at $z\sim6$, $z\sim7$, and $z\sim8$, respectively, identified from purely photometric redshift selections. This large sample, representing nearly an order of magnitude increase in the number of magnified star-forming galaxies at $z\sim 6-8$ presented to date, is unique in that we have observations in four WFC3/UVIS UV, seven ACS/WFC optical, and all five WFC3/IR broadband filters, which enable very accurate photometric redshift selections. We construct detailed lensing models for 17 of the 18 clusters to estimate object magnifications and to identify two new multiply lensed $z \gtrsim 6$ candidates. The median magnifications over the 17 clusters are 4, 4, and 5 for the $z\sim6$, $z\sim7$, and $z\sim8$ samples, respectively, over an average area of 4.5 arcmin$^2$ per cluster. We compare our observed number counts with expectations based on convolving "blank" field UV luminosity functions through our cluster lens models and find rough agreement down to $\sim27$ mag, where we begin to suffer significant incompleteness. In all three redshift bins, we find a higher number density at brighter observed magnitudes than the field predictions, empirically demonstrating for the first time the enhanced efficiency of lensing clusters over field surveys. Our number counts also are in general agreement with the lensed expectations from the cluster models, especially at $z\sim6$, where we have the best statistics.Comment: Accepted for publication in the Astrophysical Journal, 25 pages, 13 figures, 7 table

A Census of Star-Forming Galaxies in the z~9-10 Universe based on HST+Spitzer Observations Over 19 CLASH clusters: Three Candidate z~9-10 Galaxies and Improved Constraints on the Star Formation Rate Density at z~9

We utilise a two-color Lyman-Break selection criterion to search for z~9-10 galaxies over the first 19 clusters in the CLASH program. A systematic search yields three z~9-10 candidates. While we have already reported the most robust of these candidates, MACS1149-JD, two additional z~9 candidates are also found and have H_{160}-band magnitudes of ~26.2-26.9. A careful assessment of various sources of contamination suggests <~1 contaminants for our z~9-10 selection. To determine the implications of these search results for the LF and SFR density at z~9, we introduce a new differential approach to deriving these quantities in lensing fields. Our procedure is to derive the evolution by comparing the number of z~9-10 galaxy candidates found in CLASH with the number of galaxies in a slightly lower redshift sample (after correcting for the differences in selection volumes), here taken to be z~8. This procedure takes advantage of the fact that the relative volumes available for the z~8 and z~9-10 selections behind lensing clusters are not greatly dependent on the details of the lensing models. We find that the normalization of the UV LF at z~9 is just 0.28_{-0.20}^{+0.39}\times that at z~8, ~1.4_{-0.8}^{+3.0}x lower than extrapolating z~4-8 LF results. While consistent with the evolution in the UV LF seen at z~4-8, these results marginally favor a more rapid evolution at z>8. Compared to similar evolutionary findings from the HUDF, our result is less insensitive to large-scale structure uncertainties, given our many independent sightlines on the high-redshift universe.Comment: 22 pages, 11 figures, 5 tables, accepted for publication in the Astrophysical Journal, updated to include the much deeper Spitzer/IRAC observations over our three z~9-10 candidate

RELICS: The Reionization Lensing Cluster Survey and the Brightest High-z Galaxies

Massive foreground galaxy clusters magnify and distort the light of objects behind them, permitting a view into both the extremely distant and intrinsically faint galaxy populations. We present here the z ~ 6-8 candidate high-redshift galaxies from the Reionization Lensing Cluster Survey (RELICS), a Hubble and Spitzer Space Telescope survey of 41 massive galaxy clusters spanning an area of ≈200 arcmin². These clusters were selected to be excellent lenses, and we find similar high-redshift sample sizes and magnitude distributions as the Cluster Lensing And Supernova survey with Hubble (CLASH). We discover 257, 57, and eight candidate galaxies at z ~ 6, 7, and 8 respectively, (322 in total). The observed (lensed) magnitudes of the z ~ 6 candidates are as bright as AB mag ~23, making them among the brightest known at these redshifts, comparable with discoveries from much wider, blank-field surveys. RELICS demonstrates the efficiency of using strong gravitational lenses to produce high-redshift samples in the epoch of reionization. These brightly observed galaxies are excellent targets for follow-up study with current and future observatories, including the James Webb Space Telescope

CLASH-VLT: The stellar mass function and stellar mass density profile of the z=0.44 cluster of galaxies MACS J1206.2-0847

Context. The study of the galaxy stellar mass function (SMF) in relation to the galaxy environment and the stellar mass density profile, rho(r), is a powerful tool to constrain models of galaxy evolution. Aims. We determine the SMF of the z=0.44 cluster of galaxies MACS J1206.2-0847 separately for passive and star-forming (SF) galaxies, in different regions of the cluster, from the center out to approximately 2 virial radii. We also determine rho(r) to compare it to the number density and total mass density profiles. Methods. We use the dataset from the CLASH-VLT survey. Stellar masses are obtained by SED fitting on 5-band photometric data obtained at the Subaru telescope. We identify 1363 cluster members down to a stellar mass of 10^9.5 Msolar. Results. The whole cluster SMF is well fitted by a double Schechter function. The SMFs of cluster SF and passive galaxies are statistically different. The SMF of the SF cluster galaxies does not depend on the environment. The SMF of the passive population has a significantly smaller slope (in absolute value) in the innermost (<0.50 Mpc), highest density cluster region, than in more external, lower density regions. The number ratio of giant/subgiant galaxies is maximum in this innermost region and minimum in the adjacent region, but then gently increases again toward the cluster outskirts. This is also reflected in a decreasing radial trend of the average stellar mass per cluster galaxy. On the other hand, the stellar mass fraction, i.e., the ratio of stellar to total cluster mass, does not show any significant radial trend. Conclusions. Our results appear consistent with a scenario in which SF galaxies evolve into passive galaxies due to density-dependent environmental processes, and eventually get destroyed very near the cluster center to become part of a diffuse intracluster medium.Comment: A&A accepted, 15 pages, 13 figure