Measuring the dark matter velocity anisotropy in galaxy clusters

The Universe contains approximately 6 times more dark matter than normal baryonic matter, and a directly observed fundamental difference between dark matter and baryons would both be significant for our understanding of dark matter structures and provide us with information about the basic characteristics of the dark matter particle. We discuss one distinctive feature of dark matter structures in equilibrium, namely the property that a local dark matter temperature may depend on direction. This is in stark contrast to baryonic gases. We used X-ray observations of two nearby, relaxed galaxy clusters, under the assumptions of hydrostatic equilibrium and identical dark matter and gas temperatures in the outer cluster region, to measure this dark matter temperature anisotropy beta_dm, with non-parametric Monte Carlo methods. We find that beta_dm is greater than the value predicted for baryonic gases, beta_gas=0, at more than 3 sigma confidence. The observed value of the temperature anisotropy is in fair agreement with the results of cosmological N-body simulations and shows that the equilibration of the dark matter particles is not governed by local point-like interactions in contrast to baryonic gases.Comment: 5 pages, 3 figures, extended discussions, matches accepted versio

Mass distribution in the most X-ray-luminous galaxy cluster RX J1347.5-1145 studied with XMM-Newton

We report on the analysis of XMM-Newton observations of RX J1347.5-1145 (z=0.451), the most X-ray-luminous galaxy cluster. We present a detailed total and gas mass determination up to large distances (~1.7 Mpc), study the scaling properties of the cluster, and explore the role of AGN heating in the cluster cool core. By means of spatially resolved spectroscopy we derive density, temperature, entropy, and cooling time profiles of the intra-cluster medium. We compute the total mass profile of the cluster in the assumption of hydrostatic equilibrium. If the disturbed south-east region of the cluster is excluded from the analysis, our results on shape, normalization, scaling properties of density, temperature, entropy, and cooling time profiles are fully consistent with those of relaxed, cool core clusters. We compare our total and gas mass estimates with previous X-ray, lensing, dynamical, and SZ studies. We find good agreement with other X-ray results, dynamical mass measurements, weak lensing masses and SZ results. We confirm a discrepancy of a factor ~2 between strong lensing and X-ray mass determinations and find a gross mismatch between our total mass estimate and the mass reconstructed through the combination of both strong and weak lensing. We explore the effervescent heating scenario in the core of RX J1347.5-1145 and find support to the picture that AGN outflows and heat conduction are able to quenching radiative cooling.Comment: 12 pages, 6 figures, accepted for publication in A&

Comparison between Aorto-bifemoral Bypass and Aorto-iliac Kissing Stent in Patients with Complex Aorto-iliac Obstructive Disease

Introduction: To retrospectively compare early and late results of aorto-bifemoral bypass and endovascular recanalization with the kissing stent technique in the management of TASC II C and D lesions in the aorto-iliac district in a multicentre study. Methods: From January 2006 to December 2013, 293 open and endovascular interventions for TASC-II class C and D aorto-iliac obstructive lesions were performed at three Italian teaching hospitals. In 210 patients the intervention was performed for aortic and bilateral iliac involvement: an aorto-bifemoral bypass was performed in 82 patients (Group 1) while in the remaining 128 an endovascular recanalization with the kissing stent technique (Group 2). Early results in the two groups were compared with \u3c72 test. Follow up results were analyzed with Kaplan-Meyer curves and compared with log rank test. Results: There were no differences between the two groups in terms of demographic data, comorbidities, or risk factors for atherosclerosis, except for a higher percentage of females and of diabetic patients in group 2. Critical limb ischemia was present in 29 patients in group 1 (35.5%) and in 31 patients in group 2 (24%, p = 0.07). Technical success in group 2 was 98.5%; two patients required immediate conversion to open surgery for iliac rupture. There was one peri-operative death in group 1 (mortality rate 1.2%, p = 0.2 in comparison with group 2). Four peri-operative thromboses occurred; two in group 1 and two in group 2 (in one case requiring conversion to open surgical intervention) and no amputations at 30 days were recorded. Post-operative local and systemic complications occurred in 20 patients in group 1 (24%) and in 13 patients in group 2 (10% p = 0.006). Mean duration of follow up was 39 months (range 1 \u2013108 months). Survival rates at 6 years were 65% (SE 0.07) in group 1 and 82% (SE 0.05) in group 2 (p = 0.07). At the same time interval, primary, assisted primary and secondary patency rates were similar; re-intervention rates were 6% in group 1 (SE 0.05) and 11% in group 2 (SE 0.04; p = 0.2). Conclusion: Endovascular repair of complex aorto-iliac lesions with the kissing stent technique, in the multicentre experience, provided similar satisfactory early and late results to those obtained with open surgery, however with a lower rate of peri-operative complications and a trend towards better long-term survival

Estimation of cost-of-illness in patients with psoriasis in Switzerland

BACKGROUND: Evaluation of the current clinical treatment of psoriasis in Switzerland remains to be measured with the parameters cost-of-illness and quality of life. Objective: To obtain data on out-of-pocket expenses, costs of outpatient/office-based care and inpatient care for psoriasis, and to extrapolate total costs by state of severity to the entire Swiss population. METHODS: 1200 retrospective surveys were distributed to patient members of the Swiss Psoriasis and Vitiligo Society, and 400 surveys to office-/hospital-based Swiss dermatologists. The reference year for data collection was 2005. Patients were stratified into three subgroups according to severity of disease. Costs of inpatient care were measured by the amount of hospital days of psoriatic patients from the Swiss Federal Hospital Statistics. RESULTS: 383 patient questionnaires, and 170 cases documented by 57 dermatologists were analyzed. Out-of-pocket expenses/costs for ambulatory care per patient and year ranged from CHF 600-1100 for mild psoriasis to CHF 2400-9900 for severe psoriasis. Including costs for inpatient care of approximately CHF 60 million, the total annual costs for psoriasis in Switzerland in 2004/5 amounted to approximately CHF 314-458 million. CONCLUSIONS: Moderate-to-severe psoriasis is associated with a significant impact on the quality of life and at least 4-fold higher costs than mild psoriasis, indicating the need for efficient control of the disease. This cost-of-illness study provides specific health economic data for future healthcare decision making, particularly with the advent of new therapeutic agents for effective psoriasis control

Arch and access vessel complications in penetrating aortic ulcer managed with thoracic endovascular aortic repair

Background: To analyze our experience and to describe access and arch-related challenges when performing thoracic endovascular aortic repair (TEVAR) for penetrating aortic ulcers (PAUs).Methods: This is a single-center, observational, cohort study. Between October 2003 and February 2019, 48 patients with PAU were identified; 37 (77.1%) treated with TEVAR were retrospectively analyzed. Primary major outcomes were early (< 30 days) and late survival, freedom from aortic-related mortality (ARM), and a composite endpoint of arch/vascular access-related complications.Results: On admission, 17 (45.9%) patients were symptomatic with 4 (10.8%) presenting with rupture. Inhospital mortality was 8.1% (n=3). We observed 10 (27.0%) arch/access-related complications. There were 4 (10.8%) arch issues: 2 transient ischemic attacks and 2 retrograde acute type A dissections which required emergent open conversion for definitive repair. Access issues occurred in 6 (16.2%) patients: 3 (8.1%) required common iliac artery conduit, and 1 (2.7%) patient required iliac artery angioplasty to deliver the stent-graft. In addition, 2 (5.4%) patients developed access complications which required operative repair [femoral patch angioplasty (n=2), and femoral pseudoaneurysmectomy (n=1)]. Arch/access-related mortality rate was 5.4% (n=2) and median follow-up was 24 (range, 1-156; IQR, 3-52) months. Estimated survival was 87.1% (standard error: 0.6; 95% CI: 71.2-84.9%) at 1 year, and 63.3% (SE: 0.9; 95% CI: 44.1-79%) at 4 years. Estimated freedom from reintervention was 88.9% (SE: 0.5; 95% CI: 74.8-95.6%) at 1 year, and 84.2% (SE: 0.7; 95% CI: 67.3-93.2%) at 4 years. No arch/access-related issues developed during the follow-up period.Conclusions: Our experience confirms that vascular access and aortic arch issues are still a challenging aspect of performing TEVAR for PAUs. Our cumulative 27% rate of access/arch issues is lower than previously reported due to both technological advancements and meticulous management of both access routes and arch anatomy

Probing the Astrophysics of Cluster Outskirts

In galaxy clusters the entropy distribution of the IntraCluster Plasma modulates the latter's equilibrium within the Dark Matter gravitational wells, as rendered by our Supermodel. We argue the entropy production at the boundary shocks to be reduced or terminated as the accretion rates of DM and intergalactic gas peter out; this behavior is enforced by the slowdown in the outskirt development at late times, when the Dark Energy dominates the cosmology while the outer wings of the initial perturbation drive the growth. In such conditions, we predict the ICP temperature profiles to steepen into the cluster outskirts. The detailed expectations from our simple formalism agree with the X-ray data concerning five clusters whose temperature profiles have been recently measured out to the virial radius. We predict steep temperature declines to prevail in clusters at low redshift, tempered only by rich environs including adjacent filamentary structures.Comment: 4 pages, 3 figures, uses aa.cls. Typos corrected. Accepted by A&A

X-ray modelling of galaxy cluster gas and mass profiles

We present a parametric analysis of the intracluster medium and gravitating mass distribution of a statistical sample of 20 galaxy clusters using the phenomenological cluster model of Ascasibar and Diego. We describe an effective scheme for the estimation of errors on model parameters and derived quantities using bootstrap resampling. We find that the model provides a good description of the data in all cases and we quantify the mean fractional intrinsic scatter about the best-fit density and temperature profiles, finding this to have median values across the sample of 2 and 5 per cent, respectively. In addition, we demonstrate good agreement between r500 determined directly from the model and that estimated from a core-excluded global spectrum. We compare cool core and non-cool core clusters in terms of the logarithmic slopes of their gas density and temperature profiles and the distribution of model parameters and conclude that the two categories are clearly separable. In particular, we confirm the effectiveness of the logarithmic gradient of the gas density profile measured at 0.04 r500 in differentiating between the two types of cluster.Comment: 8 pages, 7 figures, accepted for publication in MNRA

Thoracic Endovascular Aortic Repair for Type B Acute Aortic Dissection Complicated by Descending Thoracic Aneurysm

OBJECTIVES: To analyse the results and review the literature about thoracic aortic endovascular repair (TEVAR) for type B acute aortic dissection (TBAAD) complicated by descending thoracic aortic aneurysm (DTA) in the hyperacute or acute phases. METHODS: This was a multicentre, observational descriptive study. Inclusion criteria were TBAAD with a DTA of 6550 mm, TBAAD on an already known aneurysmal descending thoracic aorta, and TBAAD presenting with an enlarged aorta with a total diameter <50 mm, but with >50% diameter increase compared with a previous computed tomography angiography (CTA) showing a non-dissected aorta with normal sizing. Primary endpoints were early and long-term survival, freedom from TEVAR and aortic related mortality (ARM), and freedom from re-intervention. RESULTS: Twenty-two patients were included in the analysis. The mean aortic diameter was 66 \ub1 26 mm (range 42-130; IQR 51-64). The in hospital TEVAR related mortality was 14% (n = 3). The mean radiological follow-up was 56 \ub1 45 months (range 6-149; IQR 12-82), and the follow-up index 0.97 \ub1 0.1. All surviving patients were available for follow-up. During follow-up the cumulative mortality was 26% (n = 5) and TEVAR related mortality was 5% (n = 1). Overall the estimate of survival was 82% (95%CI: 61.5-93) at 1 year, and 64% at 5 years. Ongoing primary clinical success was 79% (re-intervention n = 4). Freedom from aortic related mortality was 86% (95%CI: 66-95) at 1 and 5 year, while freedom from re-intervention was 95% (95%CI: 75.5-95) at 1 year, and 77% (95%CI: 50-92) at 5 years. CONCLUSIONS: In our experience, DTA is a frequent complication from the very beginning of the clinical onset of TBAAD. In this high-risk cohort, TEVAR showed satisfactory results, better than those predicted by the risk score for open repair, with favourable stability of the aortic diameter and no aortic related adverse events during follow-up