Use of balloon catheter dilation vs. traditional endoscopic sinus surgery in management of light and severe chronic rhinosinusitis of the frontal sinus: a multicenter prospective randomized study

OBJECTIVE: Chronic rhinosinusitis (CRS) of the frontal sinus is a complex pathological condition and many surgical techniques were described to treat this area endoscopically, like traditional endoscopic sinus surgery (ESS) and balloon catheter dilation (BCD). PATIENTS AND METHODS: We designed a multicenter prospective randomized study to assess the validity and safety of BCD vs. ESS in symptomatological chronic rhinosinusitis of the frontal sinus enrolling a population of 102 adult patients (64 men and 38 women; overall 148 frontal sinuses studied) with non-polypoid CRS. For a better evaluation of the disease, in our study we decided to analyze both radiological (Lund-McKay CT scoring modified by Zinreich) and symptomatological results (SNOT-20 questionnaire). We divided the population affected in two groups, one with light/mild frontal CRS and the other with moderate/severe frontal CRS, basing on radiological findings at Lund-MacKay modified by Zinreich score. Every group was divided in two subgroups, in one we used BCD and in the other we used traditional ESS. RESULTS: The current literature does not support the suggestion that indications for BCD and ESS are identical, and additional research is needed to determine the role for BCD in specific patient populations. The results showed a not statistically significative difference between BCD and conventional ESS of the frontal sinus in patients with light/mild CRS and in patients with moderate/severe CRS at Lund-Mackay modified by Zinreich score. The same not statistically significative difference was observed comparing the results of SNOT-20 questionnaire in the group of light/mild frontal chronic rhinosinusitis. However, we noticed a statistically significant better outcome of SNOT-20 score in patients with moderate/severe chronic rhinosinusitis that underwent BCD of frontal sinus compared to ESS. CONCLUSIONS: BCD and ESS are two alternative weapons in the baggage of every endoscopic surgeon, even because they present similar outcomes, safeness and effectiveness both in light/mild and moderate/severe chronic rhinosinusitis of the frontal sinus. An interesting result of our study was the statistically significant better outcome of SNOT-20 score in patients that underwent BCD of frontal sinus for a moderate/severe CRS, compared to those that underwent a traditional ESS

A novel approach to controlled query evaluation in DL-Lite

In Controlled Query Evaluation (CQE) confidential data are protected through a declarative policy and a (optimal) censor, which guarantees that answers to queries are maximized without disclosing secrets. In this paper we consider CQE over Description Logic ontologies and study query answering over all optimal censors. We establish data complexity of the problem for ontologies specified in DL-LiteR and for variants of the censor language, which is the language used by the censor to enforce the policy. In our investigation we also analyze the relationship between CQE and the problem of Consistent Query Answering

The Brera Multi-scale Wavelet (BMW) ROSAT HRI source catalog. I: the algorithm

We present a new detection algorithm based on the wavelet transform for the analysis of high energy astronomical images. The wavelet transform, due to its multi-scale structure, is suited for the optimal detection of point-like as well as extended sources, regardless of any loss of resolution with the off-axis angle. Sources are detected as significant enhancements in the wavelet space, after the subtraction of the non-flat components of the background. Detection thresholds are computed through Monte Carlo simulations in order to establish the expected number of spurious sources per field. The source characterization is performed through a multi-source fitting in the wavelet space. The procedure is designed to correctly deal with very crowded fields, allowing for the simultaneous characterization of nearby sources. To obtain a fast and reliable estimate of the source parameters and related errors, we apply a novel decimation technique which, taking into account the correlation properties of the wavelet transform, extracts a subset of almost independent coefficients. We test the performance of this algorithm on synthetic fields, analyzing with particular care the characterization of sources in poor background situations, where the assumption of Gaussian statistics does not hold. For these cases, where standard wavelet algorithms generally provide underestimated errors, we infer errors through a procedure which relies on robust basic statistics. Our algorithm is well suited for the analysis of images taken with the new generation of X-ray instruments equipped with CCD technology which will produce images with very low background and/or high source density.Comment: 8 pages, 6 figures, ApJ in pres

The Evolutionary Status of Clusters of Galaxies at z ~ 1

Combined HST, X-ray, and ground-based optical studies show that clusters of galaxies are largely "in place" by $z \sim 1$, an epoch when the Universe was less than half its present age. High resolution images show that elliptical, S0, and spiral galaxies are present in clusters at redshifts up to $z \sim 1.3$. Analysis of the CMDs suggest that the cluster ellipticals formed their stars several Gyr earlier, near redshift 3. The morphology--density relation is well established at $z\sim1$, with star-forming spirals and irregulars residing mostly in the outer parts of the clusters and E/S0s concentrated in dense clumps. The intracluster medium has already reached the metallicity of present-day clusters. The distributions of the hot gas and early-type galaxies are similar in $z\sim1$ clusters, indicating both have largely virialized in the deepest potentials wells. In spite of the many similarities between $z\sim1$ and present-day clusters, there are significant differences. The morphologies revealed by the hot gas, and particularly the early-type galaxies, are elongated rather than spherical. We appear to be observing the clusters at an epoch when the sub-clusters and groups are still assembling into a single regular cluster. Support for this picture comes from CL0152 where the gas appears to be lagging behind the luminous and dark mass in two merging sub-components. Moreover, the luminosity difference between the first and second brightest cluster galaxies at $z\sim1$ is smaller than in 93% of present-day Abell clusters, which suggests that considerable luminosity evolution through merging has occurred since that epoch. Evolution is also seen in the bolometric X-ray luminosity function.Comment: 18 pages, 12 figures, to appear in Penetrating Bars through Masks of Cosmic Dust: the Hubble Tuing Fork Strikes a New Note, eds. D.L. Block, K.C. Freeman, I. Puerari & R. Groess. Figures degraded to meet astroph size limit; a version with higher resolution figures may be downloaded from: http://acs.pha.jhu.edu/~jpb/z1clusters/ford_clusters.pd

XMMU J100750.5+125818: A strong lensing cluster at z=1.082

We report on the discovery of the X-ray luminous cluster XMMU J100750.5+125818 at redshift 1.082 based on 19 spectroscopic members, which displays several strong lensing features. SED modeling of the lensed arc features from multicolor imaging with the VLT and the LBT reveals likely redshifts ~2.7 for the most prominent of the lensed background galaxies. Mass estimates are derived for different radii from the velocity dispersion of the cluster members, M_200 ~ 1.8 10^{14} Msun, from the X-ray spectral parameters, M_500 ~ 1.0 10^{14} Msun, and the largest lensing arc, M_SL ~ 2.3 10^{13} Msun. The projected spatial distribution of cluster galaxies appears to be elongated, and the brightest galaxy lies off center with respect to the X-ray emission indicating a not yet relaxed structure. XMMU J100750.5+125818 offers excellent diagnostics of the inner mass distribution of a distant cluster with a combination of strong and weak lensing, optical and X-ray spectroscopy.Comment: A&A, accepted for publicatio

Is there such a thing as a family constitution? A test based on credit rationing

The paper tests the hypothesis that private transfers can be explained by the existence of self-enforcing family constitutions prescribing the minimum level at which a person in middle life should support her young children and elderly parents. The test is based on the effect of a binding credit ration on the probability of making a money transfer, which can be positive only in the presence of family constitutions. Allowing for the possible endogeneity of the credit ration, we find that rationing has a positive effect on the probability of giving money if the potential giver is under the age of retirement, but no significant effect if the person is already retired. This appears to reject the hypothesis that transfer behavior is the outcome of unfettered individual optimization on the part of either altruistic or exchange motivated agents, but not the one that individuals optimize subject to a self-enforcing family constitution. The policy implications are briefly discusse

The Swift X-ray Telescope Cluster Survey II. X-ray spectral analysis

(Abridged) We present a spectral analysis of a new, flux-limited sample of 72 X-ray selected clusters of galaxies identified with the X-ray Telescope (XRT) on board the Swift satellite down to a flux limit of ~10-14 erg/s/cm2 (SWXCS, Tundo et al. 2012). We carry out a detailed X-ray spectral analysis with the twofold aim of measuring redshifts and characterizing the properties of the Intra-Cluster Medium (ICM). Optical counterparts and spectroscopic or photometric redshifts are obtained with a cross-correlation with NED. Additional photometric redshifts are computed with a dedicated follow-up program with the TNG and a cross-correlation with the SDSS. We also detect the iron emission lines in 35% of the sample, and hence obtain a robust measure of the X-ray redshift zX. We use zX whenever the optical redshift is not available. Finally, for all the sources with measured redshift, background-subtracted spectra are fitted with a mekal model. We perform extensive spectral simulations to derive an empirical formula to account for fitting bias. The bias-corrected values are then used to investigate the scaling properties of the X-ray observables. Overall, we are able to characterize the ICM of 46 sources. The sample is mostly constituted by clusters with temperatures between 3 and 10 keV, plus 14 low-mass clusters and groups with temperatures below 3 keV. The redshift distribution peaks around z~0.25 and extends up to z~1, with 60% of the sample at 0.1<z<0.4. We derive the Luminosity-Temperature relation for these 46 sources, finding good agreement with previous studies. The quality of the SWXCS sample is comparable to other samples available in the literature and obtained with much larger X-ray telescopes. Our results have interesting implications for the design of future X-ray survey telescopes, characterised by good-quality PSF over the entire field of view and low background.Comment: 27 pages, 15 figures; minor typos corrected. To be published in A&A, Volume 567, July 2014. Websites of the SWXCS project: http://www.arcetri.astro.it/SWXCS/ and http://swxcs.ustc.edu.cn

Calculation of the Alpha--Particle Ground State within the Hyperspherical Harmonic Basis

The problem of calculating the four--nucleon bound state properties for the case of realistic two- and three-body nuclear potentials is studied using the hyperspherical harmonic (HH) approach. A careful analysis of the convergence of different classes of HH functions has been performed. A restricted basis is chosen to allow for accurate estimates of the binding energy and other properties of the 4He ground state. Results for various modern two-nucleon and two- plus three-nucleon interactions are presented. The 4He asymptotic normalization constants for separation in 2+2 and 1+3 clusters are also computed.Comment: 29 pages, 4 figures, 11 tables, revtex

The Solar hep Process in Effective Field Theory

Using effective field theory, we calculate the S-factor for the hep process in a totally parameter-free formulation. The transition operators are organized according to chiral counting, and their matrix elements are evaluated using the realistic nuclear wave functions obtained in the correlated-hyperspherical-harmonics method. Terms of up to next-to-next-to-next-to-leading order in heavy-baryon chiral perturbation theory are considered. Fixing the only parameter in the theory by fitting the tritium \beta-decay rate, we predict the hep S-factor with accuracy better than \sim 20 %.Comment: 4 pages, Revtex. Minor revision has been mad

Parameter-Free Calculation of the Solar Proton Fusion Rate in Effective Field Theory

Spurred by the recent complete determination of the weak currents in two-nucleon systems up to ${\cal O}(Q^3)$ in heavy-baryon chiral perturbation theory, we carry out a parameter-free calculation of the solar proton fusion rate in an effective field theory that combines the merits of the standard nuclear physics method and systematic chiral expansion. Using the tritium beta-decay rate as an input to fix the only unknown parameter in the effective Lagrangian, we can evaluate with drastically improved precision the ratio of the two-body contribution to the well established one-body contribution; the ratio is determined to be (0.86\pm 0.05) %. This result is essentially independent of the cutoff parameter for a wide range of its variation (500 MeV \le \Lambda \le 800 MeV), a feature that substantiates the consistency of the calculation.Comment: 10 pages. The argument is considerably more sharpened with a reduced error ba