Showing papers by "Sapienza University of Rome published in 2014"

Planck 2013 results. XVI. Cosmological parameters

Abstract: This paper presents the first cosmological results based on Planck measurements of the cosmic microwave background (CMB) temperature and lensing-potential power spectra. We find that the Planck spectra at high multipoles (l ≳ 40) are extremely well described by the standard spatially-flat six-parameter ΛCDM cosmology with a power-law spectrum of adiabatic scalar perturbations. Within the context of this cosmology, the Planck data determine the cosmological parameters to high precision: the angular size of the sound horizon at recombination, the physical densities of baryons and cold dark matter, and the scalar spectral index are estimated to be θ∗ = (1.04147 ± 0.00062) × 10-2, Ωbh2 = 0.02205 ± 0.00028, Ωch2 = 0.1199 ± 0.0027, and ns = 0.9603 ± 0.0073, respectively(note that in this abstract we quote 68% errors on measured parameters and 95% upper limits on other parameters). For this cosmology, we find a low value of the Hubble constant, H0 = (67.3 ± 1.2) km s-1 Mpc-1, and a high value of the matter density parameter, Ωm = 0.315 ± 0.017. These values are in tension with recent direct measurements of H0 and the magnitude-redshift relation for Type Ia supernovae, but are in excellent agreement with geometrical constraints from baryon acoustic oscillation (BAO) surveys. Including curvature, we find that the Universe is consistent with spatial flatness to percent level precision using Planck CMB data alone. We use high-resolution CMB data together with Planck to provide greater control on extragalactic foreground components in an investigation of extensions to the six-parameter ΛCDM model. We present selected results from a large grid of cosmological models, using a range of additional astrophysical data sets in addition to Planck and high-resolution CMB data. None of these models are favoured over the standard six-parameter ΛCDM cosmology. The deviation of the scalar spectral index from unity isinsensitive to the addition of tensor modes and to changes in the matter content of the Universe. We find an upper limit of r0.002< 0.11 on the tensor-to-scalar ratio. There is no evidence for additional neutrino-like relativistic particles beyond the three families of neutrinos in the standard model. Using BAO and CMB data, we find Neff = 3.30 ± 0.27 for the effective number of relativistic degrees of freedom, and an upper limit of 0.23 eV for the sum of neutrino masses. Our results are in excellent agreement with big bang nucleosynthesis and the standard value of Neff = 3.046. We find no evidence for dynamical dark energy; using BAO and CMB data, the dark energy equation of state parameter is constrained to be w = -1.13-0.10+0.13. We also use the Planck data to set limits on a possible variation of the fine-structure constant, dark matter annihilation and primordial magnetic fields. Despite the success of the six-parameter ΛCDM model in describing the Planck data at high multipoles, we note that this cosmology does not provide a good fit to the temperature power spectrum at low multipoles. The unusual shape of the spectrum in the multipole range 20 ≲ l ≲ 40 was seen previously in the WMAP data and is a real feature of the primordial CMB anisotropies. The poor fit to the spectrum at low multipoles is not of decisive significance, but is an “anomaly” in an otherwise self-consistent analysis of the Planck temperature data.

Information Theory: Coding Theorems for Discrete Memoryless Systems

Abstract: Csiszr and Krner's book is widely regarded as a classic in the field of information theory, providing deep insights and expert treatment of the key theoretical issues. It includes in-depth coverage of the mathematics of reliable information transmission, both in two-terminal and multi-terminal network scenarios. Updated and considerably expanded, this new edition presents unique discussions of information theoretic secrecy and of zero-error information theory, including the deep connections of the latter with extremal combinatorics. The presentations of all core subjects are self contained, even the advanced topics, which helps readers to understand the important connections between seemingly different problems. Finally, 320 end-of-chapter problems, together with helpful solving hints, allow readers to develop a full command of the mathematical techniques. It is an ideal resource for graduate students and researchers in electrical and electronic engineering, computer science and applied mathematics.

Long non-coding RNAs: new players in cell differentiation and development

Abstract: Genomes of multicellular organisms are characterized by the pervasive expression of different types of non-coding RNAs (ncRNAs). Long ncRNAs (lncRNAs) belong to a novel heterogeneous class of ncRNAs that includes thousands of different species. lncRNAs have crucial roles in gene expression control during both developmental and differentiation processes, and the number of lncRNA species increases in genomes of developmentally complex organisms, which highlights the importance of RNA-based levels of control in the evolution of multicellular organisms. In this Review, we describe the function of lncRNAs in developmental processes, such as in dosage compensation, genomic imprinting, cell differentiation and organogenesis, with a particular emphasis on mammalian development.

Defining the clinical course of multiple sclerosis: The 2013 revisions

Abstract: Accurate clinical course descriptions (phenotypes) of multiple sclerosis (MS) are important for communication, prognostication, design and recruitment of clinical trials, and treatment decision-making. Standardized descriptions published in 1996 based on a survey of international MS experts provided purely clinical phenotypes based on data and consensus at that time, but imaging and biological correlates were lacking. Increased understanding of MS and its pathology, coupled with general concern that the original descriptors may not adequately reflect more recently identified clinical aspects of the disease, prompted a re-examination of MS disease phenotypes by the International Advisory Committee on Clinical Trials of MS. While imaging and biological markers that might provide objective criteria for separating clinical phenotypes are lacking, we propose refined descriptors that include consideration of disease activity (based on clinical relapse rate and imaging findings) and disease progression. Strategies for future research to better define phenotypes are also outlined.

Planck 2013 results. I. Overview of products and scientific results

Abstract: The European Space Agency’s Planck satellite, dedicated to studying the early Universe and its subsequent evolution, was launched 14 May 2009 and has been scanning the microwave and submillimetre sky continuously since 12 August 2009. In March 2013, ESA and the Planck Collaboration released the initial cosmology products based on the first 15.5 months of Planck data, along with a set of scientific and technical papers and a web-based explanatory supplement. This paper gives an overview of the mission and its performance, the processing, analysis, and characteristics of the data, the scientific results, and the science data products and papers in the release. The science products include maps of the cosmic microwave background (CMB) and diffuse extragalactic foregrounds, a catalogue of compact Galactic and extragalactic sources, and a list of sources detected through the Sunyaev-Zeldovich effect. The likelihood code used to assess cosmological models against the Planck data and a lensing likelihood are described. Scientific results include robust support for the standard six-parameter ΛCDM model of cosmology and improved measurements of its parameters, including a highly significant deviation from scale invariance of the primordial power spectrum. The Planck values for these parameters and others derived from them are significantly different from those previously determined. Several large-scale anomalies in the temperature distribution of the CMB, first detected by WMAP, are confirmed with higher confidence. Planck sets new limits on the number and mass of neutrinos, and has measured gravitational lensing of CMB anisotropies at greater than 25σ. Planck finds no evidence for non-Gaussianity in the CMB. Planck’s results agree well with results from the measurements of baryon acoustic oscillations. Planck finds a lower Hubble constant than found in some more local measures. Some tension is also present between the amplitude of matter fluctuations (σ8) derived from CMB data and that derived from Sunyaev-Zeldovich data. The Planck and WMAP power spectra are offset from each other by an average level of about 2% around the first acoustic peak. Analysis of Planck polarization data is not yet mature, therefore polarization results are not released, although the robust detection of E-mode polarization around CMB hot and cold spots is shown graphically.

Planck 2013 results. XXII. Constraints on inflation

Abstract: We present the implications for cosmic inflation of the Planck measurements of the cosmic microwave background (CMB) anisotropies in both temperature and polarization based on the full Planck survey, which includes more than twice the integration time of the nominal survey used for the 2013 release papers. The Planck full mission temperature data and a first release of polarization data on large angular scales measure the spectral index of curvature perturbations to be ns = 0.968 ± 0.006 and tightly constrain its scale dependence to dns/ dlnk = −0.003 ± 0.007 when combined with the Planck lensing likelihood. When the Planck high-l polarization data are included, the results are consistent and uncertainties are further reduced. The upper bound on the tensor-to-scalar ratio is r0.002< 0.11 (95% CL). This upper limit is consistent with the B-mode polarization constraint r< 0.12 (95% CL) obtained from a joint analysis of the BICEP2/Keck Array and Planck data. These results imply that V(φ) ∝ φ2 and natural inflation are now disfavoured compared to models predicting a smaller tensor-to-scalar ratio, such as R2 inflation. We search for several physically motivated deviations from a simple power-law spectrum of curvature perturbations, including those motivated by a reconstruction of the inflaton potential not relying on the slow-roll approximation. We find that such models are not preferred, either according to a Bayesian model comparison or according to a frequentist simulation-based analysis. Three independent methods reconstructing the primordial power spectrum consistently recover a featureless and smooth over the range of scales 0.008 Mpc-1 ≲ k ≲ 0.1 Mpc-1. At large scales, each method finds deviations from a power law, connected to a deficit at multipoles l ≈ 20−40 in the temperature power spectrum, but at an uncompelling statistical significance owing to the large cosmic variance present at these multipoles. By combining power spectrum and non-Gaussianity bounds, we constrain models with generalized Lagrangians, including Galileon models and axion monodromy models. The Planck data are consistent with adiabatic primordial perturbations, and the estimated values for the parameters of the base Λ cold dark matter (ΛCDM) model are not significantly altered when more general initial conditions are admitted. In correlated mixed adiabatic and isocurvature models, the 95% CL upper bound for the non-adiabatic contribution to the observed CMB temperature variance is | αnon - adi | < 1.9%, 4.0%, and 2.9% for CDM, neutrino density, and neutrino velocity isocurvature modes, respectively. We have tested inflationary models producing an anisotropic modulation of the primordial curvature power spectrum findingthat the dipolar modulation in the CMB temperature field induced by a CDM isocurvature perturbation is not preferred at a statistically significant level. We also establish tight constraints on a possible quadrupolar modulation of the curvature perturbation. These results are consistent with the Planck 2013 analysis based on the nominal mission data and further constrain slow-roll single-field inflationary models, as expected from the increased precision of Planck data using the full set of observations.

Recovery of large carnivores in Europe’s modern human-dominated landscapes

Abstract: The conservation of large carnivores is a formidable challenge for biodiversity conservation. Using a data set on the past and current status of brown bears (Ursus arctos), Eurasian lynx (Lynx lynx), gray wolves (Canis lupus), and wolverines (Gulo gulo) in European countries, we show that roughly one-third of mainland Europe hosts at least one large carnivore species, with stable or increasing abundance in most cases in 21st-century records. The reasons for this overall conservation success include protective legislation, supportive public opinion, and a variety of practices making coexistence between large carnivores and people possible. The European situation reveals that large carnivores and people can share the same landscape.

Planck 2013 results. VII. HFI time response and beams

Abstract: This paper characterizes the effective beams, the effective beam window functions and the associated errors for the Planck High Frequency Instrument (HFI) detectors. The effective beam is the angular response including the effect of the optics, detectors, data processing and the scan strategy. The window function is the representation of this beam in the harmonic domain which is required to recover an unbiased measurement of the cosmic microwave background angular power spectrum. The HFI is a scanning instrument and its effective beams are the convolution of: a) the optical response of the telescope and feeds; b) the processing of the time-ordered data and deconvolution of the bolometric and electronic transfer function; and c) the merging of several surveys to produce maps. The time response transfer functions are measured using observations of Jupiter and Saturn and by minimizing survey difference residuals. The scanning beam is the post-deconvolution angular response of the instrument, and is characterized with observations of Mars. The main beam solid angles are determined to better than 0.5% at each HFI frequency band. Observations of Jupiter and Saturn limit near sidelobes (within 5 degrees) to about 0.1% of the total solid angle. Time response residuals remain as long tails in the scanning beams, but contribute less than 0.1% of the total solid angle. The bias and uncertainty in the beam products are estimated using ensembles of simulated planet observations that include the impact of instrumental noise and known systematic effects. The correlation structure of these ensembles is well-described by five errors eigenmodes that are sub-dominant to sample variance and instrumental noise in the harmonic domain. A suite of consistency tests provide confidence that the error model represents a sufficient description of the data. The total error in the effective beam window functions is below 1% at 100 GHz up to multiple l similar to 1500, below 0.5% at 143 and 217 GHz up to l similar to 2000.

Test of lepton universality using b^{+}k^{+}ℓ^{+}ℓ^{-} decays

Abstract: A measurement of the ratio of the branching fractions of the B+→K+μ+μ− and B+→K+e+e− decays is presented using proton-proton collision data, corresponding to an integrated luminosity of 3.0 fb−1, recorded with the LHCb experiment at center-of-mass energies of 7 and 8 TeV. The value of the ratio of branching fractions for the dilepton invariant mass squared range 1

A mid-term analysis of progress toward international biodiversity targets

Abstract: In 2010, the international community, under the auspices of the Convention on Biological Diversity, agreed on 20 biodiversity-related “Aichi Targets” to be achieved within a decade. We provide a comprehensive mid-term assessment of progress toward these global targets using 55 indicator data sets. We projected indicator trends to 2020 using an adaptive statistical framework that incorporated the specific properties of individual time series. On current trajectories, results suggest that despite accelerating policy and management responses to the biodiversity crisis, the impacts of these efforts are unlikely to be reflected in improved trends in the state of biodiversity by 2020. We highlight areas of societal endeavor requiring additional efforts to achieve the Aichi Targets, and provide a baseline against which to assess future progress.

Deficient neuron-microglia signaling results in impaired functional brain connectivity and social behavior

Abstract: Microglia are phagocytic cells that infiltrate the brain during development and have a role in the elimination of synapses during brain maturation. Changes in microglial morphology and gene expression have been associated with neurodevelopmental disorders. However, it remains unknown whether these changes are a primary cause or a secondary consequence of neuronal deficits. Here we tested whether a primary deficit in microglia was sufficient to induce some autism-related behavioral and functional connectivity deficits. Mice lacking the chemokine receptor Cx3cr1 exhibit a transient reduction of microglia during the early postnatal period and a consequent deficit in synaptic pruning. We show that deficient synaptic pruning is associated with weak synaptic transmission, decreased functional brain connectivity, deficits in social interaction and increased repetitive-behavior phenotypes that have been previously associated with autism and other neurodevelopmental and neuropsychiatric disorders. These findings open the possibility that disruptions in microglia-mediated synaptic pruning could contribute to neurodevelopmental and neuropsychiatric disorders.

Entity Linking meets Word Sense Disambiguation: A Unified Approach

Abstract: Entity Linking (EL) and Word Sense Disambiguation (WSD) both address the lexical ambiguity of language. But while the two tasks are pretty similar, they differ in a fundamental respect: in EL the textual mention can be linked to a named entity which may or may not contain the exact mention, while in WSD there is a perfect match between the word form (better, its lemma) and a suitable word sense. In this paper we present Babelfy, a unified graph-based approach to EL and WSD based on a loose identification of candidate meanings coupled with a densest subgraph heuristic which selects high-coherence semantic interpretations. Our experiments show state-of- the-art performances on both tasks on 6 different datasets, including a multilingual setting. Babelfy is online at http://babelfy.org

Initial Therapy with FOLFOXIRI and Bevacizumab for Metastatic Colorectal Cancer

Abstract: BackgroundA fluoropyrimidine plus irinotecan or oxaliplatin, combined with bevacizumab (a monoclonal antibody against vascular endothelial growth factor), is standard first-line treatment for metastatic colorectal cancer. Before the introduction of bevacizumab, chemotherapy with fluorouracil, leucovorin, oxaliplatin, and irinotecan (FOLFOXIRI) showed superior efficacy as compared with fluorouracil, leucovorin, and irinotecan (FOLFIRI). In a phase 2 study, FOLFOXIRI plus bevacizumab showed promising activity and an acceptable rate of adverse effects. MethodsWe randomly assigned 508 patients with untreated metastatic colorectal cancer to receive either FOLFIRI plus bevacizumab (control group) or FOLFOXIRI plus bevacizumab (experimental group). Up to 12 cycles of treatment were administered, followed by fluorouracil plus bevacizumab until disease progression. The primary end point was progression-free survival. ResultsThe median progression-free survival was 12.1 months in the experimental group, as compared...

Precision Measurement of the Proton Flux in Primary Cosmic Rays from Rigidity 1 GV to 1.8 TV with the Alpha Magnetic Spectrometer on the International Space Station

Abstract: A precise measurement of the proton flux in primary cosmic rays with rigidity (momentum/charge) from 1 GV to 1.8 TV is presented based on 300 million events. Knowledge of the rigidity dependence of the proton flux is important in understanding the origin, acceleration, and propagation of cosmic rays. We present the detailed variation with rigidity of the flux spectral index for the first time. The spectral index progressively hardens at high rigidities.

Planck 2013 results. XI. All-sky model of thermal dust emission

Abstract: This paper presents an all-sky model of dust emission from the Planck 857, 545 and 353 GHz, and IRAS 100 micron data. Using a modified black-body fit to the data we present all-sky maps of the dust optical depth, temperature, and spectral index over the 353-3000 GHz range. This model is a tight representation of the data at 5 arcmin. It shows variations of the order of 30 % compared with the widely-used model of Finkbeiner, Davis, and Schlegel. The Planck data allow us to estimate the dust temperature uniformly over the whole sky, providing an improved estimate of the dust optical depth compared to previous all-sky dust model, especially in high-contrast molecular regions. An increase of the dust opacity at 353 GHz, tau_353/N_H, from the diffuse to the denser interstellar medium (ISM) is reported. It is associated with a decrease in the observed dust temperature, T_obs, that could be due at least in part to the increased dust opacity. We also report an excess of dust emission at HI column densities lower than 10^20 cm^-2 that could be the signature of dust in the warm ionized medium. In the diffuse ISM at high Galactic latitude, we report an anti-correlation between tau_353/N_H and T_obs while the dust specific luminosity, i.e., the total dust emission integrated over frequency (the radiance) per hydrogen atom, stays about constant. The implication is that in the diffuse high-latitude ISM tau_353 is not as reliable a tracer of dust column density as we conclude it is in molecular clouds where the correlation of tau_353 with dust extinction estimated using colour excess measurements on stars is strong. To estimate Galactic E(B-V) in extragalactic fields at high latitude we develop a new method based on the thermal dust radiance, instead of the dust optical depth, calibrated to E(B-V) using reddening measurements of quasars deduced from Sloan Digital Sky Survey data.

Planck 2013 results - XXIII. Isotropy and statistics of the CMB

Abstract: We test the statistical isotropy and Gaussianity of the cosmic microwave background (CMB) anisotropies using observations made by the Planck satellite. Our results are based mainly on the full Planck mission for temperature, but also include some polarization measurements. In particular, we consider the CMB anisotropy maps derived from the multi-frequency Planck data by several component-separation methods. For the temperature anisotropies, we find excellent agreement between results based on these sky maps over both a very large fraction of the sky and a broad range of angular scales, establishing that potential foreground residuals do not affect our studies. Tests of skewness, kurtosis, multi-normality, N-point functions, and Minkowski functionals indicate consistency with Gaussianity, while a power deficit at large angular scales is manifested in several ways, for example low map variance. The results of a peak statistics analysis are consistent with the expectations of a Gaussian random field. The “Cold Spot” is detected with several methods, including map kurtosis, peak statistics, and mean temperature profile. We thoroughly probe the large-scale dipolar power asymmetry, detecting it with several independent tests, and address the subject of a posteriori correction. Tests of directionality suggest the presence of angular clustering from large to small scales, but at a significance that is dependent on the details of the approach. We perform the first examination of polarization data, finding the morphology of stacked peaks to be consistent with the expectations of statistically isotropic simulations. Where they overlap, these results are consistent with the Planck 2013 analysis based on the nominal mission data and provide our most thorough view of the statistics of the CMB fluctuations to date.

Performance of the ALICE experiment at the CERN LHC

Abstract: ALICE is the heavy-ion experiment at the CERN Large Hadron Collider. The experiment continuously took data during the first physics campaign of the machine from fall 2009 until early 2013, using proton and lead-ion beams. In this paper we describe the running environment and the data handling procedures, and discuss the performance of the ALICE detectors and analysis methods for various physics observables.

Consensus guidelines for the detection of immunogenic cell death

Abstract: Apoptotic cells have long been considered as intrinsically tolerogenic or unable to elicit immune responses specific for dead cell-associated antigens. However, multiple stimuli can trigger a functionally peculiar type of apoptotic demise that does not go unnoticed by the adaptive arm of the immune system, which we named "immunogenic cell death" (ICD). ICD is preceded or accompanied by the emission of a series of immunostimulatory damage-associated molecular patterns (DAMPs) in a precise spatiotemporal configuration. Several anticancer agents that have been successfully employed in the clinic for decades, including various chemotherapeutics and radiotherapy, can elicit ICD. Moreover, defects in the components that underlie the capacity of the immune system to perceive cell death as immunogenic negatively influence disease outcome among cancer patients treated with ICD inducers. Thus, ICD has profound clinical and therapeutic implications. Unfortunately, the gold-standard approach to detect ICD relies on vaccination experiments involving immunocompetent murine models and syngeneic cancer cells, an approach that is incompatible with large screening campaigns. Here, we outline strategies conceived to detect surrogate markers of ICD in vitro and to screen large chemical libraries for putative ICD inducers, based on a high-content, high-throughput platform that we recently developed. Such a platform allows for the detection of multiple DAMPs, like cell surface-exposed calreticulin, extracellular ATP and high mobility group box 1 (HMGB1), and/or the processes that underlie their emission, such as endoplasmic reticulum stress, autophagy and necrotic plasma membrane permeabilization. We surmise that this technology will facilitate the development of next-generation anticancer regimens, which kill malignant cells and simultaneously convert them into a cancer-specific therapeutic vaccine.

Critical assessment of methods of protein structure prediction (CASP) — round x

Abstract: This article is an introduction to the special issue of the journal PROTEINS, dedicated to the tenth Critical Assessment of Structure Prediction (CASP) experiment to assess the state of the art in protein structure modeling. The article describes the conduct of the experiment, the categories of prediction included, and outlines the evaluation and assessment procedures. The 10 CASP experiments span almost 20 years of progress in the field of protein structure modeling, and there have been enormous advances in methods and model accuracy in that period. Notable in this round is the first sustained improvement of models with refinement methods, using molecular dynamics. For the first time, we tested the ability of modeling methods to make use of sparse experimental three-dimensional contact information, such as may be obtained from new experimental techniques, with encouraging results. On the other hand, new contact prediction methods, though holding considerable promise, have yet to make an impact in CASP testing. The nature of CASP targets has been changing in recent CASPs, reflecting shifts in experimental structural biology, with more irregular structures, more multi-domain and multi-subunit structures, and less standard versions of known folds. When allowance is made for these factors, we continue to see steady progress in the overall accuracy of models, particularly resulting from improvement of non-template regions.

Joint Optimization of Radio and Computational Resources for Multicell Mobile-Edge Computing

Abstract: Migrating computational intensive tasks from mobile devices to more resourceful cloud servers is a promising technique to increase the computational capacity of mobile devices while saving their battery energy. In this paper, we consider a MIMO multicell system where multiple mobile users (MUs) ask for computation offloading to a common cloud server. We formulate the offloading problem as the joint optimization of the radio resources-the transmit precoding matrices of the MUs-and the computational resources-the CPU cycles/second assigned by the cloud to each MU-in order to minimize the overall users' energy consumption, while meeting latency constraints. The resulting optimization problem is nonconvex (in the objective function and constraints). Nevertheless, in the single-user case, we are able to express the global optimal solution in closed form. In the more challenging multiuser scenario, we propose an iterative algorithm, based on a novel successive convex approximation technique, converging to a local optimal solution of the original nonconvex problem. Then, we reformulate the algorithm in a distributed and parallel implementation across the radio access points, requiring only a limited coordination/signaling with the cloud. Numerical results show that the proposed schemes outperform disjoint optimization algorithms.

Clinical validity of circulating tumour cells in patients with metastatic breast cancer: a pooled analysis of individual patient data

Abstract: Summary Background We aimed to assess the clinical validity of circulating tumour cell (CTC) quantification for prognostication of patients with metastatic breast cancer by undertaking a pooled analysis of individual patient data. Methods We contacted 51 European centres and asked them to provide reported and unreported anonymised data for individual patients with metastatic breast cancer who participated in studies between January, 2003, and July, 2012. Eligible studies had participants starting a new line of therapy, data for progression-free survival or overall survival, or both, and CTC quantification by the CellSearch method at baseline (before start of new treatment). We used Cox regression models, stratified by study, to establish the association between CTC count and progression-free survival and overall survival. We used the landmark method to assess the prognostic value of CTC and serum marker changes during treatment. We assessed the added value of CTCs or serum markers to prognostic clinicopathological models in a resampling procedure using likelihood ratio (LR) χ 2 statistics. Findings 17 centres provided data for 1944 eligible patients from 20 studies. 911 patients (46·9%) had a CTC count of 5 per 7·5 mL or higher at baseline, which was associated with decreased progression-free survival (hazard ratio [HR] 1·92, 95% CI 1·73–2·14, p Interpretation These data confirm the independent prognostic effect of CTC count on progression-free survival and overall survival. CTC count also improves the prognostication of metastatic breast cancer when added to full clinicopathological predictive models, whereas serum tumour markers do not. Funding Janssen Diagnostics, the Nuovo-Soldati foundation for cancer research.

Autologous transplantation and maintenance therapy in multiple myeloma

Abstract: Background This open-label, randomized, phase 3 study compared melphalan at a dose of 200 mg per square meter of body-surface area plus autologous stem-cell transplantation with melphalan–prednisone–lenalidomide (MPR) and compared lenalidomide maintenance therapy with no maintenance therapy in patients with newly diagnosed multiple myeloma. Methods We randomly assigned 273 patients 65 years of age or younger to high-dose melphalan plus stem-cell transplantation or MPR consolidation therapy after induction, and 251 patients to lenalidomide maintenance therapy or no maintenance therapy. The primary end point was progression-free survival. Results The median follow-up period was 51.2 months. Both progression-free and overall survival were significantly longer with high-dose melphalan plus stem-cell transplantation than with MPR (median progression-free survival, 43.0 months vs. 22.4 months; hazard ratio for progression or death, 0.44; 95% confidence interval [CI], 0.32 to 0.61; P<0.001; and 4-year overall su...

Planck 2013 results. XX. Cosmology from Sunyaev-Zeldovich cluster counts

Abstract: We present cluster counts and corresponding cosmological constraints from the Planck full mission data set. Our catalogue consists of 439 clusters detected via their Sunyaev-Zeldovich (SZ) signal down to a signal-to-noise ratio of 6, and is more than a factor of 2 larger than the 2013 Planck cluster cosmology sample. The counts are consistent with those from 2013 and yield compatible constraints under the same modelling assumptions. Taking advantage of the larger catalogue, we extend our analysis to the two-dimensional distribution in redshift and signal-to-noise. We use mass estimates from two recent studies of gravitational lensing of background galaxies by Planck clusters to provide priors on the hydrostatic bias parameter, (1−b). In addition, we use lensing of cosmic microwave background (CMB) temperature fluctuations by Planck clusters as an independent constraint on this parameter. These various calibrations imply constraints on the present-day amplitude of matter fluctuations in varying degrees of tension with those from the Planck analysis of primary fluctuations in the CMB; for the lowest estimated values of (1−b) the tension is mild, only a little over one standard deviation, while it remains substantial (3.7σ) for the largest estimated value. We also examine constraints on extensions to the base flat ΛCDM model by combining the cluster and CMB constraints. The combination appears to favour non-minimal neutrino masses, but this possibility does little to relieve the overall tension because it simultaneously lowers the implied value of the Hubble parameter, thereby exacerbating the discrepancy with most current astrophysical estimates. Improving the precision of cluster mass calibrations from the current 10%-level to 1% would significantly strengthen these combined analyses and provide a stringent test of the base ΛCDM model.

European Stroke Organisation (ESO) guidelines for the management of spontaneous intracerebral hemorrhage

Abstract: Background Intracerebral hemorrhage (ICH) accounted for 9% to 27% of all strokes worldwide in the last decade, with high early case fatality and poor functional outcome In view of recent randomized controlled trials (RCTs) of the management of ICH, the European Stroke Organisation (ESO) has updated its evidence-based guidelines for the management of ICH Method A multidisciplinary writing committee of 24 researchers from 11 European countries identified 20 questions relating to ICH management and created recommendations based on the evidence in RCTs using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach Results We found moderate- to high-quality evidence to support strong recommendations for managing patients with acute ICH on an acute stroke unit, avoiding hemostatic therapy for acute ICH not associated with antithrombotic drug use, avoiding graduated compression stockings, using intermittent pneumatic compression in immobile patients, and using blood pressure lowering for secondary prevention We found moderate-quality evidence to support weak recommendations for intensive lowering of systolic blood pressure to <140 mmHg within six-hours of ICH onset, early surgery for patients with a Glasgow Coma Scale score 9‐12, and avoidance of corticosteroids Conclusion These guidelines inform the management of ICH based on evidence for the effects of treatments in RCTs Outcome after ICH remains poor, prioritizing further RCTs of interventions to improve outcome