Galactic foreground contributions to the 5-year Wilkinson Microwave Anisotropy Probe maps

We compute the cross-correlation between intensity and polarization from the 5-year Wilkinson Microwave Anisotropy Probe (WMAP5) data in different sky regions with respect to template maps for synchrotron, dust and free–free emission. We derive the frequency dependence and polarization fraction for all three components in 48 different sky regions of HEALPix (N_(side)= 2) pixelization. The anomalous emission associated with dust is clearly detected in intensity over the entire sky at the K (23-GHz) and Ka (33-GHz) WMAP bands, and is found to be the dominant foreground at low Galactic latitudes, between b =−40° and +10°. The synchrotron spectral index obtained from the K and Ka WMAP bands from an all-sky analysis is β_s=−3.32 ± 0.12 for intensity and β_s=−3.01 ± 0.03 for polarized intensity. The polarization fraction of the synchrotron emission is constant in frequency and increases with latitude from ≈5 per cent near the Galactic plane up to ≈40 per cent in some regions at high latitudes; the average value for |b| 20°, it is 19.3 ± 0.8 (stat) ± 0.5 (sys) per cent. Anomalous dust and free–free emissions appear to be relatively unpolarized. Monte Carlo simulations showed that there were biases of the method due to cross-talk between the components, at up to ≈5 per cent in any given pixel, and ≈1.5 per cent on average, when the true polarization fraction is low (a few per cent or less). Nevertheless, the average polarization fraction of dust-correlated emission at the K band is 3.2 ± 0.9 (stat) ± 1.5 (sys) per cent or less than 5 per cent at 95 per cent confidence. When comparing real data with simulations, eight regions show a detected polarization above the 99th percentile of the distribution from simulations with no input foreground polarization, six of which are detected at above 2σ and display polarization fractions between 2.6 and 7.2 per cent, except for one anomalous region, which has 32 ± 12 per cent. The dust polarization values are consistent with the expectation from spinning dust emission, but polarized dust emission from magnetic-dipole radiation cannot be ruled out. Free–free emission was found to be unpolarized with an upper limit of 3.4 per cent at 95 per cent confidence

Measurement of physical quantities in upper-limb tele-rehabilitation

A total of 50 patients (affected by traumatic brain injury, stroke or multiple sclerosis) were treated for one month using a rehabilitation protocol. Rehabilitation could be monitored using a Portable Unit (PU) which could be installed in a patient's home allowing the measurement of kinetic and kinematic variables during exercise. In a preliminary analysis, the variables related to four rehabilitation exercises were examined for two patients at baseline and at the end of the one-month treatment. The exercises involved movement of checkers, a pencil, a jar and a key. The results suggest that, even if the overall duration of exercise execution is an important aspect of the rehabilitation process, other variables acquired by the PU might deliver useful information for assessing the patient's status. In order to integrate such variables into the assessment process, further studies are needed to investigate their eventual correlation with traditional rehabilitation scales and variables

New constraints on the Polarization of Anomalous Microwave Emission in nearby molecular clouds

Anomalous Microwave Emission (AME) has been previously studied in two well-known molecular clouds and is thought to be due to electric dipole radiation from small spinning dust grains. It is important to measure the polarization properties of this radiation both for component separation in future cosmic microwave background experiments and also to constrain dust models. We have searched for linearly polarized radio emission associated with the $\rho$ Ophiuchi and Perseus molecular clouds using {\it WMAP} 7-year data. We found no significant polarization within an aperture of $2^{\circ}$ diameter. The upper limits on the fractional polarization of spinning dust in the $\rho$ Ophiuchi cloud are 1.7%, 1.6% and 2.6% (at 95% confidence level) at K-, Ka- and Q-bands, respectively. In the Perseus cloud we derived upper limits of 1.4%, 1.9% and 4.7%, at K-, Ka- and Q-bands, respectively; these are similar to those found by L\'opez-Caraballo et al. If AME at high Galactic latitudes has a similarly low level of polarization, this will simplify component separation for CMB polarization measurements. We can also rule out single domain magnetic dipole radiation as the dominant emission mechanism for the 20-40 GHz. The polarization levels are consistent with spinning dust models.Comment: Accepted in MNRAS as a letter - added extra sentence. 5 pages, 2 figures, 1 tabl

Macrofossil evidence for a rapid and severe Cretaceous–Paleogene mass extinction in Antarctica

Debate continues about the nature of the Cretaceous–Paleogene (K–Pg) mass extinction event. An abrupt crisis triggered by a bolide impact contrasts with ideas of a more gradual extinction involving flood volcanism or climatic changes. Evidence from high latitudes has also been used to suggest that the severity of the extinction decreased from low latitudes towards the poles. Here we present a record of the K–Pg extinction based on extensive assemblages of marine macrofossils (primarily new data from benthic molluscs) from a highly expanded Cretaceous–Paleogene succession: the López de Bertodano Formation of Seymour Island, Antarctica. We show that the extinction was rapid and severe in Antarctica, with no significant biotic decline during the latest Cretaceous, contrary to previous studies. These data are consistent with a catastrophic driver for the extinction, such as bolide impact, rather than a significant contribution from Deccan Traps volcanism during the late Maastrichtian

Evolution and extinction of Maastrichtian (Late Cretaceous) cephalopods from the López de Bertodano Formation, Seymour Island, Antarctica

One of the most expanded records to contain the final fortunes of ammonoid cephalopods is within the López de Bertodano Formation of Seymour Island, James Ross Basin, Antarctica. Located at 65° South now, and during the Cretaceous, this sequence is the highest southern latitude onshore outcrop containing the Cretaceous-Paleogene (K-Pg) transition. We present comprehensive new biostratigraphic range data for 14 ammonite and one nautiloid species based on the collection of >. 700 macrofossils from high-resolution sampling of parallel sedimentary sections, dated Maastrichtian to earliest Danian in age, across southern Seymour Island. We find evidence for only a single, abrupt pulse of cephalopod extinction at the end of the Cretaceous when the final seven ammonite species disappeared, consistent with most evidence globally. In the lead up to the K-Pg extinction in the James Ross Basin, starting during the Campanian, ammonite diversity decreased overall, but the number of endemic taxa belonging to the family Kossmaticeratidae actually increased. This pattern continued into the Maastrichtian and may be facies controlled, linked to changes in sea level and seawater temperature. During the early Maastrichtian, ammonite diversity dropped significantly with only two species recorded from the basal López de Bertodano Formation on Seymour Island. The subsequent diversification of endemic taxa and reappearance of long-ranging, widespread species into the basin resulted in an increase in ammonite diversity and abundance during the mid-Maastrichtian. This was coincident with an apparent period of warming temperatures and sea level rise interpreted from palynology and sedimentology, perhaps reflecting a high latitude expression of the Mid-Maastrichtian Event. Late Maastrichtian diversity levels remained stable despite reported climatic and environmental variation. Ammonite diversity patterns during the Maastrichtian parallel those of microfossil species such as nannofossil and planktonic foraminifera, suggesting that dynamic climatic and environmental changes affected many planktonic and nektonic organisms during the latest Cretaceous. However, we suggest that these perturbations had a minimal effect on overall diversity prior to the catastrophic extinction event at the K-Pg boundary

Breast cancer "tailored follow-up" in Italian oncology units: a web-based survey

urpose: Breast cancer follow-up procedures after primary treatment are still a controversial issue. Aim of this study was to investigate, through a web-based survey, surveillance methodologies selected by Italian oncologists in everyday clinical practice. Methods: Referents of Italian medical oncology units were invited to participate to the study via e-mail through the SurveyMonkey website. Participants were asked how, in their institution, exams of disease staging and follow-up are planned in asymptomatic women and if surveillance continues beyond the 5th year. Results: Between February and May 2013, 125 out of 233 (53.6%) invited referents of Italian medical oncology units agreed to participate in the survey. Ninety-seven (77.6%) referents state that modalities of breast cancer follow-up are planned according to the risk of disease progression at diagnosis and only 12 (9.6%) oncology units apply the minimal follow-up procedures according to international guidelines. Minimal follow-up is never applied in high risk asymptomatic women. Ninety-eight (78.4%) oncology units continue follow-up in all patients beyond 5 years. Conclusions: Our survey shows that 90.4% of participating Italian oncology units declare they do not apply the minimal breast cancer follow-up procedures after primary treatment in asymptomatic women, as suggested by national and international guidelines. Interestingly, about 80.0% of interviewed referents performs the so called "tailored follow-up", high intensity for high risk, low intensity for low risk patients. There is an urgent need of randomized clinical trials able to determine the effectiveness of risk-based follow-up modalities, their ideal frequency and persistence in time

Why Are Outcomes Different for Registry Patients Enrolled Prospectively and Retrospectively? Insights from the Global Anticoagulant Registry in the FIELD-Atrial Fibrillation (GARFIELD-AF).

Background: Retrospective and prospective observational studies are designed to reflect real-world evidence on clinical practice, but can yield conflicting results. The GARFIELD-AF Registry includes both methods of enrolment and allows analysis of differences in patient characteristics and outcomes that may result. Methods and Results: Patients with atrial fibrillation (AF) and ≥1 risk factor for stroke at diagnosis of AF were recruited either retrospectively (n = 5069) or prospectively (n = 5501) from 19 countries and then followed prospectively. The retrospectively enrolled cohort comprised patients with established AF (for a least 6, and up to 24 months before enrolment), who were identified retrospectively (and baseline and partial follow-up data were collected from the emedical records) and then followed prospectively between 0-18 months (such that the total time of follow-up was 24 months; data collection Dec-2009 and Oct-2010). In the prospectively enrolled cohort, patients with newly diagnosed AF (≤6 weeks after diagnosis) were recruited between Mar-2010 and Oct-2011 and were followed for 24 months after enrolment. Differences between the cohorts were observed in clinical characteristics, including type of AF, stroke prevention strategies, and event rates. More patients in the retrospectively identified cohort received vitamin K antagonists (62.1% vs. 53.2%) and fewer received non-vitamin K oral anticoagulants (1.8% vs . 4.2%). All-cause mortality rates per 100 person-years during the prospective follow-up (starting the first study visit up to 1 year) were significantly lower in the retrospective than prospectively identified cohort (3.04 [95% CI 2.51 to 3.67] vs . 4.05 [95% CI 3.53 to 4.63]; p = 0.016). Conclusions: Interpretations of data from registries that aim to evaluate the characteristics and outcomes of patients with AF must take account of differences in registry design and the impact of recall bias and survivorship bias that is incurred with retrospective enrolment. Clinical Trial Registration: - URL: http://www.clinicaltrials.gov . Unique identifier for GARFIELD-AF (NCT01090362)

Improved risk stratification of patients with atrial fibrillation: an integrated GARFIELD-AF tool for the prediction of mortality, stroke and bleed in patients with and without anticoagulation.

OBJECTIVES: To provide an accurate, web-based tool for stratifying patients with atrial fibrillation to facilitate decisions on the potential benefits/risks of anticoagulation, based on mortality, stroke and bleeding risks. DESIGN: The new tool was developed, using stepwise regression, for all and then applied to lower risk patients. C-statistics were compared with CHA2DS2-VASc using 30-fold cross-validation to control for overfitting. External validation was undertaken in an independent dataset, Outcome Registry for Better Informed Treatment of Atrial Fibrillation (ORBIT-AF). PARTICIPANTS: Data from 39 898 patients enrolled in the prospective GARFIELD-AF registry provided the basis for deriving and validating an integrated risk tool to predict stroke risk, mortality and bleeding risk. RESULTS: The discriminatory value of the GARFIELD-AF risk model was superior to CHA2DS2-VASc for patients with or without anticoagulation. C-statistics (95% CI) for all-cause mortality, ischaemic stroke/systemic embolism and haemorrhagic stroke/major bleeding (treated patients) were: 0.77 (0.76 to 0.78), 0.69 (0.67 to 0.71) and 0.66 (0.62 to 0.69), respectively, for the GARFIELD-AF risk models, and 0.66 (0.64-0.67), 0.64 (0.61-0.66) and 0.64 (0.61-0.68), respectively, for CHA2DS2-VASc (or HAS-BLED for bleeding). In very low to low risk patients (CHA2DS2-VASc 0 or 1 (men) and 1 or 2 (women)), the CHA2DS2-VASc and HAS-BLED (for bleeding) scores offered weak discriminatory value for mortality, stroke/systemic embolism and major bleeding. C-statistics for the GARFIELD-AF risk tool were 0.69 (0.64 to 0.75), 0.65 (0.56 to 0.73) and 0.60 (0.47 to 0.73) for each end point, respectively, versus 0.50 (0.45 to 0.55), 0.59 (0.50 to 0.67) and 0.55 (0.53 to 0.56) for CHA2DS2-VASc (or HAS-BLED for bleeding). Upon validation in the ORBIT-AF population, C-statistics showed that the GARFIELD-AF risk tool was effective for predicting 1-year all-cause mortality using the full and simplified model for all-cause mortality: C-statistics 0.75 (0.73 to 0.77) and 0.75 (0.73 to 0.77), respectively, and for predicting for any stroke or systemic embolism over 1 year, C-statistics 0.68 (0.62 to 0.74). CONCLUSIONS: Performance of the GARFIELD-AF risk tool was superior to CHA2DS2-VASc in predicting stroke and mortality and superior to HAS-BLED for bleeding, overall and in lower risk patients. The GARFIELD-AF tool has the potential for incorporation in routine electronic systems, and for the first time, permits simultaneous evaluation of ischaemic stroke, mortality and bleeding risks. CLINICAL TRIAL REGISTRATION: URL: http://www.clinicaltrials.gov. Unique identifier for GARFIELD-AF (NCT01090362) and for ORBIT-AF (NCT01165710)

Two-year outcomes of patients with newly diagnosed atrial fibrillation: results from GARFIELD-AF.

AIMS: The relationship between outcomes and time after diagnosis for patients with non-valvular atrial fibrillation (NVAF) is poorly defined, especially beyond the first year. METHODS AND RESULTS: GARFIELD-AF is an ongoing, global observational study of adults with newly diagnosed NVAF. Two-year outcomes of 17 162 patients prospectively enrolled in GARFIELD-AF were analysed in light of baseline characteristics, risk profiles for stroke/systemic embolism (SE), and antithrombotic therapy. The mean (standard deviation) age was 69.8 (11.4) years, 43.8% were women, and the mean CHA2DS2-VASc score was 3.3 (1.6); 60.8% of patients were prescribed anticoagulant therapy with/without antiplatelet (AP) therapy, 27.4% AP monotherapy, and 11.8% no antithrombotic therapy. At 2-year follow-up, all-cause mortality, stroke/SE, and major bleeding had occurred at a rate (95% confidence interval) of 3.83 (3.62; 4.05), 1.25 (1.13; 1.38), and 0.70 (0.62; 0.81) per 100 person-years, respectively. Rates for all three major events were highest during the first 4 months. Congestive heart failure, acute coronary syndromes, sudden/unwitnessed death, malignancy, respiratory failure, and infection/sepsis accounted for 65% of all known causes of death and strokes for <10%. Anticoagulant treatment was associated with a 35% lower risk of death. CONCLUSION: The most frequent of the three major outcome measures was death, whose most common causes are not known to be significantly influenced by anticoagulation. This suggests that a more comprehensive approach to the management of NVAF may be needed to improve outcome. This could include, in addition to anticoagulation, interventions targeting modifiable, cause-specific risk factors for death. CLINICAL TRIAL REGISTRATION: http://www.clinicaltrials.gov. Unique identifier: NCT01090362

Planck intermediate results. XXIII. Galactic plane emission components derived from Planck with ancillary data

Planck data when combined with ancillary data provide a unique opportunity to separate the diffuse emission components of the inner Galaxy. The purpose of the paper is to elucidate the morphology of the various emission components in the strong star-formation region lying inside the solar radius and to clarify the relationship between the various components. The region of the Galactic plane covered is l = 300\ub0 \u2192 0\ub0 \u2192 60\ub0 wherestar-formation is highest and the emission is strong enough to make meaningful component separation. The latitude widths in this longitude range lie between 1 and 2, which correspond to FWHM z-widths of 100-200 pc at a typical distance of 6 kpc. The four emission components studied here are synchrotron, free-free, anomalous microwave emission (AME), and thermal (vibrational) dust emission. These components are identified by constructing spectral energy distributions (SEDs) at positions along the Galactic plane using the wide frequency coverage of Planck (28.4-857GHz) in combination with low-frequency radio data at 0.408-2.3 GHz plus WMAP data at 23-94 GHz, along with far-infrared (FIR) data from COBE-DIRBE and IRAS. The free-free component is determined from radio recombination line (RRL) data. AME is found to be comparable in brightness to the free-free emission on the Galactic plane in the frequency range 20-40 GHz with a width in latitude similar to that of the thermal dust; it comprises 45 \ub1 1% of the total 28.4 GHz emission in the longitude range l = 300\ub0 \u2192 0\ub0 \u2192 60\ub0. The free-free component is the narrowest, reflecting the fact that it is produced by current star-formation as traced by the narrow distribution of OB stars. It is the dominant emission on the plane between 60 and 100 GHz. RRLs from this ionized gas are used to assess its distance, leading to a free-free z-width of FWHM 48 100 pc. The narrow synchrotron component has a low-frequency brightness spectral index \u3b2synch 48 -2.7 that is similar to the broad synchrotron component indicating that they are both populated by the cosmic ray electrons of the same spectral index. The width of this narrow synchrotron component is significantly larger than that of the other three components, suggesting that it is generated in an assembly of older supernova remnants that have expanded to sizes of order 150 pc in 3 7 105 yr; pulsars of a similar age have a similar spread in latitude. The thermal dust is identified in the SEDs with average parameters of Tdust = 20.4 \ub1 0.4 K, \u3b2FIR = 1.94 \ub1 0.03 (> 353 GHz), and \u3b2mm = 1.67 \ub1 0.02 (< 353 GHz). The latitude distributions of gamma-rays, CO, and the emission in high-frequency Planck bands have similar widths, showing that they are all indicators of the total gaseous matter on the plane in the inner Galaxy. \ua9 ESO, 2015