Since the year 2000, a concerted campaign against malaria has led to unprecedented levels of intervention coverage across sub-Saharan Africa. Understanding the effect of this control effort is vital ...to inform future control planning. However, the effect of malaria interventions across the varied epidemiological settings of Africa remains poorly understood owing to the absence of reliable surveillance data and the simplistic approaches underlying current disease estimates. Here we link a large database of malaria field surveys with detailed reconstructions of changing intervention coverage to directly evaluate trends from 2000 to 2015, and quantify the attributable effect of malaria disease control efforts. We found that Plasmodium falciparum infection prevalence in endemic Africa halved and the incidence of clinical disease fell by 40% between 2000 and 2015. We estimate that interventions have averted 663 (542-753 credible interval) million clinical cases since 2000. Insecticide-treated nets, the most widespread intervention, were by far the largest contributor (68% of cases averted). Although still below target levels, current malaria interventions have substantially reduced malaria disease incidence across the continent. Increasing access to these interventions, and maintaining their effectiveness in the face of insecticide and drug resistance, should form a cornerstone of post-2015 control strategies.
THE 1% CONCORDANCE HUBBLE CONSTANT Bennett, C L; Larson, D; Weiland, J L ...
The Astrophysical journal,
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The determination of the Hubble constant has been a central goal in observational astrophysics for nearly a hundred years. Extraordinary progress has occurred in recent years on two fronts: the ...cosmic distance ladder measurements at low redshift and cosmic microwave background (CMB) measurements at high redshift. The CMB is used to predict the current expansion rate through a best-fit cosmological model. Complementary progress has been made with baryon acoustic oscillation (BAO) measurements at relatively low redshifts. While BAO data do not independently determine a Hubble constant, they are important for constraints on possible solutions and checks on cosmic consistency. A precise determination of the Hubble constant is of great value, but it is more important to compare the high and low redshift measurements to test our cosmological model. Significant tension would suggest either uncertainties not accounted for in the experimental estimates or the discovery of new physics beyond the standard model of cosmology. In this paper we examine in detail the tension between the CMB, BAO, and cosmic distance ladder data sets. We find that these measurements are consistent within reasonable statistical expectations and we combine them to determine a best-fit Hubble constant of 69.6 + or - 0.7 km s super(-1) Mpc super(-1). This value is based upon WMAP9+SPT+ACT+6dFGS+BOSS/DR11+H sub(0)/Riess; we explore alternate data combinations in the text. The combined data constrain the Hubble constant to 1%, with no compelling evidence for new physics.
ABSTRACT We examine the internal consistency of the Planck 2015 cosmic microwave background (CMB) temperature anisotropy power spectrum. We show that tension exists between cosmological constant cold ...dark matter ( ) model parameters inferred from multipoles (roughly those accessible to Wilkinson Microwave Anisotropy Probe), and from , particularly the CDM density, , which is discrepant at for a Planck -motivated prior on the optical depth, . We find some parameter tensions to be larger than previously reported because of inaccuracy in the code used by the Planck Collaboration to generate model spectra. The Planck constraints are also in tension with low-redshift data sets, including Planck 's own measurement of the CMB lensing power spectrum ( ), and the most precise baryon acoustic oscillation scale determination ( ). The Hubble constant predicted by Planck from , km s Mpc−1, disagrees with the most precise local distance ladder measurement of km s Mpc−1 at the level, while the Planck value from , km s Mpc−1, is consistent within . A discrepancy between the Planck and South Pole Telescope high-multipole CMB spectra disfavors interpreting these tensions as evidence for new physics. We conclude that the parameters from the Planck high-multipole spectrum probably differ from the underlying values due to either an unlikely statistical fluctuation or unaccounted-for systematics persisting in the Planck data.
Summary Background Drug treatments for patients with high-risk myelodysplastic syndromes provide no survival advantage. In this trial, we aimed to assess the effect of azacitidine on overall survival ...compared with the three commonest conventional care regimens. Methods In a phase III, international, multicentre, controlled, parallel-group, open-label trial, patients with higher-risk myelodysplastic syndromes were randomly assigned one-to-one to receive azacitidine (75 mg/m2 per day for 7 days every 28 days) or conventional care (best supportive care, low-dose cytarabine, or intensive chemotherapy as selected by investigators before randomisation). Patients were stratified by French–American–British and international prognostic scoring system classifications; randomisation was done with a block size of four. The primary endpoint was overall survival. Efficacy analyses were by intention to treat for all patients assigned to receive treatment. This study is registered with ClinicalTrials.gov , number NCT00071799. Findings Between Feb 13, 2004, and Aug 7, 2006, 358 patients were randomly assigned to receive azacitidine (n=179) or conventional care regimens (n=179). Four patients in the azacitidine and 14 in the conventional care groups received no study drugs but were included in the intention-to-treat efficacy analysis. After a median follow-up of 21·1 months (IQR 15·1–26·9), median overall survival was 24·5 months (9·9–not reached) for the azacitidine group versus 15·0 months (5·6–24·1) for the conventional care group (hazard ratio 0·58; 95% CI 0·43–0·77; stratified log-rank p=0·0001). At last follow-up, 82 patients in the azacitidine group had died compared with 113 in the conventional care group. At 2 years, on the basis of Kaplan-Meier estimates, 50·8% (95% CI 42·1–58·8) of patients in the azacitidine group were alive compared with 26·2% (18·7–34·3) in the conventional care group (p<0·0001). Peripheral cytopenias were the most common grade 3–4 adverse events for all treatments. Interpretation Treatment with azacitidine increases overall survival in patients with higher-risk myelodysplastic syndromes relative to conventional care. Funding Celgene Corporation.
A simple cosmological model with only six parameters (matter density, Omega sub(m)h super(2), baryon density, Omega sub(b)h super(2), Hubble constant, H sub(0), amplitude of fluctuations, sigma ...sub(8), optical depth, tau , and a slope for the scalar perturbation spectrum, n sub(s)) fits not only the 3 year WMAP temperature and polarization data, but also small-scale CMB data, light element abundances, large-scale structure observations, and the supernova luminosity/distance relationship. Using WMAP data, only, the best-fit values for cosmological parameters for the power-law flat Lambda cold dark matter ( Lambda CDM) model are ( Omega sub(m)h super(2), Omega sub(b)h super(2),h,n sub(s), tau , sigma sub(8)) = (0.1277 super(+0.0080)-0.0079,0.02229 plus or minus 0.00073,0.732 super(+0.031)-0.032,0.958 plus or minus 0.016,0.089 plus or minus 0.030,0.761 super(+0.049)-0.048). The 3 year data dramatically shrink the allowed volume in mis six-dimensional parameter space. Assuming that the primordial fluctuations are adiabatic with a power-law spectrum, the WMAP data alone require dark matter and favor a spectral index that is significantly less than the Harrison-Zel'dovich-Peebles scale-invariant spectrum (n sub(s) = 1, r = 0). Adding additional data sets improves the constraints on these components and the spectral slope. For power-law models, WMAP data alone puts an improved upper limit on the tensor-to-scalar ratio, r sub(0.002) < 0.65 (95% CL) and the combination of WMAP and the lensing-normalized SDSS galaxy survey implies r sub(0.002) < 0.30 (95% CL). Models that suppress large-scale power through a running spectral index or a large-scale cutoff in the power spectrum are a better fit to the WMAP and small-scale CMB data than the power-law Lambda CDM model; however, the improvement in the fit to the WMAP data is only Delta chi super(2) = 3 for 1 extra degree of freedom. Models with a running-spectral index are consistent with a higher amplitude of gravity waves. In a flat universe, the combination of WMAP and the Supernova Legacy Survey (SNLS) data yields a significant constraint on the equation of state of the dark energy, w = -0.967 super(+0.073)-0.072. If we assume w = -1, then the deviations from the critical density, Omega sub(K) are small: the combination of WMAP and the SNLS data implies Omega sub(k) = -0.011 plus or minus 0.012. The combination of WMAP 3 year data plus the HST Key Project constraint on H sub(0) implies Omega sub(k) = -0.014 plus or minus 0.017 and Omega sub( Lambda ) = 0.716 plus or minus 0.055. Even if we do not include the prior that the universe is flat, by combining WMAP, large-scale structure, and supernova data, we can still put a strong constraint on the dark energy equation of state, w = -1.08 plus or minus 0.12. For a flat universe, the combination of WMAP and other astronomical data yield a constraint on the sum of the neutrino masses, capital sigma m sub( upsilon ) < 0.66 eV (95%CL). Consistent with the predictions of simple inflationary theories, we detect no significant deviations from Gaussianity in the CMB maps using Minkowski functionals, the bispectrum, trispectrum, and a new statistic designed to detect large-scale anisotropies in the fluctuations.
The Wilkinson Microwave Anisotropy Probe (WMAP) 5-year data provide stringent limits on deviations from the minimal, six-parameter Lambda cold dark matter model. We report these limits and use them ...to constrain the physics of cosmic inflation via Gaussianity, adiabaticity, the power spectrum of primordial fluctuations, gravitational waves, and spatial curvature. We also constrain models of dark energy via its equation of state, parity-violating interaction, and neutrino properties, such as mass and the number of species. We detect no convincing deviations from the minimal model. The six parameters and the corresponding 68% uncertainties, derived from the WMAP data combined with the distance measurements from the Type Ia supernovae (SN) and the Baryon Acoustic Oscillations (BAO) in the distribution of galaxies, are: Omega b h 2 = 0.02267+0.00058 -0.00059, Omega c h 2 = 0.1131 ± 0.0034, Omega Lambda = 0.726 ± 0.015, ns = 0.960 ± 0.013, tau = 0.084 ± 0.016, and at k = 0.002 Mpc-1. From these, we derive sigma 8 = 0.812 ± 0.026, H 0 = 70.5 ± 1.3 km s-1 Mpc-1, Omega b = 0.0456 ± 0.0015, Omega c = 0.228 ± 0.013, Omega m h 2 = 0.1358+0.0037 -0.0036, z reion = 10.9 ± 1.4, and t 0 = 13.72 ± 0.12 Gyr. With the WMAP data combined with BAO and SN, we find the limit on the tensor-to-scalar ratio of r < 0.22(95%CL), and that ns > 1 is disfavored even when gravitational waves are included, which constrains the models of inflation that can produce significant gravitational waves, such as chaotic or power-law inflation models, or a blue spectrum, such as hybrid inflation models. We obtain tight, simultaneous limits on the (constant) equation of state of dark energy and the spatial curvature of the universe: -0.14 < 1 + w < 0.12(95%CL) and -0.0179 < Omega k < 0.0081(95%CL). We provide a set of 'WMAP distance priors,' to test a variety of dark energy models with spatial curvature. We test a time-dependent w with a present value constrained as -0.33 < 1 + w 0 < 0.21 (95% CL). Temperature and dark matter fluctuations are found to obey the adiabatic relation to within 8.9% and 2.1% for the axion-type and curvaton-type dark matter, respectively. The power spectra of TB and EB correlations constrain a parity-violating interaction, which rotates the polarization angle and converts E to B. The polarization angle could not be rotated more than -59 < Delta alpha < 24 (95% CL) between the decoupling and the present epoch. We find the limit on the total mass of massive neutrinos of capital sigma m Delta < 0.67 eV(95%CL), which is free from the uncertainty in the normalization of the large-scale structure data. The number of relativistic degrees of freedom (dof), expressed in units of the effective number of neutrino species, is constrained as N eff = 4.4 ± 1.5 (68%), consistent with the standard value of 3.04. Finally, quantitative limits on physically-motivated primordial non-Gaussianity parameters are -9 < f local NL < 111 (95% CL) and -151 < f equil NL < 253 (95% CL) for the local and equilateral models, respectively.
The Wilkinson Microwave Anisotropy Probe (WMAP) has mapped the entire sky in five frequency bands between 23 and 94 GHz with polarization-sensitive radiometers. We present 3 year full-sky maps of the ...polarization and analyze them for foreground emission and cosmological implications. These observations open up a new window for understanding how the universe began and help set a foundation for future observations. WMAP observes significant levels of polarized foreground emission due to both Galactic synchrotron radiation and thermal dust emission. Synchrotron radiation is the dominant signal at l < 50 and upsilon 40 GHz, while thermal dust emission is evident at 94 GHz. The least contaminated channel is at 61 GHz. We present a model of polarized foreground emission that captures the large angular scale characteristics of the microwave sky. After applying a Galactic mask that cuts 25.7% of the sky, we show that the high Galactic latitude rms polarized foreground emission, averaged over l = 4-6, ranges from approximately 5 mu K at 22 GHz to 0.6 mu K at 61 GHz. By comparison, the levels of intrinsic CMB polarization for a Lambda CDM model with an optical depth of tau = 0.09 and assumed tensor-to-scalar ratio r = 0.3 are less than or equal to 0.3 mu K for E-mode polarization and less than or equal to 0.1 mu K for B-mode polarization. To analyze the maps for CMB polarization at l < 16, we subtract a model of the foreground emission that is based primarily on a scaling WMAP's 23 GHz map. In the foreground-corrected maps, we detect l(l + 1)Cl super(EE)=(2-6)/2 capital pi = 0.086 plus or minus 0.029 ( mu K) super(2). This is interpreted as the result of rescattering of the CMB by free electrons released during reionization at z sub(r) = 10.9 super(+2.7)-2.3 for a model with instantaneous reionization. By computing the likelihood of just the EE data as a function of tau we find tau = 0.10 plus or minus 0.03. When the same EE data are used in the full six-parameter fit to all WMAP data (TT, TE, EE), we find tau = 0.09 plus or minus 0.03. Marginalization over the foreground subtraction affects this value by delta tau < 0.01. We see no evidence for B modes, limiting them to l(l + 1)Cl super(BB)=(2-6) /2 capital pi = -0.04 plus or minus 0.03 ( mu K) super(2). We perform a template fit to the E-mode and B-mode data with an approximate model for the tensor scalar ratio. We find that the limit from the polarization signals alone is r < 2.2 (95% CL), where r is evaluated at k = 0.002 Mpc super(-1). This corresponds to a limit on the cosmic density of gravitational waves of Omega sub(GW)h super(2) < 5 x 10 super(-12). From the full WMAP analysis, we find r < 0.55 (95% CL) corresponding to a limit of Omega sub(GW)h super(2) < 1 x 10 super(-12) (95% CL). The limit on r is approaching the upper bound of predictions for some of the simplest models of inflation, r similar to 0.3.
We examine the impact of baryon acoustic oscillation (BAO) scale measurements on the discrepancy between the value of the Hubble constant (H0) inferred from the local distance ladder and that from ...Planck cosmic microwave background (CMB) data. While the BAO data alone cannot constrain H0, we show that combining the latest BAO results with WMAP, Atacama Cosmology Telescope (ACT), or South Pole Telescope (SPT) CMB data produces values of H0 that are lower than the distance ladder, independent of Planck, and that this downward pull was less apparent in some earlier analyses that used only angle-averaged BAO scale constraints rather than full anisotropic information. At the same time, the combination of BAO and CMB data also disfavors the lower values of H0 preferred by the Planck high-multipole temperature power spectrum. Combining galaxy and Ly forest BAO with a precise estimate of the primordial deuterium abundance produces km s−1 Mpc−1 for the flat model. This value is completely independent of CMB anisotropy constraints and is lower than the latest distance ladder constraint, although tension also exists between the galaxy BAO and Ly BAO. These results show that it is not possible to explain the H0 disagreement solely with a systematic error specific to the Planck data. The fact that tensions remain even after the removal of any single data set makes this intriguing puzzle all the more challenging to resolve.
We present new full-sky temperature maps in five frequency bands from 23 to 94 GHz, based on data from the first 3 years of the WMAP sky survey. The new maps are consistent with the first-year maps ...and are more sensitive. The 3 year maps incorporate several improvements in data processing made possible by the additional years of data and by a more complete analysis of the polarization signal. These include several new consistency tests as well as refinements in the gain calibration and beam response models. We employ two forms of multifrequency analysis to separate astrophysical foreground signals from the CMB, each of which improves on our first-year analyses. First, we form an improved "Internal Linear Combination" (ILC) map, based solely on WMAP data, by adding a bias-correction step and by quantifying residual uncertainties in the resulting map. Second, we fit and subtract new spatial templates that trace Galactic emission; in particular, we now use low-frequency WMAP data to trace synchrotron emission instead of the 408 MHz sky survey. The WMAP point source catalog is updated to include 115 new sources whose detection is made possible by the improved sky map sensitivity. We derive the angular power spectrum of the temperature anisotropy using a hybrid approach that combines a maximum likelihood estimate at low l (large angular scales) with a quadratic cross-power estimate for l > 30. The resulting multifrequency spectra are analyzed for residual point source contamination. At 94 GHz the unmasked sources contribute 128 plus or minus 27 mu K super(2) to l(l + 1)C sub(l)/2 capital pi at l = 1000. After subtracting this contribution, our best estimate of the CMB power spectrum is derived by averaging cross-power spectra from 153 statistically independent channel pairs. The combined spectrum is cosmic variance limited to l = 400, and the signal-to-noise ratio per l-mode exceeds unity up to l = 850. For bins of width Delta l/l = 3%, the signal-to-noise ratio exceeds unity up to l = 1000. The first two acoustic peaks are seen at / = 220.8 plus or minus 0.7 and / = 530.9 plus or minus 3.8, respectively, while the first two troughs are seen at l = 412.4 plus or minus 1.9 and l = 675.2 plus or minus 11.1. The rise to the third peak is unambiguous; when the WMAP data are combined with higher resolution CMB measurements, the existence of a third acoustic peak is well established. Spergel et al. use the 3 year temperature and polarization data to constrain cosmological model parameters. A simple six-parameter ACDM model continues to fit CMB data and other measures of large-scale structure remarkably well. The new polarization data produce a better measurement of the optical depth to reionization, tau = 0.089 plus or minus 0.03. This new and tighter constraint on tau helps break a degeneracy with the scalar spectral index, which is now found to be n sub(S) = 0.960 plus or minus 0.016. If additional cosmological data sets are included in the analysis, the spectral index is found to be n sub(S) = 0.947 plus or minus 0.015.
This paper focuses on cosmological constraints derived from analysis of WMAP data alone. A simple Lambda CDM cosmological model fits the five-year WMAP temperature and polarization data. The basic ...parameters of the model are consistent with the three-year data and now better constrained: Omega b h 2 = 0.02273 ± 0.00062, Omega c h 2 = 0.1099 ± 0.0062, Omega Lambda = 0.742 ± 0.030, ns = 0.963+0.014 -0.015, tau = 0.087 ± 0.017, and sigma 8 = 0.796 ± 0.036, with h = 0.719+0.026 -0.027. With five years of polarization data, we have measured the optical depth to reionization, tau >0, at 5 sigma significance. The redshift of an instantaneous reionization is constrained to be z reion = 11.0 ± 1.4 with 68% confidence. The 2 sigma lower limit is z reion > 8.2, and the 3 sigma limit is z reion > 6.7. This excludes a sudden reionization of the universe at z = 6 at more than 3.5 sigma significance, suggesting that reionization was an extended process. Using two methods for polarized foreground cleaning we get consistent estimates for the optical depth, indicating an error due to the foreground treatment of tau ~ 0.01. This cosmological model also fits small-scale cosmic microwave background (CMB) data, and a range of astronomical data measuring the expansion rate and clustering of matter in the universe. We find evidence for the first time in the CMB power spectrum for a nonzero cosmic neutrino background, or a background of relativistic species, with the standard three light neutrino species preferred over the best-fit Lambda CDM model with N eff = 0 at >99.5% confidence, and N eff > 2.3(95%confidence limit (CL)) when varied. The five-year WMAP data improve the upper limit on the tensor-to-scalar ratio, r < 0.43(95%CL), for power-law models, and halve the limit on r for models with a running index, r < 0.58(95%CL). With longer integration we find no evidence for a running spectral index, with dns /dln k = -0.037 ± 0.028, and find improved limits on isocurvature fluctuations. The current WMAP-only limit on the sum of the neutrino masses is capital sigma m Delta < 1.3 eV(95%CL), which is robust, to within 10%, to a varying tensor amplitude, running spectral index, or dark energy equation of state.
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