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We performed small-scale demonstrations at GSFC of high-resolution Xray TES microcalorimeters read out using a microwave SQUID multiplexer. This work is part of our effort to develop detector and readout technologies for future space-based X-ray instruments such as the microcalorimeter spectrometer envisaged for Lynx, a large mission concept under development for the Astro 2020 Decadal Survey. In this paper we describe our experiment, including details of a recently designed, microwave-optimized low-temperature setup that is thermally anchored to the 55mKstage of our laboratory ADR. Using aROACH2 FPGA at room temperature, we read out pixels of a GSFC-built detector array via a NIST-built multiplexer chip with Nb coplanar waveguide resonators coupled to rf-SQUIDs. The resonators are spaced 6 MHz apart (at ∼ 5.9 GHz) and have quality factors of ∼ 15,000. In our initial demonstration, we used flux-ramp modulation frequencies of 125 kHz to read out 5 pixels simultaneously and achieved spectral resolutions of 2.8-3.1 eV FWHM at 5.9 keV. Our subsequent work is ongoing: to-date we have achieved a median spectral resolution of 3.4 eV FWHM at 5.9 keV while reading out 28 pixels simultaneously with flux-ramp frequencies of 160 kHz. We present the measured system-level noise and maximum slew rates and briefly describe our future development work.

The safety and feasibility of same-day discharge percutaneous coronary intervention (PCI) is still controversial. Patients (n = 943) had same-day discharge radial PCI between April 1998 and March 2001 in our hospital. Patients were contacted and asked whether they had entry site complications or a repeat angiogram and/or PCI within 24 hours and 1 month after the procedure. At the time the study was conducted, 811 patients responded, 38 patients had died, and 94 were alive but refused to participate or it was impossible to contact them; 27 patients (2.8%) visited their doctor and/or the hospital within 24 hours after discharge because of entry site complications, and 38 patients (4.0%) visited within 1 month. However, none of the patients had major access site complications or needed to be admitted to the hospital. Within 24 hours from discharge 17 patients (2%) reported chest pain, and only 1 (0.1%) required a repeat angiogram, which did not show target vessel occlusion. During the first month, 94 patients (11.5%) reported chest pain, 11 (1.3%) underwent a repeat angiogram, out of which 4 had subacute vessel closure; 2 of the 132 patients that we could not contact had subacute stent thrombosis within 1 month and died. None of the patients having same-day discharge radial PCI had major access site complications. Six patients (0.6%) had subacute vessel closure, but none had this during the first 24 hours after discharge. Same-day discharge radial PCI in certain low-risk patients is a safe and feasible strategy.

Anyone looking for an authentic taste of Japan will find it in noodle houses that serve udon and ramen, and in cubbyhole convenience stores that sell rice balls, green tea and bento box lunches just as in Tokyo. In Japan, salarymen -- white-collar executives -- gather in hostess bars to unwind with female companions, modern-day geisha for those on a whiskey budget.

Byodo-In is not an active Buddhist temple (there's no resident monk or congregation), but no matter:

This report continues the practice where the IAU Working Group on Cartographic Coordinates and Rotational Elements revises recommendations regarding those topics for the planets, satellites, minor planets, and comets approximately every 3 years. The Working Group has now become a “functional working group” of the IAU, and its membership is open to anyone interested in participating. We describe the procedure for submitting questions about the recommendations given here or the application of these recommendations for creating a new or updated coordinate system for a given body. Regarding body orientation, the following bodies have been updated: Mercury, based on MESSENGER results; Mars, along with a refined longitude definition; Phobos; Deimos; (1) Ceres; (52) Europa; (243) Ida; (2867) Šteins; Neptune; (134340) Pluto and its satellite Charon; comets 9P/Tempel 1, 19P/Borrelly, 67P/Churyumov–Gerasimenko, and 103P/Hartley 2, noting that such information is valid only between specific epochs. The special challenges related to mapping 67P/Churyumov–Gerasimenko are also discussed. Approximate expressions for the Earth have been removed in order to avoid confusion, and the low precision series expression for the Moon’s orientation has been removed. The previously online only recommended orientation model for (4) Vesta is repeated with an explanation of how it was updated. Regarding body shape, text has been included to explain the expected uses of such information, and the relevance of the cited uncertainty information. The size of the Sun has been updated, and notation added that the size and the ellipsoidal axes for the Earth and Jupiter have been recommended by an IAU Resolution. The distinction of a reference radius for a body (here, the Moon and Titan) is made between cartographic uses, and for orthoprojection and geophysical uses. The recommended radius for Mercury has been updated based on MESSENGER results. The recommended radius for Titan is returned to its previous value. Size information has been updated for 13 other Saturnian satellites and added for Aegaeon. The sizes of Pluto and Charon have been updated. Size information has been updated for (1) Ceres and given for (16) Psyche and (52) Europa. The size of (25143) Itokawa has been corrected. In addition, the discussion of terminology for the poles (hemispheres) of small bodies has been modified and a discussion on cardinal directions added. Although they continue to be used for planets and their satellites, it is assumed that the planetographic and planetocentric coordinate system definitions do not apply to small bodies. However, planetocentric and planetodetic latitudes and longitudes may be used on such bodies, following the right-hand rule. We repeat our previous recommendations that planning and efforts be made to make controlled cartographic products; newly recommend that common formulations should be used for orientation and size; continue to recommend that a community consensus be developed for the orientation models of Jupiter and Saturn; newly recommend that historical summaries of the coordinate systems for given bodies should be developed, and point out that for planets and satellites planetographic systems have generally been historically preferred over planetocentric systems, and that in cases when planetographic coordinates have been widely used in the past, there is no obvious advantage to switching to the use of planetocentric coordinates. The Working Group also requests community input on the question submitting process, posting of updates to the Working Group website, and on whether recommendations should be made regarding exoplanet coordinate systems.

Patients with HER2-positive breast cancer who have received two or more previous therapies for advanced disease have few effective treatment options. The monarcHER trial aimed to compare the efficacy of abemaciclib plus trastuzumab with or without fulvestrant with standard-of-care chemotherapy of physician's choice plus trastuzumab in women with advanced breast cancer. This phase 2, three-group, open-label trial was done across 75 hospitals, clinics, and medical centres in 14 countries. Eligible patients were women aged 18 years or older, who had hormone receptor-positive, HER2-positive advanced breast cancer with unresectable, locally advanced, recurrent or metastatic disease, Eastern Cooperative Oncology Group performance status of 0 or 1, and who had previously received at least two HER2-targeted therapies for advanced disease. Patients were randomly assigned 1:1:1 to the abemaciclib, trastuzumab, and fulvestrant (group A), abemaciclib and trastuzumab (group B), or standard-of-care chemotherapy and trastuzumab (group C). Oral abemaciclib 150 mg 12 hourly was administered on days 1–21 of a 21-day cycle, intravenous trastuzumab 8 mg/kg on cycle 1 day 1, followed by 6 mg/kg on day 1 of each subsequent 21-day cycle, and intramuscular fulvestrant 500 mg on days 1, 15, and 29 and once every 4 weeks thereafter. Standard-of-care chemotherapy was administered as specified by the product label. Randomisation was by a computer-generated random sequence by means of an interactive web-response system and stratified by number of previous systemic therapies for advanced breast cancer and measurable versus non-measurable disease. The primary endpoint was investigator-assessed progression-free survival in the intention-to-treat population, first testing group A versus group C and, if this result was significant, then group B versus group C. Safety was assessed in all patients who had received at least one dose of study treatment. This trial is registered at ClinicalTrials.gov (NCT02675231) and is ongoing for long-term survival follow-up. Between May 31, 2016, and Feb 28, 2018, 325 patients were screened, of whom 237 eligible patients were enrolled and randomly assigned to groups A (n=79), B (n=79), and C (n=79). Median follow-up was 19·0 months (IQR 14·7–25·1). The study met its primary endpoint, showing a significant difference at the prespecified two-sided α of 0·2 in median progression-free survival between group A (8·3 months, 95% CI 5·9–12·6) and group C (5·7 months, 5·4–7·0; HR 0·67 [95% CI 0·45–1·00]; p=0·051). No difference was observed between median progression-free survival in group B (5·7 months, 95% CI 4·2–7·2) and group C (HR 0·94 [0·64–1·38]; p=0·77). The most common grade 3–4 treatment-emergent adverse event in groups A, B, and C was neutropenia (21 [27%] of 78 patients, 17 [22%] of 77, and 19 [26%] of 72). The most common serious adverse events were: in group A, pyrexia (three [4%]), diarrhoea (two [3%]), urinary tract infection (two [3%]), and acute kidney injury (two [3%]); in group B, diarrhoea (two [3%]) and pneumonitis (two [3%]); and in group C, neutropenia (four [6%]) and pleural effusion (two [3%]). Two deaths were attributed to treatment: one due to pulmonary fibrosis in group B and one due to febrile neutropenia in group C. The combination of abemaciclib, fulvestrant, and trastuzumab significantly improved progression-free survival versus standard-of-care chemotherapy plus trastuzumab while showing a tolerable safety profile. Our results suggest that a chemotherapy-free regimen might potentially be an alternative treatment option for patients with hormone receptor-positive, HER2-positive advanced breast cancer. Eli Lilly and Company.

The immune system comprises a complex network of specialized cells that protects against infection, eliminates cancerous cells, and regulates tissue repair, thus serving a critical role in homeostasis, health span, and life span. The subterranean-dwelling naked mole-rat (NM-R; Heterocephalus glaber) exhibits prolonged life span relative to its body size, is unusually cancer resistant, and manifests few physiological or molecular changes with advancing age. We therefore hypothesized that the immune system of NM-Rs evolved unique features that confer enhanced cancer immunosurveillance and prevent the age-associated decline in homeostasis. Using single-cell RNA-sequencing (scRNA-seq) we mapped the immune system of the NM-R and compared it to that of the short-lived, cancer-prone mouse. In contrast to the mouse, we find that the NM-R immune system is characterized by a high myeloid-to-lymphoid cell ratio that includes a novel, lipopolysaccharide (LPS)-responsive, granulocyte cell subset. Surprisingly, we also find that NM-Rs lack canonical natural killer (NK) cells. Our comparative genomics analyses support this finding, showing that the NM-R genome lacks an expanded gene family that controls NK cell function in several other species. Furthermore, we reconstructed the evolutionary history that likely led to this genomic state. The NM-R thus challenges our current understanding of mammalian immunity, favoring an atypical, myeloid-biased mode of innate immunosurveillance, which may contribute to its remarkable health span.

Carbon and other volatiles are transported from Earth’s surface into the mantle at subduction margins. The efficiency of this transfer has profound implications for the nature and scale of geochemical heterogeneities in Earth’s deep (mantle) and shallow (crustal) reservoirs, as well as Earth’s oxidation state. However, the proportion of volatiles released in the forearc and backarc are not well constrained compared to fluxes from the volcanic front. Here, we use helium and carbon isotope data from deeply sourced springs along two cross-arc transects to show that ~91% of carbon released from the slab/mantle beneath the Costa Rica forearc is sequestered within the crust by calcite deposition, and an additional ~3% is incorporated into biomass through microbial chemolithoautotrophy. We estimate that ~1.2 × 10(exp 8) to 1.3 × 10(exp 10) mol CO2/yr are released from the slab beneath the forearc, resulting in up to ~19% less carbon being transferred to Earth’s deep mantle than previously estimated.

Time-division multiplexing (TDM) is a mature scheme for the readout of arrays of transition-edge sensors (TESs). TDM is based on superconducting-quantum-interference-device (SQUID) current amplifiers. Multiple spectrometers based on gamma-ray and X-ray microcalorimeters have been operated with TDM readout, each at the scale of 200 sensors per spectrometer, as have several astronomical cameras with thousands of sub-mm or microwave bolometers. Here we present the details of two different versions of our TDM system designed to read out X-ray TESs. The first has been field-deployed in two 160-sensor (8 columns × 20 rows) spectrometers and four 240-sensor (8 columns × 30 rows) spectrometers. It has a three-SQUID-stage architecture, switches rows every 320 ns, and has total readout noise of 0.41  μ Φ 0 / √ Hz. The second, which is presently under development, has a two-SQUID-stage architecture, switches rows every 160 ns, and has total readout noise of 0.19  μ Φ 0 / √ Hz. Both quoted noise values are non-multiplexed and referred to the first-stage SQUID. In a demonstration of this new architecture, a multiplexed 1-column × 32-row array of NIST TESs achieved average energy resolution of 2.55 ± 0.01  eV at 6 keV.

Every three years the IAU Working Group on Cartographic Coordinates and Rotational Elements revises tables giving the directions of the poles of rotation and the prime meridians of the planets, satellites, minor planets, and comets. This report takes into account the IAU Working Group for Planetary System Nomenclature (WGPSN) and the IAU Committee on Small Body Nomenclature (CSBN) definition of dwarf planets, introduces improved values for the pole and rotation rate of Mercury, returns the rotation rate of Jupiter to a previous value, introduces improved values for the rotation of five satellites of Saturn, and adds the equatorial radius of the Sun for comparison. It also adds or updates size and shape information for the Earth, Mars’ satellites Deimos and Phobos, the four Galilean satellites of Jupiter, and 22 satellites of Saturn. Pole, rotation, and size information has been added for the asteroids (21) Lutetia, (511) Davida, and (2867) Šteins. Pole and rotation information has been added for (2) Pallas and (21) Lutetia. Pole and rotation and mean radius information has been added for (1) Ceres. Pole information has been updated for (4) Vesta. The high precision realization for the pole and rotation rate of the Moon is updated. Alternative orientation models for Mars, Jupiter, and Saturn are noted. The Working Group also reaffirms that once an observable feature at a defined longitude is chosen, a longitude definition origin should not change except under unusual circumstances. It is also noted that alternative coordinate systems may exist for various (e.g. dynamical) purposes, but specific cartographic coordinate system information continues to be recommended for each body. The Working Group elaborates on its purpose, and also announces its plans to occasionally provide limited updates to its recommendations via its website, in order to address community needs for some updates more often than every 3 years. Brief recommendations are also made to the general planetary community regarding the need for controlled products, and improved or consensus rotation models for Mars, Jupiter, and Saturn.