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Objective To update the 2016 formal consensus-based guidance for the management of myasthenia gravis (MG) based on the latest evidence in the literature. Methods In October 2013, the Myasthenia Gravis Foundation of America appointed a Task Force to develop treatment guidance for MG, and a panel of 15 international experts was convened. The RAND/UCLA appropriateness method was used to develop consensus recommendations pertaining to 7 treatment topics. In February 2019, the international panel was reconvened with the addition of one member to represent South America. All previous recommendations were reviewed for currency, and new consensus recommendations were developed on topics that required inclusion or updates based on the recent literature. Up to 3 rounds of anonymous e-mail votes were used to reach consensus, with modifications to recommendations between rounds based on the panel input. A simple majority vote (80% of panel members voting "yes") was used to approve minor changes in grammar and syntax to improve clarity. Results The previous recommendations for thymectomy were updated. New recommendations were developed for the use of rituximab, eculizumab, and methotrexate as well as for the following topics: early immunosuppression in ocular MG and MG associated with immune checkpoint inhibitor treatment. Conclusion This updated formal consensus guidance of international MG experts, based on new evidence, provides recommendations to clinicians caring for patients with MG worldwide.

ObjectiveTo investigate the efficacy and safety of belimumab, a fully human immunoglobulin G1λ monoclonal antibody against B-lymphocyte stimulator, in participants with generalized myasthenia gravis (MG) who remained symptomatic despite standard of care (SoC) therapy.MethodsEligible participants with MG were randomized 1:1 to receive IV belimumab 10 mg/kg or placebo in this phase II, placebo-controlled, multicenter, double-blind study (NCT01480596; BEL115123). Participants received SoC therapies throughout the 24-week treatment phase and 12-week follow-up period. The primary efficacy endpoint was mean change from baseline in the Quantitative Myasthenia Gravis (QMG) scale at week 24; safety assessments included the frequency and severity of adverse events (AEs) and serious AEs.ResultsForty participants were randomized (placebo n = 22; belimumab n = 18). The mean change in QMG score from baseline at week 24 was not significantly different for belimumab vs placebo (p = 0.256). There were no statistically significant differences between treatment groups for secondary endpoints, including the MG Composite and MG–Activity of Daily Living scores. Acetylcholine receptor antibody levels decreased over time in both treatment groups. No unexpected AEs were identified and occurrence was similar in the belimumab (78%) and placebo (91%) groups. One participant receiving placebo died (severe sepsis) during the treatment phase.ConclusionsThe primary endpoint was not met for belimumab in participants with generalized MG receiving SoC. There was no significant difference in mean change in the QMG score at week 24 for belimumab vs placebo. The safety profile of belimumab was consistent with previous systemic lupus erythematosus studies.Classification of evidenceThis study provides Class I evidence that for participants with generalized MG, belimumab did not significantly improve QMG score compared with placebo.

Faint star-forming galaxies at z ̃ 2-3 can be used as alternative background sources to probe the Lyα forest in addition to quasars, yielding high sightline densities that enable 3D tomographic reconstruction of the foreground absorption field. Here, we present the first data release from the COSMOS Lyα Mapping And Tomography Observations (CLAMATO) Survey, which was conducted with the LRIS spectrograph on the Keck I telescope. Over an observational footprint of 0.157 deg2 within the COSMOS field, we used 240 galaxies and quasars at 2.17 < z < 3.00, with a mean comoving transverse separation of 2.37 {h}-1 {Mpc}, as background sources probing the foreground Lyα forest absorption at 2.05 < z < 2.55. The Lyα forest data was then used to create a Wiener-filtered tomographic reconstruction over a comoving volume of 3.15 × {10}5 {h}-3 {Mpc}}3 with an effective smoothing scale of 2.5 {h}-1 {Mpc}. In addition to traditional figures, this map is also presented as a virtual-reality visualization and manipulable interactive figure. We see large overdensities and underdensities that visually agree with the distribution of coeval galaxies from spectroscopic redshift surveys in the same field, including overdensities associated with several recently discovered galaxy protoclusters in the volume. Quantitatively, the map signal-to-noise is {{S}}/{{{N}}}wiener}≈ 3.4 over a 3 h -1Mpc top-hat kernel based on the variances estimated from the Wiener filter. This data release includes the redshift catalog, reduced spectra, extracted Lyα forest pixel data, and reconstructed tomographic map of the absorption. These can be downloaded from Zenodo (10.5281/zenodo.1292459).

A task force of the Myasthenia Gravis Foundation of America recently published a formal consensus statement intended to be a treatment guide for clinicians caring for myasthenia gravis (MG) patients worldwide. Its development was stimulated by the fact that there is generally no accepted standard of care for MG, and no one treatment is best for all MG patients. Also, there are few randomized trials of treatments in current use, and the generalizability of the few trials that have been successful may be difficult. Fifteen international experts in MG participated in the consensus process, which used a simple consensus to develop preliminary definitions and the RAND/UCLA Appropriateness Method to quantify agreement on treatment guidance statements for seven topics: symptomatic and immunosuppressive treatment, intravenous immunoglobulin and plasma exchange, impending and manifest myasthenic crisis, thymectomy, juvenile MG, MG with muscle-specific tyrosine kinase antibodies, and MG in pregnancy. The executive summary of the guidance statement was published with open access to facilitate access by patients and healthcare professionals, and the full statement, with extensive background information, is available online. The guidance statement is a living document that will require updates as new treatments and new information on current treatments become available.

International audience; We present the results of new near-IR spectroscopic observations of passive galaxies at z greater than or similar to 1.4 in a concentration of BzK-selected galaxies in the COSMOS field. The observations have been conducted with Subaru/MOIRCS, and have resulted in absorption lines and/or continuum detection for 18 out of 34 objects. This allows us to measure spectroscopic redshifts for a sample that is almost complete to K-AB = 21. COSMOS photometric redshifts are found in fair agreement overall with the spectroscopic redshifts, with a standard deviation of similar to 0.05; however, similar to 30% of objects have photometric redshifts systematically underestimated by up to similar to 25%. We show that these systematic offsets in photometric redshifts can be removed by using these objects as a training set. All galaxies fall in four distinct redshift spikes at z = 1.43, 1.53, 1.67, and 1.82, with this latter one including seven galaxies. SED fits to broadband fluxes indicate stellar masses in the range of similar to 4-40 x 10(10) M-circle dot and that star formation was quenched similar to 1 Gyr before the cosmoic epoch at which they are observed. the spectra of several individual galaxies have allowed us to measure their H delta(F) indices and the strengths of the 4000 angstrom break, which confirms their identification as passive galaxies, as does a composite spectrum resulting from the co-addition of 17 individual spectra. The effective radii of the galaxies have been measured on the COSMOS HST/ACS i(F814W)-band image, confirming the coexistence at these redshifts of passive galaxies, which are substantially more compact than their local counterparts with others that follow the local effective radius-stellar mass relation. For the galaxy with the best signal-to-noise spectrum we were able to measure a velocity dispersion of 270 +/- 105 km s(-1) (error bar including systematic errors), indicating that this galaxy lies closely on the virial relation given its stellar mass and effective radius.

HI observations are an excellent tool for investigating tidal interactions. Ongoing major and minor interactions which can lead to traumatic mergers or to accretion and the triggering of star formation, show distinct HI signatures. Interactions and mergers in the recent past can also be recognized in the HI structure and kinematics. Recent 21cm line surveys of large samples of galaxies indicate that at least one out of every four galaxies shows signs of a present interaction or merger/accretion events in the recent past.

We present a numerical simulation of two merging equal-mass, gas-rich disk galaxies. Special emphasis is given to an accurate treatment of the interstellar medium physics and star formation with its feedback. We will explain how the negative feedback from young stars restricts the bulk of the star formation during the merger-induced starburst to the nucleus.

Recent analysis of extended rotation curves of late-type spirals have confirmed that these objects have detectable amounts of dark matter (DM) already in the optical region, with dark-to-luminous mass ratio scaling inversely with luminosity. Since currently available rotation curves of early-type spirals are often fragmentary and not extended enough, the question remains open as to whether dark halos are unequivocally present in Sa galaxies. To address this point we have observed a sample of 7 SA's measuring major axis velocities and velocity dispersion for both stars and ionized gas. Here we present results for two objects, NGC 2179 and NGC 2775. We have constructed detailed dynamical models which, for each galaxy, explain the observed kinematics for both stellar and gaseous component and which are consistent with observed photometry. The best fit model for NGC 2179 involves an oblate isotropic rotator bulge, a thin exponential disk with the same mass-to-light ratio, and a pseudo-isothermal DM halo. The mass-to-light ratio in the inner galaxy was found to be M/LR = 4.5 (M/LR)⊙ reaching M/LR = 7.5 (M/LR)⊙ at the optical radius (Ropt). For NGC 2775 the best fit model involves an oblate isotropic rotator bulge and a thin exponential disk, with M/Lr = 3.5 (M/Lr)⊙, and M/Lr = 4.7 (M/Lr)⊙ respectively. No DM halo was needed to explain the data extending to 0.7 Ropt. In the inner regions the gas rotates as fast as stars but with negligible velocity dispersion. This rules out the case where the gas kinematics is dominated by random motion, and leads us to speculate we are seeing gas rotating on a non-equatorial plane, resulting from a past external acquisition, possibly from the companion galaxy NGC 2777.

The Cosmic Evolution Survey (COSMOS) has become a cornerstone of extragalactic astronomy. Since the last public catalog in 2015, a wealth of new imaging and spectroscopic data has been collected in the COSMOS field. This paper describes the collection, processing, and analysis of this new imaging data to produce a new reference photometric redshift catalog. Source detection and multi-wavelength photometry is performed for 1.7 million sources across the $2\,\mathrm{deg}^{2}$ of the COSMOS field, $\sim$966,000 of which are measured with all available broad-band data using both traditional aperture photometric methods and a new profile-fitting photometric extraction tool, The Farmer, which we have developed. A detailed comparison of the two resulting photometric catalogs is presented. Photometric redshifts are computed for all sources in each catalog utilizing two independent photometric redshift codes. Finally, a comparison is made between the performance of the photometric methodologies and of the redshift codes to demonstrate an exceptional degree of self-consistency in the resulting photometric redshifts. The $i, Comment: 39 pages, 21 figures, accepted for publication in The Astrophysical Journal Supplement Series. Production of IRAC mosaics are presented in Moneti et al. "Euclid Preparation: XVIII. Cosmic Dawn Survey. Spitzer observations of the Euclid deep fields and calibration fields" which has been posted simultaneously. Catalogs can be accessed online now at https://cosmos2020.calet.org

International audience; We present the first results from a near-IR spectroscopic survey of the COSMOS field, using the Fiber Multi-Object Spectrograph on the Subaru telescope, designed to characterize the star-forming galaxy population at 1.4 \textless z \textless 1.7. The high-resolution mode is implemented to detect H alpha in emission between 1.6-1.8 mu m with f(H alpha) greater than or similar to 4 x 10(-17) erg cm(-2) s(-1). Here, we specifically focus on 271 sBzK-selected galaxies that yield a H alpha detection thus providing a redshift and emission line luminosity to establish the relation between star formation rate and stellar mass. With further J-band spectroscopy for 89 of these, the level of dust extinction is assessed by measuring the Balmer decrement using co-added spectra. We find that the extinction (0.6 less than or similar to A(H alpha) less than or similar to 2.5) rises with stellar mass and is elevated at high masses compared to low-redshift galaxies. Using this subset of the spectroscopic sample, we further find that the differential extinction between stellar and nebular emission E-star(B - V)/E-neb(B - V) is 0.7-0.8, dissimilar to that typically seen at low redshift. After correcting for extinction, we derive an H alpha-based main sequence with a slope (0.81 +/- 0.04) and normalization similar to previous studies at these redshifts.

We present the first set of XMM-Newton EPIC observations in the 2 square degree COSMOS field. The strength of the COSMOS project is the unprecedented combination of a large solid angle and sensitivity over the whole multiwavelength spectrum. The XMM-Newton observations are very efficient in localizing and identifying active galactic nuclei (AGN) and clusters as well as groups of galaxies. One of the primary goals of the XMM-Newton Cosmos survey is to study the co-evolution of active galactic nuclei as a function of their environment in the Cosmic web. Here we present the log of observations, images and a summary of first research highlights for the first pass of 25 XMM-Newton pointings across the field. In the existing dataset we have detected 1416 new X-ray sources in the 0.5-2, 2-4.5 and 4.5-10 keV bands to an equivalent 0.5-2 keV flux limit of 7x10-16 erg cm-2 s-1. The number of sources is expected to grow to almost 2000 in the final coverage of the survey. From an X-ray color color analysis we identify a population of heavily obscured, partially leaky or reflecting absorbers, most of which are likely to be nearby, Compton-thick AGN., 9 pages, ApJS COSMOS Special Issue, 2007 in press. the full-resolution version is available at http://www.mpe.mpg.de/XMMCosmos/PAPERS/grh_cosmos.ps.gz

We present the first estimate of the evolution of type 1 AGNs in the IR (15 mum) obtained from the ELAIS survey in the S1 region. We find that the luminosity function (LF) of Type 1 AGNs at 15mum is fairly well represented by a double power-law function with a bright slope of 2.9 and a faint slope of 1.1. There is evidence for significant cosmological evolution according to a pure luminosity evolution model L-15(z)proportional to(1+z)(k), with k=3.00(-0.20)(+0.16) in a (Omega(m),Omega(Lambda))=(1.0,0.0) cosmology. This evolution is similar to what is observed at other wavebands. From the luminosity function and its evolution, we estimate a contribution of similar to 2% from Type 1. AGN to the total Cosmic Infrared Background (CIRB) at 15 mum.

We investigate the relationships between stellar mass, gas-phase oxygen abundance (metallicity), star formation rate, and dust content of star-forming galaxies at z$\sim$1.6 using Subaru/FMOS spectroscopy in the COSMOS field. The mass-metallicity relation at $z\sim1.6$ is steeper than the relation observed in the local Universe. The steeper MZ relation at $z\sim1.6$ is mainly due to evolution in the stellar mass where the MZ relation begins to turnover and flatten. This turnover mass is 1.2 dex larger at $z\sim1.6$. The most massive galaxies at $z\sim1.6$ ($\sim 10^{11}M_\odot$) are enriched to the level observed in massive galaxies in the local Universe. The mass-metallicity relation we measure at $z\sim1.6$ supports the suggestion of an empirical upper metallicity limit that does not significantly evolve with redshift. We find an anti-correlation between metallicity and star formation rate for galaxies at a fixed stellar mass at $z\sim1.6$ which is similar to trends observed in the local Universe. We do not find a relation between stellar mass, metallicity and star formation rate that is independent of redshift; our data suggest that there is redshift evolution in this relation. We examine the relation between stellar mass, metallicity and dust extinction. We find that at a fixed stellar mass dustier galaxies tend to be more metal rich. From examination of the stellar masses, metallicities, SFRs and dust extinctions we conclude that stellar mass is most closely related to dust extinction., Comment: 21 pages, 14 figures. Updated to accepted version