Multiple myeloma, or blood plasma cancer, is characterized by increased blood vessel formulation (angiogenesis) in the bone marrow that is a predictive factor in survival. One treatment approach used for multiple myeloma is stem cell transplantation with the patient's own stem cells. The data stored in Myeloma. and shown below, represent the bone marrow micro vessel density for patients who had a complete response to the stem cell transplant (as measured by blood and urine tests). The measurements were taken immediately prior to the stem cell transplant and at the time the complete response was determined.

Data extracted from S. V. Rajkumar, R. Fonseca, T. E. Witzig, M. A. Gertz, and P. R. Greipp, "Bone Marrow Angiogenesis in Patients Achieving Complete Response After Stem Cell Transplantation for Multiple Myeloma," Leukemia 13 (1999): 469-t72.
a. At the 0.05 level of significance, is there evidence that the mean bone marrow micro vessel density is higher before the stem cell transplant than after the stem cell transplant?
b. Interpret the meaning of the p-value in (a).
c. Construct and interpret a 95% confidence interval estimate of the mean difference in bone marrow micro vessel density before and after the stem cell transplant.
d. What assumption is necessary about the population distribution in order to perform the test in (a)?

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