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We perform the first simultaneous Bayesian parameter inference and optimal reconstruction of the gravitational lensing of the cosmic microwave background (CMB), using 100 deg$^2$ of polarization observations from the SPTpol receiver on the South Pole Telescope. These data reach noise levels as low as 5.8 $\mu$K-arcmin in polarization, which are low enough that the typically used quadratic estimator (QE) technique for analyzing CMB lensing is significantly sub-optimal. Conversely, the Bayesian procedure extracts all lensing information from the data and is optimal at any noise level. We infer the amplitude of the gravitational lensing potential to be $A_\phi\,{=}\,0.949\,{\pm}\,0.122$ using the Bayesian pipeline, consistent with our QE pipeline result, but with 17\% smaller error bars. The Bayesian analysis also provides a simple way to account for systematic uncertainties, performing a similar job as frequentist "bias hardening," and reducing the systematic uncertainty on $A_\phi$ due to polarization calibration from almost half of the statistical error to effectively zero. Finally, we jointly constrain $A_\phi$ along with $A_{\rm L}$, the amplitude of lensing-like effects on the CMB power spectra, demonstrating that the Bayesian method can be used to easily infer parameters both from an optimal lensing reconstruction and from the delensed CMB, while exactly accounting for the correlation between the two. These results demonstrate the feasibility of the Bayesian approach on real data, and pave the way for future analysis of deep CMB polarization measurements with SPT-3G, Simons Observatory, and CMB-S4, where improvements relative to the QE can reach 1.5 times tighter constraints on $A_\phi$ and 7 times lower effective lensing reconstruction noise., Comment: 27 pages, 14 figures, accompanying software package available at https://cosmicmar.com/CMBLensing.jl

We study the polarization properties of extragalactic sources at 95 and 150 GHz in the SPTpol 500 deg2 survey. We estimate the polarized power by stacking maps at known source positions, and correct for noise bias by subtracting the mean polarized power at random positions in the maps. We show that the method is unbiased using a set of simulated maps with similar noise properties to the real SPTpol maps. We find a flux-weighted mean-squared polarization fraction 〈p2〉= [8.9 ± 1.1] × 10−4 at 95 GHz and [6.9 ± 1.1] × 10−4 at 150 GHz for the full sample. This is consistent with the values obtained for a subsample of active galactic nuclei. For dusty sources, we find 95 per cent upper limits of 〈p2〉95 < 16.9 × 10−3 and 〈p2〉150 < 2.6 × 10−3. We find no evidence that the polarization fraction depends on the source flux or observing frequency. The 1σ upper limit on measured mean-squared polarization fraction at 150 GHz implies that extragalactic foregrounds will be subdominant to the CMB E and B mode polarization power spectra out to at least ℓ ≲ 5700 (ℓ ≲ 4700) and ℓ ≲ 5300 (ℓ ≲ 3600), respectively, at 95 (150) GHz.

We study the polarization properties of extragalactic sources at 95 and 150 GHz in the SPTpol 500 deg2 survey. We estimate the polarized power by stacking maps at known source positions, and correct for noise bias by subtracting the mean polarized power at random positions in the maps. We show that the method is unbiased using a set of simulated maps with similar noise properties to the real SPTpol maps. We find a flux-weighted mean-squared polarization fraction 〈p2〉= [8.9 ± 1.1] × 10−4 at 95 GHz and [6.9 ± 1.1] × 10−4 at 150 GHz for the full sample. This is consistent with the values obtained for a subsample of active galactic nuclei. For dusty sources, we find 95 per cent upper limits of 〈p2〉95 < 16.9 × 10−3 and 〈p2〉150 < 2.6 × 10−3. We find no evidence that the polarization fraction depends on the source flux or observing frequency. The 1σ upper limit on measured mean-squared polarization fraction at 150 GHz implies that extragalactic foregrounds will be subdominant to the CMB E and B mode polarization power spectra out to at least ℓ ≲ 5700 (ℓ ≲ 4700) and ℓ ≲ 5300 (ℓ ≲ 3600), respectively, at 95 (150) GHz.

We report the first detection of gravitational lensing due to galaxy clusters using only the polarization of the cosmic microwave background (CMB). The lensing signal is obtained using a new estimator that extracts the lensing dipole signature from stacked images formed by rotating the cluster-centered Stokes QU map cutouts along the direction of the locally measured background CMB polarization gradient. Using data from the SPTpol 500 deg^{2} survey at the locations of roughly 18 000 clusters with richness λ≥10 from the Dark Energy Survey (DES) Year-3 full galaxy cluster catalog, we detect lensing at 4.8σ. The mean stacked mass of the selected sample is found to be (1.43±0.40)×10^{14}M_{⊙} which is in good agreement with optical weak lensing based estimates using DES data and CMB-lensing based estimates using SPTpol temperature data. This measurement is a key first step for cluster cosmology with future low-noise CMB surveys, like CMB-S4, for which CMB polarization will be the primary channel for cluster lensing measurements.

Background Previous studies have evaluated the physiological responses to video game in children with different clinical conditions, however, although no study has compared video game active with an incremental field test in healthy children. The purpose of this study was to compare the maximum heart rate (HRmax) of children, their perceived exertion and motivation during the shuttle run test (SRT) and the Virtual Systems (VS) test, an interactive video game.Methods This is a cross-sectional study of 235 children (9.0 ± 0.8 years, 109 boys). The two tests were performed one week apart and the children were instructed not to engage in any physical exercise or sports in the 24 hours preceding each test. Their heart rate was monitored at rest for one minute and then throughout the tests. To evaluate the influence of motivation on test execution (SRT and VS), at the end of the tests the children were asked to rate their motivation based on a scale from zero to 10, zero being “not cool” and 10 “awesome”. Perceived exertion at the end of the tests was assessed using the modified Borg scale.Results HRmax did not differ between the SRT and VS (194.4 ± 10.2 bpm vs. 193.2 ± 13.8 bpm, respectively). Both tests were similar in intensity > and < 96% HRmax. The children showed greater exertion on the Borg scale and motivation during the VS. The multiple logistic regression model showed that motivation (p=0.98), sex (p=0.53), age (p=0.61), nutritional status (p=0.65), and speed (p=0.18) were not predictive factors of whether the child would reach HRmax.Conclusion The VS can be used as a tool to evaluate the intensity of maximal exercise tests given that the percentage of children who achieved HRmax did not differ between the VS and SRT. The perceived exertion scales were correlated, but only the modified Borg scale correlated with HRmax in the SRT. The tests are motivational, and most children obtained the maximum score in the VS

OBJECTIVE: To explore genetic and lifestyle risk factors of MRI-defined brain infarcts (BI) in large population-based cohorts. METHODS: We performed meta-analyses of genome-wide association studies (GWAS) and examined associations of vascular risk factors and their genetic risk scores (GRS) with MRI-defined BI and a subset of BI, namely, small subcortical BI (SSBI), in 18 population-based cohorts (n = 20,949) from 5 ethnicities (3,726 with BI, 2,021 with SSBI). Top loci were followed up in 7 population-based cohorts (n = 6,862; 1,483 with BI, 630 with SBBI), and we tested associations with related phenotypes including ischemic stroke and pathologically defined BI. RESULTS: The mean prevalence was 17.7% for BI and 10.5% for SSBI, steeply rising after age 65. Two loci showed genome-wide significant association with BI: FBN2, p = 1.77 x 10(-8); and LINC00539/ZDHHC20, p = 5.82 x 10(-9). Both have been associated with blood pressure (BP)-related phenotypes, but did not replicate in the smaller follow-up sample or show associations with related phenotypes. Age- and sex-adjusted associations with BI and SSBI were observed for BP traits (p value for BI, p [BI] = 9.38 x 10(-25); p [SSBI] = 5.23 x 10(-14) for hypertension), smoking (p [BI] = 4.4 x 10(-10); p [SSBI] = 1.2 x 10(-4)), diabetes (p [BI] = 1.7 x 10(-8); p [SSBI] = 2.8 x 10(-3)), previous cardiovascular disease (p [BI] = 1.0 x 10(-18); p [SSBI] = 2.3 x 10(-7)), stroke (p [BI] = 3.9 x 10(-69); p [SSBI] = 3.2 x 10(-24)), and MRI-defined white matter hyperintensity burden (p [BI] = 1.43 x 10(-157); p [SSBI] = 3.16 x 10(-106)), but not with body mass index or cholesterol. GRS of BP traits were associated with BI and SSBI (p

An in vitro system for the investigation of the behaviour of contrast microbubbles in an ultrasound field, that provides a full diagnostic range of settings, is yet to be presented in the literature. The evaluation of a good compromise of such a system is presented in this paper. It is based on (a) an HDI3000 ATL scanner (Bothell, WA, USA) externally controlled by a PC and (b) on the use of well-defined reference materials. The suspensions of the reference ultrasonic scattering material are placed in an anechoic tank. The pulse length ranges from 2 to 10 cycles, the acoustic pressure from 0.08 to 1.8 MPa, the transmit frequency from 1 to 4.3 MHz, and the receive frequency from 1 to 8 MHz. The collection of 256 samples of RF data, at an offset distance from the transducer face, was performed at 20 MHz digitization rate, which corresponds to approximately 1 cm depth in water. Two particle suspensions are also presented for use as reference scatterers for contrast studies: (a) a suspension of Orgasol® (ELF Atochem, Paris, France) particles ( 5 μm mean diameter) and (b) a suspension of Eccosphere® (New Metals & Chemicals Ltd, Essex, UK) particles ( 50 μm mean diameter). A preliminary experiment with the contrast agent Definity (DuPont Pharmaceutical Co, Waltham, MA) showed that the above two materials are suitable for use as a reference for contrast backscatter. 46 3301 3321 3301-3321

PURPOSE: To evaluate the size and shape of commercially available polyvinyl alcohol (PVA) particles and to determine whether they change in size when suspended in nonionic contrast and in a solution of nonionic contrast and absolute alcohol. METHODS: The two-dimensional area and the long and short axis of PVA particles from several different vendors were measured using a light microscope attached to a video system and an image-processing software program. Particles were measured as packaged (dry or suspended in saline), suspended in ioversol, and suspended in ioversol containing 30% alcohol. RESULTS: All brands of dry particles had similar microscopic appearances. The saline-suspended particles had fewer and finer perforations. After suspension in contrast, all sizes and brands of dry particles significantly increased in size. The particles packaged in saline did not expand. The addition of alcohol to the contrast did not consistently change particle size. Particle aggregation was similar in both contrast suspensions for all groups of particles. Particles less than 50 microns in size were rarely observed in any PVA preparation after suspension. CONCLUSIONS: The three dry PVA preparations seem to be similar. All increase significantly in size when suspended in nonionic contrast or contrast-alcohol solutions. The saline-packaged PVA particles were different from the dry variety and did not enlarge in contrast or contrast-alcohol solutions. Alcohol did not change the size or suspension characteristics of PVA particles. Particles less than 50 microns in size were rarely identified.

Human intracranial tumours were treated using local heat therapy produced by surgically implanted catheters containing local resistive heating elements. Changes in local tumor blood flow were assessed indirectly from an algorithm based on the bioheat transfer equation. The algorithm used the ratio of catheter power to catheter temperature rise to estimate regional blood perfusion. Local heat therapy produced consistent reductions in local apparent perfusion. Changes in apparent regional perfusion occurred in intriguing patterns that gave clues to possible vascular events of therapeutic significance.

The dynamic nature of blood flow during hyperthermia therapy has made the control of minimum tumor temperature a difficult task. This paper presents initial studies of a novel approach to closed-loop control of local minimum tissue temperatures utilizing a newly developed estimation algorithm for use with conductive interstitial heating systems. The local minimum tumor temperature is explicitly estimated from the power required to maintain each member of an array of electrically heated catheters at a known temperature, in conjunction with a new bioheat equation-based algorithm to predict the ‘droop’ or fractional decline in tissue temperature between heated catheters. A closed loop controller utilizes the estimated minimum temperature near each catheter as a feedback parameter, which reflects variations in local blood flow. In response the controller alters delivered power to each catheter to compensate for changes in blood flow. The validity and stability of this estimation/control scheme were tested in computer simulations and in closed-loop control of nine patient treatments. The average estimation error from patient data analysis of 21 sites at which temperature was independently measured (three per patient) was 0.0 oC, with a standard deviation of 0.8 oC. These results suggest that estimation of local minimum temperature and feedback control of power delivery can be employed effectively during conductive interstitial heat therapy of intracranial tumors in man.

The goal of heat therapy in the treatment of malignant disease is to raise the temperature of all neoplastic tissue to a cytotoxic temperature for a predetermined period of time. This seemingly simple task has proved difficult in-vivo, in part because of nonuniform power absorption and in part because of nonhomogeneous and time varying tumour blood flow. We have addressed this difficulty first by utilizing the conceptually simple technique of conductive interstitial hyperthermia, in which the tumour is warmed by multiple, electrically heated catheters, and second by implementing on-line conu·ol of minimum tumour temperatures near each catheter, estimated on the basis of the steadystate ratio of catheter power to catheter temperature rise. This report presents an analysis of the accuracy, precision, and stability of the on-line minimum temperature estimation/conu·ol technique for 22 patients who received 31 separate courses of conductive interstitial hyperthermia for the treatment of malignant brain tumours, and in whom temperature was monitored independently by 12 to 16 independent sensors per patient. In all patients, the technique was found to accurately and precisely estimate and control the local minimum temperatures. Comparison of measured and estimated temperatures revealed a mean difference of 0.0 ±0.4 °C for those sensors within 1.0 mm of the expected location for minimum temperatures. This technique, therefore, offers an attractive method for controlling hyperthermia therapy -- even in the presence of time varying local blood flow.

Accurate knowledge of tissue temperature is necessary for effective delivery of clinical hyperthermia in the treatment of malignant tumours. This report compares computer-predicted versus measured intratumoral temperatures in 11 human subjects with intracranial tumours, treated with a conceptually simple 'conductive' interstitial hyperthermia system. Interstitial hyperthermia was achieved by the use of parallel arrays of implanted, electrically heated catheters. The tissue was warmed by thermal conduction and blood convection. Simulation of intratumoral temperatures was achieved by solving a modified bioheat transfer equation on a digital computer using a finite difference method. Comparison of intratumoral temperatures from simulations and measured values differed by about ± 0.75 oC. Further analysis of computed temperature distributions between catheters revealed a rapidly computable relationship between the local minimum tumour temperature and nearby catheter power and temperature that accounts for effects of varying blood flow. These findings suggest that 'on-line' prediction and control of local minimum tumour temperatures are feasible with the conductive interstitial technique.

Context: Patients with resistance to thyroid hormone (TH) α (RTHα) are characterized by growth retardation, macrocephaly, constipation, and abnormal thyroid function tests. In addition, almost all RTHα patients have mild anemia, the pathogenesis of which is unknown. Animal studies suggest an important role for TH and TH receptor (TR)α in erythropoiesis. Objective: To investigate whether a defect in TRα affects the maturation of red blood cells in RTHα patients. Design, Setting, and Patients: Cultures of primary human erythroid progenitor cells (HEPs), from peripheral blood of RTHα patients (n = 11) harboring different inactivating mutations in TRα (P398R, F397fs406X, C392X, R384H, A382fs388X, A263V, A263S), were compared with healthy controls (n = 11). During differentiation, erythroid cells become smaller, accumulate hemoglobin, and express different cell surface markers. We assessed cell number and cell size, and used cell staining and fluorescence-activated cell sorter analysis to monitor maturation at different time points. Results: After ∼14 days of ex vivo expansion, both control and patient-derived progenitors differentiated spontaneously. However, RTHα-derived cells differentiated more slowly. During spontaneous differentiation, RTHα-derived HEPs were larger, more positive for c-Kit (a proliferation marker), and less positive for glycophorin A (a differentiation marker). The degree of abnormal spontaneous maturation of RTHα-derived progenitors did not correlate with severity of underlying TRα defect. Both control and RTHα-derived progenitors responded similarly when differentiation was induced. T3 exposure accelerated differentiation of both control- and RTHα patient-derived HEPs. Conclusions: Inactivating mutations in human TRα affect the balance between proliferation and differentiation of progenitor cells during erythropoiesis, which may contribute to the mild anemia seen in most RTHα patients.

Resistance to Thyroid Hormone beta (RTHβ) due to homozygous THRB defects is exceptionally rare, with only five cases reported worldwide; cardiac dysfunction, which can be life-threatening, is recognised in the disorder. Here we describe the clinical, metabolic, ophthalmic and cardiac findings in a nine-year old boy harbouring a biallelic THRB mutation (R243Q), along with biochemical, physiological and cardiac responses to carbimazole and triiodothyroacetic acid (TRIAC) therapy. The patient exhibits recognised features (goitre, non-suppressed TSH levels, upper respiratory tract infections, hyperactivity, low body mass index) of heterozygous RTHβ, with additional characteristics (dysmorphic facies, winging of scapulae) and more markedly elevated thyroid hormone levels, associated with the homozygous form of the disorder. Notably, an older sibling with similar clinical features and probable homozygous RTHβ, had died of cardiac failure at age 13 yrs. Features of early dilated cardiomyopathy in our patient prompted combination treatment with carbimazole and TRIAC. Careful titration of therapy limited elevation in TSH levels and associated increase in thyroid volume. Subsequently, sustained reduction in thyroid hormones with normal TSH levels was reflected in lower basal metabolic rate, gain of lean body mass and improved growth and cardiac function. A combination of anti-thyroid drug and TRIAC therapy may prevent hyrotoxic cardiomyopathy and its decompensation in homozygous or even heterozygous RTHβ in which life-threatening hyperthyroid features predominate.

PURPOSE: To examine the effect of intraoperative angiography on neurosurgery and angiographic technical success, safety, and accuracy. METHODS: Angiographic studies, surgical reports, and hospital records were reviewed retrospectively for 112 consecutive procedures in which intraoperative angiography was performed during neurosurgery. The results of conventional postoperative angiograms in 28 of the 112 procedures were also reviewed. A portable digital subtraction angiography unit was used for all patients. Decisions in the operating room were based on review of stored videotaped images. RESULTS: Eighteen studies were obtained in 14 patients after arteriovenous malformation resection. Unsuspected residual nidus was identified and resected in 3 patients. The intraoperative angiogram also altered therapy for 2 patients undergoing staged resections of arteriovenous malformations. Sixty-six studies were performed after aneurysm clipping, with clinically significant changes in surgical therapy made in 5 patients. Of 28 examinations after carotid endarterectomy, 3 led to revision. Two complications of angiography occurred. One led to a permanent neurologic deficit, yielding a complication rate of 1.5% for stroke. Two examinations could not be completed because of technical factors. Two false-negative examinations were identified on postoperative studies. One patient with a normal intraoperative study after carotid endarterectomy thrombosed the repaired internal carotid artery after surgery. CONCLUSIONS: Intraoperative angiography altered surgery in 13 of 112 procedures on 104 patients. This study supports the use of intraoperative angiography in arteriovenous malformation resection and in complex aneurysm surgery, but not for routine carotid endarterectomy.