The Atacama Cosmology Telescope: A Measurement of the DR6 CMB Lensing Power Spectrum and its Implications for Structure Growth

We present new measurements of cosmic microwave background (CMB) lensing over $9400$ sq. deg. of the sky. These lensing measurements are derived from the Atacama Cosmology Telescope (ACT) Data Release 6 (DR6) CMB dataset, which consists of five seasons of ACT CMB temperature and polarization observations. We determine the amplitude of the CMB lensing power spectrum at $2.3\%$ precision ($43\sigma$ significance) using a novel pipeline that minimizes sensitivity to foregrounds and to noise properties. To ensure our results are robust, we analyze an extensive set of null tests, consistency tests, and systematic error estimates and employ a blinded analysis framework. The baseline spectrum is well fit by a lensing amplitude of $A_{\mathrm{lens}}=1.013\pm0.023$ relative to the Planck 2018 CMB power spectra best-fit $\Lambda$CDM model and $A_{\mathrm{lens}}=1.005\pm0.023$ relative to the $\text{ACT DR4} + \text{WMAP}$ best-fit model. From our lensing power spectrum measurement, we derive constraints on the parameter combination $S^{\mathrm{CMBL}}_8 \equiv \sigma_8 \left({\Omega_m}/{0.3}\right)^{0.25}$ of $S^{\mathrm{CMBL}}_8= 0.818\pm0.022$ from ACT DR6 CMB lensing alone and $S^{\mathrm{CMBL}}_8= 0.813\pm0.018$ when combining ACT DR6 and Planck NPIPE CMB lensing power spectra. These results are in excellent agreement with $\Lambda$CDM model constraints from Planck or $\text{ACT DR4} + \text{WMAP}$ CMB power spectrum measurements. Our lensing measurements from redshifts $z\sim0.5$--$5$ are thus fully consistent with $\Lambda$CDM structure growth predictions based on CMB anisotropies probing primarily $z\sim1100$. We find no evidence for a suppression of the amplitude of cosmic structure at low redshiftsComment: 45+21 pages, 50 figures. Prepared for submission to ApJ. Also see companion papers Madhavacheril et al and MacCrann et a

The Atacama Cosmology Telescope: High-resolution component-separated maps across one-third of the sky

Observations of the millimeter sky contain valuable information on a number of signals, including the blackbody cosmic microwave background (CMB), Galactic emissions, and the Compton-$y$ distortion due to the thermal Sunyaev-Zel'dovich (tSZ) effect. Extracting new insight into cosmological and astrophysical questions often requires combining multi-wavelength observations to spectrally isolate one component. In this work, we present a new arcminute-resolution Compton-$y$ map, which traces out the line-of-sight-integrated electron pressure, as well as maps of the CMB in intensity and E-mode polarization, across a third of the sky (around 13,000 sq.~deg.). We produce these through a joint analysis of data from the Atacama Cosmology Telescope (ACT) Data Release 4 and 6 at frequencies of roughly 93, 148, and 225 GHz, together with data from the \textit{Planck} satellite at frequencies between 30 GHz and 545 GHz. We present detailed verification of an internal linear combination pipeline implemented in a needlet frame that allows us to efficiently suppress Galactic contamination and account for spatial variations in the ACT instrument noise. These maps provide a significant advance, in noise levels and resolution, over the existing \textit{Planck} component-separated maps and will enable a host of science goals including studies of cluster and galaxy astrophysics, inferences of the cosmic velocity field, primordial non-Gaussianity searches, and gravitational lensing reconstruction of the CMB.Comment: The Compton-y map and associated products will be made publicly available upon publication of the paper. The CMB T and E mode maps will be made available when the DR6 maps are made publi

The Atacama Cosmology Telescope: DR6 Gravitational Lensing Map and Cosmological Parameters

We present cosmological constraints from a gravitational lensing mass map covering 9400 sq. deg. reconstructed from CMB measurements made by the Atacama Cosmology Telescope (ACT) from 2017 to 2021. In combination with BAO measurements (from SDSS and 6dF), we obtain the amplitude of matter fluctuations $\sigma_8 = 0.819 \pm 0.015$ at 1.8% precision, $S_8\equiv\sigma_8({\Omega_{\rm m}}/0.3)^{0.5}=0.840\pm0.028$ and the Hubble constant $H_0= (68.3 \pm 1.1)\, \text{km}\,\text{s}^{-1}\,\text{Mpc}^{-1}$ at 1.6% precision. A joint constraint with CMB lensing measured by the Planck satellite yields even more precise values: $\sigma_8 = 0.812 \pm 0.013$, $S_8\equiv\sigma_8({\Omega_{\rm m}}/0.3)^{0.5}=0.831\pm0.023$ and $H_0= (68.1 \pm 1.0)\, \text{km}\,\text{s}^{-1}\,\text{Mpc}^{-1}$. These measurements agree well with $\Lambda$CDM-model extrapolations from the CMB anisotropies measured by Planck. To compare these constraints to those from the KiDS, DES, and HSC galaxy surveys, we revisit those data sets with a uniform set of assumptions, and find $S_8$ from all three surveys are lower than that from ACT+Planck lensing by varying levels ranging from 1.7-2.1$\sigma$. These results motivate further measurements and comparison, not just between the CMB anisotropies and galaxy lensing, but also between CMB lensing probing $z\sim 0.5-5$ on mostly-linear scales and galaxy lensing at $z\sim 0.5$ on smaller scales. We combine our CMB lensing measurements with CMB anisotropies to constrain extensions of $\Lambda$CDM, limiting the sum of the neutrino masses to $\sum m_{\nu} < 0.12$ eV (95% c.l.), for example. Our results provide independent confirmation that the universe is spatially flat, conforms with general relativity, and is described remarkably well by the $\Lambda$CDM model, while paving a promising path for neutrino physics with gravitational lensing from upcoming ground-based CMB surveys.Comment: 30 pages, 16 figures, prepared for submission to ApJ. Cosmological likelihood data is here: https://lambda.gsfc.nasa.gov/product/act/actadv_prod_table.html ; likelihood software is here: https://github.com/ACTCollaboration/act_dr6_lenslike . Also see companion papers Qu et al and MacCrann et al. Mass maps will be released when papers are publishe

Widespread genomic influences on phenotype in Dravet syndrome, a ‘monogenic’ condition

Dravet syndrome is an archetypal rare severe epilepsy, considered “monogenic”, typically caused by loss-of-function SCN1A variants. Despite a recognisable core phenotype, its marked phenotypic heterogeneity is incompletely explained by differences in the causal SCN1A variant or clinical factors. In 34 adults with SCN1A-related Dravet syndrome, we show additional genomic variation beyond SCN1A contributes to phenotype and its diversity, with an excess of rare variants in epilepsy-related genes as a set and examples of blended phenotypes, including one individual with an ultra-rare DEPDC5 variant and focal cortical dysplasia. Polygenic risk scores for intelligence are lower, and for longevity, higher, in Dravet syndrome than in epilepsy controls. The causal, major-effect, SCN1A variant may need to act against a broadly compromised genomic background to generate the full Dravet syndrome phenotype, whilst genomic resilience may help to ameliorate the risk of premature mortality in adult Dravet syndrome survivors

The Atacama Cosmology Telescope: A measurement of the DR6 CMB lensing power spectrum and its implications for structure growth

We present new measurements of cosmic microwave background (CMB) lensing over 9400 deg2 of the sky. These lensing measurements are derived from the Atacama Cosmology Telescope (ACT) Data Release 6 (DR6) CMB data set, which consists of five seasons of ACT CMB temperature and polarization observations. We determine the amplitude of the CMB lensing power spectrum at 2.3% precision (43σ significance) using a novel pipeline that minimizes sensitivity to foregrounds and to noise properties. To ensure that our results are robust, we analyze an extensive set of null tests, consistency tests, and systematic error estimates and employ a blinded analysis framework. Our CMB lensing power spectrum measurement provides constraints on the amplitude of cosmic structure that do not depend on Planck or galaxy survey data, thus giving independent information about large-scale structure growth and potential tensions in structure measurements. The baseline spectrum is well fit by a lensing amplitude of A lens = 1.013 ± 0.023 relative to the Planck 2018 CMB power spectra best-fit ΛCDM model and A lens = 1.005 ± 0.023 relative to the ACT DR4 + WMAP best-fit model. From our lensing power spectrum measurement, we derive constraints on the parameter combination S8CMBL≡σ8Ωm/0.30.25 of S8CMBL=0.818±0.022 from ACT DR6 CMB lensing alone and S8CMBL=0.813±0.018 when combining ACT DR6 and Planck NPIPE CMB lensing power spectra. These results are in excellent agreement with ΛCDM model constraints from Planck or ACT DR4 + WMAP CMB power spectrum measurements. Our lensing measurements from redshifts z ∼ 0.5–5 are thus fully consistent with ΛCDM structure growth predictions based on CMB anisotropies probing primarily z ∼ 1100. We find no evidence for a suppression of the amplitude of cosmic structure at low redshifts

The Atacama Cosmology Telescope: DR6 gravitational lensing map and cosmological parameters

We present cosmological constraints from a gravitational lensing mass map covering 9400 deg2 reconstructed from measurements of the cosmic microwave background (CMB) made by the Atacama Cosmology Telescope (ACT) from 2017 to 2021. In combination with measurements of baryon acoustic oscillations and big bang nucleosynthesis, we obtain the clustering amplitude σ 8 = 0.819 ± 0.015 at 1.8% precision, S8≡σ8(Ωm/0.3)0.5=0.840±0.028 , and the Hubble constant H 0 = (68.3 ± 1.1) km s−1 Mpc−1 at 1.6% precision. A joint constraint with Planck CMB lensing yields σ 8 = 0.812 ± 0.013, S8≡σ8(Ωm/0.3)0.5=0.831±0.023 , and H 0 = (68.1 ± 1.0) km s−1 Mpc−1. These measurements agree with ΛCDM extrapolations from the CMB anisotropies measured by Planck. We revisit constraints from the KiDS, DES, and HSC galaxy surveys with a uniform set of assumptions and find that S 8 from all three are lower than that from ACT+Planck lensing by levels ranging from 1.7σ to 2.1σ. This motivates further measurements and comparison, not just between the CMB anisotropies and galaxy lensing but also between CMB lensing probing z ∼ 0.5–5 on mostly linear scales and galaxy lensing at z ∼ 0.5 on smaller scales. We combine with CMB anisotropies to constrain extensions of ΛCDM, limiting neutrino masses to ∑m ν < 0.13 eV (95% c.l.), for example. We describe the mass map and related data products that will enable a wide array of cross-correlation science. Our results provide independent confirmation that the universe is spatially flat, conforms with general relativity, and is described remarkably well by the ΛCDM model, while paving a promising path for neutrino physics with lensing from upcoming ground-based CMB surveys

Untersuchungen zur Bedeutung des präpartalen Progesteronentzugs in Hinblick auf die Steuerung der Geburt und die Ablösung der Nachgeburt beim Rind

Beim Rind ist der präpartale Abfall der maternalen Progesteron (P4)-Konzentration Voraussetzung für den Eintritt der Geburt. Der P4-Abfall spiegelt beim Rind primär den Funktionsverlust des Trächtigkeitsgelbkörpers wider. Über die Bedeutung der plazentaren P4-Produktion lagen bisher praktisch keine Informa¬tionen vor. Die Rinder¬plazenta trägt in der Endphase der Gravidität zwar nur minimal zu den maternalen P4-Spiegeln bei, jedoch bildet sie hohe lokale P4-Konzentrationen im Bereich der feto-maternalen Kontakt¬zone. Diese könnten, vermittelt über P4-Rezeptoren (PR) in den maternalen Karunkeln, ein wesentlicher Faktor für die Differenzie¬rung und Funktion der Plazentome sein. Es wurde die Arbeits¬hypothese ent¬wickelt, dass der Entzug hoher lokaler P4-Konzentrationen ein wesentliches Signal für die Vorbereitung eines termin¬gerechten Nachgeburtsabganges darstellt. Entsprechend könnte ein unvollständiges Sistieren der plazentaren P4-Produktion vor der Geburt eine wesentliche Ursache für das Auftreten idiopathischer Nachge-burts¬verhaltungen sein. Zur Überprüfung dieser Hypo¬these wurden drei gravide Kühe am 270. und 271. Graviditätstag mit dem Antigestagen Aglepriston (Ap) behandelt (Gruppe D272+Ap). Dieser PR-Blocker ermöglicht die Ausschaltung aller rezeptor¬vermittelten P4-Wirkungen unabhängig von der P4-Quelle. Als Kontrollen dienten Tiere mit termin¬gerechter spontaner Geburt und termingerechtem Nachgeburts¬abgang (Gruppe Normalgeburt, n = 4, Trächtigkeitsdauer: 280,5 ± 1,7 Tage) sowie unbehan¬delte Tiere mit Schnitt¬entbindung am Tag 272 (Gruppe D272-Ap, n = 3). Die Kühe wurden klinisch überwacht und der Geburtsverlauf dokumentiert. Von allen Tieren wurden Blutproben in regelmäßigen Abständen sowie Plazentome unmittelbar im Anschluss an die Geburt (Gruppen D272+Ap und Normalgeburt) bzw. während der Schnittentbindungen (Gruppe D272-Ap) entnommen. In den Blutproben wurden die Konzentrationen von Progesteron und Östrogenen mittels radioimmuno¬logischer Verfahren und die 13, 14-Di¬hydro-15-Keto-PGF2&#945; (PGFM)-Konzentrationen mittels ELISA gemessen. Als Parameter für die präpartale Umstrukturierung der Plazentome wurde der prozen¬tuale Anteil der Trophoblast-riesenzellen (TGC) an den Trophoblastzellen und die Reduktion des Karunkelepithels erfasst. Weiterhin wurde die Expression von Cyclooxygenase II (Cox II), PR und Glucocorticoidrezeptor (GR) auf Protein- und mRNA-Ebene beurteilt. Die Aglepristonbehandlung führte bei allen drei Kühen zu einer vorzeitigen Terminie¬rung der Gravidität. Erste Geburtsanzeichen traten 46,3 ± 6,0 Stunden nach Be¬handlungsbeginn auf. Es kam zur vollständigen Öffnung der Zervix, eine adäquate Wehentätigkeit setzte jedoch innerhalb der folgenden zwei Stunden nicht ein. So wurde ein manueller Auszug der Kälber durchgeführt. Neben der Öffnung der Zervix wurde durch die Antigestagenbehandlung die Laktogenese induziert. Entge¬gen der eigenen Hypothese wiesen alle drei Kühe der Gruppe D272+Ap, wie die Tiere der Gruppe D272-Ap, eine komplette Nachgeburts¬ver¬haltung auf und die Kälber beider Gruppen waren gleichermaßen prämatur. Die histo¬morphologischen Unter¬suchungen bestätigten, dass durch die Aglepriston¬behand¬lung die präpartale „Plazentareifung“ nicht induziert wurde. So waren, im Gegensatz zur Normalgeburtsgruppe, in den unreifen Plazentomen der Gruppen D272+Ap und D272&#8722;Ap weder ein Rück¬gang des relativen Anteils der TGC noch eine Reduktion des Karunkelepithels nach¬weisbar. Überraschenderweise wurde durch die Antigestagenbehandlung die Luteolyse induziert, erkennbar an einem steilen Abfall der P4-Werte vor bzw. während des Auszugs der Kälber. Korrespondierend mit dem Abfall der P4-Konzen¬tra¬tionen wurde bei den Tieren der Gruppe D272+Ap bereits präpartal ein schwacher Anstieg der PGFM-Werte beobachtet. Da bei diesen Tieren, im Gegensatz zur Normal¬geburtsgruppe, keine Aufregulation der plazentaren Cox II-Expression nach¬weisbar war, ist anzunehmen, dass die Antigestagen-induzierte Luteolyse indirekt durch Prostaglandine extraplazentaren, vermutlich endometrialen, Ursprungs aus¬gelöst wurde. Zum Zeitpunkt des Auszugs waren die PGFM-Plasma¬konzentrationen im Vergleich zur Normalgeburtsgruppe jedoch relativ gering (2,14 ± 1,40 ng/ml vs. 8,70 ± 2,20 ng/ml). Somit erklärt vermutlich ein Mangel an uterotonem PGF2&#945; die Wehen¬schwäche bei den Aglepriston-behandelten Tieren. Die Östrogen¬synthese im Trophoblasten sowie die GR- bzw. PR-Expression in den Plazentomen wurden durch das Antigestagen nicht beeinflusst. Insgesamt lassen die Ergebnisse dieser Arbeit darauf schließen, dass nur ein relativ geringer Anteil der geburtsassoziierten Veränderungen direkt durch den präpartalen Progesteronentzug ausgelöst wird, nämlich die Öffnung der Zervix und das Einsetzen der Laktation. Dagegen erfordern andere wesentliche geburtsassoziierte Vorgänge, wie eine adäquate Wehentätigkeit und die Ablö¬sung der Plazenta, offensichtlich primär Signale aus dem fetalen Kompartiment. Die eigenständige Bedeutung der plazentaren P4¬-Produktion bleibt unklar.In cattle the prepartal decline in maternal progesterone (P4) levels is a prerequisite for the onset of parturition. This P4 withdrawal predominantly reflects the loss of luteal function, and virtually no information on the importance of placental P4 production is available. Despite its minimal contribution to maternal P4 levels in late gestation the bovine placenta is capable of producing high P4 levels locally at the feto-maternal interface, which – mediated by progesterone receptors (PR) previously detected in the maternal caruncles – could be an essential factor in placental differentiation and function. Thus, the hypothesis was put forward that a well-timed and complete withdrawal of high local P4 concentrations is a crucial signal for the timely release of the placenta. According to this concept, an incomplete cessation of placental P4 production during the initiation of parturition could be an important factor in the etiology of placental retention. To test for this hypothesis, three cows were treated with the antiprogestin aglepristone (Ap) on days 270 and 271 of gestation to abolish receptor mediated effects of P4 irrespective of its origin (group D272+Ap). As controls, four cows giving spontaneous birth at normal term (280.5 ± 1.7 days, group NT) with timely release of fetal membranes and three cows undergoing cesarean section on day 272 (group D272-Ap) were included into the study. The cows were monitored clinically, and the progress of birth was registered. From all animals, blood samples were taken regularly during the experimental period, and placentomes were removed per vaginam immediately after birth (groups D272+Ap and NT) or during cesarean section (group D272-Ap). In blood samples, con-centrations of P4 and estrogens were measured by radioimmunological methods, and for the measurement of 13, 14-dihydro-15-keto prostaglandin F2&#945; (PGFM)-concentrations a commercial ELISA kit was used. To characterize the prepartal remodeling of placentomal microarchitecture, the percentage of trophoblast giant cells (TGC) relative to the total number of trophoblast cells and the reduction of caruncular epithelium were determined. Moreover, the expression of cyclo-oxygenase II (Cox II), PR and glucocorticoid receptor (GR) was investigated at protein and mRNA level. The application of aglepristone significantly reduced gestational length. First signs of impending parturition occurred 46.3 ± 6.0 hours after the start of treatment, and vaginal exploration confirmed that the cervix was fully open during this time. However, no progress in the expulsion of the calves could be observed during the following two hours, obviously due to insufficient myometrial activity. Consequently the calves were extracted. Besides a complete opening of the cervix, antiprogestin treatment induced the onset of lactation. Inconsistent with the working hypothesis, in all cows of the treatment group a severe retention of fetal membranes was observed. Similar cases of retained fetal membrane were also observed in all D272-Ap cows, and calves of both groups were slightly premature to a similar extent. Consistent with clinical observations histological investigations of placentomes showed that antiprogestin treatment did not induce placental maturation, whereas for the placentomes of NT cows the prepartal decline in TGC numbers and the reduction of caruncular epithelium was confirmed. Surprisingly, antiprogestin treatment induced luteolysis, as a significant decline of progesterone concentrations started before or during the expulsion of the calf. Con¬comitant with the decline in P4 concentrations in D272+Ap cows an increase of PGFM levels became detectable. The fact that, different from NT animals, no up-regu¬lation of placental Cox II was found suggests that the antiprogestin induced luteolysis indirectly stimulated prostaglandin pro¬duction from an extraplacental source, presumably the intercaruncular endometrium. However, at parturition PGFM levels in D272+Ap cows were clearly lower in comparison to NT cows (2.14 ± 1.40 ng/ml vs. 8.70 ± 2.20 ng/ml), which suggests that insufficient myometrial activity observed in antiprogestin treated cows was related to a reduced availability of uterotonic PGF2&#945;. Placental estrogen production and the expression of PR or GR were not affected by antiprogestin treatment. In conclusion, the results demonstrate that only a minor part of the processes related to bovine parturition is directly dependent on P4 withdrawal, in particular the opening of the cervix and the onset of lactation. Moreover, they suggest that other important processes such as adequate myometrial activity and timely release of the placenta are predominantly dependent on signals from the fetal compartment. The importance of placental P4 production in cattle remains unknown

Physiologic Insulin Resensitization as a Treatment Modality for Insulin Resistance Pathophysiology

Prevalence of type 2 diabetes increased from 2.5% of the US population in 1990 to 10.5% in 2018. This creates a major public health problem, due to increases in long-term complications of diabetes, including neuropathy, retinopathy, nephropathy, skin ulcers, amputations, and atherosclerotic cardiovascular disease. In this review, we evaluated the scientific basis that supports the use of physiologic insulin resensitization. Insulin resistance is the primary cause of type 2 diabetes. Insulin resistance leads to increasing insulin secretion, leading to beta-cell exhaustion or burnout. This triggers a cascade leading to islet cell destruction and the long-term complications of type 2 diabetes. Concurrent with insulin resistance, the regular bursts of insulin from the pancreas become irregular. This has been treated by the precise administration of insulin more physiologically. There is consistent evidence that this treatment modality can reverse the diabetes-associated complications of neuropathy, diabetic ulcers, nephropathy, and retinopathy, and that it lowers HbA1c. In conclusion, physiologic insulin resensitization has a persuasive scientific basis, significant treatment potential, and likely cost benefits

Physiologic Insulin Resensitization as a Treatment Modality for Insulin Resistance Pathophysiology

Prevalence of type 2 diabetes increased from 2.5% of the US population in 1990 to 10.5% in 2018. This creates a major public health problem, due to increases in long-term complications of diabetes, including neuropathy, retinopathy, nephropathy, skin ulcers, amputations, and atherosclerotic cardiovascular disease. In this review, we evaluated the scientific basis that supports the use of physiologic insulin resensitization. Insulin resistance is the primary cause of type 2 diabetes. Insulin resistance leads to increasing insulin secretion, leading to beta-cell exhaustion or burnout. This triggers a cascade leading to islet cell destruction and the long-term complications of type 2 diabetes. Concurrent with insulin resistance, the regular bursts of insulin from the pancreas become irregular. This has been treated by the precise administration of insulin more physiologically. There is consistent evidence that this treatment modality can reverse the diabetes-associated complications of neuropathy, diabetic ulcers, nephropathy, and retinopathy, and that it lowers HbA1c. In conclusion, physiologic insulin resensitization has a persuasive scientific basis, significant treatment potential, and likely cost benefits