Patient-Specific Method of Generating Parametric Maps of Patlak K(i) without Blood Sampling or Metabolite Correction: A Feasibility Study.

Currently, kinetic analyses using dynamic positron emission tomography (PET) experience very limited use despite their potential for improving quantitative accuracy in several clinical and research applications. For targeted volume applications, such as radiation treatment planning, treatment monitoring, and cerebral metabolic studies, the key to implementation of these methods is the determination of an arterial input function, which can include time-consuming analysis of blood samples for metabolite correction. Targeted kinetic applications would become practical for the clinic if blood sampling and metabolite correction could be avoided. To this end, we developed a novel method (Patlak-P) of generating parametric maps that is identical to Patlak K(i) (within a global scalar multiple) but does not require the determination of the arterial input function or metabolite correction. In this initial study, we show that Patlak-P (a) mimics Patlak K(i) images in terms of visual assessment and target-to-background (TB) ratios of regions of elevated uptake, (b) has higher visual contrast and (generally) better image quality than SUV, and (c) may have an important role in improving radiotherapy planning, therapy monitoring, and neurometabolism studies

Comparable, but distinct: Perceptions of primary care provided by physicians and nurse practitioners in full and restricted practice authority states

AimsTo understand patients- and providers- perceptions of primary care delivered by nurse practitioners (NPs) in the Veterans Affairs Healthcare System.DesignQualitative exploratory study (in convergent mixed- methods design).MethodsSemi- structured interviews in 2016 with primary care providers and patients from facilities in states with full and restricted practice authority for NPs. Patient sample based on reassignment to: (a) a NP; or (b) a different physician following an established physician relationship. Data were analysed using content analysis.ResultsWe interviewed 28 patients, 17 physicians and 14 NPs. We found: (a) NPs provided more holistic care than physicians; (b) patients were satisfied with NPs; and (c) providers- professional experience outweighed provider type.ConclusionsPatients- preferences for NPs (compared with prior physicians) contributed to perceptions of patient centredness. Similarities in providers- perceptions suggest NPs and physicians are both viable providers for primary care.ImpactNurse Practitioners (NPs): practice authorityVeterans Affairs Health care: nurse practitioners will continue to be a viable resource for primary care deliveryUnited States Health care: challenges notions patients may not be satisfied with care provided by NPs and supports expanding their use to provide much- needed access to primary care services; expanding Full Practice Authority would allow states to provide acceptable primary care without diminishing patient or provider experiencesæ è¦ ç ®æ  äº è§£æ £è å å »ç æ ºæ 对é ä¼ å äººå »ç ä¿ å ¥ç³»ç» ä¸­æ ¤ç å¸ æ ä¾ å çº§æ ¤ç ç ç æ³ ã è®¾è®¡æ ¢ç´¢æ §ç å® æ §ç  ç©¶(æ ¶æ æ··å æ ¹æ³ è®¾è®¡)ã æ ¹æ³ 2016å¹´è¿ è¡ ç å ç» æ å è®¿è° ,é è®¿äº å· å æ ¥æ æ ¤ç å¸ ç å ¨ç§ å é å ¨ç§ æ §ä¸ æ ºæ ç å çº§æ ¤ç æ ä¾ è å æ £è ã é æ °å é æ £è æ ·æ ¬:(a) ä¸ å æ ¤ç å¸ ;æ (b)ç¡®ç« å »ç å ³ç³»ç å ¦ä¸ å å »ç ã é ç ¨å 容å æ æ³ å¯¹æ °æ ®è¿ è¡ å æ ã ç» æ æ 们é è®¿äº 28å æ £è ,17å å »ç å 14å æ ¤ç å¸ ã æ 们å ç °:(a)æ ¤ç å¸ æ¯ å »ç æ ä¾ ç æ ¤ç æ ´å ¨é ¢;(b)æ £è å¯¹æ ¤ç å¸ æ å °æ»¡æ ;(c)å »ç æ ºæ ç ä¸ ä¸ ç» éª ç æ é æ¯ å »ç æ ºæ ç±»å ç æ é æ ´å¤§ã ç» è®ºæ £è å¯¹æ ¤ç å¸ ç å 好(ä¸ ä»¥å ç å »ç ç ¸æ¯ )æ å ©äº å»ºç« ä»¥æ £è ä¸ºä¸­å¿ ç è®¤ç ¥ã æ ä¾ è ç è§ å¿µç±»ä¼¼,表æ æ ¤ç å¸ å å »ç é ½æ ¯å ¯è¡ ç å çº§æ ¤ç æ ä¾ è ã å½±å - ¢æ ¤ç å¸ :æ §ä¸ æ ºæ - ¢é ä¼ å äººå »ç ä¿ å ¥ç³»ç» :æ ¤ç å¸ å° ç»§ç»­ä½ ä¸ºæ ä¾ å çº§æ ¤ç æ å ¡ç å ¯ç ¨èµ æº ã - ¢ç¾ å ½å «ç ä¿ å ¥:æ æ è§ å¿µ æ £è å ¯è ½ä¸ æ»¡æ ç ±æ ¤ç å¸ æ ä¾ ç æ ¤ç ,å ¶ä¼ æ ¯æ æ ©å¤§ä½¿ç ¨è å ´,以æ ä¾ æ ¥é ç å çº§ä¿ å ¥æ å ¡;æ ©å¤§å ¨ç§ æ §ä¸ æ ºæ å° ä½¿å å· è ½å¤ æ ä¾ å ¯æ ¥å ç å çº§ä¿ å ¥æ å ¡,è ä¸ ä¼ å å¼±æ £è æ æ ä¾ è ç ä½ éª ãPeer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/163369/2/jan14501.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/163369/1/jan14501_am.pd

A Measurement of the Cosmic Microwave Background Damping Tail from the 2500-square-degree SPT-SZ survey

We present a measurement of the cosmic microwave background (CMB) temperature power spectrum using data from the recently completed South Pole Telescope Sunyaev-Zel'dovich (SPT-SZ) survey. This measurement is made from observations of 2540 deg$^2$ of sky with arcminute resolution at $150\,$GHz, and improves upon previous measurements using the SPT by tripling the sky area. We report CMB temperature anisotropy power over the multipole range $650<\ell<3000$. We fit the SPT bandpowers, combined with the seven-year Wilkinson Microwave Anisotropy Probe (WMAP7) data, with a six-parameter LCDM cosmological model and find that the two datasets are consistent and well fit by the model. Adding SPT measurements significantly improves LCDM parameter constraints; in particular, the constraint on $\theta_s$ tightens by a factor of 2.7. The impact of gravitational lensing is detected at $8.1\, \sigma$, the most significant detection to date. This sensitivity of the SPT+WMAP7 data to lensing by large-scale structure at low redshifts allows us to constrain the mean curvature of the observable universe with CMB data alone to be $\Omega_k=-0.003^{+0.014}_{-0.018}$. Using the SPT+WMAP7 data, we measure the spectral index of scalar fluctuations to be $n_s=0.9623 \pm 0.0097$ in the LCDM model, a $3.9\,\sigma$ preference for a scale-dependent spectrum with $n_s<1$. The SPT measurement of the CMB damping tail helps break the degeneracy that exists between the tensor-to-scalar ratio $r$ and $n_s$ in large-scale CMB measurements, leading to an upper limit of $r<0.18$ (95%,C.L.) in the LCDM+$r$ model. Adding low-redshift measurements of the Hubble constant ($H_0$) and the baryon acoustic oscillation (BAO) feature to the SPT+WMAP7 data leads to further improvements. The combination of SPT+WMAP7+$H_0$+BAO constrains $n_s=0.9538 \pm 0.0081$ in the LCDM model, a $5.7\,\sigma$ detection of $n_s < 1$, ... [abridged]Comment: 21 pages, 10 figures. Replaced with version accepted by ApJ. Data products are available at http://pole.uchicago.edu/public/data/story12

Consistency of cosmic microwave background temperature measurements in three frequency bands in the 2500-square-degree SPT-SZ survey

We present an internal consistency test of South Pole Telescope (SPT) measurements of the cosmic microwave background (CMB) temperature anisotropy using three-band data from the SPT-SZ survey. These measurements are made from observations of ~2500 deg^2 of sky in three frequency bands centered at 95, 150, and 220 GHz. We combine the information from these three bands into six semi-independent estimates of the CMB power spectrum (three single-frequency power spectra and three cross-frequency spectra) over the multipole range 650 < l < 3000. We subtract an estimate of foreground power from each power spectrum and evaluate the consistency among the resulting CMB-only spectra. We determine that the six foreground-cleaned power spectra are consistent with the null hypothesis, in which the six cleaned spectra contain only CMB power and noise. A fit of the data to this model results in a chi-squared value of 236.3 for 235 degrees of freedom, and the probability to exceed this chi-squared value is 46%.Comment: 21 pages, 4 figures, current version matches version published in JCA

A Comparison of Maps and Power Spectra Determined from South Pole Telescope and Planck Data

We study the consistency of 150 GHz data from the South Pole Telescope (SPT) and 143 GHz data from the Planck satellite over the patch of sky covered by the SPT-SZ survey. We first visually compare the maps and find that the residuals appear consistent with noise after accounting for differences in angular resolution and filtering. We then calculate (1) the cross-spectrum between two independent halves of SPT data, (2) the cross-spectrum between two independent halves of Planck data, and (3) the cross-spectrum between SPT and Planck data. We find the three cross-spectra are well-fit (PTE = 0.30) by the null hypothesis in which both experiments have measured the same sky map up to a single free calibration parameter---i.e., we find no evidence for systematic errors in either data set. As a by-product, we improve the precision of the SPT calibration by nearly an order of magnitude, from 2.6% to 0.3% in power. Finally, we compare all three cross-spectra to the full-sky Planck power spectrum and find marginal evidence for differences between the power spectra from the SPT-SZ footprint and the full sky. We model these differences as a power law in spherical harmonic multipole number. The best-fit value of this tilt is consistent among the three cross-spectra in the SPT-SZ footprint, implying that the source of this tilt is a sample variance fluctuation in the SPT-SZ region relative to the full sky. The consistency of cosmological parameters derived from these datasets is discussed in a companion paper.Comment: 15 pages, 9 figures. Published in The Astrophysical Journal. Current arxiv version matches published versio

Mass Calibration and Cosmological Analysis of the SPT-SZ Galaxy Cluster Sample Using Velocity Dispersion σv\sigma_v and X-ray YXY_\textrm{X} Measurements

We present a velocity dispersion-based mass calibration of the South Pole Telescope Sunyaev-Zel'dovich effect survey (SPT-SZ) galaxy cluster sample. Using a homogeneously selected sample of 100 cluster candidates from 720 deg2 of the survey along with 63 velocity dispersion ($\sigma_v$) and 16 X-ray Yx measurements of sample clusters, we simultaneously calibrate the mass-observable relation and constrain cosmological parameters. The calibrations using $\sigma_v$ and Yx are consistent at the $0.6\sigma$ level, with the $\sigma_v$ calibration preferring ~16% higher masses. We use the full cluster dataset to measure $\sigma_8(\Omega_ m/0.27)^{0.3}=0.809\pm0.036$. The SPT cluster abundance is lower than preferred by either the WMAP9 or Planck+WMAP9 polarization (WP) data, but assuming the sum of the neutrino masses is $\sum m_\nu=0.06$ eV, we find the datasets to be consistent at the 1.0$\sigma$ level for WMAP9 and 1.5$\sigma$ for Planck+WP. Allowing for larger $\sum m_\nu$ further reconciles the results. When we combine the cluster and Planck+WP datasets with BAO and SNIa, the preferred cluster masses are $1.9\sigma$ higher than the Yx calibration and $0.8\sigma$ higher than the $\sigma_v$ calibration. Given the scale of these shifts (~44% and ~23% in mass, respectively), we execute a goodness of fit test; it reveals no tension, indicating that the best-fit model provides an adequate description of the data. Using the multi-probe dataset, we measure $\Omega_ m=0.299\pm0.009$ and $\sigma_8=0.829\pm0.011$. Within a $\nu$CDM model we find $\sum m_\nu = 0.148\pm0.081$ eV. We present a consistency test of the cosmic growth rate. Allowing both the growth index $\gamma$ and the dark energy equation of state parameter $w$ to vary, we find $\gamma=0.73\pm0.28$ and $w=-1.007\pm0.065$, demonstrating that the expansion and the growth histories are consistent with a LCDM model ($\gamma=0.55; \,w=-1$).Comment: Accepted by ApJ (v2 is accepted version); 17 pages, 6 figure

A Comparison of Cosmological Parameters Determined from CMB Temperature Power Spectra from the South Pole Telescope and the Planck Satellite

The Planck cosmic microwave background (CMB) temperature data are best fit with a LCDM model that is in mild tension with constraints from other cosmological probes. The South Pole Telescope (SPT) 2540 $\text{deg}^2$ SPT-SZ survey offers measurements on sub-degree angular scales (multipoles $650 \leq \ell \leq 2500$) with sufficient precision to use as an independent check of the Planck data. Here we build on the recent joint analysis of the SPT-SZ and Planck data in \citet{hou17} by comparing LCDM parameter estimates using the temperature power spectrum from both data sets in the SPT-SZ survey region. We also restrict the multipole range used in parameter fitting to focus on modes measured well by both SPT and Planck, thereby greatly reducing sample variance as a driver of parameter differences and creating a stringent test for systematic errors. We find no evidence of systematic errors from such tests. When we expand the maximum multipole of SPT data used, we see low-significance shifts in the angular scale of the sound horizon and the physical baryon and cold dark matter densities, with a resulting trend to higher Hubble constant. When we compare SPT and Planck data on the SPT-SZ sky patch to Planck full-sky data but keep the multipole range restricted, we find differences in the parameters $n_s$ and $A_se^{-2\tau}$. We perform further checks, investigating instrumental effects and modeling assumptions, and we find no evidence that the effects investigated are responsible for any of the parameter shifts. Taken together, these tests reveal no evidence for systematic errors in SPT or Planck data in the overlapping sky coverage and multipole range and, at most, weak evidence for a breakdown of LCDM or systematic errors influencing either the Planck data outside the SPT-SZ survey area or the SPT data at $\ell >2000$.Comment: 14 pages, 7 figures. Updated 1 figure and expanded on the reasoning for fixing the affect of lensing on the power spectrum instead of varying Alen

A CMB lensing mass map and its correlation with the cosmic infrared background

We use a temperature map of the cosmic microwave background (CMB) obtained using the South Pole Telescope at 150 GHz to construct a map of the gravitational convergence to z ~ 1100, revealing the fluctuations in the projected mass density. This map shows individual features that are significant at the ~ 4 sigma level, providing the first image of CMB lensing convergence. We cross-correlate this map with Herschel/SPIRE maps covering 90 square degrees at wavelengths of 500, 350, and 250 microns. We show that these submillimeter-wavelength (submm) maps are strongly correlated with the lensing convergence map, with detection significances in each of the three submm bands ranging from 6.7 to 8.8 sigma. We fit the measurement of the cross power spectrum assuming a simple constant bias model and infer bias factors of b=1.3-1.8, with a statistical uncertainty of 15%, depending on the assumed model for the redshift distribution of the dusty galaxies that are contributing to the Herschel/SPIRE maps.Comment: 5 pages, 3 figures, to be submitted to ApJ