Uncertainty Analysis and Order-by-Order Optimization of Chiral Nuclear Interactions

Chiral effective field theory (chi EFT) provides a systematic approach to describe low-energy nuclear forces. Moreover, chi EFT is able to provide well-founded estimates of statistical and systematic uncertainties-although this unique advantage has not yet been fully exploited. We fill this gap by performing an optimization and statistical analysis of all the low-energy constants (LECs) up to next-to-next-to-leading order. Our optimization protocol corresponds to a simultaneous fit to scattering and bound-state observables in the pion-nucleon, nucleon-nucleon, and few-nucleon sectors, thereby utilizing the full model capabilities of chi EFT. Finally, we study the effect on other observables by demonstrating forward-error-propagation methods that can easily be adopted by future works. We employ mathematical optimization and implement automatic differentiation to attain efficient and machine-precise first-and second-order derivatives of the objective function with respect to the LECs. This is also vital for the regression analysis. We use power-counting arguments to estimate the systematic uncertainty that is inherent to chi EFT, and we construct chiral interactions at different orders with quantified uncertainties. Statistical error propagation is compared with Monte Carlo sampling, showing that statistical errors are, in general, small compared to systematic ones. In conclusion, we find that a simultaneous fit to different sets of data is critical to (i) identify the optimal set of LECs, (ii) capture all relevant correlations, (iii) reduce the statistical uncertainty, and (iv) attain order-by-order convergence in chi EFT. Furthermore, certain systematic uncertainties in the few-nucleon sector are shown to get substantially magnified in the many-body sector, in particular when varying the cutoff in the chiral potentials. The methodology and results presented in this paper open a new frontier for uncertainty quantification in ab initio nuclear theory

Identifying radiologically important ESS-specific radionuclides and relevant detection methods

The European Spallation Source (ESS) is under construction in the outskirts of Lund in southern Sweden. When ESS has entered the operational phase in a few years, an intense beam of high-energy protons will not only produce the desired spallation neutrons from a large target of tungsten, but a substantial number of different radioactive by-products will also be generated. A small part of these will be released to the environment during normal operation. During an accident scenario, a wide range of gases and aerosols may be released from the tungsten target. The palette of radionuclides generated in the ESS target will differ from that of e.g. medical cyclotrons or nuclear power plants, thus presenting new challenges e.g. in the required environmental monitoring to ensure that dose limits to the public are not exceeded. This project (SSM2018-1636), financed by the Swedish Radiation Safety Authority (SSM), aimed to strengthen competence at Lund University for measurement and analysis of ESS-specific radionuclides. First, an extensive literature review, including modelling as well as experimental analyses, of ESS-relevant radionuclides was performed. We found that radionuclide production in particle accelerators is well-known, while experience with tungsten targets is very limited. As a second part of the project, an independent simplified model of the ESS target sector for the calculations of radionuclide production in the ESS tungsten target was developed using the FLUKA code. We conclude that we have a fairly good agreement with results of other authors, except for 148Gd, and that the calculated radionuclide composition is sensitive to the nuclear interaction models used.In the third part of the project, known environmental measurement technologies for various ESS-relevant radionuclides were reviewed, focussing on pure difficult-to-measure alpha- and beta-emitters. Liquid scintillation counting (LSC) is a suitable technique e.g. for the important beta emitters 3H, 14C, 35S, 31P and 33P. Several ESS radionuclides of relevance for dose estimates have never been investigated by environmental analytical techniques, due to their absence in the normal environment. Alpha spectrometry seems promising for the analysis of alpha-emitting lanthanides, in particular for 148Gd. Among the many types of mass spectrometry techniques, ICP-MS (inductively coupled plasma mass spectrometry) and AMS (accelerator mass spectrometry) seem to be the most suitable for the analysis of long-lived ESS radionuclides in environmental samples (e.g. 243Am and possibly lanthanides for ICP-MS and 10Be, 14C, 32Si, 36Cl, 60Fe and 129I for AMS).Three experimental parts were performed during the project, related to initiation of radioactivity measurements of aerosols at Lund University, mapping of environmental tritium in the Lund area, and establishment of a method to measure tritium in urine followed by a study of tritium in persons presently living or working in Lund. Aerosols were collected at a rural background station (Hyltemossa near Perstorp, northern Skåne) using a high-volume aerosol sampler with automatic filter change (DHA-80, Digitel). Gamma spectrometry measurements of 7Be agreed rather well with results from a nearby air monitoring station (SSM/FOI). Tritium (radioactive hydrogen) is expected to dominate the source term from the ESS target station to the environment. We have performed several investigations to monitor the current situation of tritium in Lund using LSC: the matrices investigated included air humidity, precipitation, pond water, indoor air at one accelerator facility and urine from the general public as well as from persons who may be occupationally exposed to tritium. Environmental tritium was generally very low (<3.4 Bq L-1), with somewhat higher concentration in the springtime than during the rest of the year. Tritium in the vast majority of the 55 urine samples was also very low: only a few exposed workers were found to have up to 11 Bq L-1 in their urine, which still is very low compared to e.g. reactor workers. Suggestions for further actions and work related to measurement and analysis of ESS relevant radionuclides are presented

Detailed comparison of amyloid PET and CSF biomarkers for identifying early Alzheimer disease

Objective:To compare the diagnostic accuracy of CSF biomarkers and amyloid PET for diagnosing early-stage Alzheimer disease (AD).Methods:From the prospective, longitudinal BioFINDER study, we included 122 healthy elderly and 34 patients with mild cognitive impairment who developed AD dementia within 3 years (MCI-AD). -Amyloid (A) deposition in 9 brain regions was examined with [F-18]-flutemetamol PET. CSF was analyzed with INNOTEST and EUROIMMUN ELISAs. The results were replicated in 146 controls and 64 patients with MCI-AD from the Alzheimer's Disease Neuroimaging Initiative study.Results:The best CSF measures for identifying MCI-AD were A42/total tau (t-tau) and A42/hyperphosphorylated tau (p-tau) (area under the curve [AUC] 0.93-0.94). The best PET measures performed similarly (AUC 0.92-0.93; anterior cingulate, posterior cingulate/precuneus, and global neocortical uptake). CSF A42/t-tau and A42/p-tau performed better than CSF A42 and A42/40 (AUC difference 0.03-0.12, p < 0.05). Using nonoptimized cutoffs, CSF A42/t-tau had the highest accuracy of all CSF/PET biomarkers (sensitivity 97%, specificity 83%). The combination of CSF and PET was not better than using either biomarker separately.Conclusions:Amyloid PET and CSF biomarkers can identify early AD with high accuracy. There were no differences between the best CSF and PET measures and no improvement when combining them. Regional PET measures were not better than assessing the global A deposition. The results were replicated in an independent cohort using another CSF assay and PET tracer. The choice between CSF and amyloid PET biomarkers for identifying early AD can be based on availability, costs, and doctor/patient preferences since both have equally high diagnostic accuracy.Classification of evidence:This study provides Class III evidence that amyloid PET and CSF biomarkers identify early-stage AD equally accurately

Infections With the Tick-Borne Bacterium "Candidatus Neoehrlichia mikurensis” Mimic Noninfectious Conditions in Patients With B Cell Malignancies or Autoimmune Diseases

We present a comprehensive study of a new infectious disease in immune compromised patients, neoehrlichiosis. The clinical picture of the disease can be misleading because the symptoms may be misinterpreted to be a worsening of the underlying diseas

Protocol description of the HOVON 141/VISION trial: a prospective, multicentre, randomised phase II trial of ibrutinib plus venetoclax in patients with creatinine clearance >= 30 mL/min who have relapsed or refractory chronic lymphocytic leukaemia (RR-CLL) with or without TP53 aberrations

Introduction Literature is scarce on the combination treatment of ibrutinib and venetoclax (IV) is scarce in relapsed or refractory chronic lymphocytic leukaemia (RR-CLL). Especially, the possibility of stopping ibrutinib in RR-CLL patients in deep remission is unclear.Methods and analysis In the HOVON 141/VISION trial, patients with RR-CLL are treated with 12 cycles of IV after a short induction with ibrutinib. Patients reaching undetectable minimal residual disease (uMRD) after 12 cycles of IV are randomised 1:2 to continue ibrutinib or stop treatment. The persistence of uMRD after stopping IV is studied. In addition, in patients who become positive for MRD again after stopping, IV treatment is reinitiated. The efficacy of this approach with regard to progression-free survival 12 months after randomisation is the primary endpoint of the study.Ethics and dissemination This protocol respects the Helsinki declaration and has been approved by the ethical committee of the Amsterdam Medical Center. Study findings will be disseminated through peer-reviewed papers. All patients who fulfil the inclusion criteria and no-exclusion criteria, and have signed the informed consent form are included in the study.</div

Evaluation of a Previously Suggested Plasma Biomarker Panel to Identify Alzheimer's Disease

There is an urgent need for biomarkers in plasma to identify Alzheimer's disease (AD). It has previously been shown that a signature of 18 plasma proteins can identify AD during pre-dementia and dementia stages (Ray et al, Nature Medicine, 2007). We quantified the same 18 proteins in plasma from 174 controls, 142 patients with AD, and 88 patients with other dementias. Only three of these proteins (EGF, PDG-BB and MIP-1δ) differed significantly in plasma between controls and AD. The 18 proteins could classify patients with AD from controls with low diagnostic precision (area under the ROC curve was 63%). Moreover, they could not distinguish AD from other dementias. In conclusion, independent validation of results is important in explorative biomarker studies