The comparative responsiveness of Hospital Universitario Princesa Index and other composite indices for assessing rheumatoid arthritis activity

Objective To evaluate the responsiveness in terms of correlation of the Hospital Universitario La Princesa Index (HUPI) comparatively to the traditional composite indices used to assess disease activity in rheumatoid arthritis (RA), and to compare the performance of HUPI-based response criteria with that of the EULAR response criteria. Methods Secondary data analysis from the following studies: ACT-RAY (clinical trial), PROAR (early RA cohort) and EMECAR (pre-biologic era long term RA cohort). Responsiveness was evaluated by: 1) comparing change from baseline (Delta) of HUPI with Delta in other scores by calculating correlation coefficients; 2) calculating standardised effect sizes. The accuracy of response by HUPI and by EULAR criteria was analyzed using linear regressions in which the dependent variable was change in global assessment by physician (Delta GDA-Phy). Results Delta HUPI correlation with change in all other indices ranged from 0.387 to 0.791); HUPI's standardized effect size was larger than those from the other indices in each database used. In ACT-RAY, depending on visit, between 65 and 80% of patients were equally classified by HUPI and EULAR response criteria. However, HUPI criteria were slightly more stringent, with higher percentage of patients classified as non-responder, especially at early visits. HUPI response criteria showed a slightly higher accuracy than EULAR response criteria when using Delta GDA-Phy as gold standard. Conclusion HUPI shows good responsiveness in terms of correlation in each studied scenario (clinical trial, early RA cohort, and established RA cohort). Response criteria by HUPI seem more stringent than EULAR''s

Evidence for Novel Hepaciviruses in Rodents

Hepatitis C virus (HCV) is among the most relevant causes of liver cirrhosis and hepatocellular carcinoma. Research is complicated by a lack of accessible small animal models. The systematic investigation of viruses of small mammals could guide efforts to establish such models, while providing insight into viral evolutionary biology. We have assembled the so-far largest collection of small-mammal samples from around the world, qualified to be screened for bloodborne viruses, including sera and organs from 4,770 roden

Moldable Tools for Object-oriented Development

Object-oriented programming aims to facilitate navigation between domain concepts and the code that addresses those domains by enabling developers to directly model those domain concepts in the code. To make informed decisions developers then formulate detailed and domain-specific questions about their systems in terms of domain concepts, and use tools to explore available information and answer those questions. Development tools however focus mainly on object-oriented idioms and do not expose or exploit domain concepts constructed on top of object-oriented programming idioms. Analysis tools are typically not tightly integrated with development tools. This has a negative effect on program comprehension, increasing the effort and the time for obtaining answers. To improve program comprehension we propose to better integrate domain concepts and program comprehension tools into the development environment through moldable tools. Moldable tools are development tools that are aware of the current development context and support inexpensive creation of domain-specific extensions. We elaborate on the idea of moldable tools and show how to apply moldable tools to support object-oriented programming. Through practical examples we show how developers can embed domain concepts into their development tools