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

Modelling Aedes aegypti mosquito control via transgenic and sterile insect techniques: endemics and emerging outbreaks

The invasion of pest insects often changes or destroys a native ecosystem,and can result in food shortages and disease endemics.Issues such as the environmental effects of chemical control methods,the economic burden of maintaining control strategies and the risk of pestresistance still remain,and mosquito-borne diseases such as malaria and dengue fever prevail in many countries,infecting over100 million worldwide in 2010.One environmentally friendly method for mosquito control is the Sterile Insect Technique(SIT).This species-specific method of insect control relies on the mass rearing, sterilization and release of large numbers of sterile insects.An alternative transgenic method is the Release of Insects carrying a Dominant Lethal(RIDL).Our objective is to consider contrasting control strategies for two invasive scenarios via SIT and RIDL:an endemic case and an emerging outbreak. We investigate how the release rate and size of release region influence both the potential for control success and there sources needed to achieve it,under a range of conditions and control strategies,and we discuss advantageous strategies with respect to reducing the release resources and strategy costs(in terms of control mosquito numbers)required to achieve complete eradication of wild-type mosquitoes

Procedural justice in carbon capture and storage

This paper examines where and how claims of procedural injustice, or demands for procedural justice, might arise with respect to carbon capture and storage (CCS), taking a broad view of the CCS research, development and deployment process. It considers the principles that might govern such claims and seeks to identify where responsibility might lie for ensuring justice, or addressing contested claims of injustice. It is suggested that claims of procedural injustice arising from CCS are most likely to arise during implementation, from locally affected populations, raising concerns of inadequate information or consultation; but they may also arise from representatives of other indirectly affected groups, such as those affected by upstream impacts of coal mining, or energy market consequences of CCS policy. It is further suggested that claims are most likely to be directed at public authorities in respect of decisions over policy, strategy or authorisations for individual developments, but there are also routes by which claims may be directed at the corporations involved, especially under human rights provisions. The paper suggests a need for careful consideration of both procedural and, by implication, distributive justice matters in the emerging regulatory and support framework for CCS, with a particular imperative for moving public engagement upstream prior to deployment and indeed even to research programmes, to maximise the scope for legitimate influence on future outcomes