Patient's Global Assessment as an Outcome Measure for Psoriatic Arthritis in Clinical Practice: A Surrogate for Measuring Low Disease Activity?

Objective.To assess the low disease activity (LDA) in a group of patients with psoriatic arthritis (PsA) receiving antitumor necrosis factor-α (TNF-α) by using the patient's global assessment (PtGA) in clinical practice, and to compare PtGA with minimal disease activity (MDA) and other outcome measures.Methods.Patients with PsA classified by the ClASsification for Psoriatic ARthritis (CASPAR) criteria and consecutively admitted to an outpatient clinic dedicated to biologic therapy were assessed during their routine followup. The primary outcome measure was the proportion of patients achieving a PtGA ≤ 20 at 4-, 8-, and 12-month followups. Secondary outcome measures included the proportion of patients achieving MDA and other outcome measures. Correlation of PtGA with MDA and other process and outcome measures were also performed.Results.During the period of observation, 124 patients were evaluated. PtGA ≤ 20 was achieved in 25.7% at 4 months, 48.9% at 8 months, and 65.3% at 12 months of followup. The percentage of PtGA ≤ 20 statistically improved throughout the 3 timepoint assessments and it was statistically correlated to MDA. A significant correlation with the Disease Activity index for PSoriatic Arthritis (DAPSA), Bath Ankylosing Spondylitis Disease Activity Index, and Health Assessment Questionnaire was also observed. MDA, DAPSA, and Disease Activity Score at 28 joints with C-reactive protein remission were achieved at 12 months in 64%, 36%, and 71% of patients, respectively.Conclusion.PtGA can estimate the LDA status and could be considered as a surrogate of outcome measures for the assessment of global disease activity in patients with PsA receiving anti-TNF therapy during routine clinical practice. These data suggest that PtGA might be used in outpatient settings, being a simple, reliable, and not time-consuming instrument

Charm production in nonresonant e(+)e(-) annihilations at √s =10.55 GeV

This is the publisher's version also available electronically from http://journals.aps.org/prd/abstract/10.1103/PhysRevD.37.1719We report results on the differential and total cross sections for inclusive production of the charmed particles D*+, D*(0), D(0), D(+), D(s), and Λc in e(+)e(-) annihilations at √s=10.55 GeV. Widely used quark fragmentation models are discussed and compared with the measured charmed-particle momentum distributions. This comparison, as well as that with measurements at other center-of-mass energies, shows the need to take QCD corrections into account and their importance for a correct interpretation of the model parameters. The observed rate of D(0) and D(+) production is compared to the expected total charm production cross section. We measure the probability of a charmed meson being produced as a vector meson and the D*(+) decay branching fraction into D(0)π+

Search for Early Gamma-ray Production in Supernovae Located in a Dense Circumstellar Medium with the Fermi LAT

Supernovae (SNe) exploding in a dense circumstellar medium (CSM) are hypothesized to accelerate cosmic rays in collisionless shocks and emit GeV gamma rays and TeV neutrinos on a time scale of several months. We perform the first systematic search for gamma-ray emission in Fermi LAT data in the energy range from 100 MeV to 300 GeV from the ensemble of 147 SNe Type IIn exploding in dense CSM. We search for a gamma-ray excess at each SNe location in a one year time window. In order to enhance a possible weak signal, we simultaneously study the closest and optically brightest sources of our sample in a joint-likelihood analysis in three different time windows (1 year, 6 months and 3 months). For the most promising source of the sample, SN 2010jl (PTF10aaxf), we repeat the analysis with an extended time window lasting 4.5 years. We do not find a significant excess in gamma rays for any individual source nor for the combined sources and provide model-independent flux upper limits for both cases. In addition, we derive limits on the gamma-ray luminosity and the ratio of gamma-ray-to-optical luminosity ratio as a function of the index of the proton injection spectrum assuming a generic gamma-ray production model. Furthermore, we present detailed flux predictions based on multi-wavelength observations and the corresponding flux upper limit at 95% confidence level (CL) for the source SN 2010jl (PTF10aaxf).Comment: Accepted for publication in ApJ. Corresponding author: A. Franckowiak ([email protected]), updated author list and acknowledgement

Multiwavelength Evidence for Quasi-periodic Modulation in the Gamma-ray Blazar PG 1553+113

We report for the first time a gamma-ray and multi-wavelength nearly-periodic oscillation in an active galactic nucleus. Using the Fermi Large Area Telescope (LAT) we have discovered an apparent quasi-periodicity in the gamma-ray flux (E >100 MeV) from the GeV/TeV BL Lac object PG 1553+113. The marginal significance of the 2.18 +/-0.08 year-period gamma-ray cycle is strengthened by correlated oscillations observed in radio and optical fluxes, through data collected in the OVRO, Tuorla, KAIT, and CSS monitoring programs and Swift UVOT. The optical cycle appearing in ~10 years of data has a similar period, while the 15 GHz oscillation is less regular than seen in the other bands. Further long-term multi-wavelength monitoring of this blazar may discriminate among the possible explanations for this quasi-periodicity.Comment: 8 pages, 5 figures. Accepted to The Astrophysical Journal Letters. Corresponding authors: S. Ciprini (ASDC/INFN), S. Cutini (ASDC/INFN), S. Larsson (Stockholm Univ/KTH), A. Stamerra (INAF/SNS), D. J. Thompson (NASA GSFC

Fermi observations of high-energy gamma-ray emission from GRB 090217A

The Fermi observatory is advancing our knowledge of Gamma-Ray Bursts (GRBs) through pioneering observations at high energies, covering more than 7 decades in energy with the two on-board detectors, the Large Area Telescope (LAT) and the Gamma-ray Burst Monitor (GBM). Here we report on the observation of the long GRB 090217A which triggered the GBM and has been detected by the LAT with a significance greater than 9 sigma. We present the GBM and LAT observations and on-ground analyses, including the time-resolved spectra and the study of the temporal profile from 8 keV up to 1 GeV. All spectra are well reproduced by a Band model. We compare these observations to the first two LAT-detected, long bursts GRB 080825C and GRB 080916C. These bursts were found to have time-dependent spectra and exhibited a delayed onset of the high-energy emission, which are not observed in the case of GRB 090217A. We discuss some theoretical implications for the high-energy emission of GRBs.Comment: 17 pages, 4 figures. Contact Authors: Fred, Piron; Sara, Cutini; Andreas, von Kienli

Constraints on the Cosmic-Ray Density Gradient beyond the Solar Circle from Fermi gamma-ray Observations of the Third Galactic Quadrant

We report an analysis of the interstellar $\gamma$-ray emission in the third Galactic quadrant measured by the {Fermi} Large Area Telescope. The window encompassing the Galactic plane from longitude 210\arcdeg to 250\arcdeg has kinematically well-defined segments of the Local and the Perseus arms, suitable to study the cosmic-ray densities across the outer Galaxy. We measure no large gradient with Galactocentric distance of the $\gamma$-ray emissivities per interstellar H atom over the regions sampled in this study. The gradient depends, however, on the optical depth correction applied to derive the \HI\ column densities. No significant variations are found in the interstellar spectra in the outer Galaxy, indicating similar shapes of the cosmic-ray spectrum up to the Perseus arm for particles with GeV to tens of GeV energies. The emissivity as a function of Galactocentric radius does not show a large enhancement in the spiral arms with respect to the interarm region. The measured emissivity gradient is flatter than expectations based on a cosmic-ray propagation model using the radial distribution of supernova remnants and uniform diffusion properties. In this context, observations require a larger halo size and/or a flatter CR source distribution than usually assumed. The molecular mass calibrating ratio, $X_{\rm CO} = N({\rm H_{2}})/W_{\rm CO}$, is found to be $(2.08 \pm 0.11) \times 10^{20} {\rm cm^{-2} (K km s^{-1})^{-1}}$ in the Local-arm clouds and is not significantly sensitive to the choice of \HI\ spin temperature. No significant variations are found for clouds in the interarm region.Comment: Corresponding authors: I. A. Grenier ([email protected]); T. Mizuno ([email protected]); L. Tibaldo ([email protected]) accepted for publication in Ap

Gamma-ray flaring activity from the gravitationally lensed blazar PKS 1830-211 observed by Fermi LAT

The Large Area Telescope (LAT) on board the Fermi Gamma-ray Space Telescope routinely detects the highly dust-absorbed, reddened, and MeV-peaked flat spectrum radio quasar PKS 1830-211 (z=2.507). Its apparent isotropic gamma-ray luminosity (E>100 MeV) averaged over $\sim$ 3 years of observations and peaking on 2010 October 14/15 at 2.9 X 10^{50} erg s^{-1}, makes it among the brightest high-redshift Fermi blazars. No published model with a single lens can account for all of the observed characteristics of this complex system. Based on radio observations, one expects time delayed variability to follow about 25 days after a primary flare, with flux about a factor 1.5 less. Two large gamma-ray flares of PKS 1830-211 have been detected by the LAT in the considered period and no substantial evidence for such a delayed activity was found. This allows us to place a lower limit of about 6 on the gamma rays flux ratio between the two lensed images. Swift XRT observations from a dedicated Target of Opportunity program indicate a hard spectrum and with no significant correlation of X-ray flux with the gamma-ray variability. The spectral energy distribution can be modeled with inverse Compton scattering of thermal photons from the dusty torus. The implications of the LAT data in terms of variability, the lack of evident delayed flare events, and different radio and gamma-ray flux ratios are discussed. Microlensing effects, absorption, size and location of the emitting regions, the complex mass distribution of the system, an energy-dependent inner structure of the source, and flux suppression by the lens galaxy for one image path may be considered as hypotheses for understanding our results.Comment: 14 pages, 6 figures, 2 tables. Accepted by the The Astrophysical Journal. Corresponding authors: S. Ciprini (ASI ASDC & INAF OAR, Rome, Italy), S. Buson (INAF Padova & Univ. of Padova, Padova, Italy), J. Finke (NRL, Washington, DC, USA), F. D'Ammando (INAF IRA, Bologna, Italy

Fermi-LAT Study of Gamma-ray Emission in the Direction of Supernova Remnant W49B

We present an analysis of the gamma-ray data obtained with the Large Area Telescope (LAT) onboard the Fermi Gamma-ray Space Telescope in the direction of SNR W49B (G43.3-0.2). A bright unresolved gamma-ray source detected at a significance of 38 sigma is found to coincide with SNR W49B. The energy spectrum in the 0.2-200 GeV range gradually steepens toward high energies. The luminosity is estimated to be 1.5x10^{36} (D/8 kpc)^2 erg s^-1 in this energy range. There is no indication that the gamma-ray emission comes from a pulsar. Assuming that the SNR shell is the site of gamma-ray production, the observed spectrum can be explained either by the decay of neutral pi mesons produced through the proton-proton collisions or by electron bremsstrahlung. The calculated energy density of relativistic particles responsible for the LAT flux is estimated to be remarkably large, U_{e,p}>10^4 eV cm^-3, for either gamma-ray production mechanism.Comment: 9 pages, 10 figure

Fermi Large Area Telescope Observations of the Cosmic-Ray Induced gamma-ray Emission of the Earth's Atmosphere

We report on measurements of the cosmic-ray induced gamma-ray emission of Earth's atmosphere by the Large Area Telescope onboard the Fermi Gamma-ray Space Telescope. The LAT has observed the Earth during its commissioning phase and with a dedicated Earth-limb following observation in September 2008. These measurements yielded 6.4 x 10^6 photons with energies >100MeV and ~250hours total livetime for the highest quality data selection. This allows the study of the spatial and spectral distributions of these photons with unprecedented detail. The spectrum of the emission - often referred to as Earth albedo gamma-ray emission - has a power-law shape up to 500 GeV with spectral index Gamma = 2.79+-0.06.Comment: Accepted for publication in PR