128 research outputs found

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

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    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

    Global, regional, and national comparative risk assessment of 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks, 1990-2015: A systematic analysis for the Global Burden of Disease Study 2015

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    Background: The Global Burden of Diseases, Injuries, and Risk Factors Study 2015 provides an up-to-date synthesis of the evidence for risk factor exposure and the attributable burden of disease. By providing national and subnational assessments spanning the past 25 years, this study can inform debates on the importance of addressing risks in context. Methods: We used the comparative risk assessment framework developed for previous iterations of the Global Burden of Disease Study to estimate attributable deaths, disability-adjusted life-years (DALYs), and trends in exposure by age group, sex, year, and geography for 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks from 1990 to 2015. This study included 388 risk-outcome pairs that met World Cancer Research Fund-defined criteria for convincing or probable evidence. We extracted relative risk and exposure estimates from randomised controlled trials, cohorts, pooled cohorts, household surveys, census data, satellite data, and other sources. We used statistical models to pool data, adjust for bias, and incorporate covariates. We developed a metric that allows comparisons of exposure across risk factors—the summary exposure value. Using the counterfactual scenario of theoretical minimum risk level, we estimated the portion of deaths and DALYs that could be attributed to a given risk. We decomposed trends in attributable burden into contributions from population growth, population age structure, risk exposure, and risk-deleted cause-specific DALY rates. We characterised risk exposure in relation to a Socio-demographic Index (SDI). Findings: Between 1990 and 2015, global exposure to unsafe sanitation, household air pollution, childhood underweight, childhood stunting, and smoking each decreased by more than 25%. Global exposure for several occupational risks, high body-mass index (BMI), and drug use increased by more than 25% over the same period. All risks jointly evaluated in 2015 accounted for 57·8% (95% CI 56·6–58·8) of global deaths and 41·2% (39·8–42·8) of DALYs. In 2015, the ten largest contributors to global DALYs among Level 3 risks were high systolic blood pressure (211·8 million [192·7 million to 231·1 million] global DALYs), smoking (148·6 million [134·2 million to 163·1 million]), high fasting plasma glucose (143·1 million [125·1 million to 163·5 million]), high BMI (120·1 million [83·8 million to 158·4 million]), childhood undernutrition (113·3 million [103·9 million to 123·4 million]), ambient particulate matter (103·1 million [90·8 million to 115·1 million]), high total cholesterol (88·7 million [74·6 million to 105·7 million]), household air pollution (85·6 million [66·7 million to 106·1 million]), alcohol use (85·0 million [77·2 million to 93·0 million]), and diets high in sodium (83·0 million [49·3 million to 127·5 million]). From 1990 to 2015, attributable DALYs declined for micronutrient deficiencies, childhood undernutrition, unsafe sanitation and water, and household air pollution; reductions in risk-deleted DALY rates rather than reductions in exposure drove these declines. Rising exposure contributed to notable increases in attributable DALYs from high BMI, high fasting plasma glucose, occupational carcinogens, and drug use. Environmental risks and childhood undernutrition declined steadily with SDI; low physical activity, high BMI, and high fasting plasma glucose increased with SDI. In 119 countries, metabolic risks, such as high BMI and fasting plasma glucose, contributed the most attributable DALYs in 2015. Regionally, smoking still ranked among the leading five risk factors for attributable DALYs in 109 countries; childhood underweight and unsafe sex remained primary drivers of early death and disability in much of sub-Saharan Africa. Interpretation: Declines in some key environmental risks have contributed to declines in critical infectious diseases. Some risks appear to be invariant to SDI. Increasing risks, including high BMI, high fasting plasma glucose, drug use, and some occupational exposures, contribute to rising burden from some conditions, but also provide opportunities for intervention. Some highly preventable risks, such as smoking, remain major causes of attributable DALYs, even as exposure is declining. Public policy makers need to pay attention to the risks that are increasingly major contributors to global burden. Funding: Bill & Melinda Gates Foundation

    Measurements of differential production cross sections for a Z boson in association with jets in pp collisions at root s=8 TeV

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    Performance of reconstruction and identification of τ leptons decaying to hadrons and vτ in pp collisions at √s=13 TeV

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    The algorithm developed by the CMS Collaboration to reconstruct and identify τ leptons produced in proton-proton collisions at √s=7 and 8 TeV, via their decays to hadrons and a neutrino, has been significantly improved. The changes include a revised reconstruction of π⁰ candidates, and improvements in multivariate discriminants to separate τ leptons from jets and electrons. The algorithm is extended to reconstruct τ leptons in highly Lorentz-boosted pair production, and in the high-level trigger. The performance of the algorithm is studied using proton-proton collisions recorded during 2016 at √s=13 TeV, corresponding to an integrated luminosity of 35.9 fb¯¹. The performance is evaluated in terms of the efficiency for a genuine τ lepton to pass the identification criteria and of the probabilities for jets, electrons, and muons to be misidentified as τ leptons. The results are found to be very close to those expected from Monte Carlo simulation

    An embedding technique to determine ττ backgrounds in proton-proton collision data

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    Observation of nuclear modifications in W±^{±} boson production in pPb collisions at √S^{S}NN = 8.16 TeV

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    Search for top squark pair production in compressed-mass-spectrum scenarios in proton-proton collisions at √s=8 TeV using the αT_{T} variable

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    An inclusive search is performed for supersymmetry in final states containing jets and an apparent imbalance in transverse momentum, (p) over right arrow (miss)(T),due to the production of unobserved weakly interacting particles in pp collisions at a centre-of-mass energy of 8 TeV. The data, recorded with the CMS detector at the CERN LHC, correspond to an integrated luminosity of 18.5fb(-1). The dimensionless kinematic variable alpha(T) is used to discriminate between events with genuine (p) over right arrow (miss)(T)associated with unobserved particles and spurious values of (p) over right arrow (miss)(T) Tarising from jet energy mismeasurements. No excess of event yields above the expected standard model backgrounds is observed. The results are interpreted in terms of constraints on the parameter space of several simplified models of supersymmetry that assume the pair production of top squarks. The search provides sensitivity to a broad range of top squark ((t) over tilde) decay modes, including the two-body decay (t)over tilde> -> c (chi) over tilde (0)(1),where c is a charm quark (chi) over tilde (0)(1) and is the lightest neutralino, as well as the four-body decay (t)over tilde> -> bf (f) over bar' (chi) over bar (0)(1),where b is a bottom quark and f and (f) over bar' are fermions produced in the decay of an intermediate off-shell W boson. These modes dominate in scenarios in which the top squark and lightest neutralino are nearly degenerate in mass. For these modes, top squarks with masses as large as 260 and 225 GeV are excluded, respectively, for the two-and four-body decays. (C) 2017 The Author. Published by Elsevier B.V

    Observation of the Higgs boson decay to a pair of τ leptons with the CMS detector

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    Search for gauge-mediated supersymmetry in events with at least one photon and missing transverse momentum in pp collisions at √s = 13 TeV

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    A search for gauge-mediated supersymmetry (SUSY) in final states with photons and large missing transverse momentum is presented. The data sample of pp collisions at s=13TeV was collected with the CMS detector at the CERN LHC and corresponds to an integrated luminosity of 35.9 fb−1. Data are compared with models in which the lightest neutralino has bino- or wino-like components, resulting in decays to photons and gravitinos, where the gravitinos escape detection. The event selection is optimized for both electroweak (EWK) and strong production SUSY scenarios. The observed data are consistent with standard model predictions, and limits are set in the context of a general gauge mediation model in which gaugino masses up to 980 GeV are excluded at 95% confidence level. Gaugino masses below 780 and 950 GeV are excluded in two simplified models with EWK production of mass-degenerate charginos and neutralinos. Stringent limits are set on simplified models based on gluino and squark pair production, excluding gluino (squark) masses up to 2100 (1750) GeV depending on the assumptions made for the decay modes and intermediate particle masses. This analysis sets the highest mass limits to date in the studied EWK models, and in the considered strong production models when the mass difference between the gauginos and the squarks or gluinos is small
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