Cut-offs and response criteria for the Hospital Universitario la Princesa Index (HUPI) and their comparison to widely-used indices of disease activity in rheumatoid arthritis

Objective To estimate cut-off points and to establish response criteria for the Hospital Universitario La Princesa Index (HUPI) in patients with chronic polyarthritis. Methods Two cohorts, one of early arthritis (Princesa Early Arthritis Register Longitudinal PEARL] study) and other of long-term rheumatoid arthritis (Estudio de la Morbilidad y Expresión Clínica de la Artritis Reumatoide EMECAR]) including altogether 1200 patients were used to determine cut-off values for remission, and for low, moderate and high activity through receiver operating curve (ROC) analysis. The areas under ROC (AUC) were compared to those of validated indexes (SDAI, CDAI, DAS28). ROC analysis was also applied to establish minimal and relevant clinical improvement for HUPI. Results The best cut-off points for HUPI are 2, 5 and 9, classifying RA activity as remission if =2, low disease activity if >2 and =5), moderate if >5 and <9 and high if =9. HUPI''s AUC to discriminate between low-moderate activity was 0.909 and between moderate-high activity 0.887. DAS28''s AUCs were 0.887 and 0.846, respectively; both indices had higher accuracy than SDAI (AUCs: 0.832 and 0.756) and CDAI (AUCs: 0.789 and 0.728). HUPI discriminates remission better than DAS28-ESR in early arthritis, but similarly to SDAI. The HUPI cut-off for minimal clinical improvement was established at 2 and for relevant clinical improvement at 4. Response criteria were established based on these cut-off values. Conclusions The cut-offs proposed for HUPI perform adequately in patients with either early or long term arthritis

Science with the Cherenkov Telescope Array

The Cherenkov Telescope Array, CTA, will be the major global observatory forvery high energy gamma-ray astronomy over the next decade and beyond. Thescientific potential of CTA is extremely broad: from understanding the role ofrelativistic cosmic particles to the search for dark matter. CTA is an explorerof the extreme universe, probing environments from the immediate neighbourhoodof black holes to cosmic voids on the largest scales. Covering a huge range inphoton energy from 20 GeV to 300 TeV, CTA will improve on all aspects ofperformance with respect to current instruments. The observatory will operate arrays on sites in both hemispheres to providefull sky coverage and will hence maximize the potential for the rarestphenomena such as very nearby supernovae, gamma-ray bursts or gravitationalwave transients. With 99 telescopes on the southern site and 19 telescopes onthe northern site, flexible operation will be possible, with sub-arraysavailable for specific tasks. CTA will have important synergies with many ofthe new generation of major astronomical and astroparticle observatories.Multi-wavelength and multi-messenger approaches combining CTA data with thosefrom other instruments will lead to a deeper understanding of the broad-bandnon-thermal properties of target sources. The CTA Observatory will be operated as an open, proposal-driven observatory,with all data available on a public archive after a pre-defined proprietaryperiod. Scientists from institutions worldwide have combined together to formthe CTA Consortium. This Consortium has prepared a proposal for a CoreProgramme of highly motivated observations. The programme, encompassingapproximately 40% of the available observing time over the first ten years ofCTA operation, is made up of individual Key Science Projects (KSPs), which arepresented in this document