bluuebunny/crossref_metadata_2025_split huggingface dataset:
Dependence of Optical Active Galactic Nuclei Identification on Stellar Population Models
Authors: Chen Yan-Ping , Zaw Ingyin , Farrar Glennys R. 
Published: July 2018

Abstract
We have conducted a study to quantify the systematic differences resulting from using different stellar population models (SPM) in optical spectroscopic identification of type II active galactic nuclei (AGNs). We examined the different AGN detection fractions of 7069 nearby galaxies (z ≤ 0.09) with Sloan Digital sky Survey (SDSS) DR8 spectra when using the Bruzual & Charlot (BC03), Vazdekis et al. (MILES), and solar metallicity Maraston & Strömbäck (MS11solar) SPM. The line fluxes obtained using BC03 and MS11solar are publicly available from SDSS data releases. We find that the BC03 templates result in systematically higher BPT line ratios and consequently higher AGN fractions, and the MS11solar templates result in systematically lower line ratios and AGN fractions compared with the MILES templates. Using MILES as the standard, BC03 results in 25% “false positives” and MS11solar results in 22% “false negatives” when using the Kewley et al. boundary for AGN identification. The fraction of galaxies whose AGN identification changes for different templates is luminosity dependent, ranging from a few percent for L
[O iii]5007 ≥ 1040 erg s−1 and increasing to ∼50% for L
[O iii]5007 ≤ 1038 erg s−1. These results suggest that template choice should be accounted for when using and comparing the AGN and emission line fluxes from different catalogs.
KL-6 But Not CCL-18 Is a Predictor of Early Progression in Systemic Sclerosis-related Interstitial Lung Disease
Authors: Salazar Gloria A. , Kuwana Masataka , Wu Minghua , Estrada-Y-Martin Rosa M. , Ying Jun , Charles Julio , Mayes Maureen D. , Assassi Shervin 
Published: July 2018

Objective.The 2 pneumoproteins, KL-6 and CCL-18, are promising biomarkers in systemic sclerosis (SSc)-related interstitial lung disease (ILD). Our goal was to determine their predictive significance for forced vital capacity % (FVC%) decline within the first year of followup in patients with early SSc-ILD.Methods.Early SSc patients with imaging-verified ILD enrolled in the Genetics versus Environment in Scleroderma Outcome Study (GENISOS) cohort were included. Annualized rate of change in FVC% based on the baseline and followup measurement within 12–18 months was used as the surrogate outcomes for ILD progression.Results.Eighty-two early SSc-ILD patients with mean disease duration of 2.3 years were investigated. FVC% change ranged from −23% to 38%. Baseline KL-6 levels were higher in patients than healthy controls (p < 0.0001). Higher KL-6 levels were predictive of faster FVC% decline at the 1-year followup (r = −0.23, p = 0.037). Upon categorizing KL-6 using a previously published cutoff of 1273 U/ml, its predictive significance remained in the univariable model (b = −0.07, p = 0.01), indicating that patients with positive KL-6 had on average 7% more decline in annualized percent change of FVC%. Moreover, KL-6 remained an independent predictor after adjustment for sex, disease type, anti-Scl-70, and immunosuppressive treatment status in multivariable models. Although CCL-18 was higher in patients than controls (p < 0.001), its levels did not predict FVC decline rate (p = 0.458).Conclusion.KL-6 but not CCL-18 is predictive of early SSc-ILD progression. KL-6 is a promising pneumoprotein that can contribute to SSc-ILD clinical trial enrichment.
Frequency of Impaired Spinal Mobility in Patients with Chronic Back Pain Compared to Patients with Early Axial Spondyloarthritis
Authors: Fongen Camilla , Dagfinrud Hanne , Berg Inger Jorid , Ramiro Sofia , van Gaalen Floris , Landewé Robert , Ramonda Roberta , van der Heijde Désirée , Fagerli Karen Minde 
Published: July 2018

Objective.To examine the frequency of impaired spinal mobility in patients with chronic back pain of short duration and to compare it with the frequency of impaired spinal mobility in patients with axial spondyloarthritis (axSpA), possible SpA, and no SpA.Methods.The SpondyloArthritis Caught Early (SPACE) cohort includes patients with chronic back pain (≥ 3 mos, ≤ 2 yrs, onset < 45 yrs). Spinal mobility was assessed with lateral spinal flexion, chest expansion, cervical rotation, occiput-to-wall distance, and lumbar flexion. Hip mobility was assessed with intermalleolar distance. Mobility measures were defined as impaired if below the 5th percentile reference curve from general population, adjusted for age and height when appropriate. Proportions of patients categorized with impaired mobility were examined with chi square.Results.In total, 393 patients with chronic back pain were included: 142 axSpA, 140 possible SpA, and 111 no SpA. Impairment in ≥ 1 mobility measure was present in 66% of all patients. The most frequently impaired mobility measure was lateral spinal flexion (40%), followed by chest expansion (22%), cervical rotation (18%), intermalleolar distance (17%), lumbar flexion (15%), and occiput-to-wall distance (11%). No statistically significant differences in proportion of patients with impaired spinal mobility were found between patients with axSpA and the other subgroups in any of the tests.Conclusion.Two out of 3 patients with chronic back pain of short duration had impaired spinal mobility compared to the general population. Impaired spinal mobility occurs as often in patients with early axSpA as in other forms of chronic back pain.
Reproducibility and Utility of the 6-minute Walk Test in Systemic Sclerosis
Authors: Pugnet Grégory , Marjanovic Zora , Deligny Christophe , Boussardon Karine , Benzidia Ilham , Puyade Mathieu , Lansiaux Pauline , Vandecasteele Els , Smith Vanessa , Farge Dominique 
Published: July 2018

Objective.To assess the reproducibility and the utility of the 6-minute walk test (6MWT) in systemic sclerosis (SSc).Methods.All patients with SSc who underwent at least two 6MWT within a minimum 3-month interval plus simultaneous routine clinical, biological, and functional evaluations were consecutively enrolled in this observational study over 6 years. Following American Thoracic Society guidelines, each 6MWT was repeated twice to assess the 6-minute walk distance (6MWD) reproducibility, with the highest value being reported for subsequent analysis.Results.Among 56 (38 female) included patients aged 46 ± SD 12.7 years, with 17 ± 10 modified Rodnan skin score (mRSS) and 1 ± 0.8 Scleroderma Health Assessment Questionnaire (SHAQ) at first referral, 277 6MWT evaluations (5 ± 3.9 6MWT per patient) were performed over 23 ± 22.5 months followup. Meanwhile, 8 deaths (87.5% SSc-related) occurred. The mean 6MWD absolute value was 457 ± 117 m with a 4 ± 2.2 mean Borg dyspnea score. The 6MWD intraclass correlation coefficient was 0.996 (95% CI 0.995–0.999, p < 0.0001). In multivariate linear regression analysis, these factors were independently associated with a lower 6MWD: sex (R2 = 0.47, p < 0.0001), mRSS (R2 = 0.47, p = 0.008), tendon friction rub (R2 = 0.47, p = 0.003), SHAQ (R2 = 0.47, p = 0.02), muscle disability score (R2 = 0.47, p = 0.03), DLCO% (R2 = 0.47, p = 0.0008), and left ventricular ejection fraction (R2 = 0.47, p = 0.006). The 6MWD at first referral was an independent predictor for the overall mortality (HR 0.99, 95% CI 0.988–0.999) and the SSc-related mortality (HR 0.99, 95% CI 0.988–0.999).Conclusion.We show strong reproducibility for the 6MWD and confirm the 6MWT utility to assess the overall prognosis of patients with SSc.
Do Poor Prognostic Factors in Rheumatoid Arthritis Affect Treatment Choices and Outcomes? Analysis of a US Rheumatoid Arthritis Registry
Authors: Alemao Evo , Litman Heather J. , Connolly Sean E. , Kelly Sheila , Hua Winnie , Rosenblatt Lisa , Rebello Sabrina , Kremer Joel M. , Harrold Leslie R. 
Published: July 2018

Objective.To characterize patients with rheumatoid arthritis (RA) by number of poor prognostic factors (PPF: functional limitation, extraarticular disease, seropositivity, erosions) and evaluate treatment acceleration, clinical outcomes, and work status over 12 months by number of PPF.Methods.Using the Corrona RA registry (January 2005–December 2015), biologic-naive patients with diagnosed RA having 12-month (± 3 mos) followup were identified and categorized by PPF (0–1, 2, ≥ 3). Changes in medication, Clinical Disease Activity Index (CDAI), and work status (baseline–12 mos) were evaluated using linear and logistic regression models.Results.There were 3458 patients who met the selection criteria: 1489 (43.1%), 1214 (35.1%), and 755 (21.8%) had 0–1, 2, or ≥ 3 PPF, respectively. At baseline, patients with ≥ 3 PPF were older, and had longer RA duration and higher CDAI versus those with 0–1 PPF. In 0–1, 2, and ≥ 3 PPF groups, respectively, 20.9%, 23.2%, and 26.5% of patients received ≥ 1 biologic (p = 0.011). Biologic/targeted synthetic disease-modifying antirheumatic drug (tsDMARD) use was similar in patients with/without PPF (p = 0.57). After adjusting for baseline CDAI, mean (standard error) change in CDAI was −4.95 (0.24), −4.53 (0.27), and −2.52 (0.34) for 0–1, 2, and ≥ 3 PPF groups, respectively. More patients were working at baseline but not at 12-month followup in 2 (13.9%) and ≥ 3 (12.5%) versus 0–1 (7.3%) PPF group.Conclusion.Despite high disease activity and worse clinical outcomes, number of PPF did not significantly predict biologic/tsDMARD use. This may warrant reconsideration of the importance of PPF in treat-to-target approaches.
Influence of Axial Involvement on Clinical Characteristics of Psoriatic Arthritis: Analysis from the Corrona Psoriatic Arthritis/Spondyloarthritis Registry
Authors: Mease Philip J. , Palmer Jacqueline B. , Liu Mei , Kavanaugh Arthur , Pandurengan Renganayaki , Ritchlin Christopher T. , Karki Chitra , Greenberg Jeffrey D. 
Published: July 2018

Objective.We analyzed the characteristics of patients with psoriatic arthritis (PsA) with and without axial involvement in the US-based Corrona Psoriatic Arthritis/Spondyloarthritis Registry.Methods.All patients were included who had PsA and data on axial involvement, defined as physician-reported presence of spinal involvement at enrollment, and/or radiograph or magnetic resonance imaging showing sacroiliitis. Demographics, clinical measures, patient-reported outcomes, and treatment characteristics were assessed at enrollment.Results.Of 1530 patients with PsA, 192 (12.5%) had axial involvement and 1338 (87.5%) did not. Subgroups were similar in sex, race, body mass index, disease duration, presence of dactylitis, and prevalence of most comorbidities. However, patients with axial involvement were younger and more likely to have enthesitis, a history of depression, and more frequently used biologics at enrollment. They were also more likely to have moderate/severe psoriasis (body surface area ≥ 3%, 42.5% vs 31.5%) and significantly worse disease as measured by a lower prevalence of minimal disease activity (30.1% vs 46.2%) and higher nail psoriasis scores [visual analog scale (VAS) 11.4 vs 6.5], enthesitis counts (5.1 vs 3.4), Bath Ankylosing Spondylitis Disease Activity Index (4.7 vs 3.5) scores, Bath Ankylosing Spondylitis Functional Index (3.8 vs 2.5) scores, C-reactive protein levels (4.1 vs 2.4 mg/l), and scores for physical function (Health Assessment Questionnaire, 0.9 vs 0.6), pain (VAS, 47.7 vs 36.2), and fatigue (VAS, 50.2 vs 38.6).Conclusion.Presence of axial involvement was associated with a higher likelihood of moderate/severe psoriasis, with higher disease activity and greater effect on quality of life. These findings highlight the importance of monitoring patients with PsA for signs of axial symptoms or spinal involvement.
Sarcoidosis in Patients with Antisynthetase Syndrome: Presentation and Outcome
Authors: Couture Priscille , Brillet Pierre-Yves , Varin Stéphane , Le Goff Benoît , Meyer Alain , Sibilia Jean , Jouneau Stéphane , Valeyre Dominique , Hervier Baptiste , Uzunhan Yurdagül 
Published: July 2018

Objective.To investigate the uncommon co-occurrence of antisynthetase syndrome (AS) and sarcoidosis.Methods.From 2000 to 2015, patients with sarcoidosis were extracted from a retrospective multicentric cohort of 352 patients with AS.Results.Ten patients (2.8%; 6 men, 8 whites, 5 smokers, median age 50 yrs) had both AS and sarcoidosis. Most of the time, sarcoidosis and AS occurred simultaneously (n = 7). Antibody testing revealed anti-Jo1 (n = 5), anti-PL12 (n = 4), or anti-PL7 (n = 1). Finally, no patient had a worsening of muscular condition, 5 patients presented respiratory deterioration, 3 remained stable, and 2 showed improvement.Conclusion.Sarcoidosis may be underdiagnosed in patients with AS.
Maternal and Fetal Outcomes in a Cohort of Patients Exposed to Tumor Necrosis Factor Inhibitors throughout Pregnancy
Authors: Genest Geneviève , Spitzer Karen A. , Laskin Carl A. 
Published: July 2018

Objective.Tumor necrosis factor inhibitors (TNFi) are increasingly used in pregnancy but are frequently withheld in the second or third trimesters. We evaluated the maternal and fetal outcomes of women who continued their TNFi throughout pregnancy compared to women who interrupted TNFi during pregnancy.Methods.We retrospectively analyzed the outcomes of women seen in clinic with rheumatoid arthritis (RA), psoriatic arthritis, juvenile idiopathic arthritis (JIA), or ankylosing spondylitis, who were exposed to TNFi during pregnancy. We separated pregnancies into 2 groups based on the level of TNFi exposure and compared outcomes.Results.In Group 1 (TNFi exposure in first trimester only), 11 women had 14 pregnancies and 12 live births. There were 2 first-trimester losses (2/14, 14%), one in the setting of active RA. Five pregnancies (5/14, 35.7%) were complicated by a disease flare. Eight patients (8/12, 66%) flared postpartum. In Group 2 (TNFi exposure throughout pregnancy), 29 women had 32 pregnancies and 34 live births. Three (3/28, 10.7%) adverse pregnancy outcomes were reported in 2 patients. One patient had a twin pregnancy and delivered at 33 weeks after developing preterm premature rupture of membranes at 32 weeks in the setting of a JIA flare. Her second pregnancy was complicated by active JIA before and throughout gestation, and hemolysis, elevated liver enzyme levels, and low platelet levels (HELLP) syndrome at 39 weeks. Another patient with comorbid antiphospholipid syndrome underwent a cesarean birth at 36 weeks for suspicion of HELLP syndrome. Six (6/32, 18.7%) postpartum flares occurred.Conclusion.Women who discontinued their TNFi during pregnancy had a higher risk of peri- or postpartum flare compared to those who continued their TNFi throughout pregnancy.
Increased Rates of Both Knee and Hip Arthroplasties in Older Patients with Ankylosing Spondylitis
Authors: Ward Michael M. 
Published: July 2018

Objective.To determine the risks of primary total hip arthroplasty (THA) and total knee arthroplasty (TKA) in older patients with ankylosing spondylitis (AS).Methods.We used administrative data from 1999 to 2013 on US Medicare beneficiaries to identify patients (< 75 yrs old) with AS and a comparison group without AS. Rates of primary THA and primary TKA were computed for each group, and standardized for age, sex, and race. We also examined risks of primary TKA among patients with AS by their THA status.Results.We analyzed 52,568 patients with AS and 4,617,179 patients without AS. Between 1999 and 2013, the standardized incidence of primary THA in patients with AS doubled from 4.5 per 1000 patient-years (PY) to 9.6 per 1000 PY. Rates of primary TKA were higher in patients with AS than controls in all years. In 2013, the standardized incidence of primary TKA in AS was 12.3 per 1000 PY versus 5.7 per 1000 PY in the comparison group (RR 2.14, 95% CI 1.93–2.38). Rates of primary TKA were twice as high among patients with AS and THA than among those without THA (20.4 vs 10.2 per 1000 PY).Conclusion.Rates of THA in older patients with AS doubled over recent years, outpacing the increase in the general population. Rates of TKA were also substantially higher in older patients with AS. The increased risk of TKA in AS may be a consequence of damage from knee inflammation, or alterations in lower extremity biomechanics due to hip arthritis.
Hospitalization Increases the Risk of Acute Arthritic Flares in Gout: A Population-based Study over 2 Decades
Authors: Zleik Nour , Elfishawi Mohanad M. , Kvrgic Zoran , Michet Clement J. , Crowson Cynthia S. , Matteson Eric L. , Bongartz Tim 
Published: July 2018

Objective.To assess in-hospital gout flares in patients with gout.Methods.Hospitalizations were evaluated for gout flares in a cohort of Olmsted County, Minnesota, residents with incident gout in 1989–1992 or 2009–2010.Results.There were 429 patients followed up to 5 years. Of these, 169 patients experienced 454 hospitalizations. Hospitalization rates increased without reaching statistical significance from 1989–1992 to 2009–2010 [rate ratio (RR) 1.19, 95% CI 0.98–1.45]. The gout flare rate increased significantly during hospitalization (RR 10.2, 95% CI 6.8–14.5). In-hospital gout flare increased the average hospital stay by 1.8 days (p < 0.001).Conclusion.Hospitalization increased the risk of gout flares 10-fold. In-hospital gout flares were associated with longer hospitalization.
Influence of Disease Manifestations on Health-related Quality of Life in Early Psoriatic Arthritis
Authors: Wervers Kim , Luime Jolanda J. , Tchetverikov Ilja , Gerards Andreas H. , Kok Marc R. , Appels Cathelijne W.Y. , van der Graaff Wiebo L. , van Groenendael Johannes H.L.M. , Korswagen Lindy-Anne , Veris-van Dieren Josien J. , Hazes Johanna M.W. , Vis Marijn 
Published: July 2018

Objective.Psoriatic arthritis (PsA) is a multifaceted disease. Affecting joints, skin, entheses, and dactylitis, its effect on health-related quality of life (HRQOL) could be substantial. We aim to assess HRQOL in patients newly diagnosed with PsA and analyze its associations with disease manifestations.Methods.Data collected at time of diagnosis from patients with PsA included in the Dutch south-west Early Psoriatic Arthritis cohort (DEPAR) study were used. HRQOL was assessed using 8 domains of the Medical Outcomes Study Short Form-36 (SF-36) questionnaire. Patients were classified based on primary manifestation in arthritis subtypes (i.e., mono-, oligo-, or polyarthritis) and other subtypes (i.e., enthesitis, dactylitis, and axial disease). In all patients, presence of arthritis, enthesitis, dactylitis, psoriasis, and chronic inflammatory back pain was determined. Multivariable linear regression was used to determine associations of PsA manifestations with HRQOL.Results.Of 405 patients, primary manifestation was peripheral arthritis in 320 (78 monoarthritis, 151 oligoarthritis, and 91 polyarthritis), enthesitis in 37, axial disease in 9, and dactylitis in 39. Mean scores of SF-36 domains were lower than the Dutch reference population and similar across arthritis subtypes. A higher number of enthesitis locations and tender joints, and presence of chronic back pain, were independently associated with worse SF-36 scores. Psoriasis and dactylitis were not associated with worse scores.Conclusion.HRQOL was diminished in PsA at time of diagnosis compared to the Dutch reference population, and tender joints, enthesitis at clinical examination, and back pain as indicators of pain affected HRQOL.
Assessing Vasculitis in Giant Cell Arteritis by Ultrasound: Results of OMERACT Patient-based Reliability Exercises
Authors: Schäfer Valentin S. , Chrysidis Stavros , Dejaco Christian , Duftner Christina , Iagnocco Annamaria , Bruyn George A. , Carrara Greta , D’Agostino Maria Antonietta , De Miguel Eugenio , Diamantopoulos Andreas P. , Fredberg Ulrich , Hartung Wolfgang , Hocevar Alojzija , Juche Aaron , Kermani Tanaz A. , Koster Matthew J. , Lorenzen Tove , Macchioni Pierluigi , Milchert Marcin , Døhn Uffe Møller , Mukhtyar Chetan , Ponte Cristina , Ramiro Sofia , Scirè Carlo A. , Terslev Lene , Warrington Kenneth J. , Dasgupta Bhaskar , Schmidt Wolfgang A. 
Published: July 2018

Objective.To test the reliability of Outcome Measures in Rheumatology Clinical Trials (OMERACT) consensus-based ultrasound definitions for normal and vasculitic temporal and axillary arteries in patients with giant cell arteritis (GCA) and in controls.Methods.A preliminary 1-day meeting and a full 3-day meeting fulfilling OMERACT Ultrasound Group guidelines were held. Temporal and axillary arteries were examined at 2 timepoints by 12 sonographers on 4 patients with GCA and 2 controls. The aim was to test inter- and intrareader reliability for normal findings, halo sign, and compression sign. In both meetings, patients had established GCA. Pathology was more recent in the full meeting, which was preceded by 6 h of training. Scanning time was 15–20 min instead of 10–13 min.Results.In the preliminary exercise, interreader reliabilities were fair to moderate for the overall diagnosis of GCA (Light κ 0.29–0.51), and poor to fair for identifying vasculitis in the respective anatomical segments (Light κ 0.02–0.46). Intrareader reliabilities were moderate (Cohen κ 0.32–0.64). In the main exercise, interreader reliability was good to excellent (Light κ 0.76–0.86) for the overall diagnosis of GCA, and moderate to good (Light κ 0.46–0.71) for identifying vasculitis in the respective anatomical segments. Intrareader reliability was excellent for diagnosis of GCA (Cohen κ 0.91) and good (Cohen κ 0.71–0.80) for the anatomical segments.Conclusion.OMERACT-derived definitions of halo and compression signs of temporal and axillary arteries are reliable in recent-onset GCA if experienced sonographers (> 300 examinations) have 15–20 min for a standardized examination with prior training and apply > 15 MHz probes.
Relationships Among Palliative Care, Ethical Climate, Empowerment, and Moral Distress in Intensive Care Unit Nurses
Authors: Altaker Krista Wolcott , Howie-Esquivel Jill , Cataldo Janine K. 
Published: July 2018

BackgroundIntensive care unit nurses experience moral distress when they feel unable to deliver ethically appropriate care to patients. Moral distress is associated with nurse burnout and patient care avoidance.ObjectivesTo evaluate relationships among moral distress, empowerment, ethical climate, and access to palliative care in the intensive care unit.MethodsIntensive care unit nurses in a national database were recruited to complete an online survey based on the Moral Distress Scale–Revised, Psychological Empowerment Index, Hospital Ethical Climate Survey, and a palliative care delivery questionnaire. Descriptive, correlational, and regression analyses were performed.ResultsOf 288 initiated surveys, 238 were completed. Participants were nationally representative of nurses by age, years of experience, and geographical region. Most were white and female and had a bachelor’s degree. The mean moral distress score was moderately high, and correlations were found with empowerment (r = −0.145; P = .02) and ethical climate scores (r = −0.354; P &lt; .001). Relationships between moral distress and empowerment scores and between moral distress and ethical climate scores were not affected by access to palliative care. Nurses reporting palliative care access had higher moral distress scores than those without such access. Education, ethnicity, unit size, access to full palliative care team, and ethical climate explained variance in moral distress scores.ConclusionsPoor ethical climate, unintegrated palliative care teams, and nurse empowerment are associated with increased moral distress. The findings highlight the need to promote palliative care education and palliative care teams that are well integrated into intensive care units.