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Showalter K, Magro C, Zhang Y, Spiera R, Orange DE, Gordon JK. Response to: 'Correspondence on 'Machine learning integration of scleroderma histology and gene expression identifies fibroblast polarisation as a hallmark of clinical severity and improvement'' by Manetti. Ann Rheum Dis 2023; 82:e22. [PMID: 33158883 DOI: 10.1136/annrheumdis-2020-219292] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Accepted: 10/22/2020] [Indexed: 02/03/2023]
Affiliation(s)
- Kimberly Showalter
- Department of Medicine, Division of Rheumatology, Hospital for Special Surgery, New York, New York, USA
| | - Cynthia Magro
- Department of Pathology and Laboratory Medicine, Weill Cornell Medicine, New York, New York, USA
| | - Yaxia Zhang
- Department of Pathology and Clinical Laboratory Medicine, Hospital for Special Surgery, New York, New York, USA
| | - Robert Spiera
- Department of Medicine, Division of Rheumatology, Hospital for Special Surgery, New York, New York, USA
| | - Dana E Orange
- Department of Medicine, Division of Rheumatology, Hospital for Special Surgery, New York, New York, USA.,Center for Clinical and Translational Science, Laboratory of Molecular Neuro-Oncology, The Rockefeller University, New York, New York, USA
| | - Jessica K Gordon
- Department of Medicine, Division of Rheumatology, Hospital for Special Surgery, New York, New York, USA
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Gordon JK, Showalter K, Wu Y, Kwakkenbos L, Carrier ME, Henry RS, Østbø N, Nordlund J, Bourgeault A, Cañedo-Ayala M, Carboni-Jiménez A, Denton CP, Mouthon L, Thombs BD, Spiera RF. Systemic sclerosis and COVID-19 vaccines: a SPIN Cohort study. The Lancet Rheumatology 2022; 4:e243-e246. [PMID: 35072109 PMCID: PMC8765760 DOI: 10.1016/s2665-9913(21)00416-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
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Jansen L, Tegomoh B, Lange K, Showalter K, Figliomeni J, Abdalhamid B, Iwen PC, Fauver J, Buss B, Donahue M. Investigation of a SARS-CoV-2 B.1.1.529 (Omicron) Variant Cluster - Nebraska, November-December 2021. MMWR Morb Mortal Wkly Rep 2021; 70:1782-1784. [PMID: 34968376 PMCID: PMC8736273 DOI: 10.15585/mmwr.mm705152e3] [Citation(s) in RCA: 112] [Impact Index Per Article: 37.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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Showalter K, Pinheiro LC, Jannat-Khah D, Sobol I, Szymonifka J, Finik J, Steen VD, Gordon JK. Hospital readmission in systemic sclerosis associated pulmonary hypertension: Results from the PHAROS registry. Rheumatology (Oxford) 2021; 61:1510-1517. [PMID: 34273167 DOI: 10.1093/rheumatology/keab569] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Accepted: 07/09/2021] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE To identify individual-level factors associated with hospital readmission among individuals with systemic sclerosis associated pulmonary hypertension (SSc-PH). METHODS Individuals enrolled in the Pulmonary Hypertension Assessment and Recognition of Outcomes in Scleroderma (PHAROS) registry contributed clinical data related to SSc-PH disease severity and hospital admissions. Readmission was defined as a subsequent hospitalization within 12 months of any hospital discharge. Characteristics were compared between individuals with and without readmissions using Fisher's exact test, Wilcoxon rank-sum test, or Kruskal Wallis test. Logistic regression was used to estimate associations between clinical predictors and likelihood of readmission. RESULTS Of 572 individuals with SSc-PH enrolled in PHAROS, 54% had ≥1 hospitalizations between 2005 and 2016. Among individuals ever-hospitalized, 34% had ≥1 readmission. Individuals with vs without readmissions had shorter median (IQR) time between index hospitalization date and next PHAROS visit (37 (3, 80) vs 81 (42, 136) days, p< 0.001). Index admissions related to PH or SSc (vs non-PH/SSc related) were associated with an increased odds of 12-month readmission (aOR 6.6 (95% CI 3.2, 13.6) and aOR 2.2 (95% CI 1.1, 4.5), respectively). Readmission was less likely among home oxygen users (vs non-users) (aOR 0.44; 95% CI 0.22, 0.89). Race, age, sex, disease duration, and disease subtype were not associated with readmission. CONCLUSION The strongest predictor for 12-month readmission was an index hospitalization reason related to PH. Home oxygen use was associated with lower odds of readmission. Future studies should determine whether testing for the need for home oxygen mediates the risk of readmission in SSc-PH.
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Affiliation(s)
- Kimberly Showalter
- Department of Medicine, Division of Rheumatology, Hospital for Special Surgery, 535 East 70th Street
- New York, NY 10021
| | - Laura C Pinheiro
- Department of Medicine, Division of General Internal Medicine, Weill Cornell Medicine, 525 East 68th Street, New York, F-2011
- , NY 10065
| | - Deanna Jannat-Khah
- Department of Medicine, Division of Rheumatology, Hospital for Special Surgery, 535 East 70th Street
- New York, NY 10021
| | - Irina Sobol
- Department of Medicine, Division of Cardiology, Weill Cornell Medicine, 520 East 70th street
- New York, NY 10021
| | - Jackie Szymonifka
- Department of Medicine, Division of Rheumatology, Hospital for Special Surgery, 535 East 70th Street
- New York, NY 10021
| | - Jackie Finik
- Department of Medicine, Division of Rheumatology, Hospital for Special Surgery, 535 East 70th Street
- New York, NY 10021
| | - Virginia D Steen
- Department of Medicine, Division of Rheumatology, MedStar Georgetown University Hospital, 3800 Reservoir Road, Washington, DC NW
- , 20007
| | - Jessica K Gordon
- Department of Medicine, Division of Rheumatology, Hospital for Special Surgery, 535 East 70th Street
- New York, NY 10021
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Showalter K, Hoffmann A, Richardson C, Aaby D, Lee J, Dematte J, Agrawal R, Savas H, Wu X, Chang RW, Hinchcliff M. Esophageal Dilation and Other Clinical Factors Associated with Pulmonary Function Decline in Patients with Systemic Sclerosis. J Rheumatol 2021; 48:1830-1838. [PMID: 34266985 DOI: 10.3899/jrheum.210533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/08/2021] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To identify clinical factors, including esophageal dilation on chest high-resolution computed tomography (HRCT), that are associated with pulmonary function decline in patients with systemic sclerosis (SSc). METHODS Patients fulfilled 2013 SSc criteria and had ≥1 HRCT and ≥2 pulmonary function tests (PFTs). According to published methods, widest esophageal diameter (WED) and radiographic interstitial lung disease (ILD) were assessed, and WED was dichotomized as dilated (≥19mm) vs. not dilated (<19mm). Clinically meaningful PFT decline was defined as %-predicted change in forced vital capacity (FVC) ≥5 and/or diffusion capacity for carbon monoxide (DLCO) ≥15. Linear mixed effect models were used to model PFT change over time. RESULTS 138 SSc patients met study criteria: 100 (72%) had radiographic ILD; 49 (35%) demonstrated FVC decline (median follow-up 2.9y). Patients with Scl-70 autoantibodies had 5- year %-predicted FVC decline (-6.3; 95% CI -9.9, -2.8), while patients without Scl-70 autoantibodies demonstrated 5-year FVC stability (+1.78; 95% CI -0.6, 4.15). Esophageal diameter did not distinguish between those with vs. without FVC decline. Patients with esophageal dilation had statistically significant 5-year %-predicted DLCO decline (-5.6; 95% CI - 10.0, -1.2), but this decline was unlikely clinically significant. Similar results were observed in sub-analysis of patients with radiographic ILD. CONCLUSION In patients with SSc, Scl-70 positivity is a risk factor for %-predicted FVC decline at five years. Esophageal dilation on HRCT was associated with a minimal, non-clinically significant decline in DLCO and no change in FVC during 5-year follow-up. These results have prognostic implications for SSc-ILD patients with esophageal dilation.
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Affiliation(s)
- Kimberly Showalter
- Northwestern University Feinberg School of Medicine Department of Medicine 240 E. Huron Street, Suite 1-200 Chicago, IL 60611; Hospital for Special Surgery Department of Medicine, Division of Rheumatology 535 E. 70th Street New York, NY 10021; Northwestern University Feinberg School of Medicine Department of Medicine, Division of Rheumatology 240 E. Huron Street Suite M-300 Chicago, IL 60611; Northwestern University Feinberg School of Medicine Department of Preventive Medicine 680 N. Lake Shore Drive Suite 1400 Chicago, IL 60611; Northwestern University Feinberg School of Medicine Institute for Public Health and Medicine 633 N St. Clair 18th Floor Chicago, IL 60611; Northwestern University Feinberg School of Medicine Department of Medicine, Division of Pulmonary and Critical Care Medicine 240 E Huron, McGaw M-300; Northwestern University Feinberg School of Medicine Department of Radiology 251 E. Huron Street, 4th Floor Chicago, IL 60611; hNew York Presbyterian/Weill Cornell Department of Medicine, Division of Pulmonary and Critical Care Medicine 1305 York Ave, 10th floor, Y-1053 New York, NY 10065; Yale School of Medicine Department of Medicine, Section of Rheumatology, Allergy & Immunology The Anlyan Center 300 Cedar Street PO Box 208031 New Haven, CT 06520. Financial support: Research was supported by the National Institute of Arthritis and Musculoskeletal and Skin Diseases of the National Institutes of Health under Award Numbers K23 AR059763 (MH), R01 AR073270 (MH), P60 AR064464 (RWC, KK, JL), and P30 AR072579 (RWC, JL) and National Center for Advancing Translational Sciences-Clinical and Translational Science Award Number UL1 TR000150 (JL). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. The Rheumatology Research Foundation (KS), Scleroderma Foundation (KS), and the Scleroderma Research Foundation (MH) also supported this work. Corresponding author: Monique Hinchcliff, MD MS, Associate Professor of Medicine, Yale School of Medicine, Department of Medicine, Section of Allergy, Rheumatology & Immunology, The Anlyan Center, 300 Cedar Street, PO Box 208031, New Haven, CT 06520.
| | - Aileen Hoffmann
- Northwestern University Feinberg School of Medicine Department of Medicine 240 E. Huron Street, Suite 1-200 Chicago, IL 60611; Hospital for Special Surgery Department of Medicine, Division of Rheumatology 535 E. 70th Street New York, NY 10021; Northwestern University Feinberg School of Medicine Department of Medicine, Division of Rheumatology 240 E. Huron Street Suite M-300 Chicago, IL 60611; Northwestern University Feinberg School of Medicine Department of Preventive Medicine 680 N. Lake Shore Drive Suite 1400 Chicago, IL 60611; Northwestern University Feinberg School of Medicine Institute for Public Health and Medicine 633 N St. Clair 18th Floor Chicago, IL 60611; Northwestern University Feinberg School of Medicine Department of Medicine, Division of Pulmonary and Critical Care Medicine 240 E Huron, McGaw M-300; Northwestern University Feinberg School of Medicine Department of Radiology 251 E. Huron Street, 4th Floor Chicago, IL 60611; hNew York Presbyterian/Weill Cornell Department of Medicine, Division of Pulmonary and Critical Care Medicine 1305 York Ave, 10th floor, Y-1053 New York, NY 10065; Yale School of Medicine Department of Medicine, Section of Rheumatology, Allergy & Immunology The Anlyan Center 300 Cedar Street PO Box 208031 New Haven, CT 06520. Financial support: Research was supported by the National Institute of Arthritis and Musculoskeletal and Skin Diseases of the National Institutes of Health under Award Numbers K23 AR059763 (MH), R01 AR073270 (MH), P60 AR064464 (RWC, KK, JL), and P30 AR072579 (RWC, JL) and National Center for Advancing Translational Sciences-Clinical and Translational Science Award Number UL1 TR000150 (JL). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. The Rheumatology Research Foundation (KS), Scleroderma Foundation (KS), and the Scleroderma Research Foundation (MH) also supported this work. Corresponding author: Monique Hinchcliff, MD MS, Associate Professor of Medicine, Yale School of Medicine, Department of Medicine, Section of Allergy, Rheumatology & Immunology, The Anlyan Center, 300 Cedar Street, PO Box 208031, New Haven, CT 06520.
| | - Carrie Richardson
- Northwestern University Feinberg School of Medicine Department of Medicine 240 E. Huron Street, Suite 1-200 Chicago, IL 60611; Hospital for Special Surgery Department of Medicine, Division of Rheumatology 535 E. 70th Street New York, NY 10021; Northwestern University Feinberg School of Medicine Department of Medicine, Division of Rheumatology 240 E. Huron Street Suite M-300 Chicago, IL 60611; Northwestern University Feinberg School of Medicine Department of Preventive Medicine 680 N. Lake Shore Drive Suite 1400 Chicago, IL 60611; Northwestern University Feinberg School of Medicine Institute for Public Health and Medicine 633 N St. Clair 18th Floor Chicago, IL 60611; Northwestern University Feinberg School of Medicine Department of Medicine, Division of Pulmonary and Critical Care Medicine 240 E Huron, McGaw M-300; Northwestern University Feinberg School of Medicine Department of Radiology 251 E. Huron Street, 4th Floor Chicago, IL 60611; hNew York Presbyterian/Weill Cornell Department of Medicine, Division of Pulmonary and Critical Care Medicine 1305 York Ave, 10th floor, Y-1053 New York, NY 10065; Yale School of Medicine Department of Medicine, Section of Rheumatology, Allergy & Immunology The Anlyan Center 300 Cedar Street PO Box 208031 New Haven, CT 06520. Financial support: Research was supported by the National Institute of Arthritis and Musculoskeletal and Skin Diseases of the National Institutes of Health under Award Numbers K23 AR059763 (MH), R01 AR073270 (MH), P60 AR064464 (RWC, KK, JL), and P30 AR072579 (RWC, JL) and National Center for Advancing Translational Sciences-Clinical and Translational Science Award Number UL1 TR000150 (JL). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. The Rheumatology Research Foundation (KS), Scleroderma Foundation (KS), and the Scleroderma Research Foundation (MH) also supported this work. Corresponding author: Monique Hinchcliff, MD MS, Associate Professor of Medicine, Yale School of Medicine, Department of Medicine, Section of Allergy, Rheumatology & Immunology, The Anlyan Center, 300 Cedar Street, PO Box 208031, New Haven, CT 06520.
| | - David Aaby
- Northwestern University Feinberg School of Medicine Department of Medicine 240 E. Huron Street, Suite 1-200 Chicago, IL 60611; Hospital for Special Surgery Department of Medicine, Division of Rheumatology 535 E. 70th Street New York, NY 10021; Northwestern University Feinberg School of Medicine Department of Medicine, Division of Rheumatology 240 E. Huron Street Suite M-300 Chicago, IL 60611; Northwestern University Feinberg School of Medicine Department of Preventive Medicine 680 N. Lake Shore Drive Suite 1400 Chicago, IL 60611; Northwestern University Feinberg School of Medicine Institute for Public Health and Medicine 633 N St. Clair 18th Floor Chicago, IL 60611; Northwestern University Feinberg School of Medicine Department of Medicine, Division of Pulmonary and Critical Care Medicine 240 E Huron, McGaw M-300; Northwestern University Feinberg School of Medicine Department of Radiology 251 E. Huron Street, 4th Floor Chicago, IL 60611; hNew York Presbyterian/Weill Cornell Department of Medicine, Division of Pulmonary and Critical Care Medicine 1305 York Ave, 10th floor, Y-1053 New York, NY 10065; Yale School of Medicine Department of Medicine, Section of Rheumatology, Allergy & Immunology The Anlyan Center 300 Cedar Street PO Box 208031 New Haven, CT 06520. Financial support: Research was supported by the National Institute of Arthritis and Musculoskeletal and Skin Diseases of the National Institutes of Health under Award Numbers K23 AR059763 (MH), R01 AR073270 (MH), P60 AR064464 (RWC, KK, JL), and P30 AR072579 (RWC, JL) and National Center for Advancing Translational Sciences-Clinical and Translational Science Award Number UL1 TR000150 (JL). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. The Rheumatology Research Foundation (KS), Scleroderma Foundation (KS), and the Scleroderma Research Foundation (MH) also supported this work. Corresponding author: Monique Hinchcliff, MD MS, Associate Professor of Medicine, Yale School of Medicine, Department of Medicine, Section of Allergy, Rheumatology & Immunology, The Anlyan Center, 300 Cedar Street, PO Box 208031, New Haven, CT 06520.
| | - Jungwha Lee
- Northwestern University Feinberg School of Medicine Department of Medicine 240 E. Huron Street, Suite 1-200 Chicago, IL 60611; Hospital for Special Surgery Department of Medicine, Division of Rheumatology 535 E. 70th Street New York, NY 10021; Northwestern University Feinberg School of Medicine Department of Medicine, Division of Rheumatology 240 E. Huron Street Suite M-300 Chicago, IL 60611; Northwestern University Feinberg School of Medicine Department of Preventive Medicine 680 N. Lake Shore Drive Suite 1400 Chicago, IL 60611; Northwestern University Feinberg School of Medicine Institute for Public Health and Medicine 633 N St. Clair 18th Floor Chicago, IL 60611; Northwestern University Feinberg School of Medicine Department of Medicine, Division of Pulmonary and Critical Care Medicine 240 E Huron, McGaw M-300; Northwestern University Feinberg School of Medicine Department of Radiology 251 E. Huron Street, 4th Floor Chicago, IL 60611; hNew York Presbyterian/Weill Cornell Department of Medicine, Division of Pulmonary and Critical Care Medicine 1305 York Ave, 10th floor, Y-1053 New York, NY 10065; Yale School of Medicine Department of Medicine, Section of Rheumatology, Allergy & Immunology The Anlyan Center 300 Cedar Street PO Box 208031 New Haven, CT 06520. Financial support: Research was supported by the National Institute of Arthritis and Musculoskeletal and Skin Diseases of the National Institutes of Health under Award Numbers K23 AR059763 (MH), R01 AR073270 (MH), P60 AR064464 (RWC, KK, JL), and P30 AR072579 (RWC, JL) and National Center for Advancing Translational Sciences-Clinical and Translational Science Award Number UL1 TR000150 (JL). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. The Rheumatology Research Foundation (KS), Scleroderma Foundation (KS), and the Scleroderma Research Foundation (MH) also supported this work. Corresponding author: Monique Hinchcliff, MD MS, Associate Professor of Medicine, Yale School of Medicine, Department of Medicine, Section of Allergy, Rheumatology & Immunology, The Anlyan Center, 300 Cedar Street, PO Box 208031, New Haven, CT 06520.
| | - Jane Dematte
- Northwestern University Feinberg School of Medicine Department of Medicine 240 E. Huron Street, Suite 1-200 Chicago, IL 60611; Hospital for Special Surgery Department of Medicine, Division of Rheumatology 535 E. 70th Street New York, NY 10021; Northwestern University Feinberg School of Medicine Department of Medicine, Division of Rheumatology 240 E. Huron Street Suite M-300 Chicago, IL 60611; Northwestern University Feinberg School of Medicine Department of Preventive Medicine 680 N. Lake Shore Drive Suite 1400 Chicago, IL 60611; Northwestern University Feinberg School of Medicine Institute for Public Health and Medicine 633 N St. Clair 18th Floor Chicago, IL 60611; Northwestern University Feinberg School of Medicine Department of Medicine, Division of Pulmonary and Critical Care Medicine 240 E Huron, McGaw M-300; Northwestern University Feinberg School of Medicine Department of Radiology 251 E. Huron Street, 4th Floor Chicago, IL 60611; hNew York Presbyterian/Weill Cornell Department of Medicine, Division of Pulmonary and Critical Care Medicine 1305 York Ave, 10th floor, Y-1053 New York, NY 10065; Yale School of Medicine Department of Medicine, Section of Rheumatology, Allergy & Immunology The Anlyan Center 300 Cedar Street PO Box 208031 New Haven, CT 06520. Financial support: Research was supported by the National Institute of Arthritis and Musculoskeletal and Skin Diseases of the National Institutes of Health under Award Numbers K23 AR059763 (MH), R01 AR073270 (MH), P60 AR064464 (RWC, KK, JL), and P30 AR072579 (RWC, JL) and National Center for Advancing Translational Sciences-Clinical and Translational Science Award Number UL1 TR000150 (JL). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. The Rheumatology Research Foundation (KS), Scleroderma Foundation (KS), and the Scleroderma Research Foundation (MH) also supported this work. Corresponding author: Monique Hinchcliff, MD MS, Associate Professor of Medicine, Yale School of Medicine, Department of Medicine, Section of Allergy, Rheumatology & Immunology, The Anlyan Center, 300 Cedar Street, PO Box 208031, New Haven, CT 06520.
| | - Rishi Agrawal
- Northwestern University Feinberg School of Medicine Department of Medicine 240 E. Huron Street, Suite 1-200 Chicago, IL 60611; Hospital for Special Surgery Department of Medicine, Division of Rheumatology 535 E. 70th Street New York, NY 10021; Northwestern University Feinberg School of Medicine Department of Medicine, Division of Rheumatology 240 E. Huron Street Suite M-300 Chicago, IL 60611; Northwestern University Feinberg School of Medicine Department of Preventive Medicine 680 N. Lake Shore Drive Suite 1400 Chicago, IL 60611; Northwestern University Feinberg School of Medicine Institute for Public Health and Medicine 633 N St. Clair 18th Floor Chicago, IL 60611; Northwestern University Feinberg School of Medicine Department of Medicine, Division of Pulmonary and Critical Care Medicine 240 E Huron, McGaw M-300; Northwestern University Feinberg School of Medicine Department of Radiology 251 E. Huron Street, 4th Floor Chicago, IL 60611; hNew York Presbyterian/Weill Cornell Department of Medicine, Division of Pulmonary and Critical Care Medicine 1305 York Ave, 10th floor, Y-1053 New York, NY 10065; Yale School of Medicine Department of Medicine, Section of Rheumatology, Allergy & Immunology The Anlyan Center 300 Cedar Street PO Box 208031 New Haven, CT 06520. Financial support: Research was supported by the National Institute of Arthritis and Musculoskeletal and Skin Diseases of the National Institutes of Health under Award Numbers K23 AR059763 (MH), R01 AR073270 (MH), P60 AR064464 (RWC, KK, JL), and P30 AR072579 (RWC, JL) and National Center for Advancing Translational Sciences-Clinical and Translational Science Award Number UL1 TR000150 (JL). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. The Rheumatology Research Foundation (KS), Scleroderma Foundation (KS), and the Scleroderma Research Foundation (MH) also supported this work. Corresponding author: Monique Hinchcliff, MD MS, Associate Professor of Medicine, Yale School of Medicine, Department of Medicine, Section of Allergy, Rheumatology & Immunology, The Anlyan Center, 300 Cedar Street, PO Box 208031, New Haven, CT 06520.
| | - Hatice Savas
- Northwestern University Feinberg School of Medicine Department of Medicine 240 E. Huron Street, Suite 1-200 Chicago, IL 60611; Hospital for Special Surgery Department of Medicine, Division of Rheumatology 535 E. 70th Street New York, NY 10021; Northwestern University Feinberg School of Medicine Department of Medicine, Division of Rheumatology 240 E. Huron Street Suite M-300 Chicago, IL 60611; Northwestern University Feinberg School of Medicine Department of Preventive Medicine 680 N. Lake Shore Drive Suite 1400 Chicago, IL 60611; Northwestern University Feinberg School of Medicine Institute for Public Health and Medicine 633 N St. Clair 18th Floor Chicago, IL 60611; Northwestern University Feinberg School of Medicine Department of Medicine, Division of Pulmonary and Critical Care Medicine 240 E Huron, McGaw M-300; Northwestern University Feinberg School of Medicine Department of Radiology 251 E. Huron Street, 4th Floor Chicago, IL 60611; hNew York Presbyterian/Weill Cornell Department of Medicine, Division of Pulmonary and Critical Care Medicine 1305 York Ave, 10th floor, Y-1053 New York, NY 10065; Yale School of Medicine Department of Medicine, Section of Rheumatology, Allergy & Immunology The Anlyan Center 300 Cedar Street PO Box 208031 New Haven, CT 06520. Financial support: Research was supported by the National Institute of Arthritis and Musculoskeletal and Skin Diseases of the National Institutes of Health under Award Numbers K23 AR059763 (MH), R01 AR073270 (MH), P60 AR064464 (RWC, KK, JL), and P30 AR072579 (RWC, JL) and National Center for Advancing Translational Sciences-Clinical and Translational Science Award Number UL1 TR000150 (JL). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. The Rheumatology Research Foundation (KS), Scleroderma Foundation (KS), and the Scleroderma Research Foundation (MH) also supported this work. Corresponding author: Monique Hinchcliff, MD MS, Associate Professor of Medicine, Yale School of Medicine, Department of Medicine, Section of Allergy, Rheumatology & Immunology, The Anlyan Center, 300 Cedar Street, PO Box 208031, New Haven, CT 06520.
| | - Xiaoping Wu
- Northwestern University Feinberg School of Medicine Department of Medicine 240 E. Huron Street, Suite 1-200 Chicago, IL 60611; Hospital for Special Surgery Department of Medicine, Division of Rheumatology 535 E. 70th Street New York, NY 10021; Northwestern University Feinberg School of Medicine Department of Medicine, Division of Rheumatology 240 E. Huron Street Suite M-300 Chicago, IL 60611; Northwestern University Feinberg School of Medicine Department of Preventive Medicine 680 N. Lake Shore Drive Suite 1400 Chicago, IL 60611; Northwestern University Feinberg School of Medicine Institute for Public Health and Medicine 633 N St. Clair 18th Floor Chicago, IL 60611; Northwestern University Feinberg School of Medicine Department of Medicine, Division of Pulmonary and Critical Care Medicine 240 E Huron, McGaw M-300; Northwestern University Feinberg School of Medicine Department of Radiology 251 E. Huron Street, 4th Floor Chicago, IL 60611; hNew York Presbyterian/Weill Cornell Department of Medicine, Division of Pulmonary and Critical Care Medicine 1305 York Ave, 10th floor, Y-1053 New York, NY 10065; Yale School of Medicine Department of Medicine, Section of Rheumatology, Allergy & Immunology The Anlyan Center 300 Cedar Street PO Box 208031 New Haven, CT 06520. Financial support: Research was supported by the National Institute of Arthritis and Musculoskeletal and Skin Diseases of the National Institutes of Health under Award Numbers K23 AR059763 (MH), R01 AR073270 (MH), P60 AR064464 (RWC, KK, JL), and P30 AR072579 (RWC, JL) and National Center for Advancing Translational Sciences-Clinical and Translational Science Award Number UL1 TR000150 (JL). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. The Rheumatology Research Foundation (KS), Scleroderma Foundation (KS), and the Scleroderma Research Foundation (MH) also supported this work. Corresponding author: Monique Hinchcliff, MD MS, Associate Professor of Medicine, Yale School of Medicine, Department of Medicine, Section of Allergy, Rheumatology & Immunology, The Anlyan Center, 300 Cedar Street, PO Box 208031, New Haven, CT 06520.
| | - Rowland W Chang
- Northwestern University Feinberg School of Medicine Department of Medicine 240 E. Huron Street, Suite 1-200 Chicago, IL 60611; Hospital for Special Surgery Department of Medicine, Division of Rheumatology 535 E. 70th Street New York, NY 10021; Northwestern University Feinberg School of Medicine Department of Medicine, Division of Rheumatology 240 E. Huron Street Suite M-300 Chicago, IL 60611; Northwestern University Feinberg School of Medicine Department of Preventive Medicine 680 N. Lake Shore Drive Suite 1400 Chicago, IL 60611; Northwestern University Feinberg School of Medicine Institute for Public Health and Medicine 633 N St. Clair 18th Floor Chicago, IL 60611; Northwestern University Feinberg School of Medicine Department of Medicine, Division of Pulmonary and Critical Care Medicine 240 E Huron, McGaw M-300; Northwestern University Feinberg School of Medicine Department of Radiology 251 E. Huron Street, 4th Floor Chicago, IL 60611; hNew York Presbyterian/Weill Cornell Department of Medicine, Division of Pulmonary and Critical Care Medicine 1305 York Ave, 10th floor, Y-1053 New York, NY 10065; Yale School of Medicine Department of Medicine, Section of Rheumatology, Allergy & Immunology The Anlyan Center 300 Cedar Street PO Box 208031 New Haven, CT 06520. Financial support: Research was supported by the National Institute of Arthritis and Musculoskeletal and Skin Diseases of the National Institutes of Health under Award Numbers K23 AR059763 (MH), R01 AR073270 (MH), P60 AR064464 (RWC, KK, JL), and P30 AR072579 (RWC, JL) and National Center for Advancing Translational Sciences-Clinical and Translational Science Award Number UL1 TR000150 (JL). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. The Rheumatology Research Foundation (KS), Scleroderma Foundation (KS), and the Scleroderma Research Foundation (MH) also supported this work. Corresponding author: Monique Hinchcliff, MD MS, Associate Professor of Medicine, Yale School of Medicine, Department of Medicine, Section of Allergy, Rheumatology & Immunology, The Anlyan Center, 300 Cedar Street, PO Box 208031, New Haven, CT 06520.
| | - Monique Hinchcliff
- Northwestern University Feinberg School of Medicine Department of Medicine 240 E. Huron Street, Suite 1-200 Chicago, IL 60611; Hospital for Special Surgery Department of Medicine, Division of Rheumatology 535 E. 70th Street New York, NY 10021; Northwestern University Feinberg School of Medicine Department of Medicine, Division of Rheumatology 240 E. Huron Street Suite M-300 Chicago, IL 60611; Northwestern University Feinberg School of Medicine Department of Preventive Medicine 680 N. Lake Shore Drive Suite 1400 Chicago, IL 60611; Northwestern University Feinberg School of Medicine Institute for Public Health and Medicine 633 N St. Clair 18th Floor Chicago, IL 60611; Northwestern University Feinberg School of Medicine Department of Medicine, Division of Pulmonary and Critical Care Medicine 240 E Huron, McGaw M-300; Northwestern University Feinberg School of Medicine Department of Radiology 251 E. Huron Street, 4th Floor Chicago, IL 60611; hNew York Presbyterian/Weill Cornell Department of Medicine, Division of Pulmonary and Critical Care Medicine 1305 York Ave, 10th floor, Y-1053 New York, NY 10065; Yale School of Medicine Department of Medicine, Section of Rheumatology, Allergy & Immunology The Anlyan Center 300 Cedar Street PO Box 208031 New Haven, CT 06520. Financial support: Research was supported by the National Institute of Arthritis and Musculoskeletal and Skin Diseases of the National Institutes of Health under Award Numbers K23 AR059763 (MH), R01 AR073270 (MH), P60 AR064464 (RWC, KK, JL), and P30 AR072579 (RWC, JL) and National Center for Advancing Translational Sciences-Clinical and Translational Science Award Number UL1 TR000150 (JL). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. The Rheumatology Research Foundation (KS), Scleroderma Foundation (KS), and the Scleroderma Research Foundation (MH) also supported this work. Corresponding author: Monique Hinchcliff, MD MS, Associate Professor of Medicine, Yale School of Medicine, Department of Medicine, Section of Allergy, Rheumatology & Immunology, The Anlyan Center, 300 Cedar Street, PO Box 208031, New Haven, CT 06520.
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Showalter K, Spiera R, Magro C, Agius P, Martyanov V, Franks JM, Sharma R, Geiger H, Wood TA, Zhang Y, Hale CR, Finik J, Whitfield ML, Orange DE, Gordon JK. Machine learning integration of scleroderma histology and gene expression identifies fibroblast polarisation as a hallmark of clinical severity and improvement. Ann Rheum Dis 2021; 80:228-237. [PMID: 33028580 PMCID: PMC8600653 DOI: 10.1136/annrheumdis-2020-217840] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2020] [Revised: 08/27/2020] [Accepted: 08/30/2020] [Indexed: 02/03/2023]
Abstract
OBJECTIVE We sought to determine histologic and gene expression features of clinical improvement in early diffuse cutaneous systemic sclerosis (dcSSc; scleroderma). METHODS Fifty-eight forearm biopsies were evaluated from 26 individuals with dcSSc in two clinical trials. Histologic/immunophenotypic assessments of global severity, alpha-smooth muscle actin (aSMA), CD34, collagen, inflammatory infiltrate, follicles and thickness were compared with gene expression and clinical data. Support vector machine learning was performed using scleroderma gene expression subset (normal-like, fibroproliferative, inflammatory) as classifiers and histology scores as inputs. Comparison of w-vector mean absolute weights was used to identify histologic features most predictive of gene expression subset. We then tested for differential gene expression according to histologic severity and compared those with clinical improvement (according to the Combined Response Index in Systemic Sclerosis). RESULTS aSMA was highest and CD34 lowest in samples with highest local Modified Rodnan Skin Score. CD34 and aSMA changed significantly from baseline to 52 weeks in clinical improvers. CD34 and aSMA were the strongest predictors of gene expression subset, with highest CD34 staining in the normal-like subset (p<0.001) and highest aSMA staining in the inflammatory subset (p=0.016). Analysis of gene expression according to CD34 and aSMA binarised scores identified a 47-gene fibroblast polarisation signature that decreases over time only in improvers (vs non-improvers). Pathway analysis of these genes identified gene expression signatures of inflammatory fibroblasts. CONCLUSION CD34 and aSMA stains describe distinct fibroblast polarisation states, are associated with gene expression subsets and clinical assessments, and may be useful biomarkers of clinical severity and improvement in dcSSc.
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Affiliation(s)
- Kimberly Showalter
- Department of Medicine, Division of Rheumatology, Hospital for Special Surgery, New York, New York, USA
| | - Robert Spiera
- Department of Medicine, Division of Rheumatology, Hospital for Special Surgery, New York, New York, USA
| | - Cynthia Magro
- Department of Pathology and Laboratory Medicine, Weill Cornell Medicine, New York, New York, USA
| | | | - Viktor Martyanov
- Molecular and Systems Biology, Dartmouth College Geisel School of Medicine, Hanover, New Hampshire, USA
- Biomedical Data Science, Dartmouth College Geisel School of Medicine, Hanover, New Hampshire, USA
| | - Jennifer M Franks
- Molecular and Systems Biology, Dartmouth College Geisel School of Medicine, Hanover, New Hampshire, USA
- Biomedical Data Science, Dartmouth College Geisel School of Medicine, Hanover, New Hampshire, USA
| | | | | | - Tammara A Wood
- Molecular and Systems Biology, Dartmouth College Geisel School of Medicine, Hanover, New Hampshire, USA
- Biomedical Data Science, Dartmouth College Geisel School of Medicine, Hanover, New Hampshire, USA
| | - Yaxia Zhang
- Department of Pathology, Hospital for Special Surgery, New York, New York, USA
| | - Caryn R Hale
- Laboratory of Molecular Neuro-Oncology, The Rockefeller University, New York, New York, USA
| | - Jackie Finik
- Department of Medicine, Hospital for Special Surgery, New York, New York, USA
| | - Michael L Whitfield
- Molecular and Systems Biology, Dartmouth College Geisel School of Medicine, Hanover, New Hampshire, USA
- Biomedical Data Science, Dartmouth College Geisel School of Medicine, Hanover, New Hampshire, USA
| | - Dana E Orange
- Department of Medicine, Division of Rheumatology, Hospital for Special Surgery, New York, New York, USA
- Laboratory of Molecular Neuro-Oncology, The Rockefeller University, New York, New York, USA
| | - Jessica K Gordon
- Department of Medicine, Division of Rheumatology, Hospital for Special Surgery, New York, New York, USA
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Showalter K, Ma X, Pinheiro L, Sobol I, Gordon JK, Mehta B. Thirty-day hospital readmission in systemic sclerosis associated pulmonary hypertension: A nationwide study. Semin Arthritis Rheum 2021; 51:324-330. [PMID: 33465591 DOI: 10.1016/j.semarthrit.2021.01.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Revised: 12/22/2020] [Accepted: 01/05/2021] [Indexed: 10/22/2022]
Abstract
OBJECTIVE To identify risk-factors for 30-day hospital readmission in systemic sclerosis pulmonary hypertension (SSc-PH) and to compare trends and characteristics of 30-day readmissions in SSc-PH versus non-SSc pulmonary arterial hypertension (non-SSc PAH). METHODS In this retrospective study, we identified SSc-PH and non-SSc PAH hospitalizations using ICD-9 codes within the Healthcare Cost and Utilization Project-National Readmission Database. Thirty-day readmission rates were calculated between 2010 and 2015. Characteristics were compared using chi-square, Wilcoxon rank-sum, or two-sample t-tests between (A) SSc-PH patients with versus without readmission and (B) patients with ≥1 readmission with SSc-PH versus non-SSc PAH. Adjusted logistic regression models were generated for readmission in SSc-PH. RESULTS 4,846 of 22,420 (22%) with SSc-PH and 10,573 of 49,254 (21%) with non-SSc PAH had ≥1 30-day readmission. Between 2010-2015, readmission rate decreased in non-SSc PAH (23% to 20%; p<0.001) and was unchanged in SSc-PH (23% to 23%; p = 0.77). In SSc-PH, independent predictors of 30-day readmission include male sex, age <60, Medicare or Medicaid, higher Charlson/Deyo comorbidity index, and congestive heart failure (CHF). A higher proportion of patients with SSc-PH (vs. non-SSc PAH) died during index hospitalizations (p = 0.001) and readmissions (p <0.001). Readmitted patients with SSc-PH (vs. non-SSc PAH) were younger and less often had CHF. In SSc-PH, the most common readmission primary diagnosis was infection, followed by respiratory and heart failure. CONCLUSION In SSc-PH, 30-day readmission is frequent, and in-hospital deaths occur at a higher rate compared to those with non-SSc PAH. This study identifies factors that may characterize those with SSc-PH at highest risk for readmission.
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Affiliation(s)
- Kimberly Showalter
- Hospital for Special Surgery, Department of Medicine, Division of Rheumatology, 535 East 70th Street, New York, NY 10021, United States.
| | - Xiaoyue Ma
- Weill Cornell Medicine, Department of Healthcare Policy and Research, 402 East 67th Street, New York, NY 10065, United States.
| | - Laura Pinheiro
- Weill Cornell Medicine, Department of Medicine, Division of General Internal Medicine, 420 East 70th Street, 3rd Floor, New York, NY 10065, United States.
| | - Irina Sobol
- Weill Cornell Medicine, Department of Medicine, Division of Cardiology, 520 East 70th Street, New York, NY 10021, United States.
| | - Jessica K Gordon
- Hospital for Special Surgery, Department of Medicine, Division of Rheumatology, 535 East 70th Street, New York, NY 10021, United States.
| | - Bella Mehta
- Hospital for Special Surgery, Department of Medicine, Division of Rheumatology, 535 East 70th Street, New York, NY 10021, United States.
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Showalter K, Merkel PA, Khanna D, Gordon JK. Assessment of skin disease in scleroderma: Practices and opinions of investigators studying scleroderma. J Scleroderma Relat Disord 2020; 5:167-171. [PMID: 35382518 PMCID: PMC8922616 DOI: 10.1177/2397198320921044] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2020] [Accepted: 03/31/2020] [Indexed: 10/28/2023]
Abstract
BACKGROUND The modified Rodnan skin score is a common primary outcome measurement tool in clinical trials of systemic sclerosis (scleroderma). However, it is unknown how often physicians perform the modified Rodnan skin score in clinical practice or what precise approach is most often used when assessing each of the 17 sites included in the modified Rodnan skin score (i.e. "maximizing," "averaging," "representative area"). This study assessed the experiences, perceptions, training, and practices of individuals studying scleroderma with regard to modified Rodnan skin score. METHODS An invitation with an online survey link was sent electronically to 282 individuals who are part of the Scleroderma Clinical Trials Consortium. The 46-item survey included three sections: participant demographics, modified Rodnan skin score background/training, and modified Rodnan skin score assessment practices. The survey was accessible for 5 weeks (October-November 2019). RESULTS The response rate was 41% (116 of 282 individuals). The majority of participants perform the modified Rodnan skin score in clinical care (>99%) and practice at academic institutions (90%) in North America (41%) or Europe (40%). Nearly all participants felt that the modified Rodnan skin score is either "somewhat important" (43%) or "essential" (56%) to the care of patients with systemic sclerosis. In total, 91% of participants reported having received modified Rodnan skin score training. The majority (60%) of those who had not received training were interested in receiving modified Rodnan skin score training, and 39% of participants felt either "uncomfortable" or only "somewhat comfortable" performing the modified Rodnan skin score. The modified Rodnan skin score approach varied: 44% used "maximizing," 28% used "averaging," and 18% used "representative area." CONCLUSION A majority of participants feel that the modified Rodnan skin score is "essential" to the care of patients with systemic sclerosis; however, the method used to measure modified Rodnan skin score varies greatly among systemic sclerosis investigators. These results indicate a continued role of modified Rodnan skin score for care and research in systemic sclerosis, support ongoing efforts to increase opportunities for modified Rodnan skin score training, and highlight a potential need to harmonize the technical approach to measuring the modified Rodnan skin score.
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Affiliation(s)
- Kimberly Showalter
- Division of Rheumatology, Department of Medicine, Hospital for Special Surgery, New York, NY, USA
| | - Peter A Merkel
- Division of Rheumatology, Department of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Division of Clinical Epidemiology, Department of Biostatistics, Epidemiology, and Informatics, University of Pennsylvania, Philadelphia, PA, USA
| | - Dinesh Khanna
- Division of Rheumatology, Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Jessica K Gordon
- Division of Rheumatology, Department of Medicine, Hospital for Special Surgery, New York, NY, USA
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Showalter K, Hoffmann A, DeCredico N, Thakrar A, Arroyo E, Goldberg I, Hinchcliff M. Complementary therapies for patients with systemic sclerosis. J Scleroderma Relat Disord 2019; 4:187-199. [PMID: 35382503 PMCID: PMC8922560 DOI: 10.1177/2397198319833503] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2018] [Accepted: 01/27/2019] [Indexed: 11/16/2022]
Abstract
Patients with systemic sclerosis often seek information regarding complementary and nutrition-based therapy. Some study results have shown that vitamins D and E, probiotics, turmeric, l-arginine, essential fatty acids, broccoli, biofeedback, and acupuncture may be beneficial in systemic sclerosis care. However, large randomized clinical trials have not been conducted. This review summarizes current data regarding various complementary therapies in systemic sclerosis and concludes with recommendations.
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Affiliation(s)
- Kimberly Showalter
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- Division of Rheumatology, Hospital for Special Surgery, New York, NY, USA
| | - Aileen Hoffmann
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Nicole DeCredico
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Anjali Thakrar
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Esperanza Arroyo
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Isaac Goldberg
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Monique Hinchcliff
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- Department of Medicine, Section of Rheumatology, Allergy and Clinical Immunology, Yale University School of Medicine, New Haven, CT, USA
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Showalter K, Hoffmann A, Rouleau G, Aaby D, Lee J, Richardson C, Dematte J, Agrawal R, Chang RW, Hinchcliff M. Performance of Forced Vital Capacity and Lung Diffusion Cutpoints for Associated Radiographic Interstitial Lung Disease in Systemic Sclerosis. J Rheumatol 2018; 45:1572-1576. [PMID: 30275265 DOI: 10.3899/jrheum.171362] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/01/2018] [Indexed: 12/22/2022]
Abstract
OBJECTIVE Forced vital capacity (FVC) and DLCO are used for screening of systemic sclerosis-associated interstitial lung disease (SSc-ILD). The study purpose was to determine the sensitivity, specificity, and negative predictive value (NPV) (proportion of true negative screening tests) of FVC and DLCO thresholds for SSc-ILD on chest high-resolution computed tomography (HRCT) scans. METHODS Patients fulfilling American College of Rheumatology 2013 SSc criteria with a chest HRCT scan and pulmonary function tests (PFT) were studied. A thoracic radiologist quantified radiographic ILD. Optimal FVC and DLCO % predicted thresholds for ILD were identified using receiver-operating characteristic curves. The FVC and DLCO combinations with greatest sensitivity and specificity were also determined. Subanalysis was performed in patients with positive Scl-70 autoantibodies. RESULTS The study included 265 patients. Of 188 (71%) with radiographic ILD, 59 (31%) had "normal" FVC (≥ 80% predicted), and 65 out of 151 (43%) had "normal" DLCO (≥ 60% predicted). FVC < 80% (sensitivity 0.69, specificity 0.73), and DLCO < 62% (sensitivity 0.60, specificity 0.70) were optimal thresholds for radiographic SSc-ILD. All FVC and DLCO threshold combinations evaluated had NPV < 0.70. The NPV for radiographic ILD for FVC < 80% was lower in patients with positive Scl-70 autoantibody (NPV = 0.05) compared to negative Scl-70 autoantibody (NPV = 0.57). CONCLUSION Radiographic ILD is prevalent in SSc despite "normal" PFT. No % predicted FVC or DLCO threshold combinations yielded high NPV for SSc-ILD screening. "Normal" FVC and DLCO in patients with SSc, especially those with positive Scl-70 autoantibodies, should not obviate consideration of HRCT for ILD evaluation.
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Affiliation(s)
- Kimberly Showalter
- From the Department of Medicine, Division of Rheumatology, Division of Pulmonary and Critical Care Medicine, Department of Preventive Medicine, Institute for Public Health and Medicine, Department of Radiology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.,K. Showalter, MD, Department of Medicine, Northwestern University Feinberg School of Medicine; A. Hoffmann, MS, Department of Medicine, Division of Rheumatology, Northwestern University Feinberg School of Medicine; G. Rouleau, MS, Department of Preventive Medicine, Northwestern University Feinberg School of Medicine; D. Aaby, MS, Department of Preventive Medicine, Northwestern University Feinberg School of Medicine; J. Lee, PhD, MPH, Department of Preventive Medicine, and Institute for Public Health and Medicine, Northwestern University Feinberg School of Medicine; C. Richardson, MD, Department of Medicine, Northwestern University Feinberg School of Medicine; J. Dematte, MD, MBA, Department of Medicine, Division of Pulmonary and Critical Care Medicine, Northwestern University Feinberg School of Medicine; R. Agrawal, MD, Department of Radiology, Northwestern University Feinberg School of Medicine; R.W. Chang, MD, MPH, Department of Medicine, Division of Rheumatology, and Department of Preventive Medicine, and Institute for Public Health and Medicine, Northwestern University Feinberg School of Medicine; M. Hinchcliff, MD, MS, Department of Medicine, Division of Rheumatology, and Department of Preventive Medicine, and Institute for Public Health and Medicine, Northwestern University Feinberg School of Medicine
| | - Aileen Hoffmann
- From the Department of Medicine, Division of Rheumatology, Division of Pulmonary and Critical Care Medicine, Department of Preventive Medicine, Institute for Public Health and Medicine, Department of Radiology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.,K. Showalter, MD, Department of Medicine, Northwestern University Feinberg School of Medicine; A. Hoffmann, MS, Department of Medicine, Division of Rheumatology, Northwestern University Feinberg School of Medicine; G. Rouleau, MS, Department of Preventive Medicine, Northwestern University Feinberg School of Medicine; D. Aaby, MS, Department of Preventive Medicine, Northwestern University Feinberg School of Medicine; J. Lee, PhD, MPH, Department of Preventive Medicine, and Institute for Public Health and Medicine, Northwestern University Feinberg School of Medicine; C. Richardson, MD, Department of Medicine, Northwestern University Feinberg School of Medicine; J. Dematte, MD, MBA, Department of Medicine, Division of Pulmonary and Critical Care Medicine, Northwestern University Feinberg School of Medicine; R. Agrawal, MD, Department of Radiology, Northwestern University Feinberg School of Medicine; R.W. Chang, MD, MPH, Department of Medicine, Division of Rheumatology, and Department of Preventive Medicine, and Institute for Public Health and Medicine, Northwestern University Feinberg School of Medicine; M. Hinchcliff, MD, MS, Department of Medicine, Division of Rheumatology, and Department of Preventive Medicine, and Institute for Public Health and Medicine, Northwestern University Feinberg School of Medicine
| | - Gerald Rouleau
- From the Department of Medicine, Division of Rheumatology, Division of Pulmonary and Critical Care Medicine, Department of Preventive Medicine, Institute for Public Health and Medicine, Department of Radiology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.,K. Showalter, MD, Department of Medicine, Northwestern University Feinberg School of Medicine; A. Hoffmann, MS, Department of Medicine, Division of Rheumatology, Northwestern University Feinberg School of Medicine; G. Rouleau, MS, Department of Preventive Medicine, Northwestern University Feinberg School of Medicine; D. Aaby, MS, Department of Preventive Medicine, Northwestern University Feinberg School of Medicine; J. Lee, PhD, MPH, Department of Preventive Medicine, and Institute for Public Health and Medicine, Northwestern University Feinberg School of Medicine; C. Richardson, MD, Department of Medicine, Northwestern University Feinberg School of Medicine; J. Dematte, MD, MBA, Department of Medicine, Division of Pulmonary and Critical Care Medicine, Northwestern University Feinberg School of Medicine; R. Agrawal, MD, Department of Radiology, Northwestern University Feinberg School of Medicine; R.W. Chang, MD, MPH, Department of Medicine, Division of Rheumatology, and Department of Preventive Medicine, and Institute for Public Health and Medicine, Northwestern University Feinberg School of Medicine; M. Hinchcliff, MD, MS, Department of Medicine, Division of Rheumatology, and Department of Preventive Medicine, and Institute for Public Health and Medicine, Northwestern University Feinberg School of Medicine
| | - David Aaby
- From the Department of Medicine, Division of Rheumatology, Division of Pulmonary and Critical Care Medicine, Department of Preventive Medicine, Institute for Public Health and Medicine, Department of Radiology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.,K. Showalter, MD, Department of Medicine, Northwestern University Feinberg School of Medicine; A. Hoffmann, MS, Department of Medicine, Division of Rheumatology, Northwestern University Feinberg School of Medicine; G. Rouleau, MS, Department of Preventive Medicine, Northwestern University Feinberg School of Medicine; D. Aaby, MS, Department of Preventive Medicine, Northwestern University Feinberg School of Medicine; J. Lee, PhD, MPH, Department of Preventive Medicine, and Institute for Public Health and Medicine, Northwestern University Feinberg School of Medicine; C. Richardson, MD, Department of Medicine, Northwestern University Feinberg School of Medicine; J. Dematte, MD, MBA, Department of Medicine, Division of Pulmonary and Critical Care Medicine, Northwestern University Feinberg School of Medicine; R. Agrawal, MD, Department of Radiology, Northwestern University Feinberg School of Medicine; R.W. Chang, MD, MPH, Department of Medicine, Division of Rheumatology, and Department of Preventive Medicine, and Institute for Public Health and Medicine, Northwestern University Feinberg School of Medicine; M. Hinchcliff, MD, MS, Department of Medicine, Division of Rheumatology, and Department of Preventive Medicine, and Institute for Public Health and Medicine, Northwestern University Feinberg School of Medicine
| | - Jungwha Lee
- From the Department of Medicine, Division of Rheumatology, Division of Pulmonary and Critical Care Medicine, Department of Preventive Medicine, Institute for Public Health and Medicine, Department of Radiology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.,K. Showalter, MD, Department of Medicine, Northwestern University Feinberg School of Medicine; A. Hoffmann, MS, Department of Medicine, Division of Rheumatology, Northwestern University Feinberg School of Medicine; G. Rouleau, MS, Department of Preventive Medicine, Northwestern University Feinberg School of Medicine; D. Aaby, MS, Department of Preventive Medicine, Northwestern University Feinberg School of Medicine; J. Lee, PhD, MPH, Department of Preventive Medicine, and Institute for Public Health and Medicine, Northwestern University Feinberg School of Medicine; C. Richardson, MD, Department of Medicine, Northwestern University Feinberg School of Medicine; J. Dematte, MD, MBA, Department of Medicine, Division of Pulmonary and Critical Care Medicine, Northwestern University Feinberg School of Medicine; R. Agrawal, MD, Department of Radiology, Northwestern University Feinberg School of Medicine; R.W. Chang, MD, MPH, Department of Medicine, Division of Rheumatology, and Department of Preventive Medicine, and Institute for Public Health and Medicine, Northwestern University Feinberg School of Medicine; M. Hinchcliff, MD, MS, Department of Medicine, Division of Rheumatology, and Department of Preventive Medicine, and Institute for Public Health and Medicine, Northwestern University Feinberg School of Medicine
| | - Carrie Richardson
- From the Department of Medicine, Division of Rheumatology, Division of Pulmonary and Critical Care Medicine, Department of Preventive Medicine, Institute for Public Health and Medicine, Department of Radiology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.,K. Showalter, MD, Department of Medicine, Northwestern University Feinberg School of Medicine; A. Hoffmann, MS, Department of Medicine, Division of Rheumatology, Northwestern University Feinberg School of Medicine; G. Rouleau, MS, Department of Preventive Medicine, Northwestern University Feinberg School of Medicine; D. Aaby, MS, Department of Preventive Medicine, Northwestern University Feinberg School of Medicine; J. Lee, PhD, MPH, Department of Preventive Medicine, and Institute for Public Health and Medicine, Northwestern University Feinberg School of Medicine; C. Richardson, MD, Department of Medicine, Northwestern University Feinberg School of Medicine; J. Dematte, MD, MBA, Department of Medicine, Division of Pulmonary and Critical Care Medicine, Northwestern University Feinberg School of Medicine; R. Agrawal, MD, Department of Radiology, Northwestern University Feinberg School of Medicine; R.W. Chang, MD, MPH, Department of Medicine, Division of Rheumatology, and Department of Preventive Medicine, and Institute for Public Health and Medicine, Northwestern University Feinberg School of Medicine; M. Hinchcliff, MD, MS, Department of Medicine, Division of Rheumatology, and Department of Preventive Medicine, and Institute for Public Health and Medicine, Northwestern University Feinberg School of Medicine
| | - Jane Dematte
- From the Department of Medicine, Division of Rheumatology, Division of Pulmonary and Critical Care Medicine, Department of Preventive Medicine, Institute for Public Health and Medicine, Department of Radiology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.,K. Showalter, MD, Department of Medicine, Northwestern University Feinberg School of Medicine; A. Hoffmann, MS, Department of Medicine, Division of Rheumatology, Northwestern University Feinberg School of Medicine; G. Rouleau, MS, Department of Preventive Medicine, Northwestern University Feinberg School of Medicine; D. Aaby, MS, Department of Preventive Medicine, Northwestern University Feinberg School of Medicine; J. Lee, PhD, MPH, Department of Preventive Medicine, and Institute for Public Health and Medicine, Northwestern University Feinberg School of Medicine; C. Richardson, MD, Department of Medicine, Northwestern University Feinberg School of Medicine; J. Dematte, MD, MBA, Department of Medicine, Division of Pulmonary and Critical Care Medicine, Northwestern University Feinberg School of Medicine; R. Agrawal, MD, Department of Radiology, Northwestern University Feinberg School of Medicine; R.W. Chang, MD, MPH, Department of Medicine, Division of Rheumatology, and Department of Preventive Medicine, and Institute for Public Health and Medicine, Northwestern University Feinberg School of Medicine; M. Hinchcliff, MD, MS, Department of Medicine, Division of Rheumatology, and Department of Preventive Medicine, and Institute for Public Health and Medicine, Northwestern University Feinberg School of Medicine
| | - Rishi Agrawal
- From the Department of Medicine, Division of Rheumatology, Division of Pulmonary and Critical Care Medicine, Department of Preventive Medicine, Institute for Public Health and Medicine, Department of Radiology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.,K. Showalter, MD, Department of Medicine, Northwestern University Feinberg School of Medicine; A. Hoffmann, MS, Department of Medicine, Division of Rheumatology, Northwestern University Feinberg School of Medicine; G. Rouleau, MS, Department of Preventive Medicine, Northwestern University Feinberg School of Medicine; D. Aaby, MS, Department of Preventive Medicine, Northwestern University Feinberg School of Medicine; J. Lee, PhD, MPH, Department of Preventive Medicine, and Institute for Public Health and Medicine, Northwestern University Feinberg School of Medicine; C. Richardson, MD, Department of Medicine, Northwestern University Feinberg School of Medicine; J. Dematte, MD, MBA, Department of Medicine, Division of Pulmonary and Critical Care Medicine, Northwestern University Feinberg School of Medicine; R. Agrawal, MD, Department of Radiology, Northwestern University Feinberg School of Medicine; R.W. Chang, MD, MPH, Department of Medicine, Division of Rheumatology, and Department of Preventive Medicine, and Institute for Public Health and Medicine, Northwestern University Feinberg School of Medicine; M. Hinchcliff, MD, MS, Department of Medicine, Division of Rheumatology, and Department of Preventive Medicine, and Institute for Public Health and Medicine, Northwestern University Feinberg School of Medicine
| | - Rowland W Chang
- From the Department of Medicine, Division of Rheumatology, Division of Pulmonary and Critical Care Medicine, Department of Preventive Medicine, Institute for Public Health and Medicine, Department of Radiology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.,K. Showalter, MD, Department of Medicine, Northwestern University Feinberg School of Medicine; A. Hoffmann, MS, Department of Medicine, Division of Rheumatology, Northwestern University Feinberg School of Medicine; G. Rouleau, MS, Department of Preventive Medicine, Northwestern University Feinberg School of Medicine; D. Aaby, MS, Department of Preventive Medicine, Northwestern University Feinberg School of Medicine; J. Lee, PhD, MPH, Department of Preventive Medicine, and Institute for Public Health and Medicine, Northwestern University Feinberg School of Medicine; C. Richardson, MD, Department of Medicine, Northwestern University Feinberg School of Medicine; J. Dematte, MD, MBA, Department of Medicine, Division of Pulmonary and Critical Care Medicine, Northwestern University Feinberg School of Medicine; R. Agrawal, MD, Department of Radiology, Northwestern University Feinberg School of Medicine; R.W. Chang, MD, MPH, Department of Medicine, Division of Rheumatology, and Department of Preventive Medicine, and Institute for Public Health and Medicine, Northwestern University Feinberg School of Medicine; M. Hinchcliff, MD, MS, Department of Medicine, Division of Rheumatology, and Department of Preventive Medicine, and Institute for Public Health and Medicine, Northwestern University Feinberg School of Medicine
| | - Monique Hinchcliff
- From the Department of Medicine, Division of Rheumatology, Division of Pulmonary and Critical Care Medicine, Department of Preventive Medicine, Institute for Public Health and Medicine, Department of Radiology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA. .,K. Showalter, MD, Department of Medicine, Northwestern University Feinberg School of Medicine; A. Hoffmann, MS, Department of Medicine, Division of Rheumatology, Northwestern University Feinberg School of Medicine; G. Rouleau, MS, Department of Preventive Medicine, Northwestern University Feinberg School of Medicine; D. Aaby, MS, Department of Preventive Medicine, Northwestern University Feinberg School of Medicine; J. Lee, PhD, MPH, Department of Preventive Medicine, and Institute for Public Health and Medicine, Northwestern University Feinberg School of Medicine; C. Richardson, MD, Department of Medicine, Northwestern University Feinberg School of Medicine; J. Dematte, MD, MBA, Department of Medicine, Division of Pulmonary and Critical Care Medicine, Northwestern University Feinberg School of Medicine; R. Agrawal, MD, Department of Radiology, Northwestern University Feinberg School of Medicine; R.W. Chang, MD, MPH, Department of Medicine, Division of Rheumatology, and Department of Preventive Medicine, and Institute for Public Health and Medicine, Northwestern University Feinberg School of Medicine; M. Hinchcliff, MD, MS, Department of Medicine, Division of Rheumatology, and Department of Preventive Medicine, and Institute for Public Health and Medicine, Northwestern University Feinberg School of Medicine.
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Hoffmann A, Lee J, Ma M, Agrawal R, Chang RW, Richardson C, Hinchcliff M, Showalter K. Comment on "Esophageal dilatation and interstitial lung disease in systemic sclerosis: A cross-sectional study". Semin Arthritis Rheum 2016; 46:e11-e12. [PMID: 27312382 DOI: 10.1016/j.semarthrit.2016.04.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2016] [Accepted: 04/28/2016] [Indexed: 11/24/2022]
Affiliation(s)
- Aileen Hoffmann
- Department of Medicine, Division of Rheumatology Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Jungwha Lee
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL; Institute for Public Health and Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Madeleine Ma
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL; Institute for Public Health and Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Rishi Agrawal
- Northwestern University Feinberg School of Medicine, Department of Radiology, Chicago, IL
| | - Rowland W Chang
- Department of Medicine, Division of Rheumatology Northwestern University Feinberg School of Medicine, Chicago, IL; Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL; Institute for Public Health and Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Carrie Richardson
- Department of Medicine, McGaw Medical Center, Northwestern University Feinberg School of Medicine, Chicago, IL 60611; Division of Rheumatology, Johns Hopkins University, Baltimore, MD
| | - Monique Hinchcliff
- Department of Medicine, Division of Rheumatology Northwestern University Feinberg School of Medicine, Chicago, IL; Institute for Public Health and Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Kimberly Showalter
- Department of Medicine, McGaw Medical Center, Northwestern University Feinberg School of Medicine, Chicago, IL 60611.
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Showalter K, Maize J, Altomare I, Fisher G. Multiple myeloma diagnosed secondary to analysis of a lytic bone lesion encountered during Mohs micrographic surgery. Dermatol Online J 2013; 19:19262. [PMID: 24021441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2013] [Accepted: 08/13/2013] [Indexed: 06/02/2023] Open
Abstract
An 89-year-old man underwent Mohs micrographic surgery for treatment of a squamous cell carcinoma of the scalp. A lytic bone lesion was found that led to the diagnosis of multiple myeloma.
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13
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Showalter K, Maize Jr. J, Altomare I, Fisher G. Multiple myeloma diagnosed secondary to analysis of a lytic bone lesion encountered during mohs micrographic surgery. Dermatol Online J 2013. [DOI: 10.5070/d3198019262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
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14
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Tinsley MR, Taylor AF, Huang Z, Showalter K. Complex organizing centers in groups of oscillatory particles. Phys Chem Chem Phys 2011; 13:17802-8. [DOI: 10.1039/c1cp22109d] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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15
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Abstract
The properties of excitable media are exploited to find minimum-length paths in complex labyrinths. Optimal pathways are experimentally determined by the collection of time-lapse position information on chemical waves propagating through mazes prepared with the Belousov-Zhabotinsky reaction. The corresponding velocity fields provide maps of optimal paths from every point in an image grid to a particular target point. Collisions of waves that were temporarily separated by obstacles mark boundary lines between Significantly different paths with the same absolute distance. The pathfinding algorithm is tested in very complex mazes with a simple reaction-diffusion model.
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16
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Mihaliuk E, Sakurai T, Chirila F, Showalter K. Experimental and theoretical studies of feedback stabilization of propagating wave segments. Faraday Discuss 2002:383-94; discussion 407-19. [PMID: 11901687 DOI: 10.1039/b103431f] [Citation(s) in RCA: 39] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Experimental and theoretical studies of the excitability boundary for spiral wave behavior are presented. The boundary is defined by unstable wave segments, which are stabilized by using a negative-feedback control algorithm. A kinematic description of the constant-size, constant-shape wave segments is presented.
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Affiliation(s)
- E Mihaliuk
- Department of Chemistry, West Virginia University, Morgantown, WV 26506, USA
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17
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Hildebrand M, Skødt H, Showalter K. Spatial symmetry breaking in the Belousov-Zhabotinsky reaction with light-induced remote communication. Phys Rev Lett 2001; 87:088303. [PMID: 11497989 DOI: 10.1103/physrevlett.87.088303] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/18/2000] [Revised: 05/02/2001] [Indexed: 05/23/2023]
Abstract
Domains containing spiral waves form on a stationary background in a photosensitive Belousov-Zhabotinsky reaction with light-induced alternating nonlocal feedback. Complex behavior of colliding and splitting wave fragments is found with feedback radii comparable to the spiral wavelength. A linear stability analysis of the uniform stationary states in an Oregonator model reveals a spatial symmetry breaking instability. Numerical simulations show behavior in agreement with that found experimentally and also predict a variety of other new patterns.
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Affiliation(s)
- M Hildebrand
- Department of Chemistry, West Virginia University, Morgantown, West Virginia 26506-6045, USA
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18
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Sendiña-Nadal I, Mihaliuk E, Wang J, Pérez-Muñuzuri V, Showalter K. Wave propagation in subexcitable media with periodically modulated excitability. Phys Rev Lett 2001; 86:1646-1649. [PMID: 11290214 DOI: 10.1103/physrevlett.86.1646] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/24/2000] [Revised: 10/02/2000] [Indexed: 05/23/2023]
Abstract
Wave propagation in a photosensitive, subexcitable Belousov-Zhabotinsky medium is made possible by periodic modulation of a homogeneous illumination field. The propagation can be understood in terms of an interplay between the radial expansion of the wave and the motion of its free ends as the excitability varies periodically. This description leads to a simple kinematic analysis that provides insights into the initial conditions and forcing parameters giving rise to sustained wave propagation.
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Affiliation(s)
- I Sendiña-Nadal
- Group of Nonlinear Physics, Facultade de Físicas, Universidade de Santiago de Compostela, Spain
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19
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Abstract
The dynamical behavior of species competing for a common resource is studied with a reaction-diffusion system based on cubic autocatalysis. Randomly seeded populations self-segregate to form a complex network of domains separated by distinct interfaces. For chaotic populations in one-dimensional media, the interfaces exhibit irregular motions on long time scales. In two-dimensional media, the interface motions are governed by curvature-induced drift.
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Affiliation(s)
- R Wackerbauer
- Department of Chemistry, West Virginia University, Morgantown, West Virginia 26506-6045, USA
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20
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Jung P, Wang J, Wackerbauer R, Showalter K. Coherent structure analysis of spatiotemporal chaos. Phys Rev E Stat Phys Plasmas Fluids Relat Interdiscip Topics 2000; 61:2095-2098. [PMID: 11046503 DOI: 10.1103/physreve.61.2095] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/18/1999] [Indexed: 05/23/2023]
Abstract
We introduce a measure to quantify spatiotemporal turbulence in extended systems. It is based on the statistical analysis of a coherent structure decomposition of the evolving system. Applied to a cellular excitable medium and a reaction-diffusion model describing the oxidation of CO on Pt(100), it reveals power-law scaling of the size distribution of coherent space-time structures for the state of spiral turbulence. The coherent structure decomposition is also used to define an entropy measure, which sharply increases in these systems at the transition to turbulence.
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Affiliation(s)
- P Jung
- Department of Physics and Astronomy, Ohio University, Athens, Ohio 45701, USA
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21
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Sun H, Scott SK, Showalter K. Uncertain destination dynamics. Phys Rev E Stat Phys Plasmas Fluids Relat Interdiscip Topics 1999; 60:3876-80. [PMID: 11970222 DOI: 10.1103/physreve.60.3876] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/12/1999] [Indexed: 04/18/2023]
Abstract
Certain dynamical systems exhibit a sensitivity to initial conditions in which the asymptotic state is selected from an infinite number of possible states. The phase space of such systems is foliated with "attractors," each of which is associated with a particular set of initial conditions. The associated uncertain destination dynamics can be analyzed by an appropriate reduction of the full system to a subsystem that explicitly yields the dynamics.
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Affiliation(s)
- H Sun
- Department of Chemistry, West Virginia University, Morgantown, West Virginia 26506-6045, USA
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22
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Jung P, Cornell-Bell A, Moss F, Kadar S, Wang J, Showalter K. Noise sustained waves in subexcitable media: From chemical waves to brain waves. Chaos 1998; 8:567-575. [PMID: 12779760 DOI: 10.1063/1.166338] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
We discuss a novel type of spatiotemporal pattern that can be observed in subexcitable media when coupled to a thermal environment. These patterns have been recently observed in several different types of systems: a subexcitable photosensitive Belousov-Zhabotinsky reaction, hippocampal slices of rat brains, and astrocyte syncytium. In this paper, we introduce the basic concepts of subexcitable media, describe recent experimental observations in chemistry and neurophysiology, and put these observation into context with computer simulations. (c) 1998 American Institute of Physics.
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Affiliation(s)
- P. Jung
- Department of Physics and Astronomy, Program for Condensed Matter and Surface Science, and Program for Neurobiology, Ohio University, Athens, Ohio 45701
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23
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Merkin JH, Poole AJ, Scott SK, Masere J, Showalter K. Competitive autocatalysis in reaction-diffusion systems Exclusive product selectivity. ACTA ACUST UNITED AC 1998. [DOI: 10.1039/a705384c] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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24
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25
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26
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27
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Petrov V, Metens S, Borckmans P, Dewel G, Showalter K. Tracking unstable turing patterns through mixed-mode spatiotemporal chaos. Phys Rev Lett 1995; 75:2895-2898. [PMID: 10059432 DOI: 10.1103/physrevlett.75.2895] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
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28
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Abstract
Chemical wave behavior in a patterned Belousov-Zhabotinsky system prepared by printing the catalyst of the reaction on membranes with an ink jet printer is described. Cellular inhomogeneities give rise to global anisotropy in wave propagation, with specific local patterns resulting in hexagonal, diamond, and pentagonal geometries. Spiral wave sources appear spontaneously and serve as organizing centers of the surrounding wave activity. The experimental methodology offers flexibility for studies of excitable media with made-to-order spatial inhomogeneities.
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29
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Steinbock O, Showalter K. Response
: Minimal Path Algorithms. Science 1995. [DOI: 10.1126/science.269.5222.418.b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Affiliation(s)
- O. Steinbock
- Department of Chemistry, West Virginia University, Morgantown, WV 26506-6045, USA
| | - K. Showalter
- Department of Chemistry, West Virginia University, Morgantown, WV 26506-6045, USA
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30
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Steinbock O, Showalter K. Response
: Minimal Path Algorithms. Science 1995. [DOI: 10.1126/science.269.5222.418-b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Affiliation(s)
- O. Steinbock
- Department of Chemistry, West Virginia University, Morgantown, WV 26506-6045, USA
| | - K. Showalter
- Department of Chemistry, West Virginia University, Morgantown, WV 26506-6045, USA
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31
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32
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Petrov V, Mihaliuk E, Scott SK, Showalter K. Stabilizing and characterizing unstable states in high-dimensional systems from time series. Phys Rev E Stat Phys Plasmas Fluids Relat Interdiscip Topics 1995; 51:3988-3996. [PMID: 9963109 DOI: 10.1103/physreve.51.3988] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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33
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Petrov V, Crowley MJ, Showalter K. Tracking unstable periodic orbits in the Belousov-Zhabotinsky reaction. Phys Rev Lett 1994; 72:2955-2958. [PMID: 10056027 DOI: 10.1103/physrevlett.72.2955] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
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34
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Edwards BF, Wilder JW, Showalter K. Onset of convection for autocatalytic reaction fronts: Laterally unbounded system. Phys Rev A 1991; 43:749-760. [PMID: 9905091 DOI: 10.1103/physreva.43.749] [Citation(s) in RCA: 55] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
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