bluuebunny/crossref_metadata_2025_split huggingface dataset:
0960 Perception of Sleep Importance in Children With Cystic Fibrosis
Authors: Reiling K , Patel A 
Published: May 2020

Abstract

Introduction
Children with cystic fibrosis (CF) are known to have poor sleep efficiency and increased nighttime awakenings secondary to factors such as nocturnal cough and time spent on therapies for airway clearance. Studies have shown that children with poor lung function have a higher Pediatric Daytime Sleepiness Score (PDSS). An increase in sleep disturbance has been associated with poorer perceived health in children with CF. There have been limited studies to date that report the perception of sleep importance in CF patients. We aim to characterize the perception of sleep importance in children with CF as measured through a self-reported questionnaire and identify barriers to sleep.

Methods
After IRB approval, subjects with CF aged 3-17 years were prospectively recruited from routine pulmonology clinic visits (n=28, 17 male). A questionnaire was provided consisting of 35 questions regarding sleep practices, perception of sleep importance, and PDSS. Recent pulmonary function tests (PFTs) were also collected.

Results
The mean PDSS was 11.3, with a range of 4 to 24. The questionnaire responses were as follows: 82% of participants reported sleep as “very important” overall, 92% reported sleep being “very important” for health, and 75% reported sleep being “very important” for lung function. In addition, 39% reported airway clearance as part of their nighttime routine and 89% reported utilizing electronic screens 2 hours prior to bed. The most frequent barriers to sleep identified were technology and bedtime resistance (14% each), and homework, excitability, and vest/airway treatments (11% each). 86% of participants had at least one symptom of disordered sleep.

Conclusion
Screening for sleep problems in the CF population may be beneficial and may contribute to improved quality of life. Further recruitment is ongoing.

Support
0967 Clinical Characteristics of Children With Sleep Problems and Comorbid Psychiatric Disorders
Authors: McIntyre E , Oles S K , Walsh K , Bandyopadhyay A 
Published: May 2020

Abstract

Introduction
Anxiety and Attention Deficit Hyperactive Disorder (ADHD) are common psychiatric comorbidities in children with sleep disorders. It is known that comorbid psychiatric disorders increase the risk of sleep problems. However, no study has compared the clinical characteristics of children presenting with sleep problems and various common psychiatric disorders.

Methods
Retrospective chart review of all children presenting to the sleep clinic for sleep problems between March 2016 to June 2017 was performed. Demographics, sleep intake patient questionnaires, polysomnograms and ICD-9/10 codes for comorbidities and sleep diagnoses were collected. In children with diagnoses of anxiety (ICD-9 300/ICD-10 F41) and ADHD (ICD-9 314/ICD-10 F90), demographics, presenting symptoms, Epworth sleepiness scores and prevalence of sleep comorbidities were compared. T-test (continuous) and Chi Square (categorical) were used. Unadjusted odds ratio was calculated for presenting symptoms and sleep comorbidities. P value of &lt;0.05 was considered significant.

Results
250 (F=145, 58%) children were evaluated. 71.2% children were diagnosed with anxiety and 28.8% diagnosed with ADHD. Mean age at presentation was 8.53 ± 4.2 years. Age, gender and race of children presenting with sleep problems and comorbid anxiety/ADHD were statistically similar. Children with anxiety spent less time in stage N3 sleep (25.2% ± 9.1 versus 28.6% ± 9.2) and had lower arousal indices (7.19 ± 3.8 versus 8.86 ± 5.5) compared to children with ADHD. Children with anxiety were more likely to present with chief complaint of “feeling tired or sleepy during the day” (OR:2.38, 1.32-4.37) and were more likely to have a diagnosis of hypersomnia (OR: 11.67, 3.19-42.75) versus children with ADHD.

Conclusion
Children with psychiatric comorbidities have distinct polysomnographic characteristics. Children with anxiety are more likely to present with daytime sleepiness and have a significantly higher prevalence of hypersomnia compared to children with ADHD.

Support
None
0971 Mother’s Parenting Style As A Moderator In The Relationship Between Temperament And Sleep Problems In Children With Obesity
Authors: Nam H , Kim J , Woo S , Park S , Lee H , Jang H , Park† K , Suh† S 
Published: May 2020

Abstract

Introduction
Based on past studies, a child’s temperament and parenting style greatly affect a child’s sleep. However, there are limited studies that have investigated how parenting styles and a child’s temperament interact and affect the child’s sleep in obese children. Thus, this study investigated parenting styles as a moderator in the relationship between temperament and sleep in obese children.

Methods
Seventy-seven obese children (male=66.2%, average BMI = 27.35±2.78) participated in the study. The mean age of the participants was 10.82(± 1.00) years. The primary caregiver (mother) of the participants completed the Junior Temperament and Character Inventory (J-TCI), and Parents as Social Context Questionnaire (K-PSCQ), and Children’s Sleep Habits Questionnaire (CSHQ). Among the different subscales, only Novelty Seeking (NS) and Reward Dependence (RD) were used for analysis among Junior Temperament and Character Inventory (J-TCI) components.

Results
In this sample, 66 children (85.7%) reported significant levels of sleep problems based on the CSHQ. Novelty seeking (NS) and reward dependence (RD) significantly predicted sleep problems (B=-.771, p&lt;.05, B=-.683, p&lt;.01). Additionally, mother’s negative parenting style moderated the relationship between NS and the child’s sleep problem [B=.03, 95% CI=.007, .049] and the relationship between RD and the child’s sleep problem [B=.031, 95% CI=.013, .049]. The more negative mother’s parenting style, the higher the child’s NS or RD scores had a negative effect on sleep.

Conclusion
The results of this study show that obese children experience high levels of sleep disturbance. Additionally, the mother’s negative parenting style moderated the relationship between temperament and sleep problems in obese children. The results suggest that sleep interventions for obese children should include the mother, especially in children with high novelty seeking and reward dependence.

Support
This work was supported by Korea Centers for Disease Control and Prevention & Korea National Research Institute of Health (2019020660E-00)
0989 Examining The Role Of Toddler Sleep Quality On Wake EEG And Language Ability
Authors: Page J , Walters R , Gould R , Wakschlag L , Norton E 
Published: May 2020

Abstract

Introduction
Sleep and the development of language are prominent concerns of many parents and until recently, many have examined these concerns tangentially. Children with developmental delays/disabilities have shown to have impaired sleep and poor sleep quality, and impairments or changes in sleep quality may play a prominent role in the acquisition of language and neuronal oscillatory patterns. This study examines the role of child sleep quality paired with a normed measure of language and wake electroencephalography (EEG). Examining the role of child sleep quality with language ability and wake EEG may provide nascent incremental utility to understanding the influences of sleep on healthy development.

Methods
Data from 109 toddlers (age range 24 to 30.5 m, M = 26.83 ± 1.58 m, 52% male) from the Brief Infant Sleep Questionnaire (BISQ), Mullen Scales of Early Learning (MSEL), and continuous EEG were collected and analyzed. EEG was recorded (32 electrode cap BioSemi) while toddlers sat in a booster seat and watched a silent video. Data were analyzed in RStudio and Matlab to examine toddler’s sleep quality (infant sleep and parent behaviors) and relations with the MSEL and EEG (controlling for child age and gender).

Results
Means and standard deviations appeared within expected limits based on the range of each variable. Toddlers with slow-developing language were associated with relatively poor sleep quality, explaining 9.75% of the variance. We find preliminary evidence to suggest a potential sleep disruption around the time when a child is undergoing a rapid expansion in their vocabulary (expressive language). Toddler’s sleep quality and language acquisition were also correlated with wake EEG (alpha and beta).

Conclusion
Sleep is regarded as an essential component supporting the myriad changes observed in early development. Sleep quality fundamentally influences healthy development across domains. Here, we showed child sleep quality is highly associated with toddler’s language ability, and wake EEG, providing new insights into the developing brain.

Support
National Institutes of Health R01DC016273, R01MH107652-03S1, and Johnson & Johnson Consumer Inc., Skillman, NJ, USA.
0995 Nightcap For School-nights: Association Between Milk Intake And Sleep Duration In First-graders
Authors: Chung A , Martinez S , Ursache A , Chang S , Huang Y , Jean-Louis G , Brotman L 
Published: May 2020

Abstract

Introduction
Insufficient sleep has been identified as an obesity risk factor due to mechanistic pathways contributing to higher carbohydrate intake, including in children. Dietary intake of macronutrients, such as fats and protein found in milk, may serve as a modifiable risk factor for adequate sleep. We hypothesize that milk intake among a sample of urban first-graders may be associated with sleep duration.

Methods
Cross-sectional analysis of parent reports of an adapted version of the Child Sleep Health Questionnaire (CSHQ) and Block Dietary Data Systems Food Frequency Questionnaire (FFQ) were analyzed among a sample of 837 Black children in Brooklyn, New York. Summary scores were created for milk type. Milk intake was classified by fat content: whole milk and 2% categorized as high-fat, and 1% and skim as low-fat. Independent t-test, correlations and regression analysis to identify associations between parent reports of child’s sleep duration and milk intake were conducted.

Results
On average, children were 7.3 + 0.6 years old and 52% female. Nearly 57% of parents were immigrants. Children’s mean BMI was 17.27, approximately at the 85th BMI percentile according to CDC index-for-age percentiles. On average, FFQ data reported children consumed high-fat milk 6 days a week. Linear variable regression analysis between high-fat milk intake and sufficient sleep were significant (β =, 0.090, p &lt; 0.05). BMI was significantly associated with high-fat milk intake (β= 0.17, p&lt;0.05). However, high-fat milk intake was not significantly associated with (in)sufficient sleep, after controlling for BMI, sex and age. No difference was reported between immigrant parents and U.S. born parents.

Conclusion
Plausibly, high-fat milk is contributing to satiety and longer sleep duration. Future studies should include more comprehensive measurement of milk consumption (i.e. time of day and volume) to consider possible effects on children’s sleep. Actigraphy measures and sleep diaries should also be considered.

Support
Bezos Grant and Community Service Plan grant.
1003 Sleep Spindle Abnormalities In Youth With Ptsd
Authors: Peterson B , Castelnovo A , Riedner B , Herringa R , Jones S 
Published: May 2020

Abstract

Introduction
Sleep disturbance is central to the phenomenology of PTSD across the lifespan with up to 90% of youth with PTSD reporting sleep disturbance. Subjective sleep dysfunction has also been linked to the development, maintenance and severity of the disorder. However, to date there have been no objective EEG assessments of sleep in youth with PTSD, and little is known about how the disease impacts specific sleep features.

Methods
Ten youth with PTSD (aged 14.5±3.2; CAPS-CA score 60.5±25.3) and ten age-and sex-matched typically developing youth (TD) (aged 14.7±3.2) completed two non-consecutive overnight high-density EEG (256-channel) polysomnography sleep studies. Prior to sleep on one night, participants performed an emotion processing task. Group differences in sleep macrostructure variables were assessed with two-way ANOVA, and group differences in all-night spectral density were assessed using unpaired t-tests. An automatic algorithm was used to detect spindle amplitude, duration, and density topographically. Statistical non-parametric mapping (SnPM) cluster testing was used to determine significantly different topographic differences between groups.

Results
No significant group differences were observed in sleep macrostructure variables. All-night spectral density analysis revealed increased power in PTSD youth relative to TD youth in the sigma band on both task and baseline nights. PTSD youth showed higher spindle duration, higher integrated spindle activity, and higher spindle amplitude globally both nights relative to TD youth. The increase in spindle duration achieved significance in a robust frontal cluster on both nights (43-channel cluster (p = .044) on baseline night, 66-channel cluster (p = .019) on task night).

Conclusion
Structural and functional abnormalities of the prefrontal cortex are a prominent feature of pediatric PTSD. The observed increase in spindle duration may represent another marker of impaired cortical function in youth with PTSD reflecting a failure of cortical inhibition of the thalamically-generated spindle rhythm.

Support
K08 MH100267 to RH, Wisconsin Institute for Sleep and Consciousness Pilot Award to SJ
The resistance and resilience of European beech seedlings to drought stress during the period of leaf development
Authors: Gebauer Roman , Plichta Roman , Urban Josef , Volařík Daniel , Hájíčková Martina 
Published: May 2020

AbstractSpring drought is becoming a frequently occurring stress factor in temperate forests. However, the understanding of tree resistance and resilience to the spring drought remains insufficient. In this study, European beech (Fagus sylvatica L.) seedlings at the early stage of leaf development were moderately and severely drought stressed for 1 month and then subjected to a 2-week recovery period after rewatering. The study aimed to disentangle the complex relationships between leaf gas exchange, vascular anatomy, tree morphology and patterns of biomass allocation. Stomatal conductance decreased by 80 and 85% upon moderate and severe drought stress, respectively, which brought about a decline in net photosynthesis. However, drought did not affect the indices of slow chlorophyll fluorescence, indicating no permanent damage to the light part of the photosynthetic apparatus. Stem hydraulic conductivity decreased by more than 92% at both drought levels. Consequently, the cambial activity of stressed seedlings declined, which led to lower stem biomass, reduced tree ring width and a lower number of vessels in the current tree ring, these latter also with smaller dimensions. In contrast, the petiole structure was not affected, but at the cost of reduced leaf biomass. Root biomass was reduced only by severe drought. After rewatering, the recovery of gas exchange and regrowth of the current tree ring were observed, all delayed by several days and by lower magnitudes in severely stressed seedlings. The reduced stem hydraulic conductivity inhibited the recovery of gas exchange, but xylem function started to recover by regrowth and refilling of embolized vessels. Despite the damage to conductive xylem, no mortality occurred. These results suggest the low resistance but high resilience of European beech to spring drought. Nevertheless, beech resilience could be weakened if the period between drought events is short, as the recovery of severely stressed seedlings took longer than 14 days.
Promoting Value Through Patient-Centered Communication: A Multisite Validity Study of Third-Year Medical Students
Authors: Natt Neena , Dekhtyar Michael , Park Yoon Soo , Shinkai Kanade , Carney Patricia A. , Fancher Tonya L. , Lawson Luan , Leep Hunderfund Andrea N. 
Published: May 2020

Purpose
To examine validity evidence for a standardized patient scenario assessing medical students’ ability to promote value using patient-centered communication (in response to a patient requesting an unnecessary test) and to explore the potential effect of various implementation and curricular factors on student scores.

Method
Third-year medical students (N = 516) from 5 U.S. MD-granting medical schools completed the communication scenario between 2014 and 2017 as part of a larger objective structured clinical examination (OSCE). Centralized raters assessed performance using an 11-item checklist. The authors collected multiple sources of validity evidence.

Results
The mean checklist score was 0.85 (standard deviation 0.09). Interrater reliability for checklist scores was excellent (0.87, 95% confidence interval = 0.78–0.93). Generalizability and Phi-coefficients were, respectively, 0.65 and 0.57. Scores decreased as the number of OSCE stations increased (r = −0.15, P = .001) and increased when they were used for summative purposes (r = 0.26, P < .001). Scores were not associated with curricular time devoted to high-value care (r = 0.02, P = .67) and decreased when more clerkships were completed before the assessment (r = −0.12, P = .006).

Conclusions
This multisite study provides validity evidence supporting the use of scenario scores to assess the ability of medical students to promote value in clinical encounters using patient-centered communication. Findings illuminate the potential effect of OSCE structure and purpose on student performance and suggest clerkship learning experiences may not reinforce what students are taught in the formal curriculum regarding high-value care. Devoting more time to the topic appears insufficient to counteract this erosion.
Transumbilical Single-port Robotically Assisted Nipple-sparing Mastectomy: A Cadaveric Study
Authors: Sarfati Benjamin , Toesca Antonio , Roulot Aurélie , Invento Alessandra 
Published: May 2020

Summary:
The authors performed a transumbilical, single-port robotically assisted, nipple-sparing mastectomy on a cadaveric model to assess technical feasibility. Surgeon-controlled, robotic-wristed instrumentation, as well as 3-dimensional high definition (HD) vision allowed the entire dissection to be performed through a single incision placed in the umbilicus. The technique warrants further exploration and development before any application in clinical applied research.
Special International Society of Plastic Regenerative Surgeons Scientific Program in San Diego, United States
Authors: Luna Jacqueline , Pu Lee L. Q. 
Published: May 2020

Summary:
The International Society of Plastic Regenerative Surgeons (ISPRES) has evolved over the years since its rebirth as an affiliated organization of the American Society of Plastic Surgeons. Over the years, ISPRES has held 6 International Congresses throughout the world. Recently, the ISPRES again had a strong and positive impact at the American Society of Plastic Surgeon’s Annual Meeting held on September 19–24, 2019, in San Diego, California. A series of educational programming dedicated to fat grafting and regenerative plastic surgery took place on September 22 known as the ISPRES Dedicated Track. Overall, there were >300 attendees throughout the day who attended our ISPRES scientific program. Many of them were international attendees from many countries. In addition, more than half of the invited speakers were also international. The interests of learning from attendees and of sharing from invited speakers on fat grafting and its new role of regenerative plastic surgery again demonstrate an important value of those scientific panels organized by ISPRES. We are all looking forward to our future world congresses with excitement. Under the capable administrative support from American Society of Plastic Surgeons, ISPRES, this new dynamic society with their primary focus on fat grafting and regenerative surgery will definitely look for more worldwide educational opportunities and will lead this subspecialty of plastic surgery to the next level of excellence.
Efficacy of Combined Suprachoroidal Stent and Cataract Surgery in Patients With Glaucoma
Authors: Law Simon K. , Salazar Diana , Yu Fei , Giaconi JoAnn A. , Chen Angela , Chopra Vikas , Francis Brian , Coleman Anne L. , Lu Kenneth , Nouri-Mahdavi Kouros , Tan James , Caprioli Joseph 
Published: May 2020

Purpose:
The purpose of this study was to evaluate the efficacy of intraocular pressure (IOP) control after combined CyPass Micro-Stent implantation and cataract surgery (combined surgery).

Methods:
All cases of combined surgery performed from February 2017 to July 2018 at Stein and Doheny Eye Institutes were reviewed. The primary outcome was a qualified success with stratified IOP targets based on criteria: final IOP (A) ≤18 mm Hg and reduction of 20%, (B) ≤15 mm Hg and reduction of 25%, (C) ≤12 mm Hg and reduction of 30%. Secondary outcome measures included postoperative IOP and number of medications, complications, additional glaucoma surgery, and postoperative refractive error. Predictive factors for failure were investigated. IOP spike was defined as a postoperative IOP ≥30 or >10 mm Hg increase from preoperative IOP.

Results:
One hundred forty-one eyes (107 patients) were included. Mean (±SD) preoperative IOP was 15.4±3.4 mm Hg on an average of 2.2±1.1 medications. A statistically significant reduction in IOP and number of medications was seen at 12 months (13.8±4.2 mm Hg, 1.3±1.3 medications, P<0.001). Fifteen eyes (10.6%) had a postoperative IOP spike. Thirteen eyes (9.2%) experienced 17 complications (12.1%). Additional glaucoma surgery was performed in 3 eyes (2 patients). Cumulative success rates at 1 year based on criteria A, B, and C were 42%, 33%, and 28%, respectively. Lower preoperative IOP, greater preoperative medication number, the occurrence of postoperative IOP spike, and non-Caucasian ethnicity were associated with failure.

Conclusion:
Combined CyPass Micro-Stent implantation and cataract surgery may reduce glaucoma medication burden with a success rate of 28% to 42% at 1 year.
Comparison of self- and nurse-measured office blood pressure in patients with chronic kidney disease
Authors: Tougaard Birgitte Godskesen , Laursen Kathrine Skaaning , Jensen Jens Dam , Buus Niels Henrik 
Published: May 2020

Objective
As blood pressure (BP) control is very important in chronic kidney disease (CKD), we investigated how office BP is influenced by the measurement circumstances and compared nonautomated self- and nurse-measured BP values.

Materials and methods
Two hundred stage 1–5 CKD patients with scheduled visits to an outpatient clinic were randomized to either self-measured office BP (SMOBP) followed by nurse-measured office BP (NMOBP) or NMOBP followed by SMOBP. The participants had been educated to perform the self-measurement in at least one previous visit. The SMOBP and NMOBP measurement series both consisted of three recordings, and the means of the last two recordings during SMOBP and NMOBP were compared for the 174 (mean age 52.5 years) with complete BP data.

Results
SMOBP and NMOBP showed similar systolic (135.3 ± 16.6 vs 136.4 ± 17.4 mmHg, Δ = 1.1 mmHg, P = 0.13) and diastolic (81.5 ± 10.2 vs 82.2 ± 10.4 mmHg, Δ = 0.6 mmHg, P = 0.09) values. The change in BP from the first to the third recording was not different for SMOBP and NMOBP. In 17 patients, systolic SMOBP was ≥10 mmHg higher than NMOBP and in 28 patients systolic NMOBP exceeded SMOBP by ≥10 mmHg. The difference between systolic SMOBP and NMOBP was independent of CKD stage and the number of medications, but significantly more pronounced in patients above 60 years.

Conclusion
In a population of CKD patients, there is no clinically relevant difference in SMOBP and NMOBP when recorded at the same visit. However, in 25% of the patients, systolic BP differs ≥10 mmHg between the two measurement modalities.