bluuebunny/crossref_metadata_2025_split huggingface dataset:
Natural history of insomnia symptoms in the transition from childhood to adolescence: population rates, health disparities, and risk factors
Authors: Fernandez-Mendoza Julio , Bourchtein Elizaveta , Calhoun Susan , Puzino Kristina , Snyder Cynthia K , He Fan , Vgontzas Alexandros N , Liao Duanping , Bixler Edward 
Published: September 2020

Abstract

Study Objectives
To determine the sociodemographic, behavioral, and clinical risk factors associated with the persistence, remission, and incidence of insomnia symptoms in the transition from childhood to adolescence.

Methods
The Penn State Child Cohort is a random, population-based sample of 700 children (5–12 years at baseline), of whom 421 were followed-up as adolescents (12–23 years at follow-up). Subjects underwent polysomnography, clinical history, physical exam, and parent- and self-reported scales at baseline and follow-up. Insomnia symptoms were defined as a parent- or self-report of difficulty falling and/or staying asleep.

Results
The 421 subjects with baseline (Mage = 8.8 years) and follow-up (Mage = 17 years) data were 53.9% male and 21.9% racial/ethnic minorities. The persistence of childhood insomnia symptoms (CIS) was 56% (95% CI = 46.5–65.4), with only 30.3% (95% CI = 21.5–39.0) fully remitting. The incidence of adolescent insomnia symptoms was 31.1% (95% CI = 25.9–36.3). Female sex, racial/ethnic minority, and low socioeconomic status as well as psychiatric/behavioral or neurological disorders, obesity, smoking, and evening chronotype were associated with a higher persistence or incidence of insomnia symptoms.

Conclusions
CIS are highly persistent, with full remission occurring in only a third of children in the transition to adolescence. Sex-, racial/ethnic-, and socioeconomic-related disparities in insomnia occur as early as childhood, while different mental/physical health and lifestyle/circadian risk factors play a key role in the chronicity of CIS versus their incidence in adolescence. CIS should not be expected to developmentally remit and should become a focus of integrated pediatric/behavioral health strategies.
Validity of the Global Physical Activity Questionnaire in Older Adults With Chronic Obstructive Pulmonary Disease: Results From the National Health and Nutrition Examination Survey
Authors: Gore Shweta , Goldberg Allon , Huang Min H. , Shoemaker Michael , Blackwood Jennifer 
Published: September 2020

Purpose:
The Global Physical Activity Questionnaire (GPAQv2) is widely used and one of the only national surveillance measures recommended by the World Health Organization for physical activity (PA) assessment globally. No studies to date have examined the validity of GPAQv2 in older adults with chronic obstructive pulmonary disease (COPD). This observational study examined its construct validity using population-based data.

Methods:
Individuals aged 65 years and older with COPD, interviewed in the National Health and Nutrition Examination Survey (NHANES) between years 2007 and 2012 were included. GPAQv2-derived PA was compared with constructs of lung function, shortness of breath, and the diagnosis of COPD.

Results:
The GPAQv2 was not found to be a significant predictor of COPD status (odds ratio = 1.00, 95% confidence interval: 0.99, 1.00) when controlling for relevant covariates. Age and smoking status emerged as the strongest predictors of COPD. Total PA was neither significantly associated with shortness of breath nor lung function.

Conclusions:
Older adults with chronic conditions such as COPD represent a unique subset of population discrete from the healthier counterparts. Given the importance of GPAQv2 as the only widely accepted population surveillance tool, future studies exploring its validity in this subset of individuals with COPD using different constructs and objective reference standards are needed.
Treatment of Refractory Melasma in Asians With the Picosecond Alexandrite Laser
Authors: Polnikorn Niwat , Tanghetti Emil 
Published: September 2020

BACKGROUND/OBJECTIVES
The picosecond Alexandrite laser was studied in our practice with the diffractive lens array and the flat optic to treat melasma.

METHODS AND MATERIALS
Sixty patients with melasma were treated in a prospective investigation with the picosecond Alexandrite laser. Nineteen patients were treated with the flat optic and 41 patients were treated with the diffractive lens array. Treatments were performed with 1 pass at 2-week intervals for 6 treatments. The Melasma Severity Index (MSI) was used to evaluate the patients before treatment and 3 and 6 months after the final treatment session.

RESULTS
At 6 months after the last treatment, there was an 18.5% difference between the groups with a 75.7% improvement in the MSI in patients with the diffractive lens array and a 57.2% improvement in the MSI score in patients with the flat optic. At 6 months, there was recurrence of melasma in 5% of the cases with no hyperpigmentation with the diffractive optic in contrast to recurrence in 16% of the cases in the flat optic group and a transient macular hyperpigmentation in 21% of the cases.

CONCLUSION
This investigation highlights the utility of a picosecond Alexandrite laser with a flat and diffractive lens to successfully treat a large percentage of Asian patients in a sunny climate.
Transvascular Hydrolysis of Hyaluronic Acid Filler With Hyaluronidase: An Ex Vivo Study
Authors: Rauso Raffaele , Zerbinati Nicola , Fragola Romolo , Nicoletti Giovanni Francesco , Tartaro Gianpaolo 
Published: September 2020

BACKGROUND
Despite the favorable safety profile of hyaluronic acid (HA) dermal fillers, side effects can occur. Skin necrosis is one of the most severe early-occurring complications resulting from accidental vascular impairment. Hyaluronidase (HYAL) is commonly used to degrade HA chains, allowing the degraded product to pass through vessels, and thus relieving the vascular obstruction.

OBJECTIVE
The purpose of this study is to evaluate, in an ex vivo setting, the capability of HYAL to degrade crosslinked HA that was injected into human vessels.

MATERIALS AND METHODS
During a neck dissection, a portion of the anterior jugular vein and facial artery was harvested. The vein and artery specimens were filled with 25 mg/mL of crosslinked HA filler. Each specimen was soaked in 0.5 mL of HYAL (300 IU/mL), in its own test tube, for 4 hours, after which the remaining HA was quantified.

RESULTS
The remaining HA volume was found to be 0.02 mL in the vein segment and 0.002 mL in the artery segment.

CONCLUSION
A single administration of HYAL may not be adequate to restore blood flow in the event of embolism, and relatively high doses of this enzyme must be injected hourly into the affected tissue until resolution is complete.
RETINAL DETACHMENT AFTER ACUTE RETINAL NECROSIS AND THE EFFICACIES OF DIFFERENT INTERVENTIONS
Authors: Zhao Xin-Yu , Meng Li-Hui , Zhang Wen-Fei , Wang Dong-Yue , Chen You-Xin 
Published: September 2020

Purpose:
To estimate the rate of retinal detachment (RD) after acute retinal necrosis (ARN) and evaluate the efficacies of different interventions.

Methods:
The databases Medline and EMBASE from inception to March 2020 were searched to identify the relevant studies. R software version 3.6.3 was used to perform the statistical analyses. Results in proportion with 95% confidence interval were calculated using generalized linear mixed models.

Results:
Sixty-seven studies involving 1,811 patients were finally included. The pooling results suggested the general RD rate of ARN was 47%. The RD rate increased with the extent of retinitis and was slightly lower when involved Zone III. The RD rate was 37% for herpes simplex virus ARN and 46% for varicella–zoster virus ARN; 52% for immunocompetent patients and 39% for immunocompromised patients. Retinal detachment presented in 2% of eyes at the first visit. Systemic antiviral therapy could lower the RD rate significantly from 67% to 43%, and prophylactic vitrectomy could lower the RD rate significantly from 45% to 22%. Systemic antiviral therapy plus vitrectomy achieved the lowest RD rate to 18%. Although the efficacy of prophylactic laser or intravitreal antiviral therapy was still limited. Prophylactic vitrectomy might significantly increase the incidence of proliferative vitreoretinopathy from 7% to 32%.

Conclusion:
About half of the eyes might develop RD during the entire course of ARN. Systemic antiviral therapy and prophylactic vitrectomy are effective interventions to prevent RD, whereas the roles of prophylactic laser or adjunctive intravitreal antiviral therapy are still unclear. Varicella–zoster virus ARN and cases with extensive retinitis might need intensified interventions.
Predictability of intraocular lens power calculation after small-incision lenticule extraction for myopia
Authors: Lazaridis Apostolos , Schraml Florian , Preußner Paul-Rolf , Sekundo Walter 
Published: September 2020

Purpose:
To evaluate and compare the predictability of intraocular lens (IOL) power calculation after small-incision lenticule extraction (SMILE) for myopia and myopic astigmatism.

Setting:
Department of Ophthalmology, Philipps University of Marburg, Marburg, Germany.

Design:
Retrospective comparative case series.

Methods:
Preoperative evaluation included optical biometry using IOLMaster 500 and corneal tomography using Pentacam HR. The corneal tomography measurements were repeated at 3 months postoperatively. The change of spherical equivalent due to SMILE was calculated by the manifest refraction at corneal plane (SMILE-Dif). A theoretical model, involving the virtual implantation of the same IOL before and after SMILE, was used, and the IOL power calculations were performed using ray tracing (OKULIX, version 9.06) and third- (Hoffer Q, Holladay 1, and SRK/T) and fourth-generation (Haigis-L and Haigis) formulas. The difference between the IOL-induced refractive error at corneal plane before and after SMILE (IOL-Dif) was compared with SMILE-Dif. The prediction error (PE) was calculated as the difference between SMILE-Dif–IOL-Dif.

Results:
The study included 204 eyes that underwent SMILE. The PE with ray tracing was −0.06 ± 0.40 diopter (D); Haigis-L, −0.39 ± 0.62 D; Haigis, 0.70 ± 0.48 D; Hoffer Q, 0.84 ± 0.47 D; Holladay 1, 1.21 ± 0.51 D; and SRK/T, 1.46 ± 0.54 D. The PE with ray tracing was significantly smaller compared with that of all formulas (P ≤ .001). The PE variance with ray tracing was σ2 = 0.159, being significantly more homogenous compared with that of all formulas (P ≤ .011, F ≥ 6.549). Ray tracing resulted in an absolute PE of 0.5 D or lesser in 81.9% of the cases, followed by Haigis-L (53.4%), Haigis (35.3%), Hoffer Q (25.5%), Holladay 1 (6.4%), and SRK/T (2.9%) formulas.

Conclusions:
Ray tracing was the most accurate approach for IOL power calculation after myopic SMILE.
IOP and Optic Nerve Head Morphology during Scleral Lens Wear
Authors: Walker Maria K. , Pardon Laura P. , Redfern Rachel , Patel Nimesh 
Published: September 2020

SIGNIFICANCE
Scleral lenses (SLs) are increasing in scope, and understanding their ocular health impact is imperative. The unique fit of an SL raises concern that the landing zone causes compression of conjunctival tissue that can lead to resistance of aqueous humor outflow and increased intraocular pressure (IOP).

PURPOSE
This study aimed to assess changes in optic nerve head morphology as an indirect assessment of IOP and evaluate other IOP assessment methods during SL wear.

METHODS
Twenty-six healthy adults wore SL on one randomly selected eye for 6 hours, whereas the fellow eye served as a control. Global minimum rim width (optical coherence tomography) and IOP (Icare, Diaton) were measured at baseline, 2 and 6 hours after SL application, and again after SL removal. Central corneal thickness, anterior chamber depth, and fluid reservoir depth were monitored.

RESULTS
Minimum rim width thinning was observed in the test (−8 μm; 95% confidence interval [CI], −11 to −6 μm) and control (−6 μm; 95% CI, −9 to −3 μm) eyes after 6 hours of SL wear (P < .01), although the magnitude of thinning was not significantly greater in the lens-wearing eyes (P = .09). Mean IOP (Icare) significantly increased +2 mmHg (95% CI, +1 to +3 mmHg) in the test eyes (P = .002), with no change in the control eyes. Mean IOP changes with Diaton were +0.3 mmHg (95% CI, −0.9 to +3.2 mmHg) in the test eyes and +0.4 mmHg (95% CI, −0.8 to +1.7 mmHg) in the control eyes. However, Diaton tonometry showed poor within-subject variation and poor correlation with Icare. No clinically significant changes were observed in central corneal thickness or anterior chamber depth.

CONCLUSIONS
This study suggests that SLs have a minimal effect on IOP homeostasis in the normal eye during SL wear and an insignificant impact on the optic nerve head morphology in healthy adult eyes.
Association Between FokI Polymorphism of Vitamin D Receptor Gene and Lumbar Spine Disc Degeneration
Authors: Castillo-Avila Rosa Giannina , González-Castro Thelma Beatriz , Tovilla-Zárate Carlos Alfonso , Juárez-Rojop Isela Esther , López-Narváez María Lilia , Rodríguez-Pérez José Manuel , Suárez-Méndez Samuel 
Published: September 2020

Objective
The aim of the present meta-analysis was to explore the association between FokI polymorphism of the vitamin D receptor gene and lumbar spine disc degeneration.

Design
The search was performed in PubMed, Scopus, and Web of Science databases up to January 2020. The authors selected nine studies comprising a total of 1549 cases and 1672 controls. The association analysis included the allelic, dominant, recessive, homozygous, and heterozygous genetic models. Odds ratios with 95% confidence intervals were used to evaluate the association. The Newcastle-Ottawa Scale was used to measure the quality of the studies included in the analyses; a cut-off of 6 stars was applied.

Results
This meta-analysis indicated that FokI polymorphism is significantly associated with lumbar degenerative disc disorder and disc herniation in the homozygous (odds ratio, 1.77; 95% confidence interval, 1.23–2.54; Z test P = 0.002, Q test P = 0.416) and recessive (odds ratio, 1.53; 95% confidence interval, 1.23–1.90; Z test P < 0.000, Q test P = 0.224) models.

Conclusions
This study indicates that the vitamin D receptor gene FokI polymorphism may be correlated with the risk of developing a lumbar degenerative disc disorder and disc herniation. However, the small sample population studied and the lack of an evaluation of environmental factors must be taken as limitations in the present meta-analysis.
A Magnetic Resonance Imaging Radiomics Signature to Distinguish Benign From Malignant Orbital Lesions
Authors: Duron Loïc , Heraud Alexandre , Charbonneau Frédérique , Zmuda Mathieu , Savatovsky Julien , Fournier Laure , Lecler Augustin 
Published: September 2020

Objectives
Distinguishing benign from malignant orbital lesions remains challenging both clinically and with imaging, leading to risky biopsies. The objective was to differentiate benign from malignant orbital lesions using radiomics on 3 T magnetic resonance imaging (MRI) examinations.

Materials and Methods
This institutional review board–approved prospective single-center study enrolled consecutive patients presenting with an orbital lesion undergoing a 3 T MRI prior to surgery from December 2015 to July 2019. Radiomics features were extracted from 6 MRI sequences (T1-weighted images [WIs], DIXON-T2-WI, diffusion-WI, postcontrast DIXON-T1-WI) using the Pyradiomics software. Features were selected based on their intraobserver and interobserver reproducibility, nonredundancy, and with a sequential step forward feature selection method. Selected features were used to train and optimize a Random Forest algorithm on the training set (75%) with 5-fold cross-validation. Performance metrics were computed on a held-out test set (25%) with bootstrap 95% confidence intervals (95% CIs). Five residents, 4 general radiologists, and 3 expert neuroradiologists were evaluated on their ability to visually distinguish benign from malignant lesions on the test set. Performance comparisons between reader groups and the model were performed using McNemar test. The impact of clinical and categorizable imaging data on algorithm performance was also assessed.

Results
A total of 200 patients (116 [58%] women and 84 [42%] men; mean age, 53.0 ± 17.9 years) with 126 of 200 (63%) benign and 74 of 200 (37%) malignant orbital lesions were included in the study. A total of 606 radiomics features were extracted. The best performing model on the training set was composed of 8 features including apparent diffusion coefficient mean value, maximum diameter on T1-WIs, and texture features. Area under the receiver operating characteristic curve, accuracy, sensitivity, and specificity on the test set were respectively 0.869 (95% CI, 0.834–0.898), 0.840 (95% CI, 0.806–0.874), 0.684 (95% CI, 0.615–0.751), and 0.935 (95% CI, 0.905–0.961). The radiomics model outperformed all reader groups, including expert neuroradiologists (P < 0.01). Adding clinical and categorizable imaging data did not significantly impact the algorithm performance (P = 0.49).

Conclusions
An MRI radiomics signature is helpful in differentiating benign from malignant orbital lesions and may outperform expert radiologists.
Fusion of Preinterventional MR Imaging With Liver Perfusion CT After RFA of Hepatocellular Carcinoma
Authors: Kobe Adrian , Kindler Yanick , Klotz Ernst , Puippe Gilbert , Messmer Florian , Alkadhi Hatem , Pfammatter Thomas 
Published: September 2020

Objectives
The aim of this study was to evaluate the ability of fusion of pretreatment magnetic resonance (MR) imaging with posttreatment perfusion–CT (P-CT) after radiofrequency ablation (RFA) of hepatocellular carcinomas (HCCs) and to determine treatment success in an objective, quantitative way.

Materials and Methods
In this institutional review board–approved study, 39 patients (78.4% male; mean age 68.2 ± 8.5 years) with a total of 43 HCCs, who underwent RFA at our institution and had diagnostic pre-RFA MR imaging and post-RFA P-CT, were included in the study. Post-RFA P-CT was performed within 24 hours after RFA. In a first step, the pre-RFA MR imaging, depicting the HCC, was registered onto the post-RFA P-CT using nonrigid image registration. After image registration, the MR data were reloaded jointly with the calculated perfusion parameter volumes into the perfusion application for quantitative analysis. A 3-dimensional volume of interest was drawn around the HCC and the ablation zone; both outlines were automatically projected onto all perfusion maps. Resulting perfusion values (normalized peak enhancement [NPE, %]; arterial liver perfusion [ALP, in mL/min/100 mL]; BF [blood flow, mL/100 mL/min]; and blood volume [BV, mL/100 mL]) and histogram data were recorded. Local tumor recurrence was defined in follow-up imaging according to the EASL guidelines.

Results
Image registration of MR imaging and CT data was successful in 37 patients (94.9%). Local tumor recurrence was observed in 5 HCCs (12%). In the local tumor recurrence group (LTR-group), HCC size was significantly larger (22.7 ± 3.9 cm vs 17.8 ± 5.3 cm, P = 0.035) and the ablation zone was significantly smaller (29.8 ± 6.9 cm vs 39.3 ± 6.8 cm, P = 0.014) compared with the no-local tumor recurrence group (no-LTR group). The differences (ablation zone − tumor) of the perfusion parameters NPE, ALP, BF, and BV significantly differed between the 2 groups (all P's < 0.005). Especially, the difference (ablation zone − tumor) of NPE and ALP, with a cutoff value of zero, accurately differentiated between LTR or no-LTR in all cases. A negative difference of these perfusion parameters identified local tumor recurrence in all cases.

Conclusions
Image registration of pre-RFA MR imaging onto post-RFA P-CT is feasible and allows to predict local tumor recurrence within 24 hours after RFA in an objective, quantitative manner and with excellent accuracy.
Cognitive decline heralds onset of symptomatic inherited prion disease
Authors: Mole Joseph , Mead Simon , Rudge Peter , Nihat Akin , Tzehow Mok , Collinge John , Caine Diana 
Published: September 2020

AbstractThe clinical effectiveness of any disease-modifying treatment for prion disease, as for other neurodegenerative disorders, will depend on early treatment before damage to neural tissue is irrevocable. Thus, there is a need to identify markers which predict disease onset in healthy at-risk individuals. Whilst imaging and neurophysiological biomarkers have shown limited use in this regard, we recently reported progressive neurophysiological changes in healthy people with the inherited prion disease mutation P102L (Rudge et al, Brain 2019). We have also previously demonstrated a signature pattern of fronto-parietal dysfunction in mild prion disease (Caine et al., 2015; 2018). Here we address whether these cognitive features anticipate the onset of symptoms in a unique sample of patients with inherited prion disease. In the cross-sectional analysis, we analysed the performance of patients at three time points in the course of disease onset: prior to symptoms (n = 27), onset of subjective symptoms without positive clinical findings (n = 8) and symptomatic with positive clinical findings (n = 24). In the longitudinal analysis, we analysed data from twenty four patients who were presymptomatic at the time of recruitment and were followed up over a period of up to seventeen years, of whom sixteen remained healthy and eight converted to become symptomatic. In the cross-sectional analysis, the key finding was that, relative to a group of 25 healthy non-gene carrier controls, patients with subjective symptoms but without positive clinical findings were impaired on a smaller but very similar set of tests (Trail Making Test part A, Stroop Test, Performance IQ, gesture repetition, figure recall) to those previously found to be impaired in mild prion disease (Caine et al., 2015; 2018). In the longitudinal analysis, Trail Making Test parts A and B, Stroop test and Performance IQ scores significantly discriminated between patients who remained presymptomatic and those who converted, even before the converters reached criteria for formal diagnosis. Notably, performance on the Stroop test significantly discriminated between presymptomatic patients and converters before the onset of clinical symptoms (AUC = .83 (95% CI, 0.62-1.00), p =.009). Thus, we report here, for the first time, neuropsychological abnormalities in healthy patients prior to either symptom onset or clinical diagnosis of IPD. This constitutes an important component of an evolving profile of clinical and biomarker abnormalities in this crucial group for preventive medicine.