Evaluation and application of a Chinese version symptom questionnaire for visual dysfunctions (CSQVD) in school-age children.

Objective: To develop and evaluate a Chinese version of the Symptom Questionnaire for Visual Dysfunctions (CSQVD) to quantify visual dysfunction symptoms in school-age children with various eye diseases, and to explore the relationship between ophthalmological disorders and visual dysfunction symptoms. Methods: Following standard scale adaptation procedures, the Symptom Questionnaire for Visual Dysfunctions (SQVD) was translated into Chinese (CSQVD). We employed random sampling to survey 198 outpatients aged 7-18 to assess the psychometric properties of the CSQVD. Using the reliable and validated questionnaire, we evaluated the determinants of visual dysfunction symptoms among 406 school-age patients at an eye center. The CSQVD scores were correlated with demographic and clinical variables, including gender, age, eye position, refractive power, and best-corrected visual acuity. Univariate analysis identified potential risk factors, followed by binary logistic regression and multiple linear regression analysis on factors with a P-value <0.05. Results: The CSQVD scale's critical ratio (CR) values ranged from 6.028 to 10.604. The Cronbach's Alpha coefficient was 0.779, and Spearman-Brown split-half reliability was also 0.779. The I-CVI varied from 0.83 to 1.000, the S-CVI/Ave was 0.857, and the KMO value was 0.821. Multifactorial regression analysis indicated that high myopia (OR â€‹= â€‹5.744, 95% CI [1.632, 20.218], P â€‹= â€‹0.006) and amblyopia (OR â€‹= â€‹9.302, 95% CI [1.878, 46.058], P â€‹= â€‹0.006) were significant predictors of CSQVD symptoms. Multiple linear regression analysis showed that BCVA of amblyopic eyes (B â€‹= â€‹-5.052, 95% CI [-7.779, 2.325], P â€‹= â€‹0.000) and SE power (B â€‹= â€‹-0.234, 95% CI [-0.375, 0.205], P â€‹= â€‹0.001) significantly affected the CSQVD scale scores. Conclusions: The Chinese version of the SQVD scale (CSQVD) demonstrates good feasibility, discriminatory power, validity, and reliability in assessing Chinese school-aged children. Furthermore, those who have severe myopia and amblyopia reported more visual dysfunction symptoms.

Gender Disparities in the Global Burden of Refractive Disorders in Children: An Analysis From the Global Burden of Disease Study 2019.

PURPOSE: To investigate gender disparities in the global burden of refractive disorders in children younger than 15 years by year, age, and national developmental status using disability-adjusted life years (DALYs). METHODS: Global, regional, and national gender-specific DALY numbers and rates of refractive disorders in children were obtained by year (from 1990 to 2019) and age group (0 to 4, 5 to 9, and 10 to 14 years) from the Global Burden of Disease Study 2019. Data from the Inequality-adjusted Human Development Index in 2019 as an indicator of national developmental status were extracted from the Human Development Report. Pearson correlation and linear regression analyses were performed to explore the association between female-to-male DALY rate ratios and national developmental status. RESULTS: Gender disparities in DALY numbers and rates of refractive disorders in children have persisted and shown little improvement from 1990 to 2019. Girls had a higher burden than boys of the same age, and gender disparities increased with age (1.120 in preschool children aged 0 to 4 years, 1.124 in younger school-aged children aged 5 to 9 years, and 1.135 in older school-aged children aged 10 to 14 years). Female-to-male DALY rate ratios were negatively related to Inequality-adjusted Human Development Index values (standardized b = -0.189, P < .05). CONCLUSIONS: Gender disparities in the global burden of refractive disorders in children have persisted for decades, with girls who are older and from lower-income countries having a higher burden than boys. Gender-specific health policies should be made to manage refractive disorders in children. [J Pediatr Ophthalmol Strabismus. 2024;61(1):51-58.].

Interrater reproducibility of the Myoton and durometer devices to quantify sclerotic chronic graft-versus-host disease.

Chronic graft-versus-host disease (cGVHD) is a severe complication in long-term survivors of allogeneic hematopoietic stem cell transplantation. This disease is challenging to manage clinically due to a lack of validated tools to quantitatively measure skin sclerosis. The current gold standard for measuring skin sclerosis is the NIH Skin Score which has only moderate agreement among clinicians and experts. To more accurately assess skin sclerosis in cGVHD, the Myoton and durometer devices can be used to directly measure biomechanical parameters of the skin. However, the reproducibility of these devices is not known in patients with cGVHD. To determine this reproducibility, three observers independently measured 10 anatomic sites in each of seven patients with sclerotic cGVHD using the Myoton and durometer. Clinical reproducibility was measured by mean pairwise differences (U-statistic) and intraclass correlation coefficients (ICCs) with 95% confidence intervals (CIs). Mean pairwise differences, expressed in true physical units, were used to report typical errors for each anatomic site and device. Mean pairwise differences were less than 11% of the average overall values for all five Myoton parameters and durometer hardness. These were lower for Myoton creep (4.1%), relaxation time (4.7%), and frequency (5.1%) than decrement (9.0%), stiffness (10.4%), and durometer hardness (9.0%). Myoton parameters creep, relaxation time, and frequency showed promise for capturing skin biomechanics more accurately than Myoton stiffness, decrement, or durometer hardness. Mean pairwise differences trended highest in the shin and volar forearm and lowest in the dorsal forearm. The interobserver ICC for overall (averaged across all measured body sites of a patient) creep (0.94; 95% CI 0.87-1.00), relaxation time (0.96; 95% CI 0.90-1.00), and frequency (0.95; 95% CI 0.88-1.00), trended higher than that for decrement (0.43; 95% CI 0.00-0.88), stiffness (0.92; 95% CI 0.81-1.00), and durometer hardness (0.82; 95% CI 0.61-1.00). Similar trends were observed in healthy participants. These findings can help clinicians design better studies to assess therapeutic response to new cGVHD treatments and support the interpretation of future measurements.

Hyperspectral imaging to accurately segment skin erythema and hyperpigmentation in cutaneous chronic graft-versus-host disease.

In 51 lesions from 15 patients with the inflammatory skin condition chronic graft-versus-host-disease, hyperspectral imaging accurately delineated active erythema and post-inflammatory hyperpigmentation. The method was validated by dermatologist-approved confident delineations of only definitely affected and definitely unaffected areas in photographs. A prototype hyperspectral imaging system acquired a 2.5 × 3.5 cm2 area of skin at 120 wavelengths in the 450-850 nm range. Unsupervised extraction of unknown absorbers by endmember analysis achieved a comparable accuracy to that of supervised extraction of known absorbers (melanin, hemoglobin) by chromophore mapping: 0.78 (IQR: 0.39-0.85) vs. 0.83 (0.53-0.91) to delineate erythema and 0.74 (0.57-0.87) vs. 0.73 (0.52-0.84) to delineate hyperpigmentation. Both algorithms achieved higher specificity than sensitivity. Whereas a trained human confidently marked a median of 7% of image pixels, unsupervised and supervised algorithms delineated a median of 14% and 27% pixels. Hyperspectral imaging could overcome a fundamental practice gap of distinguishing active from inactive manifestations of inflammatory skin disease.

Enhanced characterization of breast cancer phenotypes using Raman micro-spectroscopy on stainless steel substrate.

Biochemical insights into varying breast cancer (BC) phenotypes can provide a fundamental understanding of BC pathogenesis, while identifying novel therapeutic targets. Raman spectroscopy (RS) can gauge these biochemical differences with high specificity. For routine RS, cells are traditionally seeded onto calcium fluoride (CaF2) substrates that are costly and fragile, limiting its widespread adoption. Stainless steel has been interrogated previously as a less expensive alternative to CaF2 substrates, while reporting increased Raman signal intensity than the latter. We sought to further investigate and compare the Raman signal quality measured from stainless steel versus CaF2 substrates by characterizing different BC phenotypes with altered human epidermal growth factor receptor 2 (HER2) expression. Raman spectra were obtained on stainless steel and CaF2 substrates for HER2 negative cells - MDA-MB-231, MDA-MB-468 and HER2 overexpressing cells - AU565, SKBr3. Upon analyzing signal-to-noise ratios (SNR), stainless steel provided a stronger Raman signal, improving SNR by 119% at 1450 cm-1 and 122% at 2925 cm-1 on average compared to the CaF2 substrate. Utilizing only 22% of laser power on sample relative to the CaF2 substrate, stainless steel still yielded improved spectral characterization over CaF2, achieving 96.0% versus 89.8% accuracy in BC phenotype discrimination and equivalent 100.0% accuracy in HER2 status classification. Spectral analysis further highlighted increased lipogenesis and altered metabolism in HER2 overexpressing cells, which was subsequently visualized with coherent anti-Stokes Raman scattering microscopy. Our findings demonstrate that stainless steel substrates deliver improved Raman signal and enhanced spectral characterization, underscoring its potential as a cost-effective alternative to CaF2 for non-invasively monitoring cellular biochemical dynamics in translational cancer research.

Fast Reconstruction for Deep Learning PET Head Motion Correction.

Head motion correction is an essential component of brain PET imaging, in which even motion of small magnitude can greatly degrade image quality and introduce artifacts. Building upon previous work, we propose a new head motion correction framework taking fast reconstructions as input. The main characteristics of the proposed method are: (i) the adoption of a high-resolution short-frame fast reconstruction workflow; (ii) the development of a novel encoder for PET data representation extraction; and (iii) the implementation of data augmentation techniques. Ablation studies are conducted to assess the individual contributions of each of these design choices. Furthermore, multi-subject studies are conducted on an 18F-FPEB dataset, and the method performance is qualitatively and quantitatively evaluated by MOLAR reconstruction study and corresponding brain Region of Interest (ROI) Standard Uptake Values (SUV) evaluation. Additionally, we also compared our method with a conventional intensity-based registration method. Our results demonstrate that the proposed method outperforms other methods on all subjects, and can accurately estimate motion for subjects out of the training set. All code is publicly available on GitHub: https://github.com/OnofreyLab/dl-hmc_fast_recon_miccai2023.

Cross-Attention for Improved Motion Correction in Brain PET.

Head movement during long scan sessions degrades the quality of reconstruction in positron emission tomography (PET) and introduces artifacts, which limits clinical diagnosis and treatment. Recent deep learning-based motion correction work utilized raw PET list-mode data and hardware motion tracking (HMT) to learn head motion in a supervised manner. However, motion prediction results were not robust to testing subjects outside the training data domain. In this paper, we integrate a cross-attention mechanism into the supervised deep learning network to improve motion correction across test subjects. Specifically, cross-attention learns the spatial correspondence between the reference images and moving images to explicitly focus the model on the most correlative inherent information - the head region the motion correction. We validate our approach on brain PET data from two different scanners: HRRT without time of flight (ToF) and mCT with ToF. Compared with traditional and deep learning benchmarks, our network improved the performance of motion correction by 58% and 26% in translation and rotation, respectively, in multi-subject testing in HRRT studies. In mCT studies, our approach improved performance by 66% and 64% for translation and rotation, respectively. Our results demonstrate that cross-attention has the potential to improve the quality of brain PET image reconstruction without the dependence on HMT. All code will be released on GitHub: https://github.com/OnofreyLab/dl_hmc_attention_mlcn2023.

Theoretical simulation study on crystal property and hygroscopicity of ADN doping with nitramine explosives (RDX, HMX, and CL-20).

To effectively modify the strong hygroscopicity of ammonium dinitramide (ADN) crystal, the modification of ADN crystal in the 298 K under vacuum environment was studied through theoretical calculation. Three kinds of energetic nitramine molecules (X = RDX, HMX, and CL-20) were inserted into ADN crystal in different proportions (the molecular ratios of ADN to X are 6/1, 12/1, 18/1, and 24/1), to form a total of 12 kinds of designed ADN crystals. The results show that with the modification of ADN crystal with RDX, HMX, and CL-20, the crystal space group, cell parameters, crystal density, and growth morphology will be changed under vacuum conditions. According to the analyses of adsorption heat data, four proportional modification systems all reduced the hygroscopicity of ADN crystal to varying degrees. It is worth noting that the hygroscopicity of modified ADN crystal tends to decrease with the increase of the proportion of doping molecules, but the stability gradually deteriorates, especially 18ADN/1CL-20 and 24ADN/1CL-20. Although they have an excellent anti-moisture effect, from the perspective of crystal energy stability, the actual syntheses of these two kinds of crystal cells are the most difficult. Combined with the energy stability and hygroscopicity analysis, 1HMX/24ADN crystal is a more suitable anti-hygroscopicity modification scheme among the doped ADN crystals. In this case, the isothermal adsorption heat of ADN crystal decreases from 0.692 kcal/mol to 0.573 kcal/mol. The theoretical simulation study of ADN doping modification in a vacuum will provide significant references for ADN modification in the actual situation.

Optimal biomechanical parameters for measuring sclerotic chronic graft-versus-host disease.

Skin biomechanical parameters (dynamic stiffness, frequency, relaxation time, creep, and decrement) measured using a myotonometer (MyotonPRO) could inform management of sclerotic disease. To determine which biomechanical parameter(s) can accurately differentiate sclerotic chronic graft-versus-host disease (cGVHD) patients from post-hematopoietic cell transplant (post-HCT) controls, 15 sclerotic cGVHD patients and 11 post-HCT controls were measured with the myotonometer on 18 anatomic sites. Logistic regression and two machine learning algorithms, LASSO regression and random forest, were developed to classify subjects. In univariable analysis, frequency had the highest overfit-corrected area under the receiver operating characteristic curve (AUC 0.91). Backward stepwise selection and random forest machine learning identified frequency and relaxation time as the optimal parameters for differentiating sclerotic cGVHD patients from post-HCT controls. LASSO regression selected the combination of frequency and relaxation time (overfit-corrected AUC 0.87). Discriminatory ability was maintained when only the sites accessible while the patient is supine (12 sites) were used. We report the distribution of values for these highly discriminative biomechanical parameters, which could inform assessment of disease severity in future quantitative biomechanical studies of sclerotic cGVHD.

Effect of crop cultivation on the soil carbon stock in mine dumps of the Loess Plateau, China.

In the ecological restoration of mine dumps, soil carbon stock (SCS) improvement is an important issue. The type of land use and management approach taken can have a great influence on this issue. On the Loess Plateau, different crops have been cultivated on reclaimed land; however, the effect of long-term crop cultivation on SCS is poorly understood. To address this issue, a field investigation of mine dumps was performed at the Kee Open Pit Mine in Shanxi Province, China. Four sites utilizing different land management methods were analyzed: no reclamation (NR), reclamation with no crop cultivation (NC), and reclamation followed by 11 or 27 years crop cultivation (RC-11 and RC-27, respectively). SCS, associated soil properties (total nitrogen (TN), total phosphorus (TP), total potassium (TK), moisture content (MoiC), and pH), plant community (species composition, plant diversity, and traits), and microbial community operational taxonomic units (OTUs) of fungi and bacteria were determined by field investigation and laboratory analysis. Redundancy analysis was used to show the relationship between SCS and other environmental variables. Results varied by soil depth. At the depth range of 0-20 cm, the SCS of RC-11 was significantly greater compared to that in NR and NC, by 14.64- and 2.25-fold, respectively; whereas compared to RC-27, it was higher by 52.78%. At the depth of 20-40 cm, NC has the largest SCS; the SCS of RC-27 was the lowest, which was less compared to that in NC by 43.64%. Redundancy analysis showed a positive relationship between the SCS and TN, TP, MoiC, as well as average plant coverage, while the bacterial OTUs were negatively related with the SCS. This research suggests the potential of mine dumps for crop cultivation, which could improve the SCS of the mining area on the Loess Plateau.

Correction: Non-invasive measurement of sclerosis in cutaneous cGVHD patients with the handheld device Myoton: a cross-sectional study.

An amendment to this paper has been published and can be accessed via a link at the top of the paper.

Crowdsourcing to delineate skin affected by chronic graft-vs-host disease.

BACKGROUND: Estimating the extent of affected skin is an important unmet clinical need both for research and practical management in many diseases. In particular, cutaneous burden of chronic graft-vs-host disease (cGVHD) is a primary outcome in many trials. Despite advances in artificial intelligence and 3D photography, progress toward reliable automated techniques is hindered by limited expert time to delineate cGVHD patient images. Crowdsourcing may have potential to provide the requisite expert-level data. MATERIALS AND METHODS: Forty-one three-dimensional photographs of three cutaneous cGVHD patients were delineated by a board-certified dermatologist. 410 two-dimensional projections of the raw photos were each annotated by seven crowd workers, whose consensus performance was compared to the expert. RESULTS: The consensus delineation by four of seven crowd workers achieved the highest agreement with the expert, measured by a median Dice index of 0.7551 across all 410 images, outperforming even the best worker from the crowd (Dice index 0.7216). For their internal agreement, crowd workers achieved a median Fleiss's kappa of 0.4140 across the images. The time a worker spent marking an image had only weak correlation with the surface area marked, and very low correlation with accuracy. Percent of pixels selected by the consensus exhibited good correlation (Pearson R = 0.81) with the patient's affected surface area. CONCLUSION: Crowdsourcing may be an efficient method for obtaining demarcations of affected skin, on par with expert performance. Crowdsourced data generally agreed with the current clinical standard of percent body surface area to assess cGVHD severity in the skin.

Reproducibility of the durometer and myoton devices for skin stiffness measurement in healthy subjects.

BACKGROUND: Clinical assessment of skin stiffness is unreliable in many applications. The durometer, an industrial device to measure hardness, has previously been applied in scleroderma. The Myoton is a noninvasive handheld device for assessing soft tissue biomechanical parameters. MATERIALS AND METHODS: We evaluated the reproducibility of both devices in six healthy subjects in the volar forearm, dorsal forearm, upper arm, shin, and calf bilaterally. The intraclass correlation coefficient (ICC) was used as a measure of reproducibility among three observers. RESULTS: The interobserver intraclass correlation coefficient (ICC) of overall stiffness for the Myoton was 0.74 [95% confidence interval (CI) 0.45-1.00] and 0.71 [0.39-1.00] for the durometer. Coefficient of variation (CV) for the Myoton was 6.4% [range 1.3-12.1] and 7.6% [range 4.4-13.8] for the durometer. Myoton and durometer values had a Pearson correlation of 0.69. The intraobserver Myoton ICC was 0.89 [0.74-1.00] and CV 3.1% [range 1.6-5.0]. The 95% confidence minimal detectable change by the Myoton for a single observer is 32.4 N/m, which is 7.6% of the average subject's overall stiffness. CONCLUSION: The Myoton demonstrated high reproducibility, particularly in the overall stiffness parameter, and merits further investigation to assess disease progression and treatment efficacy.