{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T08:48:57Z","timestamp":1782377337784,"version":"3.54.5"},"reference-count":32,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2019,12,13]],"date-time":"2019-12-13T00:00:00Z","timestamp":1576195200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2019,12,13]],"date-time":"2019-12-13T00:00:00Z","timestamp":1576195200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2019,12,13]],"date-time":"2019-12-13T00:00:00Z","timestamp":1576195200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation","award":["TCRD-TPE-106-RT-1"],"award-info":[{"award-number":["TCRD-TPE-106-RT-1"]}]},{"name":"Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation","award":["TCRD-Taipei-108-28"],"award-info":[{"award-number":["TCRD-Taipei-108-28"]}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2020,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Patients with pectus excavatum have a poorer subjective sleep quality and quality of life than the general population. The Nuss procedure has been shown to improve these patients\u2019 quality of life, but data regarding their postoperative sleep quality are lacking. We aimed to evaluate the objective sleep quality of adults with pectus excavatum before and after the Nuss procedure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Twenty\u2010eight participants completed this study. Epworth Sleepiness Scale (ESS) scores for daytime sleepiness, Pittsburgh Sleep Quality Index (PSQI) scores for subjective sleep quality, and overnight polysomnography for objective sleep quality were evaluated before and 6\u00a0months after the Nuss procedure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Subjective sleep quality improved after the Nuss procedure. The median PSQI score decreased from 7 [interquartile range (IQR): 5; 9] to 5 (IQR: 4; 7,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.029); the median percentage of poor PSQI sleep quality decreased from 64.3 to 35.7% (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.048). The median percentage of rapid eye movement sleep significantly increased after surgery [15.6% (IQR: 12.2%; 19.8%) vs. 20.4% (IQR: 14.5%; 24.9%),\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.016]. Sleep interruptions also improved, with the median arousal index decreasing from 9.5 (IQR: 4.8; 18.2) to 8.2 (IQR: 4.3; 12.1;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.045). However, there was no significant change in ESS scores after surgery (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.955).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Pectus excavatum may be associated with poor subjective and objective sleep quality in adults, and the condition may improve after the Nuss procedure. For adults with pectus excavatum who report poor subjective sleep quality, polysomnography should be considered to assess their preoperative and postoperative sleep condition.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00268-019-05311-5","type":"journal-article","created":{"date-parts":[[2019,12,13]],"date-time":"2019-12-13T11:06:13Z","timestamp":1576235173000},"page":"1316-1322","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Improvement in Polysomnographic Objective Sleep Quality in Adults with Pectus Excavatum After the Nuss Procedure"],"prefix":"10.1002","volume":"44","author":[{"given":"Mei\u2010Chen","family":"Yang","sequence":"first","affiliation":[{"name":"Division of Pulmonary Medicine, Department of Internal Medicine Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation New Taipei Taiwan"},{"name":"School of Medicine Tzu Chi University Hualien Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chou\u2010Chin","family":"Lan","sequence":"additional","affiliation":[{"name":"Division of Pulmonary Medicine, Department of Internal Medicine Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation New Taipei Taiwan"},{"name":"School of Medicine Tzu Chi University Hualien Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yao\u2010Kuang","family":"Wu","sequence":"additional","affiliation":[{"name":"Division of Pulmonary Medicine, Department of Internal Medicine Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation New Taipei Taiwan"},{"name":"School of Medicine Tzu Chi University Hualien Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Min\u2010Shiau","family":"Hsieh","sequence":"additional","affiliation":[{"name":"School of Medicine Tzu Chi University Hualien Taiwan"},{"name":"Division of Thoracic Surgery, Department of Surgery Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation No. 289, Jianguo Rd., Xindian Dist. 23143 New Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bo\u2010Chun","family":"Wei","sequence":"additional","affiliation":[{"name":"Division of Thoracic Surgery, Department of Surgery Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation No. 289, Jianguo Rd., Xindian Dist. 23143 New Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1911-1419","authenticated-orcid":false,"given":"Yeung\u2010Leung","family":"Cheng","sequence":"additional","affiliation":[{"name":"School of Medicine Tzu Chi University Hualien Taiwan"},{"name":"Division of Thoracic Surgery, Department of Surgery Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation No. 289, Jianguo Rd., Xindian Dist. 23143 New Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,12,13]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1186\/1477\u20107525\u20109\u201028"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.prrv.2008.12.002"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2013.04.093"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12471\u2010010\u20100067\u2010z"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1177\/0218492314553442"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.prrv.2014.10.009"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022\u20103468(98)90314\u20101"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejcts.2010.10.022"},{"key":"e_1_2_7_10_1","unstructured":"YehSW YangMC ChangYWet al. 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