bluuebunny/crossref_metadata_2025_split huggingface dataset:
“Different but connected”: Participatory action research using Photovoice to explore well-being in autistic young adults
Authors: Lam Gary Yu Hin , Holden Emily , Fitzpatrick Megan , Raffaele Mendez Linda , Berkman Karen 
Published: January 2020

Past research has largely focused on the negative aspects of well-being of autistic young adults during the post-school transition. Research that meaningfully includes autistic individuals and captures their perspectives of positive well-being is essential for stakeholders to better understand how to provide services that respond to the needs and wants of the autistic community. In the current study, 14 autistic young adults in a post-school transition program participated in a Photovoice project and used photos to express their ideas about well-being. A participatory action research approach was used to support participants’ active engagement in the research processes and to encourage meaningful expression of their first-person perspectives. Results revealed an account of well-being reflecting expressions of individuality and growth, the significance of having close relationships, and a sense of connection with the community. This study has implications for research and practice that promotes well-being among the autistic community using approaches that are ethically informed and inclusive of autistic voices. Lay abstract Past research has mainly focused on autistic people’s deficits and poor outcomes compared to other groups of people. Little is known about their positive life experiences, and how to support them to achieve a higher quality of life. It is important to include autistic individuals in research so that they can influence how their voices are represented in a meaningful way and how the research results will be useful to them. In this study, a university researcher collaborated with 14 autistic young adults in a post-school transition program to design and run the research, collect and analyze the data, and use the results to create a presentation to the community. Specifically, the participants took photos in daily life and discussed their ideas about what a good life means to them. Results showed that these young adults described themselves as uniquely and different, but they were eager to learn and adapt. They also valued their relationships with their families, friends, and animals around them, as well as the community at large. This research shows that autistic individuals have important perspectives to share and knowledge to contribute when they are given the opportunities to participate in different aspects of research. The findings will be useful in developing services and influencing policies that promote well-being among autistic adults.
Defining the Minimal Clinically Important Difference in Athletes Undergoing Arthroscopic Correction of Sports-Related Femoroacetabular Impingement: The Percentage of Possible Improvement
Authors: Carton Patrick , Filan David 
Published: January 2020

Background: Measures of clinically meaningful improvement in patient-reported outcomes within orthopaedics are becoming a minimum requirement to establish the success of an intervention. Purpose: To (1) define the minimal clinically important difference (MCID) at 2 years postoperatively in competitive athletes undergoing hip arthroscopic surgery for symptomatic, sports-related femoroacetabular impingement utilizing existing anchor- and distribution-based methods and (2) derive a measure of the MCID using the percentage of possible improvement (POPI) method and compare against existing techniques. Study Design: Cohort study (diagnosis); Level of evidence, 2. Methods: There were 2 objective outcome measures—the modified Harris Hip Score (mHHS) and 36-Item Short Form Health Survey (SF-36)—administered at baseline and 2 years postoperatively. External anchor questions were used to determine the MCID through mean change, mean difference, and receiver operating characteristic (ROC) techniques. Distribution-based calculations consisted of 0.5 SD, effect size, and standard error of measurement techniques. The POPI was calculated alongside each technique as an achieved percentage change of maximum available improvement for each athlete relative to the individual baseline score. The impact of the preoperative baseline score on the MCID was assessed by assigning athletes to groups determined by baseline percentiles. Statistical analysis was performed, with P < .05 considered significant. Results: There were 576 athletes (96% male; mean age, 25.9 ± 5.7 years). The MCID score change (and POPI) for the mHHS and SF-36 ranged from 2.4 to 16.7 (21.6%-63.6%) and from 3.3 to 24.9 (22.1%-57.4%), respectively. The preoperative threshold value for achieving the ROC-determined MCID was 80.5 and 86.5 for the mHHS and 70.1 and 72.4 for the SF-36 for the patient-reported outcome measure (PROM) score– and POPI-calculated MCID, respectively. Through the commonly used mean change method, 40.0% (mHHS) and 42.4% (SF-36) of athletes were unable to achieve the MCID because of high baseline scores and PROM ceiling effects compared with 0% when the POPI technique was used. A highly significant difference for the overall MCID was observed between preoperative baseline percentile groups for the mHHS ( P = .014) and SF-36 ( P = .004) (improvement in points), while there was no significant difference between groups for either the mHHS ( P = .487) or SF-36 ( P = .417) using the POPI technique. Conclusion: The MCID defined by an absolute value of improvement was unable to account for postoperative progress in a large proportion of higher functioning athletes. The POPI technique negated associated ceiling effects, was unrestricted by the baseline score, and may be more appropriate in quantifying clinically important improvement.
Liouville-type theorem for Kirchhoff equations involving Grushin operators
Authors: Wei Yunfeng , Chen Caisheng , Yang Hongwei 
Published: January 2020

AbstractThe aim of this paper is to prove the Liouville-type theorem of the following weighted Kirchhoff equations:
$$\begin{aligned} \begin{aligned}[b] & -M \biggl( \int _{{\mathbb{R}} ^{N}}\omega (z) \vert \nabla _{G}u \vert ^{2}\,dz \biggr) \operatorname{div}_{G} \bigl(\omega (z) \nabla _{G}u \bigr)=f(z)e^{u}, \\ &\quad z=(x,y) \in R^{N}=R^{N_{1}}\times R^{N_{2}} \end{aligned} \end{aligned}$$

−
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and
$$\begin{aligned} \begin{aligned}[b] & M \biggl( \int _{\mathbb{R}^{N}}\omega (z) \vert \nabla _{G}u \vert ^{2}\,dz \biggr) \operatorname{div}_{G} \bigl(\omega (z) \nabla _{G}u \bigr)=f(z)u^{-q}, \\ &\quad z=(x,y) \in {\mathbb{R}} ^{N}={\mathbb{R}} ^{N_{1}}\times {\mathbb{R}} ^{N_{2}}, \end{aligned} \end{aligned}$$

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,

where $M(t)=a+bt^{k}$
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, $t\geq 0$
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, with $a>0$
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, $b, k\geq 0$
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if and only if $b=0$
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and $\omega (z), f(z)\in L^{1}_{\mathrm{loc}}({\mathbb{R}} ^{N})$
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are nonnegative functions satisfying $\omega (z)\leq C_{1}\|z \|_{G}^{\theta }$
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and $f(z)\geq C_{2}\|z\|_{G}^{d}$
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as $\|z\|_{G} \geq R_{0}$

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with $d>\theta -2$
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, $R_{0}$

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, $C_{i}$

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($i=1,2$
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and $\|z\|_{G}=(|x|^{2(1+ \alpha )}+|y|^{2})^{\frac{1}{2(1+\alpha )}}$

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is the norm corresponding to the Grushin distance. $N_{\alpha }=N_{1}+(1+\alpha )N_{2}$

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(
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is the homogeneous dimension of ${\mathbb{R}} ^{N}$

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. $\operatorname{div}_{G}$

div
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(resp., $\nabla _{G}$

∇
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) is Grushin divergence (resp., Grushin gradient). Under suitable assumptions on k, θ, d, and $N_{\alpha }$

N
α

, the nonexistence of stable weak solutions to equations (0.1) and (0.2) is investigated.
Silibinin attenuates adipose tissue inflammation and reverses obesity and its complications in diet-induced obesity model in mice
Authors: Alsaggar Mohammad , Bdour Shifa , Ababneh Qutaibah , El-Elimat Tamam , Qinna Nidal , Alzoubi Karem H. 
Published: January 2020

Abstract
Background
Obesity is a multifactorial chronic disease that comprises several pathological events, such as adipose hypertrophy, fatty liver and insulin resistance. Inflammation is a key contributer to development of these events, and therefore, targeting inflammation is increasingly considered for management of obesity and its complications. The aim of the current study was to investigate therapeutic outcomes of anti-inflammatory activities of the natural compound Silibinin in reversing obesity and its complication in mice.

Methods
C57BL/6 male mice were fed high-fat diet for 8 weeks until development of obesity, and then injected with 50 mg/kg silibinin intraperitoneally twice per week, or vehicle for 8 weeks. Throughout the experiment, mice were continuously checked for body weight and food intake, and glucose tolerance test was performed toward the end of the experiment. Animals were sacrificed and serum and tissues were collected for biochemical, histological, and gene expression analysis to assess silibinin effects on adipose inflammation, fat accumulation, liver adipogenesis and glucose homeostasis.

Results
Silibinin treatment reversed adipose tissue inflammation and adipocyte hypertrophy, and blocked progression in weight gain and obesity development with no significant effects on rates of food intake. Silibinin also reversed fatty liver disease and restored glucose homeostasis in treated animals, and reversed hyperglycemia, hyperinsulinemia and hypertriglyceridemia.

Conclusion
In this study, we demonstrated that silibinin as an anti-inflammatory therapy is a potential alternative to manage obesity, as well as its related complications. Moreover, silibinin-based therapies could further evolve as a novel treatment to manage various inflammation-driven disorders.
A direct power control of a DFIG based-WECS during symmetrical voltage dips
Authors: Mensou Sara , Essadki Ahmed , Nasser Tamou , Bououlid Idrissi Badr 
Published: January 2020

AbstractThe Wind Energy Conversion System (WECS) based Doubly Fed Induction Generator (DFIG) has experienced a rapid development in the world, which leads to an increasing insertion of this source of energy in the electrical grids. The sudden and temporary drop of voltage at the network can affect the operation of the DFIG; the voltage dips produce high peak currents on the stator and rotor circuits, without protection, the rotor side converter (RSC) will suffer also from over-current limit, consequently, the RSC may even be destroyed and the generator be damaged. In this paper a new Direct Power Control (DPC) method was developed, in order to control the stator powers and help the operation of the aero-generator during the faults grid; by injecting the reactive power into the network to contribute to the return of voltage, and set the active power to the optimum value to suppress the high peak currents. The DPC method was designed using the nonlinear Backstepping (BS) controller associated with the Lyapunov function to ensure the stability and robustness of the system. A comparison study was undertaken to verify the robustness and effectiveness of the DPC-BS to that of the classical vector control (VC) using Proportional-Integral (PI) correctors. All were simulated under the Simulink® software.
Infertility, Gravidity, and Risk Of Diabetes among High-Risk Women in the Diabetes Prevention Program Outcomes Study
Authors: Kim Catherine , Younes Naji , Temprosa Marinella , Edelstein Sharon , Goldberg Ronald B , Araneta Maria G , Wallia Amisha , Brown Angela , Darwin Christine , Ibebuogu Uzoma , Pi-Sunyer Xavier , Knowler William C 
Published: January 2020

Abstract

Objective
The extent to which infertility and pregnancy independently increase risk of diabetes and subclinical atherosclerosis is not known.

Research Design And Methods
We conducted a secondary analysis of Diabetes Prevention Program (DPP) and the DPP Outcomes Study over a 15-year period. We included women who answered questions about gravidity and infertility at baseline (n = 2085). Infertility was defined as &gt; 1 year of unsuccessful attempts to conceive; thus, women could have histories of infertility as well as pregnancy. Risk of diabetes associated with gravidity and infertility was calculated using Cox proportional hazards models adjusting for age, race/ethnicity, treatment arm, body mass index, and pregnancy during the study. Among women who underwent assessment of coronary artery calcification (CAC) (n = 1337), odds of CAC were calculated using logistic regression models with similar covariates.

Results
Among premenopausal women (n = 1075), women with histories of pregnancy and infertility (n = 147; hazard ratio [HR] 1.80; 95% confidence interval [CI] 1.30, 2.49) and women with histories of pregnancy without infertility (n = 736; HR 1.49; 95% CI 1.15, 1.93) had greater diabetes risk than nulligravid women without infertility (n = 173). Premenopausal nulligravid women with histories of infertility had a non-significant elevation in risk, although the number of these women was small (n = 19; HR 1.63; 95% CI 0.88, 3.03). Associations were not observed among postmenopausal women (n = 1010). No associations were observed between infertility or pregnancy with CAC.

Conclusions
Pregnancy, particularly combined with a history of infertility, confers increased risk of diabetes but not CAC among glucose-intolerant premenopausal women.
Risk Factors for Cardiovascular Disease (CVD) in Adults with Type 1 Diabetes: Findings from Prospective Real-life T1D Exchange Registry
Authors: Shah Viral N , Bailey Ryan , Wu Mengdi , Foster Nicole C , Pop-Busui Rodica , Katz Michelle , Crandall Jill , Bacha Fida , Nadeau Kristen , Libman Ingrid , Hiers Paul , Mizokami-Stout Kara , DiMeglio Linda A , Sherr Jennifer , Pratley Richard , Agarwal Shivani , Snell-Bergeon Janet , Cengiz Eda , Polsky Sarit , Mehta Sanjeev N 
Published: January 2020

Abstract

Context
Cardiovascular disease (CVD) is a major cause of mortality in adults with type 1 diabetes.

Objective
We prospectively evaluated CVD risk factors in a large, contemporary cohort of adults with type 1 diabetes living in the United States.

Design
Observational study of CVD and CVD risk factors over a median of 5.3 years.

Setting
The T1D Exchange clinic network.

Patients
Adults (age ≥ 18 years) with type 1 diabetes and without known CVD diagnosed before or at enrollment.

Main Outcome Measure
Associations between CVD risk factors and incident CVD were assessed by multivariable logistic regression.

Results
The study included 8,727 participants (53% female, 88% non-Hispanic white, median age 33 years [interquartile ratio {IQR} = 21, 48], type 1 diabetes duration 16 years [IQR = 9, 26]). At enrollment, median HbA1c was 7.6% (66 mmol/mol) (IQR = 6.9 [52], 8.6 [70]), 33% used a statin, and 37% used blood pressure medication. Over a mean follow-up of 4.6 years, 325 (3.7%) participants developed incident CVD. Ischemic heart disease was the most common CVD event. Increasing age, body mass index, HbA1c, presence of hypertension and dyslipidemia, increasing duration of diabetes, and diabetic nephropathy were associated with increased risk for CVD. There were no significant gender differences in CVD risk.

Conclusion
HbA1c, hypertension, dyslipidemia and diabetic nephropathy are important risk factors for CVD in adults with type 1 diabetes. A longer follow-up is likely required to assess the impact of other traditional CVD risk factors on incident CVD in the current era.
Gamma-Glutamyl Transferase Variability and Risk of Dementia in Diabetes Mellitus: A Nationwide Population-Based Study
Authors: Hong So-hyeon , Han Kyungdo , Park Sanghyun , Kim Seon Mee , Kim Nan Hee , Choi Kyung Mook , Baik Sei Hyun , Park Yong Gyu , Yoo Hye Jin 
Published: January 2020

AbstractContextGamma-glutamyl transferase (GGT) has been associated with oxidative stress and inflammatory reactions. Variability in various biomarkers has emerged as a new clinical indicator for diseases including neurodegenerative disorders.ObjectiveWe investigated the association between GGT variability and dementia risk in patients with diabetes mellitus (DM).Design, Participants, and MethodsWe used the Korean National Health Insurance Service datasets of Claims and Health Check-ups from 2004 to 2016. The risk of incident dementia (all-cause dementia, Alzheimer disease, vascular dementia) was analyzed by quartiles of GGT variability in ≥ 40-year-old DM individuals without baseline dementia.ResultsDuring 6.12 years of follow-up, 37, 983 cases of dementia developed. In the fully adjusted model, the group with the highest quartile of GGT variability had a 19% increased risk of all-cause dementia when compared with the lowest quartile group (hazard ratio; 95% confidence interval): 1.19; 1.16-1.22, with a small effect size (Cohen d’s = 0.14). Compared with the group with low baseline GGT level and the lowest quartiles of its variability, the group with high baseline GGT level and the highest quartile of its variability increased 27% of all-cause dementia. A 1 SD increment in the GGT variability was associated with a 3% increased risk of all-cause dementia. Subgroup analysis showed a more prominent association between increased GGT variability and dementia risk in men and &lt; 60-year-old individuals (P for interaction ≤ .001).ConclusionsIn subjects with DM, high variability of GGT increased the risk of dementia independently of other factors, including baseline GGT levels.
Anastomotic Leak Does Not Impact on Long-Term Outcomes in Esophageal Cancer Patients
Authors: Kamarajah S. K. , Navidi M. , Wahed S. , Immanuel A. , Hayes N. , Griffin S. M. , Phillips A. W. 
Published: January 2020

AbstractBackgroundEsophagectomy is a technically demanding procedure associated with high levels of morbidity. Anastomotic leak (AL) is a common complication with potentially major ramifications for patients. It has also been associated with poorer long-term overall survival (OS) and disease recurrence.ObjectiveThe aim of this study was to determine whether AL contributes to poor OS and recurrence-free survival (RFS) for patients with esophageal cancer.MethodsConsecutive patients undergoing a two-stage, two-field transthoracic esophagectomy from a single high-volume unit between 1997 and 2016 were evaluated. Clinicopathologic characteristics, along with oncological and postoperative outcomes, were stratified by no AL versus non-severe leak (NSL) versus severe esophageal AL (SEAL). SEAL was defined as ALs associated with Clavien–Dindo grade III/IV complications.ResultsThis study included 1063 patients, of whom 8% (87/1063) developed AL; 45% of those who developed AL were SEALs (39/87). SEAL was associated with a prolonged critical care stay (median 8 vs. 3 vs. 2 days;p < 0.001) and prolonged hospital stay (median 43 vs. 27 vs. 15 days;p < 0.001) compared with NSL or no AL. There were no significant differences in number of lymph nodes harvested and rates of R1 resection between groups. OS and RFS were not affected by either NSL or SEAL, and Cox multivariate regression showed NSL and SEAL were not independently associated with OS and RFS. Sensitivity analysis in patients receiving neoadjuvant therapy followed by esophagectomy demonstrated similar findings.ConclusionThese results demonstrate that AL leads to prolonged critical care and in-hospital length of stay; however, contrary to previous reports, our results do not compromise long-term outcomes and are unlikely to have a detrimental oncological impact.
No Clinical Predictors of Postconcussion Musculoskeletal Injury in College Athletes
Authors: BUCKLEY THOMAS A. , HOWARD CAROLINE M. , OLDHAM JESSIE R. , LYNALL ROBERT C. , SWANIK C. BUZ , GETCHELL NANCY 
Published: January 2020

ABSTRACTPurposeThis study aimed to identify clinical predictors of postconcussion subsequent musculoskeletal (MSK) injuries.MethodsWe recruited 66 National Collegiate Athletic Association intercollegiate student-athletes with a diagnosed concussion as well as 36 National Collegiate Athletic Association student-athletes without a concussion. All participants completed a multifaceted concussion baseline consisting of 1) 22-item 0–6 self-reported symptom checklist with outcomes including both the number of symptoms endorsed (0–22) and 2) total symptom score (0–132), 3) Standard Assessment of Concussion, 4) Balance Error Scoring System, 5) Immediate Post-Concussion Assessment and Cognitive Testing, 6) clinical reaction time, and 7) the King-Devick as well as demographic and injury characteristics. The concussion participants completed the same examination acutely postconcussion, and binary logistic regression was used to identify predictors of subsequent MSK from the change scores (acute minus baseline). From the 66 concussed student-athletes, a subset 36, matched with the healthy athletes, compared the risk of subsequent MSK in the year before and year after their concussion.ResultsThe concussion participants were 1.78 times (95% confidence interval, 1.12–2.84;P= 0.015) more likely to suffer a lower extremity MSK in the year after their concussion than the control participants. The participant demographics and injury characteristics (P= 0.318) and concussion clinical outcomes (P= 0.461) did not predict subsequent MSK.ConclusionThe concussion participants were 1.78 times more likely to sustain a subsequent MSK; however, no demographic, injury characteristic, or concussion assessments predicted the MSK. Thus, clinicians are not able to utilize common neurological measures or participant demographics to identify those at risk for subsequent lower extremity MSK. Injury prevention strategies should be considered for collegiate student-athletes upon premature return to participation after a concussion to reduce the subsequent MSK.
Effect of High-Intensity Training and Asthma on the V˙O2 Kinetics of Adolescents
Authors: MCNARRY MELITTA A. , WINN CHARLES O. N. , DAVIES GWYNETH A. , EDDOLLS WILLIAM T. B. , MACKINTOSH KELLY A. 
Published: January 2020

ABSTRACT

Purpose
High-intensity interval training (HIIT) represents a potent stimulus to the dynamic oxygen uptake (V˙O2) response in adults, but whether the same is evident in youth is unknown. HIIT has also been suggested to place a lower demand on the respiratory system, decreasing the likelihood of exacerbation in those with respiratory conditions, such as asthma.

Methods
Sixty-nine adolescents (13.6 ± 0.9 yr; 36 asthma) took part, 35 of which (17 asthma) participated in a 30-min HIIT intervention three times a week for 6 months. Each participant completed an incremental ramp test to volitional exhaustion and three heavy-intensity constant work rate tests to determine the dynamic V˙O2, heart rate, and deoxyhemoglobin response at baseline, midintervention, postintervention and at a 3-month follow-up.

Results
There was no influence of asthma at baseline or in response to the intervention. Participants in the intervention group demonstrated a faster V˙O2 time constant (τp) after intervention (intervention: 29.2 ± 5.7 s vs control: 34.2 ± 6.5 s; P = 0.003), with these differences maintained at follow-up (intervention: 32.5 ± 5.5 s vs control: 37.3 ± 8.7 s; P = 0.008). The intervention was associated with a speeding of the concentration of deoxyhemoglobin τ (pre: 20.1 ± 4.7 s vs post: 18.2 ± 4.1 s; P = 0.05) compared with a slowing over the same time period in the control participants (pre: 17.9 ± 4.9 s vs post: 20.1 ± 4.6 s; P = 0.012). Heart rate kinetics were not altered (pre: 46.5 ± 12.2 s vs post: 47.7 ± 11.1 s; P = 0.98).

Conclusion
These findings highlight the potential utility of school-based HIIT as a strategy to enhance the V˙O2 kinetics of youth, regardless of the presence of asthma.