bluuebunny/crossref_metadata_2025 huggingface dataset:
Research on Cross-Company Defect Prediction Method to Improve Software Security
Authors: Shao Yanli , Zhao Jingru , Wang Xingqi , Wu Weiwei , Fang Jinglong
Published: August 2021

As the scale and complexity of software increase, software security issues have become the focus of society. Software defect prediction (SDP) is an important means to assist developers in discovering and repairing potential defects that may endanger software security in advance and improving software security and reliability. Currently, cross-project defect prediction (CPDP) and cross-company defect prediction (CCDP) are widely studied to improve the defect prediction performance, but there are still problems such as inconsistent metrics and large differences in data distribution between source and target projects. Therefore, a new CCDP method based on metric matching and sample weight setting is proposed in this study. First, a clustering-based metric matching method is proposed. The multigranularity metric feature vector is extracted to unify the metric dimension while maximally retaining the information contained in the metrics. Then use metric clustering to eliminate metric redundancy and extract representative metrics through principal component analysis (PCA) to support one-to-one metric matching. This strategy not only solves the metric inconsistent and redundancy problem but also transforms the cross-company heterogeneous defect prediction problem into a homogeneous problem. Second, a sample weight setting method is proposed to transform the source data distribution. Wherein the statistical source sample frequency information is set as an impact factor to increase the weight of source samples that are more similar to the target samples, which improves the data distribution similarity between the source and target projects, thereby building a more accurate prediction model. Finally, after the above two-step processing, some classical machine learning methods are applied to build the prediction model, and 12 project datasets in NASA and PROMISE are used for performance comparison. Experimental results prove that the proposed method has superior prediction performance over other mainstream CCDP methods.
A Technoeconomic Feasibility Analysis for Affordable Energy System in the East African Community Countries
Authors: Bimenyimana Samuel , Wang Chen , Asemota Godwin Norense Osarumwense , Nduwamungu Aphrodis , Mesa Cicilia Kemunto , Ihirwe Jeanne Paula , Niyonteze Jean De Dieu , Bora Shilpi , Ho Chun-Ling , Hagumimana Noel , Mo Yiyi
Published: August 2021

Access to energy is among the key pillars to socioeconomic and improved life style. The East African Community (EAC) countries, also members of sub-Saharan Africa, are among countries with enough energy resources but still struggling with low electricity access, and the lower proportion of citizens with electricity access challenges such as expensive tariff, frequent blackouts, and unreliable service still persists. Diesel technology is among the easy and fast installation technologies for a location with an urgent need of electricity while solar is a clean technology with free fuel. Considering the diversity of electricity tariffs, cost of diesel fuel, and suitability to solar energy exploitation in EAC, this paper intends to provide a technoeconomic analysis for reliable, affordable, and sustainable energy system in the region. A daily load of 94.44 kWh recorded from averaging electricity bills of a luxury house in Kigali, Rwanda, is used as research object, and HOMER simulations are carried on considering the level of such daily load being supplied by either (a) diesel generator, (b)

solar
+
diesel

technology, (c)

PV
+
battery

storage, or (d)

PV
+
battery
 
storage
+
grid

system in each member country of the EAC. The results show that (a) solar energy is a feasible and applicable technology for energy generation for the whole six EAC countries; (b) for South Sudan, if it is a standalone system, the diesel technology is less costly than solar technology; however, solar energy can still be recommended to be adopted as it has no gas emissions; (c) except South Sudan,

PV
+
battery

storage technology is found to be more affordable and cleaner than any technology including diesel; and (d) the option of connecting

PV
+
battery

storage to the grid is found more economical for locations where grid interaction is possible because their levelized electricity costs (LCOE) are lower than the real electricity tariffs currently in use within each of the six EAC countries. The solar energy system with battery storage (both off-grid and grid connected) proposed in this research can lead to an efficient increase of national energy resource exploitation in the EAC countries, resulting in reliable, affordable, and sustainable energy access to all the citizenry of the EAC.
Novel Paracrine Action of Endothelium Enhances Glucose Uptake in Muscle and Fat
Authors: Viswambharan Hema , Yuldasheva Nadira Y. , Imrie Helen , Bridge Katherine , Haywood Natalie J. , Skromna Anna , Hemmings Karen E. , Clark Emily R. , Gatenby V. Kate , Cordell Paul , Simmons Katie J. , Makava Natallia , Abudushalamu Yilizila , Endesh Naima , Brown Jane , Walker Andrew M.N. , Futers Simon T. , Porter Karen E. , Cubbon Richard M. , Naseem Khalid , Shah Ajay M. , Beech David J. , Wheatcroft Stephen B. , Kearney Mark T. , Sukumar Piruthivi
Published: August 2021

Rationale:

A hallmark of type 2 diabetes is insulin resistance, which leads to increased endothelial cell (EC) production of superoxide and a simultaneous reduction in the availability of the vasoprotective signaling radical NO. We recently demonstrated in preclinical models that type 2 diabetes simultaneously causes resistance to IGF-1 (insulin-like growth factor-1)–mediated glucose lowering and endothelial NO release.

Objective:

To examine the effect of insulin and IGF-1 resistance specifically in ECs in vivo.

Methods and Results:

We generated mice expressing mIGF-1Rs (mouse IGF-1 receptors), which form nonfunctioning hybrid receptors with native IRs (insulin receptors) and IGF-1R, directed to ECs under control of the
Tie2
promoter-enhancer. Despite EC insulin and IGF-1 resistance, mIGFREO (mutant IGF-1R EC overexpressing) mice had enhanced insulin and IGF-1–mediated systemic glucose disposal, lower fasting free fatty acids, and triglycerides. In hyperinsulinemic-euglycemic clamp studies, mIGFREO had increased glucose disposal and increased glucose uptake into muscle and fat, in response to insulin. mIGFREO had increased Nox (NADPH oxidase)-4 expression due to reduced expression of the microRNA, miR-25. Consistent with increased Nox4, mIGFREO ECs generated increased hydrogen peroxide (H
2
O
2
), with no increase in superoxide. Treatment with catalase—a H
2
O
2
dismutase—restored insulin tolerance to WT (wild type) levels in mIGFREO.

Conclusions:

Combined insulin and IGF-1 resistance restricted to the endothelium leads to a potentially favorable adaptation in contrast to pure insulin resistance, with increased Nox4-derived H
2
O
2
generation mediating enhanced whole-body insulin sensitivity.
The Winning Party Platform: Voter Perceptions of Party Positions and Voting in Urban Africa
Authors: Kim Eun Kyung , Kim Hye-Sung
Published: August 2021

Previous literature suggests that some African parties employ non-valence positional issues in their party platforms and that this practice is more prevalent in some countries than in others; however, no quantitative research has analysed the electoral effects of non-valenced campaigns. How do African voters perceive parties’ policy positions? Who uses party platforms to choose candidates? Using data from an original survey experiment conducted in Nairobi, we examine voter perceptions of party platforms and their behaviour in the 2017 Kenyan presidential elections. We find that the opposition party’s clearer messaging helps average voters recognise and characterise the party, compared to the incumbent’s moderate policy stance. Moreover, while both parties’ policy positions positively affect voting, non-partisan voters are more likely to support a candidate advocating moderate policies. This implies an incumbency advantage: incumbents’ broad-appeal strategies help maximise their votes, whereas opposition parties have limited strategy options.
Admission Hyperglycemia is Associated with Global Registry of Acute Coronary Events Score and Complications Following Acute Myocardial Infarction During 1-Year Follow-Up
Authors: Qin Yuhan , Qiao Yong , Wang Dong , Tang Chengchun , Yan Gaoliang
Published: August 2021

We explored the effect of admission hyperglycemia (AH) on the Global Registry of Acute Coronary Events (GRACE) risk score and major adverse cardiovascular and cerebrovascular event (MACCE) incidence during 1-year follow-up in acute myocardial infarction (AMI) patients. In this retrospective observational study enrolling 1098 AMI patients, hyperglycemia was defined as blood glucose level ≥180 mg/dl at admission. Overall, 158 and 84 patients of 272 diabetic and 826 non-diabetic patients were diagnosed with AH, respectively. Glucose levels at admission were closely associated with the GRACE score in patients with/without diabetes. MACCEs occurred in 222 patients; patients with AH showed significantly higher MACCE incidence (28.1%). Multivariate Cox logistic regression analysis indicated that AH was an independent risk factor for 1-year MACCEs. Subgroup analysis demonstrated that hyperglycemia increases MACCE risk in non-diabetic patients but not in diabetic patients. The admission glucose level combined with GRACE risk score showed a certain predictive value for MACCE incidence according to ROC analysis (OR = 0.798, p < .001). AH was strongly associated with a higher GRACE risk score in ST-segment elevation myocardial infarction patients. Thus, AH was an independent risk factor and had a high predictive value for MACCE during 1-year follow-up after AMI.
From Domination of the Environment to Stewardship: A Historical Look at Denver Water's Public Communication 1933–2018
Authors: Williams Sean D.
Published: August 2021

When most people think about the water coming from their kitchen faucets, they seldom consider where the water originates and how transporting it to their homes has environmental impacts. Utilities that supply water know the complexity of their systems, but from their position as a “utility,” they view their job as supplying safe water to their customers, not necessarily stewarding the environment. Consequently, when building large projects like dams, canals, and tunnels, utilities regard environmental disruption as a necessary byproduct of serving growing cities with water. Representations of these projects often replicate the “man conquering nature” frame, praising these engineering marvels for their defiance of nature. Denver Water, the utility that serves almost 1.5 million people on the arid eastern slope of the Colorado Rockies, has produced films describing its complex system since the early 20th century, and these films reveal an evolution of values from dominating nature to actively stewarding the environment. This paper reports on a grounded theory analysis of films produced by Denver Water between 1933 and 2018 examining how the films frame human relationships to the natural environment. The results reveal that the films increasingly express stewardship ideals over those of domination, with recent public communication actively advocating for environmental causes. The paper concludes by suggesting that we can learn important lessons from Denver Water about ethical organizational action for environmental stewardship.
Addiction, Sin, and the Kierkegaardian Self: On Immanent and Transcendent Goods
Authors: Davidson Samuel
Published: August 2021

The article analyzes the relationship between sin and addiction in the recent work of Sonia Waters and Kent Dunnington, teasing out an apparently irresolvable tension rooted in their respective understandings of what fuels the addictive process. It is argued that the core divergence lies in their differing interpretations of the good sought in addiction, with Waters emphasizing the immanent good of biological and psychosocial homeostasis and Dunnington foregrounding the transcendent good of ecstatic relation with God. The essay proposes to resolve this tension by rethinking the relationship between immanent and transcendent human goods, with reference to Kierkegaard’s The Sickness Unto Death. In his definition of the human being as a synthesis, Kierkegaard helps resolve the tension between the immanent and transcendent goods sought in addiction, while his conception of sin as the refusal of selfhood allows us to sharpen our understanding of whether and how it makes sense to frame addiction as participating in sin. It is concluded that addiction may be helpfully framed as a means of avoiding the task of becoming a self, and therefore as a means of remaining in the position of sin.
Lentivirus- or AAV-mediated gene therapy interventions in ischemic stroke: A systematic review of preclinical in vivo studies
Authors: Skukan Laura , Brezak Matea , Ister Rok , Klimaschewski Lars , Vojta Aleksandar , Zoldoš Vlatka , Gajović Srećko
Published: August 2021

Due to the limited therapeutic options after ischemic stroke, gene therapy has emerged as a promising choice, especially with recent advances in viral vector delivery systems. Therefore, we aimed to provide the current state of the art of lentivirus (LV) and adeno-associated virus (AAV) mediated gene interventions in preclinical ischemic stroke models. A systematic analysis including qualitative and quantitative syntheses of studies published until December 2020 was performed. Most of the 87 selected publications used adult male rodents and the preferred stroke model was transient middle cerebral artery occlusion. LV and AAV vectors were equally used for transgene delivery, however loads of AAVs were higher than LVs. Serotypes having broad cell tropism, the use of constitutive promoters, and virus delivery before the stroke induction via stereotaxic injection in the cortex and striatum were preferred in the analyzed studies. The meta-analysis based on infarct volume as the primary outcome confirmed the efficacy of the preclinical interventions. The quality assessment exposed publication bias and setbacks in regard to risks of bias and study relevance. The translational potential could increase by using specific cell targeting, post-stroke interventions, non-invasive systematic delivery, and use of large animals.
Partnerships between Agencies and Transportation Network Companies for Transportation-Disadvantage Populations: Benefits, Problems, and Challenges
Authors: Steiner Ruth L. , Bai Xueyin , Bejleri Ilir , Han Mengjie , “Jacob” Yan Xiang
Published: August 2021

Transportation network companies (TNCs), such as Uber and Lyft, offer a new mobility option to consumers. An increasing number of transit agencies work with TNCs, and different types of partnerships have formed. While these service models may serve the general population well, their implications for transportation-disadvantage populations, including older adults, individuals with disabilities, and low-income people, have not received enough attention. These populations are highly dependent on public transit services. Additionally, we have limited firsthand knowledge of challenges that hinder transit agencies and related human service agencies from building partnerships with TNCs. Can these agency/TNC partnerships accommodate the needs of transportation-disadvantage populations? This study explores these issues through a literature review and interviews with 16 related organizations in the State of Florida, where transportation-disadvantage populations are served through a coordinated system but the partnerships with TNCs are still limited. The paper first categorizes the existing agency/TNC partnership service models into three types and examines their benefits and problems in serving transportation-disadvantage populations. It then identifies different organizations’ perceptions of TNCs and the challenges for some agencies to work with TNCs. The general challenges include difficulty in estimating service demand, data sharing problems, hidden costs and staff efforts, training and safety issues, and the need of complementary vendors. The challenges specifically in rural areas are a lack of motivation and commitment among TNCs, affordability issues, and TNCs’ adaptation to the rural geography. These challenges in agency/TNC partnerships need to be addressed to serve the public better, including transportation-disadvantage populations.
Growth Opportunities and Entrepreneurial Performance: Testing Strengths Use and Meaning-Making as Moderators of the Relationship
Authors: Tisu Luca , Vîrgá Delia
Published: August 2021

The present study investigates how developable behavioral (strengths use) and cognitive (meaning-making) mechanisms moderate the relationship between personal growth opportunities and entrepreneurial performance. We relied on a cross-sectional design. Data were gathered from 208 Romanian entrepreneurs and analyzed via hierarchical multiple linear regressions. The employed moderators boost the investigated relationship, both separately and interactively. The three-way interaction shows that entrepreneurs have to employ strengths use and meaning-making concomitantly to be able to capitalize on growth opportunities effectively. Consequently, this will enable entrepreneurs to rate their business performance more positively because they will perceive they have the necessary resources to invest in the business. Conversely, at low levels of strengths use and meaning-making, the presence of growth opportunities erodes entrepreneurial performance. This study identifies strengths use and meaning-making as vital psychological tools that allow an increase in entrepreneurial performance thus altering business-related investment and continuance decisions.
Quality of Communication Questionnaire for Patients Hospitalized in Intensive and Palliative Care: Validity Evidence for Use in Brazil
Authors: Del Castanhel Flávia , Burg Luciana , Nogueira Leonardo Maia , Filho Getúlio Rodrigues de Oliveira , Grosseman Suely
Published: August 2021

The Quality of Communication Questionnaire (QoC) was culturally adapted for Brazil due to its importance and use in several studies and different scenarios. The objective of this study was to evaluate the validity evidence of the Brazilian version of the QoC. A validation study was carried out involving 253 patients admitted to five public hospitals in Southern Brazil. Data were analyzed using descriptive analysis, Cronbach's alpha (α) to assess internal consistency, exploratory factor analysis, and goodness-of-fit index. One hundred and three patients were in intensive care (IC), and 150 were in palliative care (PC). The participants’ mean age was 51 years (SD = 14.2). QoC,and its general communication subscale, and end-of-life communication subscale means were 5.5 (SD = 1.6), 8.8 (SD = 1.5), and 5.5 (SD = 1.6) respectively. Among patients in IC, QoC Cronbach’s alpha was .75, and .84 in the general communication subscale and .51 in the end-of-life communication subscale. Among patients in PC, QoC Cronbach’s alpha was .83, and .88 in the general communication subscale, and .71 in the end-of-life communication subscale. The root mean square error of approximation was .07 (90% CI: .04 – .08); Tucker-Lewis index was .97 (95% CI: .95 – .98); comparative fit index was .98 (95% CI: .97 – .99), and χ2/df ratio was 1.33 (χ2[53] = 70.858, p = .05). The authors conclude that the general communication subscale of QoC Brazilian version has good validity evidence for patients in IC and PC, whereas the end-of-life communication subscale is only valid for patient in PC.
Are All Narcissistic CEOs Socially Responsible? An Empirical Investigation of an Inverted U-Shaped Relationship Between CEO Narcissism and Corporate Social Responsibility
Authors: Al-Shammari Marwan , Rasheed Abdul A. , Banerjee Soumendra N.
Published: August 2021

We investigate the relationship between CEO narcissism and corporate social responsibility (CSR). We suggest an alternative to the current assumption of a linear relationship between CEO narcissism and CSR. Instead, we propose an inverted U relationship between the two. Although narcissistic CEOs may engage in CSR, we argue that highly narcissistic CEOs may be drawn to actions that would garner greater attention and they may be less inclined to engage in CSR. Based on a sample of Fortune 500 firms during the period 2006–2013, we find support for an inverted U relationship and support for our arguments that CEO power moderates the relationship between CEO narcissism and CSR.
Building Reflexivity Using Service Design Methods
Authors: Vink Josina , Koskela-Huotari Kaisa
Published: August 2021

The transformative potential of service design rests on its ability to enable people to intentionally shape institutionalized social structures. To avoid simply reproducing social structures unconsciously, people need reflexivity—an awareness of existing social structures. Scholars suggest that the use of service design methods can enhance people’s reflexivity. However, the theoretical underpinning of this effect remains unclear, which in turn limits the realization of service design’s transformative potential in practice. In response, using an abductive approach that combines theoretical and empirical inputs, we develop an integrative framework that explains the mechanisms by which service design methods can increase people’s reflexivity. The current study contributes to the evolving service design discourse with an alternative categorization of service design methods, based on their affordances for different modes of reflexivity. The framework also reveals the underlying processes by which the use of service design methods can support people’s work with institutionalized social structures as design materials to enable transformation. This research supports a more thoughtful use and strategic development of service design methods to support transformative aims.
Stigma Mutation: Tracking Lineage, Variation and Strength in Emerging COVID-19 Stigma
Authors: Farrimond Hannah
Published: August 2021

In this article, I propose a novel theoretical framework for conceptualizing pandemic stigma using the metaphor of ‘mutation’. This metaphor highlights that stigma is not a static or fixed state but is enacted through processes of continuity and change. The following three orienting concepts are identified: (a) lineage (i.e. origin narratives and initial manifestations are created in relation to existing stigmas, stereotypes, and outgroups), (b) variation (i.e. stigma changes over time in response to new content and contexts), and (c) strength (i.e. stigma can be amplified or weakened through counter- or de-stigmatizing forces). I go on to use this metaphor to offer an analysis of the emergence of COVID-19 stigma. The lineage of COVID-19 stigma includes a long history of contagious disease, resonant with fears of contamination and death. Origin narratives have stigmatized Asian/Chinese groups as virus carriers, leading to socio-political manifestations of discrimination. Newer ‘risky’ groups have emerged in relation to old age, race and ethnicity, poverty, and weight, whose designation as ‘vulnerable’ simultaneously identifies them as victims in need of protection but also as a risk to the social body. Counter-stigmatizing trends are also visible. Public disclosure of having COVID-19 by high-status individuals such as the actor Tom Hanks has, in some instances, converted ‘testing positive’ into shared rather than shamed behaviour in the West. As discourses concerning risk, controllability, and blame unfold, so COVID-19 stigma will further mutate. In conclusion, the metaphor of mutation, and its three concepts of lineage, variation, and strength, offers a vocabulary through which to articulate emergent and ongoing stigma processes. Furthermore, the concept of stigma mutation identifies a clear role for social scientists and public health in terms of process engagement; to disrupt stigma, remaking it in less deadly forms or even to prevent its emergence altogether.
‘Almost Everything in the House Now Is Plastic’: Foregrounding Plastic Materiality in Household Routines and Practices
Authors: Shittu Olamide
Published: August 2021

The impact of materials in disrupting routines and practices has recently become significant in scholarship and policymaking. This has motivated alternative social theories such as practice theory to look beyond the traditional human behavioural approaches into how objects exert their materiality in achieving daily activities. While there is a substantial theoretical body of work on materiality in practice theory, this study focuses on plastic and asks how plastic facilitates the reproduction of practices in households. To foreground plastic materiality, this study makes use of the data collected in the case studies of low-income households in a suburb in Lagos, Nigeria through a mixed-methods approach, including interviews, household tours, and directed photography. The data analysis combines inductive and deductive approaches to facilitate an iterative process of identifying and refining themes related to the research aim. As a ubiquitous material, plastic facilitates the performance of household practices related to hygiene, comfortability, storage, food, and child-rearing, among others. By interacting with other practice elements, plastic actively materialises household routines through its corporality or physical features, functionality, and spatiotemporal quality. The implication of these dimensions in enabling or disrupting household routines is further discussed. The findings present important lessons for advancing the corporal and relational dimensions of materiality in social theory and implementing sustainability policies.
Own-race faces promote integrated audiovisual speech information
Authors: Ujiie Yuta , Takahashi Kohske
Published: August 2021

The other-race effect indicates a perceptual advantage when processing own-race faces. This effect has been demonstrated in individuals’ recognition of facial identity and emotional expressions. However, it remains unclear whether the other-race effect also exists in multisensory domains. We conducted two experiments to provide evidence for the other-race effect in facial speech recognition, using the McGurk effect. Experiment 1 tested this issue among East Asian adults, examining the magnitude of the McGurk effect during stimuli using speakers from two different races (own-race vs. other-race). We found that own-race faces induced a stronger McGurk effect than other-race faces. Experiment 2 indicated that the other-race effect was not simply due to different levels of attention being paid to the mouths of own- and other-race speakers. Our findings demonstrated that own-race faces enhance the weight of visual input during audiovisual speech perception, and they provide evidence of the own-race effect in the audiovisual interaction for speech perception in adults.
Collective memory and the populist cause: The Ulucanlar Prison Museum in Turkey
Authors: Ugur-Cinar Meral , Altınok Berat Uygar
Published: August 2021

This article focuses on how political actors appropriate the past by utilizing collective traumas for their populist cause. We demonstrate how the Ulucanlar Prison Museum in Turkey and the oppression of military interventions, for which it served as a backyard, became a tool for the AKP’s (Adalet ve Kalkınma Partisi-Justice and Development Party) populist agenda. Through a particular narration of history embedded in the museum, the AKP aimed to forge an internal frontier within the society between an envisioned homogenous body of people on the one hand and the elite on the other. Situating itself as the people’s authentic voice against this elite, the AKP tried to further its popular appeal and legitimize its extension of power. What appeared as coming to terms with the past was instead the instrumentalization of the past for a singular political agenda, eager to remove the complexities and pluralism of the past for the sake of telling a politically useful story.
Medical cannabis and epilepsy in the UK – A qualitative analysis of the carers’ perspective: “We're asking for quality of life for our children”
Authors: Schlag Anne Katrin , Zafar Rayyan , Nutt David
Published: August 2021

Despite the legalisation of cannabis based medicinal products (CBMPs) in the UK in November 2018, today there remains a scarcity of NHS prescriptions, and many patients continue to face unsustainable financial costs to acquire their medicines. Following on from our previous quantitative study highlighting the effectiveness of CBMPs to treat severe intractable childhood-onset epilepsy, for the present study, we used a narrative, open-ended approach to interview parents/carers of these patients. 11 families were interviewed to understand their current situation in more depth, and to contextualise the previous findings. Although these families have found CBMPs to be the most effective treatment for their child’s condition, access to these medicines remains severely restricted, causing serious challenges in their day-to-day life. Participants discussed a broad range of issues associated with medical cannabis. These included the regulation and policy surrounding medical cannabis, the anger and desperation related to these policies, and the benefits and harms of it. Evidently, the benefits of medical cannabis for these patients far outweigh any associated risks. Many of the issues raised in our study go beyond the science of medical cannabis per se. Rather, they are political issues, related to the wider issue of trust and power in society, and associated challenges of the doctor and patient relationship. The findings highlight the importance of including patients in decision-making about their medical plans and the value that should be given to their reported outcomes and wishes. We conclude by offering implications for further research and for policy making so that these families, and others like them, can finally receive the medications they so urgently require without crippling financial costs.
Partial Rotator Cuff Repair With Biceps Rerouting and Double Tenodesis: An Efficient and Cost-Effective Biological Superior Capsular Reconstruction
Authors: Lannes Xavier , Traverso Aurélien , Coron Charline , Blakeney William G. , Bauer Stefan
Published: August 2021

Background:

Chronic rotator cuff tears (RCTs) are common and are often only partially repairable. Surgical treatment is challenging in younger patients. Surgical options include partial repair, tendon transfer, subacromial spacer, superior capsular reconstruction (SCR), and reverse shoulder arthroplasty. The use of SCR has been expanded and commercialized. The proposed techniques are complex using free avascular grafts and up to 7 anchors with associated increase in theater time and nonrefunded cost. Biceps SCR has shown promising biomechanical resistance and seems to offer a simple and cost-effective alternative.

Indications:

Patients with RCTs (Goutallier stage ≥3, Patte 3) without arthritis that are at least partially repairable (infraspinatus and subscapularis) are candidates. Patients with mechanically intact long head of biceps (LHB) and superior labrum anterior to posterior (SLAP) anchor (minimal fraying of <10% and fraying of SLAP without full-thickness tears acceptable) are also candidates.

Technique:

Key steps include arthroscopic release/lateral opening of the bicipital grove (15-20 mm) and placement of a first footprint anchor 8 to 10 mm posterior to the anatomical sulcus. Use of a 5-mm burr to create a new rerouting groove obliquely from the first anchor to the original groove, 15 to 20 mm caudal to the summit of the tubercle. Lasso-loop translation and tenodesis of the LHB to the first anchor. Use of a second caudal biceps tenodesis anchor with lasso-loops at the caudal end of the new groove. These 2 anchors create a rerouting bipedicle tenodesis performing the function of both an SCR and biceps tenodesis. Single-row, tension-free over-the-top repair of infraspinatus and the bursal layer of supraspinatus is completed with a third anchor on the rerouted biceps which remains in continuity.

Results:

The pilot series (n = 10) with a mean follow-up of 12 months (9-18 months) shows satisfactory outcomes. One patient developed a postoperative frozen shoulder and one a secondary Popeye deformity. Functional scores and patient satisfaction improved in all cases. The subjective shoulder value improved from a mean of 30% (10%-40%) preoperatively to 75% (60%-80%) postoperatively and the constant score from 30 points (20-40) to 68 points (60-71).

Conclusion:

As long as LHB and its SLAP anchor are adequate, biceps rerouting in combination with partial rotator cuff repair is a safe alternative to time-consuming and expensive commercialized SCR techniques.
Increasing nausea and vomiting of pregnancy is associated with sex-dependent differences in early childhood growth: the GUSTO mother-offspring cohort study
Authors: Ong Judith , Sadananthan Suresh Anand , Soh Shu-E , Ng Sharon , Yuan Wen Lun , Aris Izzuddin M , Tint Mya Thway , Michael Navin , Loy See Ling , Tan Kok Hian , Godfrey Keith M , Shek Lynette P , Yap Fabian , Lee Yung Seng , Chong Yap Seng , Chan Shiao-Yng
Published: August 2021

Background

Nausea and vomiting of pregnancy (NVP) is common and underlying mechanisms are poorly understood. Longer-term offspring outcomes are also not well documented. This study aimed to determine if NVP, even in milder forms, is associated with adverse pregnancy and childhood growth outcomes.

Methods

In the GUSTO prospective mother-offspring cohort, women with singleton pregnancies (n = 1172) recruited in first trimester responded to interviewer-administered questions at 26–28 weeks’ gestation about earlier episodes of NVP since becoming pregnant. Pregnancy outcomes were obtained from medical records. Offspring height and weight measured at 15 time-points between birth to 72 months (m) were standardised for age and sex.

Results

58.5% (n = 686) reported mild-moderate vomiting (mNVP), 10.5% (n = 123) severe vomiting (sNVP) and 5.7% (n = 67) severe vomiting with hospitalisation (shNVP). There was no difference in odds of gestational diabetes, hypertensive disorders of pregnancy, labour induction or caesarean section after adjustment for covariates. sNVP was associated with late preterm delivery [34+ 0–36+ 6 weeks’, adjusted OR = 3.04 (95% CI 1.39,6.68)], without increased odds of neonatal unit admission. Compared with no NVP, boys born to mothers with sNVP were longer at birth [adjusted β = 0.38 standard deviations (SDs) (95% CI 0.02,0.73)], remained taller [0.64 SDs (0.23,1.04) at 72 m] and heavier [0.57 SDs (0.05,1.08) at 60 m] without differences in BMI. Conversely, girls born to mothers with shNVP were lighter from 48 m [− 0.52 SDs (− 1.00, − 0.03)] onwards with lower BMI [− 0.61 SDs (− 1.12,-0.09)]. Conditional growth modelling revealed significant sex-divergence in weight-gain at birth-3 m, 6-9 m and 4–5 years.

Conclusions

Severe NVP was associated with late preterm delivery, and both mild-moderate and severe NVP associated with sex-dependent differences in early childhood growth. Boys whose mothers had NVP were taller and heavier from birth with faster growth in the first year, whereas, girls had poorer weight gain and were lighter by 48 m. As even milder severities of NVP could have long-term impact on offspring growth, further research is needed to determine mechanisms involved and implications on future health.

Trial registration

Clinicaltrials.gov identifier NCT01174875.
Prenatal detection of congenital heart disease - results of a Swedish screening program 2013–2017
Authors: Waern Maya , Mellander Mats , Berg Anton , Carlsson Ylva
Published: August 2021

Background

This report evaluates results of a screening program on prenatal detection of congenital heart defects in a geographical cohort of western Sweden between January 1st, 2013 and June 31st, 2017. During the study period 88,230 children were born in VGR.

Methods

Retrospective data on pregnant women from the Västra Götaland region that were referred to fetal cardiologists in Gothenburg were retrieved. To determine prenatal detection rate, all neonates who underwent surgery or catheter intervention for a critical congenital heart defect born between January 1st, 2014 and December 31st, 2016 were included. The four-chamber view was implemented into the routine scan in 2009 and implementation of the ISUOG guidelines, including the outflow tracts, started in the region in 2015.

Results

113 fetuses received a prenatal diagnosis of a major congenital heart defect. 89% of these were referred because of a suspected cardiac malformation and 88% were diagnosed before 22 completed weeks. 59% of the patients diagnosed before 22 completed weeks opted for termination of pregnancy. During 2014–2016, 61 fetuses had a prenatal diagnosis of a critical congenital heart defect and a further 47 were diagnosed after birth, hence 56% were diagnosed prenatally, 82% for those which had a combination with an extracardiac abnormality and/or chromosomal aberration compared to 50% if an isolated critical congenital heart defect was diagnosed. For single ventricle cardiac defects such as hypoplastic left heart syndrome, double inlet left ventricle and tricuspid atresia, the detection rate was 100%. The detection rate for transposition of the great arteries and coarctation of the aorta was 9 and 18% respectively.

Conclusions

56% of all fetuses with a critical congenital heart defect were diagnosed prenatally during 2014–2016 and approximately 53% of all major congenital heart defects 2013–2017 as compared to 13.8% in 2009 in the same region. An increased focus towards the fetal heart in the routine scan improved the prenatal detection rate of major congenital heart defects. The detection of congenital heart defects affecting the four-chamber view seems sufficient, but more training is needed to improve the quality of the examination of the outflow tracts.
Multidisciplinary team efforts to improve the pregnancy outcome of pregnancy complicated with primary hyperparathyroidism: case series from a single hospital
Authors: Jiao Hai-ning , Sun Li-hao , Liu Yan , Zhou Jian-qiao , Chen Xi , Liu Jian-min , Zhong Hui-ping
Published: August 2021

Background

There is no consensus or management algorithm for primary hyperparathyroidism (PHPT) in pregnancy.

Methods

This study comprises a retrospective case series. From August 2014 to December 2020, 9 cases of PHPT in pregnancy were diagnosed by a multidisciplinary team (MDT) consultation center of obstetrics in our hospital. Their clinical manifestations, treatment strategies, and maternal and infant outcomes were analyzed.

Results

The median onset age of the patients was 32 (25 ~ 38) years. PHPT was diagnosed in two cases before pregnancy, in six cases during pregnancy and in one case postpartum. The main clinical manifestations were nausea, vomiting, and other nonspecific symptoms, with anemia as the most common maternal complication. Hypercalcemia crisis was developed in one case. The median levels of preoperative serum calcium and parathyroid hormone (PTH) were 3.08 (2.77 ~ 4.21) mmol/L and 300.40 (108.80 ~ 2603.60) pg/ml, respectively. The parathyroid ultrasonography tests were positive in eight cases and negative in one patient who had an ectopic lesion localized by 99mTc-MIBI. Parathyroidectomy was conducted in 7 cases during the 2nd trimester, including 2 patients diagnosed before pregnancy who refused surgery, 1 patient during the 1st trimester, and 1 patient postpartum, with a significant reduction in serum concentrations of calcium and PTH. A management algorithm was developed.

Conclusion

This case series suggests that pregnant women with PHPT should be managed by MDT according to the algorithm. If PHPT is confirmed in fertile women before pregnancy, parathyroidectomy should be strongly suggested and performed. If PHPT is diagnosed during pregnancy, even in its mild form, surgical treatment, optimally during the 2nd trimester, is effective and safe for pregnancy and neonatal outcome.
Is a ‘guideline-compliant’ primary cesarean delivery associated with a modified risk for maternal and neonatal morbidity?: a clinical evaluation of the 2014 ACOG/SMFM obstetric care consensus statement
Authors: White Andrew W. , Chambers Charis N. , Ertel Michelle C. , Gennaro Taylor R. , Chen Ling , Friedman Alexander M. , Eichelberger Kacey Y.
Published: August 2021

Background

It is currently unknown whether primary CDs performed in compliance with the 2014 ACOG/SMFM Obstetric Care Consensus Statement guidelines (“guideline-compliant”) are associated with a modified risk of maternal and neonatal morbidity, when compared to primary CDs performed outside the guidelines (“guideline-noncompliant”). Our primary objective was to determine if a guideline-compliant primary CD is associated with a modified risk for maternal or neonatal morbidity, when compared to guideline-noncompliant primary CD.

Methods

A retrospective cohort study of all primary CDs at one tertiary referral center in the calendar year following publication of the Consensus Statement. Logistic regression was performed to calculate the risk of adverse maternal and neonatal outcomes for guideline-compliant primary CDs, when compared to guideline-noncompliant and guideline-not addressed, and when adjusted for maternal age, BMI, hypertension, gestational age at delivery, insurance carrier, and provider practice.

Results

Eight hundred twenty-seven primary CDs were included during the study period, of which 34.8, 26.0, and 39.2% were guideline compliant, guideline-noncompliant, and guideline-not addressed. No statistically significant differences in the frequency of adverse maternal outcomes across these three groups were observed with the exception of maternal ICU admission, which was significantly associated with a guideline-not addressed primary CD (p = 0.0002). No statistical difference in rates of NICU admissions, 5 min APGAR < 5, or umbilical artery cord pH < 7 were observed between guideline-compliant and guideline-noncompliant primary CDs.

Conclusion

Women undergoing guideline-compliant primary CDs were not significantly more likely to experience a maternal or neonatal morbidity when compared to guideline-noncompliant primary CDs.
Establishment of a nomogram model to predict macrosomia in pregnant women with gestational diabetes mellitus
Authors: Zou Yujiao , Zhang Yan , Yin Zhenhua , Wei Lili , Lv Bohan , Wu Yili
Published: August 2021

Aim

To establish a nomogram model to predict the risk of macrosomia in pregnant women with gestational diabetes mellitus in China.

Methods

We retrospectively collected the medical records of 783 pregnant women with gestational diabetes who underwent prenatal examinations and delivered at the Affiliated Hospital of Qingdao University from October 2019 to October 2020. The pregnant women were randomly divided into two groups in a 4:1 ratio to generate and validate the model. The independent risk factors for macrosomia in pregnant women with gestational diabetes mellitus were analyzed by multivariate logistic regression, and the nomogram model to predict the risk of macrosomia in pregnant women with gestational diabetes mellitus was established and verified by R software.

Results

Logistic regression analysis showed that prepregnancy body mass index, weight gain during pregnancy, fasting plasma glucose, triglycerides, biparietal diameter and amniotic fluid index were independent risk factors for macrosomia (P < 0.05). The areas under the ROC curve for internal and external validation of the model were 0.813 (95 % confidence interval 0.754–0.862) and 0.903 (95 % confidence interval 0.588–0.967), respectively. The calibration curve was a straight line with a slope close to 1.

Conclusions

In this study, we constructed a nomogram model to predict the risk of macrosomia in pregnant women with gestational diabetes mellitus. The model has good discrimination and calibration abilities, which can help clinical healthcare staff accurately predict macrosomia in pregnant women with gestational diabetes mellitus.
Changes in pregnancy outcomes during the COVID-19 lockdown in Iran
Authors: Ranjbar Fahimeh , Allahqoli Leila , Ahmadi Soheila , Mousavi Robab , Gharacheh Maryam , Eshraghi Nooshin , Alkatout Ibrahim
Published: August 2021

Background

The Covid-19 pandemic response is influencing maternal and neonatal health care services especially in developing countries. However, the indirect effects of Covid-19 on pregnancy outcomes remain unknown. The aim of the present study was to compare pregnancy outcomes before and after the beginning of the Covid-19 pandemic in Iran.

Methods

We performed a retrospective analysis of the medical records of 2,503 pregnant women with singleton pregnancies, admitted to the maternity department of a women’s hospital in Tehran, Iran, during the pre-Covid-19 pandemic (February 19 to April 19, 2019) and the intra-Covid- 19 pandemic (February 19 to April 19, 2020) period.

Results

We included 2,503 women admitted to the hospital; 1,287 (51.4 %) were admitted before the Covid-19 lockdown and 1,216 (48.6 %) during the Covid-19 lockdown. There were no significant differences in stillbirth rates (p = 0.584) or pregnancy complications (including preeclampsia, pregnancy-induced hypertension and gestational diabetes) (p = 0.115) between pregnant women in the pre- and intra-pandemic periods. However, decreases in preterm births (p = 0.001), and low birth weight (p = 0.005) were observed in the pandemic period compared to the pre-pandemic period. No significant difference in the mode of delivery, and no maternal deaths were observed during the two time periods.

Conclusions

In our study we observed a decrease in preterm births and low birth weight, no change in stillbirths, and a rise in the admission rates of mothers to the ICU during the initial Covid-19 lockdown period compared to pre-Covid-19 lockdown period. Further research will be needed to devise plan for immediate post-pandemic care and future health care crises.