bluuebunny/crossref_metadata_2025 huggingface dataset:
Numerical study of the hydraulic excavator overturning stability during performing lifting operations
Authors: Mitrev Rosen , Marinković Dragan
Published: May 2019

This article presents a numerical study of the stability of a hydraulic excavator during performing lifting operations. A planar dynamic model is developed with six degrees of freedom, which considers the base body elastic connection with the terrain, the front digging manipulator links, and the presence of the freely suspended payload. Differential equations describing the excavator dynamic behavior are obtained by using the Lagrange formalism. Numerical experiments are carried out to study the excavator dynamic stability under different operating conditions during the motion along a vertical straight-line trajectory. It is shown that the arising inertial loads during the movement of the links along the vertical trajectory, combined with the payload swinging and the motion of the base body, decreases the excavator stability. It was found that the excavator stability during following vertical straight-line trajectory decreases considerably in the lower part of the vertical trajectory. If the stability coefficient is close to 1, the payload swinging can cause the separation of a support from the terrain; nevertheless, the excavator stability can be restored. A method for tire stiffness and damping coefficients estimation is presented. The validation of the dynamical model is performed by the use of a small-scale elastically mounted manipulator.
Parental experiences with behavioural problems in Smith–Magenis syndrome: The need for syndrome-specific competence
Authors: Nag Heidi Elisabeth , Hoxmark Lise Beate , Nærland Terje
Published: May 2019

The experience of having a rare disorder was summarised in a large study as ‘falling outside the vast field of knowledge of the professionals’. Parents (31 mothers and 17 fathers) of 32 persons with Smith–Magenis syndrome (SMS) participated in this study. A phenomenological approach was used to analyse the data into topics and themes. Four themes emerged: behavioural challenges displayed, parents’ strategies for meeting the challenging behaviours, parents’ experiences of their own competence and parents’ experiences of professionals’ competence and understanding regarding children with SMS and their behaviour challenges. We found that parents of children with SMS experience that they are exposed to severe challenging behaviours from their child. The parents believe that they experience more misunderstandings with professionals and that the challenging behaviours increase because there are some specific characteristics of SMS that professionals are not aware of or do not consider in their support services.
Introducing the storytelling analysis methodology in marketing: Principles, contributions and implementation
Authors: Chautard Tiphaine , Collin-Lachaud Isabelle
Published: May 2019

This article aims to present the storytelling analysis methodology and reveals its relevance for marketing research from an organisational perspective. Although marketing has considered different theoretical approaches to storytelling, its methodological dimension remains largely overlooked; exceptions are organisational disciplines of management science, especially organisational theory from which it originated. However, it appears to be a fertile methodology for the study of various research topics and qualitative data in marketing. The storytelling analysis methodology is a way to tap into deeper realities by exploring the symbolism conveyed by stories. This article illustrates its implementation step by step and develops its appeal for marketing research through an investigation of discourses flourishing in organisations. Recommendations, practical tools and a research agenda are suggested for marketing academics interested in the analysis of marketing in its organisational dimension.
Adjacent segment disease after posterior lumbar instrumentation surgery for degenerative disease: Incidence and risk factors
Authors: Bagheri Seyed Reza , Alimohammadi Ehsan , Zamani Froushani Alireza , Abdi Alireza
Published: May 2019

Purpose:

To identify risk factors for occurrence of symptomatic adjacent segment disease (ASD) after posterior lumbar instrumentation surgery.

Methods:

This retrospective study evaluated 630 patients who underwent posterior lumbar transpedicular instrumentation for degenerative lumbar disorders between April 2008 and April 2012. On the basis of developing ASD at follow-up, patients were categorized into two groups: the ASD group and the non-ASD (N-ASD) group. These two groups were compared for patient characteristics, surgical variables, and radiographic parameters to investigate the possible predictive factors of ASD.

Results:

Of the 630 individuals participated in the study, 76 (12.1%) patients had ASD. Mean and standard deviation of age were 61.37 ± 4.12 years for the ASD group and 62.37 ± 3.9 for the N-ASD group ( p = 0.79). The average follow-up period was 51 ± 2.2 months in the ASD group and 52 ± 2.3 months in the N-ASD group ( p = 0.691). There were no significant differences between the two groups in terms of gender, diabetes mellitus (DM), hypertension, smoking, and osteoporosis, with all p > 0.05. The logistic regression analysis demonstrated that higher preoperative body mass index (BMI; odds ratio (OR) 1.233, p = 0.005), preoperative disc degeneration (OR 1.033, p = 0.024), decreased postoperative lumbar lordosis (OR 3.080, p = 0.011), fusion at more than four levels (OR 4.280, p = 0.014), and intraoperative superior facet joint violation (OR 7.480, p = 0.009) were independently associated with ASD.

Conclusions:

Patients with higher preoperative BMI, preoperative disc degeneration, decreased postoperative lumbar lordosis, fusion at more than four levels, and intraoperative superior facet joint violation have a statistically significant increased risk of developing ASD.
A Paradigm Shift in Nurse Specialist Clinical Supervision—Implementation of a Competence Program
Authors: Jølstad Anne Lind , Røsnæs Eva Røed , Severinsson Elisabeth , Lyberg Anne
Published: May 2019

The change of the anesthesia-, intensive-, surgery-, and oncological nursing postgraduate education into clinical-oriented master programs makes it necessary to increase the professional skills of nurse specialist clinical supervisors. A competence program for clinical supervisors (15 credits) was developed by a university in Norway from 2014 to 2015 in order to facilitate capacity building of academic and pedagogical knowledge. To illuminate nurse specialist clinical supervisors' learning components by implementing a competence program in clinical supervision. A qualitative document analysis of 44 written assignments made by 18 nurse specialist clinical supervisors participating in the competence program, which were collected from the University's electronic learning platform. One main theme and two themes emerged: Changes in the professional paradigm, Learning components that influence clinical supervisors' style and Learning components that have an impact on clinical supervisors' professional growth. This study provides valuable insight into the learning components in clinical supervision that have contributed to a change in the nurse specialist clinical supervision paradigm. The supervisors have formal competence to provide clinical supervision to postgraduate students at master level. The program confirms the value of educating nurse specialist clinical supervisors and we recommend that it should be continued and further evaluated.
miR-21-5p protects IL-1β-induced human chondrocytes from degradation
Authors: Zhu Hai , Yan Xin , Zhang Meng , Ji Feng , Wang Shouguo
Published: May 2019

Objective

Osteoarthritis (OA) is a prevalent degenerative disease caused by various factors. MicroRNAs are important regulators in OA. MiR-21-5p expression is decreased in OA cartilage, but the effects of modulating miR-21-5p on cartilage regeneration are unknown. Therefore, our aim was to investigate the effects of miR-21-5p on cartilage metabolism of OA chondrocytes.

Design

We used IL-1β (10 ng/ml) to mimic OA chondrocytes. OA chondrocytes were transfected with miR-21-5p, the gene expression of COL2A1, MMP13, and ADAMTS5 was detected by qPCR. At the same time, COL2A1, MMP13, and ADAMTS5 were analyzed at the protein level by Western blot. CCK8 measured the cell’s viability and SA-β-gal detected the cell’s senescence.

Results

Upregulation of miR-21-5p had increased COL2A1 expression and decreased MM P13 and ADAMTS5 expression, which were in accord with Western blot data. SA-β-gal activity significantly increased, the viability was decreased in OA chondrocytes, and upregulation of miR-21-5p can decrease the SA-β-gal activity and increase cell viability.

Conclusion

MiR-21-5p might be a potential disease-modifying compound in OA, as it promotes hyaline cartilage production. These results provided that novel insights into the important function in OA pathological development.
Predictors of moving on from mental health supported accommodation in England: national cohort study
Authors: Killaspy Helen , Priebe Stefan , McPherson Peter , Zenasni Zohra , Greenberg Lauren , McCrone Paul , Dowling Sarah , Harrison Isobel , Krotofil Joanna , Dalton-Locke Christian , McGranahan Rose , Arbuthnott Maurice , Curtis Sarah , Leavey Gerard , Shepherd Geoff , Eldridge Sandra , King Michael
Published: May 2019

Background

Around 60 000 people in England live in mental health supported accommodation. There are three main types: residential care, supported housing and floating outreach. Supported housing and floating outreach aim to support service users in moving on to more independent accommodation within 2 years, but there has been little research investigating their effectiveness.

Aims

A 30-month prospective cohort study investigating outcomes for users of mental health supported accommodation.

Method

We used random sampling, accounting for relevant geographical variation factors, to recruit 87 services (22 residential care, 35 supported housing and 30 floating outreach) and 619 service users (residential care 159, supported housing 251, floating outreach 209) across England. We contacted services every 3 months to investigate the proportion of service users who successfully moved on to more independent accommodation. Multilevel modelling was used to estimate how much of the outcome and cost variations were due to service type and quality, after accounting for service-user characteristics.

Results

Overall 243/586 participants successfully moved on (residential care 15/146, supported housing 96/244, floating outreach 132/196). This was most likely for floating outreach service users (versus residential care: odds ratio 7.96, 95% CI 2.92–21.69, P < 0.001; versus supported housing: odds ratio 2.74, 95% CI 1.01–7.41, P < 0.001) and was associated with reduced costs of care and two aspects of service quality: promotion of human rights and recovery-based practice.

Conclusions

Most people do not move on from supported accommodation within the expected time frame. Greater focus on human rights and recovery-based practice may increase service effectiveness.
Moving From Poly (ADP-Ribose) Polymerase Inhibition to Targeting DNA Repair and DNA Damage Response in Cancer Therapy
Authors: Gourley Charlie , Balmaña Judith , Ledermann Jonathan A. , Serra Violeta , Dent Rebecca , Loibl Sibylle , Pujade-Lauraine Eric , Boulton Simon J.
Published: May 2019

The DNA damage response (DDR) pathway coordinates the identification, signaling, and repair of DNA damage caused by endogenous or exogenous factors and regulates cell-cycle progression with DNA repair to minimize DNA damage being permanently passed through cell division. Severe DNA damage that cannot be repaired may trigger apoptosis; as such, the DDR pathway is of crucial importance as a cancer target. Poly (ADP-ribose) polymerase (PARP) is the best-known element of the DDR, and several PARP inhibitors have been licensed. However, there are approximately 450 proteins involved in DDR, and a number of these other targets are being investigated in the laboratory and clinic. We review the most recent evidence for the clinical effect of PARP inhibition in breast and ovarian cancer and explore expansion into the first-line setting and into other tumor types. We critique the evidence for patient selection techniques and summarize what is known about mechanisms of PARP inhibitor resistance. We then discuss what is known about the preclinical rationale for targeting other members of the DDR pathway and the associated tumor cell genetics that may confer sensitivity to these agents. Examples include DNA damage sensors (MLH1), damage signaling molecules (ataxia-telangiectasia mutated; ataxia-telangiectasia mutated–related and Rad3-related; CHK1/2; DNA-dependent protein kinase, catalytic subunit; WEE1; CDC7), or effector proteins for repair (POLQ [also referred to as POLθ], RAD51, poly [ADP-ribose] glycohydrolase). Early-phase clinical trials targeting some of these molecules, either as a single agent or in combination, are discussed. Finally, we outline the challenges that must be addressed to maximize the therapeutic opportunity that targeting DDR provides.
Prospective Longitudinal ctDNA Workflow Reveals Clinically Actionable Alterations in Ovarian Cancer
Authors: Oikkonen Jaana , Zhang Kaiyang , Salminen Liina , Schulman Ingrid , Lavikka Kari , Andersson Noora , Ojanperä Erika , Hietanen Sakari , Grénman Seija , Lehtonen Rainer , Huhtinen Kaisa , Carpén Olli , Hynninen Johanna , Färkkilä Anniina , Hautaniemi Sampsa
Published: May 2019

PURPOSE

Circulating tumor DNA (ctDNA) detection is a minimally invasive technique that offers dynamic molecular snapshots of genomic alterations in cancer. Although ctDNA markers can be used for early detection of cancers or for monitoring treatment efficacy, the value of ctDNA in guiding treatment decisions in solid cancers is controversial. Here, we monitored ctDNA to detect clinically actionable alterations during treatment of high-grade serous ovarian cancer, the most common and aggressive form of epithelial ovarian cancer with a 5-year survival rate of 43%.

PATIENTS AND METHODS

We implemented a clinical ctDNA workflow to detect clinically actionable alterations in more than 500 cancer-related genes. We applied the workflow to a prospective cohort consisting of 78 ctDNA samples from 12 patients with high-grade serous ovarian cancer before, during, and after treatment. These longitudinal data sets were analyzed using our open-access ctDNA-tailored bioinformatics analysis pipeline and in-house Translational Oncology Knowledgebase to detect clinically actionable genomic alterations. The alterations were ranked according to the European Society for Medical Oncology scale for clinical actionability of molecular targets.

RESULTS

Our results show good concordance of mutations and copy number alterations in ctDNA and tumor samples, and alterations associated with clinically available drugs were detected in seven patients (58%). Treatment of one chemoresistant patient was changed on the basis of detection of ERBB2 amplification, and this ctDNA-guided decision was followed by significant tumor shrinkage and complete normalization of the cancer antigen 125 tumor marker.

CONCLUSION

Our results demonstrate a proof of concept for using ctDNA to guide clinical decisions. Furthermore, our results show that longitudinal ctDNA samples can be used to identify poor-responding patients after first cycles of chemotherapy. We provide what we believe to be the first comprehensive, open-source ctDNA workflow for detecting clinically actionable alterations in solid cancers.
Social Health Insurance in Europe: Basic Concepts and New Principles
Authors: Wendt Claus
Published: May 2019

This article discusses recent developments in and new principles of European social health insurance (SHI). It analyses how privatization policies and competition have altered social insurance and whether financial difficulties are caused by social insurance features not evident in other types of health care systems. There is little if any evidence that SHI causes higher cost increases than other types of systems. The comparison of five European SHI systems demonstrates that despite cost containment policies these countries do not experience a trust crisis in health care or loss in support among the public. The author shows that SHI has moved toward universal health care and that the traditional values of solidarity and social security have even been strengthened over the past decades.
Plastic changes in brain morphology in relation to learning and environmental enrichment in the guppy (Poecilia reticulata)
Authors: Fong Stephanie , Buechel Séverine D. , Boussard Annika , Kotrschal Alexander , Kolm Niclas
Published: May 2019

Despite the common assumption that the brain is mainly malleable to surrounding conditions during ontogeny, plastic neural changes can occur also in adulthood. One of the driving forces responsible for alterations in brain morphology is increasing environmental complexity that may demand for enhanced cognitive abilities (e.g. attention, memory and learning). However, studies looking at the relationship between brain morphology and learning are scarce. Here, we tested the effects of both learning and environmental enrichment on neural plasticity in guppies (Poecilia reticulata), by means of either a reversal-learning test or a spatial-learning test. Given considerable evidence supporting environmentally-induced plastic alterations, two separate control groups that were not subjected to any cognitive test were included to account for potential changes induced by the experimental setup alone. We did not find any effect of learning on any of our brain measurements. However, we found strong evidence for an environmental effect, where fish given access to the spatial-learning environment had larger relative brain size and optic tectum size in relation to those exposed to the reversal-learning environment. Our results demonstrate the plasticity of the adult brain to respond adaptively mainly to environmental conditions, providing support for the environmental enhancement theory.
Repeated stimulation of the pituitary–adrenal axis alters offspring phenotype of a wild passerine
Authors: Tilgar Vallo
Published: May 2019

Prolonged stress can have long-lasting effects on an individual physiology and growth. However, the impact of chronically elevated glucocorticoids on the expression of early antipredator responses is still poorly documented. In this study I simulated the effect of repeated acute stress on offspring phenotype in free-living pied flycatchers (Ficedula hypoleuca) by administering adrenocorticotropic hormone (ACTH) to nestlings for 6 days. The results showed that frequent induction of stress responses by ACTH injections, independently of parental care, adversely affected offspring final body size, wing length and baseline corticosterone levels. Nestling behavioural activity did not differ between ACTH- and saline-treated groups during exposure to control sounds while behavioural activity during exposure to alarm calls was reduced in manipulated offspring only. I conclude that prolonged physiological stress may have short-term benefits to nest-bound offspring, such as more effective antipredator behaviour, but at the expense of negative effects on body size and developmental speed.
The neuropeptide CCHamide 2 regulates diuresis in the Chagas’ disease vector Rhodnius prolixus
Authors: Capriotti Natalia , Ianowski Juan P. , Gioino Paula , Ons Sheila
Published: May 2019

Given that hematophagous insects ingest large quantities of blood in a single meal, they must undergo a rapid post-prandial diuresis in order to maintain homeostasis. In the kissing bug Rhodnius prolixus (Hemiptera: Reduviidae), the coordinated activity of the Malpighian tubules and anterior midgut maintains water and ion balance during the post-prandial diuresis. Three to four hours after the meal the diuretic process finishes, and the animal enters an antidiuretic state to ensure water conservation until the next blood intake. The diuretic and antidiuretic processes are tightly regulated by serotonin and neuropeptides in this insect. In the present work, we report that the neuropeptide precursor CCHamide 2 is involved in the regulation of the post-prandial diuresis in the kissing bug R. prolixus. Our results suggest a dual effect of RhoprCCHamide2 peptide, enhancing the serotonin-induced secretion by Malpighian tubules, and inhibiting serotonin-induced absorption across the anterior midgut. To our knowledge, this is the first report of a hormone presenting opposite effects in the two osmoregulatory organs (i.e. midgut and Malpighian tubules) in insects, probably reflecting the importance of a well-tuned diuretic process in hematophagous insects during different moments after the blood meal.
Evidence for a sexually selected function of the attachment system in bedbugs Cimex lectularius (Heteroptera, Cimicidae)
Authors: Reinhardt Klaus , Voigt Dagmar , Gorb Stanislav N.
Published: May 2019

Attachment to surfaces is a major aspect of an animal's interaction with the environment. Consequently, mainly natural selection is considered to have shaped the attachment system in relation to weight load and substrate. However, sexual selection may also be important because many animals attach to the partner during mating. Both hypotheses generate opposing predictions in species where males are smaller than females. Natural selection predicts the attachment ability to scale positively with load, and hence body size, and so be larger in females than males. Sexual selection predicts attachment forces in males to be larger than females, despite the males’ smaller size because males benefit from uninterrupted copulation by stronger attachment to the female. We tested these predictions in the common bedbug Cimex lectularius, a species in which both sexes, as well as nymphs, regularly carry large loads, blood meals of up to three times the body weight. By measuring attachment forces to smooth surfaces and analysing in-situ fixed copulating pairs and the morphology of attachment devices, we show i) that males generate twice the attachment force of females, although weighing 15 % less, ii) that males adhere to females during copulation using hairy tibial adhesive pads, iii) more setae, and more setae per unit area, in the pads of males than females but no difference in shape of tarsal setae, and iv) the absence of hairy tibial attachment pads and low attachment force in nymphs. These results are consistent with a sexually selected function of attachment in bedbugs. Controlling sperm transfer and mate guarding by attaching to females during copulation may also shape the evolution of male attachment structures in other species. More generally, we hypothesise the existence of arms races of male attachment structures and female counterparts to impede attachment which may result in a similar evolutionary diversification as male genitalia.
Effects of Austerity: Expenditure- and Tax-based Approaches
Authors: Alesina Alberto , Favero Carlo , Giavazzi Francesco
Published: May 2019

We review the debate surrounding the macroeconomic effects of deficit reduction policies (austerity). The discussion about "austerity" in general has distracted commentators and policymakers from a very important result, namely the enormous difference, on average, between expenditure- and tax-based austerity plans. Spending-based austerity plans are remarkably less costly than tax-based plans. The former have on average a close to zero effect on output and lead to a reduction of the debt/GDP ratio. Tax-based plans have the opposite effect and cause large and long-lasting recessions. These results also apply to the recent episodes of European austerity, which in this respect were not especially different from previous cases.
The Declining Labor Market Prospects of Less-Educated Men
Authors: Binder Ariel J. , Bound John
Published: May 2019

Over the last half century, US wage growth stagnated, wage inequality rose, and the labor-force participation rate of prime-age men steadily declined. In this article, we examine these worrying labor market trends, focusing on outcomes for males without a college education. Though wages and participation have fallen in tandem for this population, we argue that the canonical neoclassical framework, which postulates a labor demand curve shifting inward across a stable labor supply curve, does not reasonably explain the data. Alternatives we discuss include adjustment frictions associated with labor demand shocks and effects of the changing marriage market—that is, the fact that fewer less-educated men are forming their own stable families—on male labor supply incentives. In the synthesis that emerges, the phenomenon of declining prime-age male labor-force participation is not coherently explained by a series of causal factors acting separately. A more reasonable interpretation, we argue, involves complex feedbacks between labor demand, family structure, and other factors that have disproportionately affected less-educated men.
When Labor’s Lost: Health, Family Life, Incarceration, and Education in a Time of Declining Economic Opportunity for Low-Skilled Men
Authors: Coile Courtney C. , Duggan Mark G.
Published: May 2019

The economic progress of US men has stagnated in recent decades. The labor force participation rate of men ages 25–54 peaked in the mid-1960s and has declined since then (according to the Bureau of Labor Statistics), while men’s real median earnings have been flat since the early 1970s. These population averages mask considerably larger declines in participation among less-educated and non-white men as well as substantial increases in wage inequality. In this paper, we seek to illuminate the broader context in which prime-age men are experiencing economic stagnation. We explore changes for prime-age men over time in education, mortality, morbidity, disability program receipt, family structure, and incarceration rates. We focus on prime-age men, namely those ages 25–54, and on the years 1980–2016 (or 2017 when possible), encompassing much of the period of reduced economic progress for low-skilled men.
Automation and New Tasks: How Technology Displaces and Reinstates Labor
Authors: Acemoglu Daron , Restrepo Pascual
Published: May 2019

We present a framework for understanding the effects of automation and other types of technological changes on labor demand, and use it to interpret changes in US employment over the recent past. At the center of our framework is the allocation of tasks to capital and labor—the task content of production. Automation, which enables capital to replace labor in tasks it was previously engaged in, shifts the task content of production against labor because of a displacement effect. As a result, automation always reduces the labor share in value added and may reduce labor demand even as it raises productivity. The effects of automation are counterbalanced by the creation of new tasks in which labor has a comparative advantage. The introduction of new tasks changes the task content of production in favor of labor because of a reinstatement effect, and always raises the labor share and labor demand. We show how the role of changes in the task content of production—due to automation and new tasks—can be inferred from industry-level data. Our empirical decomposition suggests that the slower growth of employment over the last three decades is accounted for by an acceleration in the displacement effect, especially in manufacturing, a weaker reinstatement effect, and slower growth of productivity than in previous decades.
C9orf72 and triplet repeat disorder RNAs: G-quadruplex formation, binding to PRC2 and implications for disease mechanisms
Authors: Wang Xueyin , Goodrich Karen J. , Conlon Erin G. , Gao Jianchao , Erbse Annette H. , Manley James L. , Cech Thomas R.
Published: May 2019

Some neurological disorders, including amyotrophic lateral sclerosis (ALS), frontotemporal dementia (FTD), fragile X syndrome, Huntington's disease, myotonic dystrophy, and various ataxias, can be caused by expansions of short nucleic acid sequence repeats in specific genes. A possible disease mechanism involves the transcribed repeat RNA binding an RNA-binding protein (RBP), resulting in its sequestration and thus dysfunction. Polycomb repressive complex 2 (PRC2), the histone methyltransferase that deposits the H3K27me3 mark of epigenetically silenced chromatin, binds G-rich RNAs and has especially high affinity for G-quadruplex (G-Q) structures. Here, we find that PRC2 target genes are derepressed and the RNA binding subunit EZH2 largely insoluble in postmortem brain samples from ALS/FTD patients with C9ORF72 (C9) repeat expansions, leading to the hypothesis that the (G4C2)n repeat RNA might be sequestering PRC2. Contrary to this expectation, we found that C9 repeat RNAs (n = 6 or 10) bind weakly to purified PRC2, and studies with the G-Q specific BG4 antibody and circular dichroism studies both indicated that these C9 RNAs have little propensity to form G-Qs in vitro. Several GC-rich triplet-repeat expansion RNAs also have low affinity for PRC2 and do not appreciably form G-Qs in vitro. The results are consistent with these sequences forming hairpin structures that outcompete G-Q folding when the repeat length is sufficiently large. We suggest that binding of PRC2 to these GC-rich RNAs is fundamentally weak but may be modulated in vivo by protein factors that affect secondary structure, such as helicases and other RBPs.
Analysis of the depression and anxiety status and related risk factors in patients with lumbar disc herniation
Authors: Mu Wenzhi , Shang Yong , Zhang Chenchen , Tang Shujie
Published: May 2019

Objectives: To evaluate the depression and anxiety status and related risk factors in patients with lumbar disc herniation, and help spine surgeons better identify those patients who need psychological care.

Methods: A cross-sectional study was performed on patients with lumbar disc herniation treated in our hospital between October 2015 and August 2018. Visual analog scale and Oswestry disability index were used to assess pain intensity and lumbar function, and Zung self-rating depression and anxiety scale were employed to evaluate the depression and anxiety status of the patients, and the demographic and clinical data including age, gender, marital status, occupation type, employment status, education level, surgery history, herniation type, disease duration, and insurance status were collected for analysis.

Results: In the current study, 165 patients were enrolled based on the inclusion and exclusion criteria. In multivariate logistic regression analysis, gender (p=0.03), pain intensity (p=0.01), self-rating anxiety scale (SAS) (p=0.00), and disease duration (p=0.001) were identified as independent risk factors for depression status, and pain intensity (p=0.02), disease duration (p=0.002) and SDS (Zung self-rating depression scale) (p=0.003) were independent risk factors for anxiety status in patients with lumbar disc herniation. There was a significant correlation between Zung self-rating depression and anxiety scale in patients with lumbar disc herniation (p<0.05).

Conclusion: Psychological intervention is critical for patients with lumbar disc herniation, especially for those female patients with severe pain and longer disease duration.

doi: https://doi.org/10.12669/pjms.35.3.299

How to cite this:Mu W, Shang Y, Zhang C, Tang S. Analysis of the depression and anxiety status and related risk factors in patients with lumbar disc herniation. Pak J Med Sci. 2019;35(3):658-662. doi: https://doi.org/10.12669/pjms.35.3.299

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Principal–Agent Theory, Game Theory, and the Precautionary Principle
Authors: Hausken Kjell
Published: May 2019

Principal–agent theory and game theory are applied to the precautionary principle (PP) to open up a new research agenda. Principals assess whether the threat is uncertain above a threshold. If it is, the principals choose, pay, and command agents to decrease the uncertainty below the threshold. The agents perform the action. The process is repeated through a feedback loop impacting the threat, after which the process is renewed. The four dimensions of the PP, that is, threat, uncertainty, command, and action, are described. Games and game characteristics in the four dimensions are recognized. Games are possible between natural, technological, and human factors causing the threat and between principals, agents, and external actors. Moral hazard and adverse selection in principal–agent theory related to the PP are considered. Twelve kinds of uncertainty are identified for principal–agent theory in the PP, that is, the natures of the threat, uncertainty, and threshold; states of nature, technology, knowledge, and information; whether a game is played; players; which game is played; strategy sets; utilities; beliefs; incomplete information; imperfect information; risk attitudes; and bounded rationality.
Heavy-Traffic Analysis Through Uniform Acceleration of Queues with Diminishing Populations
Authors: Bet Gianmarco , van der Hofstad Remco , van Leeuwaarden Johan S. H.
Published: May 2019

We consider a single-server queue that serves a finite population of [Formula: see text] customers that will enter the queue (require service) only once, also known as the [Formula: see text] queue. This paper presents a method for analyzing heavy-traffic behavior by using uniform acceleration, which simultaneously lets [Formula: see text] and the service rate grow large, while the initial resource utilization approaches one. A key feature of the model is that, as time progresses, more customers have joined the queue, and fewer customers can potentially join. This diminishing population gives rise to a class of reflected stochastic processes that vanish over time and hence do not have a stationary distribution. We establish that, when the arrival times are exponentially distributed, by suitably rescaling space and time, the queue-length process converges to a Brownian motion with a negative quadratic drift, a stochastic-process limit that captures the effect of the diminishing population. When the arrival times are generally distributed, our techniques provide information on the typical queue length and the first busy period.
Spatial Pricing in Ride-Sharing Networks
Authors: Bimpikis Kostas , Candogan Ozan , Saban Daniela
Published: May 2019

Motivated by the prevalence of ride-sharing platforms, in “Spatial Pricing in Ride-Sharing Networks,” Bimpikis, Candogan, and Saban explore the impact of the demand pattern for rides across a network’s locations on a platform’s optimal pricing and compensation policy, profits, and consumer surplus. They explicitly account for the pricing problem’s spatial dimension and the fact that the drivers endogenously determine whether and where to provide service. Their first contribution is to develop a tractable model to study a platform operating on a network of locations that may differ in both the size of their potential demand and the destination preferences of riders. Second, they provide a characterization of the platform’s optimal policy and identify “balancedness” of the demand pattern as a property that captures the profit potential of a given network. Finally, they discuss the benefits and limitations of a number of alternative pricing and compensation schemes.
la infancia inmunizada
Authors: Rodriguez Gonzalo santiago
Published: May 2019

Durante las últimas décadas los estudios sobre la historia de la vida privada han considerado la infancia como una construcción histórica y social donde intervienen elementos culturales, económicos y filosóficos. Partiendo de una interpretación del Flautista de Hamelin (Browning, 2003; Browning e Pisu, 1980; Grimm e Grimm, 2000, 1816) nuestro trabajo intentará analizar las características fundantes de dicha construcción moderna utilizando como clave interpretativa el concepto de communitas del filósofo italiano Roberto Espósito (2003). Valiéndonos de algunos de sus conceptos fundamentales así como también de diversas fuentes modernas y contemporáneas acerca de la leyenda recopilada por los hermanos Grimm, nuestro trabajo mostrará hasta qué punto el relato se encuentra ligado a las transformaciones políticas que dieron origen a la pedagogía y que constituyen lo que Esposito considera como el “proceso inmunitario moderno”(Esposito, 2005): un proceso por medio del cual los individuos se han desligado de los compromisos y los deberes comunitarios que constituían los lazos sociales anteriores al surgimiento de los estados nacionales. Dicho proceso afectaría también a la niñez que a partir del siglo XIX es alterada, aislada y excluida del nexo social que la unía con los adultos  hasta ser convertida en lo que conocemos con el nombre de “infancia”. ¿Es posible una relación distinta con la infancia que no margine a los niños de la comunidad? El siguiente trabajo abre el camino a dicha posibilidad.
escola, problemas de escuta?
Authors: Roseiro Steferson zanoni , Gonçalves Nahum thiaghor lippaus pires , Rodrigues Alexsandro
Published: May 2019

Apresentando o enviesamento da escuta como um problema comum nas escolas, o artigo objetiva discutir de quais modos falas, manifestações e discursos estudantis são afinados ao ponto de perderem sua força imanente. Afirmando haver uma insistência em afinar as escutas nas escolas mesmo a partir de teorias pedagógicas, o texto aponta, na contramão, para enunciações pouco usuais de estudantes como um dever ética. Metodologicamente, essa pesquisa acompanhou o contexto de duas escolas do estado do Espírito Santo, criando redes de conversações entre estudantes e professores. Assim, apostando na perspectiva de uma escuta distraída, o artigo propõe não dar vazão apenas aos silenciamentos ou às escutas perversas, mas, antes, opta por apontar de que modos outras falas reverberam produzindo certas insurreições. Se as escutas pedagógicas dão preferências a certas alunas e alunos, é preciso enxergar ali, nos corpos menos prestigiosos, um arrombo de escuta incontrolável.
EDUCAÇÃO E LINGUAGEM NA SOCIEDADE DIGITAL: CRÍTICA E CONSTRUÇÃO DE SENTIDOS
Authors: Chaves de Barros Adriana Lúcia de Escobar , Costa de Oliveira Marcia Lisbôa , Saito Ricardo Toshihito , Gattolin Sandra Regina Buttros
Published: May 2019

O número 15 da Pensares em Revista homenageia Walkyria Maria Monte Mór, professora Livre-Docente da Universidade de São Paulo, pesquisadora adjunta do Center for Globalization and Cultural Studies da Universidade de Manitoba - Canadá, onde realizou sua  pesquisa de pós-doutorado (2007). Suas pesquisas recentes concentram-se em Linguagem e Educação, Letramentos (Novos Letramentos, Multiletramentos, Letramentos Críticos), Construção de Sentidos e Formação de Professores. Daí o título deste dossiê - Educação e linguagem na sociedade digital: crítica e construção de sentidos - que reúne pesquisas no campo da Linguística Aplicada, desenvolvidas, em sua maioria, pelos participantes do Projeto Nacional de Letramentos: Linguagem, Cultura, Educação e Tecnologia, do qual também fazem parte, os organizadores desta edição da Pensares em Revista. Os capítulos estão organizados em três eixos principais: Formação de Professores, Letramentos e a Sociedade; Translinguagem; Decolonialidade e o Ensino-Aprendizagem de Línguas; Letramentos Críticos e o Ensino de Línguas.
Implementing a key worker system within an Intensive Home Treatment Team
Authors: Clinch Kevin
Published: May 2019

This article outlines the development of a key worker/co-worker system within an Intensive Home Treatment Team for older people in south east London. Upon reflection, it was felt that the local key worker system was missing the targets of the Intensive Home Treatment Team, including continuity in contacts with patients and completing their personalised care plans, providing quality care to patients, and an understanding of their needs and risks. This article discusses, with reference to the aims and objectives of the Intensive Home Treatment Team and evidence gathered from audits, incidents and carer questionnaires, how a new key worker/co-worker system was implemented, and its associated outcomes.
Estudo Comparativo sobre a Divulgação de Intangíveis e Capital Intelectual em Instituições de Ensino Superior no Brasil e na Áustria
Authors: Rezende José Francisco de Carvalho , Lott Ana Cristina de Oliveira , Quintanilha Guilherme
Published: May 2019

A presente investigação analisou, sob o aspecto de divulgação de Intangíveis e do Capital Intelectual, os modelos de avaliação de instituições de ensino superior adotados no Brasil e na Áustria, visando explorar e evidenciar similaridades e diferenças entre os modelos, bem como contribuir para o avanço de estudos sobre da criação de valor para os stakeholders. O estudo foi desenvolvido sob a forma de pesquisa comparativa, em que foi empreendida a análise documental dos instrumentos de avaliação institucional e de cursos adotados nos dois países. Entre os principais pontos em comum, foram identificados: a obrigatoriedade por lei; o incentivo à produção científica, cultural, artística e tecnológica; a análise de experiência profissional e de magistério superior do docente; e ações de responsabilidade social. Entre as principais diferenças: a avaliação da titulação dos professores; o incentivo à realização de cursos e pesquisas em outros países; e o nível de especificidade nos indicadores relacionados às ações de inclusão social e diversidade. Achados e cruzamentos apontaram que as IES austríacas retratam com mais intensidade itens de capital humano e de capital relacional enquanto no Brasil, o foco das IES recai sobre itens de capital estrutural, com a divulgação de seus recursos e modos de gestão.
Definindo Espaços de Educação Criativa no Ensino Superior de Administração através de Mecanismos de Cocriação de Valor
Authors: Chim-Miki Adriana Fumi , Campos Danieli Barbosa , Albuquerque de Melo Lucia Silva
Published: May 2019

A pesquisa objetivou identificar os elementos e forma dos espaços de educação criativa pela ótica dos principais atores envolvidos no âmbito da educação universitária em administração. O estudo se fundamenta em três perspectivas teóricas: cocriação de valor, espaços criativos de educação e inovação educativa. A metodologia utilizada é de natureza exploratória e qualitativa, que realiza um processo de cocriação de valor, utilizando a técnica de Focus Group com uma amostragem intencional de professores, estudantes, servidores e direção em uma universidade brasileira. Os resultados indicam alinhamento com as abordagens de inovação educativa e espaços criativos, no que tange a inovação institucional, especificamente estrutural e didática. O modelo ideal de espaço criativo de educação cocriado pelo grupo mantém semelhança com os espaços de coworking e de estruturas organizacionais de empresas não tradicionais. Verificou-se consenso entre professores e alunos de que as atuais salas de aula utilizadas, na grande maioria das universidades, estão ultrapassadas e é desestimulante para a criatividade, tanto para educadores como para estudantes, devendo ser repensadas, sob pena de serem um dos pontos geradores da evasão escolar. O espaço criativo de educação foi associado a interação, tecnologias, funcionalidades, gamificação e ócio criativo.
Is statutory interpretation solely an exercise in retrieving the drafters’ intentions? R. Dworkin’s view of judges’ interpretation of the law
Authors: Hapner Fernanda Aranha
Published: May 2019

Nem sempre é claro o método que os juízes utilizam para interpretar a lei aplicável aos casos a serem julgados. Vários filósofos do direito argumentam que se deve investigar a intenção do legislador para alcançar um julgamento adequado. Por outro lado, autores dentre os quais se inclui Ronald Dworkin explicam como esse método de interpretação não é útil e nem deve ser considerado correto. Este ensaio enfoca especialmente no pensamento de Ronald Dworkin e em suas explicações sobre o assunto.
Univocidade e finitude
Authors: Barbaras Renaud
Published: May 2019

O âmbito da fenomenologia pode ser circonscrito pelo que Husserl chamou de a priori universal da correlação entre o ente transcendente e seus modos subjetivos de doação. Este a priori significa ao mesmo tempo que a essência do ente envolve sua relação com uma consciência e que o sentido de ser do sujeito consiste em se relacionar com o ente transcendante, em fazê‑lo aparecer, o que equivale a dizer que uma consciência que não fosse cons-ciência de algo, ou seja, intencionalidade, não seria. A dificuldade aqui é a de dar conta do sentido de ser dos pólos da correlação, a saber, do ente transcendente e do sujeito, à luz dessa correlação, que remete a uma forma de primado da relação sobre os termos. Trata‑se de se perguntar o que significa aparecer, qual é o estatuto daquilo que aparece e, enfim, qual é o modo de ser daquilo que chamamos de intencionalidade. Eu queria mostrar que a fenomenologia é fadada a se ultrapassar em proveito duma cosmologia e duma metafísica, que aparecem não como campos que lhe seriam estrangeiros mas, muito pelo contrário, como dimensões internas e constitutivas da própria fenomenologia.
Open Versus Closed Treatment Of Subcondyle Mandible Fracture: An Evidence-Based Case Report
Authors: Bangun Kristaninta , Nangingtuari Irinawati , Olivia Andria , Maulana Muhammad Iqbal
Published: May 2019

Background : Mandibular subcondyle fractures are accounted for 25%-35% of all mandible fractures. Closed treatment has been the preferred treatment for several years because it’s relatively easier and non invasive but the complications that may arise are varied. Open reduction was one of the options that is considered to reduce complications. This study examines whether open reduction was a better choice than closed reduction in the management of mandible subcondyle fracture with parameter outcomes are complications, facial nerve injury, pain, and mouth occlusion.

Method: A literature study was conducted from two databases: PubMed and Journal of Cranio-Maxillo-Facial Surgery (JOMS) with predefined keywords and references from 23-28 January 2018. The search was conducted with mandible subcondyle fracture, open reduction, and closed reduction. The search has been limited only for the last 5 years and limited to meta-analysis and systematic review. From the search, there were three articles used based on inclusion criteria in this case review.

Result: The reviewed articles showed that open reduction provides better results than closed reduction, although open reduction results in complications of facial injuries and facial nerve weakness, but the complications were transient and tolerable.Conclusion: Based on existing clinical evidence, open reduction was the preferred management rather than closed. reduction due to better outcome and fewer complication.
Numéro 1 - mars 2002
Authors: De la Croix David , Mahieu Géraldine
Published: May 2019

A quel rythme réduire la dette publique ? Quel budget consacrer aux soins de santé ? Et quel mode de financement de la sécurité sociale adopter face au vieillissement de la population ? Ces choix mettent en balance l’intérêt de différentes générations. Nous identifions les gagnants et les perdants de différentes options politiques.