Miracle-dz/UniFAR-FTUs huggingface dataset:
Alternative opioids to morphine in palliative care: a review of current practice and evidence

This is a review of current practice of opioid use in palliative care, conducted from the perspective of a practising clinician working in the increasingly complex area of symptom control. In examining alternative opioids to morphine, choice and availability of different drugs reflect the UK perspective. Some drugs or formulations may not be available elsewhere, but the principles discussed may hopefully still be applied. The aims of this paper are several-fold: (1) : To present an overview of available opioids. (2) : To consider factors affecting possible choice of opioid—with particular reference to the palliative care setting. (3) : To consider availability and limitations of current data which may affect evidence based decisions. (4) : To comment on areas of interest for future clinical trials. ### OPIOID RECEPTORS AND EFFECTS There are three main classes of opioid receptor: mu, kappa, and delta (table 1), responsible for differing opioid effects. Opioid drugs vary in their receptor affinity, thus affecting their principal actions (table 2). The main site of action is the mu receptor, but some opioids have more complex activity. View this table: Table 1 Classes of opioid receptor and response mediated View this table: Table 2 Differences in opioid receptor action ### SIDE EFFECTS OF OPIOIDS Side effects are common to all opioids, although to differing degrees. For practical purposes, the most important side effects are sedation, nausea, and constipation. Sedation and nausea occur particularly when starting the drug, usually temporarily, but may recur with dose increases. Nausea can be pre-empted by using a centrally acting antiemetic. This is not always necessary but advisable if the patient is already nauseated or fearful about it. Sedation is usually unavoidable but short lived (48–72 hours) among patients starting off on low doses. It may become more intractable at high dose, and there is some work on counteracting this effect with stimulants,1 although not widely practised. Constipation, in contrast, occurs in almost every patient taking opioids and does not lessen with continued use, but can be ameliorated by aperients. Respiratory depression, while potentially serious, is rarely clinically significant when treating pain (even among patients with respiratory impairment), as this antagonises the depressant effect. In practice …
Parents’ Intended Limits on Adolescents Approaching Unsupervised Driving

The purpose of this study was to determine the extent to which parents intend to place driving limits on adolescents approaching unsupervised driving. A total of 658 parents and their 16-year-old adolescents were recruited from a local Maryland Motor Vehicle Administration site as adolescents successfully tested for provisional licenses. Parents completed written surveys about parent-adolescent relations and anticipated adolescent unsupervised driving. The results indicated that parents reported high levels of intended limits on adolescents’ unsupervised driving, especially for trip conditions (e.g., getting permission) when compared with risk conditions (e.g., at night). Almost one third of parents reported completing driving agreements. Overall, intended driving limits and completed driving agreements were more likely when parents reported high levels of parental monitoring (2 times more likely), discussion of driving rules (2 to 4 times more likely), risk perception (2 times more likely), and vehicle access (2 to 3 times more likely). Completed driving agreements were not related to intended driving limits.
Teachers’ remarks about their salaries in 1800 in the Helvetic Republic

For centuries, teachers have complained about their salaries. In the Stapfer inquiry of 1799, some teachers made remarks about financial issues, particularly their low incomes. This inquiry is the main source for the arguments presented here regarding teachers’ low salary during this period of the Helvetic Republic. The disparity between the lowest and the highest income was huge in 1799. This fact invites investigations about the people who complained. The evidence indicates incoherence between the complaints regarding low salary and the real income that was earned by these teachers. However, in order for this thesis to be wholly understood, the salaries must be explained; at the time of the Stapfer inquiry, salaries were paid in different currencies, as wages in kind and using divergent measurements. The present article aims to determine who these teachers were and why they complained. The arguments presented by the teachers shed light on the topics of political appeals, the social status of teachers in 1800 and the professionalisation of teachers.
Delay Tolerant Networking with OLSRv2

This paper proposes a simple mechanism for enabling basic delay tolerant networking with off-the-shelf MANET routing protocols -- with the objective being to enable trading off slightly longer data delivery delays against resilience to a temporary lack of connectivity between a router and the ultimate destination of an IP data gram. As part of testing the benefit of said mechanism, an extreme network mobility model is proposed, entitled the "Pop Up model": a router appears in the network, and operates normally -- then may disable and disappear from the network to appear later elsewhere. Observed to cause severely degraded performance for MANET routing protocols, this model is used for testing the proposed mechanism in OLSRv2-routed MANETs. The proposed mechanism shows to vastly increase the data delivery ration, with reasonably low increases in delays and control traffic overhead incurred.
Dietary hydrated sodium calcium aluminosilicate reduction of aflatoxin M1 residue in dairy goat milk and effects on milk production and components.

Lactating dairy goats were exposed to aflatoxin (100 and 200 ppb) and hydrated sodium calcium aluminosilicate at 1, 2, and 4% in two separate experiments. Naturally occurring low levels of aflatoxin M1 (.009 ppb) were found in the milk of the control diet, whereas there were no detectable levels of aflatoxin M1 in the milk of diets containing hydrated sodium calcium aluminosilicate in both experiments. In Exp. 1, no treatment-related differences in clinical behavior or significant difference in the feed intake, milk production, or milk component analyses were observed with 200 ppb of aflatoxin and 4% hydrated sodium calcium aluminosilicate. However, 4% hydrated sodium calcium aluminosilicate was responsible for an 86.9% reduction of aflatoxin M1 residue in the milk of diary goats. In Exp. 2, the combination of 1% hydrated sodium calcium aluminosilicate and aflatoxin at 100 ppb resulted in an overall reduction of aflatoxin M1 residue by 51.9%, which represented a mean change of aflatoxin M1 from . 553 to . 266 ppb of aflatoxin M1 in the milk. The diet that contained 2% hydrated sodium calcium aluminosilicate and 100 ppb of aflatoxin further reduced aflatoxin residue by a mean change from . 553 to . 098 of ppb aflatoxin M1, which represents an 82.2% reduction of aflatoxin M1 residue in the milk. Analysis of the data by time indicated that there were no statistical differences between days of sampling. Information regarding the ability of hydrated sodium calcium aluminosilicate to prevent or reduce the level of aflatoxin M1 residues in milk is critically needed. (ABSTRACT TRUNCATED AT 250 WORDS)
Role of Epidermal Growth Factor Receptor and Endoplasmic Reticulum Stress in Vascular Remodeling Induced by Angiotensin II

The mechanisms by which angiotensin II (AngII) elevates blood pressure and enhances end-organ damage seem to be distinct. However, the signal transduction cascade by which AngII specifically mediates vascular remodeling such as medial hypertrophy and perivascular fibrosis remains incomplete. We have previously shown that AngII-induced epidermal growth factor receptor (EGFR) transactivation is mediated by disintegrin and metalloproteinase domain 17 (ADAM17), and that this signaling is required for vascular smooth muscle cell hypertrophy but not for contractile signaling in response to AngII. Recent studies have implicated endoplasmic reticulum (ER) stress in hypertension. Interestingly, EGFR is capable of inducing ER stress. The aim of this study was to test the hypothesis that activation of EGFR and ER stress are critical components required for vascular remodeling but not hypertension induced by AngII. Mice were infused with AngII for 2 weeks with or without treatment of EGFR inhibitor, erlotinib, or ER chaperone, 4-phenylbutyrate. AngII infusion induced vascular medial hypertrophy in the heart, kidney and aorta, and perivascular fibrosis in heart and kidney, cardiac hypertrophy, and hypertension. Treatment with erlotinib as well as 4-phenylbutyrate attenuated vascular remodeling and cardiac hypertrophy but not hypertension. In addition, AngII infusion enhanced ADAM17 expression, EGFR activation, and ER/oxidative stress in the vasculature, which were diminished in both erlotinib-treated and 4-phenylbutyrate–treated mice. ADAM17 induction and EGFR activation by AngII in vascular cells were also prevented by inhibition of EGFR or ER stress. In conclusion, AngII induces vascular remodeling by EGFR activation and ER stress via a signaling mechanism involving ADAM17 induction independent of hypertension.
The missing metals problem – III. How many metals are expelled from galaxies?

We revisit the metal budget at z ≃ 2, and include the contribution of the intergalactic medium (IGM). Past estimates of the metal budget have indicated that, at redshift z ≃ 2.5, 90 per cent of the expected metals were missing. In the first two papers of this series, we have already shown that ∼30 per cent of the metals are observed in all z ∼ 2.5 galaxies detected in current surveys. This fraction could increase to ≤60 per cent if we extrapolate the faint end of the luminosity function (LF), leaving >40 per cent of the metals missing. Here, we extend our analysis to the metals outside galaxies (i.e. in the IGM), using (i) observational data and (ii) analytical calculations. Our results for both are strikingly similar. (i) Observationally, we find that, besides the small (5 per cent) contribution of damped Lya absorbers (DLAs), the forest and sub-DLAs contribute substantially to make ≤30-45 per cent of the metal budget; however, neither of these appear to be sufficient to close the metal budget. The forest accounts for 15-30 per cent depending on the ultraviolet background, and sub-DLAs for ≥2 to ≤17 per cent depending on the ionization fraction. Combining the metals in galaxies and in the IGM, it appears now that >65 per cent of the metals have been accounted for, and the 'missing metals problem' is substantially eased. (ii) We perform analytical calculations based on the effective yield-mass (y eff -V c ) relation, whose deficit for small galaxies is considered as evidence for supernova-driven outflows. As a test of the method, we show that, at z = 0, the calculation self-consistently predicts the total amount of metals expelled from galaxies. At z = 2, we find that the method predicts that 25-50 per cent of the metals have been ejected from galaxies into the IGM, consistent with the observations (≥35 per cent). The metal ejection is predominantly by L B < (1/3) L * B (z = 2) galaxies, which are responsible for 90 per cent of the metal enrichment, while the 50 percentile is at L ∼ (1/10) L * B (z = 2). As a consequence, if indeed 50 per cent of the metals have been ejected from galaxies, three to five bursts of star formation are required per galaxy prior to z = 2. The ratio between the mass of metals outside galaxies to those in stars has changed from z = 2 to z = 0; it was 1: 2 or 1: 1 and is now 1: 8 or 1: 9. This evolution implies that a significant fraction of the IGM metals will cool and fall back into galaxies.
Scandals, Media, and Citizenship in Contemporary Argentina

This article examines several scandals in 1990s Argentina to discuss the linkages between scandals, media, and citizenship. Suggesting that media publicity is central for scandals to unfold, the article examines a particular arms scandal. An institutional approach that considers the role of different political actors in different scandals shows how and why the media and other institutions contributed to the making and unmaking of scandals. Although scandals offer opportunities for “doing politics by other means,” not all actors are similarly involved. Scandals that dealt with official corruption mainly featured political elites, whereas scandals that followed revelations about human rights violations showed a different pattern: public outrage and citizens’mobilization. In a political context of “scandal fatigue,” scandals do not necessarily trigger public action or moral crusades. Only those scandals that directly affected groups of citizens and were not simply causes d’état were followed by public demonstrations and intense audience attention.
2016 update of the EULAR recommendations for the management of early arthritis

Objectives Since the 2007 recommendations for the management of early arthritis have been presented, considerable research has been published in the field of early arthritis, mandating an update of the 2007 European League Against Rheumatism (EULAR) recommendations for management of early arthritis. Methods In accordance with the 2014 EULAR Standardised Operating Procedures, the expert committee pursued an approach that was based on evidence in the literature and on expert opinion. The committee involved 20 rheumatologists, 2 patients and 1 healthcare professional representing 12 European countries. The group defined the focus of the expert committee and target population, formulated a definition of ‘management’ and selected the research questions. A systematic literature research (SLR) was performed by two fellows with the help of a skilled librarian. A set of draft recommendations was proposed on the basis of the research questions and the results of the SLR. For each recommendation, the categories of evidence were identified, the strength of recommendations was derived and the level of agreement was determined through a voting process. Results The updated recommendations comprise 3 overarching principles and 12 recommendations for managing early arthritis. The selected statements involve the recognition of arthritis, referral, diagnosis, prognostication, treatment (information, education, pharmacological and non-pharmacological interventions), monitoring and strategy. Eighteen items were identified as relevant for future research. Conclusions These recommendations provide rheumatologists, general practitioners, healthcare professionals, patients and other stakeholders with an updated EULAR consensus on the entire management of early arthritis.
Media, myths, and narratives : television and the press

Introduction - James W Carey Taking Culture Seriously PART ONE: OVERVIEWS Television, Myth and Culture - Roger Silverstone Television as an Aesthetic Medium - David Thorburn Myth, Chronicle and Story - Elizabeth Bird and Robert W Dardenne Exploring the Narrative Qualities of News PART TWO: TELEVISION One Night of Prime Time - Horace Newcomb An Analysis of Television's Multiple Voices Dallas and Genesis - Tamar Liebes and Elihu Katz Primordiality and Seriality in Popular Culture The Mary Tyler Moore Show and the Transformation of Situation Comedy - Thomas Zynda Television Stardom - Jimmie L Reeves A Ritual of Social Typification and Individualization Television, Myth and Ritual - Stewart M Hoover The Role of Substantive Meaning and Spatiality PART THREE: THE PRESS The Watergate Audience - Michael Cornfield Parsing the Powers of the Press On Journalistic Authority - David L Eason The Janet Cooke Scandal What is a Reporter? The Private Face of Public Journalism - Michael Schudson Rupert Murdoch and the Demonology of Professional Journalism - John Pauly
Acute Renal Failure in Endotoxemia Is Caused by TNF Acting Directly on TNF Receptor-1 in Kidney1

Bacterial endotoxin (LPS) is responsible for much of the widespread inflammatory response seen in sepsis, a condition often accompanied by acute renal failure (ARF). In this work we report that mice deficient in TNFR1 (TNFR1−/−) were resistant to LPS-induced renal failure. Compared with TNFR1+/+ controls, TNFR1−/− mice had less apoptosis in renal cells and fewer neutrophils infiltrating the kidney following LPS administration, supporting these as mediators of ARF. TNFR1+/+ kidneys transplanted into TNFR1−/− mice sustained severe ARF after LPS injection, which was not the case with TNFR1−/− kidneys transplanted into TNFR1+/+ mice. Therefore, TNF is a key mediator of LPS-induced ARF, acting through its receptor TNFR1 in the kidney.
Social capital as a mechanism for exploring the low educational achievements of looked after children

Purpose – The purpose of this article is to explore whether the concept of social capital is helpful in explaining the educational underachievement of looked after children.Design/methodology/approach – Analysis of data on educational achievement and social care in a cohort of 1,407 children over the age of 15 who left care in two Scottish local authorities between 2000 and 2005.Findings – The educational attainments of children do reflect key factors in their backgrounds before entry to care but their characteristics also lead them to be placed in specific placements that have differing abilities for promoting social capital. An examination of evidence on bonding social capital, bridging social capital, and linking social capital and trust, shows that social capital theory helps to theoretically interpret the low educational achievements of looked after children.Originality/value – The large and comprehensive data set permits a factor analysis of background and care variables, thus clarifying the signifi.
Intact social, cognitive ability, and selfhood: A case study of Alzheimer' s disease

An in-depth case study of the discourse of an Alzheimer's disease (AD) sufferer reveals a variety of intact social and cognitive abilities as well as intact manifestations of selfhood as viewed from a social constructionist point of view. Intact social and cognitive abilities included those which have been referred to by Kitwood and Bredin as being indicators of relative well-being— indicators understood to be abilities typically found among the healthy, and whose presence thus signals common ground between the healthy and the afflicted. Such abilities are found to exist despite the sufferer's severe losses of cognitive function as measured by standard tests. Possible brain mechanisms supporting such intact abilities are discussed as well as the importance of recognizing such intact abilities. Such recognition can enhance the interaction between AD sufferers and caregivers.
Limiting stress states in granular avalanches

The Savage-Hutter theory for granular avalanches assumes that the granular material is in either of two limiting stress states, depending on whether the motion is convergent or divergent. At transitions between convergent and divergent regions, a jump in stress occurs, which necessarily implies that there is a jump in the avalanche velocity and/or its thickness. In this paper, a regularizaron scheme is used, which smoothly switches from one stress state to the other, and avoids the generation of such singular surfaces. The resulting algorithm is more stable than previous numerical methods but shocks can still occur during rapid convergence in the run-out zone. Results are presented from two-dimensional calculations on complex geometry which illustrate that some necking features observed in laboratory experiments can be explained by the regularized Savage-Hutter model.
Analysis and Design of a 10 Gbps Transimpedance Amplifier using 0.18μm CMOS technology

This paper examines the design of a 10 Gbps transimpedance amplifier (TIA) in 0.18 mum CMOS technology. In order to compensate for the high parasitic capacitances in the CMOS process, this design uses a shunt and series inductive peaking technique to achieve the required transimpedance bandwidth. A noise analysis on the input stage of the TIA is shown. This noise model is used to determine the optimum device size required to minimize the average input referred noise current. Simulation results for the TIA are presented showing a transimpedance gain of approximately 52 dBΩ. The simulated average input referred noise current of the differential TIA is shown to be approximately 27 pA/√radicHz
High Rates of Human Immunodeficiency Virus Type 1 Recombination: Near-Random Segregation of Markers One Kilobase Apart in One Round of Viral Replication

ABSTRACT One of the genetic consequences of packaging two copies of full-length viral RNA into a single retroviral virion is frequent recombination during reverse transcription. Many of the currently circulating strains of human immunodeficiency virus type 1 (HIV-1) are recombinants. Recombination can also accelerate the generation of multidrug-resistant HIV-1 and therefore presents challenges to effective antiviral therapy. In this study, we determined that HIV-1 recombination rates with markers 1.0, 1.3, and 1.9 kb apart were 42.4, 50.4, and 47.4% in one round of viral replication. Because the predicted recombination rate of two unlinked markers is 50%, we conclude that markers 1 kb apart segregated in a manner similar to that for two unlinked markers in one round of retroviral replication. These recombination rates are exceedingly high even among retroviruses. Recombination rates of markers separated by 1 kb are 4 and 4.7% in one round of spleen necrosis virus and murine leukemia virus replication, respectively. Therefore, HIV-1 recombination can be 10-fold higher than that of other retroviruses. Recombination can be observed only in the proviruses derived from heterozygous virions that contain two genotypically different RNAs. The high rates of HIV-1 recombination observed in our studies also indicate that heterozygous virions are formed efficiently during HIV-1 replication and most HIV-1 virions are capable of undergoing recombination. Our results demonstrate that recombination is an effective mechanism to break the genetic linkage between neighboring sequences, thereby reassorting the HIV-1 genome and increasing the diversity in the viral population.
The Three Educational Ideologies of the British Labour Party, 1997-2001

The dominant academic conclusion about Labour's education policy since 1997 has been that it is mainly a continuation of Thatcherism. This is inadequate. There are three strands of Labour practice in education: a renovated version of social liberalism, a form of weak developmentalism, and a type of new social democracy that is in the mainstream of European thinking on the left. One significant source of ideological diversity in government is now the devolved responsibilities for educational policy that are held by the Scottish Parliament and (to a more limited extent) by the National Assembly for Wales.
Landmark Representation of Shapes and Fisher-Rao Geometry

We develop computational strategies to calculate geodesies and geodesic distances between plane shapes represented by mixture of Gaussians centered at landmark points with a fixed variance with respect to the information-theoretic Fisher-Rao metric. This representation and metric have been investigated recently by Peter and Rangarajan, but a feasible computational approach was not provided. The algorithms developed are applied to shape clustering and the results are compared to those obtained with other methods.