bluuebunny/crossref_metadata_2025_split huggingface dataset:
Assessment and Management of Opioid-Induced Constipation, 95 Susan Derby and Russell K. PortenoyOpioid-Induced Constipation
Authors: Derby Susan , Portenoy Russell K 
Published: November 2023

Abstract
In 1995, approximately 547,000 people in the U.S. died of cancer and several million lived with their disease.1 Of those with metastatic solid tumors, more than two thirds had pain severe enough to necessitate opioid therapy. Opioid analgesics are highly effective, but produce side effects that may limit therapy or contribute to impaired quality of life. Constipation, a particularly common side effect with multiple contributing etiologies, may be difficult to treat. Constipation should be defined as a symptom (that is, a subjective phe­ nomenon) characterized by diminished frequency of defecation associated with difficulty or discomfort. It is usually distressing when present, and occasionally poses serious risks. Associated symptoms include abdominal pain, bloating and distention, and sometimes anorexia and nausea. Untreated constipation may progress to obstipation, which may potentially lead to life­ threatening complications associated with bowel obstruction. Constipation is also a risk factor for intestinal perforation in patients receiving corticosteroids for the management of intracranial lesions.
Clinical Implications of Morphine Metabolites
Authors: Sj0gren Per 
Published: November 2023

Abstract
Morphine is the most widely used opioid analgesic and remains the “gold standard” when the effects of other analgesic drugs are to be compared. Mor­ phine is a hydrophilic phenanthrene alkaloid, which is a natural constituent of opium. With its pKa of 7.9, 23% is unprotonized in plasma at physiological pH. About 30% of morphine is bound to plasma proteins. In humans, the mean volume of distribution ranges from 1.2 to 6.2 Ukg, the mean elimination half-life ranges from 1.7 to 4.5 hours, and the mean clearance ranges from 6.4 to 23 Ukg/min.1,2 Absorption after parenteral administration averages 90% within 45 minutes, whereas oral bioavailability is low and variable (15%- 65%).3,4 In humans the predominant metabolic pathway for morphine is glu­ curonidation. 5 The high hepatic extraction rate of 0.7 indicates the important first-pass effect and explains the low oral bioavailability. To a much lesser extent, biotransformation takes place in the kidneys and lungs. The glu­ curonides, which are the main metabolites, are eliminated via bile and urine. Smaller amounts are excreted via sweat and breast milk. Ninety percent of the total elimination takes place within one day. The conjugation rate seems to increase gradually during chronic use of morphine.
The Emerging Role of the Fentanyl Series in the Treatment of nChronic Cancer Pain
Authors: Gauthier Michaele. , Fine Perry G 
Published: November 2023

Abstract
Historically, the fentanyl series of opioid analgesics was not developed with chronic pain indications in mind. The driving force for synthetic opioid re­ search and development during the past three decades has centered around surgical anesthesia needs. Fentanyl only recently emerged in a formal manner outside the operating theater.
Neuropathic Cancer Pain: Syndromes And Clinical Controversies
Authors: Moulin Dwight E 
Published: November 2023

Abstract
Neuropathic cancer pain can be due to direct tumor infiltration of neural structures or to secondary effects produced by treatments of the underlying neoplasm. Neuropathic pain due to the former etiology is present in 20%-30% of patients attending specialized cancer pain centers, and pain due to the latter occurs in about 10% of attendees. Although patients with neuropathic pain due to tumor infiltration clinically resemble those with neuropathic pain arising from nonmalignant causes, there are important differences between these populations. Neuropathic cancer pain is almost always accompanied by other pain syndromes, including bone pain and visceral pain:3 Tumor infiltration usually implies progressive incurable disease, inevitably leading to loss of motor, sensory, and autonomic function. Relentless disability that is obvious to the patient and the physician, and the knowledge that the disease process is ultimately fatal, adds a major suffering component to the pain syndrome that must be addressed.4 Finally, the dynamics of progressive nerve injury attributable to tumor infiltration may impact on the pathophysiology of neuropathic pain in a way that is not present following monophasic nerve injury (e.g., trauma), and this also has implications for treatment.
Adjuvant drugs for neuropathic cancer pain
Authors: Hewitt David J , Portenoy Russell K 
Published: November 2023

Abstract
Neuropathic pain refers to any syndrome in which pain is imputed to have a pathophysiology related to aberrant somatosensory processing in the peripheral or central nervous systems. Neuropathic pain can result from injury to nervous tissue at any point along afferent pathways, including peripheral nerves, nerve plexus, nerve root, spinal cord, brainstem, thalamus, or cortex. Cancer can produce neuropathic pain through direct compression or invasion of neural structures by tumor or by injury caused by antineoplastic therapies. These therapies include neurotoxic drugs (e.g., vinca alkaloids, cisplatinum, and paclitaxel), radiation, and surgery.
The Reversible Causes of Asthenia in Cancer Patients
Authors: Cleary James F 
Published: November 2023

Abstract
Although asthenia is a relatively new term in oncology, the symptoms that it encompasses have long been recognized as part of the clinical presentation of cancer. Asthenia is derived from the Greek: a (absence) thenia (strength) and is defined as a lack of strength, diminution of vital power, weakness, debility (Oxford English Dictionary). For many years, “asthenia” has been considered to be a natural concomitant of malignant neoplasms and it was suggested that asthenia may be a form of carcinomatous myopathy.
The Spectrum of Grief in Palliative Care
Authors: Katz Laurence , Chochinov Harvey Max 
Published: November 2023

Abstract
The experience of losing a loved one as a result of death is an inevitable part of adult life. It has been estimated that for every person who dies, at least jive close friends, relatives, and loved ones are left behind. The annual incidence of bereavement in the population is estimated at between 5% and 9%. Because of the nature of progressive medical illness, a substantial portion of the newly bereaved will have been intimately involved with the deceased during their medical treatment. It is a salient aspect of grief in this situation that there is usually a period of anticipatory grieving preceding the death. This presents an opportunity and an obligation for palliative care teams to combine care and comfort of the patient with guidance and assessment of the family through the final phases of terminal illness and death. If this is done with understanding, concern, and sensitivity, this care can substantially benefit the subsequent grieing process.
Treatment of Symptoms Other Than Pain in Pediatric Palliative Care
Authors: Levetown Marcia 
Published: November 2023

Abstract
The frequency of various symptoms among pediatric palliative care patients largely depends on the site of the survey. If patients are assessed following admission to a specialized program, the philosophy of the program influences the mix of patients and, consequently, the prevalence of symptoms. In England, for example, where patients are qualified for admission early in the disease process, there is a very large proportion of patients with slowly degenerative disorders, such as Sanfilippo syndrome, a metabolic disorder. This disease causes thickened facial features, progressive loss of intellect and other central nervous system functions, and seizures. Accordingly, a high proportion of English patients have this type of symptomatology.
Surgical Palliation of Malignant Bone Pain
Authors: Frassica Frank J , Frassica Deborah Anne , Lietman Steven A , Huckell Cameron A , Kostuik John P , Chao Edmund Y S , Sim Franklin H 
Published: November 2023

Abstract
Bone metastases are the third most common site of metastases. Although lung and liver metastases are more common, destructive lesions of the skeleton often cause more problems for the patient than do visceral metastases. A marked reduction in the quality of life can occur when bone metastases are not managed in an aggressive fashion to prevent fractures, pain and neurologic deficits. Patients may despair when they lose their independence as a result of uncontrolled bone metastases. Surgery is an important adjunct to maintain the independence of the patient with bone metastases. Surgical treatment is centered on three principal areas: prevention and treatment of long bone fractures, reconstruction of major joints, and reconstruction of the spine (with or without decompression) to restore structural stability. Patients must be carefully evaluated prior to surgery and during the perioperative period to minimize the risk of complications.
From Sadness to Major Depression: Assessment and Management in Patients with Cancer
Authors: Porter Maryfrances R , Musselman Dominique L , Mcdaniel J Stephen , Nemeroff Charles B 
Published: November 2023

Abstract
Mental health professionals face the challenge of differentiating expected emotional distress associated with a cancer diagnosis (such as sadness, grief, and bereavement) from the disabling psychiatric disorder of major depression. To manage patients appropriately, professionals must contend with patients’ hurried schedules and sudden hospitalizations, educate family members, negotiate complex medication regimens, and interact with a multidisciplinary treatment team. Skillful diagnosis and careful attention to management strategies are needed to optimize care.
Symptom Control in Patients with Severe Character Pathology
Authors: Passik Steven D , Hay Jennifer L 
Published: November 2023

Abstract
Living with life-threatening illness presents all patients with profound physical and emotional challenges. Physically, they must often adapt to painful, uncomfortable, invasive, or exhausting treatment regimens, and they may experience increasing bodily or cognitive decline. Emotionally, patients must contend with reactions such as shock, fear, anxiety, or sadness upon learning their diagnosis, and then make the necessary changes required to live with it. Such emotional reactions are to be expected, even in the psychologically healthy. Indeed, a prevalence study of psychiatric disorders in cancer patients found that emotional distress was quite common: nearly half (47%) of assessed inpatients and outpatients had levels of emotional disturbance that could be classified as a psychiatric disorder.
Palliative Care and the Clinical Approach to Disorders of the Skin
Authors: Hale Lloyd R , Ryan Terence J 
Published: November 2023

Abstract
In the context of palliative care, several new concepts guide the management of skin disease. First, the disease processes that contribute to skin failure in the severely ill result in functional impairment of the skin and consequent handicap. Management may focus on attempting to cure or diminish the causes of skin failure, or it may address the specific impairments. Mostly, it attempts to relieve handicap. Second, one of the principal functions of the skin is communication. Isolation, loss of confidence, and the feeling of being unwelcome are perhaps the worst handicaps. Remedies include touch, camouflage, the prescription of a prosthesis (after mastectomy, for example) or a wig, and the teaching of communication skills. The “look good, feel good” factor is an important component of well-being, and hence, of health. It is a neglected factor in most “Health for All” documents, although it is quite well recognized in the cancer management literature.
What went wrong?: Derailed Encounters
Authors: Korsch Barbara M , Harding Caroline 
Published: November 2023

Abstract
Have you ever gotten into an actual argument with your doctor? While out and-out battles are an extreme, most of us have, at one time or another, felt dissatisfied with a visit to the doctor even though things seemed to go well on the surface. Intrinsically, the doctor-patient encounter is fraught with risks and pitfalls. All too often, both fail to realize their potential. The patient is anxious, the doctor usually isn’t. The problem they are there to deal with is a personal threat to the patient and a professional challenge to the doctor. At the beginning of the visit, each has a completely different viewpoint. The perceptions and emotions they experience are very different. Their knowledge base, values, and very often their goals are different. So incongruence is inevitable.
Getting the Most Out of Managed Care
Authors: Korsch Barbara M , Harding Caroline 
Published: November 2023

Abstract
In the past, patients were often kept in the hospital too long. It’s a lot easier, for instance, for a doctor to see a series of patients between 7:30 and 8:00 A.M. and send them each a bill than to schedule them all separately in the office. And you may not realize that for a hospital, in view of all the services that have to be available at all times, there is nothing more expensive than keeping an empty bed. But that reason for hospitalization is no longer acceptable under managed care.
But What Have You Done for Us Lately? Some Recent Perspectives on Linguistic Nativism
Authors: Green Christopher D , Vervaeke John 
Published: November 2023

Abstract
The problem with many contemporary criticisms of Chomsky and linguistic nativism is that they are based on features of the theory that are no longer germane; aspects that either have been superseded by more adequate proposals, or dropped altogether under the weight of contravening evidence. It is notable that, contrary to the misguided opinion of many of his critics, Chomsky has been more willing than the vast majority of psychological theorists to revise and extend his theory in the face of new evidence. His resistance to the proposals of those of his early students and colleagues who banded together under the name “generative semantics” was not, as is widely believed, a matter of his unwillingness to entertain evidence contrary to his own position. Rather, it was a matter of his unwillingness to entertain vague, ambiguous, and inconsistent theoretical claims. His ultimate victory over generative semantics was grounded squarely in his willingness to alter his theory to bring it more in line with new evidence; and the theory now bears only a modest resemblance to that which he developed in the 1950s and 1960s.
Will Cognitive Revolutions Ever Stop?
Authors: Bruner Jerome 
Published: November 2023

Abstract
I do not write this chapter as an historian of the cognitive revolution. I’m not very good at that sort of thing, and besides, we’re all still too much on the barricades to be historians. Modem historiography teaches one big truth that should sober us. The Past (with a capital letter) is a construction: how one constructs it depends on your perspective toward the past, and equally on the kind of future you are trying to legitimize (see, e.g., Mink, 1978).
Analyzing Temporal Factors in Urban Morphology Development
Authors: Campari Irene 
Published: November 2023

Abstract
There is nothing continuous. Continuous is only the present. Urban morphologies have been described as provided with a strong structural stability. The stability is due to some persistent basic forms of urban components as well as to some topological relations between them. The disciplines that deal with urban development have adopted the historical model of time to temporally define events and actions about the modifications of urban spaces. This model applied to events and actions, defines temporally by dates only the causes of urban space modifications. This leads to an accumulation of historical details on the causes of morphological modifications. This accumulation often is done without any reference to a process model that should account for the factors that make the configuration of an urban space constant in time.
Alcoholism in Russia: The Enemy Within
Authors: Bratus Boris S 
Published: November 2023

Abstract
It was spring 1985 when Gorbachev assumed the post of general secretary of the Communist Party of the Soviet Union. Neither the Soviet people nor the rest of the world knew that Gorbachev’s era would mean the end of the Soviets, the end of socialist rule in Eastern Europe, and the destruction of the Berlin Wall that had come to symbolize the impenetrable Soviet empire. The only major change that Gorbachev announced soon after he assumed office was the start of a rigorous anti-alcohol campaign. Ironically, this was to be the last purely Soviet campaign, and it was launched in traditional Bolshevik style-a sudden and surprise attack of grand scale against a long-time enemy. Students of history will recognize that the anti-alcohol campaign did not originate with Gorbachev. The Central Committee of the Communist Party of the Soviet Union (CPSU) had already planned the campaign before Gorbachev took office. Although in the minds of most Soviet citizens the campaign against the use of alcohol is associated with Gorbachev, most are aware that it was really the brainchild of the secretary of ideology, Egor Ligachev.
lnterethnic Intolerance in Post-Soviet Ukraine
Authors: Golovakha Evgueny , Panina Natalya 
Published: November 2023

Abstract
The population of modern Ukraine is an uneven mix of various ethnicities. According to the last general census (1989), the 51.5 million Ukrainians are composed of72.7 percent Ukrainian nationals, 22.1percent Russians, .9 percent Jews, and 4.3 percent “other.” Although Ukrainian history contains less of the sort of interethnic conflict that resulted in armed rebellions than occurred in other parts of the former Soviet Union, recent events have caused increased tensions among the ethnic groups in modern Ukraine. Several ethnic groups have been forced to move to Ukraine because of conditions caused by the breakup of the Soviet Union. For example, the Crimean Tartars have been resettling in Ukraine, which has caused problems as they adapt to life in a new country. The bigger problem, however, is the unknown consequences of the “Ukrainization” policy that makes Ukrainian the official language of this newly independent country. Of course, ethnic Russians who have been living in Ukraine are worried about the change in language because only those who are fluent in Ukrainian will be able to hold high-level positions in government, academia, and political life. There are also large numbers of ethnic Ukrainians, especially in East Ukraine, whose mother tongue is Russian. They fear that they will be outcasts in their own country because of the new language requirements. Members of this large group have an ambivalent identification with modern Ukraine because their parents or grandparents decided to make the dominant language of their time Russian, which was taught and learned at home, in the belief that this choice was in the best interest of their offspring.
Conspecific Brood Parasitism, Population Dynamics, and the Conservation of Cavity-Nesting Birds
Authors: Eadie John , Sherman Paul , Semel Brad 
Published: November 2023

Abstract
A substantial number of bird species nest or roost in cavities (9-18% of all species in Europe, North America, southern Africa, and Australia). More than half of these are obligate cavity-nesters (Newton, 1994a,b). A central conservation problem facing many species is loss of breeding habitat. Considerable evidence, both observational and experimental, indicates that populations of hole-nesting birds frequently are limited by shortages of suitable nesting cavities (von Haartmann, 1957; Brush, 1983; Brawn and Baida, 1988; Bock et al., 1992; Newton, 1994a,b). Development, and the removal of large, mature timber and snags (dead trees) for commercial purposes, exacerbate these shortages. The problem is most acute for secondary cavity-nesting birds, which rely on primary cavity excavators (mainly woodpeckers), physical damage (from storms), or natural tree rot to produce cavities of sufficient size and quality.
The Evolved Psychological Apparatus of Human Decision-Making Is One Source of Environmental Problems
Authors: Wilson Margo , Daly Martin , Gordon Stephen 
Published: November 2023

Abstract
It has become increasingly difficult to ignore or deny the fact that the Earth’s biota are in crisis. The abundance and diversity of flora and fauna have been and are being diminished at an accelerating pace, both as a direct result of human exploitation and as an indirect result of habitat loss and environmental degradation (Wilson, 1992). Despite the efforts of parties with economic interests antagonistic to conservation, it is no longer possible for informed citizens to doubt the reality of these trends, nor is there reason to doubt that the diversity and abundance of species will continue to decline for some time as a result of human numbers and activities. What is controversial is what to do about it (Clark, 1991).
A Brief History of the Flute
Authors: Toff Nancy 
Published: November 2023

Abstract
The history of music for the flute and the history of the instrument itself are intimately related. For the modern flutist, therefore, familiarity with the history of the instrument helps in understanding how its physical characteristics determined the technical content and stylistic features of the music. Particularly since 1700, the structural and mechanical development of the flute correlates quite closely with developments in musical composition and performance practice. Needless to say, the correlation is not coincidental. The history of the flute naturally divides itself into two distinct, though chronologically overlapping, phases, that of the “German” or “old system” flute and that of the Boehm flute. What would seem obvious designations, A.B. and P.B. (Ante Boehm and Post Boehm), do not strictly apply, however, because the Boehm flute, like most new inventions, did not gain immediate public acceptance.
Tone
Authors: Toff Nancy 
Published: November 2023

Abstract
“The tone is the voice without which one cannot even begin to sing,” wrote Theobald Boehm in The Flute and Flute-Playing. 1 One needs no higher authority to assert the status of flute tone as the most important element of flute playing. It is the flute’s tone that gives the instrument its distinctive quality. Historically, tone has been the reason for the flute’s popularity among players and listeners alike. Tone, wrote the great English flutist Charles Nicholson, is “the proudest boast of the instrument.”
Articulation
Authors: Toff Nancy 
Published: November 2023

Abstract
Articulation, says the dictionary definition, is “the art or process of speaking.” The definition applies to flute playing just as it applies to verbal utterance. The components-breath, rhythm, accent, phrasing, termination, and silence-are the same, as are the tools-the respiratory system, lips, and tongue. The intellectual process, too, is similar, whether it forms verbal syllables into words, phrases, and sentences or joins musical notes into phrases, periods, and movements. Articulation is not just tonguing, as most wind players define it, but something much broader, and more akin to what we generally think of as phrasing. Articulation is a method of joining musical tones, determining their beginnings and ends and the relationships between individual notes and those around them. Therefore, while this chapter will discuss the usual, narrow definition of articulation-the physical motion of the tongue-remember that tonguing, like fingering, is only a tool, which must be informed by a broader musical logic.