A look inside the association codeine-paracetamol: clinical pharmacology supports analgesic efficacy

Acute and chronic pain often requires a multimodal approach. Combination therapy reduces the number of individual daily administrations and improves patient's compliance with the prescribed analgesic treatment. Despite the association codeine/paracetamol is one of the most widely used central analgesic, the exact mechanism of action, particularly of paracetamol, is still object of pharmacological research. Recent findings showed that paracetamol may act through cerebral cyclo-oxygenase, descending opioidergic inhibitory pathways, serotonin pathway, and the endocannabinoid system; while codeine activity seems to related not only to its conversion to morphine, as previously known, but also by itself and through its metabolites, such as norcodeine (NORC) and codeine-6-glucuronide (C-6-G). The addition of codeine to paracetamol significantly improves the analgesic action and reduces the number needed to treat (NNT) from 5 to 2.3-3.1. Recent warnings about the risk of its metabolism related to CYP450 and its genetic variability in general population should be mainly considered when the association is used in paediatric patients undergoing tonsillectomy and/or adenoidectomy procedures for obstructive sleep apnoea syndrome (OSAS). In adults, the association codeine/paracetamol has been shown to be effective and safe in different settings: acute pain, trauma patients, and chronic nociceptive pain

Using your friends: social mechanics in social games

This paper analyzes the social mechanics in top social games. It identifies several mechanisms by which social games encourage sociality: the friend bar, gifting, visiting, challenge/competition, and communication. Different implementations of these components result in varying gameplay experiences. However, no mechanics were found to offer very deep or sustained social interactions between players

The unsolved case of “bone-impairing analgesics”. The endocrine effects of opioids on bone metabolism

The current literature describes the possible risks for bone fracture in chronic analgesics users. There are three main hypotheses that could explain the increased risk of fracture associated with central analgesics, such as opioids: 1) the increased risk of falls caused by central nervous system effects, including sedation and dizziness; 2) reduced bone mass density caused by the direct opioid effect on osteoblasts; and 3) chronic opioid-induced hypogonadism. The impact of opioids varies by sex and among the type of opioid used (less, for example, for tapentadol and buprenorphine). Opioid-associated androgen deficiency is correlated with an increased risk of osteoporosis; thus, despite that standards have not been established for monitoring and treating opioid-induced hypogonadism or hypoadrenalism, all patients chronically taking opioids (particularly at doses ≥100 mg morphine daily) should be monitored for the early detection of hormonal impairment and low bone mass density

Confronting toxic gamer culture: A challenge for feminist game studies scholars

University of Oregon Librarie

Designing Technology for Different Scales of Irrigation Scheduling

Uncertainty in water availability is a significant challenge to the agriculture industry. Farmers and irrigators depend on novel uses of sensors and data to maximize water efficiency. Documented studies have demonstrated scheduling irrigation is a straightforward, deterministic means of achieving water efficiency. Irrigation scheduling uses several parameters to determine the moment of crop water stress due to available water in the soil. However, sensors and data for soil moisture and matric potential, a parameter describing water available to plants, have the potential to train machine learning algorithms to forecast water irrigation needs based on previous measurements. Satellite remote-sensing is another developing technology that describes the environmental conditions that enable irrigation scheduling and provides data on crop health by allowing for calculations on collected field images. This project trains a learning machine with soil moisture and home-brew tensiometer information. To create a water management system that avoids exposing crops to stress, the learning machine uses previous soil water conditions to forecast crop water demand. This machine learning model informs the farmer of the moment maximum water depletion will occur, providing the farmer opportunity to irrigate in advance of crop water stress conditions. Additionally, this research evaluates the value of soil moisture, matric potential, and trained machine learning against characteristics of the specified agricultural undertaking. Because larger agricultural undertakings can be managed with remote-sensing of crop health, this research investigates the viability of ground-sensing against satellite remote-sensing. Sensor-improvements would be more viable for an urban agriculture system. Understanding scenarios in agriculture to tailor technological development will allow farmers to further maximize crop yield and quality with their increasingly limited water availability

Performing Game Development Live on Twitch

This study is a preliminary exploration of how professional game developers live stream their creative work on Twitch.tv. It asks how and in what ways these developers engage in co-creative acts with their viewers and how they engage in game talk in their design process. It further analyzes discourse about the act of streaming development as presented in professional and popular journalistic and personal sites online

Chronic non-cancer pain: Focus on once-daily tramadol formulations

Despite progress in pain management, chronic non-cancer pain (CNCP) represents still a clinical challenge. The efficacy and safety profile of tramadol make it suitable as a long-term treatment in a variety of CNCP conditions. New once-daily (OD) formulations of tramadol have been marketed in various countries, in order to offer the advantage of a reduced dosing regimen and to improve patients’ compliance. This review focuses on the technology, pharmacology, clinical efficacy, and safety of different once-daily tramadol formulations. Hydrophilic vs hydrophobic matrix systems and newer technologies used in once-daily formulations to control drug delivery are discussed. Three randomized controlled trials (RCTs) established OD tramadol analgesic efficacy to be superior to that of placebo for pain management and functional improvement in patients with osteoarthritis. Three RCTs demonstrated similar rates of efficacy between OD tramadol and immediate-release (IR) or sustained-release (SR) formulations, with a better adverse events profile. An open trial on long term tolerability showed that OD tramadol is generally safe in rheumatological pain treatment