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Digital journalism and its research have evolved significantly over the last twenty-five years. When the first online media were installed on an experimental basis in the mid-1990s, neither media companies nor scientific observers expected them to transform the way journalism operates. However, very soon after these humble beginnings, a seemingly infectious euphoria spread among journalism scholars who hoped to rejuvenate journalism and democracy with the help of user participation and a resulting "dialogue with the audience." Still, many of these promises remained unfulfilled, and this led to considerable disenchantment of academics with online media and user participation during the second decade of the 2000s. Indeed, current journalism scholars exhibit a preoccupation with fears of disinformation and forms of "dark" participation. This essay analyzes the process of co-evolution in digital journalism and academia from the personal perspective of a European scholar. Four broad empirical phases are discussed: (1) niche, (2) euphoria, (3) disillusionment, and (4) doom and gloom. Using this typology, a fifth phase will be suggested to extend the current state of the field. [ABSTRACT FROM AUTHOR]

Despite some changes in how masculinity is portrayed over time, certain disturbing patterns and characteristics continue. Yet, popular media exposure may be the primary way that children and most adults learn about others as well as absorb and internalize social norms, values, and beliefs that are reflected in the way the media is presented and expressed. One disturbing characteristic that is shown in TV series is toxic masculinity. This study aims to study the representation of toxic masculinity in Nate Jacob in the critically acclaimed series Euphoria (2019). In this research, the writers used the qualitative method to gather an in-depth, detailed, and comprehensive portrayal of toxic masculinity based on the characteristics of toxic masculinity proposed by Kupers. This study showed that Nate Jacobs represents Kupers' characteristics of toxic masculinity: misogyny, homophobia, greed, and violent domination. He performs toxic masculinity to prove to himself, symbolically, that he is not like his father. Nate exhibits dominance and violence because of his biggest fear of becoming like his homosexual father

In frontotemporal dementia (FTD), left-lateralized atrophy patterns have been associated with elevations in certain positive emotions. Here, we investigated whether positive emotional reactivity was enhanced in semantic variant primary progressive aphasia (svPPA), an FTD syndrome that targets the left anterior temporal lobe. Sixty-one participants (16 people with svPPA, 24 people with behavioral variant FTD, and 21 healthy controls) viewed six 90-sec trials that were comprised of a series of photographs; each trial was designed to elicit a specific positive emotion, negative emotion, or no emotion. Participants rated their positive emotional experience after each trial, and their smiling behavior was coded with the Facial Action Coding System. Results indicated that positive emotional experience and smiling were elevated in svPPA in response to numerous affective and non-affective stimuli. Voxel-based morphometry analyses revealed that greater positive emotional experience and greater smiling in the patients were both associated with smaller gray matter volume in the left superior temporal gyrus (pFWE

Mental illness in media can shape viewer's beliefs about mental health, help-seeking, and empathic behaviors. The current study sought to investigate how mental health and substance use is depicted in popular media targeted for youth. The visual-verbal video analysis (VVVA) framework was applied to the HBO American drama television series Euphoria to understand how mental illness, substance use, and mental health service use is portrayed, and how characters respond to mental health scenes. Euphoria follows a group of high school students as they navigate adolescence, mental illness and substance use. The VVVA provides a framework for social science and medical researchers to qualitatively analyze multimodal information (e.g., text, cinematography, music and sounds, body language and facial expressions) of visual content. This commentary will briefly describe the VVVA framework, provide an overview of how the framework was applied and adapted to analyze a scene in the television series Euphoria, note similarities and differences to the original VVVA framework, and benefits and drawbacks. The VVVA framework was flexible and effective in coding various elements (e.g., body language, camera angles) in a scene in Euphoria. [ABSTRACT FROM AUTHOR]

This essay explores how engaging linguistic patterns and philosophical aporias in writing has helped me cope with the pains of disillusionment of quotidian life in Lebanon. Three Ps cause and aggravate my illness: the Protests, Pandemic, and Pandæmonium. I name my illness 3P and I seek a rhyming therapy in writing—a 3P-Therapy—to combat my illness of illusion and disillusionment. The pattern of confrontation and self-destruction recurring in the arena of Lebanese politics enables me to trace a linguistic expression of such a pattern in the double consonant 'l' found in the words illness, illusion, and disillusionment (ll appears as the deceptively similar looking 1–1/one to one). I explain that the 'll' as 1–1 represses an inherent strife between self and self on the personal level, simultaneously as it betrays a 1–1 confrontation between self and other on the political level. The Port Blast becomes this force of disillusionment that suddenly makes the euphoria of being Lebanese transfigure into an aporia in which it is hard to determine whether I am alive or dead, having hopeful fears or fearful hopes, being a citizen of the world or a monstrosity of stoic survival. [ABSTRACT FROM AUTHOR]

Objective: To explore the effects of propofol and ciprofol on patient euphoric reactions during sedation in patients undergoing gastroscopy and to investigate potential factors that may influence euphoric reactions in patients. Methods: A total of 217 patients were randomly divided into two groups: the propofol group (P group, n = 109) and the ciprofol group (C group, n = 108). The patients in the P group were given 2 mg/kg propofol, and those in the C group were given 0.5 mg/kg ciprofol. The patients were assessed using the Addiction Research Center Inventory-Chinese Version (ARCI-CV) to measure euphoric reactions at three time points: preexamination, 30 min after awakening, and 1 week after examination. Anxiety, depression, and sleep status were evaluated using appropriate scales at admission and 1 week after the examination. The dream rate, sedative effects, vital sign dynamics, and adverse reactions were documented during the sedation process. Results: After 30 min of awakening, the P group and C group showed no statistically significant differences in the mean morphine-benzedrine group (MBG) score (8.84 vs. 9.09, P > 0.05), dream rate (42.2 % vs. 40.7 %, P > 0.05), or MBG score one week after the examination (7.04 vs. 7.05, P > 0.05). The regression analysis revealed that sex, dream status, Alcohol Use Disorders Identification Test (AUDIT) score, and examination time had notable impacts on the MBG-30 min score. No statistically significant differences were observed in sedative effects, anxiety, depression, or sleep status between the two groups (P > 0.05). The incidence of injection pain and severe hypotension was significantly lower in the C group (P

The aim of our research is to show elements of communicative tolerance, to emphasize the actuality of this problem, to introduce communicative tolerance as a psychological phenomenon, which is especially interested in Psycholinguistics and Sociolinguistics. Methods of the research. The following theoretical methods of the research were used to solve the tasks formulated in the article: a categorical method, structural and functional methods, the methods of the analysis, systematization, modeling and generalization. The method of organizing empirical research was used as an experimental method. The results of the research. We proved that communicative tolerant speech was a means of communication in its form, it was directly related to the mental characteristics and states of the individual (as a manifestation of different feelings: moods, emotions, euphoria, anxiety, frustration, etc.; as a manifestation of the person’s attention: concentration, inattention; as a manifestation of will, determination, confusion, composure; as a manifestation of thinking: doubts, confidence; as a manifestation of imagination: dreams, creative thoughts). Conclusions. In our research we proved that speech behavior was caused by the following social factors: culture, national characteristics, ethics, education and interpersonal communication, which in the process of internalization have become internal components of mental structures. At the same time, the external manifestations of psychophysiological processes of communicative tolerance in human speech behavior are expressed from the phonetic side of speech (as vibration of the person’s voice, timbre modulation, increased tempo, speed of speech reactions).

Objective Individual experience with opioids is highly variable. Some patients with acute pain do not experience pain relief with opioids, and many report no euphoria or dysphoric reactions. In this study, we describe the clinical phenotypes of patients who receive intravenous opioids. Methods This was an emergency department-based study in which we enrolled patients who received an intravenous opioid. We collected 0 to 10 pain scores prior to opioid administration and 15 minutes after. We also used 0 to 10 instruments to determine how high and how much euphoria the patient felt after receipt of the opioid. Using a cutoff point of ≥50% improvement in pain and the median score on the high and euphoria scales, we assigned each participant to one of the following clinical phenotypes: pain relief with feeling high or euphoria, pain relief without feeling high or euphoria, inadequate relief with feeling high or euphoria, and inadequate relief without feeling high or euphoria. Results A total of 713 patients were enrolled, 409 (57%) of whom reported not feeling high, and 465 (65%) reported no feeling of euphoria. Median percent improvement in pain was 37.5% (interquartile range, 12.5%–60.0%). One hundred seventy-eight participants (25%) were classified as experiencing pain relief with euphoria or feeling high, 190 (27%) experienced inadequate relief with euphoria or feeling high, 101 (14%) experienced pain relief without euphoria or feeling high, and 244 (34%) reported inadequate relief without euphoria or feeling high. Conclusion Among patients who receive intravenous opioids in the emergency department, the experiences of pain relief and euphoria are highly variable. For many, pain relief is independent of feeling high.

The psychological reproduction of cocaine’s ability to increase happiness was studied. The first part of this study consisted of building and validating an instrument to measure the stable and transient aspects of happiness via the 10-item Happiness Trait–State Scale (10 HTSS) in a sample of volunteers (N = 128). In the second part, Self-Regulation Therapy (SRT, a procedure based on suggestion and classic conditioning) was applied to all the participants to increase their relaxation during a single session. The relaxation session slightly increased happiness. A subgroup of participants who were cocaine users (N = 33) took part in a second session to reproduce the stimulant and euphoric cocaine effects. That was a “mental” reproduction session to simulate the effects of cocaine. For both conditions, all the participants filled in the 10 HTSS at the beginning and the end of the session to compare scores and to prove if the happiness state increased. For the cocaine condition, happiness markedly increased, especially in comparison to the increase during the relaxation session, for both the total group and the cocaine users group. Although this increase was achieved during a single session, similar previous studies with more continuous training and monitoring suggest that improvement in emotions can be durable and long term.

Summary: Exposure to opioid analgesics due to surgery increases the risk of new persistent opioid use. A mechanistic hypothesis for opioids' abuse liability rests on the belief that, in addition to pain relief, acute opioid treatment improves well‐being (e.g. via euphoria) and relieves anxiety. However, opioids do not consistently improve mood in laboratory studies of healthy non‐opioid users. This observational study determined how two commonly used opioid analgesics affected patients' subjective well‐being in standard clinical practice. Day surgery patients rated how good and how anxious they felt before and after an open‐label infusion of remifentanil (n = 159) or oxycodone (n = 110) in the operating theatre before general anaesthesia. One minute after drug injection, patients reported feeling intoxicated (> 6/10 points). Anxiety was reduced after opioids, but this anxiolytic effect was modest (remifentanil Cohen's d = 0.21; oxycodone d = 0.31). There was moderate to strong evidence against a concurrent improvement in well‐being (Bayes factors > 6). After remifentanil, ratings of 'feeling good' were significantly reduced from pre‐drug ratings (d = 0.28). After oxycodone, one in three participants felt better than pre‐drug. Exploratory ordered logistic regressions revealed a link between previous opioid exposure and opioid effects on well‐being, as only 14 of the 80 opioid‐naïve patients reported feeling better after opioid injection. The odds of improved well‐being ratings after opioids were higher in patients with previous opioid exposure and highest in patients with > 2 weeks previous opioid use (adjusted OR = 4.4). These data suggest that opioid‐induced improvement of well‐being is infrequent in opioid‐naïve patients. We speculate that peri‐operative exposure could increase risk of persistent use by rendering subsequent positive opioid effects on well‐being more likely. [ABSTRACT FROM AUTHOR]

The runner's high is an ephemeral feeling some humans experience during and after endurance exercise. Recent evidence in mice suggests that a runner's high depends on the release of endocannabinoids (eCBs) during exercise. However, little is known under what circumstances eCBs are released during exercise in humans. This systematic review sampled all data from clinical trials in humans on eCB levels following exercise from the discovery of eCBs until April 20, 2021. PubMed/NCBI, Ovid MEDLINE, and Cochrane library were searched systematically and reviewed following the PRISMA guidelines. From 278 records, 21 met the inclusion criteria. After acute exercise, 14 of 17 studies detected an increase in eCBs. In contrast, after a period of long-term endurance exercise, four articles described a decrease in eCBs. Even though several studies demonstrated an association between eCB levels and features of the runner's high, reliable proof of the involvement of eCBs in the runner's high in humans has not yet been achieved due to methodological hurdles. In this review, we suggest how to advance the study of the influence of eCBs on the beneficial effects of exercise and provide recommendations on how endocannabinoid release is most likely to occur under laboratory conditions. [ABSTRACT FROM AUTHOR]

ObjectivesNonpharmacological options to treat pain are in demand, in part to address the opioid crisis. One such option is acupuncture. Battlefield acupuncture (BFA) is an auricular needling protocol currently used to treat pain in the Veterans Health Administration. We aimed to identify the advantages and disadvantages of BFA from providers' perspectives.MethodsWe rely on an inductive qualitative approach to explore provider perceptions through thematic analysis of semistructured interviews with 43 BFA providers across the nation.ResultsWe identified the following themes. Disadvantages included: (1) clinical guidelines are insufficient; (2) patients often request multiple BFA visits from providers; (3) BFA can be uncomfortable; (4) BFA may not be an effective treatment option unless it can be provided "on demand"; and (5) BFA can promote euphoria, which can have deleterious consequences for patient self-care. Perceived advantages included: (1) BFA can simultaneously effectively control pain while reducing opioid use; (2) BFA may alleviate the pain that has been unsuccessfully treated by conventional methods; (3) BFA gives providers a treatment option to offer patients with substance use disorder; (4) BFA helps build a trusting patient-provider relationship; (5) BFA can create the opportunity for hope.ConclusionsProviders perceive BFA to have many benefits, both clinical and relational, including ways in which it may have utility in addressing the current opioid crisis. BFA is easy to deliver and has potential clinical and relational utility. Efforts to better understand effectiveness are warranted.

Background: The utilization of Propofol, a widely used intravenous sedative or anesthetic, is characterized by its quick onset, predictable control, and fleeting half-life during both general anesthesia and intensive care unit sedation. Recent evidence, however, has highlighted propofol's propensity to induce euphoria, particularly in patients undergoing painless procedures such as gastrointestinal or gastric endoscopy. Given its widespread use in patients undergoing such procedures, this study aims to investigate the clinical evidence and factors that may influence propofol-induced euphoria in these settings. Methods: The Addiction Research Center Inventory-Chinese Version (ARCI-CV) scale was administered to 360 patients undergoing gastric or gastrointestinal endoscopy using propofol as a sedative. Patient characteristics including past medical history, depression, anxiety, alcohol abuse, and sleep disturbance were recorded through history taking and assessment using various questionnaires prior to the examination. The euphoric and sedative statuses were assessed at 30 min and 1 week post-examination. Results: The experimental results of a survey of 360 patients who underwent gastric or gastrointestinal endoscopy using propofol showed that the mean Morphine-Benzedrine Group (MBG) score before the procedure and after 30 min of the procedure was 4.23 and 8.67, respectively. The mean Pentobarbital-Chlorpromazine-Alcohol Group (PCAG) score before the procedure and after 30 min of the procedure was 3.24 and 6.22, respectively. These results showed that both MBG and PCAG scores increased significantly after the procedure. Certain factors, such as dreaming, propofol dose, duration of anesthesia, and etomidate dose, were all correlated with MBG both at 30 min and 1 week after the examination. In addition, etomidate had an effect of decreasing MBG scores and increasing PCAG scores both at 30 min and 1 week after the examination. Conclusion: Taken together, propofol may elicit euphoria and potentially contribute to propofol addiction. There are several risk factors for the development of propofol addiction, including dreaming, propofol dose, duration of anesthesia, and etomidate dose. These findings suggest that propofol may have a euphoric effect and may have the potential for drug addiction and abuse. [ABSTRACT FROM AUTHOR]

The affective states of animals comprise a key aspect of welfare that can be difficult to assess. An attention-bias test was developed for sheep, which assessed allocation of attention between a predator threat and a food reward, as a potential measure of affective state. The method was pharmacologically validated as a measure of anxiety-like states, finding that 'anxious' sheep were more vigilant, less likely to feed and spent more time looking towards the previous location of a dog than did 'calm' sheep. Across six further validation studies, the method was modified and explored as a measure of other types of affective states. This perspective article aims to provide guidance on what the method can tell us about affective state and make recommendations for further research by using this approach. Evidence was strongest across the studies for the test as a measure of anxiety-like states, but it is clear that there are other factors affecting animal behaviour during testing that need to be further investigated. One study showed potential for a modified method to assess depression-like states in sheep, while the impact of chronic stress on affect and attention bias remains unclear. It is likely that the test cannot be used to measure positive affect in sheep without further modification, due to the fear-eliciting nature of the test. Versions of the method using food as a positive stimulus allow for a clearer interpretation of attention than do versions using a conspecific photograph, and are recommended for use in future studies where appetite is not expected to be a confounding factor. In this context, vigilance behaviour may indicate trait anxiety or fearfulness, while other measures of attention may be more sensitive to transient changes in affect. Modifications to the method are suggested to allow for a clearer characterisation of attention in livestock species and to improve the practical application of the test. Overall, the attention-bias test shows promise as a measure of negative affective states, but the method is still very new and further research is needed to better determine its potential use as a welfare-assessment tool. Tools that consider the emotional states of livestock are needed for comprehensive welfare assessment. We examined a relatively new method called the attention-bias test, finding that it may provide a practical measure of negative emotional states and trait fearfulness in sheep and other livestock species. The attention-bias test can potentially be used in further research to better understand how management practices and environments affect livestock welfare, with an ultimate aim to improve welfare outcomes on-farm. [ABSTRACT FROM AUTHOR]

Voice-over narration features in various ways in contemporary TV series. One recent series that employs voice-over extensively is HBO’s Euphoria. In the series, the protagonist, Rue, narrates repeatedly in each episode of the first season and critics have labelled her voice-over with terms such as “unreliable” or “omniscient”. The aim of this article is to analyze the uses of character voice-over in Euphoria and to argue that such analysis require examining the theoretical terminology often applied to film and TV voice-overs. The article argues that character voice-over should not be defined based on a structuralist narratological conception of the narrator. Rather, voice-over should be approached within a framework of narrative rhetoric and viewed as a medium-specific rhetorical resource. The proposed view, as opposed to one classifying different types of voice-over narrators, is better able to explain how voice-over works in serial storytelling and how this resource is employed in Euphoria to create different effects and affect the audience in different ways.

This article draws on Heidegger's notion of Stimmung (mood, attunement, atmosphere) to further develop the study of public moods in IR. To that end, it synthesises two recent developments in ontological security studies (OSS), the decentred Deleuzian approach that emphasises the role of affective environments in subjects' sense of and search for ontological security and Heideggerian readings of anxiety as (public) mood. The developed framework maintains OSS' conceptual focus on anxiety whilst centring the locus of analysis around dynamic affective environments rather than individual subjects. This framework allows for exploring the relationship between anxiety and the radical agency, emerging political subjectivities, and intense (positive) moods it can facilitate. The empirical added value of this framework is illustrated through an analysis of the public mood of anxiety that preceded and enabled the "border opening" in Germany during the so-called migration crisis and the subsequent euphoria it engendered. [ABSTRACT FROM AUTHOR]

Recent anti‐LGBTQ+ discourse has increased the threat of violence against people who do not follow the cisheteronormative mandates. To face these dialectics, the media can offer alternative discourses, in particular by providing realistic and non‐stereotyped LGBTQ+ representations. Media portrayals can be seen as both positive and negative. On one hand, they may offer stereotypical and narrow representations, but on the other, they can include representations that can become aspirational models and improve visibility. The objective of this article is to explore this second perspective by analyzing the representation of Jules, a trans female character from the American series Euphoria (Levinson et al., 2019–present). To this end, we conducted a close reading analysis (Castelló, 2008) of the first season of the series. The results show three axes of representation that move away from the traditional portrayal of trans characters: (a) a narrative that moves beyond the “trans fact” and presents complex and plural stories, (b) a representation of the trans individual as an element of value and love, away from fetishism, and (c) a link between the trans realm and specific spaces of comfort and freedom.

• The dynamic time warping method is useful for predicting the end of the euphoria phase. • The AI market is not currently in the euphoria phase. • The AI market experienced a phase of euphoria due to COVID-19. The article investigates the existence of a price bubble in the artificial intelligence market, employing the Generalised Supremum Augmented Dickey-Fuller test and dynamic time warping methodology. It proposes a method to detect the end of the price bubble euphoria phase, generating an average profit of close to 7 % over 5 days and over 10.5 % over 20 days, with almost 90 % effectiveness. The study found that the AI market experienced a phase of euphoria due to the COVID-19 pandemic. Four companies – META PLATFORMS, WORKDAY, SALESFORCE and NVIDIA CORPORATION – were identified, whose stock prices currently resemble the euphoria phase. [ABSTRACT FROM AUTHOR]

In frontotemporal dementia (FTD), left-lateralized atrophy patterns have been associated with elevations in certain positive emotions. Here, we investigated whether positive emotional reactivity was enhanced in semantic variant primary progressive aphasia (svPPA), an FTD syndrome that targets the left anterior temporal lobe. Sixty-one participants (16 people with svPPA, 24 people with behavioral variant FTD, and 21 healthy controls) viewed six 90-sec trials that were comprised of a series of photographs; each trial was designed to elicit a specific positive emotion, negative emotion, or no emotion. Participants rated their positive emotional experience after each trial, and their smiling behavior was coded with the Facial Action Coding System. Results indicated that positive emotional experience and smiling were elevated in svPPA in response to numerous affective and non-affective stimuli. Voxel-based morphometry analyses revealed that greater positive emotional experience and greater smiling in the patients were both associated with smaller gray matter volume in the left superior temporal gyrus (pFWE < .05), among other left-lateralized frontotemporal regions. Whereas enhanced positive emotional experience related to atrophy in middle superior temporal gyrus and structures that promote cognitive control and emotion regulation, heightened smiling related to atrophy in posterior superior temporal gyrus and structures that support motor control. Our results suggest positive emotional reactivity is elevated in svPPA and offer new evidence that atrophy in left-lateralized emotion-relevant systems relates to enhanced positive emotions in FTD. [ABSTRACT FROM AUTHOR]

This paper seeks to address the 'black hole' in the literature on addiction: the experience of drunkenness. Intoxication is the starting point for addiction. It is the spell that bewitches addicts. Using the philosophical insights of Merleau-Ponty I will examine the way that alcohol distorts our perception and changes our relationship with our bodies. [ABSTRACT FROM AUTHOR]

Objectives: Some opioid-naïve patients with acute musculoskeletal pain who are treated with opioids develop persistent opioid use. The impact of opioid-induced euphoria on this transition to persistent use has not been explored. We determined whether opioid-induced euphoria could be measured as a phenomenon distinct from relief of pain.Methods: Patients with acute pain were randomized to receive oxycodone/acetaminophen (Oxy) or acetaminophen (APAP). We measured pain using a 0-10 verbal scale. To assess euphoria, participants provided a 0-10 response to each of these: 1) How good did the medication make you feel?; 2) How high did the medication make you feel?; 3) How blissful did the medication make you feel? We analyzed these data using successive multivariable linear regression models, in which each of these items was the dependent variable, and improvement in pain and medication were the independent variables, while controlling for age and sex.Results: 75 were randomized to Oxy, 76 to APAP. Mean "how good" scores were 6.3 (SD 3.3) in the Oxy group and 4.8 (3.3) in the APAP group. Mean "how high" scores were 3.8 (3.7) in the Oxy group and 2.0 (3.0) in the APAP group. Mean "how blissful" scores were 4.9 (3.7) in the Oxy group and 3.1 (3.4) in the APAP group. After controlling for improvement in pain, age, and sex, the between-group difference in "how good" was 1.0 (95%CI: -0.1, 2.0), "how high" 1.5 (95% CI 0.4, 2.6), and "how blissful" 1.5 (95%CI: 0.4, 2.7).Discussion: "How high" and "how blissful" but not "how good" were associated with opioid use after controlling for improvement in pain. [ABSTRACT FROM AUTHOR]

Along with the other tourism writings, travel guides are the result of a socio-discursive practice, since they are created in professional situations. As a social activity, the travel guide introduces, within the framework of human exchanges, a specific type of discourse which shares certain characteristics with other genres, while maintaining a specificity that distinguishes it from the others. The question that arises is: "What are the characteristics that contribute to the conceptualization of the notion of discourse, especially tourism discourse?". This paper relates to the theoreticalmethodological journey carried out during my PhD thesis, as part of the analysis of the travel guide’s tourism discourse. Our paper, situated within the written discourse analysis, aims to answer the question: "Which are the features shared with other types of discourse and which are the characteristics specific to tourism discourse?". The aim is to provide an overview of this type of discourse.

Joo Yong Lee, Hyeon Tae Kim, Jeong Moon Won, Young Duck Shin Department of Anesthesiology and Pain Medicine, Chungbuk National University Hospital, College of Medicine, Chungbuk National University, Cheongju, KoreaCorrespondence: Young Duck Shin; Hyeon Tae KimDepartment of Anesthesiology and Pain Medicine, Chungbuk National University Hospital, 776, 1 Sunhwan-Ro, Seowon-Gu, Cheongju, Chungbuk 28644, KoreaTel +82-43-269-6234; +82-43-269-6988Fax +82-43-272-0264Email yydshin@naver.com; gskht@naver.comAbstract: Lidocaine is a cost-effective drug that is widely used for local and regional anesthesia. However, central nervous system (CNS) toxicity can occur when lidocaine is administered above the maximum recommended dose (approximately 4.5 mg/kg) or if lidocaine is injected intravascularly rather than administered locally. Systemic toxicity by lidocaine has been reported in several studies. However, psychotic reactions due to lidocaine have been rarely reported; furthermore, reports of lidocaine-related euphoria are very rare. We report a very rare case of euphoria caused by CNS toxicity that occurred during the local administration of lidocaine at the therapeutic dose. Therefore, anesthesiologists should be aware of the severe side effects of local anesthetics despite administering the appropriate dosage at the appropriate location. Future studies should investigate pharmacokinetics to determine the safety profile of local anesthetics.Keywords: euphoria, lidocaine, adverse effects, nerve block

Along with the other tourism writings, travel guides are the result of a socio-discursive practice, since they are created in professional situations. As a social activity, the travel guide introduces, within the framework of human exchanges, a specific type of discourse which shares certain characteristics with other genres, while maintaining a specificity that distinguishes it from the others. The question that arises is: "What are the characteristics that contribute to the conceptualization of the notion of discourse, especially tourism discourse?". This paper relates to the theoretical-methodological journey carried out during my PhD thesis, as part of the analysis of the travel guide's tourism discourse. Our paper, situated within the written discourse analysis, aims to answer the question: "Which are the features shared with other types of discourse and which are the characteristics specific to tourism discourse?". The aim is to provide an overview of this type of discourse. [ABSTRACT FROM AUTHOR]

Disruptions in emotional, cognitive, and social behavior are common in neurodegenerative disease and in many forms of psychopathology. Because neurodegenerative diseases have patterns of brain atrophy that are much clearer than those of psychiatric disorders, they may provide a window into the neural bases of common emotional and behavioral symptoms. We discuss five common symptoms that occur in both neurodegenerative disease and psychopathology (i.e., anxiety, dysphoric mood, apathy, disinhibition, and euphoric mood) and their associated neural circuitry. We focus on two neurodegenerative diseases (i.e., Alzheimer's disease and frontotemporal dementia) that are common and well characterized in terms of emotion, cognition, and social behavior and in patterns of associated atrophy. Neurodegenerative diseases provide a powerful model system for studying the neural correlates of psychopathological symptoms; this is supported by evidence indicating convergence with psychiatric syndromes (e.g., symptoms of disinhibition associated with dysfunction in orbitofrontal cortex in both frontotemporal dementia and bipolar disorder). We conclude that neurodegenerative diseases can play an important role in future approaches to the assessment, prevention, and treatment of mental illness.

Bruce Parsons,1 Rainer Freynhagen,2,3 Stephan Schug,4,5 Ed Whalen,1 Marie Ortiz,1 Pritha Bhadra Brown,1 Lloyd Knapp61Pfizer Inc, New York, NY, USA; 2Department of Anesthesiology, Critical Care Medicine, Pain Therapy & Palliative Care, Pain Center Lake Starnberg, Benedictus Hospital, Tutzing, Germany; 3Department of Anesthesiology, Klinikum rechts der Isar, Technische Universität München, Munich, Germany; 4Discipline of Anaesthesiology and Pain Medicine, Medical School, University of Western Australia, Perth, WA, Australia; 5Department of Anaesthesia and Pain Medicine, Royal Perth Hospital, Perth, WA, Australia; 6Pfizer Inc, Groton, CT, USACorrespondence: Bruce ParsonsPfizer Inc, 235 East 42nd Street, New York, NY, USATel +1 212 573 1649Email bruce.parsons@pfizer.comBackground: Euphoria is a complex, multifactorial problem that is reported as an adverse event in clinical trials of analgesics including pregabalin. The relationship between the reporting of euphoria events and pregabalin early treatment responses was examined in this exploratory post-hoc analysis.Methods: Data were from patients with neuropathic or non-neuropathic chronic pain enrolled in 40 randomized clinical trials, who received pregabalin (75–600 mg/day) or placebo. Reports of treatment-emergent euphoria events were based on the Medical Dictionary of Regulatory Activities preferred term “euphoric mood”. Prevalence rates of euphoria events overall and by indication were assessed. Post-treatment endpoints included ≥30% improvements in pain and sleep scores up to 3 weeks as well as a ≥1-point improvement in daily pain score up to 11 days after treatment.Results: 13,252 patients were analyzed; 8,501 (64.1%) and 4,751 (35.9%) received pregabalin and placebo, respectively. Overall, 1.7% (n=222) of patients reported euphoria events. Among pregabalin-treated patients, a larger proportion who reported euphoria events achieved an early pain response compared with those who did not report euphoria (30% pain responders in week 1 with euphoria events [43.0%], without euphoria events [24.2%]). Results were similar for weeks 2 and 3. For Days 2–11, a larger proportion of pregabalin-treated patients with (relative to without) euphoria events were 1-point pain responders. Findings were similar in pregabalin-treated patients for sleep endpoints (30% sleep responders in week 1 with euphoria events [50.7%], without euphoria events [36.1%]). Similar results were found for weeks 2 and 3. Patients who received placebo showed similar patterns, although the overall number of them who reported euphoria events was small (n=13).Conclusion: In patients who received pregabalin for neuropathic or non-neuropathic chronic pain, those who experienced euphoria events may have better early treatment responses than those who did not report euphoria events.Keywords: euphoria, pain, pregabalin, sleep

BackgroundAbuse liability assessments influence drug development, federal regulation, and clinical care. One suggested procedure to reduce variability of assessments is a qualification phase, which assesses whether study applicants adequately distinguish active drug from placebo; applicants failing to make this distinction are disqualified. The present analyses assessed differences between qualification phase qualifiers and non-qualifiers.MethodsData were collected from 23 completers of the qualification phase of an abuse liability study. Opioid abusing participants received 30 mg oxycodone and placebo orally on separate days, and were characterized as qualifiers (vs. non-qualifiers) if their peak visual analog scale liking rating for oxycodone was at least 20 points higher than placebo's peak rating. Groups were compared on demographic characteristics, drug history, and physiologic, subject and observer ratings.Results61% of participants were qualifiers and 39% were non-qualifiers. Groups had similar demographic characteristics, drug use histories, and pupillary constriction responses. However, unlike qualifiers, non-qualifiers had an exaggerated placebo response for the liking score (p=0.03) and an attenuated oxycodone response for the liking score (p

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