Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P < 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

The fundamental parameter approach of quantitative XRFA investigation of photoelectric absorption coefficients

Zsfassung in dt. u. arab. Sprache14

Spectroscopic Assessment of Platinum Group Elements of PM10 Particles Sampled in Three Different Areas in Jeddah, Saudi Arabia

Platinum group elements (PGE) including Ru, Rh, Pt and Pd have been quantified in air particulate matter with an aerodynamic diameter equal or less than 10 microns (PM10) using inductively coupled plasma mass spectrometry (ICP-MS). PM10 aerosols have been collected from three sites representing various activities in Jeddah city, Saudi Arabia. These locations are residential site with heavy traffic, industrial site and heavy traffic and a light traffic site outside the city. To obtain reasonable data of the PGE concentrations, a group from 10 to 15 PM10 samples were collected every month. The annual and seasonal variation of the mass concentration of the PGE were demonstrated. In all locations, Pt and Pd were relatively higher than Ru and Rh possibly because their main use is in automobile catalytic converters. Concentrations of observed PGE in PM10 could be arranged in ascending order as: Rh < Ru < Pd < Pt. In case of Ru and Pt, there are clear similarities in terms of the overall mean concentrations at the sampling locations. Due to the high concentration of Ru, Rh and Pd at low traffic site, there are certainly other sources of these elements rather than vehicle catalytic converters. However, at the industrial/heavy traffic location, high concentrations of Ru were detected during February 2015. In addition, high Pt concentrations were also detected at the light traffic site during May 2015. Results indicate that Pt source in PM10 is mainly the automobile catalytic converters

Influence of Niobium Pentoxide particulates on the properties of Brushite/Gelatin/Alginate membranes

Novel non-porous membranes were prepared by impregnating of nano-brushite and niobium pentoxide (Nb2O5) into a gelatin/alginate matrix. The physicochemical properties, morphology and mechanical properties of the prepared membranes were characterized using XRD, FTIR, SEM, TEM and universal testing machine, respectively. Swelling ability of the prepared membranes was determined in distilled water. The surfaces of the membranes were characterized by means of FTIR and SEM coupled with EDX after submersion in simulated body fluid (SBF) up to 15 days. Moreover, the calcium and phosphorus ion concentrations in the SBF were measured by UV-spectrophotometer. The in vitro drug release and the release mechanism of a model antibiotic, namely, ciprofloxacin (CFX), were tested in phosphate buffer saline (PBS) for 15 days. The antibacterial activities of the CFX-loaded membranes were tested against known microorganisms. The physicochemical properties, morphology, mechanical properties and swelling ability of the prepared membranes were found to be dependent on the presence of Nb2O5 allowing control of their properties. For example, the Nb2O5-loaded membranes exhibited a higher in vitro bioactivity and slower drug release compared to those of Nb2O5-free membranes. The CFX-loaded membranes also exhibited an excellent inhibition zones against the selected microorganisms. Overall, the prepared membranes have been found to be very promising for use in bone substitute’s applications

Elemental Variability of PM_2.5 Aerosols in Historical and Modern Areas of Jeddah, Saudi Arabia

Air particulate matter with a diameter of 2.5 µm (PM2.5) were assembled for a whole year from the historical Jeddah district. Additional PM2.5 aerosols were collected during the autumn and winter seasons from another newly constructed district in Jeddah city (Alnaeem). The annual concentration of the total mass of the PM2.5 aerosols from the historical Jeddah site was found to be 43 ± 6 µg/m3. In addition, the average of the total mass concentration at the Alnaeem site was 61 ± 14 µg/m3. These values were greater than the annual mass concentration of the air quality standards of the European Commission (25 µg/m3) and the World Health Organization (10 µg/m3). The elemental analysis of the collected fine atmospheric aerosols was achieved by energy dispersive X-ray fluorescence (EDXRF) with three secondary targets (CaF2, Ge, and Mo). Quantitative elemental analyses of twenty-two (22) elements were achieved starting from the low atomic number element (Na) up to the high atomic number element (Pb). Although the historical Jeddah site is not well organized, the elemental concentrations and total mass concentrations were lower than those of the other site. The statistical analyses including enrichment factors, correlation analysis, and the principal component analysis revealed more information about the source identification of the PM2.5 aerosols collected from both locations. It was recognized that the elements Al, Si, K, Ca, Ti, Mn, Fe, Rb, and Sr originated from a natural source. On the other hand, the elements Ta, Br, Pb, Sc, Ni, Cu, Zn, and S originated from anthropogenic sources. Finally, the elements Na, Cl, and Br came mainly from the sea spray source

Cathodically activated Au/TiO2 nanocomposite synthesized by a new facile solvothermal method: an efficient electrocatalyst with Pt-like activity for hydrogen generation

We report here a facile, template-free and one-step solvothermal approach for the synthesis of high-temperature stable gold/titania nanocomposite (NCs), providing a new, simple, quick and inexpensive wet-chemical route. Our approach is based on the assembly of gold salt and titanium butoxide in dimethyl sulfoxide (DMSO). Also, we present here, for the first time, a cathodically activated Au/TiO2 catalyst with Pt/C activity for the hydrogen evolution reaction (HER) in 0.5 M H2SO4 in the dark. The as-prepared (unactivated) Au/TiO2 NCs exhibits considerable electrocatalytic activity for H-2 generation in the dark, with a low onset potential (E-HER) of -64mV vs. RHE, a Tafel slope (-b(c)) of 60 mV dec(-1) and an exchange current density (j(o)) of 0.12 mA cm(-2). Long-term stability and durability tests in 0.5 M H2SO4, employing cyclic voltammetry technique (10,000 of repetitive cycling) and 72 h of chronoamperometry measurements at a high cathodic potential (cathodic activation), reveal that the electrocatalyst activates during such aging processes yielding an activated Au/TiO2 catalyst with Pt/C-like activity for H-2 generation (E-HER-3 mV, -b(c): 35 mV dec(-1), and j(o): 0.95 mA cm(-2)). The outstanding HER activity of the activated catalyst is discussed. (C) 2018 Elsevier Ltd. All rights reserved

Non-Covalent Functionalization of Graphene Oxide-Supported 2-Picolyamine-Based Zinc(II) Complexes as Novel Electrocatalysts for Hydrogen Production

Three mononuclear 2-picolylamine-containing zinc(III) complexes viz [(2-PA)2ZnCl]2(ZnCl4)] (Zn1), [(2-PA)2Zn(H2O)](NO3)2] (Zn2) and [Zn(2-PA)2(OH)]NO3] (Zn3) were synthesized and fully characterized. Spectral and X-ray structural characteristics showed that the Zn1 complex has a square-pyramidal coordination environment around a zinc(II) core. The hydroxide complex Zn3 was non-covalently functionalized with few layers of graphene oxide (GO) sheets, formed by exfoliation of GO in water. The resulting Zn3/GO hybrid material was characterized by FT-IR, TGA-DSC, SEM-EDX and X-ray powder diffraction. The way of interaction of Zn3 with GO has been established through density functional theory (DFT) calculations. Both experimental and theoretical findings indicate that, on the surface of GO, the complex Zn3 forms a complete double-sided adsorption layer. Zn3 and its hybrid form Zn3/GO have been individually investigated as electrocatalysts for the hydrogen evolution reaction. The hybrid heterogenized form Zn3/GO was supported on glassy carbon (GC) with variable loading densities of Zn3 (0.2, 0.4 and 0.8 mg cm−2) to form electrodes. These electrodes have been tested as molecular electrocatalysts for the hydrogen evolution reaction (HER) using linear sweep voltammetry (LSV) and electrochemical impedance spectroscopy (EIS) in 0.1 M KOH. Results showed that both GC-Zn3 and GC-Zn3/GO catalysts for the HER are highly active, and with increase of the catalyst’s loading density, this catalytic activity enhances. The high catalytic activity of HER with a low onset potential of −140 mV vs. RHE and a high exchange current density of 0.22 mA cm−2 is achieved with the highest loading density of Zn3 (0.8 mg cm−2). To achieve a current density of 10 mA cm−2, an overpotential of 240 mV was needed