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

Search for top squark production in fully hadronic final states in proton-proton collisions at root s=13 TeV

A search for production of the supersymmetric partners of the top quark, top squarks, is presented. The search is based on proton-proton collision events containing multiple jets, no leptons, and large transverse momentum imbalance. The data were collected with the CMS detector at the CERN LHC at a center-of-mass energy of 13 TeV, and correspond to an integrated luminosity of 137 fb(-1). The targeted signal production scenarios are direct and gluino-mediated top squark production, including scenarios in which the top squark and neutralino masses are nearly degenerate. The search utilizes novel algorithms based on deep neural networks that identify hadronically decaying top quarks and W bosons, which are expected in many of the targeted signal models. No statistically significant excess of events is observed relative to the expectation from the standard model, and limits on the top squark production cross section are obtained in the context of simplified supersymmetric models for various production and decay modes. Exclusion limits as high as 1310 GeVare established at the 95% confidence level on the mass of the top squark for direct top squark production models, and as high as 2260 GeV on the mass of the gluino for gluino-mediated top squark production models. These results represent a significant improvement over the results of previous searches for supersymmetry by CMS in the same final state.Peer reviewe

Measurement of the W gamma Production Cross Section in Proton-Proton Collisions at root s=13 TeV and Constraints on Effective Field Theory Coefficients

A fiducial cross section for W gamma production in proton-proton collisions is measured at a center-of-mass energy of 13 TeV in 137 fb(-1) of data collected using the CMS detector at the LHC. The W -> e nu and mu nu decay modes are used in a maximum-likelihood fit to the lepton-photon invariant mass distribution to extract the combined cross section. The measured cross section is compared with theoretical expectations at next-to-leading order in quantum chromodynamics. In addition, 95% confidence level intervals are reported for anomalous triple-gauge couplings within the framework of effective field theory.Peer reviewe

Search for long-lived particles decaying to jets with displaced vertices in proton-proton collisions at root s=13 Te V

A search is presented for long-lived particles produced in pairs in proton-proton collisions at the LHC operating at a center-of-mass energy of 13 TeV. The data were collected with the CMS detector during the period from 2015 through 2018, and correspond to a total integrated luminosity of 140 fb(-1). This search targets pairs of long-lived particles with mean proper decay lengths between 0.1 and 100 mm, each of which decays into at least two quarks that hadronize to jets, resulting in a final state with two displaced vertices. No significant excess of events with two displaced vertices is observed. In the context of R-parity violating supersymmetry models, the pair production of long-lived neutralinos, gluinos, and top squarks is excluded at 95% confidence level for cross sections larger than 0.08 fb, masses between 800 and 3000 GeV, and mean proper decay lengths between 1 and 25 mm.Peer reviewe

Commentary: Teaching ‘best practices’ of journalism in Malaysia

Journalism has over the years invited distrust, scorn, cynicism, even sheer revulsion, from the general public. This is especially so with fraudulent reporting on the rise, such as the one committed by New York Times reporter Jayson Blair in 2003. Investigative journalism of the ‘Watergate’ type seems to have faded to the extent that it would take concerted effort by journalism educators to ‘excite’ students into taking up journalism as a career. In Malaysia, journalism ethics, standards and credibility have long been compromised at the altar of political expediency and corporate interests particularly within sections of the mainstream media. This situation is aggravated by the fact that the media are also controlled by the state through illiberal laws such as the Printing Presses and Publications Act (PPPA), Official Secrets Act (OSA), Sedition Act, Communications and Multimedia Act, and the Internal Security Act (ISA)

Global media product and construction of “Japanese identity”: a case study of anime on Malaysian Television

Japanese animation or, as it is popularly known, anime appears to be the most celebrated Asian television product around the globe today. Anime was first created in 1917 and developed well into the 1970’s in Japan. By the 1990’s anime series, such as Dragon Ball, Pokemon, and Sailormoon became worldwide successes (Patten: 2009). By the year 2000, the proliferation of Japanese animation in the global market is beyond imagination. Current global response and market trend suggest that the anime industry is indeed a significant contribution to the economic growth of Japan. Proliferation of Japanese programmes in Malaysia became prominent in the 1980’s where more Japanese dramas and anime were used to fill in the time slot. The fact that the percentage of imports of animation programme from the west had decreased in the recent years suggests that Japanese anime has started to claim a steady position in Malaysian television industry. It is in this larger context that this study aims to understand how “Japaneseness’ has been negotiated in representing Japan unique identity in anime through critical content analysis of selected anime programmes available on Malaysia television

Journalism in Good Faith: Issues and Practices in Religion Reporting

This book is written from our experience as former journalists and part-time media trainers currently teaching full-time in tertiary journalism programmes in Australia and Malaysia. The case studies and discursive frameworks are therefore derived from our observations of the media portrayal of religion and, in some cases, its related topic area race- in Malaysia, Australia, Indonesia and the Philippines. Where cross-cultural communication elements and reporting methodologies are discussed, they are contextualised for flexible applications by journalists and journalism students across geographical and cultural boundaries. Various terms are used interchangeably in this book. For instance, the term \u27dominant\u27 is used interchangeably with \u27mainstream\u27. \u27Mainstream\u27 refers to a collective group of people who are numerically, socially, economically, culturally and politically central to and dominant in the reporting of public issues and events. \u27It applies specifically to people who constitute part of the ruling elite. Our book primarily explores how \u27mainstream\u27 journalists from the mainline media ought to communicate their stories emanating from different religious communities to their \u27mainstream\u27 audience in the spirit of fostering an educated perception and understanding of the religious and spiritual dimension of issues and events. Citation Loo, Eric and Anuar, Mustafa, 2010, Journalism in Good Faith: Issues and Practices in Religion Reporting, Marshall Cavendish Editions, Malaysia, 224p. http://ro.uow.edu.au/era/132