Antioxidants l-carnitine and d-methionine modulate neuronal activity through GABAergic inhibition

Article on antioxidants L-carnitine and D-methionine modulate neuronal activity through GABAergic inhibition

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

High velocity domain wall propagation using voltage controlled magnetic anisotropy

The use of voltage-controlled magnetic anisotropy (VCMA) via the creation of a sloped electric field has been hailed as an energy-efficient approach for domain wall (DW) propagation. However, this method suffers from a limitation of the nanowire length which the DW can propagate on. Here, we propose the use of multiplexed gate electrodes to propagate DWs on magnetic nanowires without having any length constraints. The multi-gate electrode configuration is demonstrated using micromagnetic simulations. This allows controllable voltages to be applied to neighboring gate electrodes, generating large strength of magnetic anisotropy gradients along the nanowire, and the results show that DW velocities higher than 300 m/s can be achieved. Analysis of the DW dynamics during propagation reveals that the tilt of the DW and the direction of slanted gate electrode greatly alters the steady state DW propagation. Our results show that chevron-shaped gate electrodes is an effective optimisation that leads to multi-DW propagation with high velocity. Moreover, a repeating series of high-medium-low magnetic anisotropy regions enables a deterministic VCMA-controlled high velocity DW propagation.NRF (Natl Research Foundation, S’pore)Published versio