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

Enhanced device efficiency and long-term stability via boronic acid-based self-assembled monolayer modification of indium tin oxide in a planar perovskite solar cell

WOS:000444355700085PubMed:30088757Interfacial engineering is essential for the development of highly efficient and stable solar cells through minimizing energetic losses at interfaces. Self-assembled monolayers (SAMs) have been shown as a handle to tune the work function (WF) of indium tin oxide (ITO), improving photovoltaic cell performance and device stability. In this study, we utilize a new class of boronic acid-based fluorine-terminated SAMs to modify ITO surfaces in planar perovskite solar cells. The SAM treatment demonstrates an increase of the WF of ITO, an enhancement of the short-circuit current, and a passivation of trap states at the ITO/[poly(3,4ethylenedioxylenethiophene):poly(styrenesulfonic acid)] interface. Device stability improves upon SAM modification, with efficiency decreasing only 20% after one month. Our work highlights a simple treatment route to achieve hysteresis-free, reproducible, stable, and highly efficient (16%) planar perovskite solar cells.Tubitak 2211-C special areas [1649B031502037]; TubitakTurkiye Bilimsel ve Teknolojik Arastirma Kurumu (TUBITAK) [Tubitak 2214/A-1059B141501315]; Turkey Scholarship Council [2214/A -1059B141501316]; Office of Naval ResearchOffice of Naval Research [N00014-16-1-2612, N000147-14-1-0053]We acknowledge to Haydar Akdag and Dr. Cisem Kirbiyik for their valuable discussion during the study. D.A.K. thank to (Tubitak 2211-C special areas -1649B031502037) and to Tubitak research fellowship (Tubitak 2214/A-1059B141501315). K.K. thank to Turkey Scholarship Council (2214/A -1059B141501316). J.J.K., D.L.G.A., E.K.B., and A.L.B. acknowledge the Office of Naval Research (N00014-16-1-2612 and N000147-14-1-0053)

Functionalized organic semiconductor molecules to enhance charge carrier injection in electroluminescent cell

WOS:000404305200042Organic semiconductor (OSC) materials as a charge carrier interface play an important role to improve the device performance of organic electroluminescent cells. In this study, 4,4"-bis(diphenyl amino)-1,1':3',1"-terphenyl-5'-carboxylic acid (TPA) and 4,4"-di-9H-carbazol-9-yl-1,1':3',1"-terphenyl-5'-carboxylic acid (CAR) has been designed and synthesized to modify indium tin oxide (ITO) layer as interface. Bare ITO and PEDOT:PSS coated on ITO was used as reference anode electrodes for comparison. Furthermore, PEDOT:PSS coated over CAR/ITO and TPA/ITO to observe stability of OSC molecules and to completely cover the ITO surface. Electrical, optical and surface characterizations were performed for each device. Almost all modified devices showed around 36% decrease at the turn on voltage with respect to bare ITO. The current density of bare ITO, ITO/CAR and ITO/TPA were measured as 288, 1525 and 1869 A/m(2), respectively. By increasing current density, luminance of modified devices showed much better performance with respect to unmodified devices. (C) 2017 Elsevier B.V. All rights reserved

A snapshot of pediatric inpatients and outpatients with COVID-19: a point prevalence study from Turkey

This multi-center point prevalence study evaluated children who were diagnosed as having coronavirus disease 2019 (COVID-19). On February 2nd, 2022, inpatients and outpatients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) were included in the study from 12 cities and 24 centers in Turkey. Of 8605 patients on February 2nd, 2022, in participating centers, 706 (8.2%) had COVID-19. The median age of the 706 patients was 92.50 months, 53.4% were female, and 76.7% were inpatients. The three most common symptoms of the patients with COVID-19 were fever (56.6%), cough (41.3%), and fatigue (27.5%). The three most common underlying chronic diseases (UCDs) were asthma (3.4%), neurologic disorders (3.3%), and obesity (2.6%). The SARS-CoV-2-related pneumoniae rate was 10.7%. The COVID-19 vaccination rate was 12.5% in all patients. Among patients aged over 12 years with access to the vaccine given by the Republic of Turkey Ministry of Health, the vaccination rate was 38.7%. Patients with UCDs presented with dyspnea and pneumoniae more frequently than those without UCDs (p < 0.001 for both). The rates of fever, diarrhea, and pneumoniae were higher in patients without COVID-19 vaccinations (p = 0.001, p = 0.012, and p = 0.027). Conclusion: To lessen the effects of the disease, all eligible children should receive the COVID-19 vaccine. The illness may specifically endanger children with UCDs. What is Known: • Children with COVID-19 mainly present with fever and cough, as in adults. • COVID-19 may specifically threaten children with underlying chronic diseases. What is New: • Children with obesity have a higher vaccination rate against COVID-19 than children without obesity. • Among unvaccinated children, fever and pneumoniae might be seen at a higher ratio than among vaccinated children