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

Adaptive modified artificial bee colony algorithms (AMABC) for optimization of complex systems

WOS: 000576687400001Complex systems are large scale and involve numerous uncertainties, which means that such systems tend to be expensive to operate. Further, it is difficult to analyze systems of this kind in a real environment, and for this reason agent-based modeling and simulation techniques are used instead. Based on estimation methods, modeling and simulation techniques establish an output set against the existing input set. However, as the data set in a given complex systems becomes very large, it becomes impossible to use estimation methods to create the output set desired. Therefore, a new mechanism is needed to optimize data sets in this context. in this paper, the adaptive modified artificial bee colony algorithm is shown to be successful in optimizing the numerical test function and complex system parameter data sets. Moreover, the results show that this algorithm can be successfully adapted to a given problem. Specifically, this algorithm can be more successful in optimizing problem solving than either the artificial bee colony algorithm or the modified artificial bee colony algorithm. the adaptive modified artificial bee colony algorithm performs a search in response to feedback received from the simulation in run-time. Because of its adaptability, the adaptive modified artificial bee colony algorithm is of great importance for its ability to find solutions to multiple kinds of problems across numerous fields

Parameter Tuning in Modeling and Simulations by Using Swarm Intelligence Optimization Algorithms

9th International Conference on Computational Intelligence and Communication Networks (CICN) -- SEP 16-17, 2017 -- Final Int Univ, Girne, CYPRUSWOS: 000432249700032Modeling and simulation of real-world environments has in recent times being widely used. The modeling of environments whose examination in particular is difficult and the examination via the model becomes easier. The parameters of the modeled systems and the values they can obtain are quite large, and manual tuning is tedious and requires a lot of effort while it often it is almost impossible to get the desired results.. For this reason, there is a need for the parameter space to be set. The studies conducted in recent years were reviewed, it has been observed that there are few studies for parameter tuning problem in modeling and simulations. In this study, work has been done for a solution to be found to the problem of parameter tuning with swarm intelligence optimization algorithms Particle swarm optimization and Firefly algorithms. The performance of these algorithms in the parameter tuning process has been tested on 2 different agent based model studies. The performance of the algorithms has been observed by manually entering the parameters found for the model. According to the obtained results, it has been seen that the Firefly algorithm where the Particle swarm optimization algorithm works faster has better parameter values. With this study, the parameter tuning problem of the models in the different fields were solved.MIR Labs, IEEE Turkey Sec

A CRITICAL REVIEW ON CLASSIFICATION AND TERMINOLOGY OF SCISSOR STRUCTURES

When the existing literature on the research of scissor structures is thoroughly investigated, it is seen that different researchers use different terminologies and classifications especially for the definition of the primary units and the motion type. Some of the studies define the whole geometry based on the geometric properties of the primary scissor units and the unit lines while some other studies define it according to the loops. All these studies use different names for similar elements. This article aims to review the literature on the classification and terminology of scissor structures and represent the state of art on the studies. Tables are represented showing all approaches in the literature. In addition, the article criticizes the missing points of each terminology and definition, and proposes some new terminology. In order to arrive at this aim, different definitions of the primary scissor units and motion types used in key studies in the literature are investigated thoroughly. With several examples, it is demonstrated that naming the scissor units according to the resulting motion type might be misleading and it is better to specify the motion type for the whole structure. A classification for transformation of planar curves is presented

PLASMA NITRIC OXIDE LEVELS AND NITRIC OXIDE SYNTHASE ACTIVITY IN LUNG CANCER PATIENTS

GURBUZ, ASLIHAN/0000-0002-5089-3965WOS: 000264089500345

Loop based classification of planar scissor linkages

Scissor linkages have been used for several applications since ancient Greeks and Romans. In addition to simple scissor linkages with straight rods, linkages with angulated elements have been introduced in the last decades. In the related literature, two methods have been used to design scissor linkages, one of which is based on scissor elements, and the other is based on assembling loops. This study presents a systematic classification of scissor linkages as assemblies of rhombus, kite, dart, parallelogram and anti-parallelogram loops using frieze patterns and long-short diagonal connections. After the loops are replicated along a curve as a pattern, the linkages are obtained by selection of proper common link sections for adjacent loops. The resulting linkages are analyzed for their motions and they are classified as realizing scaling deployable, angular deployable or transformable motion. Some of the linkages obtained are novel. Totally 10 scalable deployable, 1 angular deployable and 8 transformable scissor linkages are listed. Designers in architecture and engineering can use this list of linkages as a library of scissor linkage topologies

Usage of Riot Control Agents and other methods resulting in physical and psychological injuries sustained during civil unrest in Turkey in 2013

Turkey has experienced a wave of demonstrations in the summer of 2013, called Gezi Park Demonstrations. Between 31 May and 30 August, 297 people who had been subjected to trauma by several methods of demonstration control and Riot Control Agents applied to the Human Rights Foundation of Turkey Rehabilitation Centers to receive treatment/rehabilitation and/or documentation