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

Improving Morpho-Physiological Indicators, Yield, and Water Productivity of Wheat through an Optimal Combination of Mulching and Planting Patterns in Arid Farming Systems

Mulching practices (M), which conserve soil water and improve water productivity (WP), are receiving increasing attention worldwide However, so far, little attention has been given to investigating the effects of the integrations of mulching and planting patterns (IMPPs) on spring wheat performance under arid regions conditions. A two-year field study was conducted to compare the effects of eight IMPPs on growth parameters at 80 and 100 days after sowing (DAS), growth indicators, physiological attributes, grain yield (GY), and WP of wheat under adequate (1.00 ET) and limited (0.50 ET) irrigation conditions. The IMPPs included three planting patterns (PPs), that is, flat (F), raised-bed (RB), and ridge–furrow (RF), in combination with three M, that is, no-mulch (NM), plastic film mulch (PFM), and crop residues mulch (CRM). The results indicated that PPs mulched with PFM and CRM significantly increased growth indicators, different growth parameters, physiological attributes, GY, and WP by 6.9–39.3%, 8.2–29.2%, 5.2–24.9%, 9.9, and 11.2%, respectively, compared to non-mulched PPs. The F and RB patterns mulched with CRM were more effective in improving growth parameters at 100 DAS (2.7–13.6%), physiological attributes (0.2–20.0%), GY, and WP (9.7%) than were the F and RB patterns mulched with PFM under 1.00 ET, while the opposite was true under 0.50 ET conditions. Although the RFPFM failed to compete with other IMPPs under 1.00 ET, the values of different parameters in this PP were comparable to those in F and RB patterns mulched with PFM, and were 1.3–24.5% higher than those in F and RB patterns mulched with CRM under 0.50 ET conditions. Although the RFNM did not use mulch, the values of different parameters for this PP were significantly higher than those of F and RB patterns without mulch. Irrespective of irrigation treatments, the heatmap analysis based on different stress tolerance indices identified the different PPs mulched with PFM as the best IMPPs for the optimal performance of wheat under arid conditions, followed by PPs mulched with CRM. The different growth indicators exhibited second-order and strong relationships with GY (R2 = 0.78 to 0.85) and moderate relationships with WP (R2 = 0.59 to 0.79). Collectively, we concluded that using PPs mulched with CRM is the recommended practice for achieving good performance and production for wheat under adequate irrigation, whereas using PPS mulched with PFM is recommended as a viable management option for sustainable production of wheat and improving WP under limited irrigation in arid countries

Photosensitizers in the fight against ticks: safranin as a novel photodynamic fluorescent acaricide to control the camel tick Hyalomma dromedarii (Ixodidae)

Ticks transmit more pathogen species than any other group of blood-feeding arthropods worldwide, affecting humans, livestock, and companion animals. Hyalomma dromedarii is the predominant tick species infesting camels, and its effective control is of pivotal importance. In this research, we compared the phytoefficacy of safranin (SF), a fluorescent dye applied as an acaricide for the first time, to that of tetramethrin (TM) against engorged females of H. dromedarii through in vitro immersion bioassays. Furthermore, the effect of SF exposure was evaluated on the reproductive potential of surviving tick females. Different concentrations of SF (0.03, 0.06, 0.3, 1, and 4 % w:v) and TM (0.03, 0.13, 0.5, 2, and 4 %) were prepared in distilled water and administered to engorged females of H. dromedarii. SF-treated ticks were illuminated with a light source for 30 min post-treatment (PT). Photophysical properties of SF were studied, and the relative efficacy of the used light source and sunlight was calculated. Results showed that the minimum least concentration that causes 100 % acaricidal effect was 4 % PT with SF and TM, for 8 and 48 h, respectively. LC50 values 8 and 24 h PT were 0.08, 0.03 and 0.78, 0.20 %, respectively. Comparing LC50 and LC90 2 h PT, SF was 33 and 22 times more potent than TM. LT50 of 4 % SF and TM were 0.80 and 2.17 h, respectively. Treatment with the lowest concentrations of SF and TM induced reduction of the number of ovipositing females, eggs per female, ticks laying viable eggs, and hatched eggs. Overall, our results highlighted that SF is highly effective if compared to TM, allowing use to candidate it for the development of novel and safer acaricides

Effects of Salicylic Acid and Macro- and Micronutrients through Foliar and Soil Applications on the Agronomic Performance, Physiological Attributes, and Water Productivity of Wheat under Normal and Limited Irrigation in Dry Climatic Conditions

Ensuring food security with severe shortages of freshwater and drastic changes in climatic conditions in arid countries requires the urgent development of feasible and user-friendly strategies. Relatively little is known regarding the impacts of the co-application (Co-A) of salicylic acid (SA), macronutrients (Mac), and micronutrients (Mic) through foliar (F) and soil (S) application strategies on field crops under arid and semiarid climatic conditions. A two-year field experiment was designed to compare the impacts of seven (Co-A) treatments of this strategy, including a control, FSA + Mic, FSA + Mac, SSA + FMic, SSA + FSA + Mic, SSA + Mic + FSA, and SSA + Mic + FMac + Mic on the agronomic performance, physiological attributes, and water productivity (WP) of wheat under normal (NI) and limited (LMI) irrigation conditions. The results reveal that the LMI treatment caused a significant reduction in various traits related to the growth (plant height, tiller and green leaf numbers, leaf area index, and shoot dry weight), physiology (relative water content and chlorophyll pigments), and yield components (spike length, grain weight and grain numbers per spike, thousand-grain weight, and harvest index) of wheat by 11.4–47.8%, 21.8–39.8%, and 16.4–42.3%, respectively, while WP increased by 13.3% compared to the NI treatment. The different Co-A treatments have shown a 0.2–23.7%, 3.6–26.7%, 2.3–21.6%, and 12.2–25.0% increase in various traits related to growth, physiology, yield, and WP, respectively, in comparison to the control treatment. The SSA+ FSA + Mic was determined as the best treatment that achieved the best results for all studied traits under both irrigation conditions, followed by FSA + Mic and SSA + Mic + FSA under LMI in addition to FSA + Mac under NI conditions. It can be concluded that the Co-A of essential plant nutrients along with SA accomplished a feasible, profitable, and easy-to-use strategy to attenuate the negative impacts of deficit irrigation stress, along with the further improvement in the growth and production of wheat under NI conditions

Assessing the Suitability of Multivariate Analysis for Stress Tolerance Indices, Biomass, and Grain Yield for Detecting Salt Tolerance in Advanced Spring Wheat Lines Irrigated with Saline Water under Field Conditions

Successfully evaluating and improving the salt tolerance of genotypes requires an appropriate analysis tool to allow simultaneous analysis of multiple traits and to facilitate the ranking of genotypes across different growth stages and salinity levels. In this study, we evaluate the salt tolerance of 56 recombinant inbred lines (RILs) in the presence of salt-tolerant and salt-sensitive control genotypes using multivariate analysis of plant dry weight, measured at 75 (PDW-75) and 90 (PDW-90) days from sowing, biological yield (BY), grain yield (GY), and their salt tolerance indices (STIs). All RILs and genotypes were evaluated under the control and 15 dS m−1 for two consecutive years (2019/2020 and 2020/2021). Results showed significant main effects of salinity and genotype as well as their interactions on four plant traits. Significant genotypic differences were also found for all calculated STIs. STIs exhibited moderate to strong relationships with the four plant traits when measured under either the control or salinity conditions and between each other. The principal component analysis (PCA) showed that the most variation among all analyzed variables was explained by the first two PCs, with the PC1 and PC2 explained at 61.8–71.8% and at 28.0–38.2% of the total variation, respectively. The PC1 had positive and strong correlations with the four plant traits measured under salinity conditions and STI, YI, REI, SWPI, MRPI, MPI, GMPI, and HMPI. The PC2 had strong correlations with BY and GY measured under the control conditions and SSI, TOL, RSE, and YSI. The PC1 was able to identify the salt-tolerant genotypes, while the PC2 was able to isolate the salt-sensitive ones. Cluster analysis based on multiple traits organized 64 genotypes into four groups varied from salt-tolerant to salt-sensitive genotypes, with the salt-tolerant group attaining higher value for plant traits under salinity conditions and the STIs related to the PC1. In conclusion, the use of multivariate analysis together with the STIs that evaluated the performance of genotypes under contrasting environmental conditions will help breeders to distinguish salt-tolerant genotypes from salt-sensitive ones, even at the early growth stages of plant development

A Green Voltammetric Determination of Molnupiravir Using a Disposable Screen-Printed Reduced Graphene Oxide Electrode: Application for Pharmaceutical Dosage and Biological Fluid Forms

A new green-validated and highly sensitive electrochemical method for the determination of molnupiravir (MOV) has been developed using cyclic voltammetry. The proposed analytical platform involves the use of a disposable laboratory-made screen-printed reduced graphene oxide 2.5% modified electrode (rGO-SPCE 2.5%) for the first time to measure MOV with high specificity. The surface morphology of the sensor was investigated by using a scanning electron microscope armed with an energy-dispersive X-ray probe. The fabricated sensor attained improved sensitivity when sodium dodecyl sulfate (SDS) surfactant (3 µM) was added to the supporting electrolyte solution of 0.04 M Britton–Robinson buffer at pH 2. The electrochemical activity of rGO-SPCE was examined in comparison with two different working electrodes in order to demonstrate that it was the most competitive sensor for MOV monitoring. The method was validated using differential pulse voltammetry according to ICH guidelines, resulting in good precision, accuracy, specificity, and robustness over a concentration range of 0.152–18.272 µM, with a detection limit of 0.048 µM. The stability investigation demonstrated that rGO-SPCE 2.5% can provide high-stability behavior towards the analyte throughout a six-week period under refrigeration. The fabricated rGO-SPCE 2.5% was successfully employed for the measurement of MOV in pharmaceutical capsules and human biofluids without the interference of endogenous matrix components as well as the commonly used excipient

Metabolomic profiling and biological evaluations of <i>Spongia irregularis</i>-associated actinomycetes supported by multivariate statistical analysis

AimMetabolomic analysis using LC–HRESIMS of 12 extracts of Spongia irregularis-associated actinomycetes for dereplication purposes in addition to evaluation of cytotoxic and antiviral activities of the extracts.Methods and resultsIn this study, three actinomycetes belonging to the genera Micromonospora, Streptomyces, and Rhodococcus were recovered from the marine sponge Spongia irregularis. Applying the OSMAC approach, each strain was fermented on four different media, resulting in 12 extracts. All extracts were subjected to metabolomic analysis using LC–HRESIMS for dereplication purposes. Multivariate data statistical analysis was carried out for the differentiation between extracts. Additionally, the cytotoxic and anti-hepatitis C virus (anti-HCV) potentials of extracts were evaluated. Most of extracts showed strong to moderate cytotoxicity effects against HepG-2, CACO-2, and MCF-7 cell lines with a general IC50 range of 2.8–8.9 µg/ml. Moreover, the extracts of Micromonospora sp. UR44 using ISP2 and OLIGO media and Streptomyces sp. UR32 using ISP2 medium exhibited anti-HCV activity with IC50 of 4.5 ± 0.22, 3.8 ± 0.18, and 5.7 ± 0.15 µM, respectively.ConclusionMetabolomic analysis of 12 extracts of S. irregularis-associated actinomycetes led to the identification of a large number of secondary metabolites. Morever, investigation of cytotoxic and antiviral activities of the extracts revealed that only three extracts exhibited antiviral activity and seven extracts exhibited cytotoxic activity

Combining Planting Patterns with Mulching Bolsters the Soil Water Content, Growth, Yield, and Water Use Efficiency of Spring Wheat under Limited Water Supply in Arid Regions

Innovations in water-saving cultivation strategies are urgently needed to achieve high yield and elevated water use efficiency (WUE) simultaneously in arid regions with limited water resources. Here, we conducted a two-year field study to compare the impacts of eight combinations of planting patterns (PPs) and mulching on the soil water content (SWC) in the top 60 cm soil layer, the growth, the yield, and the WUE of wheat under two irrigation rates (1.00 and 0.50 ET). These combinations included three conventional flat planting (CF) patterns, including CF without mulch (CFNM), with plastic film (CFPM), and with wheat straw mulch (CFSM); three raised-bed planting (RB) patterns, including RB without mulch (RBNM), with plastic film (RBPM), and wheat straw (RBSM) mulch; and two ridge–furrow planting (RF) patterns, including RF without mulch (RFNM) and with plastic film mulch (RFPM). The results showed that the tested treatments affected the SWC at different depths under both irrigation rates. Compared with the two non-mulched treatments under 0.50 ET, the SWC of the three PPs with plastic film and the two PPs with wheat straw mulching were significantly higher before irrigation by 14.4–22.0% and 6.9–17.2% at 0–20 cm soil depth, 16.4–29.0% and 6.6–14.9% at 20–40 cm soil depth, and 3.3–34.8% and 3.4–14.5% at 40–60 cm soil depth, respectively. All measured wheat parameters, except harvest index, were significantly affected by the interaction between irrigation rate and PPs. The highest values for plant dry weight (PDW), yield components, grain yield (GY), and WUE under 1.00 ET were obtained in the two PPs with wheat straw mulch, while the three PPs with plastic film showed the highest values of these parameters under 0.50 ET. The yield response factor (Ky) based on PDW was acceptable for all PPs mulched with plastic film and wheat straw as well as for RFNM, while Ky based on GY was acceptable only for the PPs mulched with plastic film and for RFNM, as the Ky values of these PPs were less than 1 under 0.50 ET. The SWC at different depths exhibited quadratic and nonsignificant relationships with all parameters under 1.00 ET, while these relationships were linear and strong under 0.50 ET, with a few exceptions. Overall, we conclude that combining any PPs with plastic film mulching could be used as a feasible and effective strategy for obtaining high wheat yield and WUE in the irrigated and arid agroecosystem

Combining Planting Patterns with Mulching Bolsters the Soil Water Content, Growth, Yield, and Water Use Efficiency of Spring Wheat under Limited Water Supply in Arid Regions

Innovations in water-saving cultivation strategies are urgently needed to achieve high yield and elevated water use efficiency (WUE) simultaneously in arid regions with limited water resources. Here, we conducted a two-year field study to compare the impacts of eight combinations of planting patterns (PPs) and mulching on the soil water content (SWC) in the top 60 cm soil layer, the growth, the yield, and the WUE of wheat under two irrigation rates (1.00 and 0.50 ET). These combinations included three conventional flat planting (CF) patterns, including CF without mulch (CFNM), with plastic film (CFPM), and with wheat straw mulch (CFSM); three raised-bed planting (RB) patterns, including RB without mulch (RBNM), with plastic film (RBPM), and wheat straw (RBSM) mulch; and two ridge&ndash;furrow planting (RF) patterns, including RF without mulch (RFNM) and with plastic film mulch (RFPM). The results showed that the tested treatments affected the SWC at different depths under both irrigation rates. Compared with the two non-mulched treatments under 0.50 ET, the SWC of the three PPs with plastic film and the two PPs with wheat straw mulching were significantly higher before irrigation by 14.4&ndash;22.0% and 6.9&ndash;17.2% at 0&ndash;20 cm soil depth, 16.4&ndash;29.0% and 6.6&ndash;14.9% at 20&ndash;40 cm soil depth, and 3.3&ndash;34.8% and 3.4&ndash;14.5% at 40&ndash;60 cm soil depth, respectively. All measured wheat parameters, except harvest index, were significantly affected by the interaction between irrigation rate and PPs. The highest values for plant dry weight (PDW), yield components, grain yield (GY), and WUE under 1.00 ET were obtained in the two PPs with wheat straw mulch, while the three PPs with plastic film showed the highest values of these parameters under 0.50 ET. The yield response factor (Ky) based on PDW was acceptable for all PPs mulched with plastic film and wheat straw as well as for RFNM, while Ky based on GY was acceptable only for the PPs mulched with plastic film and for RFNM, as the Ky values of these PPs were less than 1 under 0.50 ET. The SWC at different depths exhibited quadratic and nonsignificant relationships with all parameters under 1.00 ET, while these relationships were linear and strong under 0.50 ET, with a few exceptions. Overall, we conclude that combining any PPs with plastic film mulching could be used as a feasible and effective strategy for obtaining high wheat yield and WUE in the irrigated and arid agroecosystem

Impacts of Human Activities on Urban Sprawl and Land Surface Temperature in Rural Areas, a Case Study of El-Reyad District, Kafrelsheikh Governorate, Egypt

Anthropogenic activities affect the surrounding environment dynamically in different ways. In the arid and hyper arid, agriculture is concentrated in rural communities, which are cooling surfaces that help mitigate surface temperature increases. Recently, rural communities are suffering from increasing urban sprawl. The current work focuses on evaluating the changes in land cover and their impacts on land surface temperature (LST) during (1988–2022) and predicting the changes until 2056 in El-Reyad District, Kafrelsheikh Governorate, Egypt. For achieving this purpose, Landsat images (TM, ETM+, and OLI) were used. The support vector machine (SVM) was applied using Google Earth Engine (GEE) to monitor changes in land use/cover and LST. The prediction of land use until 2056 was achieved using the CA-Markov simulation model. The results showed six land cover classes: agricultural lands, bare lands, urban areas, natural vegetation, Lake Burullus, and fish farms. The results showed the effects of human activity on the conversion of agricultural land to other activities, as agricultural lands have decreased by about 3950.8 acres, while urban areas have expanded by 6283.2 acres, from 1988 to 2022. Fish farms have increased from 3855.6 to 17,612 acres from 1988 to 2022. While the area of bare land decreased from 28.3% to 0.7% of the total area, it was converted to urban, agricultural, and fish farms. The spatiotemporal change in land cover affected the balance of LST in the study area, although the average temperature increased from 32.4 ± 0.5 to 33.6 ± 0.2 °C. In addition, it is expected to reach 36 ± 0.5 °C in 2056, and there are some areas with decreased LST where it is converted from bare areas into fish farms and agricultural uses. The prediction results show that the agricultural area will decrease by −11.38%, the urban area will increase by 4.6%, and the fish farms area will increase by 6.1%. Thus, preserving green spaces and reducing urban sprawl in rural communities are very important objectives