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

L-cysteine-mediated self-assembled Ag-Au nanoparticles as fractal patterns with bowling-alley-like hollow arrays for electrochemical sensing of dopamine

In this study, hierarchical self-assembly of Au-Ag fractal patterns with bowling-alley-like hollow arrays was achieved by a hydrothermal method using L-cysteine as an environmentally friendly reducing and stabilizing reagent. Here, free thiol groups of cysteine molecules electrostatically stabilized gold and silver nanoparticles (NPs). The plasmonic resonance red-shift of Au-Ag was confirmed from self-assembled fractal patterns that consist of micro/nano fern structures forming bowling-alley-like hollow arrays. The as-synthesized large-area hierarchical self-assembly of Au-Ag fractal patterns with the synergistic catalytic advantage of a Au and Ag NPs/glassy carbon electrode (GCE) is investigated as a potential electrochemical dopamine (DA) sensor. The biosensor based on a GCE modified with bimetallic nanoparticle fractals exhibited a reversible electrochemical behavior with limits of detection and quantification of 0.014 and 0.048 mu M, respectively. Detection of DA using the developed electrochemical sensor has several advantages, such as low cost, ease-of-use, sensitivity, and stability, that can be potentially applied for detection in a variety of chemical and biosensing applications

Automated Traffic Detection System Based on Image Processing

This paper proposes a low-cost automated traffic detection system based on image processing. Dhaka is one of the crowded cities in the world with highly challenging traffic system. There is substantial lack of awareness among the drivers of transport system. As a result, citizens do not follow the rules and regulation while driving in Dhaka city. The tendency of violating the traffic regulation is noticeable throughout the country. As a result, the whole traffic system collapses very often and sometimes it ends-up with severe accidents. In recent days, the government has taken different initiatives including enlargement of pedestrian walkways, building new flyovers and foot-over bridges, expansion of existing roads. But, violation still the outcome of all these initiatives could not improve the situation significantly. The proposed system will automatically detect the traffic through live streaming video so that the detected images can be used to detect traffic violation. Later on, the law enforcement agency will be able to take necessary legal steps based on the stored information on the database

Seed Priming with Salicylic Acid Alleviates Salt Stress Toxicity in Barley by Suppressing ROS Accumulation and Improving Antioxidant Defense Systems, Compared to Halo- and Gibberellin Priming

Plants are highly sensitive to various environmental stresses, which can hinder their growth and reduce yields. In this study, we investigated the potential of seed priming with salicylic acid (SA), gibberellic acid (GA3), and sodium chloride (NaCl) to mitigate the adverse effects of salinity stress in Hordeum vulgare at the germination and early seedling stages. Exposing H. vulgare seeds to salt stress reduced the final germination percentage and seedling shoot and root growth. Interestingly, all seed treatments significantly improved salt-induced responses, with GA3 being more effective in terms of germination performance, plant growth, and photosynthesis. SA priming exhibited promising effects on antioxidant defense mechanisms, proline, sugar, and ascorbic acid production. Notably, SA priming also suppressed reactive oxygen species accumulation and prevented lipid peroxidation. These findings highlight the ability of SA to manage crosstalk within the seed, coordinating many regulatory processes to support plant adaptation to salinity stress

In-silico Investigations of quinine and quinidine as potential Inhibitors of AKR1B1 and AKR1B10: Functional and structural characterization

The aberrant expression of aldo keto reductases (AKR1B1 &amp; AKR1B10) has been extensively studied in different types of cancer especially the colon cancer but a very few studies have yet been reported regarding the discovery of inhibitors for the treatment of colon cancer by targeting these isozymes. Therefore, there is a need of selective inhibitors of both targets for the eradication of colon cancer. Currently, the study is focused on the exploration of two quinolone compounds i.e., (S)-(6-Methoxyquinolin-4-yl)[(1S,2R,4S,5R)-5-vinylquinuclidin-2-yl]methanol (Quinidine) and (R)-(6-Methoxyquinolin-4-yl)[(1S,2S,4S,5R)-5-vinylquinuclidin-2-yl]methanol (Quinine) as the potential inhibitors of AKR1B1 and AKR1B10 via detailed in-silico approach. The structural properties including vibrational frequencies, dipole moment, polarizability and the optimization energies were estimated using density functional theory (DFT) calculations; where both compounds were found chemically reactive. After that, the optimized structures were used for the molecular docking studies and here quinidine was found more selective towards AKR1B1 and quinine exhibited maximum inhibition of AKR1B10. The results of molecular docking studies were validated by molecular dynamics simulations which provided the deep insight of stability of protein ligand complex. At the end, the ADMET properties were determined to demonstrate the druglikeness properties of both selected compounds. These findings suggested further exploration of both compounds at molecular level using different in-vivo and in-vitro approaches that will lead to the designing of potential inhibitor of AKR1B1/AKR1B10 for curing colon cancer and related malignancies.Funding Agencies|Princess Nourah bint Abdulrahman University Researchers Supporting Project [PNURSP2022R26]</p

Additional file 1 of Genome-wide identification of CCO gene family in cucumber (Cucumis sativus) and its comparative analysis with A. thaliana

Additional file 1