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Search indexed NASA NTRS and DOE OSTI research on propulsion, heat transfer, battery materials and energy systems. Follow report and document links to the original sources.

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All sourcesNASA NTRSDOE OSTI
DOE OSTI2023

A network analysis of the long-term quality of life and mental distress of COVID-19 survivors 1 year after hospital discharge

Objectives COVID-19 survivors suffer from persistent mental distress and impaired quality of life (QOL) after recovery from the infection. However, the symptom-symptom interaction between these psychological variables remained unexplored. The present study aimed to determine the symptom network of mental distress (depression, anxiety, sleep disturbance, fatigue, and post-traumatic stress disorder) and their association with QOL among 535 COVID-19 survivors 1 year after hospital discharge. Methods 9-item Patient Health Questionnaire, 7-item Generalized Anxiety Disorder Scale, Chalder fatigue scale, Impact of Event Scale-Revised, Pittsburgh Sleep Quality Index, and 36-Item Short-Form Health Survey were applied to measure depression, anxiety, fatigue, PTSD, sleep disturbances, and QOL, respectively. Two networks were estimated using Gaussian graphical model. Network 1 consisted of mental symptoms to determine the central and bridge symptoms. Network 2 additionally included QOL to determine which mental symptoms were mostly related to QOL. Results 60% of the COVID-19 survivors experienced mental distress 1 year after hospital discharge. Uncontrollable and excessive worry, psychomotor symptoms, intrusion, and daytime dysfunction were the most central symptoms. Daytime dysfunction and fatigue (especially mental fatigue and loss of energy) served as the bridge symptoms across the mental distress network and exhibited the most substantial association with QOL. Conclusion Our study demonstrated several key symptoms that played a vital role in mental distress and QOL among COVID-19 survivors. Prompt screening and targeted interventions for these symptoms might hold great promise in preventing mental distress and improving QOL in COVID-19 survivors.

Peng, Pu↗
DOE OSTI2023

Bullying among children with heart conditions, National Survey of Children’s Health, 2018–2020

Abstract Children with chronic illnesses report being bullied by peers, yet little is known about bullying among children with heart conditions. Using 2018–2020 National Survey of Children’s Health data, the prevalence and frequency of being bullied in the past year (never; annually or monthly; weekly or daily) were compared between children aged 6–17 years with and without heart conditions. Among children with heart conditions, associations between demographic and health characteristics and being bullied, and prevalence of diagnosed anxiety or depression by bullying status were examined. Differences were assessed with chi-square tests and multivariable logistic regression using predicted marginals to produce adjusted prevalence ratios and 95% confidence intervals. Weights yielded national estimates. Of 69,428 children, 2.2% had heart conditions. Children with heart conditions, compared to those without, were more likely to be bullied (56.3% and 43.3% respectively; adjusted prevalence ratio [95% confidence interval] = 1.3 [1.2, 1.4]) and bullied more frequently (weekly or daily = 11.2% and 5.3%; p < 0.001). Among children with heart conditions, characteristics associated with greater odds of weekly or daily bullying included ages 9–11 years compared to 15–17 years (3.4 [2.0, 5.7]), other genetic or inherited condition (1.7 [1.0, 3.0]), ever overweight (1.7 [1.0, 2.8]), and a functional limitation (4.8 [2.7, 8.5]). Children with heart conditions who were bullied, compared to never, more commonly had anxiety (40.1%, 25.9%, and 12.8%, respectively) and depression (18.0%, 9.3%, and 4.7%; p < 0.01 for both). Findings highlight the social and psychological needs of children with heart conditions.

Cardiovascular System & Cardiology↗
DOE OSTI2022

Optimization-based trip chain emulation for electrified ride-sourcing charging demand analyses

Range anxiety remains one of the key concerns for ride-sourcing drivers to adopt battery electric vehicles (BEVs). To investigate the feasibility of using BEVs for ride-sourcing services, we propose an optimization-based methodology to estimate the daily driving trip patterns of ride-sourcing vehicles based on widely available non-identifiable trip data. Furthermore, we investigate the charging needs of electrified ride-sourcing vehicles using agent-based simulation. The methodologies are illustrated through a case study in the city of Chicago. Through sensitivity analysis on driver working hours and initial charging status, we quantify the range of daily average vehicle miles traveled (VMT) per car and identify the hot spots of current public charging demand and potential unsatisfied charging demand. This study can be used to determine the priorities of future charging infrastructure investment to further mitigate range anxiety and promote the adoption of electrified ride-sourcing services

42 ENGINEERING↗
DOE OSTI2019

Quality of life trajectories during the first three years after diagnosis of breast cancer: the NEON-BC study

Abstract Background We aimed to identify and characterize quality of life trajectories up to 3 years after breast cancer diagnosis. Methods A total of 460 patients were evaluated at baseline (before treatments), and after 1- and 3-years. Patient-reported outcomes, including quality of life (European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30, QLQ-C30), anxiety, depression and sleep quality, were assessed in all evaluations. Model-based clustering was used to identify quality of life trajectories. Results We identified four trajectories without intersection during 3 years. The two trajectories characterized by better quality of life depicted relatively stable scores; in the other trajectories, quality of life worsened until 1 year, though in one of them the score at 3 years improved. Sociodemographic and clinical characteristics at baseline did not differ between trajectories, except for mastectomy, which was higher in the worst trajectory. Anxiety, depression and poor sleep quality increased from the best to the worst trajectory. Conclusions The type of surgery and the variation of other patient-reported outcomes were associated with the course of quality of life over 3 years. More research to understand the heterogeneity of individual trajectories within these major patterns of variation is needed.

Lopes-Conceição, Luisa↗
DOE OSTI2023

Improving Resiliency for Electric Vehicle Charging

Electric vehicles are seeing growing adoption. However, challenges with range anxiety persists. While charging infrastructure is anticipated to expand, EV charger systems have not been as robust to challenges. This paper discusses potential outage conditions associated with EV charging and presents new technology in development to improve EV charging resilience.

Electric vehicle charging, electric vehicle chargi↗
DOE OSTI2021

Efficient and Safe Hydrogen Refueling of Fuel Cell Vehicles from an Emergency Chemical Hydride Storage Source

Zero-emissions hydrogen fuel cell electrical vehicles (FCEVs) have become more popular in recent years. However, the limited availability of hydrogen fueling stations is considered a critical barrier to sustainable adoption of hydrogen FCEV. To enable the widespread deployment and commercialization of hydrogen FCEV, the availability of hydrogen refueling stations needs to improve. One of the consequences of the lack of hydrogen refueling infrastructure is that consumers can suffer from “range anxiety”, meaning consumers would get anxious of running out of fuel during long-distance trip [4]. A practical solution is to provide a compact emergency hydrogen refueler that can be used if the consumer runs out of hydrogen before reaching the nearest hydrogen refueling station. A safe, compact, and user-friendly hydrogen refueler would give consumers the flexibility they need to feel comfortable using their hydrogen FCEV when planning a long-distance trip. Offering this product would alleviate range anxiety, and it would make Hydrogen FCEV a more attractive alternative to gasoline vehicles. The emergency hydrogen refueler consists of a lithium hydride bed that reacts with liquid water to produce hydrogen gas and lithium hydroxide.

08 HYDROGEN↗
DOE OSTI2023

High-Efficiency, Medium-Voltage-Input, Solid-State-Transformer-Based 400-kW/1000V/400A Extreme Fast Charger for Electric Vehicles

Range anxiety and long battery charging time continue to be critical challenges to mass adaptation of EVs. A major identified gap to wider adoption of BEVs is the ability and availability to refuel quickly or to fast charge. Studies have shown that in areas where drivers have access to 50-kW or 120-kW fast charge stations, annual electric vehicle (EV) miles traveled (i.e., eVMT) increased by over 25%, even in cases where fast charging was used for 1% to 5% of total charging events. Charge stations of higher power not only alleviate the “range anxiety” and reduce the driver’s waiting time, but also requires less investment. Michigan Energy Office completed a study in early 2019 titled “Electric Vehicle Charger Placement Optimization in Michigan: Phase I – Highways”. This study finds a system with 150kW chargers, though more expensive individually, actually has lower total system cost when compared to a 50kW charging system when serving the same battery size EV. To be truly competitive to the ICEV refueling experience, even higher power stations are necessary. However, high power charge stations would create large power draws from the grid. If this occurs during peak demand periods, grid capacity could be overloaded. This problem needs to be addressed to reduce the impact on the electric utility infrastructure. The main goal of this project is to develop a 400-kW/400-A XFC system targeting total efficiency of 96.5 percent from the MVAC grid to a vehicle. The novel SST power cell topology, combined with a new silicon carbide (SiC) MOSFET device, enables a 3.5 percent improvement in system efficiency, a 50-percent smaller equipment footprint, and four times less weight than today’s DCFC systems. The SST technology would directly utilize MVAC at 4.8-kV or 13.2-kV. This would eliminate the line frequency transformer (LFT), which steps down medium-voltage AC to 3-Phase 480-V line-to-line voltage in current DCFC systems.

42 ENGINEERING↗
DOE OSTI2024

Health Care Usage During the COVID-19 Pandemic and the Adoption of Telemedicine: Retrospective Study of Chronic Disease Cohorts

Background: The COVID-19 pandemic accelerated telehealth adoption across disease cohorts of patients. For many patients, routine medical care was no longer an option, and others chose not to visit medical offices in order to minimize COVID-19 exposure. In this study, we take a comprehensive multidisease approach in studying the impact of the COVID-19 pandemic on health care usage and the adoption of telemedicine through the first 12 months of the COVID-19 pandemic. Objective: We studied the impact of the COVID-19 pandemic on in-person health care usage and telehealth adoption across chronic diseases to understand differences in telehealth adoption across disease cohorts and patient demographics (such as the Social Vulnerability Index [SVI]). Methods: We conducted a retrospective cohort study of 6 different disease cohorts (anxiety: n=67,578; depression: n=45,570; diabetes: n=81,885; kidney failure: n=29,284; heart failure: n=21,152; and cancer: n=35,460). We used summary statistics to characterize changes in usage and regression analysis to study how patient characteristics relate to in-person health care and telehealth adoption and usage during the first 12 months of the pandemic. Results: We observed a reduction in in-person health care usage across disease cohorts (ranging from 10% to 24%). For most diseases we study, telehealth appointments offset the reduction in in-person visits. Furthermore, for anxiety and depression, the increase in telehealth usage exceeds the reduction in in-person visits (by up to 5%). We observed that younger patients and men have higher telehealth usage after accounting for other covariates. Patients from higher SVI areas are less likely to use telehealth; however, if they do, they have a higher number of telehealth visits, after accounting for other covariates. Conclusions: The COVID-19 pandemic affected health care usage across diseases, and the role of telehealth in replacing in-person visits varies by disease cohort. Understanding these differences can inform current practices and provides opportunities to further guide modalities of in-person and telehealth visits. Critically, further study is needed to understand barriers to telehealth service usage for patients in higher SVI areas. A better understanding of the role of social determinants of health may lead to more support for patients and help individual health care providers improve access to care for patients with chronic conditions.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2023

Early life stress induces irritable bowel syndrome from childhood to adulthood in mice

Background Irritable bowel syndrome (IBS) is one of the most common functional gastrointestinal disorder. Traditionally, early life stress (ELS) is predisposed to IBS in adult. However, whether ELS induces IBS in early life remains unclear. Methods Separated cohort studies were conducted in neonatal male pups of C57BL/6 mice by maternal separation (MS) model. MS and non-separation mice were scheduled to be evaluated for prime IBS-phenotypes, including visceral hypersensitivity, intestinal motility, intestinal permeability, and anxiety-like behavior. Ileal contents and fecal samples were collected and analyzed by 16S rRNA gene sequencing and bacterial community analyses. Subcellular structures of intestinal epithelial, such as epithelial tight junctions and mitochondria, were observed under transmission electron microscopy. Results MS induced visceral hypersensitivity and decreased total intestinal transit time from childhood to adulthood. In addition, MS induced intestinal hyperpermeability and anxiety-like behavior from adolescence to adulthood. Besides, MS affected intestinal microbial composition from childhood to adulthood. Moreover, MS disrupted intestinal mitochondrial structure from childhood to adulthood. Conclusion The study showed for the first time that MS induced IBS from early life to adulthood in mice. The disrupted intestinal mitochondrial structure and the significant dysbiosis of intestinal microbiota in early life may contribute to the initiation and progress of IBS from early life to adulthood.

Tao, Enfu↗
DOE OSTI2023

Psychometric property study of the Affective Lability Scale-short form in Chinese patients with mood disorders

Introduction This study aimed to investigate the psychometric properties of the Affective Lability Scale-short form (ALS-SF) among Chinese patients with mood disorders, and to compare ALS-SF subscale scores between patients with major depressive disorder (MDD) and patients with bipolar disorder (BD) depression. Methods A total of 344 patients with mood disorders were included in our study. Participants were measured through a set of questionnaires including the Chinese version of ALS-SF, Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder 7-item (GAD-7), and NEO-Five Factor Inventory (NEO-FFI). Exploratory factor analysis and confirmatory factor analysis were applied to examine the psychometric properties of ALS-SF. Besides, correlation and regression analyses were performed to explore the relationship between affective lability and depression, anxiety, and neuroticism. Independent samples t -tests were used to compare the subscale scores of ALS-SF between the MDD and BD depression groups. Results Results of factor analysis indicated that the model of ALS-SF was consistent with ALS-SF. The ALS-SF showed a solid validity and high internal consistency (Cronbach’s alpha = 0.861). In addition, each subscale of ALS-SF was significantly correlated with PHQ-9, GAD-7, and NEO-FFI neuroticism subscale, except for the anger subscale showed no significant correlation with PHQ-9. Besides, the depression/elation and anger factor scores in patients with BD depression were higher than in patients with MDD. Conclusion Our study suggests that the Chinese version of ALS-SF has good reliability and validity for measuring affective lability in Chinese patients with mood disorders. Assessing affective lability would assist clinicians to distinguish between MDD and BP depression and may decrease the risks of misdiagnosis.

Ma, Mohan↗
DOE OSTI2020

Range cost-effectiveness of plug-in electric vehicle for heterogeneous consumers: An expanded total ownership cost approach

Plug-in electric vehicles (PEV) appears to have sales momentum in major personal vehicle markets but are still at the early market stage. Opportunities to accelerate PEV adoption can be discovered through comprehensive total cost of ownership (TCO) analysis. Understanding the cost-effective electric ranges of PEVs for consumers, manufacturers, and the society is critical for any discussion of PEV mass markets. This study expanded the traditional TCO approach by (1) fully considering heterogeneous consumer driving patterns, (2) quantifying the charging inconvenience and range anxiety cost of battery-electric vehicles (BEVs), and (3) monetizing both tangible and intangible PEV policies. Uncertainties were handled through Monte Carlo simulation. The results suggest that BEVs with an electric range of 250–350 km have the lowest TCO in cities with government-enacted purchase limitations, and internal combustion engine vehicles (ICEVs) have the lowest TCO in cities without purchase limitations, even when considering PEV subsidies. The lowest TCO for some consumer groups is obtained by BEVs with an electric range of 400–450 km, especially in northern China, where the weather is colder. The cost-effective all-electric range for BEVs in each city in 2025 will decrease due to improved battery performance in cold environments and an expanded charging infrastructure. Finally, based on TCO, plug-in hybrid electric vehicles (PHEVs) are currently more suitable for drivers with a high average daily mileage or a large mileage variance. However, by 2025, BEVs with a long driving range may become a more cost-effective choice for these drivers.

33 ADVANCED PROPULSION SYSTEMS↗
DOE OSTI2024

Non-DNA radiosensitive targets that initiate persistent behavioral deficits in rats exposed to space radiation

Predicting future CNS risks for astronauts during deep-space missions will rely substantially on ground-based rodent data with space-relevant ions and behaviors. For rats, the accumulated evidence indicates that less densely ionizing radiation, such as 4 He and 12 C ions, induce behavior deficits at lower doses than densely ionizing ions, such as 48 Ti and 56 Fe. However, this observation conflicts with standard somatic radiobiology, in which densely ionizing ions are generally more effective than less densely ionizing ions, and where the DNA/nucleus is the accepted target for radiation-induced tumorigenesis, cytogenetic aberrations, genetic mutations, and reproductive cell death. To gain deeper insight into the subcellular nature of the radiation targets for behavior risks, we compared the effects of dose, fluence, and linear energy transfer (LET) of 4 He and 56 Fe particles using existing datasets for four distinct behavioral outcomes in rats: elevated plus maze (EPM-anxiety), novel object recognition (NOR-memory), operant responding (OR-response to environmental stimuli), and attentional set-shifting (ATSET-cognitive flexibility). We confirmed that less densely ionizing particles (except protons) showed ~100-fold lower threshold doses than densely ionizing particles for behavioral deficits (0.1–1 cGy for 4 He vs. 15–100 cGy for 56 Fe). However, when analyzed by fluence the behavioral responses converged, indicating that 4 He and 56 Fe were equally effective on a per-track basis. When analyzed by LET, there were ~100-fold differences in the LET for maximum effectiveness for behavioral deficits and DNA endpoints (~1 vs ~100 keV/μm, respectively). These unique features of radiation-induced behavioral deficits (high sensitivity to particles in the 1-keV/μm range, insensitivity to protons in the 0.2 keV/μm range, and isofluence dependence for particles with LET>1 keV/μm) provide evidence in support of a new hypothesis of sub-micron sized radiosensitive targets for behavioral effects consistent with the thickness of plasma membranes and/or small subcellular structures, smaller than a whole synapse. Like our behavior findings, mouse immature oocyte killing which is known to have a plasma membrane target was also better explained by fluence, rather than dose. In contrast, fluence analyses for DNA/nuclear endpoints in somatic cells (e.g., tumor induction, chromosome aberrations) showed opposite results, suggesting that behavior targets are not DNA. Our findings raise questions regarding the identity of subcellular targets and the multi-cellular functional unit for behavior risks, low-dose susceptibility, and generalizability from rat to other species and astronauts.

63 RADIATION, THERMAL, AND OTHER ENVIRON. POLLUTAN↗
DOE OSTI2024

Electric Vehicles Charging Time Constrained Deliverable Provision of Secondary Frequency Regulation

Aggregation of electric vehicles (EVs) is a promising technique for providing secondary frequency regulation (SFR) in highly renewable energy-penetrated power systems. Equipped with energy storage devices, EV aggregation can provide reliable SFR. However, the main challenge is to guarantee reliable intra-interval SFR capacities and inter-interval delivery following the automatic generation control (AGC) signal. Furthermore, aggregated EV SFR provision will be further complicated by the EV charging time anxiety because SFR provision might extend EV's charging time. This paper proposes a deliverable EV SFR provision with a charging-time-constrained control strategy. First, a charging-time-constrained EV aggregation is proposed to address the uncertainty of EV capacity based on the state-space model considering the charging-time restriction of EV owners. Second, a real-time economic dispatch and time domain simulation (RTED-TDS) cosimulation framework is proposed to verify financial results and the dynamic performance of the EV SFR provision. Last, the proposed charging time-constrained EV aggregation is validated on the IEEE 39-bus system. In conclusion, the results demonstrate that with charging time-constrained EV aggregation, the dynamic performance of the system can be improved with a marginal increase in total cost. More importantly, the charging time constraint can be respected in the proposed SFR provision of the EV aggregation.

24 POWER TRANSMISSION AND DISTRIBUTION↗
DOE OSTI2024

Next-Generation NGV Driver Information System

Measuring the amount of fuel contained in the tank of a Natural Gas Vehicle (NGV) is not as straightforward as it is for a liquid-fueled vehicle. The fuel in an NGV is a compressed gas at pressures up to 4200psig, and its pressure changes with temperature. The current state-of-the-art, which is used on most NGVs, is a simple pressure gauge as a rough guide for remaining fuel. This presents a high degree of error because pressure varies widely depending on temperature. Immediately following refueling, the temperature in the vehicle’s cylinders is often greater than 150°F. As the driver pulls out of the fueling station and begins consuming gas, the pressure drops at a very fast rate due to expansion cooling of the gas. This pressure drop appears to the driver to be a very rapid decrease in fuel level, reducing trust in the fuel level indication and leading to concern about the distance the vehicle can travel before refueling again, which is known as “range anxiety.”

03 NATURAL GAS↗
DOE OSTI2021

Early Warning Signs of a Mental Health Tsunami: A Coordinated Response to Gather Initial Data Insights From Multiple Digital Services Providers

The immediate impact of coronavirus 2019 (COVID-19) on morbidity and mortality has raised the need for accurate and real-time data monitoring and communication. The aim of this study is to document the initial observations from multiple digital services providers during the COVID-19 crisis, especially those related to mental health and well-being. We used email and social media to announce an urgent call for support. Digital mental health services providers (N = 46), financial services providers (N = 4), and other relevant digital data source providers (N = 3) responded with quantitative and/or qualitative data insights. People with lived experience of distress, as service users/consumers, and carers are included as co-authors. This study provides proof-of-concept of the viability for researchers and private companies to work collaboratively toward a common good. Digital services providers reported a diverse range of mental health concerns. A recurring observation is that demand for digital mental health support has risen, and that the nature of this demand has also changed since COVID-19, with an apparent increased presentation of anxiety and loneliness. Following this study, we will continue to work with providers in more in-depth ways to capture follow-up insights at regular time points. We will also onboard new providers to address data representativeness. Looking ahead, we anticipate the need for a rigorous process to interpret insights from an even wider variety of sources in order to monitor and respond to mental health needs.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2023

Achieving Thermodynamic Stability of Single-Crystal Co-Free Ni-Rich Cathode Material for High Voltage Lithium-Ion Batteries

Ni-rich layered cathode materials are progressively considered as the standard configuration of high-energy electric vehicles by virtues of their high capacity and eliminated “range anxiety.” However, the poor cyclic stability and severe cobalt supply crisis would restrain their wide commercial applicability. Here, a cost-effective single-crystal Co-free Ni-rich cathode material LiNi 0.8 Mn 0.18 Fe 0.02 O 2 (NMF), which outperforms widely commercial polycrystalline LiNi 0.83 Co 0.11 Mn 0.06 O 2 (MNCM) and single-crystal LiNi 0.83 Co 0.11 Mn 0.06 O 2 (SNCM) is reported. Surprisingly, NMF can compensate for the reversible capacity loss under the designed conditions of high-temperature and elevated-voltage, achieving a competitive energy density compared with conventional MNCM or SNCM. Further, combining operando characterizations and density functional theory calculation, it is revealed that NMF cathode with improved dynamic structure evolution largely alleviates the mechanical strain issue commonly found in Ni-rich cathode, which can reduce the formation of intragranular cracks and improve the safety performance. Consequently, this new Co-free NMF cathode can achieve a perfect equilibrium between material cost and electrochemical performance, which not only reduces the production cost by >15%, but also demonstrates excellent thermal stability and cycling performance.

25 ENERGY STORAGE↗
DOE OSTI2022

Behavioral and neuroinflammatory changes caused by glyphosate: Base herbicide in mice offspring

Abstract Background Glyphosate is a pesticide considered of low toxicity, but scientific evidences show it can be harmful to health. This study aimed to evaluate the toxicity in mice offspring exposed to glyphosate‐based herbicide (GBH) during the intrauterine period. Methods Female matrices received glyphosate 0.3 mg/kg daily per oral throughout the gestational period, which was variable between 18 and 22 days. From the 25th until the 28th days post‐birth, mice offspring were subjected to behavioral tests, and the prefrontal cortex was processed for immunohistochemical analysis. Results Two significant behavioral changes were observed: anxiety in the GLIF0.3 group, increase in the behavior burying marbles in the marble‐burying test and hyperactivity, expressed by the significant increase of the crossing number in the open field test. The increased microglia, TNF‐alpha, and astrocyte expression were also observed in the prefrontal cortex of offspring treated with GLIF0.3. Conclusion Exposure to GBH during mice intrauterine development induces hyperactive and anxious behavior, evidencing neuroinflammation.

de Castro Vieira Carneiro, Carla Larissa↗
DOE OSTI2022

A novel methodology to integrate outcomes regarding perioperative pain experience into a composite score: Prediction model development and validation

Abstract Background An integrated score that globally assesses perioperative pain experience and rationally weights each component has not yet been developed. Methods A development dataset specific to adult Chinese patients undergoing orthopaedic surgery was obtained from PAIN OUT (1985 qualified patients of 2244). A more recent validation dataset obeying the same conditions was obtained from the Chinese Anaesthesia Shared‐database Platform (1004 qualified patients of 1032). Outcomes were assessed using the International Pain Outcomes Questionnaire (IPO‐Q), which comprises key patient‐level outcomes of perioperative pain management, including pain experience and perceptions of care. Using principal component analysis and regression models, a composite score (CS) was inferred to integrate pain experience. The discrimination of the CS for dissatisfaction and desire for more pain treatment was compared with that of the worst pain score. Results A CS was developed from the 12 items of the IPO‐Q regarding pain experience. The weight for calculating the CS was worst pain 11, least pain 17, time spent in severe pain 11, interference with activity in bed 9, interference with breathing deeply or coughing 10, interference with sleep 9, anxiety 12, helplessness 12, nausea 0, drowsiness 2, itch 5 and dizziness 2. In external validation, the CS indicated superior discrimination to the worst pain in predicting dissatisfaction ( p < 0.001) and desire for more pain treatment ( p < 0.001). Conclusions This study introduced a methodology to integrate outcomes regarding perioperative pain experience into a CS, which was based on the weight of each item. Significance This novel methodology sheds additional light on the riveting issue of carefully integrating several measures into a composite endpoint, which may be useful for quality improvement purposes when addressing the impact of a change in clinical practice.

Jiang, Bailin↗