Quality of analgesic care in labor: A cross-sectional study of the first national register-based benchmarking system.

OBJECTIVE: Unlike other types of acute pain, labor pain is considered physiological. Due to the heterogeneous management during labor, there is a lack of intention to define quality of care of peripartal analgesia. This study presents the first results of the national register for this evaluation. METHODS: This prospective cross-sectional study, conducted in five different German level-three hospitals, included women after vaginal childbirth between January 2020 and January 2022. A validated questionnaire was completed 24 h postpartum, including information about labor pain, satisfaction, and expectations regarding analgesia. Data were centrally recorded with obstetric records using the database of the QUIPS (Quality Improvement in Postoperative Pain Management) Project. RESULTS: A total of 514 women were included. On an 11-point Numerical Rating Scale, pain intensity during labor was severe (8.68 ± 1.8) while postpartal pain was 3.9 (±2.1). The second stage of labor was considered the most painful period. Only 62.6% of the parturients obtained pharmacological support, with epidural being the most effective (reduction of 3.8 ± 2.8 points). Only epidural (odds ratio [OR] 0.22) and inhalation of nitrous oxide (OR 0.33) were protective for severe pain. In benchmarking, a relation between satisfaction, pain intensity, and the use of epidural was found; 40.7% of the women wished they had received more analgesic support during labor. CONCLUSION: This study highlights deficiencies in analgesic management in high-level perinatal centers, with more than 40% of parturients considering actual practices as insufficient and wishing they had received more analgesic support, despite the availability of analgesic options. Using patient-reported outcomes can guarantee qualitative tailored analgesic care in women.

Objectively measured activity is not associated with average pain intensity 1 week after surgery: A cross-sectional study.

BACKGROUND: Measures of physical activity and pain-related patient-reported outcomes are important components of patient recovery after surgery. However, little is known about their association in the early post-operative period. This study aims to increase this knowledge. Our primary objective was to determine the association between average pain intensity and activity (in steps) 1 week after surgery. Secondary objectives were the association of activity with other patient-reported outcomes, age, sex, comorbidities and body mass index. METHODS: Data were obtained from the PROMPT sub-project of IMI-PainCare. Patients after breast and endometriosis-related surgery, sternotomy and total knee arthroplasty completed pain-related outcomes questionnaires and wore an ActiGraph activity-tracking device. We correlated steps with average pain intensity on post-operative days 6 and 7. Secondary analyses were done using correlations and t-tests. RESULTS: In 284 cases, there was no statistically significant correlation between steps and average pain intensity. In addition, none of the 28 secondary analyses showed a statistically significant result. CONCLUSIONS: Pain-related patient-reported outcome measures and physical activity are separate entities. Both should be measured after surgery to assess patient recovery and to identify treatment deficiencies. SIGNIFICANCE STATEMENT: Measuring recovery is a multi-dimensional challenge. After surgery, clinicians need to be aware that neither pain intensity nor activity levels tell the whole story. Each can hint to problems and treatment requirements.

Demonstration of the trapped-ion quantum CCD computer architecture.

The trapped-ion quantum charge-coupled device (QCCD) proposal1,2 lays out a blueprint for a universal quantum computer that uses mobile ions as qubits. Analogous to a charge-coupled device (CCD) camera, which stores and processes imaging information as movable electrical charges in coupled pixels, a QCCD computer stores quantum information in the internal state of electrically charged ions that are transported between different processing zones using dynamic electric fields. The promise of the QCCD architecture is to maintain the low error rates demonstrated in small trapped-ion experiments3-5 by limiting the quantum interactions to multiple small ion crystals, then physically splitting and rearranging the constituent ions of these crystals into new crystals, where further interactions occur. This approach leverages transport timescales that are fast relative to the coherence times of the qubits, the insensitivity of the qubit states of the ion to the electric fields used for transport, and the low crosstalk afforded by spatially separated crystals. However, engineering a machine capable of executing these operations across multiple interaction zones with low error introduces many difficulties, which have slowed progress in scaling this architecture to larger qubit numbers. Here we use a cryogenic surface trap to integrate all necessary elements of the QCCD architecture-a scalable trap design, parallel interaction zones and fast ion transport-into a programmable trapped-ion quantum computer that has a system performance consistent with the low error rates achieved in the individual ion crystals. We apply this approach to realize a teleported CNOT gate using mid-circuit measurement6, negligible crosstalk error and a quantum volume7 of 26 = 64. These results demonstrate that the QCCD architecture provides a viable path towards high-performance quantum computers.

Measuring the difference in nuclear charge radius of Xe isotopes by EUV spectroscopy of highly charged Na-like ions.

The difference in the mean-square nuclear charge radius of xenon isotopes was measured utilizing a method based on extreme ultraviolet spectroscopy of highly charged Na-like ions. The isotope shift of the Na-like D1 (3s 2 S 1/2 - 3p 2 P 1/2) transition between the 124Xe and 136Xe isotopes was experimentally determined using the electron-beam ion-trap facility at the National Institute of Standards and Technology. The mass-shift and the field-shift coefficients were calculated with enhanced precision by the relativistic many-body perturbation theory and multiconfiguration Dirac-Hartree-Fock method. The mean-square nuclear charge radius difference was found to be δ〈r 2〉136,124 = 0.269(42) fm2. Our result has smaller uncertainty than previous experimental results and agrees with the literature values.

Anomalously Large Chiral Sensitivity in the Dissociative Electron Attachment of 10-Iodocamphor.

We have studied dissociative electron attachment (DEA) between low energy (≤0.6 eV) longitudinally polarized electrons and gas-phase chiral targets of 3-bromocamphor (C_{10}H_{15}BrO), 3-iodocamphor (C_{10}H_{15}IO), and 10-iodocamphor. The DEA rate depends on the sign of the incident electron helicity for a given target handedness, and it varies with both the atomic number (Z) and location of the heaviest atom in the molecule. While simple dynamic mechanisms can account for the asymmetry dependence on Z, they fail to explain the large asymmetry variation with the heavy atom location.

New technique for the reduction of helicity-correlated instrumental asymmetries in photoemitted beams of spin-polarized electrons.

We present a new optical system that significantly reduces helicity-dependent instrumental intensity asymmetries. It is an extension of a previous scheme [Appl. Opt.47, 2465 (2008)], where one laser beam is split using a polarizing beam splitter into two with orthogonal linear polarizations. The beams are sent through a chopper, allowing only one to pass at a time. The two temporally separated beams are then spatially recombined using a second beam splitter. A liquid crystal retarder preceding the first beam splitter controls the relative intensity of the two oppositely polarized beams, allowing reduction of instrumental asymmetries. This system has been modified to include a spatial filter and a Pockels cell placed after the second beam splitter to act as a second active polarization element. Using this method, we can control instrumental asymmetries to ∼5×10(-7) in 1 h of data taking, which is comparable to the precision achieved in "second-generation" high energy electron-nuclear scattering parity violation experiments.

Chirally sensitive electron-induced molecular breakup and the Vester-Ulbricht hypothesis.

We have studied dissociative electron attachment in sub-eV collisions between longitudinally polarized electrons and chiral bromocamphor molecules. For a given target enantiomer, the dissociative Br anion production depends on the helicity of the incident electrons, with an asymmetry that depends on the electron energy and is of order 3×10^{-4}. The existence of chiral sensitivity in a well-defined molecular breakup reaction demonstrates the viability of the Vester-Ulbrict hypothesis, namely, that the longitudinal polarization of cosmic beta radiation was responsible for the origins of biological homochirality.

Behavioral characterization of dopamine D5 receptor null mutant mice.

To study behavioral functions of the D5 subtype, mice were generated with null mutations in the D5 gene. This 1st behavioral characterization of D5 null mutant mice (D5-/-) indicated normal general health, sensory abilities, and neurological reflexes. Under basal conditions, D5-/- mice were generally normal on locomotor activity, the rotarod test, acoustic startle response, prepulse inhibition, elevated plus-maze, light <--> dark exploration, Morris water maze, and cued and contextual fear conditioning. In the Porsolt forced swim test for antidepressant activity, male D5-/- mice showed lower levels of immobility. D5-/- mice showed some evidence of reduced responses to the hyperactivity-inducing effects of the D1/D5 receptor agonist SKF 81297. The ability of SKF 81297 to disrupt acoustic startle and prepulse inhibition appeared to be attenuated in D5-/- mice. These results suggest that the D5 receptor is not essential for many dopamine-mediated behaviors but may contribute to the pharmacological activation of dopaminergic pathways relevant to exploratory locomotion, startle, and prepulse inhibition.

Rat strain differences in response to galanin on the Morris water task.

Galanin acts as an inhibitory modulator of cholinergic transmission in the septohippocampal pathway of the rat. Centrally administered galanin induces performance deficits on rodent learning and memory tasks, including delayed non-matching to position, T-maze delayed alternation, passive avoidance, starbust radial maze acquisition, and the Morris water task. The present study investigates differences in responsiveness to intraventricularly administered galanin across three strains of laboratory rat on acquisition of spatial learning in the Morris water task. Sprague-Dawley rats showed normal performance during training, but lack of selective quadrant search on the probe trial in response to galanin treatment. Long-Evans rats showed no effects of galanin on performance during training or probe trial. Wistar rats showed longer latencies to reach the hidden platform during training, and lack of selective quadrant search on the probe trial in response to galanin. Performance on the visible platform task and on locomotor activity in the open field was normal in rats treated with galanin. These results are consistent with an interpretation of strain differences in sensitivity to the inhibitory actions of galanin on learning and memory.