Probability Of Outcome Research Articles

Predictors of the effectiveness of initial therapy with antimuscarinic agents in children with neurogenic urination disorders

BACKGROUND: Almost a third of patients with neurogenic urinary disorders have a refractory nature to therapy with antimuscarinic agents. The aim of the current trial was to identify predictors of the effectiveness of initial therapy with antimuscarinic agents in children with neurogenic urination disorders. For this, a comprehensive analysis of clinical parameters and video urodynamic findings in children was made. AIM: The purpose of this study was to identify predictors of the successful initial therapy with M-anticholinergic preparations in children with neurogenic urinary disorders. For this, results of a comprehensive analysis of initial clinical and video urodynamic parameters were used.. METHODS: A prospective longitudinal cohort study involved 62 patients, aged 1.8–18 years, with neurogenic urination. In addition to the standard examination, all patients underwent a video urodynamic examination at Laborite Delphis UDS-600 device with parallel cystography at Siemens X-ray C-arc (Siemens, Germany). By the obtained results, 52 out of 62 patients were prescribed antimuscarinic agents as the first line therapy. Therapy effectiveness was assessed in 3 months. Analysed parameters were age, presence/absence of self-catheterization, as well as presence/absence of vesicoureteral reflux (VUR) revealed at conventional retrograde urethrocystography and/or video urodynamic examination. RESULTS: The multivariate regression analysis demonstrated that the risk of ineffective antimuscarinic therapy increases by 75,6% in patients with VUR revealed at retrograde uretrocystography, regardless of patient's age and self-catheterization (OR=0.244; 95% CI=0.063-0.937; p=0.040) and by 89.8% (OR=0.102; 95% CI=0.019-0.554; p=0.008) when VUR is detected at video urodynamic examination. Unlike patients with a positive effect (n=24; 50%), 24 patients (50%) who had no response to antimuscarinic therapy were younger (median age 8 years); they also were self-catheterized and had VUR revealed at video urodynamic examination. Outcomes of the prescribed therapy were not associated with other video urodynamic parameters. The identified significant predictors (age, self-catheterization and VUR at video urodynamic examination) have allowed to develop a model for predicting antimuscarinic therapy effectiveness before its administration. This model can promote a rational selection of patients for antimuscarinic therapy, as the first line therapy, with a high probability of positive outcome in 84.9% of patients. CONCLUSION: When prescribing antimuscarinic agents, patient's age, self-catheterization, VUR revealed at retrograde urethrocystography and video urodynamic examination should be taken into account. Predictors of effective antimuscarinic therapy in children with neurogenic urinary disorders, which increase the likelihood of successful outcomes, are patient's age (over 12 years), no self-catheterization and no VUR at video urodynamic examination. Patients younger than 12 years, with self-catheterization and VUR are less likely to respond to antimuscarinic therapy.

Wind speed multi-step prediction based on the comparison of wind characteristics and error correction: Focusing on periodic thermally-developed winds

To leverage the abundant wind energy resources available in mountainous regions, an increasing number of wind power facilities and associated transportation infrastructure are being constructed in these areas. There are different types of intense winds in mountainous areas and the non-linear characteristics of the different intense winds vary significantly. The periodic thermally-developed winds are the commonly occurring type of intense wind. Based on the comparison of wind characteristics, this research proposes a prediction model for the periodic thermally-developed winds. The research utilizes the Bi-directional Long Short-Term Memory model(Bi-LSTM), which has been optimized by the Bayesian optimization(BO), to predict wind speed. Based on the relationship between wind field characteristics in periodic thermally-developed winds, a regression correction module is proposed using a joint probability model. Additionally, to address the volatility and uncertainty of wind speed, a Gaussian mixture model is employed for probability prediction. The experimental results demonstrate several findings: 1. The BO-Bi-LSTM model accurately and reliably predicts multi-step results for periodic thermally-developed winds in mountainous areas. 2. The proposed correction module, when combined with other models, yields improved wind speed accuracy compared to the uncorrected values. 3. The Gaussian mixture model produces probabilistic prediction results that consider both interval coverage and interval bandwidth simultaneously. 4. The proposed model can successfully predict periodic thermally-developed winds in mountainous areas for practical engineering purposes, resulting in reliable probabilistic prediction outcomes. It is of great significance for the utilization of wind energy resources and the driving safety of vehicles on ancillary structures.

Promoting Adolescent Safer Gambling Through Self-Referent Counterfactual Thinking and Knowledge of Probabilistic Outcome.

Research have continued to advocate for various safer gambling strategies (SGs) to curb initiation and sustenance of problem gambling through the conceptualization and development of SG tools. The present study aims to extend this advocacy by examining cognitive processes that promote adolescent responsible gambling (RG) in Nigeria. Young adolescents (N = 962, Mage =16.06, SD = 4.12) recruited from a high school population responded to measures of self-referent counterfactual thinking (S-RCFT), knowledge of probabilistic outcomes (KPO), and RG. Hayes PROCESS macro analysis result showed that S-RCFTs and KPO were positively associated with RG. More importantly, it was revealed that KPO amplified the S-RCFT-RG link and provided a plausible pathway to understanding the effect of S-RCFT on RG. This calls for SG advocacies to encourage adolescent gamblers to hold themselves responsible for responsible gambling, and to understand that gambling wins randomly occur. The limitations of the study and recommendations are highlighted.

Does correlation matter in probability matching? A laboratory investigation

Probability Matching, a classical violation of expected utility maximization, refers to people's tendency to randomize, or even match their choice frequency to the outcome probability, when choosing over binary lotteries that differ only in their probabilities. Why? I present an experiment designed to distinguish between several broad classes of explanations: (1) models of Correlation-Invariant Stochastic Choice — randomizing due to factors orthogonal to the correlation between lotteries, such as non-standard preferences or errors, and (2) models of Correlation-Sensitive Stochastic Choice — deliberately randomizing due to misperceived hedging opportunities, especially when lotteries are negatively correlated. My experimental design differentiates between their testable predictions by varying the correlation between lottery outcomes. The findings indicate that the first class, despite being home to most existing theories, has limited explanatory power. Using additional treatment, I rule out Similarity Heuristics as a competing explanation with the second class. The results indicate that a vast majority of individuals deliberately randomize due to misperceived hedging opportunities.

Primary hyperparathyroidism in pregnancy after in vitro fertilization

Primary hyperparathyroidism (PHPT) in pregnant women is a rare condition, often remaining undiagnosed due to non-specific clinical symptoms. However, it can lead to life-threatening complications for both the mother and fetus. In vitro fertilization (IVF) is also associated with an increased probability of adverse outcomes compared to the general population. Timely diagnostics and personalized treatment, taking into account the extremely high risk of complications if PHPT and pregnancy result from IVF, require attention of healthcare professionals and formation of a multidisciplinary team.

Factors affecting the course and prognosis of implant-associated infection caused by <i>Klebsiella</i> spp.

Background. The outcome of complex treatment of implant-associated infection (IAI) depends on various factors, but one of the most important is the etiology of the inflammatory process. Treatment of orthopedic infection caused by Gram-negative microorganisms in general and representatives of the family Enterobacteriaceae in particular causes many difficulties, one of which is the rapid growth of antibiotic resistance. Aim of the study — to evaluate the factors affecting the course and prognosis of implant-associated infection caused by Klebsiella spp. Methods. We performed a retrospective analysis of case histories of 85 patients who underwent treatment of IAI caused by Klebsiella spp. in the clinical departments of the center from January 1, 2017 to December 31, 2021. According to the results of the telephone survey, the patients were divided into 2 main groups depending on the outcome of the 2-year follow-up period determined in accordance with the Delphi criteria. Results. It was found that the prognosis was significantly worsened by the number of sanitizing surgical interventions in the anamnesis (p = 0.022), the need for sanitizing intervention in the early postoperative period (p0.001) and the presence of Klebsiella spp. growth in postoperative culture tests (p = 0.002), hypoalbuminemia on 7-14 days after the surgery (p = 0.008). The administration of trimethoprim-sulfamethoxazole for the outpatient treament stage significantly improved the outcome (p = 0.038), which is most likely due to a high proportion of polymicrobial associations — 69.5%. Conclusions. There is a statistically significant direct relationship between the probability of an unfavorable treatment outcome of patients with IAI caused by Klebsiella spp. and the number of sanitizing surgical interventions in the anamnesis, low serum albumin (g/l) on 7-14 days after the operation, revision intervention in the early postoperative period, positive growth of Klebsiella spp. in postoperative culture tests. The probability of a favorable outcome was increased by the prescription of trimethoprim-sulfamethoxazole for oral administration at the outpatient stage.

The first step of two-stage hip revision: what affects the result?

Background. The most common method of treatment of chronic periprosthetic joint infection (PJI) is considered to be a two-stage revision arthroplasty. The efficacy of this technique is largely determined by the results of infection management after the first (debridement) stage, which may depend on many factors. At the same time, the widespread tendency to reduce the duration of patients’ hospital stay brings to the forefront the problem of long wait for the results of preoperative microbiological examination. Aims of the study: 1) to retrospectively evaluate the efficacy of the debridement stage of chronic periprosthetic hip joint infection in 2021 depending on the availability of preoperative microbiological examination results; 2) to determine the factors influencing the treatment outcome. Methods. Patients (n = 86) with chronic PJI of the hip were allocated into two groups depending on the presence or absence of results of the microbiological examination of preoperative biomaterials (aspirate and/or tissue biopsy) at the time of performing the first stage of the two-stage revision arthroplasty. Results. The availability of final results of the microbiological examination (MBE) of joint aspirate at the time of surgery had no significant effect on the efficacy of infection management (p = 0.536; OR = 1.53, 95% CI 0.43-5.45). There was a significant reduction of the risk when the results of preoperative and intraoperative MBE coincided (p = 0.024; OR = 0.121, 95% CI 0.015-0.990). An increased risk of adverse outcome of the debridement stage of treatment was observed in the case of types 2C (p = 0.042; OR = 6.66; 95% CI 1.26-35.2) and 3B (p = 0.078; OR = 8.1, 95% CI 1.015-64.8) acetabular defects, type 3A femoral defects (p = 0.021; OR = 6.57, 95% CI 1.49-29.01), and connective tissue diseases (p = 0.062; OR = 5.25, 95% CI 1.05-26.2). The presence of microbial associations (p=0.02; OR = 6.75, 95% CI 1.36-33.44) and the presence of Gram-negative bacteria in them (p = 0.058; OR = 4.2, 95% CI 1.02-17.20) significantly worsened the treatment prognosis. As the number of patient’s risk factors increased, the probability of an unfavorable outcome increased significantly (p0.001). Conclusion. Polymicrobial infection, presence of Gram-negative bacteria in microbial associations, connective tissue diseases, types 2C and 3B acetabular defects, type 3A femoral bone defects, and total number of risk factors in one patient had a significant negative impact on the outcome of debridement surgery. Apparently, the results of the microbiological examination of preoperatively sampled biomaterials are much more important as a diagnostic criterion for suspected periprosthetic infection than as a criterion for the drug choice for etiotropic antibacterial therapy. However, this assumption should be studied on a larger sample of patients.

Preferences reveal dissociable encoding across prefrontal-limbic circuits.

Individual preferences for the flavor of different foods and fluids exert a strong influence on behavior. Most current theories posit that preferences are integrated with other state variables in the orbitofrontal cortex (OFC), which is thought to derive the relative subjective value of available options to guide choice behavior. Here, we report that instead of a single integrated valuation system in the OFC, another complementary one is centered in the ventrolateral prefrontal cortex (vlPFC) in macaques. Specifically, we found that the OFC and vlPFC preferentially represent outcome flavor and outcome probability, respectively, and that preferences are separately integrated into value representations in these areas. In addition, the vlPFC, but not the OFC, represented the probability of receiving the available outcome flavors separately, with the difference between these representations reflecting the degree of preference for each flavor. Thus, both the vlPFC and OFC exhibit dissociable but complementary representations of subjective value, both of which are necessary for decision-making.

Computational Modeling Differentiates Learning Rate From Reward Sensitivity Deficits Produced by Early-Life Adversity in a Rodent Touchscreen Probabilistic Reward Task

BackgroundExposure to adversity, including unpredictable environments, during early life is associated with neuropsychiatric illness in adulthood. One common factor in this sequela is anhedonia, the loss of responsivity to previously reinforcing stimuli. To accelerate the development of new treatment strategies for anhedonic disorders induced by early-life adversity, animal models have been developed to capture critical features of early-life stress and the behavioral deficits that such stressors induce. We have previously shown that rats exposed to the limited bedding and nesting protocol exhibited blunted reward responsivity in the probabilistic reward task, a touchscreen-based task reverse translated from human studies. MethodsTo test the quantitative limits of this translational platform, we examined the ability of Bayesian computational modeling and probability analyses identical to those optimized in previous human studies to quantify the putative mechanisms that underlie these deficits with precision. Specifically, 2 parameters that have been shown to independently contribute to probabilistic reward task outcomes in patient populations, reward sensitivity and learning rate, were extracted, as were trial-by-trial probability analyses of choices as a function of the preceding trial. ResultsSignificant deficits in reward sensitivity, but not learning rate, contributed to the anhedonic phenotypes in rats exposed to early-life adversity. ConclusionsThe current findings confirm and extend the translational value of these rodent models by verifying the effectiveness of computational modeling in distinguishing independent features of reward sensitivity and learning rate that complement the probabilistic reward task’s signal detection end points. Together, these metrics serve to objectively quantify reinforcement learning deficits associated with anhedonic phenotypes.

When Half Is at Least 50%: Effect of “Framing” and Probability Level on Frequency Estimates

ABSTRACTExpert judgment often involves estimating magnitudes, such as the frequency of deaths due to a pandemic. Three experiments (Ns = 902, 431, and 755, respectively) were conducted to examine the effect of outcome framing (e.g., half of a threatened group expected to survive vs. die), probability level (low vs. high), and probability format (verbal, numeric, or combined) on the estimated frequency of survivals/deaths. Each experiment found an interactive effect of frame and probability level, which supported the hypothesis that forecasted outcomes received by participants were implicitly quantified as lower bounds (i.e., “at least half”). Responding in a manner consistent with a lower‐bound “at least” interpretation was unrelated to incoherence (Experiments 1 and 2) and positively related to numeracy (Experiments 1 and 3), verbal reasoning (Experiment 3), and actively open‐minded thinking (Experiments 2 and 3). The correlational results indicate that implicit lower bounding is an aspect of linguistic inference and not a cognitive error. Implications for research on framing effects are discussed.

Savings associated with surgical aortic valve replacement with a RESILIA tissue valve based on seven-year COMMENCE trial results

Background Bioprostheses with RESILIA tissue demonstrate a reduction in calcification and improve health outcomes in pre-clinical and clinical studies. Prior economic analyses which relied on 5 years of evidence from the COMMENCE trial demonstrate financial savings for RESILIA tissue valves relative to mechanical valves after surgical aortic valve replacement (SAVR). Given the recent release of 7-year COMMENCE data, this economic evaluation updates the estimate for long-run savings of bioprosthetic valves with RESILIA. Methods Simulation models estimated disease progression across two hypothetical SAVR cohorts (tissue vs. mechanical) of 10,000 patients each in the US. The primary comparison calculated the SAVR-related expenditures associated with each valve type ($US, 2023). Health outcome probabilities were based on the COMMENCE trial though year 7 and projected for an additional 8 years based on prior studies of tissue and mechanical SAVR. Costs for key outcomes (mortality, reoperation, bleeding, thromboembolism, endocarditis) and anticoagulant monitoring were sourced from the literature. Incidence rates of health outcomes associated with mechanical valves relied on relative risks of tissue valve versus mechanical valve patients. Results Seven-year savings are $13,415 (95% CI = $10,472–$17,321) per patient when comparing RESILIA versus mechanical SAVR. Projected 15-year savings were $23,001 ($US, 2023; 95% CI = $17,802–$30,421). Most of the 15-year savings are primarily attributed to lower anti-coagulation monitoring costs ($21,073 in ACM savings over 15 years), but lower bleeding cost (savings: $2,294) and thromboembolism-related expenditures (savings: $852) also contribute. Reoperation and endocarditis expenditures were slightly larger in the RESILIA cohort. If reoperation relative risk reverts from 1.1 to 2.2 (the level in legacy tissue valves) after year 7, savings are $18,064. RESILIA SAVR also reduce costs relative to legacy tissue valves. Conclusion Patients receiving RESILIA tissue valves are projected to have lower SAVR-related health expenditures relative to mechanical and legacy tissue valves.

The Importance of Pharmacovigilance in the Polyherbal Sector: Challenges and Future Potential

Pharmacovigilance is crucial in ensuring the safety and potency of polyherbal products, as many have not been extensively evaluated for their pharmacology and toxicity. With the increasing popularity of polyherbal medications, there has been a rise in complaints of probable toxicity and adverse outcomes. This study investigates the importance of pharmacovigilance in the polyherbal sector and examines its challenges and future potential. Data was collected from various databases from 2000-2024. Pharmacovigilance has become a key domain in medicine and public health, with a significant portion of India’s population relying on Indian medical systems. The study highlights the importance of implementing pharmacovigilance procedures for polyherbal medications, promoting rational use and appropriate treatment methods. Polyherbal drugs may have negative interactions with other medications, foods, biologicals, and compounds, leading to decreased therapeutic efficacy, undesirable side effects, and severe complications. Systematic pharmacovigilance is necessary to collect accurate data and develop guidelines for safe and effective use.

Maternal and foetal risks associated with teenage pregnancy - a comparative retrospective study in Turkey

Background Adolescent pregnancy is defined as pregnancy occurring in young women between the ages of 10 and 19 years. Adolescent pregnancies, which are among the social healthcare concerns in developed and developing countries, have negative effects on maternal and infant health. Pregnancy in adolescence puts the health of both the mother and child at risk, as adolescent pregnancies have higher rates of eclampsia, systemic infection, low birth weight, and preterm delivery compared to other pregnancies. In this study, the effects of education level, smoking, and marital status on maternal and foetal outcomes in adolescent pregnancies were evaluated. Methods The records of a total of 960 pregnant women (480 pregnant adolescents aged 15–19 years and 480 pregnant adult women aged 20–26 years) were examined retrospectively. The demographic data of the groups and maternal and foetal outcomes of the pregnancies were compared. A logistic regression model was established as a statistical method for reducing confounding effects. Results Unmarried women were statistically significantly more prevalent in the adolescent group (38.3% vs. 7.3%). Among the considered risk factors, preeclampsia (2.9% vs. 0.8%) and smoking (29.8% vs. 9.8%) were statistically significantly more common in the adolescent group. When the groups were compared in terms of risk factors in pregnancy, it was found that pregnancy in adolescence was associated with a 3.04-fold higher risk of smoking, 5.25-fold higher risk of being unmarried, 3.50-fold higher risk of preeclampsia, and 1.70-fold higher risk of intrauterine growth retardation (IUGR). Conclusions This study demonstrates an increased risk of preeclampsia, IUGR, and smoking during pregnancy in adolescent pregnant women. These findings can be used to identify adolescent pregnancies requiring specific assistance and to take measures to reduce the probability of adverse outcomes.

Door-to-Needle Time for Extracorporeal Cardiopulmonary Resuscitation and Neurological Outcomes in Out-of-Hospital Cardiac Arrest: A Nationwide Study.

Extracorporeal cardiopulmonary resuscitation (ECPR) is an option for refractory cardiac arrest, and immediate initiation after indication is recommended. However, the practical goals of ECPR preparation (such as the door-to-needle time) remain unclear. This study aimed to elucidate the association between the door-to-needle time and neurological outcomes of out-of-hospital cardiac arrest. This is a post hoc analysis of a nationwide multicenter study on out-of-hospital cardiac arrest treated with ECPR at 36 institutions between 2013 and 2018 (SAVE-J [Study of Advanced Cardiac Life Support for Ventricular Fibrillation with Extracorporeal Circulation in Japan] II study). Adult patients without hypothermia (≥32 °C) in whom circulation was not returned at ECPR initiation were included. The probability of favorable neurological function at 30 days (defined as Cerebral Performance Category ≤2) was estimated using a generalized estimating equations model, in which institutional, patient, and treatment characteristics were adjusted. Estimated probabilities were then calculated according to the door-to-needle time with 3-minute increments, and a clinical threshold was assumed. Among 1298 patients eligible for this study, 136 (10.6%) had favorable neurological function. The estimated probability of favorable outcomes was highest in patients with 1 to 3 minutes of door-to-needle time (12.9% [11.4%-14.3%]) and remained at 9% to 10% until 27 to 30 minutes. Then, the probability dropped gradually with each 3-minute delay. A 30-minute threshold was assumed, and shorter door-to-extracorporeal membrane oxygenation/low-flow time and fewer adverse events related to cannulation were observed in patients with door-to-needle time <30 minutes. The probability of favorable functions after out-of-hospital cardiac arrest decreased as the door-to-needle time for ECPR was prolonged, with a rapid decline after 27 to 30 minutes. URL: https://center6.umin.ac.jp/cgi-open-bin/ctr/ctr_view.cgi?recptno=R000041577; Unique identifier: UMIN000036490.

Neural Representation of Valenced and Generic Probability and Uncertainty.

Representing the probability and uncertainty of outcomes facilitates adaptive behavior by allowing organisms to prepare in advance and devote attention to relevant events. Probability and uncertainty are often studied only for valenced (appetitive or aversive) outcomes, raising the question of whether the identified neural machinery also processes the probability and uncertainty of motivationally neutral outcomes. Here, we aimed to dissociate valenced from valence-independent (i.e., generic) probability (p; maximum at p = 1) and uncertainty (maximum at p = 0.5) signals using human neuroimaging. In a Pavlovian task (n = 41; 19 females), different cues predicted appetitive, aversive, or neutral liquids with different probabilities (p = 0, p = 0.5, p = 1). Cue-elicited motor responses accelerated, and pupil sizes increased primarily for cues that predicted valenced liquids with higher probability. For neutral liquids, uncertainty rather than probability tended to accelerate cue-induced responding and decrease pupil size. At the neural level, generic uncertainty signals were limited to the occipital cortex, while generic probability also activated the anterior ventromedial prefrontal cortex. These generic probability and uncertainty signals contrasted with cue-induced responses that only encoded the probability and uncertainty of valenced liquids in medial prefrontal, insular, and occipital cortices. Our findings show a behavioral and neural dissociation of generic and valenced signals. Thus, some parts of the brain keep track of motivational charge while others do not, highlighting the need and usefulness of characterizing the exact nature of learned representations.

Can quantum theory be underpinned by a non-local hidden variable theory?

In this paper we consider the description by a general Bell-type non-local hidden variable theory of bipartite quantum states with two observables per sub-system. We derive Bell inequalities of the Collins-Gisin.-Liden-Massar-Popescu type which involve combinations of the probabilities of related outcomes for measurements for the four pairs of sub-system observables. It is shown that the corresponding quantum theory expressions violate the Bell inequalities in the case of the maximally entangled state of the bipartitite system. The CHSH Bell inequality is also derived from this general CGLMP Bell-type non-local hidden variable theory. This shows that quantum theory can not be underpinned by a Bell-type non-local hidden variable theory. So as a general Bell-type local hidden variable theory has already been shown to conflict with quantum theory, it follows that quantum theory can not be understood in terms of any CGLMP Bell-type hidden variable theory—local or non-local.

Sociodemographic Factors Associated with Suicide Outcomes in Transgender and Gender Diverse Young Adults

Objective Transgender and gender diverse (TGD) populations have a higher prevalence of suicide outcomes compared to cisgender peers. Further, among TGD groups, young adults frequently demonstrate a higher risk compared to other age cohorts. While evidence supports sociodemographic differences in suicide risk, these relationships are not well-established for TGD young adults. Method A secondary data analysis of the young adult (18–24 years) subpopulation of the 2015 U.S. Transgender Survey was conducted. Predicted probabilities of 12-month and lifetime suicide outcomes by gender identity, sexual orientation, race/ethnicity, homelessness, and poverty were estimated comparing fully adjusted models. Results Gender identity, race/ethnicity, and homelessness were significantly associated with all suicide outcomes. Comparisons of gender identities were significant for all outcomes and varied based on the outcome. American Indian/Alaska Native TGD young adults had the highest predicted probabilities compared to other race/ethnicity groups. Further, having a heterosexual/straight sexual identity was among the lowest predicted probabilities for suicide outcomes and significantly differed from several of the other sexual identities. Conclusions Findings underscore the importance of heterogeneity among TGD young adults and the need for intersectional research within this population. Elucidating sociodemographic characteristics that contribute to differential suicide risk is necessary for effective intervention strategies and policy advocacy.

Outcome-based analytical performance specifications: current status and future challenges.

Analytical performance specifications (APS) based on outcomes refer to how 'good' the analytical performance of a test needs to be to do more good than harm to the patient. Analytical performance of a measurand affects its clinical performance. Without first setting clinical performance requirements, it is difficult to define how good analytically the test needs to be to meet medical needs. As testing is indirectly linked to health outcomes through clinical decisions on patient management, often simulation-based studies are used to assess the impact of analytical performance on the probability of clinical outcomes which is then translated to Model 1b APS according to the Milan consensus. This paper discusses the related key definitions, concepts and considerations that should assist in finding the most appropriate methods for deriving Model 1b APS. We review the advantages and limitations of published methods and discuss the criteria for transferability of Model 1b APS to different settings. We consider that the definition of the clinically acceptable misclassification rate is central to Model 1b APS. We provide some examples and guidance on a more systematic approach for first defining the clinical performance requirements for tests and we also highlight a few ideas to tackle the future challenges associated with providing outcome-based APS for laboratory testing.

Photonic implementation of the quantum Morra game

The Morra game, an age-old noncooperative game, traditionally played on one's hand, has proved to be a rich setting to study game-theoretic strategies, both classically and within the quantum realm. In this paper, we study a faithful translation of a two-player quantum Morra game, which builds on previous study by including the classical game as a special case. We propose a natural deformation of the game in the quantum regime in which Alice has a winning advantage, breaking the balance of the classical game. A Nash equilibrium can be found in some cases by employing a pure strategy, which is impossible in the classical game where a mixed strategy is always required. We prepared our states using photonic qubits on a linear optics setup, with an average deviation ≤2% with respect to the measured outcome probabilities. Finally, we discuss potential applications of the quantum Morra game to the study of quantum information and communication. Published by the American Physical Society 2024

Ascertainment of Aboriginal and Torres Strait Islander status for assessment of perinatal health outcomes: Reported versus derived maternal ethnicity in Western Australian pregnancy data.

Under-identification of Aboriginal and Torres Strait Islander (hereafter referred to as Aboriginal) people can result in inaccurate estimation of health outcomes. Data linkage has improved identification of Aboriginal people in administrative datasets. To compare three methods of ascertainment of Aboriginal status using only pregnancy data from the Western Australian Midwives Notification System (MNS), to the linked Indigenous Status Flag (ISF) derived by the Department of Health. This retrospective population-based cohort study utilised logistic regression to determine which demographic characteristics were associated with under-identification, and the effect of ascertainment method on perinatal adverse outcomes. All methods identified a core group of 19 017 (83.0%) Aboriginal women and the ISF identified 2298 (10.0%) women who were not identified using any other method. Under-ascertainment was lowest when a woman's Aboriginal status was determined by ever being recorded as Aboriginal in the MNS data, and highest when taken as it had been recorded for the birth in question. Maternal age <20 years, smoking during pregnancy, pre-existing diabetes, a history of singleton preterm birth and being in the lowest 20% of Socio-Economic Indexes for Areas score were all associated with a higher chance of being identified by the methods using only the MNS. These methods were less likely to identify nulliparous women, and those with maternal age ≥35 years. The method of ascertainment of Aboriginality did not make a significant difference to the adjusted predicted marginal probabilities of adverse perinatal outcomes. Unlinked pregnancy data can be used for epidemiological research in Aboriginal obstetric populations.