The performance of serial correlation preliminary test estimators under asymmetry loss functions

The risk performances, under the symmetric squared error loss function, of the estimators of the regression coefficients after a preliminary test for serial correlation have been widely investigated in the literature. However, it is well known that the use of the symmetric loss functions is inappropriate in estimation problems where underestimation and overestimation have different consequences. We consider the Linear Exponential and Bounded Linear Exponential loss functions which allows for asymmetry. The risks of the estimators are derived and numerically evaluated by using simulations

Sensitivity to New Physics of Isotope Shift Studies using the Coronal Lines of Highly Charged Calcium Ions

Promising searches for new physics beyond the current Standard Model (SM) of particle physics are feasible through isotope-shift spectroscopy, which is sensitive to a hypothetical fifth force between the neutrons of the nucleus and the electrons of the shell. Such an interaction would be mediated by a new particle which could in principle be associated with dark matter. In so-called King plots, the mass-scaled frequency shifts of two optical transitions are plotted against each other for a series of isotopes. Subtle deviations from the expected linearity could reveal such a fifth force. Here, we study experimentally and theoretically six transitions in highly charged ions of Ca, an element with five stable isotopes of zero nuclear spin. Some of the transitions are suitable for upcoming high-precision coherent laser spectroscopy and optical clocks. Our results provide a sufficient number of clock transitions for -- in combination with those of singly charged Ca$^+$ -- application of the generalized King plot method. This will allow future high-precision measurements to remove higher-order SM-related nonlinearities and open a new door to yet more sensitive searches for unknown forces and particles

How digital health affects the patient-physician relationship: An empirical-ethics study into the perspectives and experiences in obstetric care

Background: Digital health technologies are believed to change the patient-physician relationship. Such changes are still speculative, as there are no studies in which both patients and health care professionals are asked for their experiences and perspectives on how digital health affects the patient-physician relationship. Methods: We performed a qualitative interview study (n = 25) to identify relevant aspects of the patient-physician relationship as perceived by both health care professionals (n = 14) and patients (n = 11) of a digital monitoring platform for hypertensive disorders related to pregnancy. We focus on roles, responsibilities and medical decision-making. Results: Digital monitoring helps patients to better understand their own condition and contributes to shared decision-making in terms of information exchange. Yet for clinical decision-making both patients and health care professionals argue that health care professionals should stay in the lead. The collected data is by some health care professionals considered hard data that allows objective and more standardized decision-making, while others believe digital monitoring requires further interpretation in order to personalize the clinical care to the patient. Conclusion: Digital technologies have subtle, yet double-edged, effects on the patient-physician relationship in terms of roles and responsibilities and the value addressed to the digital data. These insights let to 6 ethical recommendations for the implementation of digital health technologies to replace and support clinical care

Change in cervical length after arrested preterm labor and the risk of preterm birth

ACKNOWLEDGMENTS B.W.J.M. is supported by a NHMRC Investigator grant (GNT1176437). B.W.J.M. reports consultancy for Guerbet, has been a member of the ObsEva advisory board and holds stock options for ObsEva. B.W.J.M. has received research funding from Guerbet and Merck.Peer reviewedPublisher PD

Pop-off mechanisms in fetal megacystis: extravasation, umbilical cord cyst, ureterocele and mega-ureter

UCC was associated with early-onset megacystis, normal AFI, other congenital anomalies and the highest prevalences of IUFD, while the occurrence of urinary extravasation was associated with an antenatal clinical picture characterised by severe megacystis, abnormal AFI and other congenital anomalies and associated with high rates of pregnancy termination and neonatal death. A mega-ureter/ureterocele mainly occurred in late-onset and isolated megacystis showing a thickened bladder wall, low prevalences of other congenital anomalies and highest survival rates

Implementation of a standard outcome set in perinatal care: a qualitative analysis of barriers and facilitators from all stakeholder perspectives

Background: To improve their quality, healthcare systems are increasingly focused on value delivered to patients. For perinatal care, the International Consortium for Health Outcomes Measurement (ICHOM) proposed a patient-centred outcome set with both clinical and patient-reported measures for pregnancy and childbirth (PCB set). This study aimed to identify factors that affect the implementation of the PCB set at the pre-implementation stage, using the consolidated framework for implementation research (CFIR). Methods: In this qualitative study, we conducted semi-structured interviews amongst a purposive sample of key stakeholders within an obstetric care network (OCN): 1) patients, 2) perinatal care professionals involved in the full cycle of perinatal care, and 3) policy makers, including hospital managers, administrative staff and health care insurers. While the CFIR guided data capture and structuring, thematic analysis revealed overarching themes that best reflected the barriers and facilitators from different stakeholder perspectives. Within these overarching themes, the CFIR constructs were maintained. Results: Interviews were conducted with 6 patients, 16 professionals and 5 policy makers. Thematic analysis supported by the CFIR framework identified four main themes: the instrument and its implementation process, use in individual patient care, use in quality improvement, and the context of the OCN. Important barriers included professional workload, data reliability, and interprofessional and interorganizational collaboration. Potential facilitators were the PCB set’s direct value in individual care, interprofessional feedback and education, and aligning with existing systems. Prominent variations between stakeholder groups included the expected patient burden, the level of use, transparency of outcomes and the degree of integrated care. Conclusions: This study clarified critical factors that affect successful implementation of the PCB set in perinatal care. Practice recommendations, suggested at multiple levels, can enable structural patient-centred care improvement and may unite stakeholders towards integrated birth care