Beyond statistical significance:Embracing minimal clinically important difference for better patient care

The minimal clinically important difference(MCID)represents a pivotal metric in bridging the gap between statistical significance and clinical relevance,addressing the direct impact of medical interventions from the patient's perspective.This comprehensive review analyzes the evolution,applications,and challenges of MCID across medical specialties,emphasizing its necessity in ensuring that clinical outcomes not only demonstrate statistical significance but also offer genuine clinical utility that aligns with patient expectations and needs.We discuss the evolution of MCID since its inception in the 1980s,its current applications across various medical specialties,and the methodologies used in its calculation,highlighting both anchor-based and distribution-based approaches.Furthermore,the paper delves into the challenges associated with the application of MCID,such as methodological variability and the interpretation difficulties that arise in clinical settings.Recommendations for the future include standardizing MCID calculation methods,enhancing patient involvement in setting MCID thresholds,and extending research to incorporate diverse global perspectives.These steps are critical to refining the role of MCID in patient-centered healthcare,addressing existing gaps in methodology and interpretation,and ensuring that medical interventions lead to significant,patient-perceived improvements.

Spatial Differences of Coastal Urban Expansion in China from 1970s to 2013

As the ′economic engines′ of China,coastal cities have developed and expanded considerably since the 1970 s.In this study,information on the urban expansion process of Chinese coastal cities from the 1970 s to 2013 was retrieved.Through the analysis of stage characteristics,spatial expansion modes,influences on land use,centroid shifts,and spatial morphological evolutions,the spatial differences of coastal urban expansion were revealed.Results indicate that 1) the expansion stages of southern coastal cities are more complex than those of northern coastal cities,and the expansion ranges and speeds of the former are far higher than those of the latter;2) the spatial expansion of southern coastal cities mostly adopt a single mode,whereas northern coastal cities mostly adopt a mixed mode;3) significant spatial differences in the occupations of different land sources exist between the south and the north along the coastline;4) the centroid of coastal cities tends to migrate toward the coastline,and the centroid shift distances of southern coastal cities are clearly higher than those of northern coastal cities;and 5) the spatial morphology of southern coastal cities tends to be compact,whereas that of northern coastal cities tends to be loose.Policies have a powerful significance in terms of guiding urban expansion and its spatial differences in coastal cities.Urban expansion in coastal cities will encounter new opportunities and challenges under the guidance of new types of urbanization strategies.

Regional Differences of China′s Urban Expansion from Late 20th to Early 21st Century Based on Remote Sensing Information

This study investigated the regional differences of China′s urban land expansion from the late 1980s to the year of 2008, based on the spatio-temporal analysis of CLCD (China′s land cover/land use database) datasets which were mainly produced from remote sensing imagery data. A newly defined urbanization level index (UI), based on urban land area, is proposed to describe Chinese urban expansion process at 1 kilometer, provincial, regional, and na-tional scales, together with the absolute urban expansion index (UEa) and the relative urbanization expansion index (UEr). The results indicate that the percentages of total land area occupied by urban in the late 1980s, 1995, 2000, 2005, and 2008 were approximately 0.25%, 0.32%, 0.33%, 0.43% and 0.52% of China′s total land area, respectively. Between the late 1980s and 2008, the total urban expansion in the mainland of China was 2.645 × 104 km2, resulting in an annual urban expansion area of about 1322.7 km2/yr, with the UEr of 111.9%. This study also finds that there has been an obvious spatial gradient of urbanization ratio running from the east coast to the west inland, and the urbanization gaps among different regions have persisted over the past two decades. The study also reveals obvious temporal varia-tions of the urbanization rates. There was very little urban growth during the period of 1995-2000 due to the governmental policy factors.

The Limiting Case of Blending Differences for Bivariate Blending Continued Fraction Expansions

For a univariate function given by its Taylor series expansion, a continued fraction expansion can be obtained with the Viscovatov＇s algorithm, as the limiting value of a Thiele interpolating continued fraction or by means of the determinantal formulas for inverse and reciprocal differences with coincident data points. In this paper, both Viscovatov-like algorithms and Taylor-like expansions are incorporated to yield bivariate blending continued expansions which are computed as the limiting value of bivariate blending rational interpolants, which are constructed based on symmetric blending differences. Numerical examples are given to show the effectiveness of our methods.

Study of Difference-Expansion Embedding Schemes

Difference expansion（DE） is one of the famous schemes in the field of reversible data hiding.With the high efficiency and simplicity,DE also has received more attention over the years.DE has a good information capacity,but due to its major location map,the pure payload is rather low.Therefore many scholars did relevant improvements which let n pixels as a unit instead of the original two pixels as a unit and can adaptively adjust the number of embedding secret information according to the smoothness degree of the block,which achieves the result of improving the information payload or the image quality.In this paper,the study of DE-based reversible data hiding schemes is comprehensively discussed.The performance of DEbased schemes is evaluated and compared in terms of embedding capacity and stego-image quality.

Application of Rational Expansion Method for Differential-Difference Equation

In this paper, we applied the rational formal expansion method to construct a series of sofiton-like and period-form solutions for nonlinear differential-difference equations. Compared with most existing methods, the proposed method not only recovers some known solutions, but also finds some new and more general solutions. The efficiency of the method can be demonstrated on Toda Lattice and Ablowitz-Ladik Lattice.

Exact solutions of the nonlinear differential-difference equations associated with the nonlinear electrical transmission line through a variable-coefficient discrete(G'/G)-expansion method

We investigated exact traveling soliton solutions for the nonlinear electrical transmission line. By applying a concise and straightforward method, the variable-coefficient discrete（G /G）-expansion method, we solve the nonlinear differential–difference equations associated with the network. We obtain some exact traveling wave solutions which include hyperbolic function solution, trigonometric function solution, rational solutions with arbitrary function, bright as well as dark solutions.

Semi-analytical solution for drained expansion analysis of a hollow cylinder of critical state soils

The expansion of a thick-walled hollow cylinder in soil is of non-self-similar nature that the stress/deformation paths are not the same for different soil material points.As a result,this problem cannot be solved by the common self-similar-based similarity techniques.This paper proposes a novel,exact solution for rigorous drained expansion analysis of a hollow cylinder of critical state soils.Considering stress-dependent elastic moduli of soils,new analytical stress and displacement solutions for the nonself-similar problem are developed taking the small strain assumption in the elastic zone.In the plastic zone,the cavity expansion response is formulated into a set of first-order partial differential equations(PDEs)with the combination use of Eulerian and Lagrangian descriptions,and a novel solution algorithm is developed to efficiently solve this complex boundary value problem.The solution is presented in a general form and thus can be useful for a wide range of soils.With the new solution,the non-self-similar nature induced by the finite outer boundary is clearly demonstrated and highlighted,which is found to be greatly different to the behaviour of cavity expansion in infinite soil mass.The present solution may serve as a benchmark for verifying the performance of advanced numerical techniques with critical state soil models and be used to capture the finite boundary effect for pressuremeter tests in small-sized calibration chambers.

Age-specific differences in the association between prediabetes and cardiovascular diseases in China:A national cross-sectional study

BACKGROUND Cardiovascular disease(CVD)is a leading cause of morbidity and mortality worldwide,the global burden of which is rising.It is still unclear the extent to which prediabetes contributes to the risk of CVD in various age brackets among adults.To develop a focused screening plan and treatment for Chinese adults with prediabetes,it is crucial to identify variations in the connection between prediabetes and the risk of CVD based on age.AIM To examine the clinical features of prediabetes and identify risk factors for CVD in different age groups in China.METHODS The cross-sectional study involved a total of 46239 participants from June 2007 through May 2008.A thorough evaluation was conducted.Individuals with prediabetes were categorized into two groups based on age.Chinese atherosclerotic CVD risk prediction model was employed to evaluate the risk of developing CVD over 10 years.Random forest was established in both age groups.SHapley Additive exPlanation method prioritized the importance of features from the perspective of assessment contribution.RESULTS In total,6948 people were diagnosed with prediabetes in this study.In prediabetes,prevalences of CVD were 5(0.29%)in the younger group and 148(2.85%)in the older group.Overall,11.11%of the younger group and 29.59% of the older group were intermediate/high-risk of CVD for prediabetes without CVD based on the Prediction for ASCVD Risk in China equation in ten years.In the younger age group,the 10-year risk of CVD was found to be more closely linked to family history of CVD rather than lifestyle,whereas in the older age group,resident status was more closely linked.CONCLUSION The susceptibility to CVD is age-specific in newly diagnosed prediabetes.It is necessary to develop targeted approaches for the prevention and management of CVD in adults across various age brackets.

Can Industrial Structure Upgrading Restrain Industrial Land Expansion?Evidence from China

China has made great achievements in industrial development and is transforming into a powerful manufacturing country.Meanwhile,the industrial land scale is also expanding.However,whether industrial structure upgrading achieves the purpose of restraining industrial land expansion remains unanswered.By calculating the industrial land structure index(ILSI)and industrial land expansion scale(ILES),this study analyzed their temporal and spatial distribution characteristics at both regional and city levels from 2007to 2020 in China.Results show that industrial land expansion presents a different trend in the four regions,the ILES in the eastern region is the largest,and the speed of industrial land expansion has declined since 2013,but it has gradually increased since 2016.The ILSI of the eastern and central regions is higher than that of the western and northeastern regions.Furthermore,a spatial Durbin model(SDM)has been established to estimate the spatial effect of industrial structure upgrading on industrial land expansion from 2007 to2020.Notably,industrial structure upgrading has not slowed industrial land expansion.The eastern and western regions require a greater amount of industrial land while upgrading the industrial structure.The improvement of the infrastructure level and international trade level has promoted industrial land expansion.

A new expansion method of first order nonlinear ordinary differential equation with at most a sixth-degree nonlinear term and its application to mBBM model

Based on a first order nonlinear ordinary differential equation with at most a sixth-degree nonlinear term which is extended from a type of elliptic equation, and by converting it into a new expansion form, this paper proposes a new algebraic method to construct exact solutions for nonlinear evolution equations. Being concise and straightforward, the method is applied to modified Benjamin-Bona-Mahony （mBBM） model, and some new exact solutions to the system are obtained. The algorithm is of important significance in exploring exact solutions for other nonlinear evolution equations.

Ex vivo expansion and pluripotential differentiation of cryopreserved human bone marrow mesenchymal stem cells

This study is aimed at investigating the potentials of ex vivo expansion and pluri-differentiation of cryopreservation of adult human bone marrow mesenchymal stem cells （hMSCs） into chondrocytes, adipocytes and neurocytes. Cryopreserved hMSCs were resuscitated and cultured for 15 passages, and then induced into chondrocytes, adipocytes and neurocytes with corresponding induction medium. The induced cells were observed for morphological properties and detected for expressions of type II collagen, triglyceride or neuron-specific enolase and nestin. The result showed that the resuscitated cells could differentiate into chondrocytes after exposure to transforming growth factor 61 （TGF-~0, insulin-like growth factor I （IGF-I） and vitamin C （Vc）, and uniformly changed morphologically from a spindle-like fibroblastic appearance to a polygonal shape in three weeks. The induced cells were heterochromatic to safranin O and expressed cartilage matrix-procollagenal （If） mRNA. The resuscitated cells cultured in induction medium consisting of dexamethasone, 3-isobutyl-l-methylxanthine, indomethacin and IGF-I showed adipogenesis, and lipid vacuoles accumulation was detectable after 21 d. The resuscitated hMSCs were also induced into neurocytes and expressed nestin and neuron specific endolase （NSE） that were special surface markers associated with neural cells at different stage. This study suggested that the resuscitated hMSCs should be still a population ofpluripotential cells and that it could be used for establishing an abundant bMSC reservoir for further experiment and treatment of various clinical discases.

Effect of colouring green stage zirconia on the adhesion of veneering ceramics with different thermal expansion coefficients

This study evaluated the adhesion of zirconia core ceramics with their corresponding veneering ceramics, having different thermal expansion coefficients （TECs）, when zirconia ceramics were coloured at green stage. Zirconia blocks （N=240; 6 mm x 7 mm x 7 mm） were manufactured from two materials namely, ICE Zirconia （Group 1） and Prettau Zirconia （Group 2）. In their green stage, they were randomly divided into two groups. Half of the specimens were coloured with colouring liquid （shade A2）, Three different veneering ceramics with different TEC （ICE Ceramic, GC Initial Zr and IPS e.max Ceram） were fired on both coloured and non-coloured zirconia cores. Specimens of high noble alloys （Esteticor Plus） veneered with ceramic （VM 13） （n= 16） acted as the control group. Core-veneer interface of the specimens were subjected to shear force in the Universal Testing Machine （0.5 mm-min-1）. Neither the zirconia core material （P=0.318） nor colouring （P=0.188） significantly affected the results （three-way analysis of variance, Tukey＇s test）. But the results were significantly affected by the veneering ceramic （P=0.000）. Control group exhibited significantly higher mean bond strength values （45.7__.8） MPa than all other tested groups （（27.1__.4.1）-（39.7__.4.7） and （27.4__.5.6）-（35.9___4.7） MPa with and without colouring, respectively） （P^0.001）. While in zirconia-veneer test groups, predominantly mixed type of failures were observed with the veneering ceramic covering ~ 1/3 of the substrate surface, in the metal-ceramic group, veneering ceramic was left adhered 1/3 of the metal surface. Colouring zirconia did not impair adhesion of veneering ceramic, but veneering ceramic had a significant influence on the core-veneer adhesion. Metal-ceramic adhesion was more reliable than all zirconia-veneer ceramics tested.

Swelling pressure evolution characterization of strong expansive soil considering the influence of reserved expansion deformation

Numerous engineering cases have demonstrated that the expansive soil channel slope remains susceptible to damage with the implementation of a rigid or closed protective structure. It is common for the protective structure to experience bulging failure due to excessive swelling pressure. To investigate the swelling pressure properties of expansive soil, the constant volume test was employed to study the influence of water content and reserved expansion deformation on the characteristics of swelling pressure in strong expansive soils, and also to explore the evolution mechanism of the swelling pressure. The findings demonstrate that the swelling pressure-time curve can be classified into swelling pressure-time softening and swelling pressure-time stability type. The swelling pressuretime curve of the specimen with low water content is the swelling pressure-time softening type, and the softening level will be weakened with increasing reserved expansion deformation. Besides, the maximum swelling pressure Psmax decreases with increasing water content and reserved expansion deformation, especially for expansion ratio η from 24% to 37%. The reserved deformation has little effect on reducing Psmax when it is beyond 7% of the expansion rate. The specimen with low water content has a more homogeneous structure due to the significant expansion-filling effect, and the fracture and reorganization of the aggregates in the specimens with low water content cause the swelling pressure-time softening behavior. In addition, the proposed swelling pressure-time curve prediction model has a good prediction on the test results. If necessary, a deformation space of about 7% expansion rate is recommended to be reserved in the engineering to reduce the swelling pressure except for keeping a stable water content.

Expansion of spherical cavity of strain-softening materials with different elastic moduli of tension and compression

An expansion theory of spherical cavities in strain-softening materials with different moduli of tension and com-pression was presented. For geomaterials,two controlling parameters were introduced to take into account the different moduli and strain-softening properties. By means of elastic theory with different moduli and stress-softening models,general solutions cal-culating Tresca and Mohr-Coulomb materials' stress and displacement fields of expansion of spherical cavity were derived. The effects caused by different elastic moduli in tensile and compression and strain-softening rates on stress and displacement fields and development of plastic zone of expansion of cavity were analyzed. The results show that the ultimate expansion pressure,stress and displacement fields and development of plastic zone vary with the different elastic moduli and strain-softening prop-erties. If classical elastic theory is adopted and strain-softening properties are neglected,rather large errors may be the result.

ON THE COEFFICIENTS OF DIFFERENTIATED EXPANSIONS AND DERIVATIVES OF CHEBYSHEV POLYNOMIALS OF THE THIRD AND FOURTH KINDS

Two new analytical formulae expressing explicitly the derivatives of Chebyshev polynomials of the third and fourth kinds of any degree and of any order in terms of Chebyshev polynomials of the third and fourth kinds themselves are proved. Two other explicit formulae which express the third and fourth kinds Chebyshev expansion coefficients of a general-order derivative of an infinitely differentiable function in terms of their original expansion coefficients are also given. Two new reduction formulae for summing some terminating hypergeometric functions of unit argument are deduced. As an application of how to use Chebyshev polynomials of the third and fourth kinds for solving high-order boundary value problems, two spectral Galerkin numerical solutions of a special linear twelfth-order boundary value problem are given.

Assessment of vegetation cover changes and the contributing factors in the Al-Ahsa Oasis using Normalized Difference Vegetation Index(NDVI)

The abandonment of date palm grove of the former Al-Ahsa Oasis in the eastern region of Saudi Arabia has resulted in the conversion of delicate agricultural area into urban area.The current state of the oasis is influenced by both expansion and degradation factors.Therefore,it is important to study the spatiotemporal variation of vegetation cover for the sustainable management of oasis resources.This study used Landsat satellite images in 1987,2002,and 2021 to monitor the spatiotemporal variation of vegetation cover in the Al-Ahsa Oasis,applied multi-temporal Normalized Difference Vegetation Index(NDVI)data spanning from 1987 to 2021 to assess environmental and spatiotemporal variations that have occurred in the Al-Ahsa Oasis,and investigated the factors influencing these variation.This study reveals that there is a significant improvement in the ecological environment of the oasis during 1987–2021,with increase of NDVI values being higher than 0.10.In 2021,the highest NDVI value is generally above 0.70,while the lowest value remains largely unchanged.However,there is a remarkable increase in NDVI values between 0.20 and 0.30.The area of low NDVI values(0.00–0.20)has remained almost stable,but the region with high NDVI values(above 0.70)expands during 1987–2021.Furthermore,this study finds that in 1987–2002,the increase of vegetation cover is most notable in the northern region of the study area,whereas from 2002 to 2021,the increase of vegetation cover is mainly concentrated in the northern and southern regions of the study area.From 1987 to 2021,NDVI values exhibit the most pronounced variation,with a significant increase in the“green”zone(characterized by NDVI values exceeding 0.40),indicating a substantial enhancement in the ecological environment of the oasis.The NDVI classification is validated through 50 ground validation points in the study area,demonstrating a mean accuracy of 92.00%in the detection of vegetation cover.In general,both the user’s and producer’s accuracies of NDVI classification are extremely high in 1987,2002,and 2021.Finally,this study suggests that environmental authorities should strengthen their overall forestry project arrangements to combat sand encroachment and enhance the ecological environment of the Al-Ahsa Oasis.

Expansion of human umbilical cord derived mesenchymal stem cells in regenerative medicine

BACKGROUND Stem cells are undifferentiated cells that possess the potential for self-renewal with the capacity to differentiate into multiple lineages.In humans,their limited numbers pose a challenge in fulfilling the necessary demands for the regeneration and repair of damaged tissues or organs.Studies suggested that mesenchymal stem cells(MSCs),necessary for repair and regeneration via transplantation,require doses ranging from 10 to 400 million cells.Furthermore,the limited expansion of MSCs restricts their therapeutic application.AIM To optimize a novel protocol to achieve qualitative and quantitative expansion of MSCs to reach the targeted number of cells for cellular transplantation and minimize the limitations in stem cell therapy protocols.METHODS Human umbilical cord(hUC)tissue derived MSCs were obtained and re-cultured.These cultured cells were subjected to the following evaluation pro-cedures:Immunophenotyping,immunocytochemical staining,trilineage differentiation,population doubling time and number,gene expression markers for proliferation,cell cycle progression,senescence-associatedβ-galactosidase assay,human telomerase reverse transcriptase(hTERT)expression,mycoplasma,cytomegalovirus and endotoxin detection.RESULTS Analysis of pluripotent gene markers Oct4,Sox2,and Nanog in recultured hUC-MSC revealed no significant differences.The immunophenotypic markers CD90,CD73,CD105,CD44,vimentin,CD29,Stro-1,and Lin28 were positively expressed by these recultured expanded MSCs,and were found negative for CD34,CD11b,CD19,CD45,and HLA-DR.The recultured hUC-MSC population continued to expand through passage 15.Proliferative gene expression of Pax6,BMP2,and TGFb1 showed no significant variation between recultured hUC-MSC groups.Nevertheless,a significant increase(P<0.001)in the mitotic phase of the cell cycle was observed in recultured hUC-MSCs.Cellular senescence markers(hTERT expression andβ-galactosidase activity)did not show any negative effect on recultured hUC-MSCs.Additionally,quality control assessments consistently confirmed the absence of mycoplasma,cytomegalovirus,and endotoxin contamination.CONCLUSION This study proposes the development of a novel protocol for efficiently expanding stem cell population.This would address the growing demand for larger stem cell doses needed for cellular transplantation and will significantly improve the feasibility of stem cell based therapies.

Analytic Theory of Finite Asymptotic Expansions in the Real Domain. Part II-B: Solutions of Differential Inequalities and Asymptotic Admissibility of Standard Derivatives

Part II-B of our work continues the factorizational theory of asymptotic expansions of type (*) , , where the asymptotic scale , , is assumed to be an extended complete Chebyshev system on a one-sided neighborhood of x0. The main result states that to each scale of this type it remains as-sociated an important class of functions (namely that of generalized convex functions) enjoying the property that the expansion (*), if valid, is automatically formally differentiable n ? 1 times in the two special senses characterized in Part II-A. A second result shows that formal applications of ordinary derivatives to an asymptotic expansion are rarely admissible and that they may also yield skew results even for scales of powers.

Q estimation using multifrequency point average method based on the Taylor series expansion with a different order

The quality factor Q is an important parameter because it can refl ect the reservoir attenuated features and can be used for inverse-Q filtering to compensate for the seismic wave energy.The accuracy of the Q estimation is greatly significant for improving the precision of the reservoir prediction and the resolution of seismic data.In this paper,the Q estimation formulas of the single-frequency point are derived on the basis of a diff erent-order Taylor series expansion of the amplitude attenuated factor.Moreover,the multifrequency point average(MFPA)method is introduced to obtain a stable Q estimation.The model tests demonstrate that the MFPA method is less aff ected by the frequency band,travel time diff erence,time window width,and noise interference than the logical spectrum ratio(LSR)method and the energy ratio(ER)method and has a higher Q estimation accuracy.In addition,the proposed method can be applied to post-stack seismic data and obtain eff ective Q values of complex models.When the MFPA method was applied to real marine seismic data,the Q values estimated by the MFPA method with the 1st–4th order showed good consistency with each other.In contrast,the Q values obtained by the ER method were larger than those of the proposed method,while those estimated by the LSR method signifi cantly deviated from the average values.In conclusion,the MFPA method has superior stability and practicability for the Q estimation.