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.

Temporal and spatial differences in human activities performed in Urban Green Spaces of Vilnius(Lithuania)

Urban green spaces(UGS)are relevant to city well-being,as recognized by the United Nations’Sustainable Development Goals(SDGs).However,few studies have studied the temporal use of UGS.This work assessed the seasonal,weekly,and daily use of three urban green spaces(Vingis Park,Bernardino Garden,and Jomantas Park)in Vilnius(Lithuania).The study is based on an on-site observation-based survey,which recorded users’characteristics,activities,and weather conditions during summer and winter.The results showed that UGS’s seasonal,weekly,and daily use differed according to park and users’characteristics.Parks with a higher diversity of facilities had a high seasonal difference in the number of observed activities.User numbers were higher in the summer for activities with children,social activities,sports,and water activities than in the winter.Jomantas Park had the lowest variability in user characteristics.Weather variables were linked to changes in users’activities.Higher precipitation and lower temperature were associated with reducing the number of users and the diversity of registered activities.Most of the stationary activities were observed during summer.The diversity of the observed activities was associated with the available facilities rather than the park size.The distribution of stationary activities was spatially correlated with facility/equipment(benches,playgrounds,sports,and fitness equipment)and proximity to water features.The results of this study are relevant for UGS design,planning,and management.

Viscoacoustic prestack reverse time migration based onthe optimal time-space domain high-order finite-difference method

Prestack reverse time migration （RTM） is an accurate imaging method ofsubsurface media. The viscoacoustic prestack RTM is of practical significance because itconsiders the viscosity of the subsurface media. One of the steps of RTM is solving thewave equation and extrapolating the wave field forward and backward; therefore, solvingaccurately and efficiently the wave equation affects the imaging results and the efficiencyof RTM. In this study, we use the optimal time-space domain dispersion high-order finite-difference （FD） method to solve the viscoacoustic wave equation. Dispersion analysis andnumerical simulations show that the optimal time-space domain FD method is more accurateand suppresses the numerical dispersion. We use hybrid absorbing boundary conditions tohandle the boundary reflection. We also use source-normalized cross-correlation imagingconditions for migration and apply Laplace filtering to remove the low-frequency noise.Numerical modeling suggests that the viscoacoustic wave equation RTM has higher imagingresolution than the acoustic wave equation RTM when the viscosity of the subsurface isconsidered. In addition, for the wave field extrapolation, we use the adaptive variable-lengthFD operator to calculate the spatial derivatives and improve the computational efficiencywithout compromising the accuracy of the numerical solution.

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.

COMPACT DIFFERENCES OF COMPOSITION OPERATORS ON HOLOMORPHIC FUNCTION SPACES IN THE UNIT BALL

We find a lower bound for the essential norm of the difference of two composition operators acting on H 2（BN ） or As2 （BN ） （s 1）. This result plays an important role in proving a necessary and sufficient condition for the difference of linear fractional composition operators to be compact, which answers a question posed by MacCluer and Weir in 2005.

ON SOME GENERALIZED DIFFERENCE PARANORMED SEQUENCE SPACES ASSOCIATED WITH MULTIPLIER SEQUENCE DEFINED BY MODULUS FUNCTION

In this article we introduce the paranormed sequence spaces （f,A, Am,p）, c0（f,A,Am,p） and L00（f,A, Am,p）, associated with the multiplier sequence ∧ = （hk）, defined by a modulus function f. We study their different properties like solidness, symmetricity, completeness etc. and prove some inclusion results.

SOME GEOMETRIC PROPERTIES OF A NEW DIFFERENCE SEQUENCE SPACE INVOLVING LACUNARY SEQUENCES

In this paper, we define a new generalized difference sequence space involving lacunary sequence. Then, we examine k-NUC property and property （β） for this space and also show that it is not rotund where p = （pr） is a bounded sequence of positive real numbers with pr ≥ 1 for all r ∈ N.

Extraction of Acoustic Normal Mode Depth Functions Using Range-Difference Method with Vertical Linear Array Data

Data-derived normal mode extraction is an effective method for extracting normal mode depth functions in the absence of marine environmental data.However,when the corresponding singular vectors become nonunique when two or more singular values obtained from the cross-spectral density matrix diagonalization are nearly equal,this results in unsatisfactory extraction outcomes for the normal mode depth functions.To address this issue,we introduced in this paper a range-difference singular value decomposition method for the extraction of normal mode depth functions.We performed the mode extraction by conducting singular value decomposition on the individual frequency components of the signal's cross-spectral density matrix.This was achieved by using pressure and its range-difference matrices constructed from vertical line array data.The proposed method was validated using simulated data.In addition,modes were successfully extracted from ambient noise.

A NEW NND DIFFERENCE SCHEME OF SECOND-ORDER IN TIME AND SPACE

The study by H.X.Zhang shows that in order to suppress the spurious oscillation at both upstream and downstream of the shock, the coefficient of the third_order derivative on the right hand side of the modified equation of the difference scheme must be positive upstream and negative downstream of the shock. According to this principle, a new non_oscillatory, containing no free parameters and dissipative difference scheme of second_order both in time and space is proposed. It is proved that this scheme possesses TVD property and is generalized Gudunov scheme of second_order. In the presence of the shock wave in the flow field, this scheme is the generalization and improvement of the Lax_Wendroff scheme. Several numerical examples are given which demonstrate that the proposed scheme is non_oscillatory of high order accuracy and high resolution. It also has the advantages of compact form, greater maximum allowable Courant number and convenient to use.

TSCND:Temporal Subsequence-Based Convolutional Network with Difference for Time Series Forecasting

Time series forecasting plays an important role in various fields, such as energy, finance, transport, and weather. Temporal convolutional networks (TCNs) based on dilated causal convolution have been widely used in time series forecasting. However, two problems weaken the performance of TCNs. One is that in dilated casual convolution, causal convolution leads to the receptive fields of outputs being concentrated in the earlier part of the input sequence, whereas the recent input information will be severely lost. The other is that the distribution shift problem in time series has not been adequately solved. To address the first problem, we propose a subsequence-based dilated convolution method (SDC). By using multiple convolutional filters to convolve elements of neighboring subsequences, the method extracts temporal features from a growing receptive field via a growing subsequence rather than a single element. Ultimately, the receptive field of each output element can cover the whole input sequence. To address the second problem, we propose a difference and compensation method (DCM). The method reduces the discrepancies between and within the input sequences by difference operations and then compensates the outputs for the information lost due to difference operations. Based on SDC and DCM, we further construct a temporal subsequence-based convolutional network with difference (TSCND) for time series forecasting. The experimental results show that TSCND can reduce prediction mean squared error by 7.3% and save runtime, compared with state-of-the-art models and vanilla TCN.

Deep reinforcement learning using least-squares truncated temporal-difference

Policy evaluation(PE)is a critical sub-problem in reinforcement learning,which estimates the value function for a given policy and can be used for policy improvement.However,there still exist some limitations in current PE methods,such as low sample efficiency and local convergence,especially on complex tasks.In this study,a novel PE algorithm called Least-Squares Truncated Temporal-Difference learning(LST2D)is proposed.In LST2D,an adaptive truncation mechanism is designed,which effectively takes advantage of the fast convergence property of Least-Squares Temporal Difference learning and the asymptotic convergence property of Temporal Difference learning(TD).Then,two feature pre-training methods are utilised to improve the approximation ability of LST2D.Furthermore,an Actor-Critic algorithm based on LST2D and pre-trained feature representations(ACLPF)is proposed,where LST2D is integrated into the critic network to improve learning-prediction efficiency.Comprehensive simulation studies were conducted on four robotic tasks,and the corresponding results illustrate the effectiveness of LST2D.The proposed ACLPF algorithm outperformed DQN,ACER and PPO in terms of sample efficiency and stability,which demonstrated that LST2D can be applied to online learning control problems by incorporating it into the actor-critic architecture.

Study on sex differences and potential clinical value of threedimensional computerized tomography pelvimetry in rectal cancer patients

BACKGROUND Laparoscopic rectal cancer radical surgery is a complex procedure affected by various factors.However,the existing literature lacks standardized parameters for the pelvic region and soft tissues,which hampers the establishment of consistent conclusions.AIM To comprehensively assess 16 pelvic and 7 soft tissue parameters through computerized tomography(CT)-based three-dimensional(3D)reconstruction,providing a strong theoretical basis to address challenges in laparoscopic rectal cancer radical surgery.METHODS We analyzed data from 218 patients who underwent radical laparoscopic surgery for rectal cancer,and utilized CT data for 3D pelvic reconstruction.Specific anatomical points were carefully marked and measured using advanced 3D modeling software.To analyze the pelvic and soft tissue parameters,we emp-loyed statistical methods including paired sample t-tests,Wilcoxon rank-sum tests,and correlation analysis.RESULTS The investigation highlighted significant sex disparities in 14 pelvic bone parameters and 3 soft tissue parameters.Males demonstrated larger measurements in pelvic depth and overall curvature,smaller measurements in pelvic width,a larger mesorectal fat area,and a larger anterior-posterior abdominal diameter.By contrast,females exhibited wider pelvises,shallower depth,smaller overall curvature,and an increased amount of subcutaneous fat tissue.However,there were no significant sex differences observed in certain parameters such as sacral curvature height,superior pubococcygeal diameter,rectal area,visceral fat area,waist circumference,and transverse abdominal diameter.CONCLUSION The reconstruction of 3D CT data enabled accurate pelvic measurements,revealing significant sex differences in both pelvic and soft tissue parameters.This study design offer potential in predicting surgical difficulties and creating personalized surgical plans for male rectal cancer patients with a potentially“difficult pelvis”,ultimately improving surgical outcomes.Further research and utilization of these parameters could lead to enhanced surgical methods and patient care in laparoscopic rectal cancer radical surgery.

Analysis of Extended Fisher-Kolmogorov Equation in 2D Utilizing the Generalized Finite Difference Method with Supplementary Nodes

In this study,we propose an efficient numerical framework to attain the solution of the extended Fisher-Kolmogorov(EFK)problem.The temporal derivative in the EFK equation is approximated by utilizing the Crank-Nicolson scheme.Following temporal discretization,the generalized finite difference method(GFDM)with supplementary nodes is utilized to address the nonlinear boundary value problems at each time node.These supplementary nodes are distributed along the boundary to match the number of boundary nodes.By incorporating supplementary nodes,the resulting nonlinear algebraic equations can effectively satisfy the governing equation and boundary conditions of the EFK equation.To demonstrate the efficacy of our approach,we present three numerical examples showcasing its performance in solving this nonlinear problem.

Keep in mind sex differences when prescribing psychotropic drugs

Women represent the majority of patients with psychiatric diagnoses and also the largest users of psychotropic drugs.There are inevitable differences in efficacy,side effects and long-term treatment response between men and women.Psychopharmacological research needs to develop adequately powered animal and human trials aimed to consider pharmacokinetics and pharmacodynamics of central nervous system drugs in both male and female subjects.Healthcare professionals have the responsibility to prescribe sex-specific psychopharmacotherapies with a priority to differentiate between men and women in order to minimize adverse drugs reactions,to maximize therapeutic effectiveness and to provide personalized management of care.

Finite Difference-Peridynamic Differential Operator for Solving Transient Heat Conduction Problems

Transient heat conduction problems widely exist in engineering.In previous work on the peridynamic differential operator(PDDO)method for solving such problems,both time and spatial derivatives were discretized using the PDDO method,resulting in increased complexity and programming difficulty.In this work,the forward difference formula,the backward difference formula,and the centered difference formula are used to discretize the time derivative,while the PDDO method is used to discretize the spatial derivative.Three new schemes for solving transient heat conduction equations have been developed,namely,the forward-in-time and PDDO in space(FT-PDDO)scheme,the backward-in-time and PDDO in space(BT-PDDO)scheme,and the central-in-time and PDDO in space(CT-PDDO)scheme.The stability and convergence of these schemes are analyzed using the Fourier method and Taylor’s theorem.Results show that the FT-PDDO scheme is conditionally stable,whereas the BT-PDDO and CT-PDDO schemes are unconditionally stable.The stability conditions for the FT-PDDO scheme are less stringent than those of the explicit finite element method and explicit finite difference method.The convergence rate in space for these three methods is two.These constructed schemes are applied to solve one-dimensional and two-dimensional transient heat conduction problems.The accuracy and validity of the schemes are verified by comparison with analytical solutions.

Refraction difference value variations in children and adolescents with different refractive errors

AIM:To evaluate the refraction difference value(RDV)variations in children and adolescents with different refractive errors and analyze its correlation with refractive development.METHODS:Participants aged 4-16y with different refractive statuses(hyperopia,emmetropia,myopia)underwent comprehensive eye examinations,including spherical equivalent(SE)refraction,axial length(AL),total RDV(TRDV),and RDVs at various eccentricities(0°-15°,15°-30°,30°-45°)and quadrants(inferior,superior,nasal,temporal).Statistical analysis involved one-way ANOVA for group comparisons and Pearson correlation for examining relationships between SE/AL and RDVs.Paired t-tests compared quadrant-specific RDVs within groups.RESULTS:Significant difference was found in TRDV(P<0.001),RDV15°-30°(P=0.033),RDV30°-45°(P<0.001),RDV-inferior(RDV-I,P<0.001)and RDV-temporal(RDV-T,P<0.001)among hyperopia,emmetropia and myopia group.Pearson correlation analysis revealed a negative correlation of SE with TRDV(P=0.001),RDV30°-45°(P=0.004),RDV-I(P=0.047),and RDV-T(P<0.001).The differences between RDV-superior(RDV-S)and RDV-I were statistically significant in all groups(P<0.001 for all)and between RDV-T and RDV-nasal(RDV-N)were statistically significant in hyperopia group(P<0.001).Within the premyopic group,the analysis revealed a negative correlation of SE with RDV-I(P=0.009).Pearson correlation analysis revealed a positive correlation of AL with TRDV(P=0.036),RDV15°-30°(P=0.004),RDV30°-45°(P<0.001),RDV-S(P=0.003),RDV-I(P<0.001),RDV-T(P<0.001),RDV-N(P=0.022),while revealed a negative correlation of AL with RDV0-15°(P=0.018).CONCLUSION:Our study indicates TRDV,RDV30°-45°,RDV-I,RDV-T may relate to refractive development,and a negative correlation between SE and RDV-I in pre-myopic children.

Three-dimensional analysis of age and sex differences in femoral head asphericity in asymptomatic hips in the United States

BACKGROUND The sphericity of the femoral head is a metric used to evaluate hip pathologies and is associated with the development of osteoarthritis and femoral-acetabular impingement.AIM To analyze the three-dimensional asphericity of the femoral head of asymptomatic pediatric hips.We hypothesized that femoral head asphericity will vary significantly between male and female pediatric hips and increase with age in both sexes.METHODS Computed tomography scans were obtained on 158 children and adolescents from a single institution in the United States(8-18 years;50%male)without hip pain.Proximal femoral measurements including the femoral head diameter,femoral head volume,residual volume,asphericity index,and local diameter difference were used to evaluate femoral head sphericity.RESULTS In both sexes,the residual volume increased by age(P<0.05).Despite significantly smaller femoral head size in older ages(>13 years)in females,there were no sex-differences in residual volume and aspherity index.There were no age-related changes in mean diameter difference in both sexes(P=0.07)with no significant sex-differences across different age groups(P=0.06).In contrast,there were significant increases in local aspherity(maximum diameter difference)across whole surface of the femoral head and all quadrants except the inferior regions in males(P=0.03).There were no sex-differences in maximum diameter difference at any regions and age group(P>0.05).Increased alpha angle was only correlated to increased mean diameter difference across overall surface of the femoral head(P=0.024).CONCLUSION There is a substantial localized asphericity in asymptomatic hips which increases with age in.While 2D measured alpha angle can capture overall asphericity of the femoral head,it may not be sensitive enough to represent regional asphericity patterns.

Analysis of Regional Difference of Agricultural Land Productivity in Heilongjiang Province

The sustenance of humanity is contingent upon the production of food.The foundation of this production is agriculture,which in turn is dependent upon the cultivation of the land.As a fundamental element of agricultural advancement,the rational development and utilization of land play a pivotal role in the process of rural revitalization.Agricultural land productivity serves as a principal indicator of the efficacy of land utilization and the extent of agricultural advancement.Nevertheless,there is a paucity of research examining the productivity of agricultural land,particularly a lack of specialized research on large agricultural provinces.In light of the aforementioned considerations,this paper presents a comprehensive examination of agricultural land productivity and its regional variations in Heilongjiang Province in 2022,with the aid of pertinent statistical data.The findings of the analysis indicate that among the prefecture-level cities,Daqing and Suihua exhibit the highest levels of agricultural land productivity.Additionally,Zhaodong City,Zhaozhou,Qinggang,Wangkui,and Lanxi counties exhibit high levels of agricultural land productivity within their respective prefecture-level cities.There are notable disparities in agricultural land productivity across various regions,including Yichun,Heihe,Harbin,Daqing,Hegang,and Suihua.In contrast,other regions demonstrate a more balanced spatial distribution.In order to facilitate the prosperous development of the agricultural industry in Heilongjiang Province,it is essential to optimize the spatial planning of the land,to investigate the potential for agricultural development in each region,to establish effective collaboration between resources and industries,and to create a development synergy that will collectively advance rural revitalization.

Emotional differences based on comments on doctor-patient disputes with varying levels of severity

BACKGROUND The risks associated with negative doctor-patient relationships have seriously hindered the healthy development of medical and healthcare and aroused wide-spread concern in society.The number of public comments on doctor-patient relationship risk events reflects the degree to which the public pays attention to such events.Thirty incidents of doctor-patient disputes were collected from Weibo and TikTok,and 3655 related comments were extracted.The number of comment sentiment words was extracted,and the comment sentiment value was calculated.The Kruskal-Wallis H test was used to compare differences between each variable group at different levels of incidence.Spearman’s correlation analysis was used to examine associations between variables.Regression analysis was used to explore factors influencing scores of comments on incidents.RESULTS The study results showed that public comments on media reports of doctor-patient disputes at all levels are mainly dominated by“good”and“disgust”emotional states.There was a significant difference in the comment scores and the number of partial emotion words between comments on varying levels of severity of doctor-patient disputes.The comment score was positively correlated with the number of emotion words related to positive,good,and happy)and negatively correlated with the number of emotion words related to negative,anger,disgust,fear,and sadness.CONCLUSION The number of emotion words related to negative,anger,disgust,fear,and sadness directly influences comment scores,and the severity of the incident level indirectly influences comment scores.

Efficient Finite Difference WENO Scheme for Hyperbolic Systems withNon-conservativeProducts

Higher order finite difference weighted essentially non-oscillatory(WENO)schemes have been constructed for conservation laws.For multidimensional problems,they offer a high order accuracy at a fraction of the cost of a finite volume WENO or DG scheme of the comparable accuracy.This makes them quite attractive for several science and engineering applications.But,to the best of our knowledge,such schemes have not been extended to non-linear hyperbolic systems with non-conservative products.In this paper,we perform such an extension which improves the domain of the applicability of such schemes.The extension is carried out by writing the scheme in fluctuation form.We use the HLLI Riemann solver of Dumbser and Balsara(J.Comput.Phys.304:275-319,2016)as a building block for carrying out this extension.Because of the use of an HLL building block,the resulting scheme has a proper supersonic limit.The use of anti-diffusive fluxes ensures that stationary discontinuities can be preserved by the scheme,thus expanding its domain of the applicability.Our new finite difference WENO formulation uses the same WENO reconstruction that was used in classical versions,making it very easy for users to transition over to the present formulation.For conservation laws,the new finite difference WENO is shown to perform as well as the classical version of finite difference WENO,with two major advantages:(i)It can capture jumps in stationary linearly degenerate wave families exactly.(i)It only requires the reconstruction to be applied once.Several examples from hyperbolic PDE systems with non-conservative products are shown which indicate that the scheme works and achieves its design order of the accuracy for smooth multidimensional flows.Stringent Riemann problems and several novel multidimensional problems that are drawn from compressible Baer-Nunziato multiphase flow,multiphase debris flow and twolayer shallow water equations are also shown to document the robustness of the method.For some test problems that require well-balancing we have even been able to apply the scheme without any modification and obtain good results.Many useful PDEs may have stiff relaxation source terms for which the finite difference formulation of WENO is shown to provide some genuine advantages.