Variations in quantifying patient reported outcome measures to estimate treatment effect

In the practice of healthcare,patient-reported outcomes(PROs)and PRO measures(PROMs)are used as an attempt to observe the changes in complex clinical situations.They guide us in making decisions based on the evidence regarding patient care by recording the change in outcomes for a particular treatment to a given condition and finally to understand whether a patient will benefit from a particular treatment and to quantify the treatment effect.For any PROM to be usable in health care,we need it to be reliable,encapsulating the points of interest with the potential to detect any real change.Using structured outcome measures routinely in clinical practice helps the physician to understand the functional limitation of a patient that would otherwise not be clear in an office interview,and this allows the physician and patient to have a meaningful conver-sation as well as a customized plan for each patient.Having mentioned the rationale and the benefits of PROMs,understanding the quantification process is crucial before embarking on management decisions.A better interpretation of change needs to identify the treatment effect based on clinical relevance for a given condition.There are a multiple set of measurement indices to serve this effect and most of them are used interchangeably without clear demarcation on their differences.This article details the various quantification metrics used to evaluate the treatment effect using PROMs,their limitations and the scope of usage and implementation in clinical practice.

Resilience based importance measure analysis for SoS

In a system of systems(SoS),resilience is an important factor in maintaining the functionality,stability,and enhancing the operation effectiveness.From the perspective of resilience,this paper studies the importance of the SoS,and a resilience-based importance measure analysis is conducted to provide suggestions in the design and optimization of the structure of the SoS.In this paper,the components of the SoS are simplified as four kinds of network nodes:sensor,decision point,influencer,and target.In this networked SoS,the number of operation loops is used as the performance indicator,and an approximate algorithm,which is based on eigenvalue of the adjacency matrix,is proposed to calculate the number of operation loops.In order to understand the performance change of the SoS during the attack and defense process in the operations,an integral resilience model is proposed to depict the resilience of the SoS.From different perspectives of enhancing the resilience,different measures,parameters and the corresponding algorithms for the resilience importance of components are proposed.Finally,a case study on an SoS is conducted to verify the validity of the network modelling and the resiliencebased importance analysis method.

Integrated importance measure for multi-state coherent systems of k level

To verify the effectiveness of the integrated importance measure （IIM） for multi-state coherent systems of k level, the definition and physical meaning of IIM are demonstrated. Then, the improvement potential and Δ-importance measures are generalized to multi-state coherent systems based on the system performance level, and the relationships between IIM and traditional importance measures are discussed. The characteristics of IIM are demonstrated in both series and parallel systems. Also, an application to an oil transportation system is given. The comparison results show that： （i） IIM has some useful properties that are not possessed by traditional importance measures; （ii） IIM is effective in evaluating the component role in multi-state systems when the component reliability and the failure rate are simultaneously considered.

Possibilistic entropy-based measure of importance in fault tree analysis

With respect to the subjective factors and nonlinear characteristics inherent in the important identification of fault tree analysis （FTA）, a new important measure of FTA is proposed based on possibilistic information entropy. After investigating possibilistic information semantics, measure-theoretic terms, and entropy-like models, a two-dimensional framework has been constructed by combining both the set theory and the measure theory. By adopting the possibilistic assumption in place of the probabilistic one, an axiomatic index of importance is defined in the possibility space and then the modelling principles are presented. An example of the fault tree is thus provided, along with the concordance analysis and other discussions. The more conservative numerical results of importance rankings, which involve the more choices can be viewed as “soft” fault identification under a certain expected value. In the end, extension to evidence space and further research perspectives are discussed.

Dependency-based importance measures of components in mechatronic systems with complex network theory

To compensate for the limitations of previous studies,a complex network-based method is developed for determining importance measures,which combines the functional roles of the components of a mechatronic system and their topological positions.First,the dependencies among the components are well-represented and well-calculated.Second,a mechatronic system is modeled as a weighted and directional functional dependency network(FDN),in which the node weights are determined by the functional roles of components in the system and their topological positions in the complex network whereas the edge weights are represented by dependency strengths.Third,given that the PageRank algorithm cannot calculate the dependency strengths among components,an improved PageRank importance measure(IPIM)algorithm is proposed,which combines the node weights and edge weights of complex networks.IPIM also considers the importance of neighboring components.Finally,a case study is conducted to investigate the accuracy of the proposed method.Results show that the method can effectively determine the importance measures of components.

Hierarchical Modeling by Recursive Unsupervised Spectral Clustering and Network Extended Importance Measures to Analyze the Reliability Characteristics of Complex Network Systems

The complexity of large-scale network systems made of a large number of nonlinearly interconnected components is a restrictive facet for their modeling and analysis. In this paper, we propose a framework of hierarchical modeling of a complex network system, based on a recursive unsupervised spectral clustering method. The hierarchical model serves the purpose of facilitating the management of complexity in the analysis of real-world critical infrastructures. We exemplify this by referring to the reliability analysis of the 380 kV Italian Power Transmission Network (IPTN). In this work of analysis, the classical component Importance Measures (IMs) of reliability theory have been extended to render them compatible and applicable to a complex distributed network system. By utilizing these extended IMs, the reliability properties of the IPTN system can be evaluated in the framework of the hierarchical system model, with the aim of providing risk managers with information on the risk/safety significance of system structures and components.

Characteristics of Integrated Importance Measure for Whole Lifetime-Oriented System Performance Evaluation

Importance measures are being widely used to characterize the importance of component in systems.Focus on the integrated importance measure(IIM)of the whole lifetime measure based on the transition rates of component states.To describe the impact of each component in whole lifetime,the IIM is generalized in nonrepairable and repairable systems at first.Then,their formulas are computed in series and parallel systems.Finally,the characteristics of generalized IIM in typical series systems and parallel systems are analyzed.The results show that the generalized IIM of component can evaluate the expected effect of component state on the system performance in whole lifetime.

Importance Measure Analysis for Use in Dynamic Performance Design of a Co-cured Composite Damping Instrument Panel

For the best dynamic performance of a co-cured composite damping instrument panel with light weight and high strength, a multilayer sandwich structure with polymethaerylimide （PMI） foam combined with embedded and co-cured composite damping structure is proposed. The struetue can maintain the excellent mechanical properties of composite materials, and achieve the damping and light effect at the same time. Input variables which may affect the dynamic performance of the instrument panel were selected and variance based importance measure was analyzed through multi- finite element method （FEM） analysis. Using the results of the importance measure analysis, with other design requirements, the important design variable was optimized and an instrument panel with the best dynamic performance under the requirements of light weight and high strength was obtained. The structure of the instrument panel can provide reference for the design of precision, high speed, and dynamic composite component. The importance measure analysis of dynamic performance of the instrument panel can provide a reference for relative design.

Variable Importance Measure System Based on Advanced Random Forest

The variable importance measure(VIM)can be implemented to rank or select important variables,which can effectively reduce the variable dimension and shorten the computational time.Random forest(RF)is an ensemble learning method by constructing multiple decision trees.In order to improve the prediction accuracy of random forest,advanced random forest is presented by using Kriging models as the models of leaf nodes in all the decision trees.Referring to the Mean Decrease Accuracy(MDA)index based on Out-of-Bag(OOB)data,the single variable,group variables and correlated variables importance measures are proposed to establish a complete VIM system on the basis of advanced random forest.The link of MDA and variance-based sensitivity total index is explored,and then the corresponding relationship of proposed VIM indices and variance-based global sensitivity indices are constructed,which gives a novel way to solve variance-based global sensitivity.Finally,several numerical and engineering examples are given to verify the effectiveness of proposed VIM system and the validity of the established relationship.

Importance measure based optimal maintenance policy for deteriorating components

An optimal maintenance policy tor deteriorating components based on quasi renew-process model is presented. In this policy, the first N - 1 failures of a component are maintained by repairs and the N＇h failure is maintained by replacement. The policy takes replacement actions at component lev- el by considering the fact that more and more components are designed to be field replaceable and maintenance activities are setting free from system halt. Concerning system structure impact, impor- tance measure is employed in the optimization procedure which aims at maximizing the long-rnn prof- it per unit time. Two example series parallel systems are taken to illustrate the policy and it is proved to work well. According to importance analysis, components are classified into important ones and unimportant ones based on the system behavior under their failures. Simulation results show that the presented policy makes a clear distinction between them and takes effective mainte- nance actions to compensate the deteriorating of components.

Analysis on the Epidemic Situation of Intercepted Alien Pests from Imported Hides in Hebei and the Countermeasures during 2013-2014

The situation of intercepted alien pests from imported hides in Hebei during 2013-2014 was systematically analyzed. The results showed that 163 batches of alien pests were intercepted, including 2 batches of quarantine weeds and they both were Italian cocklebur. According to the statistics of original countries, the intercepted hides from 21 countries all had alien pests, in which Australia was the largest number of batches and species of alien pests. The analysis results showed that there was severe risk in the imported hides carrying alien pests, thus to effectively prevent the invasion of alien pests to our country, several quarantine measures should be taken in the future, such as enhancing the quarantine inspection in ports, and promoting the personnel ability of interception and species identification of alien pests.

Establishing minimum clinically important difference values for the Patient-Reported Outcomes Measurement Information System Physical Function, hip disability and osteoarthritis outcome score for joint reconstruction, and knee injury and osteoarthritis out

AIM To establish minimum clinically important difference(MCID) for measurements in an orthopaedic patient population with joint disorders.METHODS Adult patients aged 18 years and older seeking care for joint conditions at an orthopaedic clinic took the Patient-Reported Outcomes Measurement Information System Physical Function(PROMIS~? PF) computerized adaptive test(CAT), hip disability and osteoarthritis outcome score for joint reconstruction(HOOS JR), and the knee injury and osteoarthritis outcome score for joint reconstruction(KOOS JR) from February 2014 to April 2017. MCIDs were calculated using anchorbased and distribution-based methods. Patient reports of meaningful change in function since their first clinic encounter were used as an anchor.RESULTS There were 2226 patients who participated with a mean age of 61.16(SD = 12.84) years, 41.6% male, and 89.7% Caucasian. Mean change ranged from 7.29 to 8.41 for the PROMIS~? PF CAT, from 14.81 to 19.68 for the HOOS JR, and from 14.51 to 18.85 for the KOOS JR. ROC cut-offs ranged from 1.97-8.18 for the PF CAT, 6.33-43.36 for the HOOS JR, and 2.21-8.16 for the KOOS JR. Distribution-based methods estimated MCID values ranging from 2.45 to 21.55 for the PROMIS~? PF CAT; from 3.90 to 43.61 for the HOOS JR, and from 3.98 to 40.67 for the KOOS JR. The median MCID value in the range was similar to the mean change score for each measure and was 7.9 for the PF CAT, 18.0 for the HOOS JR, and 15.1 for the KOOS JR.CONCLUSION This is the first comprehensive study providing a wide range of MCIDs for the PROMIS? PF, HOOS JR, and KOOS JR in orthopaedic patients with joint ailments.

Important Economic Reform Measures in 1994

1994 was of special significance to the reform of China’s economic system. The new reform measures for taxation, finance, foreign trade, investment, and the price and enterprise system were smoothly implemented in the past year. In the reform of the taxation system, the taxation quota assigned by central government for the enterprises in the provinces and municipalities, regardless of their actual profits and losses, was replaced by a system in which tax was levied in proportion to the business turnover and profit. A turnover tax system with added-value tax as its core

Measures for Administration of the Import of Mechanical and Electronic Products

The Measures for the Administration of the Import of Mechanical and Electronic' Products co-formulated by the Ministry of Commerce,the General Administration of Customs and the General Administration of Quality Supervision,Inspection and Quarantine,was hereby promul- gated,which entered into force as of May 1,2008.

Modified sequential importance resampling filter

In order to deal with the particle degeneracy and impov- erishment problems existed in particle filters, a modified sequential importance resampling （MSIR） filter is proposed. In this filter, the resampling is translated into an evolutional process just like the biological evolution. A particle generator is constructed, which introduces the current measurement information （CMI） into the resampled particles. In the evolution, new particles are first pro- duced through the particle generator, each of which is essentially an unbiased estimation of the current true state. Then, new and old particles are recombined for the sake of raising the diversity among the particles. Finally, those particles who have low quality are eliminated. Through the evolution, all the particles retained are regarded as the optimal ones, and these particles are utilized to update the current state. By using the proposed resampling approach, not only the CMI is incorporated into each resampled particle, but also the particle degeneracy and the loss of diver- sity among the particles are mitigated, resulting in the improved estimation accuracy. Simulation results show the superiorities of the proposed filter over the standard sequential importance re- sampling （SIR） filter, auxiliary particle filter and unscented Kalman particle filter.

Analysis of Phased-Mission System Reliability and Importance with Imperfect Coverage

Accounting for static phased-mission systems (PMS) and imperfect coverage (IPC), generalized and integrated algorithm (GPMS-CPR) implemented a synthesis of several approaches into a single methodology whose advantages were in the low computational complexity, broad applicability, and easy implementation. The approach is extended into analysis of each phase in the whole mission. Based on Fussell-Vesely importance measure, a simple and efficient importance measure is presented to analyze component’s importance of phased-mission systems considering imperfect coverage.

Some Implications of Theoretical Relation between RAW and RRW Measures on Risk Reduction Strategies

In using risk-informed approaches for ensuring safety of operating NPPs(nuclear power plants),risk importance measures obtained from PRAs(probabilistic risk assessments)of the plants are integral elements of consideration in many cases.In PSA models and applications associated with NPPs the risk importance of a particular feature(e.g.function,system,component,failure mode or operator action)can be,most generally,divided into two categories:importance with respect to risk increase potential and importance with respect to risk decrease potential.The representative of the first category,as used for practical purposes,is RAW(risk achievement worth).Representative of the second category,as mentioned in consideration of risk importance,is RRW(risk reduction worth).It can be shown that the two risk importance measures,RAW and RRW,are dependent on each other.The only parameter in this mutual dependency is probability of failure of the considered feature.The paper discusses the relation between RAW and RRW and some of its implications,including those on the general strategies for the reduction of risk imposed for the operation of the considered facility.Two general risk reduction strategies which are considered in the discussion are:a)risk reduction by decreasing the failure probability of the considered feature;and b)risk reduction while keeping the failure probability of the considered feature at the same level.Simple examples are provided to illustrate the differences between two strategies and point to main issues and conclusions.

Evaluation Strategies for Coupled GC-IMS Measurement including the Systematic Use of Parametrized ANN

Data evaluation strategies for the novel coupled MCC-IMS sensory system are developed. Mayor attention to the plausibility of applied procedures and the feasibility of automation was paid. Three stages of extraction levels with increasing data reduction are presented for several fields of application. According to suitable extraction levels, real data were tested on various structures of artificial neural networks (ANN) with the result, that the computational levels must still be chosen by expertise, but subsequent processing and training can be fully automated. For the training of larger net- works a method of automated generation of secondary training data is presented which exceeds the quality of previous noise models by far. It is concluded that the combination of MCC-IMS as measuring instrument and ANNs as evalua- tion technique have high potential for industrial use in process monitoring.

Importance measure-based maintenance strategy optimization:Fundamentals,applications and future directions in AI and IoT

Numerous maintenance strategies have been proposed in the literature related to reliability.This paper focuses on the utilization of reliability importance measures to optimize maintenance strategies.We analyze maintenance strategies based on importance measures and identify areas lacking sufficient research.The paper presents principles and formulas for advanced importance measures within the context of optimizing maintenance strategies.Additionally,it classifies methods of maintenance strategy optimization according to importance measures and outlines the roles of these measures in various maintenance strategies.Finally,it discusses potential challenges that optimization of maintenance strategies based on importance measures may encounter with future technologies.

Human Invasion by Lesser Known Medically Important Trematodes in the Proximity of Tshwane,Gauteng Province,South Africa

It is well-documented that digenetic trematodes exhibit complex life cycles where the definitive hosts are vertebrates—mostly birds,other mammals and reptiles.It is also known that digenetic trematodes are host specific,but changes in our feeding habits, agricultural and social practices,have led to human beings infected with parasites that were previously regarded to be of no or insignificant medical importance. The objective of this study was to identify the less known digenetic parasites in the water bodies around Tshwane that may result in possible