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.

An Analysis of Innovative Contributions to the Important Discourse on the Development of New Quality Productivity

The discourse on developing high-quality productivity marks a significant theoretical innovation,which is conducive to the modernization and sinicization of Marxism.It refines our understanding of“new quality productivity,”defining it as an advanced form driven by innovation,embodying“high technology,efficiency,and quality,”with the aim of comprehensively enhancing productivity.It elucidates the necessity of cultivating such forces,asserting that they are crucial for achieving high-quality development,securing a leading position in global technology,and fulfilling the aspirations for a better life.Moreover,it outlines a new implementation route,emphasizing strategies such as fostering technological autonomy,nurturing emerging industries,integrating education and talent in technology,adopting a“build through challenges”approach,adjusting solutions locally,and providing categorized guidance,all of which are based on the ongoing comprehensive reforms.

Identification of Important FPGA Modules Based on Complex Network

The globalization of hardware designs and supply chains,as well as the integration of third-party intellectual property(IP)cores,has led to an increased focus from malicious attackers on computing hardware.However,existing defense or detection approaches often require additional circuitry to perform security verification,and are thus constrained by time and resource limitations.Considering the scale of actual engineering tasks and tight project schedules,it is usually difficult to implement designs for all modules in field programmable gate array(FPGA)circuits.Some studies have pointed out that the failure of key modules tends to cause greater damage to the network.Therefore,under limited conditions,priority protection designs need to be made on key modules to improve protection efficiency.We have conducted research on FPGA designs including single FPGA systems and multi-FPGA systems,to identify key modules in FPGA systems.For the single FPGA designs,considering the topological structure,network characteristics,and directionality of FPGA designs,we propose a node importance evaluationmethod based on the technique for order preference by similarity to an ideal solution(TOPSIS)method.Then,for the multi-FPGA designs,considering the influence of nodes in intra-layer and inter-layers,they are constructed into the interdependent network,and we propose a method based on connection strength to identify the important modules.Finally,we conduct empirical research using actual FPGA designs as examples.The results indicate that compared to other traditional indexes,node importance indexes proposed for different designs can better characterize the importance of nodes.

The minimal clinically important difference for gait speed in significant unilateral vestibular hypofunction after vestibular rehabilitation

Gait speed is a valid measure of both physical function and vestibular health.Vestibular rehabilitation is useful to improve gait speed for patients with vestibular hypofunction,yet there is little data to indicate how changes in gait speed reflect changes in patient-reported health outcomes.We determined the minimal clinically important difference in the gait speed of patients with unilateral vestibular hypofunction,mostly due to deafferentation surgery,as anchored to the Dizziness Handicap Index and the Activities Balance Confidence scale,validated using regression analysis,change difference,receiveroperator characteristic curve,and average change methods.After six weeks of vestibular rehabilitation,a change in gait speed from 0.20 to 0.34 m/s with 95%confidence was required for the patients to perceive a significant reduction in perception of dizziness and improved balance confidence.

Important edge identification in complex networks based on local and global features

Identifying important nodes and edges in complex networks has always been a popular research topic in network science and also has important implications for the protection of real-world complex systems.Finding the critical structures in a system allows us to protect the system from attacks or failures with minimal cost.To date,the problem of identifying critical nodes in networks has been widely studied by many scholars,and the theory is becoming increasingly mature.However,there is relatively little research related to edges.In fact,critical edges play an important role in maintaining the basic functions of the network and keeping the integrity of the structure.Sometimes protecting critical edges is less costly and more flexible in operation than just focusing on nodes.Considering the integrity of the network topology and the propagation dynamics on it,this paper proposes a centrality measure based on the number of high-order structural overlaps in the first and second-order neighborhoods of edges.The effectiveness of the metric is verified by the infection-susceptibility(SI)model,the robustness index R,and the number of connected branchesθ.A comparison is made with three currently popular edge importance metrics from two synthetic and four real networks.The simulation results show that the method outperforms existing methods in identifying critical edges that have a significant impact on both network connectivity and propagation dynamics.At the same time,the near-linear time complexity can be applied to large-scale networks.

Study on Determination Methods of Important Landscapes along the Mainstream of Yellow River

According to the response relationship between landscape and water resource,the selection principle of important landscapes was determined from the perspectives of nature and history in this study,and determination methods or steps of important landscapes along the mainstream of Yellow River were also established to select important landscapes that should be protected.

Variations of population structure and important value of the main edificators along the elevation gradient on the northern slope of Changbai Mountain

From 700 m to 1900 m on the northern slope of Changbai Mountain, 13 plots with an interval of 100 m in elevation were investigated to study the variations of population structure and important value of the main edificators along the elevation gradient. In their core distribution areas, most of the edificators had healthy population structure and could regenerate smoothly except Larix olgensis, but important value of Larix olgensis had no obvious variations with elevation changes, which showed that Larix olgensis had its own particularity and strong adaptability. At high elevation above 1800 m, Betula ermanii was the only species that could form a mono-dominant community. Important values of Pinus koraiensis and Acer mono had similar changing trends, and they had the similar ecological adaptabilities.

Zoonotic origins of human coronavirus 2019(HCoV-19/SARS-CoV-2):why is this work important?

The ongoing pandemic of coronavirus disease 2019 (COVID-19), caused by infection with human coronavirus 2019 (HCoV-19/SARS-CoV-2/2019-nCoV), is a global threat to the human population. Here, we briefly summarize the available data for the zoonotic origins of HCoV-19, with reference to the other two epidemics of highly virulent coronaviruses, SARSCoV and MERS-CoV, which cause severe pneumonia in humans. We propose to intensify future efforts for tracing the origins of HCoV-19, which is a very important scientific question for the control and prevention of the pandemic.

The most important questions in cancer research and clinical oncology Question 2-5.Obesity-related cancers:more questions than answers

Obesity is recognized as the second highest risk factor for cancer. The pathogenic mechanisms underlying tobaccorelated cancers are well characterized and efective programs have led to a decline in smoking and related cancers, but there is a global epidemic of obesity without a clear understanding of how obesity causes cancer. Obesity is heterogeneous, and approximately 25% of obese individuals remain healthy(metabolically healthy obese, MHO), so which fat deposition(subcutaneous versus visceral, adipose versus ectopic) is "malignant"? What is the mechanism of carcinogenesis? Is it by metabolic dysregulation or chronic inflammation? Through which chemokines/genes/signaling pathways does adipose tissue influence carcinogenesis? Can selective inhibition of these pathways uncouple obesity from cancers? Do all obesity related cancers(ORCs) share a molecular signature? Are there common(overlapping) genetic loci that make individuals susceptible to obesity, metabolic syndrome, and cancers? Can we identify precursor lesions of ORCs and will early intervention of high risk individuals alter the natural history? It appears unlikely that the obesity epidemic will be controlled anytime soon; answers to these questions will help to reduce the adverse efect of obesity on human condition.

Responsiveness and minimal clinically important difference of the Chinese version of the Low Vision Quality of Life Questionnaire after cataract surgery

AIM: To investigate the Chinese version of the Low Vision Quality of Life Questionnaire(CLVQOL) as an instrument for obtaining clinically important changes after cataract surgery.METHODS: Patients underwent cataract surgery in Shanghai General Hospital, Shanghai Jiao Tong University, who fit the inclusion criteria were recruited. Two CLVQOLs were administered, including a preoperative CLVQOL and a CLVQOL at the end of the 3 mo follow-up period, and were completed using face-to-face interviews or phone interviews conducted by trained investigators. The minimal clinically important difference(MCID) was calculated using an anchor-based method and a distribution method. In addition, the responsiveness of the questionnaire was measured.RESULTS: A total of 155 residents were enrolled. The average visual acuity(VA) preoperatively was 0.08(SD=0.05), and it increased to 0.47(SD=0.28) at the end of followup. Statistically significant positive changes in the CLVQOL scores indicated significant improvement of vision related quality of life after cataract surgery. With the larger value between the two results as the final value, the MCID values of the CLVQOL(scores of the four scales as well as the total score) were 8.94, 2.61, 4.34, 3.10 and 17.63, respectively. The CLVQOL has both good internal and external responsiveness.CONCLUSION: CLVQOL scores are appropriate instruments for obtaining clinically important changes after cataract surgery. This study is an effective exploration for establishingcataract surgery efficacy standards, which helps clinical and scientific research workers in ophthalmology to gain a more in-depth understanding when using CLVQOL.

Decadal variations in the community status of economically important invertebrates in the Bohai Sea

With the decline of fish stocks,the proportions of economically important invertebrates like crustaceans and cephalopods have increased in the Bohai Sea.The community structure and trophic level of economically important invertebrates were analyzed using the bottom trawl survey data collected by the Yellow Sea Fisheries Research Institute in the Bohai Sea in May and August of 1958–1959,1982,1992–1993,2004,2009 and 2015.A total of 37 species of economically important invertebrates,belonging to 5 orders,24 families,were captured.The biomass densities of economically important invertebrates in the Bohai Sea displayed an overall downward trend from 1982 to 2015.Oratosquilla oratoria and Loligo spp.were the most dominant species in the past 30 years,the biomass proportion of O.oratoria increased gradually in both May and August from 1982 to 2015.Moreover,biodiversity indices of economically important invertebrates in the Bohai Sea appeared to decline from 1982 to 2004 and then increased in 2015.Similarly,the mean trophic level of economically important invertebrates declined from 1982 to 2004 and increased slightly in 2015.Overall,although the proportions of invertebrates have increased,the biomass densities in the Bohai Sea have displayed an overall downward trend from 1982 to 2015.The increases in the biodiversity and trophic level of economically important invertebrates after the 2000s,possibly benefit from stock enhancement projects implemented by governments at different levels and national fishery management measures such as the“double-control”of the total number and engine power of fishing vessels and summer moratorium of fishing.

50 years of scanning electron microscopy of bone——a comprehensive overview of the important discoveries made and insights gained into bone material properties in health,disease,and taphonomy

Bone is an architecturally complex system that constantly undergoes structural and functional optimisation through renewal and repair.The scanning electron microscope (SEM) is among the most frequently used instruments for examining bone.It offers the key advantage of very high spatial resolution coupled with a large depth of field and wide field of view.Interactions between incident electrons and atoms on the sample surface generate backscattered electrons,secondary electrons,and various other signals including X-rays that relay compositional and topographical information.Through selective removal or preservation of specific tissue components (organic,inorganic,cellular,vascular),their individual contribution(s) to the overall functional competence can be elucidated.With few restrictions on sample geometry and a variety of applicable sample-processing routes,a given sample may be conveniently adapted for multiple analytical methods.While a conventional SEM operates at high vacuum conditions that demand clean,dry,and electrically conductive samples,non-conductive materials (e.g.,bone) can be imaged without significant modification from the natural state using an environmental scanning electron microscope.This review highlights important insights gained into bone microstructure and pathophysiology,bone response to implanted biomaterials,elemental analysis,SEM in paleoarchaeology,3D imaging using focused ion beam techniques,correlative microscopy and in situ experiments.The capacity to image seamlessly across multiple length scales within the meso-micro-nano-continuum,the SEM lends itself to many unique and diverse applications,which attest to the versatility and user-friendly nature of this instrument for studying bone.Significant technological developments are anticipated for analysing bone using the SEM.

VEGF in the nervous system: an important target for research in neurodevelopmental and regenerative medicine

Vascular endothelial growth factor（VEGF）in neurodevelopment and regeneration：VEGF is a well-known factor that promotes vascularization and angiogenesis.Besides this it participates in the pathogenesis of several diseases,such as colorectal carcinoma,lung cancer or diabetic retinopathy.Within the last decade,VEGF has been successfully integrated into the treatment of such diseases,for example as a therapy for colorectal cancer with the VEGF-receptor （VEGFR）-inhibitor axitinib.

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.

Mutagenesis reveals that the rice OsMPT3 gene is an important osmotic regulatory factor

Plant mitochondrial phosphate transporters regulate phosphate transport and ATP synthesis. Determining whether they function in abiotic stress response process would shed light on their response to salt stress. We used the CRISPR/Cas9 gene-editing system to mutagenize two mitochondrial phosphate transporters, OsMPT3;1 and OsMPT3;2, to investigate their regulatory roles under salt stress. Two cas9(CRISPR-associated protein9)-free homozygous mutants, mpt33 and mpt30, were confirmed to be stable. Both OsMPT3;1 and OsMPT3;2 were markedly induced by salt stress, and their mutagenesis strongly inhibited growth and development, especially under salt stress. Mutagenesis sharply reduced the accumulation of ATP, phosphate, calcium, soluble sugar, and proline and increased osmotic potential, malondialdehyde, and Na^+ /K^+ ratio under salt stress. Both mutants demonstrate normal growth and development in the presence of ATP, revealing high sensitivity to exogenous ATP under salt stress. The mutants showed lowered rates of Na^+ efflux but also of K^+ and Ca^(2+) influx under salt stress. Mutagenesis of OsMPT3;2 altered the enrichment profiles of differentially expressed genes involved mainly in synthesis of secondary metabolites, metabolism of glycolysis, pyruvate, tricarboxylic acid cycle, in response to salt stress. The mutant displayed significant accumulation differences in 14 metabolites involved in 17 metabolic pathways, and strongly up-regulated the accumulation of glutamine, a precursor in proline synthesis, under salt stress. These findings suggest that the OsMPT3 gene modulates phosphate transport and energy supply for ATP synthesis and triggers changes in accumulation of ions and metabolites participating in osmotic regulation in rice under salt stress, thus increasing rice salt tolerance. This study demonstrates the effective application of CRISPR/Cas9 gene-editing to the investigation of plant functional genes.

Flora, life form characteristics, and plan for the promotion of biodiversity in South Korea＇s Globally Important Agricultural Heritage System, the traditional Gudeuljang irrigated rice terraces in Cheongsando

The objectives of this study were to analyze the biodiversity of the Traditional Gudeuljang Irrigated Rice Terraces in Cheongsando, South Korea's representative GIAHS(Globally Important Agricultural Heritage System) site, with reference to position and land-use features, and to develop a plan to promote agricultural biodiversity in the region. We confirmed approximately 54,000 m2 of Gudeuljang paddy fields by an on-site survey. Of the Traditional Gudeuljang Irrigated Rice Terraces confirmed by onsite inspection, our survey showed that approximately 24,000 m2 are currently being used as paddy fields, approximately 15,000 m2 are being used as dry fields, and approximately 14,000 m2 are fallow. In terms of other non-agricultural land use, there was grassland, including graveyards; artificial arboreal land, such as orchards, rivers and wetlands, and man-made facilities, such as roads and residences. We also confirmed that the Traditional Gudeuljang Irrigated Rice Terraces had higher plant species diversity than conventional terraced rice paddies, and there was a difference in life form characteristics between the two types. Although the superficial topsoil structure is thesame for the Traditional Gudeuljang Irrigated Rice Terraces(TGIRTs) and conventional terraced rice paddies, it is thought that the differences in the subsurface structure of the TGIRTs contribute greatly to species and habitat diversity. However, the TGIRTs in Cheongsando are facing degeneration, due to damage and reduction in agricultural activity. The main cause is the reduction in the number of farming households due to an aging population in Cheongsando. In order to address this problem, we proposed a management plan, related to fallow paddy fields in South Korea, to initiate voluntary activities in the TGIRTs.

Magnetite Quartzite-Type Iron Ores – China's Most Important Current Iron Ore Source

China is abundant in iron-ore resources, with proven ore reserves of 576.62×10^8 t and proven reserves of 210×10^8 t, containing an average iron content of 33%. However, the rich iron-ore reserves of 10.85×10^8 t only account for 1.9% of all proven reserves. China＇s iron-ore resources are characterized by many lean ores and a few rich ones.

Important Achievement and Advance of Natural Gas Geology and Geochemical Exploration in China

Academician Dai Jinxing has long been engaged in natural gas geology and geochemical researches,and has made prominent contributions to the establishment and development of China’s theory of coal-derived gas.He has opened up new areas of coal-derived gas exploration,natural gas formation theory and formation“ control conditions of large ” medium gas fields.

GhDET2,a Steroid 5alpha-reductase,Plays an Important Role in Cotton Fiber Cell Initiation and Elongation

Cotton(Gossypium hirsutum L.) fibers,one of the most important natural raw materials for the textile industry,are highly elongated trichomes from epidermal cells of cotton ovules.Among the longest plant cells ever characterized,cotton fiber is an ideal system for studying plant cell elongation.

Sustainable tourism development of globally important agricultural heritage sites:a case study of "traditional rice-fish agriculture system"

Traditional rice-fish agricultural heritage site in Qingtian County, China, one of the pilot sites of Globally Important Agricultural Heritage Systems （GIAHS）, is of great value in tourism development. This paper aims to explore how to realize sustainable tourism development in agricultural heritage site through identifying current problems in GIAHS site. and making constructive recommendations for coupled development of heritage preservation and economic development. Field survey was carried out and data was collected through field questionnaire surveys of tourists and residents in Longxian Village of Qingtian County, as well as interviews of residents with semi. structured questionnaires for their perceptions and attitudes to tourism development. The following results are got： （1） the tourism industry is still at its early state of Non, tale tourism （enjoy and experience authentic country life- style）, under very limited administrative management; （2） what attracts visitors most are delicious.fish and beautiful natural environment, but not agricultural heritage itself; （3） most tourists eome from adjacent areas and stay. only half day, many of whom pay their visits twice or more; （4） a few local residents take part in the activities of tourism industry, but in very limited manners even if they do. Current patterns of tourism development are casting negative impacts on agricultural heritage. Conservatton of agricultural heritage should be put in the first place for sustainable tourism development.Agricultural heritage, as a key attraction, should be taken as the focus for tourism development. The important thing is to change the present Nongjiale tourism into real heritage tourism, to establish a cooperative mechanism among different stakeholders. and to increase local residents＇ income through engaging in tourism industry.