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.

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.

Effects of carbon content on the microstructure and tensile properties of a low-density steel

Carbon can change the phase components of low-density steels and influence the mechanical properties.In this study,a new method to control the carbon content and avoid the formation ofδ-ferrite by decarburization treatment was proposed.The microstructural changes and mechanical characteristics with carbon content induced by decarburization were systematically examined.Crussard-Jaoul(C-J)analysis was employed to examine the work hardening characteristics during the tensile test.During decarburization by heat treatments,the carbon content within the austenite phase decreased,while Mn and Al were almost unchanged;this made the steel with full austenite transform into the austenite and ferrite dual phase.Meanwhile,(Ti,V)C carbides existed in both matrix phase and the mole fraction almost the same.In addition,the formation of other carbides restrained.Carbon loss induced a decrease in strength due to the weakening of the carbon solid solution.For the steel with the single austinite,the deformation mode of austenite was the dislocation planar glide,resulting in the formation of microbands.For the dual-phase steel,the deformation occurred by the dislocation planar glide of austenite first,with the increase in strain,the cross slip of ferrite took place,forming dislocation cells in ferrite.At the late stage of deformation,the work hardening of austinite increased rapidly,while that of ferrite increased slightly.

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.

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.

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.

Why Is It Important Awareness of Cross Culture Differences in Cultural Communi cation——Awareness of Cross Culture Differences Influences Cultural Communication

No matter you agree or not,the world is in a fast developing time.The communication between people contributes to this de velopment.However,during these communications,people find out the culture difference between countries and the realized the impor tance of develop awareness of cross culture differences.In my point of view,there are some reasons why it is important to develop aware ness of cross culture differences.

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.

Oil Content Conversion between Ether-based and Ethanol-based Methods and Establishment of Admissible Error for Imported Wool

Due to various reasons, the inspection methods often need to be changed, and the detection reagents often need to be replaced. In this study, a comparative experiment was conducted between the ethanol-based and ether-based determination methods for oil content in imported wool. The determination results obtained from the two methods were treated as abscissa and ordinate respectively,and their linear relationship was analyzed. According to the linear regression analysis, the conversion equation of determination result between the two methods was obtained. In addition, the repeatability admissible error and reproducibility admissible error were established through analyzing the comparative experimental results by scientific software. This study will bring new ideas for further researches in this field, and provide reference for solving the similar problems in actual inspection work.

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

Ranking important nodes in complex networks by simulated annealing

In this paper, based on simulated annealing a new method to rank important nodes in complex networks is presented.First, the concept of an importance sequence（IS） to describe the relative importance of nodes in complex networks is defined. Then, a measure used to evaluate the reasonability of an IS is designed. By comparing an IS and the measure of its reasonability to a state of complex networks and the energy of the state, respectively, the method finds the ground state of complex networks by simulated annealing. In other words, the method can construct a most reasonable IS. The results of experiments on real and artificial networks show that this ranking method not only is effective but also can be applied to different kinds of complex networks.

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.

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.

Solar light,seawater temperature,and nutrients,which one is more important in affecting phytoplankton growth?

Based on research results on the impacts of solar light,seawater temperature,and nutrient available to phytoplankton growth and changes in phytoplankton physiology and assemblage,we discussed the order of influence of these factors.By clarifying the mechanisms and processes of the impacts by these factors,we have determined the rising order of the importance as solar light,seawater temperature,and nutrient silicon (Si).Therefore,for human interests in sustaining economic development,the first thing to be considered is the input of nutrient Si into the ocean,followed by seawater temperature change.

Influence of Therapy on Some Important Final Products of Oxidation of Lipids, Proteins and Nucleic Acids in Patients with Parkinson’s Diseases

The major clinical disturbances in Parkinson’s disease (PD) are consequence of dopamine depletion in the neostriatum, due to degeneration of dopaminergic neurons. The aim of the present study was to determine whether oxidative stress (OS) occurs during the clinical course of Parkinson’s disease and to evaluate the influence of therapy on the levels of some important final products of oxidation of lipids, proteins and nucleic acids in PD patients with drug therapy. For this purpose, we investigated the levels of malondialdehid (MDA), protein carbonyl content (PCC) and 8-hydroxy-2’-deoxyguanosine quantity (8-OHdG) in PD patients with and without drug therapy. The observed changes in MDA levels, PCC and 8-OHdG quantity in blood of untreated PD patients, suggested impaired antioxidant status and presence of oxidative stress in Parkinson disease. After treatment with Madopar, the elevation in by-products significantly progresses. Our results demonstrate that administration of Madopar causes in greater degree oxidative stress than that induced by Parkinson disease, by itself.

Interaction of genotype and environment effects on important traits of cassava(Manihot esculenta Crantz)

General and specific environmental adaptation of genotypes is the main goal of breeders.However, genotype-by-environment(G x E) interaction complicates the identification of genotypes for release. This study aimed at analyzing the effects of G x E interaction on the expression of important cassava traits using two multivariate analyses: additive main effects and multiplicative interaction(AMMI) and genotype stability index(GSI). Total carotene content(TCC), postharvest physiological deterioration(PPD), and reaction to viral diseases were significantly affected by G x E interaction effects. The low percent(%)variation due to genotype for cassava brown streak disease(GBSD) explained the influence of environment on CBSD expression. The % variation due to genotype for TCC was higher(96%) than variation due to environment(1.7%) and G x E interaction(2.4%) indicating a low interaction effect of environment on TCC accumulation. The % variation due to genotype was higher than % variation due to environment for all traits but CBSD root necrosis and CBSD on stems, indicating the influence of environment on the severity of the viral diseases. These findings indicate that screening for disease resistance requires multi-environment trials, whereas a single-environment trial suffices to screen for total carotene content.

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.

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.

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.