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.

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.

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.

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.

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.

Fuzzy Difference Equations in Diagnoses of Glaucoma from Retinal Images Using Deep Learning

The intuitive fuzzy set has found important application in decision-making and machine learning.To enrich and utilize the intuitive fuzzy set,this study designed and developed a deep neural network-based glaucoma eye detection using fuzzy difference equations in the domain where the retinal images converge.Retinal image detections are categorized as normal eye recognition,suspected glaucomatous eye recognition,and glaucomatous eye recognition.Fuzzy degrees associated with weighted values are calculated to determine the level of concentration between the fuzzy partition and the retinal images.The proposed model was used to diagnose glaucoma using retinal images and involved utilizing the Convolutional Neural Network(CNN)and deep learning to identify the fuzzy weighted regularization between images.This methodology was used to clarify the input images and make them adequate for the process of glaucoma detection.The objective of this study was to propose a novel approach to the early diagnosis of glaucoma using the Fuzzy Expert System(FES)and Fuzzy differential equation(FDE).The intensities of the different regions in the images and their respective peak levels were determined.Once the peak regions were identified,the recurrence relationships among those peaks were then measured.Image partitioning was done due to varying degrees of similar and dissimilar concentrations in the image.Similar and dissimilar concentration levels and spatial frequency generated a threshold image from the combined fuzzy matrix and FDE.This distinguished between a normal and abnormal eye condition,thus detecting patients with glaucomatous eyes.

Sex differences in the association between the muscle quality index and the incidence of depression: A cross-sectional study

BACKGROUND Depression presents significant challenges to mental health care.Although phy-sical activity is highly beneficial to mental and physical health,relatively few stu-dies have conducted on the relationship between them.AIM To investigate the association between muscle quality index(MQI)and incidence of depression.METHODS The data used in this cross-sectional study were obtained from the 2011-2014 National Health and Nutritional Examination Survey,which included informa-tion on MQI,depression,and confounding factors.Multivariable logistic regre-ssion models were employed,while taking into account the complex multi-stage sampling design.A restricted cubic spline model was utilized to investigate the non-linear relationship between the MQI and depression.Additionally,subgroup analyses were performed to identify influential factors.RESULTS The prevalence of depression in this population was 8.44%.With the adjusted model,the MQI was associated with depression in females(odds ratio=0.68,95%confidence interval:0.49-0.95)but not in males(odds ratio=1.08,95%confidence interval:0.77-1.52).Restricted cubic spline adjustment of all covariates showed a significant negative non-linear relationship between depression and the MQI in females.The observed trend indicated an 80%decrease in the risk of depression for each unit increase in MQI,until a value of 2.2.Subsequently,when the MQI exceeded 2.2,the prevalence of depression increased by 20%for every unit increase in the MQI.Subgroup analyses further confirmed that the MQI was negatively associated with de-pression.CONCLUSION The MQI was inversely correlated with depression in females but not males,suggesting that females with a higher MQI might decrease the risk of depression.

Analyzing the Differences in the Concepts of Love Between Korean and American Women Using the Female Characters in Kim Ji-young,Born in 1982 and The Sun Also Rises as Examples

This paper scrutinizes the differences in the conceptualization of love between Korean and American women.Grounded in an analysis of literary figures,Brett and Kim Ji-young,the study unravels the intricate interplay of cultural,historical,and societal forces shaping these perspectives.The contrasting landscapes of the United States,driven by ideals of freedom and individualism,and Korea,entrenched in Confucian values and collectivism,serve as crucibles for forming women’s roles,self-perception,and societal expectations.The examination extends to communication styles,illuminating the directness of American expression versus Korea’s reliance on formalism.Through this exploration,the paper illustrates the profound impact of cultural contexts on the intricate tapestry of love,offering a nuanced understanding of divergent viewpoints within a global context.

Isozyme Phenotypic Difference of Varicorhinus macrolepis Malic Enzyme

By using polyacrylamide gel electrophoresis and biochemical straining method, malic enzyme isozyme in 10 organs of male or female Varicorhinus macrolepis were analyzed. The results showed that malic enzyme exists in heart, gonads, eyes and gills tissues in both female and male V. macrolepis. There was only one ME-2 in heart and ME-1 in eye of female fish, while there were ME-1 and ME-2 in heart and ME-2 in eyes of male fish. Ovary contained ME-1 and ME-2, while spermary only contained ME-1. In kidney and spleen tissues, malic enzyme was found only in female fish, while in muscle, malic enzyme existed only in male fish. The phenotypic of malic enzyme had obvious differences no matter in the same organ of different sexes in V. macrolepis or different organs in the same sex. But there were no differences among different individuals of the same sex. The results will provide basic data for developmental genetics, breed improvement and directed breeding of V. macrolepis, and lay a foundation for its development and protection.

Accelerating f inite difference wavef ield-continuation depth migration by GPU

The most popular hardware used for parallel depth migration is the PC-Cluster but its application is limited due to large space occupation and high power consumption. In this paper, we introduce a new hardware architecture, based on which the finite difference （FD） wavefield-continuation depth migration can be conducted using the Graphics Processing Unit （GPU） as a CPU coprocessor. We demonstrate the program module and three key optimization steps for implementing FD depth migration： memory, thread structure, and instruction optimizations and consider evaluation methods for the amount of optimization. 2D and 3D models are used to test depth migration on the GPU. The tested results show that the depth migration computational efficiency greatly increased using the general-purpose GPU, increasing by at least 25 times compared to the AMD 2.5 GHz CPU.

A Study on Representation of Gender Differences in English Language

Studying the relation between language and gender nowadays has been an inevitable requirement of social development. From the perspective of sociolinguistics, this paper will discuss the gender differences in English language through several aspects: pronunciation, lexicon, syntax and verbal communication, and try to make scientific, accurate and objective interpretations of the phenomenon.

Research on Sex and Tissue Differences in Isozymic Phenotype of Varicorhinus macrolepis through Isozyme Electrophoresis

Polyacrylamide gel electrophoresis (PAGE) and biochemical staining method were used in this study for the analysis on malate dehydrogenase (MDH,E.C. 1.1.1.37) isozymes zymogram in 11 different types of tissues of male and female Varicorhinus macrolepis. It had been found for the first time that the phenotype of malate dehydrogenase (MDH),acid phosphatase (ACP) and superoxide dismutase (SOD) showed difference between male and female V. macrolepis,and there was no difference among different individuals in the same sex. Therefore,the electrophoresis band of malate dehydrogenase,acid phosphatase and superoxide dismutase could be used as an indicator for the identification of gender and tissues of V. macrolepis,which would provide basic data for the developmental genetics,variety improvement and directed breeding of V. macrolepis groups,thus facilitating the development and protection of this valuable fish species.

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.

Division of Matrix- and Fracture-Type Shale Oils in the Jiyang Depression and Their Differences

This study discussed the division of matrix- and fracture-type shale oils in the Jiyang Depression, and proposed the concept of fracture development coefficient. The fracture development coefficient is defined as the ratio of fault throw to the distance between a shale oil well and the nearest fault. Based on CO_2 content, state of water, oil production and logging response of shale oil formations, the classification of shale oils was established, i.e., a fracture-type shale oil well has a fracture development coefficient greater than 0.2, while a matrix-type one has a fracture development coefficient less than 0.2. Furthermore, the key control factors of matrix- and fracture-type shale oil enrichment were analyzed using typical anatomical and statistical methods. For matrix-type shale oil enrichment, these factors are lithofacies, total organic carbon（TOC）, shale porosity and abnormal pressure; for fracture-type shale oil enrichment, they are lithofacies, extent of fracture development, and abnormal pressure. This study also first described the differences between matrix- and fracture-type shale oils. The results provide reference for the exploration of terrestrial faulted basins in eastern China.

The tectonic differences between the east and the west in the deep-water area of the northern South China Sea

The deep-water area of the northern South China Sea, which has active and complicated tectonics, is rich in natural gas and gas hydrate. While the tectonic characteristics is different obviously between the east and the west because of the special tectonic position and tectonic evolution process. In terms of submarine geomorphology, the eastern shelf-slope structure in Pearl River Mouth Basin is characterized by having wide sub-basins and narrow intervening highs, whereas the western （Qiongdongnan Basin） structure is characterized by narrow sub- basins and wide uplift. As to the structural features, the deep-water sags in the east are all structurally half- grabens, controlled by a series of south-dipping normal faults. While the west sags are mainly characterised by graben structures with faulting in both the south and north. With regards to the tectonic evolution, the east began neotectonic activity when the post-rifting stage had completed at the end of the Middle Miocene. In the Baiyun Sag, tectonic activity became strong and was characterised by rapid subsidence and obvious faulting. Whereas in the west, neotectonic activity began at the end of the Late Miocene with rapid deposition and weak fault activity.

Gender differences in ghrelin, nociception genes, psychological factors and quality of life in functional dyspepsia

AIM to evaluate gender differences in the aspect of ghrelin,nociception-related genes and psychological aspects and the quality of life(Qo L) in Korean functional dyspepsia(FD) patients.METHODS Total of 191 persons were prospectively enrolled between March 2013 and May 2016 in Seoul National Bundang Hospital,and classified into control and FD group based on ROME Ⅲ criteria. Questionnaire included assessment for dyspepsia symptoms,Qo L and anxiety or depression. Preproghrelin and nociception genes in the gastric mucosa and plasma acyl/des-acyl ghrelin were measured. RESULTS Lower level of plasma acyl ghrelin in FD patients compared to control was significant only in male(15.9 fmol/m L vs 10.4 fmol/m L,P = 0.017). Significantly higher m RNA expressions of nerve growth factor and transient receptor potential vanilloid receptor 1 were observed in male(P = 0.002 and P = 0.014,respectively) than in female. In contrast,female FD patients had a higher anxiety and depression score than male FD(P = 0.029),and anxiety score was correlated with epigastric pain only in female FD patients(female: Spearman rho = 0.420,P = 0.037). The impairment of overall Qo L was more prominent in female FD patients than male patients(5.4 ± 0.3 vs 6.5 ± 0.3,P = 0.020). CONCLUSION Gender differences of ghrelin and nociception-related genes in male and psychological factors in female underlie FD symptoms. More careful assessment of psychological or emotional status is required particularly for the female FD patients.

Evaluating the Effect of Tillage on Carbon Sequestration Using the Minimum Detectable Difference Concept

Three long-term field trials in humid regions of Canada and the USA were used to evaluate the influence of soil depth and sample numbers on soil organic carbon (SOC) sequestration in no-tillage (NT) and moldboard plow (MP) corn (Zea mays L.) and soybean (Glycine max L.) production systems. The first trial was conducted on a Maryhill silt loam (Typic Hapludalf) at Elora, Ontario, Canada, the second on a Brookston clay loam (Typic Argiaquoll) at Woodslee, Ontario, Canada, and the third on a Thorp silt loam (Argiaquic Argialboll) at Urbana, Illinois, USA. No-tillage led to significantly higher SOC concentrations in the top 5 cm compared to MP at all 3 sites. However, NT resulted in significantly lower SOC in sub-surface soils as compared to MP at Woodslee (10-20 cm, P = 0.01) and Urbana (20-30 cm, P < 0.10). No-tillage had significantly more SOC storage than MP at the Elora site (3.3 Mg C ha-1) and at the Woodslee site (6.2 Mg C ha-1) on an equivalent mass basis (1350 Mg ha-1 soil equivalent mass). Similarly, NT had greater SOC storage than MP at the Urbana site (2.7 Mg C ha-1) on an equivalent mass basis of 675 Mg ha-1 soil. However, these differences disappeared when the entire plow layer was evaluated for both the Woodslee and Urbana sites as a result of the higher SOC concentrations in MP than in NT at depth. Using the minimum detectable difference technique, we observed that up to 1500 soil sample per tillage treatment comparison will have to be collected and analyzed for the Elora and Woodslee sites and over 40 soil samples per tillage treatment comparison for the Urbana to statistically separate significant differences in the SOC contents of sub-plow depth soils. Therefore, it is impracticable, and at the least prohibitively expensive, to detect tillage-induced differences in soil C beyond the plow layer in various soils.

Single channel source separation of radar fuze mixed signal based on phase difference analysis

A new method based on phase difference analysis is proposed for the single-channel mixed signal separation of single-channel radar fuze.This method is used to estimate the mixing coefficients of de-noised signals through the cumulants of mixed signals,solve the candidate data set by the mixing coefficients and signal analytical form,and resolve the problem of vector ambiguity by analyzing the phase differences.The signal separation is realized by exchanging data of the solutions.The waveform similarity coefficients are calculated,and the time鈥攆requency distributions of separated signals are analyzed.The results show that the proposed method is effective.

NUMERICAL METHOD OF MIXED FINITE VOLUME-MODIFIED UPWIND FRACTIONAL STEP DIFFERENCE FOR THREE-DIMENSIONAL SEMICONDUCTOR DEVICE TRANSIENT BEHAVIOR PROBLEMS

Transient behavior of three-dimensional semiconductor device with heat conduc- tion is described by a coupled mathematical system of four quasi-linear partial differential equations with initial-boundary value conditions. The electric potential is defined by an ellip- tic equation and it appears in the following three equations via the electric field intensity. The electron concentration and the hole concentration are determined by convection-dominated diffusion equations and the temperature is interpreted by a heat conduction equation. A mixed finite volume element approximation, keeping physical conservation law, is used to get numerical values of the electric potential and the accuracy is improved one order. Two con- centrations and the heat conduction are computed by a fractional step method combined with second-order upwind differences. This method can overcome numerical oscillation, dispersion and decreases computational complexity. Then a three-dimensional problem is solved by computing three successive one-dimensional problems where the method of speedup is used and the computational work is greatly shortened. An optimal second-order error estimate in L2 norm is derived by using prior estimate theory and other special techniques of partial differential equations. This type of mass-conservative parallel method is important and is most valuable in numerical analysis and application of semiconductor device.

FINITE DIFFERENCE FRACTIONAL STEP METHODS FOR THE TRANSIENT BEHAVIOR OF A SEMICONDUCTOR DEVICE

Characteristic finite difference fractional step schemes are put forward. The electric potential equation is described by a seven-point finite difference scheme, and the electron and hole concentration equations are treated by a kind of characteristic finite difference fractional step methods. The temperature equation is described by a fractional step method. Thick and thin grids are made use of to form a complete set. Piecewise threefold quadratic interpolation, symmetrical extension, calculus of variations, commutativity of operator product, decomposition of high order difference operators and prior estimates are also made use of. Optimal order estimates in l2 norm are derived to determine the error of the approximate solution. The well-known problem is thorongley and completely solred.