Zhiming Liu

Guisen Wu, Liyun Dai, Zhiming Liu et al.

Observabililty is an important topic of Boolean control networks (BCNs). In this paper, we propose a new type of observability named online observability to present the sufficient and necessary condition of determining the initial states of BCNs, when their initial states cannot be reset. And we design an algorithm to decide whether a BCN has the online observability. Moreover, we prove that a BCN is identifiable iff it satisfies controllability and the online observability, which reveals the essence of identification problem of BCNs.

Quanjiang Li, Zhiming Liu, Wei Luo et al.

Multimodal large language models (MLLMs) frequently suffer from object hallucinations, yet the visual perceptual mechanism underlying this failure remains poorly understood. In this work, we reveal that hallucinations are strongly associated with a human-like attention distraction phenomenon, where humans under divided focus experience degraded visual clarity and produce inaccurate descriptions, while in models the same mechanism manifests as spatial inconsistency in multi-head attention and temporal fading of attention to image tokens during decoding. We further provide theoretical insights that attention dispersion increases model complexity and degrades classification generalization. Motivated by these findings, we propose an Attention-Focused Approach for Improved Image Perception (AFIP), which corrects attention distraction via cross-head attention enrichment and reinforces visual grounding through dynamic historical attention enhancement. Extensive experiments on multiple benchmarks and models validate the effectiveness of AFIP without additional training.

Liyun Dai, Bo Liu, Zhiming Liu et al.

We consider the parameter synthesis problem of parametric timed automata (PTAs). The problem is, given a PTA and a property, to compute the set of valuations of the parameters under which the resulting timed automaton satisfies the property. Such a set of parameter valuations is called a feasible region for the PTA and the property. The problem is known undecidable in general. This paper, however, presents our study on some decidable sub-classes of PTAs and proposes efficient parameter synthesis algorithms for them.

Zhiming Liu, Zhicheng Zou, Nantheera Anantrasirichai

Atmospheric turbulence severely degrades video quality by introducing distortions such as geometric warping, blur, and temporal flickering, posing significant challenges to both visual clarity and temporal consistency. Current state-of-the-art methods are based on transformer, 3D architectures and require multi-frame input, but their large computational cost and memory usage limit real-time deployment, especially in resource-constrained scenarios. In this work, we propose ReMATF, a lightweight recurrent framework that restores videos using only two frames at a time while preserving spatial detail and temporal stability. ReMATF combines a multi-scale encoder-decoder with temporal warping and a motion-adaptive temporal fusion module that performs per-pixel fusion between the warped previous output and the current prediction to enhance coherence without enlarging the temporal window. This design reduces flicker, sharpens details, and remains efficient. Experiments on synthetic and real turbulence datasets show consistent improvements in PSNR/SSIM and perceptual quality (LPIPS), along with substantially faster inference than multi-frame transformer baselines, making ReMATF suitable turbulence mitigation in resource-constrained scenarios.

Shuaitong Liu, Renjue Li, Lijia Yu et al.

Recent advances in Chain-of-Thought (CoT) prompting have substantially improved the reasoning capabilities of large language models (LLMs), but have also introduced their computational efficiency as a new attack surface. In this paper, we propose BadThink, the first backdoor attack designed to deliberately induce "overthinking" behavior in CoT-enabled LLMs while ensuring stealth. When activated by carefully crafted trigger prompts, BadThink manipulates the model to generate inflated reasoning traces - producing unnecessarily redundant thought processes while preserving the consistency of final outputs. This subtle attack vector creates a covert form of performance degradation that significantly increases computational costs and inference time while remaining difficult to detect through conventional output evaluation methods. We implement this attack through a sophisticated poisoning-based fine-tuning strategy, employing a novel LLM-based iterative optimization process to embed the behavior by generating highly naturalistic poisoned data. Our experiments on multiple state-of-the-art models and reasoning tasks show that BadThink consistently increases reasoning trace lengths - achieving an over 17x increase on the MATH-500 dataset - while remaining stealthy and robust. This work reveals a critical, previously unexplored vulnerability where reasoning efficiency can be covertly manipulated, demonstrating a new class of sophisticated attacks against CoT-enabled systems.

Quanjiang Li, Zhiming Liu, Tianxiang Xu et al.

Multi-view multi-label learning frequently suffers from simultaneous feature absence and incomplete annotations, due to challenges in data acquisition and cost-intensive supervision. To tackle the complex yet highly practical problem while overcoming the existing limitations of feature recovery, representation disentanglement, and label semantics modeling, we propose an Adaptive Disentangled Representation Learning method (ADRL). ADRL achieves robust view completion by propagating feature-level affinity across modalities with neighborhood awareness, and reinforces reconstruction effectiveness by leveraging a stochastic masking strategy. Through disseminating category-level association across label distributions, ADRL refines distribution parameters for capturing interdependent label prototypes. Besides, we formulate a mutual-information-based objective to promote consistency among shared representations and suppress information overlap between view-specific representation and other modalities. Theoretically, we derive the tractable bounds to train the dual-channel network. Moreover, ADRL performs prototype-specific feature selection by enabling independent interactions between label embeddings and view representations, accompanied by the generation of pseudo-labels for each category. The structural characteristics of the pseudo-label space are then exploited to guide a discriminative trade-off during view fusion. Finally, extensive experiments on public datasets and real-world applications demonstrate the superior performance of ADRL.

Lu Hou, Kan Zheng, Zhiming Liu et al.

Efficiency and security have become critical issues during the development of the long-range (LoRa) system for Internet-of-Things (IoT) applications. The centralized work method in the LoRa system, where all packages are processed and kept in the central cloud, cannot well exploit the resources in LoRa gateways and also makes it vulnerable to security risks, such as data falsification or data loss. On the other hand, the blockchain has the potential to provide a decentralized and secure infrastructure for the LoRa system. However, there are significant challenges in deploying blockchain at LoRa gateways with limited edge computing abilities. This article proposes a design and implementation of the blockchain-enabled LoRa system with edge computing by using the open-source Hyperledger Fabric, which is called as HyperLoRa. According to different features of LoRa data, a blockchain network with multiple ledgers is designed, each of which stores a specific kind of LoRa data. LoRa gateways can participate in the operations of the blockchain and share the ledger that keep the time-critical network data with small size. Then, the edge computing abilities of LoRa gateways are utilized to handle the join procedure and application packages processing. Furthermore, a HyperLoRa prototype is implemented on embedded hardware, which demonstrates the feasibility of deploying the blockchain into LoRa gateways with limited computing and storage resources. Finally, various experiments are conducted to evaluate the performances of the proposed LoRa system.

Jinghan Ru, Yuxin Xie, Xianwei Zhuang et al.

Web-scale pre-training datasets are the cornerstone of LLMs' success. However, text data curated from the Internet inevitably contains random noise caused by decoding errors or unregulated web content. In contrast to previous works that focus on low quality or synthetic data, our study \textbf{provides the first systematic investigation of such random noise through a cohesive ``What-Why-How'' framework.} Surprisingly, we observed that the resulting increase in the loss of next-token prediction (NTP) was significantly lower than the proportion of random noise even when the model was scaled up to 2.7B. We provide a theoretical justification for this phenomenon, which also elucidates the success of multilingual models and can be applied to multimodal models. On the other hand, experiments show that the model's performance in downstream tasks is not based solely on the NTP loss, which means that random noise may result in degraded downstream performance. To address the potential adverse effects, we introduce a novel plug-and-play Local Gradient Matching loss, which explicitly enhances the denoising capability of the downstream task head by aligning the gradient of normal and perturbed features without requiring knowledge of the model's parameters. Additional experiments on 8 language and 14 vision benchmarks further validate its effectiveness.

Paul Hill, Zhiming Liu, Nantheera Anantrasirichai

Restoration and enhancement are essential for improving the quality of videos captured under atmospheric turbulence conditions, aiding visualization, object detection, classification, and tracking in surveillance systems. In this paper, we introduce a novel Mamba-based method, the 3D Mamba-Based Atmospheric Turbulence Removal (MAMAT), which employs a dual-module strategy to mitigate these distortions. The first module utilizes deformable 3D convolutions for non-rigid registration to minimize spatial shifts, while the second module enhances contrast and detail. Leveraging the advanced capabilities of the 3D Mamba architecture, experimental results demonstrate that MAMAT outperforms state-of-the-art learning-based methods, achieving up to a 3\% improvement in visual quality and a 15\% boost in object detection. It not only enhances visualization but also significantly improves object detection accuracy, bridging the gap between visual restoration and the effectiveness of surveillance applications.

Kai Zhao, Zhiming Liu, Jiaqi Liu et al.

Epicardial adipose tissue (EAT) is a type of visceral fat that can secrete large amounts of adipokines to affect the myocardium and coronary arteries. EAT volume and density can be used as independent risk markers measurement of volume by noninvasive magnetic resonance images is the best method of assessing EAT. However, segmenting EAT is challenging due to the low contrast between EAT and pericardial effusion and the presence of motion artifacts. we propose a novel feature latent space multilevel supervision network (SPDNet) with uncertainty-driven and adversarial calibration learning to enhance segmentation for more accurate EAT volume estimation. The network first addresses the blurring of EAT edges due to the medical images in the open medical environments with low quality or out-of-distribution by modeling the uncertainty as a Gaussian distribution in the feature latent space, which using its Bayesian estimation as a regularization constraint to optimize SwinUNETR. Second, an adversarial training strategy is introduced to calibrate the segmentation feature map and consider the multi-scale feature differences between the uncertainty-guided predictive segmentation and the ground truth segmentation, synthesizing the multi-scale adversarial loss directly improves the ability to discriminate the similarity between organizations. Experiments on both the cardiac public MRI dataset (ACDC) and the real-world clinical cohort EAT dataset show that the proposed network outperforms mainstream models, validating that uncertainty-driven and adversarial calibration learning can be used to provide additional information for modeling multi-scale ambiguities.

Zhiming Liu, Yujie Wei, Lei Feng et al.

Current VLMs have demonstrated capabilities across a wide range of multimodal tasks. Typically, in a pretrained VLM, all layers are engaged by default to make predictions on downstream tasks. We find that intervening on a single layer, such as by zeroing its parameters, can improve the performance on certain tasks, indicating that some layers hinder rather than help downstream tasks. We systematically investigate how individual layers influence different tasks via layer intervention. Specifically, we measure the change in performance relative to the base model after intervening on each layer and observe improvements when bypassing specific layers. This improvement can be generalizable across models and datasets, indicating the presence of Task-Interfering Layers that harm downstream tasks' performance. We introduce Task-Layer Interaction Vector, which quantifies the effect of intervening on each layer of a VLM given a task. These task-interfering layers exhibit task-specific sensitivity patterns: tasks requiring similar capabilities show consistent response trends under layer interventions, as evidenced by the high similarity in their task-layer interaction vectors. Inspired by these findings, we propose TaLo (Task-Adaptive Layer Knockout), a training-free, test-time adaptation method that dynamically identifies and bypasses the most interfering layer for a given task. Without parameter updates, TaLo improves performance across various models and datasets, including boosting Qwen-VL's accuracy on the Maps task in ScienceQA by up to 16.6%. Our work reveals an unexpected form of modularity in pretrained VLMs and provides a plug-and-play, training-free mechanism to unlock hidden capabilities at inference time. The source code will be publicly available.

Zhiming Liu, Nantheera Anantrasirichai

Atmospheric turbulence severely degrades video quality by introducing distortions such as geometric warping, blur, and temporal flickering, posing significant challenges to both visual clarity and temporal consistency. Current state-of-the-art methods are based on transformer and 3D architectures and require multi-frame input, but their large computational cost and memory usage limit real-time deployment, especially in resource-constrained scenarios. In this work, we propose RMFAT: Recurrent Multi-scale Feature Atmospheric Turbulence Mitigator, designed for efficient and temporally consistent video restoration under AT conditions. RMFAT adopts a lightweight recurrent framework that restores each frame using only two inputs at a time, significantly reducing temporal window size and computational burden. It further integrates multi-scale feature encoding and decoding with temporal warping modules at both encoder and decoder stages to enhance spatial detail and temporal coherence. Extensive experiments on synthetic and real-world atmospheric turbulence datasets demonstrate that RMFAT not only outperforms existing methods in terms of clarity restoration (with nearly a 9\% improvement in SSIM) but also achieves significantly improved inference speed (more than a fourfold reduction in runtime), making it particularly suitable for real-time atmospheric turbulence suppression tasks.

Zhiming Liu, Paul Hill, Nantheera Anantrasirichai

Atmospheric turbulence (AT) introduces severe degradations, such as rippling, blur, and intensity fluctuations, that hinder both image quality and downstream vision tasks like target detection. While recent deep learning-based approaches have advanced AT mitigation using transformer and Mamba architectures, their high complexity and computational cost make them unsuitable for real-time applications, especially in resource-constrained settings such as remote surveillance. Moreover, the common practice of separating turbulence mitigation and object detection leads to inefficiencies and suboptimal performance. To address these challenges, we propose JDATT, a Joint Distillation framework for Atmospheric Turbulence mitigation and Target detection. JDATT integrates state-of-the-art AT mitigation and detection modules and introduces a unified knowledge distillation strategy that compresses both components while minimizing performance loss. We employ a hybrid distillation scheme: feature-level distillation via Channel-Wise Distillation (CWD) and Masked Generative Distillation (MGD), and output-level distillation via Kullback-Leibler divergence. Experiments on synthetic and real-world turbulence datasets demonstrate that JDATT achieves superior visual restoration and detection accuracy while significantly reducing model size and inference time, making it well-suited for real-time deployment.

Paul Hill, Zhiming Liu, Alin Achim et al.

Atmospheric Turbulence (AT) degrades the clarity and accuracy of surveillance imagery, posing challenges not only for visualization quality but also for object classification and scene tracking. Deep learning-based methods have been proposed to improve visual quality, but spatio-temporal distortions remain a significant issue. Although deep learning-based object detection performs well under normal conditions, it struggles to operate effectively on sequences distorted by atmospheric turbulence. In this paper, we propose a novel framework that learns to compensate for distorted features while simultaneously improving visualization and object detection. This end-to-end training strategy leverages and exchanges knowledge of low-level distorted features in the AT mitigator with semantic features extracted in the object detector. Specifically, in the AT mitigator a 3D Mamba-based structure is used to handle the spatio-temporal displacements and blurring caused by turbulence. Optimization is achieved through back-propagation in both the AT mitigator and object detector. Our proposed DMAT outperforms state-of-the-art AT mitigation and object detection systems up to a 15% improvement on datasets corrupted by generated turbulence.

Zhiming Liu, Xuefei Zhang, Chongyang Liu et al.

Object detection is a basic and important task in the field of aerial image processing and has gained much attention in computer vision. However, previous aerial image object detection approaches have insufficient use of scene semantic information between different regions of large-scale aerial images. In addition, complex background and scale changes make it difficult to improve detection accuracy. To address these issues, we propose a relationship representation network for object detection in aerial images (RelationRS): 1) Firstly, multi-scale features are fused and enhanced by a dual relationship module (DRM) with conditional convolution. The dual relationship module learns the potential relationship between features of different scales and learns the relationship between different scenes from different patches in a same iteration. In addition, the dual relationship module dynamically generates parameters to guide the fusion of multi-scale features. 2) Secondly, The bridging visual representations module (BVR) is introduced into the field of aerial images to improve the object detection effect in images with complex backgrounds. Experiments with a publicly available object detection dataset for aerial images demonstrate that the proposed RelationRS achieves a state-of-the-art detection performance.

Mehdi Rahimi, Yantao Shen, Zhiming Liu et al.

This paper presents our recent development on a portable and refreshable text reading and sensory substitution system for the blind or visually impaired (BVI), called Finger-eye. The system mainly consists of an opto-text processing unit and a compact electro-tactile based display that can deliver text-related electrical signals to the fingertip skin through a wearable and Braille-dot patterned electrode array and thus delivers the electro-stimulation based Braille touch sensations to the fingertip. To achieve the goal of aiding BVI to read any text not written in Braille through this portable system, in this work, a Rapid Optical Character Recognition (R-OCR) method is firstly developed for real-time processing text information based on a Fisheye imaging device mounted at the finger-wearable electro-tactile display. This allows real-time translation of printed text to electro-Braille along with natural movement of user's fingertip as if reading any Braille display or book. More importantly, an electro-tactile neuro-stimulation feedback mechanism is proposed and incorporated with the R-OCR method, which facilitates a new opto-electrotactile feedback based text line tracking control approach that enables text line following by user fingertip during reading. Multiple experiments were designed and conducted to test the ability of blindfolded participants to read through and follow the text line based on the opto-electrotactile-feedback method. The experiments show that as the result of the opto-electrotactile-feedback, the users were able to maintain their fingertip within a $2mm$ distance of the text while scanning a text line. This research is a significant step to aid the BVI users with a portable means to translate and follow to read any printed text to Braille, whether in the digital realm or physically, on any surface.

Hengjun Zhao, Xia Zeng, Taolue Chen et al.

We provide a novel approach to synthesize controllers for nonlinear continuous dynamical systems with control against safety properties. The controllers are based on neural networks (NNs). To certify the safety property we utilize barrier functions, which are represented by NNs as well. We train the controller-NN and barrier-NN simultaneously, achieving a verification-in-the-loop synthesis. We provide a prototype tool nncontroller with a number of case studies. The experiment results confirm the feasibility and efficacy of our approach.

Yufeng Zhang, Jialu Pan, Wanwei Liu et al.

Recent research has revealed that deep generative models including flow-based models and Variational Autoencoders may assign higher likelihoods to out-of-distribution (OOD) data than in-distribution (ID) data. However, we cannot sample OOD data from the model. This counterintuitive phenomenon has not been satisfactorily explained and brings obstacles to OOD detection with flow-based models. In this paper, we prove theorems to investigate the Kullback-Leibler divergence in flow-based model and give two explanations for the above phenomenon. Based on our theoretical analysis, we propose a new method \PADmethod\ to leverage KL divergence and local pixel dependence of representations to perform anomaly detection. Experimental results on prevalent benchmarks demonstrate the effectiveness and robustness of our method. For group anomaly detection, our method achieves 98.1\% AUROC on average with a small batch size of 5. On the contrary, the baseline typicality test-based method only achieves 64.6\% AUROC on average due to its failure on challenging problems. Our method also outperforms the state-of-the-art method by 9.1\% AUROC. For point-wise anomaly detection, our method achieves 90.7\% AUROC on average and outperforms the baseline by 5.2\% AUROC. Besides, our method has the least notable failures and is the most robust one.

Yuxiu Hua, Zhifeng Zhao, Rongpeng Li et al.

Time series prediction can be generalized as a process that extracts useful information from historical records and then determines future values. Learning long-range dependencies that are embedded in time series is often an obstacle for most algorithms, whereas Long Short-Term Memory (LSTM) solutions, as a specific kind of scheme in deep learning, promise to effectively overcome the problem. In this article, we first give a brief introduction to the structure and forward propagation mechanism of the LSTM model. Then, aiming at reducing the considerable computing cost of LSTM, we put forward the Random Connectivity LSTM (RCLSTM) model and test it by predicting traffic and user mobility in telecommunication networks. Compared to LSTM, RCLSTM is formed via stochastic connectivity between neurons, which achieves a significant breakthrough in the architecture formation of neural networks. In this way, the RCLSTM model exhibits a certain level of sparsity, which leads to an appealing decrease in the computational complexity and makes the RCLSTM model become more applicable in latency-stringent application scenarios. In the field of telecommunication networks, the prediction of traffic series and mobility traces could directly benefit from this improvement as we further demonstrate that the prediction accuracy of RCLSTM is comparable to that of the conventional LSTM no matter how we change the number of training samples or the length of input sequences.

Yilong Yang, Xiaoshan Li, Zhiming Liu et al.

Prototyping is an effective and efficient way of requirement validation to avoid introducing errors in the early stage of software development. However, manually developing a prototype of a software system requires additional efforts, which would increase the overall cost of software development. In this paper, we present an approach with a developed tool to automatic generation of prototypes from formal requirements models. A requirements model consists of a use case diagram, a conceptual class diagram, use case definitions specified by system sequence diagrams and the contracts of their system operations. We propose a method to decompose a contract into executable parts and non-executable parts. A set of transformation rules is given to decompose the executable part into pre-implemented primitive operations. A non-executable part is usually realized by significant algorithms such as sorting a list, finding the shortest path or domain-specific computation. It can be implemented manually or by using existing code. A CASE tool is developed that provides an interface for developers to develop a program for each non-executable part of a contract, and automatically transforms the executables into sequences of pre-implemented primitive operations. We have conducted four cases studies with over 50 use cases. The experimental result shows that the 93.65% of requirement specifications are executable, and only 6.35% are non-executable such as sorting and event-call, which can be implemented by developers manually or invoking the APIs of advanced algorithms in Java library. The one second generated the prototype of a case study requires approximate nine hours manual implementation by a skilled programmer. Overall, the result is satisfiable, and the proposed approach with the developed CASE tool can be applied to the software industry for requirements engineering.

Liyun Dai, Taolue Chen, Zhiming Liu et al.

In this paper, we study the parameter synthesis problem for a class of parametric timed automata. The problem asks to construct the set of valuations of the parameters in the parametric timed automa- ton, referred to as the feasible region, under which the resulting timed automaton satisfies certain properties. We show that the parameter syn- thesis problem of parametric timed automata with only one parametric clock (unlimited concretely constrained clock) and arbitrarily many pa- rameters is solvable when all the expressions are linear expressions. And it is moreover the synthesis problem is solvable when the form of con- straints are parameter polynomial inequality not just simple constraint and parameter domain is nonnegative real number.

Yilong Yang, Xiaoshan Li, Nafees Qamar et al.

Legacy Electronic Health Records (EHRs) systems were not developed with the level of connectivity expected from them nowadays. Therefore, interoperability weakness inherent in the legacy systems can result in poor patient care and waste of financial resources. Large hospitals are less likely to share their data with external hospitals due to economic and political reasons. Motivated by these facts, we aim to provide a set of software implementation guidelines, i.e., MedShare to deal with interoperability issues among disconnected healthcare systems. The proposed integrated architecture includes: 1) a data extractor to fetch legacy medical data from a hemodialysis center, 2) converting it to a common data model, 3) indexing patient information using the HashMap technique, and 4) a set of services and tools that can be installed as a coherent environment on top of stand-alone EHRs systems. Our work enabled three cooperating but autonomous hospitals to mutually exchange medical data and helped them develop a common reference architecture. It lets stakeholders retain control over their patient data, winning the trust and confidence much needed towards a successful deployment of MedShare. Security concerns were effectively addressed that also included patient consent in the data exchange process. Thereby, the implemented toolset offered a collaborative environment to share EHRs by the healthcare providers.

Yuxiu Hua, Zhifeng Zhao, Rongpeng Li et al.

Traffic prediction plays an important role in evaluating the performance of telecommunication networks and attracts intense research interests. A significant number of algorithms and models have been put forward to analyse traffic data and make prediction. In the recent big data era, deep learning has been exploited to mine the profound information hidden in the data. In particular, Long Short-Term Memory (LSTM), one kind of Recurrent Neural Network (RNN) schemes, has attracted a lot of attentions due to its capability of processing the long-range dependency embedded in the sequential traffic data. However, LSTM has considerable computational cost, which can not be tolerated in tasks with stringent latency requirement. In this paper, we propose a deep learning model based on LSTM, called Random Connectivity LSTM (RCLSTM). Compared to the conventional LSTM, RCLSTM makes a notable breakthrough in the formation of neural network, which is that the neurons are connected in a stochastic manner rather than full connected. So, the RCLSTM, with certain intrinsic sparsity, have many neural connections absent (distinguished from the full connectivity) and which leads to the reduction of the parameters to be trained and the computational cost. We apply the RCLSTM to predict traffic and validate that the RCLSTM with even 35% neural connectivity still shows a satisfactory performance. When we gradually add training samples, the performance of RCLSTM becomes increasingly closer to the baseline LSTM. Moreover, for the input traffic sequences of enough length, the RCLSTM exhibits even superior prediction accuracy than the baseline LSTM.

Nafees Qamar, Yilong Yang, Andras Nadas et al.

This paper takes on the problem of automatically identifying clinically-relevant patterns in medical datasets without compromising patient privacy. To achieve this goal, we treat datasets as a black box for both internal and external users of data that lets us handle clinical data queries directly and far more efficiently. The novelty of the approach lies in avoiding the data de-identification process often used as a means of preserving patient privacy. The implemented toolkit combines software engineering technologies such as Java EE and RESTful web services, to allow exchanging medical data in an unidentifiable XML format as well as restricting users to the need-to-know principle. Our technique also inhibits retrospective processing of data, such as attacks by an adversary on a medical dataset using advanced computational methods to reveal Protected Health Information (PHI). The approach is validated on an endoscopic reporting application based on openEHR and MST standards. From the usability perspective, the approach can be used to query datasets by clinical researchers, governmental or non-governmental organizations in monitoring health care services to improve quality of care.