Sample Survey Research Articles

Assessing the determinants of out-of-pocket health expenditures among Cambodian households in informal employment using survey data

BackgroundAs the deadline for the Sustainable Development Goals approaches, financial protection in Cambodia remains inadequate, especially for nonpoor informal workers lacking formal social health protection coverage or access to other prepayment schemes. This exposes them to high out-of-pocket health expenditures (OOPE) and related financial hardship. To better understand the drivers behind these expenditures, our study aims to model their healthcare, health, and social determinants and to assess their relative importance.MethodsIn 2023, we conducted a cross-sectional multistage clustered sampling survey across seven Cambodian provinces, surveying 3,254 households engaged in informal employment and not covered by any formal social health protection scheme. The survey gathered information on households’ use of outpatient and inpatient care and associated OOPE. We employed generalized linear models (GLMs) to analyse the healthcare, health, and social determinants of OOPE and the OOPE budget share (the proportion of total annual household consumption expenditure spent on OOPE) and applied Shapley decomposition analysis to quantify the relative contributions of these determinants to the explained variance in our outcomes.ResultsHealthcare variables were the dominant contributors to the explained variance in all outcomes (41.36–50.73%), followed by health factors. While several social variables were significant, only the wealth quintile made notable contributions to explaining variance in our outcomes. The key healthcare contributors included the sector type and level of care, and the number of outpatient medications. Important health contributors included illness severity and the presence of chronic illnesses or noncommunicable diseases.ConclusionsOur findings emphasize the necessity of integrating nonpoor informal workers and their dependents into formal prepayment schemes to reduce OOPE and enhance financial protection on Cambodia’s path toward universal health coverage. Strategically engaging with private providers and pharmacies to improve access to essential services and medicines, coupled with the implementation of an effective referral system are important policy considerations to this end. Further research is needed on how health determinants are modifiable with policy interventions. Our findings can assist the Cambodian government in advancing its universal health coverage goals and offer insights for other countries aiming to extend coverage to similar population groups.

P-1908. The Relationship Between Long COVID and PHQ-4 Measures of Emotional Health

Abstract Background The COVID-19 pandemic was one of the most devastating public health crises in US history. Millions of Americans experience ongoing symptoms, often termed “Long COVID.” Long COVID (LC) has been defined as symptoms lasting 3 months or longer that were not present prior to the COVID infection. LC’s neurological effects have been associated with psychological issues like depression. Furthermore, given that many individuals with LC report difficulty getting treatment for these symptoms, the emotional effects associated with LC may be profound. Methods The US Census Bureau conducts an ongoing study called the Household Pulse Survey, with the purpose of measuring emergent social and economic matters facing U.S. households. Data analyzed was collected January 9 - February 5, 2024. Respondents were asked about their self-reported COVID-19 experiences and their mental health, as measured by the Patient Health Questionnaire-4 (PHQ-4) for depression and anxiety. The survey was conducted in English and Spanish and the survey sample was N=68,544. Data were analyzed using χ2 and between group contrast analysis. Results Of those surveyed, N=9,298 or 16.5% reported experiencing LC. When asked about their experiences during the last two weeks, 60.1% reported feeling anxious on several days or more, vs. 40.5% of those who had experienced COVID-19 but had no long term symptoms (termed Short COVID or SC) and 38.7% of those who had not contracted COVID-19 (called No COVID or NC), with LC significantly higher than both other groups (p< .05). Fully 51.1% of LC respondents were unable to stop or control their worrying, vs. 29.1% SC and 31.9% NC= (both comparisons vs. LC, p< .05). Similarly, those with LC were also significantly more likely to report having experienced little pleasure or interest in doing things (47.5% vs. 25.2% SC and 30.4% NC, p< .05) and feeling down, depressed or hopeless in the past two weeks (48.3% vs. 27.4% SC and 30.9% NC, p< .05). Conclusion Many Americans surveyed report experiencing LC and this appears to be associated with significant negative mental health effects, as measured by the PHQ-4. Further research should examine the relationship between LC and mental health, as well as mechanisms of how these factors relate to one another. Disclosures All Authors: No reported disclosures

Self-assessed health of adult Australian sport club participants during and after COVID-19 restrictions: a longitudinal study

BackgroundInternationally, COVID-19 restrictions impacted negatively on participation in sport and physical activity. Participation in community club sport was particularly disrupted with cancelled training and competitions, and this has been shown to impact the health of individuals. We now need to investigate the effects of the lifting of COVID-19 restrictions.AimThe aim of this study was to longitudinally investigate the health of Australian adult sports club participants, during and post-COVID-19 restrictions.MethodsTwo waves of an online survey were conducted in mid-2020 and mid-2021. The first wave also captured retrospective pre-COVID19 (2019) data. For each year 2019–2021 each survey respondent was categorized as participating (Yes/No) in club sport. Respondents also assessed their current health (overall, physical and mental) in both 2020 and 2021. The six health assessments were cross-tabulated against three patterns of participation (dropout, dropout and return, continuation), for the survey sample overall and for six demographic subsamples: 42 crosstabulations in all.ResultsA total of 1,037 Australians aged 18 years and above completed both survey waves. Those who continued playing club sport throughout, and to a lesser degree those who returned to club sport in 2021, reported better physical and general health than those who dropped out. This pattern was consistent, for the overall survey sample and for the sub-samples based on gender, age and region of residence, with statistically significantly associations (p < 0.05) in 24 of 28 analyses. The pattern of club sport participation was only weakly associated with reported mental health, with only one of 14 associations being statistically significant.ConclusionChanges in club sport participation impact general and physical health of adults; continuation or return were associated with better physical and general health than drop-out. There was little evidence of an association between participation in sport and mental health, which is inconsistent with previously reported cross-sectional results; this may be due to a combination of factors, including confounding with the broader effects of the pandemic. In conclusion, it is clear that retention in participation in sport is not just important for sports management policy and strategies; it is also important for the health of individuals.

First density estimates of the Endangered Claire's mouse lemur Microcebus mamiratra and recommendations for its conservation

Abstract Mouse lemurs Microcebus spp. are small, nocturnal primates endemic to Madagascar. The genus is extraordinarily diverse, with 25 extant species, several of which have been described recently. The Endangered Claire's mouse lemur Microcebus mamiratra was first described in 2006, but, similarly to other newly described mouse lemurs, remains understudied, and estimates of its population size are unavailable, hampering effective conservation management. We conducted line transect distance sampling surveys of M. mamiratra across several habitat types in and around Lokobe National Park on the island of Nosy Be in north-western Madagascar. Using a systematic random design we surveyed 15 transects over a 6-week period in 2023, recording 92 detections from a total survey effort of 46.5 km. We estimate the density of M. mamiratra on Nosy Be to be 125.1 individuals/km2, which extrapolates to an estimate of c. 4,700 individuals across the forested areas of its range on the island. Our results indicate that Nosy Be harbours moderately high densities of M. mamiratra, with the highest encounter rates in the unprotected secondary and degraded forests around Lokobe National Park. Our population estimate will inform future conservation status assessments and conservation planning for this range-restricted species and provide a baseline for monitoring population changes over time. We present recommendations for the conservation of M. mamiratra and highlight the potential for lemur watching, sustained by the strong tourism industry on Nosy Be, to help protect lemur habitat and generate economic opportunities for local communities.

A Seasonal Fresh Tea Yield Estimation Method with Machine Learning Algorithms at Field Scale Integrating UAV RGB and Sentinel-2 Imagery

Traditional methods for estimating tea yield mainly rely on manual sampling surveys and empirical estimation, which are labor-intensive and time-consuming. Accurately estimating fresh tea production in different seasons has become a challenging task. It is possible to estimate the seasonal yield of tea at the field scale by using the spatial resolution of 10 m, 5-day revisit period and rich spectral information of Sentinel-2 imagery. This study integrated Sentinel-2 images and uncrewed aerial vehicle (UAV) RGB imagery to develop six regression models at the field scale, which were employed for the estimation of seasonal and annual fresh tea yields of the Yunlong Tea Cooperatives in Yixiang Town, Pu’er City, China. Firstly, we gathered fresh tea production data from 133 farmers in the cooperative over the past five years and obtained UAV RGB and Sentinel-2 imagery. Secondly, 23 spectral features were extracted from Sentinel-2 images. Based on the UAV images, the parcel of each farmer was positioned and three topographic features of slope, aspect, and elevation were extracted. Subsequently, these 26 features were screened using the random forest algorithm and Pearson correlation analysis. Thirdly, we applied six different regression algorithms to establish fresh tea yield models for each season and evaluated their estimation accuracy. The results showed that random forest regression models were the optimal choice for estimating spring and summer yields, with the spring model achieving an R2 value of 0.45, an RMSE of 40.38 kg/acre, and an rRMSE of 40.79%. Similarly, the summer model achieved an R2 value of 0.5, an RMSE of 78.46 kg/acre, and an rRMSE of 39.81%. For autumn and annual yield estimation, voting regression models demonstrated superior performance, with the autumn model achieving an R2 value of 0.42, an RMSE of 70.6 kg/acre, and an rRMSE of 39.77%, and the annual model attained an R2 value of 0.47, an RMSE of 168.7 kg/acre, and an rRMSE of 34.62%. This study provides a promising new method for estimating fresh tea yield in different seasons at the field scale.

Use of images to assess awareness and use of emerging nicotine pouch products.

Accurate measurement is critical for understanding the population health impact of nicotine pouches, yet precise, standardized measures of nicotine pouch use are lacking, possibly driving disparate prevalence estimates across studies. We implemented a split sample survey experiment to assess the impact of including a product image when asking about nicotine pouches. We randomized an online sample of US adults ages 18-45 (N=2,130) recruited through the February 2023 wave of the Rutgers Omnibus Study to view either a text-only or text-plus-image description of oral nicotine pouches before being asked about awareness of the products. Participants who endorsed awareness were then asked about their use and brands they had tried. We calculated prevalence of awareness, ever, and current use of nicotine pouches and used chi-square tests to assess differences in responses to each question by survey condition. Participants in the image condition were more likely than those in the text condition to report awareness (40.6% vs 31.5%, P<.001) and ever use (7.2% vs 5.2%, P=.044). Among those reporting nicotine pouch use, 5.9% in the text-only condition, compared to 0% in the image condition, listed a smokeless tobacco brand as one they tried, suggesting they were misclassified by the text-only question. Inclusion of product imagery can improve nicotine pouch measurement accuracy in surveys, while text-only measures may misestimate prevalence of awareness and use. Differences in nicotine pouch prevalence estimates may be explained in part by differences in survey measures, highlighting a need to harmonize measures across studies. In this first study to evaluate nicotine pouch measurement methods, findings suggest that existing surveillance and research efforts may be undermined by misclassification. Text-only measures of nicotine pouch awareness and use may produce biased prevalence estimates, and inclusion of product imagery can improve nicotine pouch measurement accuracy in surveys.

When Leaders Are Safe Havens: How Secure Base Leadership Buffers the Impact of Emotional Demands on Exhaustion

Based on attachment theory, this research explores Secure Base Leadership’s (SBL) efficacy in mitigating the negative impact of emotional demands on employee exhaustion, with an aim to reduce burnout rates and improve workplace well-being. A survey sample of 428 Spanish employees from various sectors was collected, and Partial Least Squares Structural Equation Modeling (PLS-SEM) was used to test the research model. Emotional demands were found to significantly increase employee exhaustion, whereas SBL reduced and moderated these effects, proving its protective function. Furthermore, increased exhaustion was associated with longer tenure and employment in private organizations. Findings support integrating SBL in leadership development to foster a supportive environment, mitigate burnout, and boost employee well-being. Highlighting the application of attachment theory in organizational settings, this study contributes to understanding SBL’s effectiveness against emotional demands, guiding leadership practices to enhance organizational health.

Monitoring the Risk of Corruption in the MENA Region: What Are the Most Reliable Data to Address the Sustainable Development Goals?

ABSTRACTCountering corruption is recognized by the United Nations Sustainable Development Goals (UN SDGs) as crucial for effective and sustainable governance. Sample surveys are often used as the primary tool for monitoring corruption, making the evaluation of their quality essential for building a reliable evidence base strategy and achieving the UN SDGs 16.5. However, there is a lack of studies assessing the quality of corruption surveys in the Middle East and North African (MENA) region. This gap can be attributed to various factors, including low prioritization, insufficient resources for anti‐corruption initiatives, the sensitivity of the topic, and language and cultural barriers. This article aims to assess the quality of corruption surveys in the MENA region by developing an ad‐hoc quality evaluation framework, MENA_QUEST_16.5. This framework includes criteria for assessing survey relevance, validity, accuracy, credibility, periodicity, and comparability to evaluate MENA surveys' effectiveness in capturing corruption events, in line with SDGs' requirement for measuring corruption. The framework is then applied to evaluate the quality of 19 national and cross‐national corruption surveys targeting countries in the MENA region. The study finds that the overall quality of MENA corruption surveys is good, but the number of national initiatives is low. Surveys often lack accuracy in depicting corruption issues, typically operationalizing corruption through only one or two questions. Details about corruption events (e.g., types of officials involved; types of benefits exchanged) are rarely investigated. Also, MENA surveys are not periodically conducted and suffer from a lack of transparency, with raw data generally unavailable or inaccessible. These results point to methodological shortcomings that should be addressed to obtain a reliable overview of corruption in the MENA region. Tackling these issues can improve the monitoring of corruption trends and inform anti‐corruption policy design and evaluation, to ultimately achieve the UN SDGs.

Exploring Illegal Trade and Management Strategies in Protected Aquatic Wildlife in Xiamen, China

In recent decades, illegal wildlife trade has become a global problem that threatens the conservation of many species. To promote sustainable animal trade, conservation plans must be developed and implemented locally. However, illegal trade in protected aquatic wildlife still occurs in many places. To understand the current situation of illegal sales, we conducted a sampling survey on eight sites in Xiamen for 5 consecutive years. The results show that illegal sales behavior is widespread, but there are changes. Notably, the proportion of stores with illegal sales fell from 17.7% in 2018 to 10.8% in 2022. We observed 24 species, 12 of which are listed in CITES. Among them, 15 species were recorded in annual surveys, accounting for 62.5% of the total species surveyed. Among the 24 species investigated, there were 8 living species. From 2018 to 2022, the number of food stalls selling protected species dropped the most, from 22.7% to 0%. Followed by dry goods stores, the number of stores selling protected species dropped from 24% to 8.3%. However, the number of craft shops selling protected species increased by 14.8%. It put forward protection suggestions such as focusing on cracking down on illegal sales and strengthening consumer publicity and education.

New Class of Estimators for Finite Population Mean Under Stratified Double Phase Sampling with Simulation and Real-Life Application

Sampling survey data can sometimes contain outlier observations. When the mean estimator becomes skewed due to the presence of extreme values in the sample, results can be biased. The tendency to remove outliers from sample data is common. However, performing such removal can reduce the accuracy of conventional estimating techniques, particularly with regard to the mean square error (MSE). In order to increase population mean estimation accuracy while taking extreme values into consideration, this study presents an enhanced class of estimators. The method uses extreme values from an auxiliary variable as a source of information rather than eliminating these outliers. Using a first-order approximation, the properties of the suggested class of estimators are investigated within the context of a stratified two-phase sampling framework. A simulation research is conducted to examine the practical performance of these estimators in order to validate the theoretical conclusions. To further demonstrate the superiority of the suggested class of estimators for dealing with extreme values, an analysis of three different datasets demonstrates that they consistently provide higher percent relative efficiency (PRE) when compared to existing estimators.

A decade of AGO QS-Mamma – Adherence to the Recommendations of The AGO Breast Committee for Diagnosis and Treatment in EBC in Routine Therapy in Germany

Introduction: The cure for Early Breast Cancer (EBC) is increasing over the last decades due to the improvement of diagnosis and therapy. Individualization of cancer treatment in EBC requires constant optimization by implementing current guidelines. The AGO (working group gynecologic oncology) QS-Mamma initiative, a quality assurance program (QS) of the AGO Breast Committee, was introduced to provide insight in guideline adherence in real world practice in Germany. We evaluated 10 years of QS-Mamma data to identify gaps and trends implementing those guidelines. Methods: QS-Mamma is a retrospective sample survey providing a representative overview of the treatment landscape for the treatment of breast cancer in Germany. The last six cohorts were analyzed over a period of ten years. Across all cohorts, an average of 264 centers documented a total of n=4,577 patients with EBC. Results: Testing for BRCA mutations in triple-negative patients increased significantly. Breast conserving surgery has been standard of care since the start of data collection; choice of surgical procedure depends primarily on tumor size and nodal status according to the patient´s preference, if possible. Axillary intervention has shifted towards SLNE or targeted axillary procedures in patients with negative preoperative nodal staging. Neoadjuvant systemic therapy (NAST) in operable EBC is established. Anthracycline administration in the adjuvant setting decreases. We noted an uptake on using platinum-containing CTx in TNBC, corresponding to AGO recommendations. Dual HER2 blockade is established in HER2 positive EBC with increased risk of relapse. Changes in guidelines are reflected in real-world data. Conclusion: Guideline adherence in breast cancer care is high and new treatments and diagnostic options are implemented promptly. Finally, escalation and de-escalation of treatment is depending on individual tumor characteristics resulting in the individual risk of recurrence. Guidelines should be flanked by real-world evidence to ensure and survey their impact.

Predictors of insecticide-treated nets utilization among children under five years in refugee settlements in Uganda: analysis of the 2018–2019 Uganda Malaria Indicator Survey

BackgroundDespite significant distribution of insecticide-treated net (ITNs) by the Government of Uganda to refugees, malaria is major cause of mortality and morbidity among children under five years in refugee settlements. This highlights the persistent challenges and complexities surrounding malaria control and prevention efforts in these settings. Studies that focus on the determinants of ITN utilization among children under five years in refugee settlements in Uganda are not available. Using the 2018–2019 Uganda’s Malaria Indicator Survey (UMIS) data, analysis of the individual and household factors associated with utilization of ITN among children under five in refugee settlements of Uganda was conducted.MethodsThis study focused on 589 children under five staying in refugee settlements located in Uganda. The extracted variables from the UMIS included social-economic factors associated with ITN utilization. Descriptive analysis was performed to generate summarized statistics, while inferential statistics by way of bivariate analysis were performed to assess the association between the outcome and the independent variables using the chi-square test, and multivariable logistic regression modelling to assess the magnitude of the associations after controlling for other covariates. All analyses considered the survey sampling design and sampling weights, and are conducted in Stata version 18.ResultsThe odds of children sleeping under ITN were higher if their mothers had secondary and higher education (8.1 times) as well as primary education (1.5 times). The odds of children sleeping under ITN reduced by 50% if their mothers were pregnant. Interestingly, the odds of children sleeping under ITN were 70% lower if their mothers knew that ‘not sleeping in nets’ caused malaria. Mothers who were exposed to malaria messages had lower odds of their children sleeping under ITNs.ConclusionsThe results highlight areas of intervention that can increase ITN use in refugee settlements of Uganda. Improving access to education for mothers, providing targeted health education on the importance of ITN, dispelling misconceptions about malaria transmission, facilitating the proper installation of ITNs among others, can all contribute to increased ITN utilization among children under five.

Demand conditions of physical experience-based tourism in an urban-centered wetland

The target area of the survey is the rehabilitated flat area behind the capital cities of Vienna and Bratislava, which lies in the tourist area of Győr. Wetlands provide a backdrop for tourism products such as kite flying, cycling and walking. The city centre offers tourists an easy sightseeing tour behind the natural scenery of the Danube tributary (Szigetköz). Objective: The demographic characteristics of demand and preferences for active tourism product types and the extent of the scope of supply were analyzed. The present research also analyses the cycling routes in the region with regard to the EUROVELO 6 road network. The primary research was a quantitative (questionnaire) survey conducted between 10 September 2023 and 30 October 2023. The survey sample of 666 respondents is not representative and was selected by random sampling. The results of the research include an analysis of the demand for participation in cycling tourism and tour programs as activities requiring activity. The findings of the research provide a basis for demand-supply segmentation of sustainable active tourism product development based on physical experience according to demographic characteristics (e.g. age, education). The landscape of the wetland can be positioned for the bicycle tourists. Especially for the target group of people over 40 and for people with higher education. The scope of the guided tours, linked to the central offer, extends over an area of more than 50 km. Activating the target group helps the rehabilitated natural scenery to connect to sustainable tourism.

Characteristics of functional constipation and analysis of intestinal microbiota in children aged 0–4 in Zunyi region

BackgroundFunctional constipation (FC) significantly impacts children’s health. This study investigates the prevalence and microbiota characteristics of FC in children aged 0–4 years in Zunyi area.MethodsFrom October to December 2023, 2039 children aged 0–4 years in Zunyi were selected using stratified sampling and cross-sectional survey methods. A questionnaire based on Rome IV diagnostic criteria was used. Twenty-nine children with FC were randomly selected as the functional constipation group (FCG), and 26 healthy children, matched for age, sex, and area, were selected as the control group (CG).ResultsA total of 2051 questionnaires were collected, with 2039 valid responses. Among them, 151 children had FC, resulting in a prevalence rate of 7.4%. The prevalence rates in boys and girls were 6.6% and 8.5%, respectively, with no significant gender difference (P > 0.05). Alpha diversity analysis revealed higher richness and diversity of intestinal flora in the FCG compared to the CG. At the phylum level, Actinobacteria, Firmicutes, Proteobacteria, and Bacteroidetes were dominant in both groups. The FCG showed a higher relative abundance of Firmicutes, Actinobacteria, and Proteobacteria compared to the CG (P < 0.05).ConclusionsThe prevalence of FC in children aged 0–4 years in Zunyi is 7.4%. Disease characteristics vary with age and living environment but are unrelated to gender. The gut microbiota of children with FC shows significant alterations, with higher diversity and specific phyla abundance.

Working-class youth participation in climate action: networks, civic experience, and equity

Research on individual participation in climate action largely focuses on middle class environmental activism around protest events. To better understand the expansion of civic engagement on climate issues, more work needs to be carried out on wider sectors of the population. This study examines the drivers associated with involvement in climate action at the individual level with a survey sample of working-class youth of color. The findings suggest that youth embedded in pro-climate social networks, a history of civic engagement, and an equity belief system increase willingness to participate in several forms of climate action, including climate meetings, demonstrations, and inviting others to participate. For larger climate action initiatives to overcome the barriers of participation, linking to specific pools of sympathy in civil society that value economic equality may provide a mass base of support for policies consistent with just transition perspectives.

Unveiling social disparities in employment and wages: a labour market segmentation analysis of India’s IT industry

PurposeThis study investigates the caste-based disparities in employment probabilities and wage earnings within India’s rapidly growing IT industry, using insights from the labour market segmentation theory. Our theoretical conceptualization attempts to pin down the inaccessibility of marginalised sections of the population to the high productivity job market.Design/methodology/approachWe rely on the National Sample Survey rounds of 2011–2012 and 2020–2021 to estimate employment probabilities and wage differentials using linear and logic regression models, controlling for educational attainments and other important determinants of individual’s job market outcomes.FindingsThe results indicate a significant −1.24 odds differential, even after considering education and other control variables. Notably, this disparity has increased since 2011–2012, with lower caste graduate pass-outs facing a mere 13% probability of IT sector employment compared to their upper caste counterparts at 41%. Further, our findings expose gender and rural-urban differentials, highlighting the vulnerability faced by females and individuals from rural areas. The wage analysis shows a 24% and a 22% earning gap for SCs and OBCs, respectively, which remain statistically significant even after controlling for educational attainments and employment arrangements.Originality/valueThis is first micro-level study that counters Indian IT sector’s claim of “castelessness” and “pro-merit”, identifying significant presence of labour market segmentation in the sector. The caste-based labour market segmentation has far-reaching consequences as it can perpetuate income inequalities and hurt industrial efficiency, stifling economic growth in the long-run. Concerted policy responses are imperative to eliminate structural barriers, ensuring equitable access to quality education and employment opportunities for marginalized sections of the society.

High-resolution mapping of global winter-triticeae crops using a sample-free identification method

Abstract. Winter-triticeae crops, such as winter wheat, winter barley, winter rye and triticale, are important in human diets and are planted worldwide, and thus accurate spatial distribution information on winter-triticeae crops is crucial for monitoring crop production and food security. However, there is still a lack of global high-resolution maps of winter-triticeae crops because of the reliance of existing crop mapping methods on training samples, which limits their application at the global scale. In this study, we propose a new method based on the Winter-Triticeae Crops Index (WTCI) for global winter-triticeae crop mapping. This is a new sample-free method for identifying winter-triticeae crops based on differences in their normalized difference vegetation index (NDVI) characteristics from the heading to harvesting stages and those of other types of vegetation. We considered state (or province) or country to be an identification unit and employed the WTCI to produce the first global 30 m resolution distribution maps of winter-triticeae crops from 2017 to 2022 using Landsat and Sentinel images. Validation using field survey samples and visual interpretation samples from Google Earth images indicated that the method exhibited satisfying performance and stable spatiotemporal transferability, with producer's accuracy, user's accuracy and overall accuracy values of 81.12 %, 87.85 % and 87.7 %, respectively. Moreover, compared with the Cropland Data Layer (CDL) and EuroCrops datasets, the overall accuracy and F1 score in most regions of the United States and Europe were more than 80 % and 75 %, respectively. The identified area of winter-triticeae crops was consistent with the agricultural statistical area in almost all the investigated countries or regions, and the correlation coefficient (R2) between the identified area and the statistical area was over 0.6, while the relative mean absolute error (RMAE) was less than 30 % in all 6 years. Overall, this study provides a reliable and automatic identification method for winter-triticeae crops without any training samples. The high-resolution distribution maps of global winter-triticeae crops are expected to support multiple agricultural applications. The distribution maps can be obtained at https://doi.org/10.57760/sciencedb.12361 (Fu et al., 2023a).

Velocity dispersion function evolution from strong lensing statistics

ABSTRACT The redshift and size distributions of galaxy-scale strong lenses depend on the evolution of early-type galaxies. We use this dependence to constrain the velocity dispersion function (VDF) evolution from the Strong Lensing Legacy Survey sample of lenses in the redshift range $0.25\lesssim z \lesssim 0.75$. Our modelling of the lens population includes lens identifiability given survey parameters, and constrains the evolution of the VDF based on the redshift distributions of sources and lenses as well as the distribution of Einstein radii. We consider five different assumptions for the reference VDF at redshift zero and two sets of scaling relations for the VDF. We find that in all cases the observed lens sample favours a slow evolution of both the VDF normalization factor and the VDF characteristic velocity with redshift which is consistent with a VDF that is constant in redshift for $z\lesssim 0.75$.

Assessing the financial burden of multimorbidity among patients aged 30 and above in India

BackgroundMultimorbidity is associated with significant out-of-pocket expenditures (OOPE) and catastrophic health expenditure (CHE), especially in low- and middle-income countries like India. Despite this, there is limited research on the financial burden of multimorbidity in outpatient and inpatient care, and cross-state comparisons of CHE are underexplored.MethodsWe conducted a cross-sectional analysis using nationally representative data from the National Sample Survey 75th Round ‘Social Consumption in India: Health (2017–18)’, focusing on patients aged 30 and above in outpatient and inpatient care in India. We assessed multimorbidity prevalence, OOPE, CHE incidence, and CHE intensity. Statistical models, including linear, log-linear, and logistic regressions, were used to examine the financial risk, with a focus on non-communicable diseases (NCDs), healthcare facility choice, and socioeconomic status and Epidemiological Transition Levels (ETLs).ResultsMultimorbidity prevalence in outpatient care (6.1%) was six times higher than in inpatient care (1.1%). It was most prevalent among older adults, higher MPCE quintiles, urban patients, and those with NCDs. Multimorbidity was associated with higher OOPE, particularly in the rich quintile, patients seeking care from private providers, low ETL states, and rural areas. CHE incidence was highest in low ETL states, private healthcare users, poorest quintile, males, and patients aged 70 + years. CHE intensity, measured by mean positive overshoot, was greatest among the poorest quintile, low ETL states, rural, and male patients. Log-linear and logistic regressions indicated that multimorbidity patients with NCDs, those seeking private care, and those in low ETL states had higher OOPE and CHE risk. The poorest rural multimorbidity patients had the greatest likelihood of experiencing CHE. Furthermore, CHE intensity was significantly elevated among multimorbidity patients with NCDs (95% CI: 19.29–45.79), patients seeking care in private, poorest, and from low ETL states (95% CI: 7.36–35.79).ConclusionsThe high financial burden of OOPE and CHE among multimorbidity patients, particularly those with NCDs, highlight the urgent need for comprehensive health policies that address financial risk at the primary care level. To alleviate the financial burden among multimorbidity patients, especially in low-resource settings, it is crucial to expand public healthcare coverage, incorporate outpatient care into financial protection schemes, advocate for integrated care models and preventive strategies, establish standardized treatment protocols for reducing unnecessary medications linked to polypharmacy, and leverage the support of digital health technologies.

Detection, quantification, and characterization of airborne Aspergillus flavus within the corn canopy

Aflatoxin contamination of corn can occur when developing kernels are infected by the plant pathogen Aspergillus flavus. One route of infection is from airborne conidia. We executed a series of experiments within the corn canopy during two growing seasons and in two states to document the abundance and dynamics of the airborne A. flavus population. We did not observe any significant diurnal changes in the conidial density (p = 0.171) or any effect of sampler height (p = 0.882) within the canopy. Significant changes (p < 0.001) were noted during the season, with a trend towards increased airborne populations with later stages of corn development and more than a 20-fold increase from July to August. The median aflatoxigenicity of airborne isolates from a corn canopy in Texas was about 50 times higher than the corresponding population in Mississippi. It was also noteworthy that highly aflatoxigenic, weakly sporulating S-morphotypes accounted for 14–30% of the airborne isolates in Mississippi at a site with historically rare abundance of S-morphotypes. The genetic diversity was high among the 140 analyzed airborne isolates, with 76 unique haplotypes identified and 55 haplotypes occurring only in 1 isolate. Even in the context of this highly diverse population, a haplotype matching that of a commercial biocontrol strain was found in 13 of the 70 isolates from Mississippi and 1 of the 70 isolates from Texas. The airborne A. flavus population is genetically diverse (Shannon’s index = 1.4 to 1.6), similar to grain samples in other surveys, and much less aflatoxigenic in Mississippi than in Texas.