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Exploring the temporal and spatial dynamics of vegetation coverage in the Heilongjiang Basin and its response to climate change can provide a theoretical basis and data support for integrated basin management for three countries (Mongolia, China and Russia) in the region. We used MOD13Q1 remote sensing data from Google Earth Engine (GEE) platform between 2000 and 2020 to process the normalized vegetation index (NDVI) through the maximum value composites method, and calculated the vegetation coverage (FVC) using the dimidiate pixel model. The Sen+MK trend analysis method was employed to monitor the dynamics of FVC, while the Pearson correlation coefficient was utilized to quantify the responses of FVC to climate change. The results showed that the overall FVC in the Heilongjiang Basin exhibited a slight decreasing trend during 2000-2020, with an annual rate of 0.1%. The FVC in Mongolia showed a fluctuating increase trend (0.13%), while slight decrease trends were observed for Russia (0.15%) and China (0.08%). The FVC predominantly slightly degraded and severely degraded, accounting for 34% and 17% of the area, respectively, while the significantly improved area only accounted for 9%. The impact of precipitation on FVC in the study area was significantly greater than that of temperature. The proportion of areas where precipitation and temperature had a significant impact on FVC was 8.2% and 2.2%, respectively. The correlation coefficient between precipitation and FVC was the highest in Mongolia (r=0.446, P<0.05), and the lowest in Russian region (r=-0.442, P< 0.05).

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OBJECTIVE: to assess the feasibility of a new stated preference approach, the multiple bounded dichotomous choice (MBDC), designed to generate value sets for preference-based measurement of health-related quality of life. METHODS: MBDC and standard gamble (SG) tasks were completed to derive SF-6Dv2 value sets from a sample of the general population in Quebec, Canada. Participants were randomized between the two approaches: 6 health states were evaluated in SG and 11 health states in MBDC. Several models were used to estimate data in each approach, and the preferred models were chosen by using mean absolute error (MAE), logical consistency of parameters, and significance levels. Results of MBDC were compared with SG in terms of acceptability (self-reported difficulty and quality levels in answering, and completion time), consistency (monotonicity of model coefficients), accuracy (standard errors), dimensions coefficient magnitude, correlation between the value sets estimated, and the range of estimated values. The intra-class correlation coefficient (ICC) was computed to assess value sets' consistency. RESULTS: Out of 655 individuals who completed MBDC tasks and 828 who completed SG tasks, a total of 585 participants for MBDC and 714 for SG tasks were included for analysis. The preferred models for both approaches were GLS Tobit. No significant difference was observed in self-reported difficulties and qualities in answers among approaches, but MBDC had less excluded participants and was less prone to report difficulties in answering. Additionally, completion time in the MBDC group was significantly lower (99.80 vs 68.12 s). Most standard errors in the MBDC were lower than those in SG, and the number of non-significant parameters was also lower. The range of utility values generated by MBDC tended to be wider (-0.372 to 1) than those generated by the SG (-0.137 to 1) and the number of worse-than-dead states in MBDC (0.91%) was higher than for SG (0.08%). The Pain dimension was identified as the most significant, while the Vitality dimension showed the lowest significant decrement. Both approaches exhibited a tendency to overestimate severe health state values and underestimate better health state values. The correlation and ICC between the two value sets were 0.937 and 0.983, respectively. CONCLUSION: Based on empirical evidence, it can be inferred that the MBDC method is not only feasible but also holds the potential to generate meaningful and well-informed preference data from respondents. This approach can be used to derive a value set for preference-based instrument.

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The PM2.5 and PM10 particles were characterized in terms of morphology (size and shape) and surface elemental composition at two different (traffic and industrial) locations in urban region of India and further linked to different morphological defining parameters. The overall PM2.5 and PM10 showed significant daily variability indicating higher PM10 as compared to PM2.5. PM2.5/PM10 ratio was found to be 0.58 ± 0.10 indicating the abundance of PM2.5. Soot aggregates, aluminosilicates, and brochosomes particles were classified based on morphology, aspect ratio (AR), and surface elemental composition of single particles. The linear regression analysis indicates the significant correlation between area equivalent (Daeq) and feret diameter (Dfd) (R2 0.86-0.98). Higher aspect ratio (1.48 ± 0.87-1.43 ± 0.50) was noted at traffic site as compared to industrial site (1.33 ± 0.58-1.29 ± 0.30), while circularity showed the opposite trend. Fractal dimension (Df) of soot aggregates estimated by the soot parameters method (SPM) were found to be 1.70, 1.72, and 1.88, mainly attributed to vehicular emissions, biomass, and industrial emission/coal burning, respectively. This further inferred that freshly emitted soot particles exhibited lacey in nature with spherical shape (Df 1.70) at traffic site, while at industrial location, they were different with compact shapes (Df 1.88) due to particle aging processes. This study inferred the synoptic changes in mass, chemical characteristics, and morphology of aerosol particles which provide the new insights into individual atmospheric particle and their dynamic nature.

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Documenting changes in the distribution and abundance of a given taxon requires historical data. In the absence of long-term monitoring data collected throughout the range of a taxon, conservation biologists often rely on preserved museum specimens to determine the past or present, putative geographic distribution. Distributional data for the Houston Toad (Anaxyrus houstonensis) has consistently been confounded by similarities with a sympatric congener, the Dwarf American Toad (A. americanus charlesmithi), both in monitoring data derived from chorusing surveys, and in historical data via museum specimens. In this case, misidentification can have unintended impacts on conservation efforts, where the Houston Toad is federally endangered, and the Dwarf American Toad is of least concern. Previously published reports have compared these two taxon on the basis of their male advertisement call and morphological appearance, often with the goal of using these characters to substantiate their taxonomic status prior to the advent of DNA sequencing technology. However, numerous studies report findings that contradict one another, and no consensus on the true differences or similarities can be drawn. Here, we use contemporary recordings of wild populations of each taxon to test for quantifiable differences in male advertisement call. Additionally, we quantitatively examine a subset of vouchered museum specimens representing each taxon to test previously reported differentiating morphometric characters used to distinguish among other Bufonids of East-Central Texas, USA. Finally, we assemble and qualitatively evaluate a database of photographs representing catalogued museum vouchers for each taxon to determine if their previously documented historic ranges may be larger than are currently accepted. Our findings reveal quantifiable differences between two allopatric congeners with respect to their male advertisement call, whereas we found similarities among their detailed morphology. Additionally, we report on the existence of additional, historically overlooked, museum records for the Houston Toad in the context of its putative historic range, and discuss errors associated with the curation of these specimens whose identity and nomenclature have not been consistent through time. These results bookend decades of disagreement regarding the morphology, voice, and historic distribution of these taxa, and alert practitioners of conservation efforts for the Houston Toad to previously unreported locations of occurrence.

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This paper includes a comprehensive taxonomical study based on seed morphology of 31 Euphorbia L species from Türkiye. The studied Euphorbia taxa have been examined for morphological traits such as seed color, dimensions, surface ornamentation, cell wall structures, lipid granule presence, and caruncle shape and dimensions with Scanning electron microscopy (SEM) and stereo microscopy to develop a better understanding of the basis of its species. The outcomes show that the species differ based on seed shape and color. The seed width dimensions are between 0.55 and 3.83 mm and the length dimensions are between 1.03 and 5.87 mm. Euphorbia lathyris, E. prostrata, and E. nutans are marked differently from the rest of the studied species based on their seed dimension. The seed surface ornamentation is classified into 12 different types: tuberculate, reticulate, areolate, colliculate, verrucate, alveolate, rugose, alveolate-reticulate, slightly reticulate, reticulate-areolate, pusticulate, and ruminate. The most common form is reticulate, found in eight species. The tuberculate (in E. helioscopia), areolate (in E. oblongata), slightly reticulate (in E. amygdaloides), and ruminate (in E. herniariifolia) ornamentation types are each characterized by only one species. The presence of lipid granules and anticlinal and periclinal cell walls disclose interspecific relationships within the examined taxa. Also, an identification key is offered for the studied species based on seed characters. RESEARCH HIGHLIGHTS: The seeds of Turkish Euphorbia species have been studied in depth. The morphological characters of seeds of Turkish Euphorbia species have been examined utilizing SEM and light microscopy for the first time and discussed the taxonomic practice of these characteristics. A dichotomous key containing seed morphological data has presented.

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Null hypothesis significance testing (NHST) in medical research is increasingly being supplemented by estimation statistics, focusing on effect sizes (ESs) and confidence intervals (CIs). This study evaluates the expression of ESs and CIs for binary outcomes. A utilitarian framework is proposed, emphasizing the number of beneficiaries and the impact level. To evaluate clinical significance, minimal clinically important risk difference (MCIRD) is proposed based on event magnitude (EM). Within this framework, risk difference (RD) is introduced as the primary measure. To assess the performance of RD, we compared its statistical power against other measures (risk ratio, RR; odds ratio, OR; Cohen's h) in individual study scenarios, and visual information conveyance in meta-analysis scenarios. RDs maintain statistical power in comparison to other measures in individual studies. They provide clarity on the true impact of clinical interventions without compromising statistical integrity. Meta-analytic results indicate that using RDs directly enhances transparency, uncovers heterogeneity, and addresses misaligned assumptions. This approach, by quantifying clinical effectiveness under a utilitarian perspective, facilitates the applicability of research to patient care and encourages shared decision-making. The study advocates for reporting baseline risks (BRs) with RDs and recommends a standardized presentation of these statistics. In a utilitarian perspective, adopting RD as the preferred ES can foster a transparent, patient-focused research ethos. This aids in accurately presenting the magnitude and variability of treatment effects, offering a new direction in methodology.

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Background: Re-envisioning healthcare in technology tools includes robust utilisation of telehealth, improvement in access, quality, care efficiencies and cost-effectiveness of healthcare services. In reality, the technology's potential to transform healthcare may be limited by the ability to pay for it. This study aims to estimate Malaysian citizens' willingness to pay (WTP) for telehealth consultations and determine the factors contributing to it. This is vital to inform decision-making about expansion, preferences and deployment of a pricing strategy for telehealth services. Methods: A random sample of 220 adult Malaysians was surveyed using social network services (SNS). Three different WTP bid arrays were identified and each respondent received a randomly drawn bid price. The WTP fee for using the telehealth consultation for 30 min was measured and estimated using a Double-Bounded Dichotomous Choice (DBDC) and the Random Utility Logit Model. Result: The median WTP was estimated to be RM58 (JPY2,198), RM78 (JPY2,956) for 132 respondents' willingness to use telehealth consultation and RM26 (JPY985) for 51 respondents who were unwilling. Further analysis found that WTP is correlated with the perception and willingness of the respondents to use it. Conclusion: Despite most respondents being willing to pay for telehealth consultations, sociodemographic characteristics and affordability influenced the process of making decisions about WTP for telehealth consultation. This finding suggests that the private sector can play a crucial role in the deployment of telehealth. However, there may be a need to consider affordability and how to increase access and use of telehealth services.

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PURPOSE: Overly rigid forms of dietary restraint are associated with poorer weight loss outcomes. Dichotomous ("all or nothing") thinking has been shown to mediate this relationship in non-clinical participants, but this finding has yet to be replicated in clinical samples of individuals who have had weight-loss surgery. MATERIALS AND METHODS: A cross-sectional design was used, adopting quantitative questionnaires with 129 individuals who had previously underwent bariatric surgery at least 12 months prior to participation. Bootstrapped mediation analysis was used to establish the mediating role of dichotomous thinking. RESULTS: Eating-specific dichotomous thinking was shown to fully mediate the relationship between dietary restraint and post-surgical weight loss. In contrast, no mediation effect was found for generalised dichotomous thinking. CONCLUSION: Dichotomous thinking specifically about food/eating may play a central role in weight loss maintenance after weight-loss surgery. Pre-surgical assessment of dichotomous thinking, and provision of psychological therapy to think more flexibly about food, is suggested.

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Alzheimer's disease (AD) is a leading cause of dementia, characterized by two defining neuropathological hallmarks: amyloid plaques composed of Aß aggregates and neurofibrillary pathology. Recent research suggests that microglia have both beneficial and detrimental effects in the development of AD. A new theory proposes that microglia play a beneficial role in the early stages of the disease but become harmful in later stages. Further investigations are needed to gain a comprehensive understanding of this shift in microglia's function. This transition is likely influenced by specific conditions, including spatial, temporal, and transcriptional factors, which ultimately lead to the deterioration of microglial functionality. Additionally, recent studies have also highlighted the potential influence of microglia diversity on the various manifestations of AD. By deciphering the multiple states of microglia and the phenotypic heterogeneity in AD, significant progress can be made towards personalized medicine and better treatment outcomes for individuals affected by AD.

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Agreement studies often involve more than two raters or repeated measurements. In the presence of two raters, the proportion of agreement and of positive agreement are simple and popular agreement measures for binary scales. These measures were generalized to agreement studies involving more than two raters with statistical inference procedures proposed on an empirical basis. We present two alternatives. The first is a Wald confidence interval using standard errors obtained by the delta method. The second involves Bayesian statistical inference not requiring any specific Bayesian software. These new procedures show better statistical behaviour than the confidence intervals initially proposed. In addition, we provide analytical formulas to determine the minimum number of persons needed for a given number of raters when planning an agreement study. All methods are implemented in the R package simpleagree and the Shiny app simpleagree.

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There are plenty of Multi-Criteria Decision-Making (MCDM) methods that help to choose the most suitable solution assessed by several criteria (e.g. Saaty 1990; Simos 1990; Pamucar et al. 2018). They are applied in cases where several scales of different units describe the variants or the variants' properties are represented by linguistic, non-numbered terms. The inherent part of the MCDM algorithms is calculating the weights of the variants' properties, necessary for ordering the variants. If - in a certain problem - there are several properties to consider, sequencing their importance becomes a problem itself. The innovative method of sequencing is proposed in the article based on dichotomous splitting of the properties' importance. If made several times, it leads to the coherent - internally and with the decision-maker's intention - order of the properties' importance. Then the weights of the properties can be calculated with the use of different MCDM methods. The description of the method can be shortened as follows:•Divide the full set of features into two dichotomous subsets of lower and higher importance•Continue dichotomous divisions until there are only the subsets containing one element or subsets containing elements of equal importance.

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BACKGROUND: The COVID-19 pandemic has posed unprecedented challenges, particularly for healthcare workers (HCWs). The prolonged struggles exposed the HCWs to a variety of stressors, potentially leading to burnout. Emotional exhaustion is widely recognized as the core component of burnout. This research aims to conceptualize and develop an emotional exhaustion screening questionnaire through literature review, validation, and accuracy testing. METHOD: A literature review of questionnaires and extraction of items on emotional exhaustion were performed in June 2022. We proceed with the face validity of the items by experts. The items with good content validity ratio and index were selected and reworded to suit the context of HCWs working during the COVID-19 pandemic. A pilot test of the questionnaire was done in the Central University Hospital of Asturias (HUCA) from October to December 2022 with a sample of 148 HCWs from the ORCHESTRA cohort to determine its reliability, convergent validity, and accuracy. RESULTS: Our literature review identified 15 validated questionnaires. After exclusion, 32 items were sent for content validation by experts, yielding five final items that proceeded with the pilot test. Resulting in a Cronbach's alpha-coefficient of .83 for the scale and .78 for dichotomous responses, demonstrating good internal consistency and convergent validity. The result of our accuracy test yielded sensitivity (90.6%) and specificity (91.6%) for the OEEQ scale; and sensitivity (88.7%) and specificity (89.5%) for OEEQ dichotomous responses. CONCLUSION: This study developed and validated the ORCHESTRA Emotional Exhaustion Questionnaire, demonstrating the questionnaire's clarity, relevance, and comprehensibility in screening emotional exhaustion among HCWs.

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The way people perceive the things around them is closely related to living in a complex and challenging social environment. Dichotomous thinking (preference for dichotomy, dichotomous belief, and profit-and-loss thinking), which classifies things in a simple way, can be useful in dangerous and resource-limited environments. However, based on prior studies, people's manner of perceiving things may have developed as a response to the harshness of their childhood environment, and may not be related to their current environment. Therefore, we examined the relationship between individual differences in dichotomous thinking and high-crime environments as indicators of environmental harshness. We assessed dichotomous thinking in 41,284 Japanese residents using large-scale data from the Human Information Database FY19 compiled by NTT DATA Institute of Management Consulting, Inc. The fixed effects regression model showed that, after controlling for age, high-crime environment of the residents' childhood was associated with dichotomous thinking, with the exception of dichotomous belief. On the other hand, their current environment of crime was not associated. In sum, our research suggests that people's dichotomous thinking tendency may be a form of adaptation to the harshness of their childhood environment rather than their current one.

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Studies that examine racial disparities in health outcomes often include analyses that account or adjust for baseline differences in co-morbid conditions. Often, these conditions are defined as dichotomous (Yes/No) variables, and few analyses include clinical and/or laboratory data that could allow for more nuanced estimates of disease severity. However, disease severity - not just prevalence - can differ substantially by race and is an underappreciated mechanism for health disparities. Thus, relying on dichotomous disease indicators may not fully describe health disparities. This study explores the effect of substituting continuous clinical and/or laboratory data for dichotomous disease indicators on racial disparities, using data from the Queen's Medical Center's (QMC) cardiac surgery database (a subset of the national Society of Thoracic Surgeon's cardiothoracic surgery database) as an example case. Two logistic regression models predicting in-hospital mortality were constructed: (I) a baseline model including race and dichotomous (Yes/No) indicators of disease (diabetes, heart failure, liver disease, kidney disease), and (II) a more detailed model with continuous laboratory values in place of the dichotomous indicators (eg, including Hemoglobin A1c level rather than just diabetes yes/no). When only dichotomous disease indicators were used in the model, Native Hawaiian and other Pacific Islander (NHPI) race was significantly associated with in-hospital mortality (OR: 1.57[1.29,2.47], P=.04). Yet when the more specific laboratory values were included, NHPI race was no longer associated with in-hospital mortality (OR: 1.67[0.92,2.28], P=.28). Thus, researchers should be thoughtful in their choice of independent variables and understand the potential impact of how clinical measures are operationalized in their research.

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Males often perform mate choice with the aim of maximizing reproductive success. To identify profitable mates, the males of some animals are known to use visual and chemical cues derived from females. In this study, we aimed to examine mate discrimination by male guppies (Poecilia reticulata) using chemical cues received from females under different reproductive statuses, i.e., virgin females, pregnant females, females after copulation with another male, and post-partum females. We conducted a dichotomous choice experiment for each combination of chemical stimuli from females under different reproductive statuses. In experiment 1, in which females were removed from water that was subsequently used as a chemical stimulus, male preferences did not differ significantly in all combinations of chemical stimuli from females under different reproductive statuses. However, in experiment 2, in which females remained within bottles containing the water used as a chemical stimulus, with the exception of one combination of chemical stimuli, significant differences in male preferences were detected for chemical stimuli derived from females under different reproductive statuses. Overall, males generally showed a preference for chemical stimulus received from females after copulation with other males. The findings of this study indicate that male guppies can discriminate the reproductive status of females based solely on chemical cues that may disappear or degenerate within a short period of time, thereby facilitating profitable mate choice.

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INTRODUCTION: Livestock vaccination coverage rates remain low in many lower and middle income countries despite effective vaccines being commonly available. Consequently, many preventable infectious livestock diseases remain highly prevalent, causing significant animal mortalities and threatening farmers' livelihood and food security. This study sought to assess farmers' maximum willingness to pay (WTP) for contagious bovine pleuropneumonia (CBPP), and peste-des-petits-ruminants (PPR) vaccination of cattle, and sheep and goats, respectively. METHODS: Overall, 350 ruminant livestock farmers were randomly selected from three districts located in the northern, middle and southern farming belts of Ghana. We implemented a double-bounded dichotomous contingent valuation experiment, where farmers indicated their WTP for vaccinating each livestock specie(s) owned at randomly assigned price points. WTP responses were analyzed using maximum likelihood estimation, and factors influencing WTP were assessed using censored regression analysis accounting for village-level clustering. RESULTS: Mean WTP for CBPP vaccination was USD 1.43 or Ghanaian Cedi (GHC) 8.63 (95% CI: GHC 7.08-GHC 10.19) per cattle. Mean WTP for PPR vaccination was USD 1.17 or GHC 7.02 (95% CI: GHC 5.99-GHC 8.05) per sheep, and USD 1.1 or GHC 6.66 (95% CI: GHC 5.89-GHC 7.44) per goat. WTP was positively associated with resilience, limited knowledge about vaccines (assessed prior to WTP experiment), farmland size, and male gender, after adjusting for other covariates. To attain 70% vaccination coverage in Ghana, vaccination costs should be no larger than GHC 5.30 (USD 0.88) for CBPP per cattle and GHC 3.89 (USD 0.65) and GHC 3.67 (USD 0.61), respectively, for PPR vaccines per sheep and goat. CONCLUSIONS: Ruminant livestock farmers in Ghana value vaccination highly, and are, on average, willing to pay vaccination costs that exceed the prevailing market prices (GHC 6 for CBPP and GHC 5 for PPR vaccination) to protect their livestock resources. To achieve 70% coverage, only minor subsidies would likely be required. These results suggest that effective disease control in these settings should be possible with appropriate distribution strategies.

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Species in the genus Cryphalus are small and notoriously difficult to identify. Even among the relatively well studied European species, erroneous identifications are evident from literature and in museum collections. These misidentifications relate to the small size and similar appearance of Cryphalus species but they are also a product of insufficient diagnostic characters. This is especially unfortunate since some European species are considered pests. Based on the study of more than 1000 specimens and a thorough literature review, robust morphological and molecular evidence supporting all five hitherto recognised native species of Cryphalus in Europe is provided. A key for the reliable identification of these repetition species including new diagnostic characters recognised for the first time, including those from male genitalia, has been constructed. Each native species is provided with a detailed morphological description and their economic significance, distribution, and ecology discussed. Significant genetic variability is observed between certain clusters that should be further explored in a broader geographic context. Lastly, the need for a taxonomic revision of the genus Cryphalus for the entire Palearctic region due to the presence of many similar looking species which are often confused, thus distorting the knowledge of each species is highlighted.

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OBJECTIVES: To determine the willingness to pay (WTP) for the fecal occult blood test (FOBT) and colonoscopy among the general population to provide evidence for policymakers in deciding whether to include them in the social health insurance benefit package and facilitate the pricing practice. METHODS: The conventional double-bounded dichotomous choice contingent valuation survey was used to determine the WTP. We recruited 402 people aged 50 to 75 who came to 3 primary healthcare clinics in Hanoi from February 2019 to April 2019. The questionnaire was built based on the pilot research with a 5-bid design, that is, the starting bids of US $4.05, 6.75, 13.51, 21.01, and 36.47 for FOBT and US $21.01, 40.52, 54.03, 81.04, and 182.34 for colonoscopy. The data analysis was performed using the DCchoice package version 3.5.1. Cost in Vietnam dong is converted to 2022 US $using purchasing power parity method. RESULTS: A total of 7.2% of participants refused to pay for FOBT and colonoscopy. Analysis of the univariate model showed that the mean and median WTP for FOBT were US $62.08 and 45.28. The mean and median WTP for colonoscopy were US $101.61 and 78.61. When adjusting the WTP value by related factors, the mean and median WTP estimates for FOBT were almost the same. The choice of WTP for FOBT and colonoscopy was statistically associated with several variables. CONCLUSIONS: This study supports the inclusion of FOBT and colonoscopy into the social health insurance benefits package. This study also supports policymakers in pricing practice to optimize the uptake rate of colorectal cancer screening tests.

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Past methodological research on mediation analysis mainly focused on situations where all variables were complete and continuous. When issues of categorical data occur combined with missing data, more methodological considerations are involved. Specifically, appropriate decisions need to be made on estimation methods of the indirect effects and on confidence intervals for testing the indirect effects with accommodations of missing data. We compare strategies that address these issues based on a model with a dichotomous mediator, aiming to provide guidelines for researchers facing such challenges in practice.

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It is now almost three years that COVID-19 has been the cause of misery for millions of people around the world. Many countries are in process of vaccination. Due to the social complexity of the problem, the future of decisions is not clear. As such, there is a need for the mathematical modeling to predict the long-run behavior of the COVID-19 dynamic for the decision-making with regard to the result of the pandemic on the economy, health, and others. In this paper, we have studied the short and long-run behavior of COVID-19. In a novel way, random evolution (Trichotomous and Dichotomous Markov Noise) is used to model and analyze the long-run behavior of the pandemic in different phases of the pandemic in different countries. On the given conditions, the random evolution model can help us establish the long-run asymptotic behaviour of the pandemic. This allows us to consider different phases of the pandemic as well as the effect of vaccination and other measures taken. The simplicity of the model makes it a practical tool for decision-making based on the long-run behavior of the pandemic. As such, we have established a criterion for the comparison of different regions and countries in different phases. In this regard, we have used real pandemic data from different countries to validate our results.