Search Results (53)

This paper examines the impact of carbon capture and storage (CCS) deployment on national carbon intensity (CI) across 43 countries from 2010 to 2020. Using a dynamic common correlated effects (DCCE) log–log panel, we estimate the elasticity of CI with respect to sectoral CCS facility counts within four income-group panels and the full sample. In the high-income panel, CCS in direct air capture, cement, iron and steel, power and heat, and natural gas processing sectors produces statistically significant CI declines of 0.15%, 0.13%, 0.095%, 0.092%, and 0.087% per 1% increase in facilities, respectively (all p < 0.05). Upper-middle-income countries exhibit strong CI reductions in direct air capture (–0.22%) and cement (–0.21%) but mixed results in other sectors. Lower-middle- and low-income panels show attenuated or positive elasticities—reflecting early-stage CCS adoption and infrastructure barriers. Robustness checks confirm these patterns both before and after the 2015 Paris Agreement and between emerging and developed economy panels. Spatial analysis reveals that the United States and United Kingdom achieved 30–40% CI reductions over the decade, whereas China, India, and Indonesia realized only 10–20% declines (relative to a 2010 baseline), highlighting regional deployment gaps. Drawing on these detailed income-group insights, we propose tailored policy pathways: in high-income settings, expand tax credits and public–private infrastructure partnerships; in upper-middle-income regions, utilize blended finance and technology-transfer programs; and in lower-income contexts, establish pilot CCS hubs with international support and shared storage networks. We further recommend measures to manage CCS’s energy and water penalties, implement rigorous monitoring to mitigate leakage risks, and design risk-sharing contracts to address economic uncertainties. Full article

Population aging–weakening has become a critical constraint on rural sustainability in China’s Yellow River Basin (YRB), posing substantial challenges to ecological conservation and high-quality development. This study develops a multidimensional evaluation framework categorizing rural aging–weakening into four typologies: general development type (GDT), shallow aging–weakening type (SAT), medium aging–weakening type (MAT), and deep aging–weakening type (DAT). Then, the XGBoost model is used to assess the factors influencing the spatial diversity of aging–weakening types in the rural population at different spatial and temporal scales. The key findings reveal the following: (1) The proportion of aging–weakening areas increased from 65% (2000) to 72% (2020), exhibiting distinct regional trajectories. Upper reaches demonstrate severe manifestations (34% combined MAT/DAT in 2020), contrasting with middle reaches dominated by GDT/SAT (>80%). Lower reaches show accelerated deterioration (MAT/DAT surged from 10% to 31%). (2) Spatial differentiation primarily arises from terrain-habitat conditions, industrial capacity, urbanization, and agricultural income. While most factors maintained stable directional effects, agricultural income transitioned from positive to negative correlation post-2010. Upper/middle reaches are predominantly influenced by geographical environment, with the role of socioeconomic factors gradually increasing. Lower reaches exhibit stronger economic–environmental interactions. (3) This research provides actionable insights for differentiated regional strategies: upper reaches require ecological migration programs, middle areas need industrial transition support, while lower regions demand coordinated economic–environmental governance. Our typological framework offers methodological advancements for assessing demographic challenges in vulnerable watersheds, with implications extending to similar developing regions globally. Full article

Objective: This study seeks to forecast the global burden of diabetes-related mortality by type, age group, WHO region, and income classification through 2030, and to assess progress toward Sustainable Development Goal (SDG) 3.4, which aims to reduce premature mortality (among people age 30–70 years) from noncommunicable diseases (including diabetes) by one-third. Methods: We analyzed diabetes mortality data from the Institute for Health Metrics and Evaluation, Global Burden of Disease 2019, covering 30 years (1990–2019). Using this historical dataset, we generated 11-year prospective forecasts (2020–2030) globally and stratified by diabetes type (type 1, type 2), age groups, WHO regions, and World Bank income classifications. We employed multiple time series and epidemic modeling approaches to enhance predictive accuracy, including ARIMA, GAM, GLM, Facebook’s Prophet, n-sub-epidemic, and spatial wave models. We compared model outputs to identify consistent patterns and trends. Results: Our forecasts indicate a substantial increase in global diabetes-related mortality, with type 2 diabetes driving the majority of deaths. By 2030, annual diabetes mortality is projected to reach 1.63 million deaths (95% PI: 1.48–1.91 million), reflecting a 10% increase compared to 2019. Particularly concerning is the projected rise in mortality among adults aged 15–49 and 50–69 years, especially in Southeast Asia and low- and middle-income countries. Mortality in upper-middle-income countries is also expected to increase significantly, exceeding a 50% rise compared to 2019. Conclusions: Diabetes-related deaths are rising globally, particularly in younger and middle-aged adults in resource-limited settings. These trends jeopardize the achievement of SDG 3.4. Urgent action is needed to strengthen prevention, early detection, and management strategies, especially in Southeast Asia and low-income regions. Our findings provide data-driven insights to inform global policy and target public health interventions. Full article

Recent years have been exceptionally turbulent due to various crises such as COVID-19, wars, and natural disasters. We conduct a systematic literature review to address the current state of the regional economic resilience literature, a topic regaining significance amid recent global crises. Considering the findings, we not only conduct the most up-to-date analysis of resilience types but also innovate previous research by collecting and processing data on the spatial and income features of regions, providing statistics about shock coverage, and sharing insights into region types. Additionally, we supplement the systematic literature analysis methodology by experimenting with large language models and defining new search strategies. The results show that most of the literature covers European countries, while that covering all other countries is far behind. Empirical coverage comes from high- and upper-middle-income countries (~97% of research), highlighting the lack of analysis on lower-middle- and low-income countries. This brings into question the applicability of regional resilience policies worldwide. The latest papers still mainly analyze the Great Recession, the most covered shock in the regional economic resilience literature. Not all authors have turned their attention to more recent crises. Finally, we believe future research should focus more on compound resilience—how regional economies cope with cascading or simultaneous shocks. Full article

Background: Acute ischemic stroke (AIS) is a leading cause of mortality and long-term disability worldwide, with upper-middle-income countries (UMICs) facing a disproportionate burden due to systemic inefficiencies in healthcare delivery. Kazakhstan reports the highest global age-standardized mortality rate from ischemic stroke, underscoring the need to evaluate current stroke care practices and identify areas for improvement. Objective: This study aimed to assess the current state of acute ischemic stroke care in Kazakhstan by examining key time metrics, protocol adherence, and the utilization of advanced technologies such as artificial intelligence (AI) and telemedicine. Additionally, this study sought to identify regional disparities in care and propose actionable recommendations to improve patient outcomes. Methods: A multi-center cross-sectional survey was conducted across 79 stroke centers in Kazakhstan. Data were collected from 145 healthcare professionals, including neurologists, neurosurgeons, and interventional radiologists, through a validated 23-question online questionnaire. Statistical analysis was performed to identify significant associations between variables. Results: Significant regional disparities were observed in stroke care timelines and technology adoption. Remote and rural areas experienced prolonged prehospital delays, with transport times ranging from 120 to 180 min, contributing to door-to-needle times exceeding the recommended benchmark. Urban centers with higher adoption of AI and telemedicine demonstrated faster treatment initiation and better protocol compliance. Staff training was significantly associated with improved treatment outcomes, with trained centers more likely to implement direct-to-angiography suite protocols, reducing in-hospital delays. Conclusions: Addressing acute ischemic stroke care disparities in Kazakhstan requires a multifaceted approach, including expanding AI and telemedicine, implementing targeted staff training programs, and establishing standardized national stroke protocols. These strategies can help reduce treatment delays, bridge the urban–rural healthcare divide, and improve patient outcomes. The findings have implications for other UMICs facing similar challenges in delivering equitable stroke care. Full article

This study empirically investigated the drivers of port competitiveness among low-, upper-, and high-income countries in the Middle East and North Africa region. It explored the effects of country-level competitiveness, logistic performance, and ease of doing business on port competitiveness for 17 countries from the region using a 14-item scale and covering the years 2010 to 2022. Port competitiveness indicators were analyzed using confirmatory factor analysis to determine the research constructs’ validity. Structural path analysis was deployed to verify hypotheses concerning effects between conceptualized variables. The findings demonstrate that in high-income countries, an increase in country competitiveness notably enhances port sustainability and competitiveness. Conversely, in low-income countries, higher country competitiveness appears to diminish port competitiveness. For countries with average income, the association is relatively neutral, exhibiting a slight positive trend. This study explains the specific drivers and interactions that improve port sustainability and competitiveness as countries move from low- to high-income levels of development. Full article

Over the past 27 years, three major global TB control strategies have been implemented, and it is important at this stage to evaluate their impact on tuberculosis (TB) case notification rates (CNRs). This study, therefore, analyzed TB CNR trends from 1995 to 2022 across 208 countries and islands, using data from the WHO Global TB Programme database. Countries were classified by income level and population size based on World Bank criteria. The analysis revealed significant disparities in TB CNRs across income groups: Low-income, lower-middle-income, and upper-middle-income countries consistently reported higher CNRs compared to high-income countries. Regional analysis further demonstrated notable variations influenced by both economic and geographical factors. These findings reaffirm the strong link between TB and poverty, underscoring the need for a holistic approach to combat the disease. Efforts must extend beyond enhancing health care access and delivery to addressing the social determinants that drive TB transmission and progression. Full article

This study examines the relationship between country-level corruption (proxied by the Corruption Perception Index, CPI) and firm performance (measured by Return on Assets, ROA) across 18,286 firms in the East Asia, South Asia, and Southeast Asia regions. Additionally, the moderating effects of audit quality (proxied by auditors’ reputation) on the relationship are examined. The findings of the study indicate a positive association between corruption and ROA in high-income nations, thus providing evidence in favor of the “greasing the wheel” theory. On the other hand, a negative association is documented in the upper middle- and low-income nations, which is consistent with the “sanding the wheel” notion. Notably, audit quality has a positive moderating influence on the relationship between corruption and ROA, especially in nations with low corruption levels, reaffirming the pivotal role of reputable auditors in enhancing firm performance within these economic contexts. The results of this study have important ramifications for forming policy suggestions and enhancing governance. The findings highlight the opportunity to improve governance practices and regulations to reduce corruption and increase transparency. Policymakers can develop ways to strengthen institutional frameworks by recognizing the complex link between corruption, corporate profitability, and the function of respected auditors. Full article

Brazil is a continent-size country with 203 million inhabitants, classified as a developing upper-middle-income country, although inequities remain significant. Most of the population is assisted by the public Unified Health System (SUS), along with a thriving private health sector. Congenital malformations are the second leading cause of infant mortality and chronic/genetic disorders and a significant burden in hospital admissions. The past two decades have been crucial for formalizing medical genetics as a recognized medical specialty in the SUS, as well as for implementing a new health policy by the Ministry of Health for comprehensive care for rare diseases. These public health policies had the broad support of the Brazilian Society of Medical Genetics and Genomics and patient organizations. Most comprehensive genetic services are concentrated in large urban centers in the South and Southeast regions of Brazil; with this new policy, new services throughout the country are progressively being integrated. The number of medical geneticists increased by 103% in a decade. Details on the policy and an overview of the availability of services, testing, human resources, newborn screening, research projects, patient organizations, and relevant issues regarding medical genetics in this vast and diverse country are presented. Full article

This study aims to explore how a region’s degree of vulnerability influences the perceived level of support toward social entrepreneurship from a social entrepreneurial ecosystem perspective. The study of social entrepreneurial ecosystems (SEEs) constitutes a promising area for its potential to support high-impact entrepreneurs, but they are currently underexplored in upper-middle-income countries. This study also combines a macro-level (countries) and a meso-level (vulnerability regions) analysis to better understand how national policies may affect the perceptions of different ‘regions’ and, consequently, sustainable economic development. This study follows principal component analysis and non-parametric statistics to compare the means of the countries and the levels of regions’ vulnerabilities based on the Global Entrepreneurship Monitor’s regional data from Chilean (n = 276) and Mexican (n = 188) experts. At the macro level, the results show that experts in Chile have a better perception of social policies for social entrepreneurship than their counterparts in Mexico. At the meso-level, experts in high-vulnerability regions have a better perception of the social ecosystem dynamism than those in the low-vulnerability regions. The results contribute to the urgent dialogue to set up strategies that allow upper-middle-income countries and their regions to achieve greater impact and sustainability. Full article

This study investigated the impact of economic, environmental, and social indicators on inclusive growth in 19 member countries of the Asian Cooperation Dialogue from 1995 to 2021. This research employed the Driscoll–Kraay standard error regression technique. The findings reveal that the impact of independent variables on inclusive growth differs significantly among three distinct income categories: lower-middle-income countries (LMYCs), upper-middle-income countries (UMYCs), and high-income countries (HYCs). One of the primary contributions of this research is the provision of empirical evidence concerning the role played by fishery and aquaculture production in fostering inclusive growth in the Asian context. This research also highlights the trade-offs between economic development and environmental sustainability in terms of trade openness; agriculture, forestry, and fishing; the ecological footprint; and renewable energy utilization. Enhancing inclusive growth in Asia requires improving fishery and aquaculture management, diversifying economic activities, reducing the ecological footprint, and increasing renewable energy utilization. This paper suggests some future work directions for extending the analysis to other regions and indicators. The paper also suggests some policy implications for fostering inclusive growth in Asia through regional cooperation, capacity building, technology transfer, and green financing. Full article

There are frequent and intensive periods of heavy rain in the arid areas of southern Xinjiang. This study uses a typical rainstorm process in the South Xinjiang Basin to investigate the weather, physical mechanisms, mesoscale characteristics, and income and expenditure characteristics of water vapor sources, analyzing them using the observation data from southern Xinjiang regional automatic stations, ERA5 reanalysis data, multi-source satellite data, and WRF numerical simulation results. The study results show that torrential rain processes occur in the double-body distribution of the South Asian High in the upper troposphere, which is “high in the east and low in the west,” with “two ridges and one trough” in the middle layer. The development and movement of the low vortex, the configuration of low-level convergence and high-level divergence, and vertical upward movement provide favorable dynamic conditions for heavy rain. Additionally, the Black Sea, the Caspian Sea, the Aral Sea, the Arabian Sea, and the Bay of Bengal are important water vapor sources for this rainstorm. The water vapor reaches the South Xinjiang Basin along westward, southwest, and eastward paths. It is mainly imported into the South Xinjiang Basin from 500 to 300 hPa on the southern border and 700–500 hPa on the west, north, and east borders, and exported from 500 to 300 hPa on the eastern border. The simulation results show that the change in water vapor content significantly influences the precipitation intensity and range. The water vapor transport at the southern boundary contributes the most precipitation during the rainstorm. As the water vapor in the rainstorm area increases (decreases), the ascending motion is strengthened (weakened), the low-level convergence and high-level divergence are strengthened (weakened), the water vapor transport to the middle and high levels increases (decreases), and the precipitation increases (decreases). Full article

Actively exploring a reduction in carbon emissions from rural residents’ living consumption (RRLC) is necessary to address climate change and achieve high-quality development of the rural economy. Based on the measurement of the carbon emissions from RRLC in China between the years 2000 and 2021, and it uncovers regional differences, dynamic evolution and convergence. The main findings are as follows: (1) Using the Dagum Gini coefficient, it was found that the differences in carbon emissions from RRLC in the nationwide and low-income level group (LLLG), low-middle-income level group (LMLG), upper-middle-income level group (UMLG), and high-income level group (HHLG) are all significantly decreasing, and the intensity of transvariation is the primary source of the overall difference. (2) Using the kernel density estimation, it was found that the level of carbon emissions from RRLC in the nationwide and the four major regions have generally gone upward, as well as a polarisation phenomenon. (3) Using the Markov chain, it was shown that there is an instability in the carbon emissions from RRLC, which can be transferred downward to the ideal state, but there is also a risk of increasing the upward shift of carbon emissions. (4) The nationwide level and the four regions showed typical σ convergence characteristics and absolute β convergence. After considering the influence of socio-economic and natural climatic factors, conditions β convergence trend is shown. And there are significant regional differences in spatial β convergence. The limitation of this study is that the data on carbon emissions from RRLC are only obtained at the macro level, which cannot accurately reflect the micro and individual impact on RRLC. On this basis, the paper puts forward policy recommendations to reduce the spatial imbalance of carbon emissions from RRLC. Full article

For sustainable development of the world, it is crucial to solve the problems related to water environment pollution, water shortage, and the inefficient utilization of water resources during the process of urbanization in developing countries. At present, scholars mainly focus on the measurement of new urbanization (NU) and the water ecological civilization (WEC) level and the coordination relationship between NU and ecological civilization. However, there have been few studies on the coordination relationship between NU and WEC and its driving factors. We take the Yangtze River Economic Belt (YREB) in China as a case study, construct the indicator system of NU and WEC, analyze the current situation of NU and WEC in the YREB, and study the coordination state of NU and WEC in the YREB from 2011 to 2020 by using a state coordination function. We further examine the factors driving the coordination of NU and WEC by employing a two-way fixed-effects model. The results show the following: (1) The growth rate of NU and WEC in the YREB shows a fluctuating upward trend, where there is significant heterogeneity between the upper reaches, the middle reaches, and the lower reaches of the YREB. (2) The static coordination degree of NU and WEC in the YREB shows a trend of fluctuating upwards and then falling, and the dynamic coordination degree deviated from the coordinated development trajectory from 2018 to 2020. The classification of the static coordination degree of various regions in the YREB gradually becomes obvious with significant spatial aggregation characteristics, and the dynamic coordination degree of various regions has significant heterogeneity. (3) The opening-up degree, foreign direct investment, population growth, and urban–rural income gap are not advantageous to the coordination degree, while the marketization level, industrial structure, and human capital are advantageous to the coordination degree, but the regression coefficients of the latter two are not significant. The regional regression results show that the impacts of driving factors on the coordination degree have obvious heterogeneity. The research results provide a new idea and method that can be used by developing countries similar to the YERB to control water pollution, improve the ecological environment, alleviate water shortages, and improve the level of WEC in the process of NU. Full article

Background: Post-marketing vaccine safety surveillance aims to monitor and quantify adverse events following immunization in a population, but little is known about their implementation in low- and middle-income countries (LMICs). We aimed to synthesize methodological approaches used to assess adverse events following COVID-19 vaccination in LMICs. Methods: For this systematic review, we searched articles published from 1 December 2019 to 18 February 2022 in main databases, including MEDLINE and Embase. We included all peer-reviewed observational COVID-19 vaccine safety monitoring studies. We excluded randomized controlled trials and case reports. We extracted data using a standardized extraction form. Two authors assessed study quality using the modified Newcastle–Ottawa Quality Assessment Scale. All findings were summarized narratively using frequency tables and figures. Results: Our search found 4254 studies, of which 58 were eligible for analysis. Many of the studies included in this review were conducted in middle-income countries, with 26 studies (45%) in lower-middle-income and 28 (48%) in upper-middle-income countries. More specifically, 14 studies were conducted in the Middle East region, 16 in South Asia, 8 in Latin America, 8 in Europe and Central Asia, and 4 in Africa. Only 3% scored 7–8 points (good quality) on the Newcastle–Ottawa Scale methodological quality assessment, while 10% got 5–6 points (medium). About 15 studies (25.9%) used a cohort study design and the rest were cross-sectional. In half of them (50%), vaccination data were gathered from the participants’ self-reporting methods. Seventeen studies (29.3%) used multivariable binary logistic regression and three (5.2%) used survival analyses. Only 12 studies (20.7%) performed model diagnostics and validity checks (e.g., the goodness of fit, identification of outliers, and co-linearity). Conclusions: Published studies on COVID-19 vaccine safety surveillance in LMICs are limited in number and the methods used do not often address potential confounders. Active surveillance of vaccines in LMICs are needed to advocate vaccination programs. Implementing training programs in pharmacoepidemiology in LMICs is essential. Full article