The Global Investment Report 2023 revealed that after a sharp decline in 2020 and a strong rebound in 2021, global foreign direct investment (FDI) declined by 12 percent to $1.3 trillion in 2022. However, in developing countries, FDI increased by 4% to $916 billion, a record share of more than 70% of global flows. The number of greenfield investment projects in developing countries increased by 37 percent and international project finance transactions by 5 percent. Foreign investment from China, the second largest recipient of foreign investment globally, increased by 5 percent. The service industry has become the mainstream industry in the global FDI structure. The global industry is accelerating its transformation to a \"service-based economy,\" international FDI in productive service industries has become an essential means of industrial transfer in developed countries and a meaningful way to upgrade the industrial structure and high-quality development in emerging economies. As a representative province in central China, Hubei Province has unique advantages in human capital, factor cost, and market potential, which provide preferential conditions to attract foreign investment. This paper first introduced the concept of the productive service industry, based on the relevant statistical data from 2011 to 2022, focused on the current situation of foreign investment utilization in five major sub-sectors of the productive service industry in Hubei Province in the past ten years, and empirically investigated the impact of foreign investment utilization in five major sub-sectors of the productive service industry on the economic growth of Hubei Province, and obtained that the level of foreign investment attraction varied significantly among the regions in Hubei Province. The three productive service industries, namely transportation, storage and postal services, information transmission, software and information technology services, and financial services, played a significant role in the active attraction and optimal utilization of foreign capital and the economic development of Hubei Province. Based on this, it was proposed to build a market-oriented rule of law and internationalized business environment, improve the infrastructure construction in different regions of the province, focus on the training of professional talents for the development of productive service industries, and pay attention to the improvement of independent innovation capacity.

BACKGROUND: Obesity is associated with cancer, including gastrointestinal (GI). Data from low (LICs) and lower-middle-income countries (MICs) are limited.
METHODS: We utilized data from the Global Burden of Disease Study 2019 to determine the mortality from GI cancer risk of high body mass index (BMI) in these countries.
RESULTS: Mortality rates of GI cancers from high BMI increased in LICs and lower MICs, while burdens decreased or remained stable in high and middle-income countries.
CONCLUSIONS: The GI cancer-related burden from high BMI increased in LICs and lower MICs, necessitating a concerted effort to tackle the obesity pandemic.

UNASSIGNED: The outbreak of norovirus represents a significant public health emergency within densely populated, impoverished, and underdeveloped areas and countries. Our objective is to conduct an epidemiology study of a norovirus outbreak that occurred in a kindergarten located in rural western China. We aim to raise awareness and garner increased attention towards the prevention and control of norovirus, particularly in economically underdeveloped regions.
UNASSIGNED: Retrospective on-site epidemiological investigation results, including data on school layout, case symptoms, onset time, disposal methods and sample testing results, questionnaire surveys, and case-control study were conducted in a kindergarten to analyze the underlying causes of the norovirus outbreak.
UNASSIGNED: A total of 15 cases were identified, with an attack rate of 44.12% (15/34). Among them, 10 cases were diagnosed through laboratory tests, and 5 cases were diagnosed clinically. Vomiting (100%, 15/15) and diarrhea (93.33%, 14/15) were the most common symptoms in the outbreak. Case control study revealed that cases who had close contact (<1 m) with the patient\'s vomitus (OR = 5.500) and those who had close contact with similar patients (OR = 8.000) had significantly higher ORs compared to the control participants. The current study demonstrated that improper handling of vomitus is positively associated with norovirus outbreak. The absence of standardized disinfection protocols heightens the risk of norovirus outbreaks.
UNASSIGNED: To our knowledge, this study represents the first investigation into a norovirus outbreak in rural areas of western China. We aspire that amidst rapid economic development, a greater emphasis will be placed on the prevention and control of infectious diseases in economically underdeveloped areas and countries.

UNASSIGNED: Road traffic accidents are still serious, especially in developing countries. This paper takes China as a typical example of a developing country with rich characteristics related to road traffic safety for analysis.
UNASSIGNED: Temporal, spatial, road traffic accidents and economic information were gathered from the China Statistical Yearbook. Principal components analysis (PCA) was employed to establish a comprehensive indicator to represent road traffic safety based on different types of road traffic accidents information. Pearson correlation analysis and Eta coefficient test were performed to analyze whether time and space characteristics would affect the established indicator. Then the established indicator was introduced as dependent variable while year and regions as independent variables in the mixed linear model (MLM). At last, single-element regression model was built to study the impact of GDP per capita on road traffic safety.
UNASSIGNED: In PCA, the variance explained by the established indicator was 93.993%. The results of Pearson correlation analysis and Eta coefficient test suggested that time and region were both related to the established indicator. MLM showed that the year, the regions and the interaction between them influenced road traffic safety in China significantly. The single-variable regression analysis indicated that, with the increase in GDP per capita, road traffic safety initially decreased and then increased.
UNASSIGNED: Road traffic safety in China was grim and changed greatly between different regions and years. This might be attributed to the yearly economic development and disparities among regions. .

BACKGROUND: Sepsis is a life-threatening condition which may arise from infection in any organ system and requires early recognition and management. Healthcare professionals working in any specialty may need to manage patients with sepsis. Educating medical students about this condition may be an effective way to ensure all future doctors have sufficient ability to diagnose and treat septic patients. However, there is currently no consensus on what competencies medical students should achieve regarding sepsis recognition and treatment. This study aims to outline what sepsis-related competencies medical students should achieve by the end of their medical student training in both high or upper-middle incomes countries/regions and in low or lower-middle income countries/regions.
METHODS: Two separate panels from high or upper-middle income and low or lower-middle income countries/regions participated in a Delphi method to suggest and rank sepsis competencies for medical students. Each panel consisted of 13-18 key stakeholders of medical education and doctors in specialties where sepsis is a common problem (both specialists and trainees). Panelists came from all continents, except Antarctica.
RESULTS: The panels reached consensus on 38 essential sepsis competencies in low or lower-middle income countries/regions and 33 in high or upper-middle incomes countries/regions. These include competencies such as definition of sepsis and septic shock and urgency of antibiotic treatment. In the low or lower-middle income countries/regions group, consensus was also achieved for competencies ranked as very important, and was achieved in 4/5 competencies rated as moderately important. In the high or upper-middle incomes countries/regions group, consensus was achieved in 41/57 competencies rated as very important but only 6/11 competencies rated as moderately important.
CONCLUSIONS: Medical schools should consider developing curricula to address essential competencies, as a minimum, but also consider addressing competencies rated as very or moderately important.

Collaborative efforts in artificial intelligence (AI) are increasingly common between high-income countries (HICs) and low- to middle-income countries (LMICs). Given the resource limitations often encountered by LMICs, collaboration becomes crucial for pooling resources, expertise, and knowledge. Despite the apparent advantages, ensuring the fairness and equity of these collaborative models is essential, especially considering the distinct differences between LMIC and HIC hospitals. In this study, we show that collaborative AI approaches can lead to divergent performance outcomes across HIC and LMIC settings, particularly in the presence of data imbalances. Through a real-world COVID-19 screening case study, we demonstrate that implementing algorithmic-level bias mitigation methods significantly improves outcome fairness between HIC and LMIC sites while maintaining high diagnostic sensitivity. We compare our results against previous benchmarks, utilizing datasets from four independent United Kingdom Hospitals and one Vietnamese hospital, representing HIC and LMIC settings, respectively.

BACKGROUND: Exposure to ambient fine particulate matter (PM2.5) has been associated with reduced human fecundity. However, the attributable burden has not been estimated for low- and middle-income countries (LMICs), where the exposure-response function between PM2.5 and the infertility rate has been insufficiently studied.
OBJECTIVE: This study examined the associations between long-term exposure to PM2.5 and human fecundity indicators, namely the expected time to pregnancy (TTP) and 12-month infertility rate (IR), and then estimated PM2.5-attributable burden of infertility in LMICs.
METHODS: We analyzed 164,593 eligible women from 100 Demographic and Health Surveys conducted in 49 LMICs between 1999 and 2021. We assessed PM2.5 exposures during the 12 months before a pregnancy attempt using the global satellite-derived PM2.5 estimates produced by Atmospheric Composition Analysis Group (ACAG). First, we created a series of pseudo-populations with balanced covariates, given different levels of PM2.5 exposure, using a matching approach based on the generalized propensity score. For each pseudo-population, we used 2-stage generalized Gamma models to derive TTP or IR from the probability distribution of the questionnaire-based duration time for the pregnancy attempt before the interview. Second, we used spline regressions to generate nonlinear PM2.5 exposure-response functions for each of the two fecundity indicators. Finally, we applied the exposure-response functions to estimate number of infertile couples attributable to PM2.5 exposure in 118 LMICs.
RESULTS: Based on the Gamma models, each 10 µg/m3 increment in PM2.5 exposure was associated with a TTP increase by 1.7 % (95 % confidence interval [CI]: -2.3 %-6.0 %) and an IR increase by 2.3 % (95 %CI: 0.6 %-3.9 %). The nonlinear exposure-response function suggested a robust effect of an increased IR for high-concentration PM2.5 exposure (>75 µg/m3). Based on the PM2.5-IR function, across the 118 LMICs, the number of infertile couples attributable to PM2.5 exposure exceeding 35 µg/m3 (the first-stage interim target recommended by the World Health Organization global air quality guidelines) was 0.66 million (95 %CI: 0.061-1.43), accounting for 2.25 % (95 %CI: 0.20 %-4.84 %) of all couples affected by infertility. Among the 0.66 million, 66.5 % were within the top 10 % high-exposure infertile couples, mainly from South Asia, East Asia, and West Africa.
CONCLUSIONS: PM2.5 contributes significantly to human infertility in places with high levels of air pollution. PM2.5-pollution control is imperative to protect human fecundity in LMICs.

OBJECTIVE: The incidence of type 1 diabetes (T1D) in children and adolescents has been increased over decades worldwide. Recent studies showed that the trend of T1D incidences were different between developed and underdeveloped countries. This review aimed to summarize the changes of childhood T1D incidences in underdeveloped countries over the past decade.
RESULTS: Majority of the underdeveloped countries lacked of nationwide population-based studies on childhood T1D. We reviewed the trend of childhood T1D in important underdeveloped countries with available data in recent years. The incidences of childhood T1D in underdeveloped countries were low decades ago, but it increased significantly recently, particularly in the sub-Saharan African, Middle East and North African regions.
CONCLUSIONS: The incidences of childhood T1D increased significantly in underdeveloped countries, especially in the sub-Saharan African, Middle East and North African regions. T1D registry and population-based studies are helpful to understand the situation and characteristic of childhood T1D in underdeveloped countries.

Although radiotherapy continues to evolve as a mainstay of the oncological armamentarium, research and innovation in radiotherapy in low-income and middle-income countries (LMICs) faces challenges. This third Series paper examines the current state of LMIC radiotherapy research and provides new data from a 2022 survey undertaken by the International Atomic Energy Agency and new data on funding. In the context of LMIC-related challenges and impediments, we explore several developments and advances-such as deep phenotyping, real-time targeting, and artificial intelligence-to flag specific opportunities with applicability and relevance for resource-constrained settings. Given the pressing nature of cancer in LMICs, we also highlight some best practices and address the broader need to develop the research workforce of the future. This Series paper thereby serves as a resource for radiation professionals.

UNASSIGNED: To assess global, regional and national trends in the impact of floods from 1990 to 2022 and determine factors influencing flood-related deaths.
UNASSIGNED: We used data on flood disasters from the International Disaster Database for 1990-2022 from 168 countries. We calculated the annual percentage change to estimate trends in the rates of people affected and killed by floods by study period, World Health Organization (WHO) region, country income level and flood type. We used multivariable logistic regression analysis to assess the factors associated with death from floods.
UNASSIGNED: From 1990 to 2022, 4713 floods were recorded in 168 countries, which affected > 3.2 billion people, caused 218 353 deaths and were responsible for more than 1.3 trillion United States dollars of economic losses. The WHO Western Pacific Region had the most people affected by floods (> 2.0 billion), accounting for 63.19% (2 024 599 380/3 203 944 965) of all affected populations. The South-East Asia Region had the most deaths (71 713, 32.84%). The African and Eastern Mediterranean Regions had the highest number of people affected and killed by floods per 100 000 population in 2022. The odds of floods causing more than 50 deaths were significantly higher in low-income countries (adjusted odds ratio: 14.34; 95% confidence interval: 7.46 to 30.04) compared with high-income countries. Numbers of people affected and mortality due to floods declined over time.
UNASSIGNED: Despite the decreases in populations affected and deaths, floods still have a serious impact on people and economies globally, particularly in lower-income countries. Action is needed to improve disaster risk management and flood mitigation.
UNASSIGNED: Évaluer les tendances mondiales, régionales et nationales relatives à l\'impact des inondations entre 1990 et 2022, mais aussi déterminer les facteurs influençant les décès causés par ces inondations.
UNASSIGNED: Nous avons exploité les données concernant 168 pays et reprises dans la base de données internationale sur les catastrophes pour la période allant de 1990 à 2022. Nous avons ensuite calculé la variation annuelle en pourcentage afin de dégager des tendances quant au nombre de personnes touchées, voire tuées par des inondations en fonction de la période d\'étude, de la région telle que définie par l\'Organisation mondiale de la Santé (OMS), du niveau de revenu du pays et du type d\'inondation. Enfin, nous avons employé une analyse multivariée de régression logistique pour déterminer les facteurs associés aux décès en cas d\'inondations.
UNASSIGNED: Entre 1990 et 2022, 4713 inondations ont été recensées dans 168 pays. Elles ont touché plus de 3,2 milliards de personnes, causé 218 353 morts et entraîné des pertes économiques supérieures à 1,3 billion de dollars américains. La région du Pacifique occidental de l\'OMS est celle où le plus grand nombre d\'habitants ont été affectés par ces phénomènes (> 2 milliards), représentant 63,19 % (2 024 599 380 / 3 203 944 965) de l\'ensemble des populations impactées. C\'est la région d\'Asie du Sud-Est qui comptait le plus grand nombre de décès (71 713, soit 32,84 %). La région Africaine et la région de la Méditerranée orientale dénombraient toutes deux la plus grande proportion de personnes touchées et tuées lors d\'inondations par 100 000 habitants en 2022. La probabilité que les inondations soient à l\'origine de plus de 50 morts était nettement plus importante dans les pays à revenu faible (odds ratio ajusté : 14,34 ; intervalle de confiance à 95 % : 7,46 à 30,04) que dans les pays à revenu élevé. L\'étendue des répercussions et le taux de mortalité des inondations diminuaient au fil du temps.
UNASSIGNED: Malgré une baisse du nombre de personnes touchées et tuées, les inondations continuent à avoir un impact considérable sur les populations et les économies à travers le monde, surtout dans les pays aux revenus plus faibles. Des actions sont requises pour améliorer la gestion des risques de catastrophes et la lutte contre les inondations.
UNASSIGNED: Evaluar las tendencias mundiales, regionales y nacionales del impacto de las inundaciones de 1990 a 2022 y determinar los factores que influyen en las muertes relacionadas con las inundaciones.
UNASSIGNED: Se utilizaron datos sobre catástrofes por inundaciones de la Base de Datos Internacional sobre catástrofes para 1990-2022 de 168 países. Se calculó la variación porcentual anual para estimar las tendencias de las tasas de personas afectadas y fallecidas por inundaciones según el periodo de estudio, la región de la Organización Mundial de la Salud (OMS), el nivel de ingresos del país y el tipo de inundación. Se utilizó un análisis de regresión logística multivariable para evaluar los factores asociados a la muerte por inundaciones.
UNASSIGNED: Entre 1990 y 2022, se registraron 4713 inundaciones en 168 países, que afectaron a >3200 millones de personas, causaron 218 353 muertes y fueron responsables de más de 1,3 billones de dólares estadounidenses de pérdidas económicas. La Región del Pacífico Occidental de la OMS fue la más afectada por las inundaciones (>2000 millones), con un 63,19% (2 024 599 380/3 203 944 965) de todas las poblaciones afectadas. La Región de Asia Sudoriental fue la que registró más muertes (71 713, 32,84%). Las regiones de África y el Mediterráneo Oriental registraron el mayor número de personas afectadas y fallecidas por inundaciones por cada 100 000 habitantes en 2022. Las probabilidades de que las inundaciones causaran más de 50 muertes fueron significativamente mayores en los países de ingresos bajos (razón de probabilidades ajustada: 14,34; intervalo de confianza del 95%: 7,46 a 30,04) en comparación con los países de ingresos altos. El número de personas afectadas y la mortalidad por inundaciones disminuyeron con el tiempo.
UNASSIGNED: A pesar de la disminución de las poblaciones afectadas y de las muertes, las inundaciones siguen teniendo un grave impacto en las personas y las economías de todo el mundo, en especial en los países con ingresos más bajos. Es preciso actuar para mejorar la gestión del riesgo de catástrofes y la mitigación de las inundaciones.
UNASSIGNED: تقييم الاتجاهات العالمية والإقليمية والوطنية في تأثير الفيضانات للفترة من 1990 إلى 2022، وتحديد العوامل المؤثرة على الوفيات المرتبطة بالفيضانات.
UNASSIGNED: قمنا باستخدام البيانات الخاصة بكوارث الفيضانات من قاعدة بيانات الكوارث الدولية للفترة من 1990 إلى 2022، من 168 دولة. وقمنا بحساب التغيُّر في النسبة المئوية لتقدير الاتجاهات في معدلات الأشخاص المتضررين والمتوفين بسبب الفيضانات، وذلك حسب فترة الدراسة، ومنطقة منظمة الصحة العالمية (WHO)، ومستوى الدخل في الدولة، ونوع الفيضان. كما استخدمنا تحليل التحوّف اللوجستي متعدد المتغيرات لتقييم العوامل المرتبطة بالوفيات المترتبة على الفيضانات.
UNASSIGNED: في الفترة من 1990 إلى 2022، تم تسجيل 4713 فيضانًا في 168 دولة، مما أثر على أكثر من 3.2 مليار شخص، وتسبب في وفاة 218353 شخصًا، وكانت مسؤولة عن خسائر اقتصادية تزيد قيمتها عن 1.3 تريليون دولار أمريكي. سجّل إقليم غرب المحيط الهادئ التابع لمنظمة الصحة العالمية أكبر عدد من الأشخاص المتضررين بسبب الفيضانات (أكثر من 2.0 مليار شخص)، وهو ما يمثل %63.19 (2024599380/3203944965) من جميع السكان المتضررين. وشهدت منطقة جنوب شرق آسيا أكبر عدد من الوفيات (71713، %32.84). وسجّلت منطقتا أفريقيا وشرق البحر الأبيض المتوسط أكبر عدد من الأشخاص المتضررين والوفيات بسبب الفيضانات لكل 100000 نسمة في عام 2022. وكانت احتمالات تسبب الفيضانات في أكثر من 50 حالة وفاة أعلى بشكل ملموس في الدول ذات الدخل المنخفض (نسبة الاحتمالات المعدلة: 14.34؛ وبفاصل ثقة مقداره %95: 7.46؛ %95) مقارنة بالدول ذات الدخل المرتفع. انخفض معدل التأثير وعدد الوفيات الناتجة عن الفيضانات مع مرور الوقت.
UNASSIGNED: على الرغم من حالات الانخفاض عدد السكان المتضررين والوفيات، لا تزال الفيضانات ذات تأثير خطير على الأشخاص والنظم الاقتصادية على مستوى العالم، وبخاصة في الدول ذات الدخل المنخفض. هناك حاجة إلى اتخاذ إجراءات لتحسين إدارة مخاطر الكوارث، والتخفيف من تأثير الفيضانات.
UNASSIGNED: 旨在评估 1990 年至 2022 年期间洪水在全球、区域和国家层面的影响趋势，并确定影响洪水致死率的因素。.
UNASSIGNED: 我们利用从国际灾难数据库获取的 1990-2022 年期间 168 个国家的洪水灾害相关数据。我们计算了年度百分比变化，从而基于研究时段、世界卫生组织 (WHO) 区域、国家收入水平和洪水类型估计了因洪水而受影响甚至致死的人数比例变化趋势。我们使用了多变量逻辑回归分析方法来评估洪水致死率相关因素。.
UNASSIGNED: 记录显示，1990 年至 2022 年期间，168 个国家共发生了 4,713 次洪水，超过 32 亿人受到影响，导致 218,353 人死亡，造成经济损失超过了 1.3 万亿美元。WHO 西太平洋区域受洪水影响的人数最多（超过 20 亿），占所有受影响人口的 63.19% (2,024,599,380/3,203,944,965)。东南亚区域因洪水致死的人数最多（71,713 人，占 32.84%）。2022 年非洲和东地中海区域每 100,000 人口中因洪水而受影响甚至致死的人数最多。与高收入国家相比，低收入国家因洪水造成 50 人以上死亡的几率要高得多（调整后优势比：14.34；95% 置信区间：7.46 至 30.04）。随着时间的推移，洪水的影响率和死亡率均有所下降。.
UNASSIGNED: 尽管受影响人口和致死人数均有所减少，但洪水仍然严重影响着全球人类和全球经济，特别是在低收入国家。需要采取行动以加强灾害风险管理和减轻洪灾影响。.
UNASSIGNED: Оценить глобальные, региональные и национальные тенденции в отношении последствий наводнений с 1990 по 2022 год и определить факторы, влияющие на смертность от наводнений.
UNASSIGNED: В статье использованы данные о наводнениях из Международной базы данных о чрезвычайных ситуациях за 1990–2022 гг. по 168 странам. Чтобы оценить тенденции изменения числа пострадавших и погибших от наводнений, авторы рассчитали годовое процентное изменение в зависимости от периода исследования, региона Всемирной организации здравоохранения (ВОЗ), уровня дохода в стране и типа наводнения. Для оценки факторов, связанных со смертью от наводнений, использовался многомерный логистический регрессионный анализ.
UNASSIGNED: За период с 1990 по 2022 год в 168 странах было зарегистрировано 4713 случаев наводнений, в результате которых пострадали более 3,2 миллиарда человек, погибли 218 353 человека, а экономический ущерб составил более 1,3 триллиона долларов США. Больше всего пострадавших от наводнений (> 2,0 млрд человек) пришлось на Западно-Тихоокеанский регион ВОЗ – 63,19% (2 024 599 380/3 203 944 965) от общей численности пострадавшего населения. Больше всего случаев летального исхода было зарегистрировано в регионе Юго-Восточной Азии (71 713, 32,84%). В 2022 году наибольшее число пострадавших и погибших от наводнений на 100 000 человек населения приходится на Африканский и Восточно-Средиземноморский регионы. Вероятность того, что в результате наводнений погибнет более 50 человек, была значительно выше в странах с низким уровнем дохода (скорректированное отношение шансов: 14,34; 95%-й ДИ: 7,46–30,04) по сравнению со странами с высоким уровнем дохода. С течением времени количество пострадавших и смертность от наводнений снижались.
UNASSIGNED: Несмотря на сокращение числа пострадавших и погибших, наводнения по-прежнему оказывают серьезное воздействие на людей и экономику во всем мире, особенно в странах с низким уровнем дохода. Необходимо принять меры для повышения эффективности управления рисками стихийных бедствий и смягчения последствий наводнений.