Low-income Regions Research Articles

Unveiling the research landscape of planetscope data in addressing earth-environmental issues: a bibliometric analysis

The PlanetScope (PS) satellite constellation, developed by Planet Labs Inc., represents a significant advancement in Earth observation, offering high spatial resolution and daily revisit capabilities. This study provides a comprehensive bibliometric analysis of PS satellite imagery, exploring its utilization in scientific research from 2017 to 2023. Using data extracted from the Scopus database, 582 documents were analyzed to uncover the publication trends, key research disciplines, collaboration networks, and research themes related to PS imagery. The results highlight the increasing use of PS data in Earth and Planetary Sciences, Environmental Science, and Computer Science, with a notable concentration of research outputs from the United States, China, and Brazil. Furthermore, our findings indicate that PS data is applied in diverse fields, including land use/land cover classification, agriculture, environmental monitoring, and disaster assessment. Notably, machine learning techniques are increasingly applied to PS data, enhancing analysis capabilities. Despite the growing adoption of PS imagery, challenges related to data access, particularly in low-income regions, were identified, and PS data often plays a secondary or supplementary role in many studies. Recommendations for enhancing interdisciplinary collaboration, expanding open-access data programs, and integrating advanced processing techniques are proposed to maximize the impact of PS data in addressing global environmental challenges. This study provides valuable insights into the evolving landscape of PS-based research, emphasizing the potential of PS data and identifying areas for future exploration.

Cost-effectiveness of camrelizumab plus rivoceranib for advanced hepatocellular carcinoma in the context of regional disparities in China

ObjectiveTo assess the cost-effectiveness of combining camrelizumab with rivoceranib versus sorafenib as initial treatment options for advanced hepatocellular carcinoma (HCC) across different developmental regions in China.MethodsUtilizing TreeAge Pro and data from the phase III randomized CARES-310 clinical trial, a model based on Markov state transitions was developed. Health state utility values were derived from the CARES-310 trial, and direct medical costs were obtained from relevant literature and local pricing data. The primary outcome measured was the incremental cost-effectiveness ratio (ICER), defined as the cost per additional quality-adjusted life year (QALY) gained per person. The ICERs were compared against the willingness-to-pay (WTP) thresholds of different regions in China, including low-income ($16,426.80), medium-income ($34,319.01), and high-income regions ($81,036.63). Sensitivity analyses were also conducted to assess the robustness and reliability of the model under various assumptions. A tornado diagram was used to illustrate the impact of parameter variations on the model’s cost-effectiveness.ResultsFor base case analysis, QALYs per person for the cohort receiving sorafenib were 0.91, with a corresponding cost of $8,860.97. For the cohort receiving camrelizumab plus rivoceranib, the QALYs per person were 1.71, with a corresponding cost of $16,190.72. The camrelizumab plus rivoceranib treatment group exhibited an increase of 0.80 QALYs and an additional expenditure of $7,329.75. The calculated ICER was $9,150.75 per QALY, which is below the WTP thresholds for all regions in China. The camrelizumab plus rivoceranib regimen is regarded as highly cost-effective in medium-income areas of China, with a probability of 99.9%. In high-income regions, the probability reaches 100.0%. Even in low-income regions, this regimen is considered 95.6% cost-effective. Sensitivity analysis further verified that these findings were robust across various assumptions.ConclusionThe combination of camrelizumab and rivoceranib as a treatment strategy not only improves health outcomes but also represents a cost-effective option across different developmental regions in China.

Macro-Economic Analysis of Literacy Rates Across Five Indian States: Trends, Determinants, and Socio-Economic Impact

This research explores the relationship between literacy rates, economic development, poverty, and the gender literacy gap in five Indian states. The study examines how economic growth influences educational outcomes, particularly in terms of gender disparities. The analysis highlights the interconnectedness between higher literacy rates, lower poverty levels, and reduced gender gaps in education. The findings underscore the importance of aligning economic policies with educational reforms to improve literacy, especially for girls in low-income regions. The study suggests that enhancing educational access and opportunities, addressing gender-specific barriers, and promoting economic growth are key strategies for reducing poverty and promoting sustainable development. This research offers valuable insights for policymakers focused on creating inclusive and equitable educational systems to foster long-term socio-economic growth. Keywords : Literacy Rates, Economic Development, Gender Literacy Gap, Poverty Reduction , Educational Reforms

Assessing the Health Impacts of Urban Air Pollution on Marginalized Populations in Bangladesh

Air pollution has become a paramount environmental and public health concern worldwide, significantly affecting socio-economic conditions and health, especially in emerging nations. The study aims to investigate the impact of air pollution on the health of marginalized populations in urban Bangladesh, concentrating on identifying pollution sources, analyzing health effects, assessing socio-economic vulnerabilities, and evaluating the efficacy of regulatory frameworks. A systematic review methodology was employed, integrating data from pertinent research and official publications to deliver a thorough study of air pollution sources and health effects in these communities. The results indicate that sources of air pollution, including automobile emissions, industrial waste, and unregulated brick kilns, disproportionately impact vulnerable communities due to their closeness to high-pollution areas. The health consequences, particularly exacerbated respiratory and cardiovascular conditions, are more pronounced in these populations due to restricted healthcare access and socio-economic obstacles. Socio-economic vulnerabilities, including income level, housing circumstances, and access to healthcare, intensify exposure risks, underscoring differences in pollution exposure between marginalized and non-marginalized areas. The study suggests that although legal frameworks such as the Air Quality Management Project and the Brick Kiln Control Act establish a basis for air quality management, their inadequate enforcement in low-income regions diminishes their efficacy. This research underscores the necessity for focused policy interventions and community-oriented methods.

The PRIS-Tool. A simple screening device for eye care

Abstract With the PRIS-Tool we aim to enable a fast, simple and stable eye self-screening that makes pathological changes in the retinal blood vessels visible to the patient. Furthermore, we envision its application as a quick retinal function test prior to cataract surgeries in low-income regions of the world. Our pocket-sized PRIS-Tool allows for a simplified entoptic testing, due to its integrated light stimulation. PRIS stands for Purkinje Retinal Image Stabilizer. So far, we have built 12 devices in small series and distributed them in our PRIS clinical research network to discuss potential clinical applications. An assisting app will support patients in performing a reliable self-diagnosis and documenting the progress of the disease. Future work will focus on app development and the initiation and evaluation of user studies.

Energy input and food output: The energy imbalance across regional agrifood systems.

Biomass was the principal energy source in preindustrial societies; their agriculture provided more energy than it required. Thus, the energy return on energy investment (EROEI) needed to be >1. Recent studies have indicated that this may not be the case for modern industrialized agrifood systems (AFSs). Although the green revolution radically improved agricultural yields, it came at the expense of increased energy inputs, mainly in the form of fossil fuels. AFSs relying on external energy pose a food security risk, an economic issue for agricultural producers, and an environmental issue for all. Previous EROEI studies investigated mainly certain groups of commodities, typically at the local or national level. Here, a comprehensive global analysis shows that current AFSs have a lower EROEI than previously estimated. Globally, EROEI has increased from 0.68 in 1995 to 0.91 in 2019. In low-income regions, AFSs are still energy sources, but their EROEI has declined with increasing wealth, reflecting the growing utilization of fossil fuels. AFSs of high-income regions are energy sinks, although their EROEI has improved. Food processing is responsible for 40% of the total energy use in the global AFS, notably larger than fertilizer, which accounts for 17%. More than half of the energy use in food processing is for livestock products that also require disproportionate energy input through their inefficient conversion of (human-edible) feed. Livestock products use 60% of energy inputs while delivering <20% of food calories.

Quantifying food security and mitigation risks consequential to climate change impacts on crop yields

Abstract Climate change is expected to impact crop yields globally, with some regions benefiting from favorable conditions and CO2 fertilization, while others face adverse effects from altered precipitation and higher temperatures. Changes in crop yields can destabilize the global food system and pose challenges to food security. Moreover, crop production is crucial, as biofuels are becoming increasingly important contributors to climate change mitigation measures aimed at limiting global warming. This study uses the IMAGE integrated assessment model framework to analyze different indicators related to food security and climate change mitigation under varying climate change impacts on crop yields. Twelve spatially explicit crop productivity projections were taken from the full archive of the Global Gridded Crop Model Intercomparison (GGCMI) of 120 climate-crop model combinations, forced by CMIP6-based climate scenarios. The selection includes two average-performing climate-crop model combinations, two pessimistic combinations that perform one standard deviation below the mean, and two optimistic model combinations that perform one standard deviation above the mean. To single out the effect of climate change on productivity changes, we drew samples from two representative concentration pathways (RCP2.6 and RCP8.5). These productivity projections were applied within an otherwise uniform scenario (SSP2) and analyzed for their effect on total calorie demand, crop prices, and number of people at risk of undernourishment to quantify food security. Risks to climate change mitigation targets were explored by modeling the total bioenergy supply, emissions, and global mean temperature. The results revealed significant differences in the risk of food security and mitigation potential between different regions and climate change scenarios. Across scenarios, the crop area extent can vary up to 2 million km2 due to changing crop yields. The projected change in global hunger ranges from 60 to 160 million undernourished people, indicating uncertainty between climate and crop model combinations. Low-income regions are especially impacted because of their high sensitivity to changes in food prices. Global climate change mitigation ambitions can also deviate by the latter part of the 21st century, as changes in yields will impact biofuel production as well as Agriculture, Forestry and Other Land Use (AFOLU) emissions. The quantitative insights generated by this study highlight the need for global policy efforts to make the agricultural system more adaptive to climate change to handle potential negative impacts.

Assessing the role of participatory planning approach in enhancing informal settlements upgrading in low income regions

Assessing the role of participatory planning approach in enhancing informal settlements upgrading in low income regions

The impact of diurnal temperature range on the risk of hospitalizations in a low-income setting: the case of the Central Coast of Vietnam.

The study aims to evaluate the effects of diurnal temperature range (DTR) on all causes, cardiovascular and respiratory conditions in the Central Coast of Vietnam, a tropical, low-income region with high DTR exposure but limited research. Daily hospital admission data from the largest hospitals in three provinces were analyzed alongside meteorological data. A time-series analysis using a generalized linear distributed lag model was conducted to examine the non-linear DTR-hospitalization association. A random-effect meta-analysis using restricted maximum likelihood was performed to calculate the pooled effects across three provinces. Stratified analyses by gender, age, season and natural disaster occurrence were conducted to identify vulnerable subpopulations. The multi-province pooled effects indicated that a 1°C increase in DTR raised the risk of hospitalizations for all causes and respiratory diseases by 1.5% [1.2-1.8%] and 0.5% [0.0-1.0%], at lag 0-6 days. The effects of DTR on cardiovascular diseases, as well as those stratified by subgroups, were not statistically significant. Additionally, DTR had a greater adverse effect during the dry season and in the presence of natural disaster. Females and the elderly were slightly more susceptible to respiratory admissions, while males and younger individuals had a higher risk of all-cause admissions due to greater DTR effects. DTR was an independent risk factor for the exacerbation of all and specific causes, particularly among the susceptible subgroups. The findings suggested that it is necessary to take preventive measures to protect these at-risk populations from the adverse effects of extreme DTR exposure.

Anthropogenic climate change doubled the frequency of compound drought and heatwaves in low-income regions

Anthropogenic climate change doubled the frequency of compound drought and heatwaves in low-income regions

Diagnosis and Treatment of Bronchopulmonary Lophomoniasis in a Patient with Persistent Granuloma: A Case Report

Background and Clinical Significance: Lophomonas is a multiflagellate anaerobic protozoan that usually inhabits the intestines of insects, mainly cockroaches. However, bronchopulmonary infections caused by this parasite have been increasingly reported worldwide in recent decades. We provide important information for the diagnosis of this disease, which often goes undetected and frequently leads to misdiagnosis and inadequate treatment. It is noteworthy that this is the third case reported in Mexico. Case Presentation: A 37-year-old male patient was hospitalized several times for pneumonia with a persistent granuloma in the right bronchial lobe. After extensive testing, the patient was diagnosed with bronchopulmonary lophomoniasis and successfully treated with metronidazole. Conclusions: Clinicians worldwide should be aware of the existence of lophomoniasis, especially in low-income regions with poor sanitation and high insect exposure. This parasitic infection, although rare, may be underestimated due to its nonspecific respiratory symptoms, which may mimic other infections.

Stability and Bifurcation Analysis for the Transmission Dynamics of Skin Sores with Time Delay

Impetigo is a highly contagious skin infection that primarily affects children and communities in low-income regions and has become a significant public health issue impacting both individuals and healthcare systems. A nonlinear deterministic model based on the transmission dynamics of skin sores (impetigo) is developed with a specific emphasis on the time delay effects in the infection and recovery processes. To address this complexity, we introduce a delay differential equation (DDE) to describe the dynamic process. We analyzed the existence of Hopf bifurcations associated with the two equilibrium points and examined the mechanisms underlying the occurrence of these bifurcations as delays exceeded certain critical values. To obtain more comprehensive insights into this phenomenon, we applied the center manifold theory and the normal form method to determine the direction and stability of Hopf bifurcations near bifurcation curves. This research not only offers a novel theoretical perspective on the transmission of impetigo but also lays a significant mathematical foundation for developing clinical intervention strategies. Specifically, it suggests that an increased time delay between infection and isolation could lead to more severe outbreaks, further supporting the development of more effective intervention approaches.

An Economically Sustainable Glass Recycling Business Model in Puerto Rico: A Conceptual Solution for Regions Without Government Recycling Programs

In Puerto Rico, less than 5% of glass waste is recycled annually compared to a US national average of 25%. In regions like Puerto Rico, where government glass recycling programs are absent, glass presents a challenging waste stream to profitably recycle due to high transportation costs and low market prices, with few scalable models identified in the literature. This study emerged from a multi-year shared action learning partnership between Worcester Polytechnic Institute’s Puerto Rico Project Center and the Corporación del Proyecto ENLACE, a community development NGO serving the Caño Martín Peña communities in San Juan, Puerto Rico. Based on online research and interviews with 16 key stakeholders, we describe an economically sustainable glass recycling business model designed for the Caño Martín Peña communities that offers broader applicability for similar contexts. The business model achieves three goals: (1) it offers a free and convenient glass-collection service for the Caño Martín Peña communities; (2) it generates local employment opportunities in a low-income region; and (3) it operates in an economically sustainable manner. The viability of the glass-recycling business model is premised on strategic partnerships with government agencies, recycling companies, glass-sand markets, and local businesses.

Increased accessibility of computer-based testing for residency application to a hospital in Brazil with item characteristics comparable to paper-based testing: a psychometric study

With the coronavirus disease 2019 pandemic, online high-stakes exams have become a viable alternative. This study evaluated the feasibility of computer-based testing (CBT) for medical residency applications in Brazil and its impacts on item quality and applicants’ access compared to paper-based testing. In 2020, an online CBT was conducted in a Ribeirao Preto Clinical Hospital in Brazil. In total, 120 multiple-choice question items were constructed. Two years later, the exam was performed as paper-based testing. Item construction processes were similar for both exams. Difficulty and discrimination indexes, point-biserial coefficient, difficulty, discrimination, guessing parameters, and Cronbach’s α coefficient were measured based on the item response and classical test theories. Internet stability for applicants was monitored. In 2020, 4,846 individuals (57.1% female, mean age of 26.64±3.37 years) applied to the residency program, versus 2,196 individuals (55.2% female, mean age of 26.47±3.20 years) in 2022. For CBT, there was an increase of 2,650 applicants (120.7%), albeit with significant differences in demographic characteristics. There was a significant increase in applicants from more distant and lower-income Brazilian regions, such as the North (5.6% vs. 2.7%) and Northeast (16.9% vs. 9.0%). No significant differences were found in difficulty and discrimination indexes, point-biserial coefficients, and Cronbach’s α coefficients between the 2 exams. Online CBT with multiple-choice questions was a viable format for a residency application exam, improving accessibility without compromising exam integrity and quality.

Impact of Low Physical Activity on Cardiovascular Disease Across Regions and Demographic Groups: Insights from the Global Burden of Disease Study.

Cardiovascular disease (CVD) is a leading cause of death globally, with low physical activity (LPA) as a significant modifiable risk factor. The prevalence of LPA remains high, necessitating a comprehensive assessment of its impact on CVD. We applied Joinpoint regression to assess trends in deaths and Disability-Adjusted Life Years (DALYs) and employed ARIMA models to project future BMI-related burdens. From 1990 to 2021, CVD-related deaths due to LPA rose from 218,938 to 371,736 globally, with the most significant increases in Southeast Asia and Sub-Saharan Africa. DALYs surged from 4.47 million to 7.29 million. Although age-standardized death rates showed a slight decline in high-income countries (-2.27% EAPC), lower-income regions experienced a steady rise. YLDs grew from 344,680 to 725,181, while YLLs increased from 4.13 million to 6.57 million, with older adults (75+ years) carrying the highest burden. The growing burden of CVD linked to LPA highlights the urgent need for interventions, particularly in low- and middle-income countries, to reduce future risks and improve public health outcomes.

The effect of day-to-day temperature variability on agricultural productivity

Abstract With rising extreme weather events due to climate change, the impact on agricultural production has become increasingly severe. Yet, there has been a significant gap in research that assesses the influence of day-to-day temperature variability on agricultural productivity on a global scale. Our study addresses this gap by exploring the effects of day-to-day temperature variability and the change of rainfall patterns on agricultural productivity worldwide from 1961 to 2018. The results reveal that day-to-day temperature variability not only has a direct, negative impact on agricultural Total Factor Productivity (TFP), but also influences it by modulating the effects of monthly average temperatures and wet days. One unit increase of day-to-day temperature variability leads to a 2% decrease in TFP. Day-to-day temperature variability neutralizes the impact of monthly average temperature on TFP, while exacerbating the impact of wet days on TFP. Furthermore, extreme rainfall events result in a consistent negative marginal effect across all countries/seasons/rainfall intervals. This study also identifies differentiated impacts across countries with varying income levels. Low-income regions’ TFP demonstrates markedly significant sensitivities to both monthly average temperatures and daily temperature fluctuations, which means less resilient. Furthermore, the impacts of general and extreme rainfall are comparatively less pronounced in high-income countries, indicating higher resilience to climate variability in these regions and a relative vulnerability to extreme weather events in low-income regions. Our findings illuminate the intricate and multifaceted role that daily temperature variability plays in agricultural productivity, providing a theoretical basis for understanding the heterogeneous impacts of climate change on agriculture and contributing insights into the broader discourse on climate resilience and agricultural sustainability.

Innovative approaches to risk management in clinical research: Balancing ethical standards, regulatory compliance, and intellectual property concerns

This study explores innovative approaches to risk management in clinical research, focusing on the intricate balance between ethical standards, regulatory compliance, and intellectual property (IP) concerns. As clinical trials become increasingly complex and globalized, managing risks effectively while maintaining participant safety and upholding legal and ethical principles has become paramount. The study adopts a comprehensive review of emerging technologies, such as artificial intelligence (AI), machine learning (ML), blockchain, and big data analytics, to assess their role in transforming risk management strategies. Key findings reveal that AI and predictive analytics significantly enhance real-time monitoring and the early identification of risks, while adaptive trial designs offer flexibility in managing unforeseen challenges during trials. Blockchain technology improves transparency and data integrity, ensuring secure and verifiable data transactions. However, the intersection of IP protections and equitable access to treatments presents ongoing ethical challenges, particularly in low-income regions. The study concludes that while technological innovations provide robust tools for mitigating risks, a balanced approach to regulatory frameworks and IP protections is essential. The study recommends increased collaboration between regulatory bodies, research institutions, and technology providers to harmonize global regulatory standards, ensuring both innovation and accessibility. Furthermore, it advocates for more flexible IP frameworks that address the tension between protecting innovations and ensuring equitable access to life-saving treatments.

Innovation in distributed energy services for sustainable development: case studies from sub-Saharan Africa

Abstract In this work, we explore how locally led innovations can advance sustainable energy access in low-income regions of Africa. Given the emphasis of the Sustainable Development Goals on the importance of affordable, reliable, and sustainable energy, we critically assess how local innovations can address the unique challenges of regions characterized by informality and low purchasing power and where existing grid-based electricity supply is weak. Through case studies, we highlight successful initiatives in expanding energy services access, including product bundling, pay-as-you-go financial models, leveraging existing supply chains, and securing strong funding support. Our findings underscore the importance of local ownership, contextual knowledge, and the adaptation of innovations to specific socio-economic and cultural conditions. By comparing the case studies, we identify common strategies that can contribute to the effectiveness of local innovations in improving energy access and sustainability that can inform efforts to replicate and scale up such initiatives. We conclude by identifying common elements contributing to the success of these cases and their significance, focusing on those crucial for achieving speed, scale, and impact.

Telemedicine networks for acute stroke: An analysis of global coverage, gaps, and opportunities.

Despite the proven efficacy of telestroke in improving clinical outcomes by providing access to specialized expertise and allowing rapid expert hyperacute stroke management and decision-making, detailed operational evidence is scarce, especially for less developed or lower income regions. We aimed to map the global telestroke landscape and characterize existing networks. We employed a four-tiered approach to comprehensively identify telestroke networks, primarily involving engagement with national stroke experts, stroke societies, and international stroke authorities. A carefully designed questionnaire was then distributed to the leaders of all identified networks to assess these networks' structures, processes, and outcomes. We identified 254 telestroke networks distributed across 67 countries. High-income countries (HICs) concentrated 175 (69%) of the networks. No evidence of telestroke services was found in 58 (30%) countries. From the identified networks, 88 (34%) completed the survey, being 61 (71%) located in HICs. Network setup was highly heterogeneous, ranging from 17 (22%) networks with more than 20 affiliated hospitals, providing thousands of annual consultations using purpose-built highly specialized technology, to 11 (13%) networks with fewer than 120 consultations annually using generic videoconferencing equipment. Real-time video and image transfer was employed in 64 (75%) networks, while 62 (74%) conducting quality monitoring. Most networks established in the past 3 years were located in low- and middle-income countries (LMICs). This comprehensive global survey of telestroke networks found significant variation in network coverage, setup, and technology use. Most services are in HICs, and a few services are in LMICs, although an emerging trend of new networks in these regions marks a pivotal moment in global telestroke care. The wide variation in quality monitoring practices across networks, with many failing to report key performance metrics, underscores the urgent need for standardized, resource-appropriate, quality assurance measures that can be adapted to diverse settings.

Risk factors associated with multidrug-resistant Klebsiella pneumoniae infections: a multicenter observational study in Lebanese hospitals

BackgroundKlebsiella pneumoniae is a significant global public health burden, especially in low-income countries and regions with fragile healthcare infrastructures, due to its ability to cause severe infections, increase mortality rates, and its rising antimicrobial resistance. This study aimed to estimate the proportion of multidrug-resistant (MDR) K. pneumoniae infections and identify associated risk factors.MethodsData were retrospectively collected from three academic hospitals in Beirut, Lebanon, between January 2021 and September 2023 using a standardized form. Binary logistic regression was used to determine risk factors associated with MDR, extended-spectrum beta-lactamase (ESBL)-producing, and carbapenem-resistant K. pneumoniae (CRKP) infections.ResultsOut of 2,655 K. pneumoniae cases, 410 met the inclusion criteria. The primary infection sources were the urinary tract (58.3%) and the respiratory tract (12.4%). Among the isolates, 61% were MDR K. pneumoniae, with 7.3% being extensively drug-resistant, and 0.5% pandrug-resistant. Additionally, 36.8% were ESBL-producing, while 6.3% were CRKP. Predictors significantly associated with MDR K. pneumoniae infections included male sex (adjusted odds ratio [AOR] = 3.46, 95% CI = 1.01–11.86, P = 0.04), recent antibiotics use (AOR = 4.52, 95% CI = 1.65–12.36, P = 0.003), and recent cancer chemotherapy (AOR = 3.43, 95% CI = 1.25–9.42, P = 0.01). ESBL-producing infections were associated with age ≥ 65 years, higher Charlson Comorbidity Index (CCI), and recent antibiotic use. CRKP infections were linked to male sex, prior antibiotic use, and longer hospital stays prior to infection (all P < 0.05).ConclusionsMDR K. pneumoniae infections are steadily rising in Lebanon, along with an increase in ESBL-producing and CRKP cases. The main risk factors for MDR K. pneumoniae infections were male sex, recent antibiotic use, and cancer chemotherapy. ESBL-producing infections were associated with advanced age, higher CCI, and recent antibiotic use, while CRKP infections were linked to male sex, prior antibiotic use, and prolonged hospital stays. This situation is further exacerbated by inadequate healthcare infrastructure and suboptimal national surveillance. Strengthening local surveillance and implementing effective antibiotic stewardship programs are critical to managing this growing threat..