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This paper establishes a fractional-order economic growth model to model the gross domestic product (GDP). The fractional-order model consists of a differential equation of integer and fractional orders, where the GDP is a function of several exploratory variables. An empirical application is adopted using Malaysia's GDP data from 1956 to 2018, incorporating exploratory variables such as total population, crude death rate, production of logs, gross fixed capital formation, exports of goods and services, general government final consumption expenditure, private final consumption expenditure, and the impact of investment. Extensive comparisons were carried out to evaluate the modelling performance of the full and reduced fractional-order multiple linear regression models with the benchmark models, namely full and reduced integer-order multiple linear regression models. Results indicate that the reduced fractional-order model with six exploratory variables, excluding the crude death rate and production of logs, predominates other models for the in-sample model fitting based on the Akaike information criterion, coefficient of determination and other criteria. Furthermore, the fractional-order model offers the best-of-sample forecasts evaluated based on the root mean square forecast error and mean absolute forecast error. The application of the Diebold-Mariano test also serves to confirm the superior performance of the suggested fractional-order model, revealing a significant difference in forecasting ability between the fractional-order and integer-order models.

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Objective: To estimate decadal trends in the prevalence of metabolic syndrome (MetS) in economically developed regions in China and its association with city economic levels. Methods: Using a comprehensive Chinese healthcare database, repeated cross-sectional studies were conducted on adults who had annual health check-ups from 2012 to 2021 in 4 economically developed cities. MetS was defined by the criteria of the Chinese Diabetes Society in 2013. The crude prevalence of MetS adjusted for sex and age was reported. The association between prevalence, calendar year, and city gross domestic product (GDP) per capita was analyzed by regression model. Results: 158 274 participants aged 18 years and older were included. The unadjusted prevalence of MetS increased from 15.5% (95% CI: 14.2%-16.8%) to 20.0% (95% CI: 19.5%-20.5%) from 2012 to 2021. The adjusted overall prevalence has increased steadily from 12.8% to 20.8% after controlling age and sex (P < .001). Male and older age groups had a higher MetS prevalence. In the regression model of the association between the MetS prevalence, calendar year, and city GDP per capita, calendar year had a positive association with the prevalence (P < .001, 95% CI: 0.648-1.954) and city GDP per capita had a negative association (P = .030, 95% CI: -0.136 to -0.007). Conclusion: The MetS prevalence increased steadily in the economically developed regions in China among the health check-up population during 2012-2021. The MetS prevalence is shown to be negatively associated with GDP per capita in the study population.

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Objective: The aim of this study was to assess research productivity on preterm birth (PTB) in Southeast Asian (SEA) countries and its correlation with socioeconomic characteristics and burden of disease. Methods: A systematic review of preterm birth publications by SEA authors indexed in Scopus, PubMed, ClinicalTrials. gov, and Cochrane was done. Case reports, cohorts, control trials, reviews and cost analysis studies done by SEA researches involving pathophysiology, diagnosis, management, and complications of preterm birth was included in the study while published letters to editors were excluded. The correlation of bibliometric indices, namely Scopus citations, and PlumX metrics indices (citations, usage, captures, mentions, and social media), with socioeconomic status and burden of preterm birth in SEA countries were analyzed by computing for the correlation coefficient (r) and p-value at an alpha of 0.05. Results: Thailand had the highest number of publications and the highest count across all bibliometric indices among all countries in SEA. The percent gross domestic product (GDP) per capita allotted for research and development (R & D) had direct correlation with publications and captures while crude birth rates had indirect correlation with publications, citations, and captures. Neonatal mortality had indirect correlation with publications and captures. Conclusion: Support for research and development is essential to increase research productivity in SEA, which in turn may help in finding solutions to decrease the rate of preterm birth in the region.

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OBJECTIVE: To evaluate the epidemiological evolution and economic impact of COVID-19 pandemic in the European Union (EU) and worldwide, and the effects of control strategies on them. MATERIAL AND METHODS: We collected incidence, mortality, and gross domestic product (GDP) data between the first quarter of 2020 and of 2023. Then, we reviewed the effectiveness of the mitigation and zero-COVID control strategies. The statistical analysis was done calculating the incidence rate ratio (IRR) of two rates and its 95% confidence interval (CI). RESULTS: In the EU, COVID-19 presented six epidemic waves. The sixth one at the beginning of 2022 was the biggest. Globally, the biggest wave occurred at the beginning of 2023. Highest mortality rates were observed in the EU during 2020-2021 and globally at the beginning of 2021. In mitigation countries, mortality was much higher than in zero-COVID countries (IRR=6.82 [95% CI: 6.14-7.60]; p<0.001). A GDP reduction was observed worldwide, except in Asia. None of the eight zero-COVID countries presented a GDP growth percentage lower than the EU percentage in 2020, and 3/8 in 2022 (p=0.054). COVID-19 pandemic caused epidemic waves with high mortality rates and a negative impact on GDP. CONCLUSION: The zero-COVID strategy was more effective in avoiding mortality and potentially had a lower impact on GDP in the first pandemic year.

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On the one hand, economies, particularly developing ones, need to grow. On the other hand, climate change is the most pressing issue globally, and nations should take the necessary measures. Such a complex task requires new theoretical and empirical models to capture this complexity and provide new insights. Our study uses a newly developed theoretical framework that involves renewable energy consumption (REC) and total factor productivity (TFP) alongside traditional factors of CO2 emissions. It provides policymakers with border information compared to traditional models, such as the Environmental Kuznets Curve (EKC), being limited to income and population. Advanced panel time series methods are also employed, addressing panel data issues while producing not only pooled but also country-specific results. 20 Renewable Energy Country Attractiveness Index (RECAI) nations are considered in this study. The results show that REC, TFP, and exports reduce CO2 emissions with elasticities of 0.3, 0.4, and 0.3, respectively. Oppositely, income and imports increase emissions with elasticities of 0.8 and 0.3. Additionally, we show that RECAI countries are commonly affected by global and regional factors. Moreover, we find that shocks can create permanent changes in the levels of the factors but only temporary changes in their growth rates. The main policy implication of the findings is that authorities should implement measures boosting TFP and REC. These factors are driven mainly by technological progress, innovation, and efficiency gains. Thus, they can simultaneously reduce emissions while promoting long-run green economic growth, which addresses the complexity mentioned above to some extent.

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Background: The widespread absence of papers originating in low and middle income economies (LAMIE) across various scholarly disciplines has been widely acknowledged. One potential reason for this could be editorial biases against submissions from LAMIE. Although this bias has been observed in different academic areas, its extent in spinal research remains largely uninvestigated. This research endeavored to investigate the composition of editorial staff members (ESM) within major spinal journals and scrutinize the degree of international diversity represented among the ESM. Methods: We pinpointed ten major spinal journals by referencing their presence in the Journal Citation Reports of 2021. Countries of the ESM affiliated with these journals were categorized according to World Bank classifications. Following this, we conducted a thorough analysis of the ESM compositions. Results: A total of 982 ESM from 50 countries were identified. The United States exhibited the highest representation among ESM (395, 40.22%), followed by South Korea (57, 5.80%), Switzerland (53, 5.40%). When segmented by geographical regions, North America emerged with the highest representation, constituting 43.38% of ESM at 426, trailed by Europe & Central Asia at 31.16% (306), East Asia & Pacific at 17.92% (175). The majority of ESM, amounting to 87.98%, hailed from high income economies (HIE). There was an absence of ESM representation of low income economies. The relationship regarding the quantity of ESM in each country and its population failed to demonstrate significance (p = 0.274, r = 0.281). However, a notable positive correlation emerged when exploring the connection between ESM numbers and gross domestic product (p = 0.033, r = 0.517). Conclusions: Major spinal journals exhibit a notable absence of international representation within their editorial boards, predominantly comprising members from HIE. This underscores a substantial underrepresentation of ESM originating from LAMIE within the sphere of spinal investigation.

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Political will is the key to public health policy-making and a major driving force for the attainment of Universal Health Coverage (UHC) in any nation. To achieve UHC, the Indian government laid down National Health Policy in 1983 and updated it in 2002 and recently in 2017. This recent policy emphasized increasing healthcare spending and economic growth. In the current budget, there is an increment in the share of GDP of 0.34% from the previous year's allocation, but still staggering for the envisaged 2.5% to achieve UHC. Enthusiastic announcements of opening 157 new nursing colleges, a separate programme for eliminating sickle cell anemia by 2047, and Centers of excellence establishment for pharma companies for promoting research and development and focusing on Particularly Vulnerable Tribal Groups (PVTGs) are the few overarching and new highlights in the current budget. But, in a country so huge and varied in terms of its needs in every sector, the announcements in the financial budget speech taking India forward in becoming a "shining star" is a matter of debate. This is an attempt to review the budget for this financial year in the healthcare sector and what it means: is the country willing to build a self-driven healthcare sector in the Amrit Kaal with strong public finances and a robust financial sector through "efforts by all"?

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Media, social scientists and public health researchers often present comparisons across countries, and policy makers use such comparisons to take evidence-based action. For a meaningful comparison among countries, one often needs to normalize the measure for differences in population size. To address this issue, the first choice is usually to calculate per capita ratios. Such ratios, however, normalize the measure for differences in population size directly only under the highly restrictive assumption of a proportional increase of the measure with population size. Violation of this assumption frequently leads to misleading conclusions. We compare per capita ratios with an approach based on regression, a widely used statistical procedure that eliminates many of the problems with ratios and allows for straightforward data interpretation. It turns out that the per capita measures in three global datasets (gross domestic product, COVID-19-related mortality and CO2 production) systematically overestimate values in countries with small populations, while countries with large populations tend to have misleadingly low per capita ratios owing to the large denominators. Unfortunately, despite their biases, comparisons based on per capita ratios are still ubiquitous, and they are used for influential recommendations by various global institutions. Their continued use can cause significant damage when employed as evidence for policy actions and should therefore be replaced by a more scientifically substantiated and informative method, such as a regression-based approach.

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Objective: To investigate the relationship between vaccination rates and excess mortality during distinct waves of SARS-CoV-2 variant-specific infections, while considering a state's GDP per capita. Methods: We ranked U.S. states by vaccination rates and GDP and employed the CDC's excess mortality model for regression and odds ratio analysis. Results: Regression analysis reveals that both vaccination and GDP are significant factors related to mortality when considering the entire U.S. population. Notably, in wealthier states (with GDP above $65,000), excess mortality is primarily driven by slow vaccination rates, while in less affluent states, low GDP plays a major role. Odds ratio analysis demonstrates an almost twofold increase in mortality linked to the Delta and Omicron BA.1 virus variants in states with the slowest vaccination rates compared to those with the fastest (OR 1.8, 95% CI 1.7-1.9, p < 0.01). However, this gap disappeared in the post-Omicron BA.1 period. Conclusion: The interplay between slow vaccination and low GDP per capita drives high mortality.

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The purpose of this study is to examine the impact of gross domestic product, energy consumption, and trade openness on carbon emission in Asia. Among the 48 countries in Asia, 42 were included in the analysis, spanning a period of 20 years. Given that Asia is the predominant contributor, accounting for 53% of global emissions as of 2019, a comprehensive examination at both continental and individual country levels becomes imperative. Such an approach aligns with local, regional, and global development agendas, contributing directly and indirectly to climate change mitigation. The analytical techniques employed in this study encompassed panel regression and multiple linear regression, illuminating the specific contributions of each country to the study variables and their impact on carbon emissions. The findings suggest that gross domestic product (13 out of 42 countries), energy consumption (21 out of 42 countries), and trade openness (eight out of 42 countries) have a highly significant impact (p < 0.01) on carbon emissions in Asia. Energy consumption plays a vital role in increasing carbon emissions in Asia, driven by rising populations, urbanisation, and oil and gas production. Policymakers can take several actions such as adopting a carbon pricing system, using sustainable transportation, renewable energy development, and international cooperation within Asia to reach the goal of being carbon neutral by 2050.

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OBJECTIVE: This study investigated the association of economic status with metabolic index control in type 2 diabetes mellitus (T2DM) patients. METHODS: In total, 37 454 T2DM patients from 10 National Metabolic Management Centers in China were recruited and categorized into two groups: a high-gross domestic product (GDP) group (n = 23 993) and a low-GDP group (n = 13 461). Sociodemographic characteristics, medical histories, and lifestyle factors were recorded. Logistic regression and interaction analysis were performed to evaluate the association of economic status and healthy lifestyle with metabolic control. RESULTS: Compared to the low-GDP group, there were fewer patients with glycated hemoglobin (HbA1c) levels ≥7% in the high-GDP group. Fewer patients with a high GDP had an abnormal metabolic state (HbA1c ≥ 7%, blood pressure [BP] ≥130/80 mm Hg, total cholesterol [TCH] ≥4.5 mmol/L or body mass index [BMI] ≥24 kg/m2 ). The risks of developing HbA1c ≥ 7% (odds ratios [OR] = 0.545 [95% CI: 0.515-0.577], p < .001), BP ≥ 130/80 mm Hg (OR = 0.808 [95% CI: 0.770-0.849], p < .001), BMI ≥ 24 kg/m2 (OR = 0.840 [95% CI: 0.799-0.884], p < .001), and an abnormal metabolic state (OR = 0.533 [95% CI: 0.444-0.636], p < .001) were significantly lower in the high-GDP group even after adjustment for confounding factors. Younger participants; those with a family history of diabetes, normal weight, and a physical activity level up to standard; and those who did not drink alcohol in the high-GDP group were predisposed to better glycemic levels. CONCLUSIONS: T2DM patients in economically developed regions had better metabolic control, especially glycemic control. A healthy lifestyle had an additive effect on achieving glycemic goals, even among high-GDP patients.

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OBJECTIVES: National-level data on the incidence of retinopathy of prematurity (ROP) in different regions of China is insufficient. This study aimed to compare ROP incidences and care practices in different regions of China and their relationship with regional gross domestic product (GDP) per capita. STUDY DESIGN: Retrospective cohort study. METHODS: All infants born at <32 weeks gestational age (GA) and admitted to 70 neonatal intensive care units (NICUs) from January 1, 2019, to December 31, 2020, were enrolled. Hospitals were categorised into three regional groups according to geographical locations and GDP per capita from high to low: Eastern, Central, and Western China. The incidence of death or ROP, and care practices were compared among the groups. RESULTS: A total of 18,579 infants were enrolled. Median GA was 29.9 (interquartile range 28.4-31.0) weeks and birth weight was 1318.1 (317.2) g. The percentage of GA <28 weeks, complete administration of antenatal steroids, and weight gain velocity during NICU stay were highest in Eastern China and lowest in Western China (all P < 0.01). In Eastern, Central, and Western China, the rates of death or any stage of ROP were 33.3%, 38.5%, and 39.2%, respectively (P < 0.01). CONCLUSIONS: There were considerable regional disparities in ROP incidence in preterm infants with GA <32 weeks in China. The incidence of death or ROP ranged from high to low in Western, Central, and Eastern China.

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Comparative frailty prevalence data across European countries is sparse due to heterogeneous measurement methods. The Survey of Health, Ageing and Retirement (SHARE) initiative conducted interviews with probability sampling of non-institutionalized elderly people in several European countries. Previous frailty analyses of SHARE datasets were limited to initial SHARE countries and did not provide age- and gender-stratified frailty prevalence. Our aim was to provide age- and gender-stratified frailty prevalence estimates in all European countries, with predictions where necessary. From 29 SHARE participating countries, 311,915 individual surveys were analyzed. Frailty prevalence was estimated by country and gender in 5-year age bands using the SHARE Frailty Instrument and a frailty index. Association of frailty prevalence with age, gender, and GDP per capita (country-specific economic indicator for predictions) was investigated in multivariate mixed logistic regression models with or without multiple imputation. Female gender and increasing age were significantly associated with higher frailty prevalence. Higher GDP per capita, with or without purchasing power parity adjustment, was significantly associated with lower frailty prevalence in the 65-79 age groups in all analyses. Observed and predicted data on frailty rates by country are provided in the interactive SHARE Frailty Atlas for Europe. Our study provides age- and gender-stratified frailty prevalence estimates for all European countries, revealing remarkable between-country heterogeneity. Higher frailty prevalence is strongly associated with lower GDP per capita, underlining the importance of investigating transferability of evidence across countries at different developmental levels and calling for improved policies to reduce inequity in risk of developing frailty across European countries.

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The importance of food (in)security has been one of the United Nations Sustainable Development's main goals. Over 828 million people worldwide cannot acquire enough food to meet the minimum daily dietary energy requirements (undernourished). Therefore, the present study examines the factors that affect the number of undernourished people in Colombia by assessing macroeconomic data for the period 2000-2021 including gross domestic product (GDP) per capita, unemployment, and inflation rates. A quantitative, empirical, correlation design was used to examine and describe the relationship among the variables. The findings showed that the proposed variables presented the correct signs, were statistically significant, and were in line with the economic theory Thus, the study concluded that although income shocks brought on by inflation and unemployment undoubtedly impact household food (in)security, other factors must also be considered for policy and practice to effectively reduce food insecurity for households.

La importancia de la (in)seguridad alimentaria ha sido uno de los principales objetivos del Desarrollo Sostenible de las Naciones Unidas y más de 820 millones de personas en el mundo no pueden adquirir suficientes alimentos para satisfacer los requerimientos mínimos diarios de energía dietética (subalimentadas). Por lo tanto, el presente estudio examina los factores que afectan el número de personas subalimentadas en Colombia mediante la evaluación de datos macroeconómicos para el período 2000-2021, incluido el producto interno bruto (PIB) per cápita, el desempleo y las tasas de inflación. Se utilizó un diseño cuantitativo, empírico y correlacional, para examinar y describir la relación entre las variables. Los hallazgos mostraron que las variables propuestas presentaron los signos correctos, fueron estadísticamente significativas y de acuerdo con el propuesto por la teoría económica. Por lo tanto, el estudio concluyó que, si bien los impactos en los ingresos causados por la inflación y el desempleo indudablemente afectan la inseguridad alimentaria de los hogares, también es importante considerar otros factores en los esfuerzos de políticas y prácticas para mitigar la inseguridad alimentaria de los hogares.

A importância da (in)segurança alimentar tem sido um dos principais objetivos do Desenvolvimento Sustentável das Nações Unidas e mais de 820 milhões de pessoas no mundo não podem adquirir alimentos suficientes para atender às necessidades energéticas diárias mínimas (subalimentadas). Por tanto o presente estudo examina os fatores que afetam o número de pessoas subalimentadas na Colômbia, avaliando dados macroeconômicos para o período 2000-2021, incluindo produto interno bruto (PIB) per capita, desemprego e taxas de inflação. Um desenho quantitativo, empírico e de correlação foi usado para examinar e descrever a relação entre as variáveis. Os achados mostraram que as variáveis propostas apresentaram os sinais corretos, foram estatisticamente significativas e em consonância com a teoria econômica. Assim, o estudo concluiu que, embora os choques de renda causados pela inflação e pelo desemprego indubitavelmente afetem a insegurança alimentar das famílias, outros fatores também são importantes a serem considerados nos esforços de políticas e práticas para mitigar a insegurança alimentar das famílias.

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The study investigated "Building Ecological Civilization: the Importance of Promoting Green Investments by Chinese Companies" to examine the complex connections between the factors affecting Chinese businesses' ecological performance (EP). An autoregressive distributed lag (ARDL) model is used in the study to analyze the impact of green investments (GI), the policy environment (PE), government support (GS), public awareness and perception (PAP), and technological capability (TC) on companies' earnings per share (EPS). The results show a strong correlation between GI and EP, indicating that businesses' growing use of green initiatives is essential for raising environmental sustainability. The study also shows that PE, TC, and EP have an inverse relationship, indicating the need for more supportive governmental policies and regulations and the effective adoption and implementation of green technologies. The interaction of GS and PAP significantly reduces the ecological impact of green investments, highlighting the significance of citizen involvement and the role of government in advancing ecological civilization. The findings also demonstrated that green investments, policy environments, public perception, and technology influence the ecological performance of businesses. They also demonstrate statistical robustness with low p-values. This information is essential for developing policies that support an ecological civilization, which is necessary for China and globally in light of the current climate crisis.

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BACKGROUND: Economic prosperity has fostered numerous changes that may translate into better or worse outcomes across all domains of health. This study aims to explore the associations of economic development with uveitis onset in mainland China. METHODS: We used Poisson regression with generalized estimated equations to quantify the associations of per capita gross domestic product (GDP) with uveitis onset in 31 provinces of mainland China from 2006 to 2017. We further estimated the effects mediated by economic growth on the temperature-uveitis and PM2.5-uveitis associations established in our previous studies. RESULTS: A total of 12,721 uveitis patients from 31 provinces of mainland China were studied. Overall, every 10,000 Chinese yuan ($ 1491.278, 2006-2017) increase in per capita GDP, with no weighted value or weighted by population, corresponded to 1.85% (95% confidence interval, 1.19-2.52%) and 1.43% (95% confidence interval, 0.37-2.51%) lnRR decrease in the uveitis onsets. Stratified analysis showed this negative association between per capita GDP and uveitis onset, only existed in male patients (P < .001), individuals aged 20-50 years (P < 0 .05), non-infectious uveitis, uveitis with systemic disease, and Bechet's disease (all P < 0 .05). Moreover, the increased per capita GDP, if above the national level, could reinforce both temperature-uveitis and PM2.5-uveitis association (both P < 0.001). CONCLUSIONS: The findings suggest that economic development is negatively associated with uveitis onset. However, it may facilitate the uveitis onset mediated by both increased temperature and PM2.5 exposure if the per capita GDP is above national level.

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Introduction: In 2019, the East African Community (EAC) lost 12,048,918 disability-adjusted life-years (DALY) across all ages from neglected tropical diseases (NTDs). The specific objectives of the study reported in the paper were to estimate for EAC the monetary value of DALYs sustained by all ages from NTDs, and the potential productivity losses within the working age bracket of 15 years and above. Methods: The EAC total monetary value of DALYs lost from all 20 NTDs is the sum of each partner state's monetary value of DALYs lost from all 20 NTDs. The ith partner state's monetary value of DALY from jth disease equals ith state's GDP per capita net of current health expenditure multiplied by DALYs lost from jth disease in 2019. The EAC total productivity losses attributable to DALYs lost from all 20 NTDs is the sum of lost productivity across the seven partner states. The ith partner state's productivity loss associated with jth disease equals ith state's GDP per capita net of current health expenditure multiplied by DALYs lost from jth disease and the ith state's labour force participation rate adjusted for underutilization (unemployment and time-related underemployment) in 2019. Results: The total 12,048,918 DALYs lost in EAC from NTDs had a of International Dollars (Int$) 21,824,211,076 and an average of Int$ 1811 per DALY. The 2,614,464 DALYs lost from NTD among 15-year-olds and above caused an estimated of Int$ 2,588,601,097 (0.392% of the EAC gross domestic product in 2019), and an average of Int$ 990.1 per DALY. Conclusion: The study succeeded in estimating the monetary value of DALYs sustained by all ages from 20 NTDs, and the potential productivity losses within the working age bracket of 15 years and above in the seven EAC partner states. The DALYs lost from NTD among 15-year-olds and above caused a sizeable loss in the economic productivity of EAC.