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There is limited data on the influence of various factors on mammography accuracy in low- and middle-income regions. In this cross-sectional study using registry data, we examined the sensitivity of screening mammograms by comparing mammography results with biopsies-confirmed breast cancer diagnoses in the state of São Paulo, Brazil. Additionally, we evaluate factors related to the screened women and to the breast lesions that could affect false-positive mammograms results. All screening mammograms conducted from January to December 2012 and biopsy results from January 2012 to December 2013 in the São Paulo State were retrieved from the Brazilian Breast Cancer Information System. We gathered details on women-related factors such as age, hormone therapy usage, prior radiotherapy, skin color, education level, skin type, breast density, and familial history of cancer, as well as on breast lesions, including type, size, characteristics, edges, and topographic site on the breast. To assess the risk effect of these factors on false-positive mammography results, we employed logistic regression analyses. Our results indicate that age under 50 years, use of hormone therapy, dense breasts, lesions smaller than 10 mm with defined edges, and the presence of calcifications were predictors of false-positive mammograms results. Finally, we observed that false-positives lead to longer times to diagnosis. These findings are relevant for the planning and management of organized breast cancer screening programs.

This paper examines the environmental Kuznets curve (EKC) relationship between energy consumption and economic growth in upper-middle-income regions of China with the panel data of 21 provinces from 2000 to 2017. The influence mechanism of socio-economic factors on the EKC of these regions is also detected. The results show that the energy consumption EKC fitting map in these regions conforms to the classical environmental Kuznets curve, which is an inverted “N” type, and the inflection point is ahead and more accurate after adding spatial effects. The direct effect of energy consumption has delayed the inflection point, indicating that the level of industrialization, urbanization, and population density have a significant impact on EKC. At the same time, it is found that the level of industrialization and population density have a positive relationship with energy consumption, while the level of urbanization has a negative correlation with energy consumption. The spatial spillover effect of the indirect effects of total energy consumption, coal consumption, and crude oil consumption shows that the level of industrialization has a significant and negative link with EKC. The increase in the level of industrialization will affect the total energy consumption of neighboring areas and the consumption of coal and crude oil.

The sustainability of rural groundwater supply infrastructure, primarily boreholes fitted with hand pumps, remains a challenge. This study evaluates whether coverage targets set out within the Millennium Development Goals (MDG) inadvertently increased the challenge to sustainably manage water supply infrastructure. Furthermore, the drive towards decentralised service delivery contributes to the financial burden of water supply assets. A sample size of 14,943 Afridev hand pump boreholes was extracted from a comprehensive live data set of 68,984 water points across Malawi to investigate the sustainability burden as emphasis shifts to the 2030 agenda. The results demonstrate that the push for coverage within the MDG era has impacted the sustainability of assets. A lack of proactive approaches towards major repairs and sub-standard borehole construction alongside aging infrastructure contributes to reduced functionality of decentralised supplies. Furthermore, costly rehabilitation is required to bring assets to operational standards, in which external support is commonly relied upon. Acceleration towards the coverage targets has contributed towards unsustainable infrastructure that has further implications moving forward. These findings support the need for Sustainable Development Goals (SDG) investment planning to move from a focus on coverage targets to a focus on quality infrastructure and proactive monitoring approaches to reduce the future burden placed on communities.

Depopulated rural or post-industrial areas, which are often low-income with fewer job opportunities, represent an open challenge for the European Union. Sharp demographic declines especially in Eastern and Southern Europe, due to the intra-EU migration of younger, skilled workers from these areas have become a serious obstacle to the sustainable development of many EU lower-income regions. The European Parliament highlights the gap in ICT connectivity among other reasons.  This paper aims to provide empirical evidence, by applying Panel Data Analysis, that digitalisation of European NUTS-2 regions with lower incomes via Broadband Access may contribute to reversing negative demographic trends. 

Substantial progress has been seen in the drinking water supply as per the Millennium Development Goals (MDG), but achieving the Sustainable Development Goals (SDG), particularly SGD 6.1 regarding safely managed drinking water with much more stringent targets, is considered as a development challenge. The problem is more acute in low-income water-scarce hard-to-reach areas such as the southwest coastal region of Bangladesh, where complex hydrogeological conditions and adverse water quality contribute to a highly vulnerable and insecure water environment. Following the background, this study investigated the challenges and potential solutions to drinking water insecurity in a water-scarce area of southwest coastal Bangladesh using a mixed-methods approach. The findings revealed that water insecurity arises from unimproved, deteriorated, unaffordable, and unreliable sources that have significant time and distance burdens. High rates of technical dysfunction of the existing water infrastructure contribute to water insecurity as well. Consequently, safely managed water services are accessible to only 12% of the population, whereas 64% of the population does not have basic water. To reach the SDG 6.1 target, this underserved community needs well-functioning readily accessible water infrastructure with formal institutional arrangement rather than self-governance, which seems unsuccessful in this low-income context. This study will help the government and its development partners in implementing SDG action plans around investments to a reliable supply of safe water to the people living in water-scarce hard-to-reach coastal areas.

Karangasem region is the lowest income region in Bali Province-Indonesia. The people are highly dependent on using motorcycle for their daily movement. Karangasem has a high fatality rate of traffic accidents. There are 190 cases of the traffic accident and causing the death of 140 people. The number of accidents involving motorcycles are 172 cases. The objective of this study is to investigate factors that influence fatal traffic accidents involving motorcycles. This study used traffic accident data over 6 years period from 2007-2012 and applied logistic regression. It was found that there are four variable significantly affect accident fatality at 95% confidence level, i.e. accident location, collision type, violation type, and age.

This study aims to determine the Capital Expenditure and Income Original Region is considered to have a significantly positive effect on the increase in income per capita in the Government of North Sumatera Province and West Java Province. The method of research in this thesis is by using a causal research design, with a sample of 25 districts/cities in North Sumatera Province and West Java Province. This study was conducted for the period 2012-2015. The type of data used is secondary data. The method of analysis used in this research is SEM method using software AMOS. The result of this hypothesis shows that simultaneously both independent variables significantly influence to increase of income per capita.

Small scale producers in developing countries lack easy access to efficient logistics services. They are faced with long distances from both domestic and international markets. Unless they consolidate their trade volumes they face high costs which diminish their ability to trade. However, the process of consolidation is not without cost nor does it occur on its own accord. As a result, the consolidation is typically handled by intermediaries. Using case studies of sisal and soybean supply chains in Brazil and India respectively, this study explores the role and impact of intermediaries in facilitating trade in lagging regions. The study assesses the horizontal relationships between the small scale producers in thin markets and the vertical connections between different tiers of the same supply chain. The study analyzes the traditional approach to linking producers namely through cooperatives and itinerant traders and the relatively newer innovations using ICT. The study finds that farmers linked through the different mechanisms are more integrated to international supply chains or are able to better manage supply chains longer than would otherwise be the case. Intermediaries play several roles including providing transport services and facilitating market exchanges, payments, risk sharing and quality improvements. Generally, information technology driven innovations make it easier to integrate adjacent steps in the value chain. This report on logistics performance at the sub-national level is an on-going endeavour. Similar analysis is being carried out in some countries in Africa to identify the evolving role of intermediaries in low income regions. The results will be developed into a major publication on this topic, with recommendations on how development agencies, civil society and the private sector can improve the design of strategies to reduce logistics costs in low income areas.

This paper examines whether Japanese regional banks entering the banking market in other prefectures, including neighboring prefectures, can increase their lending-based income. To stimulate local economies and support local small- and medium-sized enterprises, the current Japanese Government's policies for regional banks require these banks to engage in region-based relationship banking practices. In this study, three lending-based income measures were used as dependent variables, and estimation was made using panel data from Japanese regional banks. As a result, it was determined that regional banks that enter markets in other prefectures experience positive effects in all three lending-based income measures. Moreover, it was determined that regional banks whose headquarters are located in non-urban areas derive greater benefit from their loan businesses upon entry into other prefectures, including neighboring prefectures, where economic activity is more vibrant than regional banks whose headquarters are located in urban areas.