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Objective To assess global, regional and national trends in the impact of floods from 1990 to 2022 and determine factors influencing flood-related deaths. Methods 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. Findings 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. Conclusion 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. Objectif Evaluer les tendances mondiales, regionales et nationales relatives a l'impact des inondations entre 1990 et 2022, mais aussi determiner les facteurs influengant les deces causes par ces inondations. Methodes Nous avons exploite les donnees concernant 168 pays et reprises dans la base de donnees internationale sur les catastrophes pour la periode allant de 1990 a 2022. Nous avons ensuite calcule la variation annuelle en pourcentage afin de degager des tendances quant au nombre de personnes touchees, voire tuees par des inondations en fonction de la periode d'etude, de la region telle que definie par l'Organisation mondiale de la Sante (OMS), du niveau de revenu du pays et du type d'inondation. Enfin, nous avons employe une analyse multivariee de regression logistique pour determiner les facteurs associes aux deces en cas d'inondations. Resultats Entre 1990 et 2022, 4713 inondations ont ete recensees dans 168 pays. Elles ont touche plus de 3,2 milliards de personnes, cause 218 353 morts et entraine des pertes economiques superieures a 1,3 billion de dollars americains. La region du Pacifique occidental de l'OMS est celle ou le plus grand nombre d'habitants ont ete affectes par ces phenomenes (> 2 milliards), representant 63,19% (2 024 599 380 / 3 203 944 965) de l'ensemble des populations impactees. C'est la region d'Asie du Sud-Est qui comptait le plus grand nombre de deces (71 713, soit 32,84%). La region Africaine et la region de la Mediterranee orientale denombraient toutes deux la plus grande proportion de personnes touchees et tuees lors d'inondations par 100 000 habitants en 2022. La probability que les inondations soient a l'origine de plus de 50 morts etait nettement plus importante dans les pays a revenu faible (odds ratio ajuste : 14,34; intervalle de confiance a 95% : 7,46 a 30,04) que dans les pays a revenu eleve. Letendue des repercussions et le taux de mortalite des inondations diminuaient au fil du temps. Conclusion Malgre une baisse du nombre de personnes touchees et tuees, les inondations continuent a avoir un impact considerable sur les populations et les economies a travers le monde, surtout dans les pays aux revenus plus faibles. Des actions sont requises pour ameliorer la gestion des risques de catastrophes et la lutte contre les inondations. Objetivo 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. Metodos Se utilizaron datos sobre catastrofes por inundaciones de la Base de Datos Internacional sobre catastrofes para 1990-2022 de 168 paises. Se calculo la variacion porcentual anual para estimar las tendencias de las tasas de personas afectadas y fallecidas por inundaciones segun el periodo de estudio, la region de la Organizacion Mundial de la Salud (OMS), el nivel de ingresos del pais y el tipo de inundacion. Se utilizo un analisis de regresion logistica multivariable para evaluar los factores asociados a la muerte por inundaciones. Resultados Entre 1990 y 2022, se registraron 4713 inundaciones en 168 paises, que afectaron a >3200 millones de personas, causaron 218 353 muertes y fueron responsables de mas de 1,3 billones de dolares estadounidenses de perdidas economicas. La Region del Pacifico Occidental de la OMS fue la mas afectada por las inundaciones (>2000 millones), con un 63,19% (2 024 599 380/3 203 944 965) de todas las poblaciones afectadas. La Region de Asia Sudoriental fue la que registro mas muertes (71 713, 32,84%). Las regiones de Africa y el Mediterraneo Oriental registraron el mayor numero de personas afectadas y fallecidas por inundaciones por cada 100 000 habitantes en 2022. Las probabilidades de que las inundaciones causaran mas de 50 muertes fueron significativamente mayores en los paises de ingresos bajos (razon de probabilidades ajustada: 14,34; intervalo de confianza del 95%: 7,46 a 30,04) en comparacion con los paises de ingresos altos. El numero de personas afectadas y la mortalidad por inundaciones disminuyeron con el tiempo. Conclusion A pesar de la disminucion de las poblaciones afectadas y de las muertes, las inundaciones siguen teniendo un grave impacto en las personas y las economias de todo el mundo, en especial en los paises con ingresos mas bajos. Es preciso actuar para mejorar la gestion del riesgo de catastrofes y la mitigacion de las inundaciones. [phrase omitted], Introduction Natural disasters are catastrophic events of atmospheric, geological and hydrological origins. These disasters include earthquakes, floods, volcanic eruptions, landslides, tsunamis and droughts. (1) From 1998 to 2017, 1.3 million [...]

The primary healthcare system is key to achieving a health equity. In China, great obstacles are challenged by imbalanced medical resources, shortage of primary healthcare providers, and the prevention and treatment of chronic diseases. Artificial intelligence large language models have demonstrated strong advantages in the medical system. This article deeply explored the application of large language models in the primary healthcare system and the challenges. The large language models are expected to assist the diagnosis and treatment of common diseases in grassroot medical institutions, promote intelligent health education and chronic disease management, underpin primary health services in the undeveloped and remote areas, stimulate the leapfrog development of general medicine, and accelerate the industrialization of large language models in general diagnosis and treatment and primary health services, thus providing important support for the construction of healthy China.

Background The "Healthy China 2030" strategy has put forward higher demands for the allocation of health human resources, and more regional studies on the evaluation of the equity of health human resources have been conducted in China, but there is no overview of multiple categories of health human resources in various medical institutions from a national perspective. Objective To describe the trend and equity of 12 categories of health care institutions and 5 categories of health human resources in 31 provinces (autonomous regions and municipalities directly under the central government) nationwide from 2005-2021, so as to provide reference for the optimization of human resource allocation in various health institutions in the future. Methods National data on health human resources was collected from China Public Health Statistical Yearbook (2006-2012), China Health and Family Planning Statistical Yearbook (2013-2017) and China's Hygiene and Health Statistical Yearbook (2018-2022), demographic and economic data was collected from China Statistical Yearbook (2006-2022). The average annual growth rate and concentration index were calculated by collecting the per capita occupancy of each health human resource in medical and health institutions in each province (autonomous regions and municipalities directly under the central government) of China from 2005 to 2021, and the equity analysis was conducted based on the level of economic development. Results The total number of health personnel in China continued to rise, with an average annual growth rate of 5.58%, with faster growth in rural areas at an average annual growth rate of 10.87%; the number of health personnel in community health service centers (stations) had the fastest growth rate (average annual growth rate of 18.05%), the number of personnel in health supervision offices grew at a lower rate (average annual growth rate of 0.18%), and the number of personnel in disease prevention and control centers showed a decreasing trend (average annual growth rate of -0.39%). Except for community health service centers (stations), the concentration index of the total number of health personnel in all types of medical institutions was

New chiral targets of orientational chirality have been designed and asymmetrically synthesized by taking advantage of N‐sulfinyl imine‐directed nucleophilic addition/oxidation, Suzuki‐Miyaura, and Sonogashira cross‐coupling reactions. Orientation of single isomers has been selectively controlled by using aryl/alkynyl levers [C(sp2)‐C(sp) axis] and tBuSO2‐ protecting group on nitrogen as proven by X‐ray diffraction analysis. The key structural characteristic of resulting orientational products is shown by remote through‐space blocking manner. Seventeen examples of multi‐step synthesis were obtained with modest to good chemical yields and complete orientational selectivity. [ABSTRACT FROM AUTHOR]