Does digitalization mitigate regional inequalities?Evidence from China

Regional inequality significantly influences sustainable development and human well-being.In China,there exists pronounced regional disparities in economic and digital advancements;however,scant research delves into the interplay between them.By analyzing the economic development and digitalization gaps at regional and city levels in China,extending the original Cobb-Douglas production function,this study aims to evaluate the impact of digitalization on China's regional inequality using seemingly unrelated regression.The results indicate a greater emphasis on digital inequality compared to economic disparity,with variable coefficients of 0.59 for GDP per capita and 0.92 for the digitalization index over the past four years.However,GDP per capita demonstrates higher spatial concentration than digitalization.Notably,both disparities have shown a gradual reduction in recent years.The southeastern region of the Hu Huanyong Line exhibits superior levels and rates of economic and digital advancement in contrast to the northwestern region.While digitalization propels economic growth,it yields a nuanced impact on achieving balanced regional development,encompassing both positive and negative facets.Our study highlights that the marginal utility of advancing digitalization is more pronounced in less developed regions,but only if the government invests in the digital infrastructure and education in these areas.This study's methodology can be utilized for subsequent research,and our findings hold the potential to the government's regional investment and policy-making.

COVID-19 and regional resilience:Trends,priorities,and the geography of research

The global economic crisis of 2008-2013 led to the emergence of the concept of resilience,which focuses on the ability of socio-economic system store cover socially,economically,and environmentally after external impacts.The COVID-19 pandemic spurred scholarly interest in regional resilience as a new conceptual framework for the sustainability theory.This paper aims to examine the influence of the pandemic on the trends and geography of regional resilience studies.We analyzed data derived from Science Direct and used vOSviewer to perform clus-tering and bibliometric network analysis.The countries that suffered the most from the pandemic and showed the largest regional socioeconomic disparities have become new centers of knowledge on regional resilience.Moreover,the pandemic has led to a visible shift in the research focus.Thus,after 2020,more attention has been paid to the structural and topological characteristics of regions that enable them to reorganize their resources more effectively in times of crisis.This study investigates the potential of the resilient development concept as a framework for gaining insights into the factors supporting regional adaptability.

Enhancing Autonomy Capability in Regional Power Grids:A Strategic Planning Approach with Multiple Autonomous Evaluation Indexes

After the integration of large-scale DistributedGeneration(DG)into the distribution network,the randomness and volatility of its output result in a reduction of spatiotemporal alignment between power generation and demand in the distribution network,exacerbating the phenomenon of wind and solar power wastage.As a novel power system model,the fundamental concept of Regional Autonomous Power Grids(RAPGs)is to achieve localized management and energy autonomy,thereby facilitating the effective consumption of DGs.Therefore,this paper proposes a distributed resource planning strategy that enhances the autonomy capabilities of regional power grids by considering multiple evaluation indexes for autonomy.First,a regional Energy Storage(ES)configuration strategy is proposed.This strategy can select a suitable reference value for the upper limit of ES configuration based on the regional load andDGoutput to maximize the elimination of source load deviations in the region as the upper limit constraint of ES capacity.Then,a control strategy for regional ES is proposed,the charging and discharging reference line of ES is set,and multiple autonomy and economic indexes are used as objective functions to select different proportions of ES to control the distributed resources of the regional power grid and establish evaluation indexes of the internal regional generation and load power ratio,the proportion of power supply matching hours,new energy consumption rate and tie line power imbalance outside the region to evaluate changes in the regional autonomy capabilities.The final simulation results showthat in the real regional grid example,the planning method in the planning year in the region of the overall power supply matching hour ratio and new energy consumption rate increased by 3.9%and 4.8%on average,and the power imbalance of the tie line decreased by 7.8%on average.The proposed planning approach enables the maximization of regional autonomy while effectively smoothing the fluctuation of power exchange between the regional grid and the higher-level grid.This presents a rational and effective planning solution for the regional grid,facilitating the coordinated development between the region and the distribution network.

Construction and Application of a Regional Kilometer-Scale Carbon Source and Sink Assimilation Inversion System(CCMVS-R)

CO_(2)is one of the most important greenhouse gases(GHGs)in the earth’s atmosphere.Since the industrial era,anthropogenic activities have emitted excessive quantities of GHGs into the atmosphere,resulting in climate warming since the 1950s and leading to an increased frequency of extreme weather and climate events.In 2020,China committed to striving for carbon neutrality by 2060.This commitment and China’s consequent actions will result in significant changes in global and regional anthropogenic carbon emissions and therefore require timely,comprehensive,and objective monitoring and verification support(MVS)systems.The MVS approach relies on the top-down assimilation and inversion of atmospheric CO_(2)concentrations,as recommended by the Intergovernmental Panel on Climate Change(IPCC)Inventory Guidelines in 2019.However,the regional high-resolution assimilation and inversion method is still in its initial stage of development.Here,we have constructed an inverse system for carbon sources and sinks at the kilometer level by coupling proper orthogonal decomposition(POD)with four-dimensional variational(4DVar)data assimilation based on the weather research and forecasting-greenhouse gas(WRF-GHG)model.Our China Carbon Monito ring and Verification Support at the Regional level(CCMVS-R)system can continuously assimilate information on atmospheric CO_(2)and other related information and realize the inversion of regional and local anthropogenic carbon emissions and natural terrestrial ecosystem carbon exchange.Atmospheric CO_(2)data were collected from six ground-based monito ring sites in Shanxi Province,China to verify the inversion effect of regio nal anthropogenic carbon emissions by setting ideal and real experiments using a two-layer nesting method(at 27 and 9 km).The uncertainty of the simulated atmospheric CO_(2)decreased significantly,with a root-mean-square error of CO_(2)concentration values between the ideal value and the simulated after assimilation was close to 0.The total anthropogenic carbon emissions in Shanxi Province in 2019 from the assimilated inversions were approximately 28.6%(17%-38%)higher than the mean of five emission inventories using the bottomup method,showing that the top-down CCMVS-R system can obtain more comprehensive information on anthropogenic carbon emissions.

Uncertainties of ENSO-related Regional Hadley Circulation Anomalies within Eight Reanalysis Datasets

El Nino-Southern Oscillation(ENSO),the leading mode of global interannual variability,usually intensifies the Hadley Circulation(HC),and meanwhile constrains its meridional extension,leading to an equatorward movement of the jet system.Previous studies have investigated the response of HC to ENSO events using different reanalysis datasets and evaluated their capability in capturing the main features of ENSO-associated HC anomalies.However,these studies mainly focused on the global HC,represented by a zonal-mean mass stream function(MSF).Comparatively fewer studies have evaluated HC responses from a regional perspective,partly due to the prerequisite of the Stokes MSF,which prevents us from integrating a regional HC.In this study,we adopt a recently developed technique to construct the three-dimensional structure of HC and evaluate the capability of eight state-of-the-art reanalyses in reproducing the regional HC response to ENSO events.Results show that all eight reanalyses reproduce the spatial structure of HC responses well,with an intensified HC around the central-eastern Pacific but weakened circulations around the Indo-Pacific warm pool and tropical Atlantic.The spatial correlation coefficient of the three-dimensional HC anomalies among the different datasets is always larger than 0.93.However,these datasets may not capture the amplitudes of the HC responses well.This uncertainty is especially large for ENSO-associated equatorially asymmetric HC anomalies,with the maximum amplitude in Climate Forecast System Reanalysis(CFSR)being about 2.7 times the minimum value in the Twentieth Century Reanalysis(20CR).One should be careful when using reanalysis data to evaluate the intensity of ENSO-associated HC anomalies.

Regional economic assessment of a novel place-based model for sustainable food systems

Several actions from both the environmental and human viewpoints have already been made to meet the sustainability goals targeted at food systems.Still,new place-based ideas to improve sustainability are needed.Agroecological symbiosis(AES),a novel food system model,is an example of a suggested system-level change to attain sustainability targets;it is a symbiosis of food production and processing using renewable energy that uses its own feedstock.AES has already been found advantageous from the ecological and biophysical viewpoints,but a regional economic evaluation of the model is still lacking.Thus,the aim of our paper is to assess the regional economic impact of a possible systemic change in the food system using the network of agroecological symbiosis(NAES)as an example.We applied scenarios representing different ways of moving towards envisioned NAES models in Mäntsälä,Finland,and a computable general equilibrium model to evaluate the regional economic impact.According to our results,both regional economy and employment would increase,and the regional production base would diversify with NAES implementation applied to the region,but the extent of the benefits varies between scenarios.The scenario that includes change in both public and private food demand,production of bioenergy and utilization of by-products would cause the largest impacts.However,realizing NAES requires investments that may influence the actual implementation of such models.Nonetheless,a change towards NAES can promote an economically and spatially just transition to sustainability,as NAES seems to be economically most beneficial for rural areas.

Individual alcohol consumption by the population of Russia versus regional living conditions

Background:There are substantial regional differences in drinking alcohol in Russia,both at the population and individual levels.However,the causes of these differences have not been studied yet.Objective:The goal of our study was to examine the effect of regional living conditions on individual alcohol consumption by the population of Russia.Methods:For the analysis,we used data from a cross-sectional epidemiological study conducted in 2013-2014.The final analytical sample included 18,130 people aged 25-64 years.We conducted the interviews face to face,based on which any drinking in the last year,as well as alcohol abuse,were considered as a response.Alcohol abuse was recorded when the respondent consumed 5.75 or more grams of pure ethanol per day(75th percentile of average daily alcohol consumption among alcohol drinkers).The assessment of the regional living conditions was accomplished via integral indexing,which was previously performed based on publicly available data for 2010-2014.Associations were assessed using generalized scoring equations with unchanging standard errors.The associations were expressed by odds ratios(OR)and 95%confidence intervals(C).Results:Deterioration of social conditions and increase in demographic depression in the region of residence increased the odds of any drinking(OR 1.51,95%CI:1.33 to 1.72,P<0.001 and OR 1.22,95%CI:1.05 to 1.41,P=0.oo9,respectively).The odds of alcohol abuse increased with the deterioration of social living conditions and the growth of the industrial development in the region:OR 1.35,95%CI:1.14 to 1.59,P<0.001 and OR 1.16,95%CI:1.05 to 1.28,P=0.002,respectively.Conclusion:Our analysis allowed assessing the impact of the regional living conditions on individual drinking alcohol in the population of Russia.

Online identification and extraction method of regional large-scale adjustable load-aggregation characteristics

This article introduces the concept of load aggregation,which involves a comprehensive analysis of loads to acquire their external characteristics for the purpose of modeling and analyzing power systems.The online identification method is a computer-involved approach for data collection,processing,and system identification,commonly used for adaptive control and prediction.This paper proposes a method for dynamically aggregating large-scale adjustable loads to support high proportions of new energy integration,aiming to study the aggregation characteristics of regional large-scale adjustable loads using online identification techniques and feature extraction methods.The experiment selected 300 central air conditioners as the research subject and analyzed their regulation characteristics,economic efficiency,and comfort.The experimental results show that as the adjustment time of the air conditioner increases from 5 minutes to 35 minutes,the stable adjustment quantity during the adjustment period decreases from 28.46 to 3.57,indicating that air conditioning loads can be controlled over a long period and have better adjustment effects in the short term.Overall,the experimental results of this paper demonstrate that analyzing the aggregation characteristics of regional large-scale adjustable loads using online identification techniques and feature extraction algorithms is effective.

Regional Block Anesthesia in Breast Surgery: What Do We Know So Far?

Breast cancer is the most prevalent cancer in women worldwide, and pain following mastectomy is a major post-surgical complication. This paper highlights the risk factors for chronic pain in breast surgery and evaluates various regional block techniques used to reduce post-operative pain, and minimize hospital stays in high-risk patients. Further research is needed to evaluate the effectiveness of novel regional anaesthesia techniques in an enhanced recovery context, and to assess their role in preventing or reducing chronic pain.

Current evidence on artificial intelligence in regional anesthesia

The recent advancement in regional anesthesia(RA)has been largely attributed to ultrasound technology.However,the safety and efficiency of ultrasound-guided nerve blocks depend upon the skill and experience of the performer.Even with adequate training,experience,and knowledge,human-related limitations such as fatigue,failure to recognize the correct anatomical structure,and unintentional needle or probe movement can hinder the overall effectiveness of RA.The amalgamation of artificial intelligence(AI)to RA practice has promised to override these human limitations.Machine learning,an integral part of AI can improve its performance through continuous learning and experience,like the human brain.It enables computers to recognize images and patterns specifically useful in anatomic structure identification during the performance of RA.AI can provide real-time guidance to clinicians by highlighting important anatomical structures on ultrasound images,and it can also assist in needle tracking and accurate deposition of local anesthetics.The future of RA with AI integration appears promising,yet obstacles such as device malfunction,data privacy,regulatory barriers,and cost concerns can deter its clinical implementation.The current mini review deliberates the current application,future direction,and barrier to the application of AI in RA practice.

Analysis of Regional Difference of Agricultural Land Productivity in Heilongjiang Province

The sustenance of humanity is contingent upon the production of food.The foundation of this production is agriculture,which in turn is dependent upon the cultivation of the land.As a fundamental element of agricultural advancement,the rational development and utilization of land play a pivotal role in the process of rural revitalization.Agricultural land productivity serves as a principal indicator of the efficacy of land utilization and the extent of agricultural advancement.Nevertheless,there is a paucity of research examining the productivity of agricultural land,particularly a lack of specialized research on large agricultural provinces.In light of the aforementioned considerations,this paper presents a comprehensive examination of agricultural land productivity and its regional variations in Heilongjiang Province in 2022,with the aid of pertinent statistical data.The findings of the analysis indicate that among the prefecture-level cities,Daqing and Suihua exhibit the highest levels of agricultural land productivity.Additionally,Zhaodong City,Zhaozhou,Qinggang,Wangkui,and Lanxi counties exhibit high levels of agricultural land productivity within their respective prefecture-level cities.There are notable disparities in agricultural land productivity across various regions,including Yichun,Heihe,Harbin,Daqing,Hegang,and Suihua.In contrast,other regions demonstrate a more balanced spatial distribution.In order to facilitate the prosperous development of the agricultural industry in Heilongjiang Province,it is essential to optimize the spatial planning of the land,to investigate the potential for agricultural development in each region,to establish effective collaboration between resources and industries,and to create a development synergy that will collectively advance rural revitalization.

Effectiveness and safety of rocuronium or nitroglycerin plus ropivacaine on pain during intravenous regional anesthesia:A double-blind randomized controlled trial

Objective:To compare the effects of adding rocuronium and nitroglycerin to ropivacaine in intravenous regional anesthesia(IVRA)on pain and hemodynamic parameters.Methods:This randomized controlled trial was done in 2023.Participants were 177 candidates for forearm operation surgery under IVRA selected from Valiasr Hospital,Arak,Iran.They were allocated by block randomization to three different groups,namely nitroglycerin group,rocuronium group and control group.Hemodynamic parameters were recorded before tourniquet application up to postoperative recovery time.Sensory block and motor block onset and duration and pain were also evaluated.The data analysis was carried out by IMB SPSS software 20.0.Results:177 Eligible patients were included in study,with 59 in each group.Time to sensory and motor block onset in the nitroglycerin group was significantly less than the other groups and the time of motor block in the rocuronium group was statistically higher than the control and the nitroglycerin groups(P<0.001).Seven participants in the nitroglycerin group experienced headache and three from the rocuronium group experienced dizziness.The side effects occurrence in the nitroglycerin group was more prevalent than in the control and rocuronium groups(P=0.009).Conclusions:Nitroglycerin significantly reduces the time to sensory and motor block onset,while rocuronium is more effective in prolonging the time of motor block.Although there is no difference between nitroglycerin and rocuronium respecting the pain score and opioid need administration,nitroglycerin is associated with a higher prevalence of medication side effects.Therefore,both nitroglycerin and rocuronium can be used as adjuvant for IVRA.The final choice relies on patients’conditions and anesthesiologists’judgment.

Resilience-Oriented Load Restoration Method and Repair Strategies for Regional Integrated Electricity-Natural Gas System

The rising frequency of extreme disaster events seriously threatens the safe and secure operation of the regional integrated electricity-natural gas system(RIENGS).With the growing level of coupling between electric and natural gas systems,it is critical to enhance the load restoration capability of both systems.This paper proposes a coordinated optimization strategy for resilience-enhanced RIENGS load restoration and repair scheduling and transforms it into a mixed integer second-order cone programming(MISOCP)model.The proposed model considers the distribution network reconfiguration and the coordinated repair strategy between the two systems,minimizing the total system load loss cost and repair time.In addition,a bi-directional gas flow model is used to describe the natural gas system,which can provide the RIENGS with more flexibility for load restoration during natural gas system failure.Finally,the effectiveness of the proposed approach is verified by conducting case studies on the test systems RIENGS E13-G7 and RIENGS E123-G20.

Complex Regional Pain Syndrome: Outpatient Pain Management in the Chronic Setting: A Case Report

Background: Complex Regional Pain Syndrome (CRPS), previously known as reflex sympathetic dystrophy and causalgia, is a neuropathic pain condition that usually develops after an injury to an extremity. CRPS can be a debilitating condition with high levels of pain and reduced function. Aim: This case report aims to discuss the multimodal approach in the management of a patient who presented with ongoing poorly controlled pain secondary to CRPS from an injury that happened years prior. Case Presentation: A 45-year-old female was involved in a motor vehicle accident where her right leg was injured. She underwent several surgeries and developed CRPS that significantly reduced her mobility and quality of life. She presented to the pain clinic years after her initial injury and a multimodal regimen was started for her resulting in significantly improved function. Conclusion: CRPS can be a severely debilitating condition. While early diagnosis and management are important, ongoing management in the outpatient chronic pain setting is important in maintaining a good level of function.

Specialization and Coordination: New Paradigm, Theory, and Path for Regional Development

In its new development stage,China seeks to derive new dynamism from reform and opening up at a higher level to boost consumption and services.This process coincides with a further differentiation of comparative advantages across regions.Economic activity and population will continue to concentrate in clusters in coastal and central cities amid a continuous outflow of population from remote areas.Development expansion from coastal to interior regions and from central cities to the periphery will promote a new regional development paradigm of“dual centers and periphery”.Therefore,China’s regional development strategy should follow the new theory of seeking relative equilibrium amid development,identify regions of population inflow and outflow,and explore a new development path of regional specialization and coordination.By deepening market reforms and increasing central government coordination,the country is poised to improve the spatial allocation of resources and unleash institutional dividends in the process of developing a unified national market.

Regional Rainfall Damage Functions to Estimate Direct Economic Losses in Rainstorms:A Case Study of the 2016 Extreme Rainfall Event in Hebei Province of China

Developing a regional damage function to quickly estimate direct economic losses(DELs)caused by heavy rain and foods is crucial for providing scientifc supports in efective disaster response and risk reduction.This study investigated the factors that infuence regional rainfall-induced damage and developed a calibrated regional rainfall damage function(RDF)using data from the 2016 extreme rainfall event in Hebei Province,China.The analysis revealed that total precipitation,asset value exposure,per capita GDP,and historical geological disaster density at both the township and county levels signifcantly afect regional rainfall-induced damage.The coefcients of the calibrated RDF indicate that doubling the values of these factors leads to varying increases or decreases in rainfall-induced damage.Furthermore,the study demonstrated a spatial scale dependency in the coefcients of the RDF,with increased elasticity values for asset value exposure and per capita GDP at the county level compared to the township level.The fndings emphasize the challenges of applying RDFs across multiple scales and highlight the importance of considering socioeconomic factors in assessing rainfall-induced damage.Despite the limitations and uncertainties of the RDF developed,this study contributes to our understanding of the relationship between physical and socioeconomic factors and rainfall-induced damage.Future research should prioritize enhancing exposure estimation and calibrating RDFs for various types of rainfall-induced disasters to improve model accuracy and performance.The study also acknowledges the variation in RDF performance across diferent physical environments,especially concerning geological disasters and slope stability.

Asia Pacific Regional Young Professional Campaign held in Shenzhen

Jointly supported by the Secretariat of IEC and SAC,the 2024 Asia Pacific Regional Young Professional(APRE YP)Campaign was successfully held in Shenzhen from June 25 to 30.The event was hosted by the Quality and Standards Academy,Shenzhen Technology University(SZTU),guided by the IEC Asia-Pacific Regional Center and the IEC Academy&Capacity Building.The 6-day event included roundtable discussion,theme discussion,expert lectures,business practice,and other activities,which were participated by 27 young experts from Singapore,Malaysia,Thailand,Vietnam,Laos,Myanmar,Cambodia,Russia,and China.

Coupling coordinated development among digital economy,regional innovation,and talent employment:A case study in the Hangzhou Metropolitan Circle,China

Coordinative development across various systems,particularly the economic,social,cultural,and human resources subsystems,is a key aspect of urban sustainability and has a direct impact on the quality of urbanization.The Hangzhou Metropolitan Circle,comprising Hangzhou City,Huzhou City,Jiaxing City,and Shaoxing City,was the first metropolitan circle approved by the National Development and Reform Commission(NDRC)as a demonstration of economic transformation in China.To evaluate the coupling coordination degree of the four cities and analyze the coordinative development in three systems(including digital economy,regional innovation,and talent employment),we collected panel data during 2015–2022 from these four cities.The development level of the three systems was evaluated by the standard deviation method and comprehensive development index.The results are as follows:(1)the level of coupling coordinated development of the three systems in the Hangzhou Metropolitan Circle was relatively low;(2)the coupling coordination degree of the four cities in the Hangzhou Metropolitan Circle showed significant regional differences,among which Hangzhou City was in the leading position,and Huzhou,Jiaxing,and Shaoxing cities made steady but slow progress in the coupling development of the three systems;and(3)the development of digital economy and talent employment needs to be strengthened.This study contributes to the coordinative development of Hangzhou Metropolitan Circle by innovatively focusing on the coupling coordination relationship among digital economy,regional innovation,and talent employment,which also meets the industrial layout of Hangzhou Metropolitan Circle.In this way,the optimal allocation and sustainable development of digital economy,regional innovation,and talent employment in the Hangzhou Metropolitan Circle can be achieved.

Training Mode of Design Talents under the Concept of Regional Revitalization and Industrial Upgrading

Based on the background of the revitalization of Northeast China and industrial transformation,with the goal of serving society with design,leading the future with design,and revitalizing the economy with design,we adhere to the innovative,comprehensive and cultural design talent cultivation concept,fully practice the“student-centered,output-oriented,continuously-improving”educational philosophy taking quality as the first priority,and continuously improve the theoretical system and implementation path for cultivation of postgraduate talents in design science,hoping to optimize the entire process of talent cultivation.Meanwhile,on the basis of“fostering character and civic virtue,cultivating people in a three-all manner,and cultivating people from five aspects simultaneously”,we cultivate high-quality design talents with brand-new models and ideas,through a series of educational reform measures,such as strategic cooperation,resource integration,systematic sorting,quality improvement,standard formulation,strengthening characteristics,platform construction,so that the quality of talents and social development can be perfectly integrated and mutually assist each other to achieve a win-win effect,and the training of design talents can be implemented and serve the society.

Prostate cancer temporal and regional trends in Brazil

Objectives:The Brazilian Unified Health System(SistemaÚnico de Saúde−SUS)is the universal public healthcare system of Brazil that maintains a nationwide database of its patients.Our primary objective was to analyze regional and temporal trends,while our secondary goal was to establish correlations between states’health economy status and their prostate cancer(PCa)epidemiology.Methods:We analyzed Brazil’s nationwide data on prostate cancer(PCa)incidence,mortality,and care gathered between 2013 and 2021 by the Information Technology Department of SUS(DATA-SUS),updated monthly using the International Classification of Diseases(ICD-10)code.Results:In the period,273,933 new cases of PCa and 135,336 PCa deaths were reported in men aged 50 years or over in Brazil.The median annual PCa-specific incidence rate(PCSIR)ranged from 14.7 in the Southeast to 6.9 in the North region and the median annual PCa-specific mortality rate(PCSMR)ranged from 7.7 in the Northeast to 6.0 in the South region(per 10,000 men>50).The median annual mortality to incidence ratio(MIR)was highest in the North(0.88)and lowest in the Southeast region(0.44).There were significant regional differences in PCa treatment rates(per new cases);the Midwest region had the highest median annual surgery rate(0.63)while the North region had the highest median annual systemic therapy rate(0.75)and the lowest radiation therapy rate(0.06).Temporal analysis of the data showed significant change in annual rate trends after the year 2018 for PCSIR(coefficient[β]=+3.66,p<0.001),any treatment(β=−0.06,p=0.016),surgery([SR]β=+0.05,p=0.017)radiation therapy([RTR]β=−0.06,p=0.005)and systemic therapy([STR]β=−0.10,p=0.002).After the 2020 pandemic,annual PCSIR decreased(β=−2.15,p=0.002)but annual PCSMR,MIR,and treatment rates remained stable.Correlation studies showed that the PCSIR was strongly negatively correlated with STR(p<0.001)and positively correlated with RTR(p=0.004).MIR was positively correlated with STR(p<0.001)and negatively correlated with the number of robotic surgical systems per million population(p=0.003).Conclusion:Our data shows that PCa care is dependent on the region and is likely influenced by access to treatment options.Furthermore,changes after the year 2018 underscore the influence of international guidelines on Brazilian clinicians’decision-making especially concerning population screening which in turn affected incidence and treatment rates.Limitation of our study includes limited patientrelated information and data on private practices as well as an unknown impact of traveling patients.