Category: Nevin Manimala

East Mediterr Health J. 2022 Mar 29;28(3):204-212. doi: 10.26719/emhj.22.007.

ABSTRACT

BACKGROUND: The main social contradictions in China have changed: the core concept is high quality development. Health care investment improves the health of residents and promotes regional economic growth.

AIMS: To analyse the direct and indirect economic effects of health expenditure during 2012-2018 and to test whether China’s investment in health care meets the requirements for high quality development.

METHOD: We selected spatial panel data reflecting the input and output of health resources. We used the knowledge production function and a model of spatial economics to conduct empirical analysis of 31 provinces to show the effects of health expenditure on economic growth.

RESULTS: Economic development (LnGDP) was the dependent variable; explanatory variables included health financial input (LnHI), health personnel input (LnHR), health assets (LnCW) and health insurance expenditure (LnHIE). The regression coefficients for indirect, direct and total effects of LnHI were 0.4346, 0.0623 and 0.4970 respectively (all statistically significant). The direct effect coefficient of LnHR (0.3343) was statistically significant. The regression coefficients for the indirect and total effects were -0.6779 and -0.3436, respectively. The direct, indirect and total effect regression coefficients for LnCW and LnHIE were all statistically significant.

CONCLUSION: Both LnHI and LnHIE positively promote economic growth within provinces and in neighbouring provinces, i.e. there are direct and indirect positive effects from investing in health care. Increasing the input of health care personnel can promote the economic growth of a province but not that of neighbouring provinces. Overall planning and coordinated development will facilitate high quality development and economic advancement.

PMID:35394052 | DOI:10.26719/emhj.22.007

Biometrics. 2022 Apr 8. doi: 10.1111/biom.13670. Online ahead of print.

ABSTRACT

Gene-environment (G×E) interactions have important implications to elucidate the etiology of complex diseases beyond the main genetic and environmental effects. Outliers and data contamination in disease phenotypes of G×E studies have been commonly encountered, leading to the development of a broad spectrum of robust regularization methods. Nevertheless, within the Bayesian framework, the issue has not been taken care of in existing studies. We develop a fully Bayesian robust variable selection method for G×E interaction studies. The proposed Bayesian method can effectively accommodate heavy-tailed errors and outliers in the response variable while conducting variable selection by accounting for structural sparsity. In particular, for the robust sparse group selection, the spike-and-slab priors have been imposed on both individual and group levels to identify important main and interaction effects robustly. An efficient Gibbs sampler has been developed to facilitate fast computation. Extensive simulation studies, analysis of diabetes data with SNP measurements from the Nurses’ Health Study and TCGA melanoma data with gene expression measurements demonstrate the superior performance of the proposed method over multiple competing alternatives. This article is protected by copyright. All rights reserved.

PMID:35394058 | DOI:10.1111/biom.13670

Med Mycol. 2022 Apr 8:myac026. doi: 10.1093/mmy/myac026. Online ahead of print.

ABSTRACT

COVID-19 associated pulmonary aspergillosis (CAPA) incidence varies depending on the country. Serum galactomannan quantification is a promising diagnostic tool since samples are easy to obtain with low biosafety issues. A multicenter prospective study was performed to evaluate the CAPA incidence in Argentina and to assess the performance of the lateral flow assay with digital readout (Sōna Aspergillus LFA) as a CAPA diagnostic and screening tool. The correlation between the values obtained with Sōna Aspergillus LFA and Platelia® EIA was evaluated. In total, 578 serum samples were obtained from 185 critically ill COVID patients. CAPA screening was done weekly starting from the first week of ICU stay. Probable CAPA incidence in critically ill patients was 10.27% (19/185 patients when LFA was used as mycological criteria) and 9% (9/100 patients when EIA was used as mycological criteria). We found a very good correlation between the two evaluated galactomannan quantification methods (overall agreement of 92.16% with a Kappa statistic value of 0.721). CAPA diagnosis (>0.5 readouts in LFA) were done during the first week of ICU stay in 94.7% of the probable CAPA patients. The overall mortality was 36.21%. CAPA patients’ mortality and length of ICU stay were not statistically different from for COVID (non-CAPA) patients (42.11% vs 33.13% and 29 vs 24 days, respectively). These indicators were lower than in other reports. LFA-IMMY with digital readout is a reliable tool for early diagnosis of CAPA using serum samples in critically ill COVID patients. It has a good agreement with Platelia® EIA.

PMID:35394043 | DOI:10.1093/mmy/myac026

Rheumatology (Oxford). 2022 Apr 8:keac219. doi: 10.1093/rheumatology/keac219. Online ahead of print.

ABSTRACT

OBJECTIVES: This follow-up study of the INSTinCTS (INjection vs SplinTing in Carpal Tunnel Syndrome) trial compared the effects of corticosteroid injection (CSI) and night splinting (NS) for the initial management of mild-to-moderate carpal tunnel syndrome (CTS) on symptoms, resource use, and carpal tunnel surgery, over 24 months.

METHODS: Adults with mild-to-moderate CTS were randomised 1:1 to a local corticosteroid injection or a night splint worn for 6 weeks. Outcomes at 12 and 24 months included the Boston Carpal Tunnel Questionnaire (BCTQ), hand/wrist pain intensity numeric rating scale (NRS), the number of patients referred for and undergoing CTS surgery, and healthcare utilisation. A cost-utility analysis was conducted.

RESULTS: 116 participants received a CSI and 118 a NS. The response rate at 24 months was 73% in the CSI arm and 71% in the NS arm. By 24 months, a greater proportion of the CSI group had been referred for (28% vs 20%) and undergone (22% vs 16%) CTS surgery compared with the NS group. There were no statistically significant between-group differences in BCTQ score or pain NRS at 12 or 24 months. CSI was more costly (mean difference £68o59 (95% CI: -120·84, 291·24)) with fewer quality-adjusted life-years (QALYs) than NS over 24 months (mean difference -0·022 (95% CI: (-0·093, 0·045)).

CONCLUSION: Over 24 months, surgical intervention rates were low in both groups, but less frequent in the NS group. Whilst there were no differences in the clinical effectiveness of CSI and NS, initial treatment with CSI may not be cost-effective in the long-term compared with NS.

PMID:35394019 | DOI:10.1093/rheumatology/keac219

Int Health. 2022 Apr 8:ihac015. doi: 10.1093/inthealth/ihac015. Online ahead of print.

ABSTRACT

BACKGROUND: Gestational trophoblastic diseases (GTDs) may follow any form of pregnancy or a pregnancy loss. Early detection of GTDs is important, as some benign forms of the disease may progress into a chemoresistant and metastatic disease. This study aimed at determining the frequency of GTDs among women experiencing first trimester pregnancy loss and the associated patients’ characteristics.

METHODS: This was a cross-sectional study that included 200 conveniently sampled women who experienced first trimester pregnancy loss from January to December 2019 at a Regional Referral Hospital in central Tanzania. The specimen obtained from products of conception were collected, formalin-fixed and paraffin-embedded and submitted for histopathological evaluation, for which haematoxylin and eosin stain was used. Data were analysed using SPSS version 23.0. The χ2 test was used to determine the association between categorical variables. p-Values ˂0.05 were considered statistically significant.

RESULTS: Among 200 study participants, the overall frequency of GTDs was 42 (21%). Among those with GTDs, the most common histopathological diagnosis was partial hydatidiform mole (18 [42.9%]), followed by complete hydatidiform mole (17 [40.5%]) and choriocarcinoma (7 [16.5%]). In the studied participants, only increased human chorionic gonadotropin hormone levels were found to be statistically significantly associated with GTDs (p=0.000).

CONCLUSIONS: Results from this study suggest that routine histopathological evaluation of the products of conception is recommended in order to allow early detection of GTDs, including choriocarcinoma, which usually carries a poor prognosis. The histopathological reporting of choriocarcinoma among first trimester products of conception from Tanzania is novel.

PMID:35394041 | DOI:10.1093/inthealth/ihac015

Bioinformatics. 2022 Apr 8:btac199. doi: 10.1093/bioinformatics/btac199. Online ahead of print.

ABSTRACT

MOTIVATION: Single cell technologies play a crucial role in revolutionizing biological research over the past decade, which strengthens our understanding in cell differentiation, development, and regulation from a single-cell level perspective. Single-cell RNA sequencing (scRNA-seq) is one of the most common single cell technologies, which enables probing transcriptional states in thousands of cells in one experiment. Identification of cell types from scRNA-seq measurements is a fundamental and crucial question to answer. Most previous studies directly take gene expression as input while ignoring the comprehensive gene-gene interactions.

RESULTS: We propose scGraph, an automatic cell identification algorithm leveraging gene interaction relationships to enhance the performance of the cell type identification. ScGraph is based on a graph neural network to aggregate the information of interacting genes. In a series of experiments, we demonstrate that scGraph is accurate and outperforms eight comparison methods in the task of cell type identification. Moreover, scGraph automatically learns the gene interaction relationships from biological data and the pathway enrichment analysis shows consistent findings with previous analysis, providing insights on the analysis of regulatory mechanism.

AVAILABILITY: scGraph is freely available at https://github.com/QijinYin/scGraph and https://figshare.com/articles/software/scGraph/17157743.

SUPPLEMENTARY INFORMATION: Supplementary data are available at Bioinformatics online.

PMID:35394015 | DOI:10.1093/bioinformatics/btac199

Huan Jing Ke Xue. 2022 Apr 8;43(4):2115-2123. doi: 10.13227/j.hjkx.202108038.

ABSTRACT

In order to study the current status of heavy metal pollution, the accumulation capacity of farmland Sphagnum for heavy metals and the source of heavy metal pollution in the soil near Gaozhai Reservoir in Maojian Tea Town, Duyun City, Guizhou Province were assessed. Sphagnum and topsoil near this area were selected as the research object to measure the content of heavy metals. Spatial analysis and multivariate statistical analysis methods were used to conduct pollution evaluation and source analysis of heavy metals. The results showed that the heavy metal content in topsoil and farmland Sphagnum were V>Zn>Cr>Pb>Cu>Ni>As>Cd>Hg and Zn>Cr>Ni>Cu>Pb>V>As>Cd>Hg, respectively. The dominant species of Sphagnum in the study area were Sphagnum palustre L. ssp. palustre and Sphagnum ovatum Hamp.C.Muell, both of which had a strong ability to accumulate soil Cd, Ni, Cu, and Zn; however, the S. ovatum enrichment capacity of soil heavy metals was generally higher than that of the latter. Both the single pollution index (C_f) and the geo-accumulation index (I_geo) indicated that the Cd and Hg content in soil were at the highest levels, and the average comprehensive pollution index RI was 87.75, which indicates a slight ecological risk. The sources of heavy metals in soil and Sphagnum included transportation, domestic sewage, agricultural activities, and natural soil-forming processes.

PMID:35393835 | DOI:10.13227/j.hjkx.202108038

Huan Jing Ke Xue. 2022 Apr 8;43(4):2081-2093. doi: 10.13227/j.hjkx.202109024.

ABSTRACT

Carbonatite and basalt are widely distributed in southwest China, and potentially toxic elements (PTEs) are associated with the naturally high background properties. It is important to carry out ecological risk assessments and identify potential sources of PTEs. A total of 3180 soil samples (0-20 cm) were collected in Hezhang county, a typical high background area of PTEs with the parent lithology of carbonatite and basalt. Samples were obtained from 18 large lead-zinc mines, which belong to a multi-ecological risk superimposed area with high ecological risk. The concentration of PTEs (Cd, Cr, As, Hg, Pb, Cu, Zn, and Ni) in the topsoil were analyzed, and statistical analysis (SA), geographic information system (GIS), enrichment factor (EF), potential ecological risk index (RI), and positive matrix factorization (PMF) methods were used to assess the ecological risk and quantify sources of PTEs. The mean values of PTEs concentrations in topsoil were 24.55, 2.25, 176.40, 89.60, 0.19, 64.20, 102.00, and 257.00 mg·kg^-1 for As, Cd, Cr, Cu, Hg, Ni, Pb, and Zn, respectively, which were remarkably higher than the average background value (ABV) of soils in Guizhou Province. The average concentrations of Cd, Cr, Cu, Ni, Pb, and Zn exceeded the screening values specified for the soil contamination risk in agricultural land (GB 15618-2018) by 7.50, 1.18, 1.79, 1.07, 1.40, and 1.29 times, respectively. The EF showed that Cd had a large area of moderate pollution; Pb, Zn, and Cu had a small area of slight pollution; the EFs values of Hg, Cr, Ni, and As were near the baseline value (EF≈1), and contaminations were slight or nonexistent. The PMF indicated that there were five sources, namely pyrite mines, lead-zinc mines, natural sources of basalt and carbonatite, and agricultural activities; the risk contribution ratios were 5.25%, 27.37%, 28.94%, 17.91%, and 20.53%, respectively. The most toxic coefficients of Hg and Cd were mainly natural sources, with contribution ratios of 86.3% and 72.7%, respectively. The soil samples in the mining areas expectedly contained high ratios of Zn/Cd and Pb/Cd, which confirmed that PTEs in the soil were mainly derived from the smelting wastes. The contents of metal oxides such as Fe, Mn, and Si were the influencing factors of PTEs enrichment. On the contrary, soil samples exhibited much lower Zn/Cd and Pb/Cd ratios in non-mining areas, indicating that the main origin of these metals in soil was the smelting flue gas dusts and geological background.

PMID:35393832 | DOI:10.13227/j.hjkx.202109024

Huan Jing Ke Xue. 2022 Apr 8;43(4):1898-1907. doi: 10.13227/j.hjkx.202107187.

ABSTRACT

As an important food production area in the north of China, the Hetao plain is extremely vulnerable to nitrate pollution caused by agricultural production activities and additional factors. Thus, it is of great significance for the environmental protection and rational use of groundwater to detect the current situation of groundwater nitrate pollution, temporal and spatial evolution characteristics, and main influencing factors in the Hetao irrigation district. We selected the Wualte irrigation area as the study area, and the characteristics of temporal and spatial changes in groundwater nitrate concentration and the main influencing factors in this area were explored. We used statistical analysis to analyze the nitrogen content of groundwater in the study area, and the Piper three-line diagram was used to explore the characteristics of chemical composition and evolution; furthermore, we used ion ratio and correlation analysis methods to explore the source of NO₃^–-N in groundwater. The results showed that NO₃^–-N was the main existing form of nitrogen in the Wulate irrigation area, and its concentration varied from 0.01 to 60.00 mg·L^-1, with an exceeding standard rate of 10.50%. In terms of time, the characteristic of time change was that the NO₃^–-N concentration in August of groundwater was the highest (average 6.61 mg·L^-1), followed by that in October (6.22 mg·L^-1) and November (6.25 mg·L^-1), and that in March (average value of 1.77 mg·L^-1) was the lowest. With the influence of rainfall and irrigation, the NO₃^–-N in the soil was infiltrated into the groundwater, showing the characteristic that wet season and concentrated irrigation periods were higher than those in other periods. Spatially, it appeared as southwest (8.87 mg·L^-1)>northwest (4.25 mg·L^-1)>east (0.89 mg·L^-1), mainly due to the original geological conditions, land use, and domestic waste stacking. In addition, the concentration of NO₃^–-N of groundwater in the study area was closely related to the depth of groundwater and redox conditions but was relatively less affected by the concentration of water chemical ions. Therefore, identifying the temporal and spatial distribution characteristics and main sources of groundwater nitrogen pollution can provide a scientific basis for scientific fertilization, groundwater nitrate pollution control, and water safety.

PMID:35393813 | DOI:10.13227/j.hjkx.202107187

Huan Jing Ke Xue. 2022 Apr 8;43(4):2018-2029. doi: 10.13227/j.hjkx.202107040.

ABSTRACT

Rainfall runoff is one of the important sources of urban river pollution. In order to understand the pollution characteristics of rainfall runoff, the synchronous sampling and monitoring of rainfall runoff in the old urban area of Nanning were carried out; the pollution condition, initial scouring effect, and pollution contribution ratio of different underlying surfaces under different rainfall conditions were analyzed; and the calculation method and influence factor analysis of initial scouring of runoff pollution were discussed. According to the underlying surface of the vegetable market in the old urban area, the selection standard and necessity of the underlying surface of rainfall runoff were discussed. The results showed that the average concentration (EMC) of COD and TSS in roads and vegetable markets were greater than those in green spaces and roofs in the runoff pollution of the old urban area of Nanning, and the EMC values of nutrient pollutants in field rainfall runoff were ranked in decreasing order as vegetable markets, green spaces, roofs, and roads. Under the condition of heavy rain, each underlying surface had an obvious initial scouring effect, the average value of initial scouring coefficient (b) was 0.67, and there were many pollutants transported by roads and green spaces at the initial stage. Under light rain and moderate rain conditions, there was no obvious initial scouring effect, and the average b values were 0.83 and 0.94, respectively. The b value calculated by the whole process was preferred for evaluating the scouring effect. Based on multivariate statistical analysis, the EMC value of TSS in road runoff was significantly positively correlated with the total rainfall duration (RD), and the EMC value of TN in green land runoff was significantly negatively correlated with the average rainfall intensity (ARI). Whether the vegetable market was considered as the underlying surface had a great impact on the calculation results of nutrient pollution load but had little impact on the calculation results of COD and TSS load. The difference percentage of nutrient pollution load under heavy rain reached 80%. Under this condition, the difference percentage of pollutant EMC between the road and vegetable market reached 1012%.

PMID:35393825 | DOI:10.13227/j.hjkx.202107040