Tracking development assistance for health and for COVID-19 : a review of development assistance, government, out-of-pocket, and other private spending on health for 204 countries and territories, 1990-2050

Background The rapid spread of COVID-19 renewed the focus on how health systems across the globe are financed, especially during public health emergencies. Development assistance is an important source of health financing in many low-income countries, yet little is known about how much of this funding was disbursed for COVID-19. We aimed to put development assistance for health for COVID-19 in the context of broader trends in global health financing, and to estimate total health spending from 1995 to 2050 and development assistance for COVID-19 in 2020. Methods We estimated domestic health spending and development assistance for health to generate total health-sector spending estimates for 204 countries and territories. We leveraged data from the WHO Global Health Expenditure Database to produce estimates of domestic health spending. To generate estimates for development assistance for health, we relied on project-level disbursement data from the major international development agencies' online databases and annual financial statements and reports for information on income sources. To adjust our estimates for 2020 to include disbursements related to COVID-19, we extracted project data on commitments and disbursements from a broader set of databases (because not all of the data sources used to estimate the historical series extend to 2020), including the UN Office of Humanitarian Assistance Financial Tracking Service and the International Aid Transparency Initiative. We reported all the historic and future spending estimates in inflation-adjusted 2020 US$, 2020 US$ per capita, purchasing-power parity-adjusted US$per capita, and as a proportion of gross domestic product. We used various models to generate future health spending to 2050. Findings In 2019, health spending globally reached$8. 8 trillion (95% uncertainty interval [UI] 8.7-8.8) or $1132 (1119-1143) per person. Spending on health varied within and across income groups and geographical regions. Of this total,$40.4 billion (0.5%, 95% UI 0.5-0.5) was development assistance for health provided to low-income and middle-income countries, which made up 24.6% (UI 24.0-25.1) of total spending in low-income countries. We estimate that $54.8 billion in development assistance for health was disbursed in 2020. Of this,$13.7 billion was targeted toward the COVID-19 health response. $12.3 billion was newly committed and$1.4 billion was repurposed from existing health projects. $3.1 billion (22.4$2.4 billion (17.9%) was for supply chain and logistics. Only $714.4 million (7.7$1519 (1448-1591) per person in 2050, although spending across countries is expected to remain varied. Interpretation Global health spending is expected to continue to grow, but remain unequally distributed between countries. We estimate that development organisations substantially increased the amount of development assistance for health provided in 2020. Continued efforts are needed to raise sufficient resources to mitigate the pandemic for the most vulnerable, and to help curtail the pandemic for all. Copyright (C) 2021 The Author(s). Published by Elsevier Ltd.Peer reviewe

New insights into the genetic etiology of Alzheimer's disease and related dementias

Characterization of the genetic landscape of Alzheimer's disease (AD) and related dementias (ADD) provides a unique opportunity for a better understanding of the associated pathophysiological processes. We performed a two-stage genome-wide association study totaling 111,326 clinically diagnosed/'proxy' AD cases and 677,663 controls. We found 75 risk loci, of which 42 were new at the time of analysis. Pathway enrichment analyses confirmed the involvement of amyloid/tau pathways and highlighted microglia implication. Gene prioritization in the new loci identified 31 genes that were suggestive of new genetically associated processes, including the tumor necrosis factor alpha pathway through the linear ubiquitin chain assembly complex. We also built a new genetic risk score associated with the risk of future AD/dementia or progression from mild cognitive impairment to AD/dementia. The improvement in prediction led to a 1.6- to 1.9-fold increase in AD risk from the lowest to the highest decile, in addition to effects of age and the APOE ε4 allele

Multi-ancestry GWAS of the electrocardiographic PR interval identifies 202 loci underlying cardiac conduction

The electrocardiographic PR interval reflects atrioventricular conduction, and is associated with conduction abnormalities, pacemaker implantation, atrial fibrillation (AF), and cardiovascular mortality. Here we report a multi-ancestry (N = 293,051) genome-wide association meta-analysis for the PR interval, discovering 202 loci of which 141 have not previously been reported. Variants at identified loci increase the percentage of heritability explained, from 33.5% to 62.6%. We observe enrichment for cardiac muscle developmental/contractile and cytoskeletal genes, highlighting key regulation processes for atrioventricular conduction. Additionally, 8 loci not previously reported harbor genes underlying inherited arrhythmic syndromes and/or cardiomyopathies suggesting a role for these genes in cardiovascular pathology in the general population. We show that polygenic predisposition to PR interval duration is an endophenotype for cardiovascular disease, including distal conduction disease, AF, and atrioventricular pre-excitation. These findings advance our understanding of the polygenic basis of cardiac conduction, and the genetic relationship between PR interval duration and cardiovascular disease

Exact solutions for the blood flow through a circular tube under the influence of a magnetic field using fractional Caputo-Fabrizio derivatives

In this work, we study the flow of both blood and magnetic particles using Caputo-Fabrizio fractional derivative model approach. The fluid flow through a circular cylinder is influenced by an external magnetic field which is perpendicular to the circular tube and an oscillating pressure gradient. Integral transforms are used to find solutions for the blood and magnetic particle velocities. Comparison of profiles of velocities for different values of α, the impact of physical variables on the dynamics of fluid and magnetic parameters are highlighted graphically

The influence of transgenic (Bt) and non-transgenic (non-Bt) cotton mulches on weed dynamics, soil properties and productivity of different winter crops

The introduction of transgenic cotton (Bt-cotton) for controlling bollworms has resulted in increased production; however, the residual effects of mulches from Bt-cotton are poorly understood. Therefore, the current study evaluated the impact of Bt and non-Bt cotton mulches on soil properties, weed dynamics and yield of winter crops sown after cotton. Three different winter crops, i.e., wheat (Triticum aestivum L.), canola (Brassica napus L.) and Egyptian clover (Trifolium alexandrinum L.) and two mulch types, i.e., Bt mulch (obtained from Bt-cotton cultivars, i.e., ‘CIM-616’ and ‘GH-Mubarik’) and non-Bt mulch (obtained from non-Bt cultivars, i.e., ‘CIM-620’ and ‘N-414’) were included in the study. The mulches were applied at a rate of 2 t ha-1 before planting the winter crops. The Bt and non-Bt mulches differentially affected soil properties, weed dynamics and productivity of winter crops. The non-Bt mulches decreased the soil bulk density and penetration resistance, while increased the soil porosity. Wheat crop increased the soil porosity, pH, available N and soil organic matter content. Overall, non-Bt mulches improved the productivity of winter crops compared with Bt mulches. The toxins released by Bt mulches lowered the weed density; however, it negatively influenced soil properties (bulk density and available nitrogen) and productivity of winter crops. Therefore, appropriate crop rotation measures may be opted for the soils cultivated with Bt-cotton to conserve soil and achieve yield sustainability for the crops sown after cotton. Nonetheless, non-Bt mulches can be used for improving soil properties and productivity of winter crops

Analytic solutions of Oldroyd-B fluid with fractional derivatives in a circular duct that applies a constant couple

The aim of this article was to analyze the rotational flow of an Oldroyd-B fluid with fractional derivatives, induced by an infinite circular cylinder that applies a constant couple to the fluid. Such kind of problem in the settings of fractional derivatives has not been found in the literature. The solutions are based on an important remark regarding the governing equation for the non-trivial shear stress. The solutions that have been obtained satisfy all imposed initial and boundary conditions and can easily be reduced to the similar solutions corresponding to ordinary Oldroyd-B, fractional/ordinary Maxwell, fractional/ordinary second-grade, and Newtonian fluids performing the same motion. The obtained results are expressed in terms of Newtonian and non-Newtonian contributions. Finally, the influence of fractional parameters on the velocity, shear stress and a comparison between generalized and ordinary fluids is graphically underlined

Boundary layer flow of MHD generalized Maxwell fluid over an exponentially accelerated infinite vertical surface with slip and Newtonian heating at the boundary

The aim of this article is to investigate the unsteady natural convection flow of Maxwell fluid with fractional derivative over an exponentially accelerated infinite vertical plate. Moreover, slip condition, radiation, MHD and Newtonian heating effects are also considered. A modern definition of fractional derivative operator recently introduced by Caputo and Fabrizio has been used to formulate the fractional model. Semi analytical solutions of the dimensionless problem are obtained by employing Stehfest’s and Tzou’s algorithms in order to find the inverse Laplace transforms for temperature and velocity fields. Temperature and rate of heat transfer for non-integer and integer order derivatives are computed and reduced to some known solutions from the literature. Finally, in order to get insight of the physical significance of the considered problem regarding velocity and Nusselt number, some graphical illustrations are made using Mathcad software. As a result, in comparison between Maxwell and viscous fluid (fractional and ordinary) we found that viscous (fractional and ordinary) fluids are swiftest than Maxwell (fractional and ordinary) fluids. Keywords: Free convection, Slip, Maxwell fluid, Newtonian heating, Exponentially accelerated plate, Caputo-Fabrizio fractional derivatives, Stehfest’s and Tzou’s algorithm