Health insurance in sub-Saharan Africa : a survey and analysis

Health insurance is one in a portfolio of options that are available to augment government budgetary resources for health-care spending. Yet, little comparative information is available on the kinds of health insurance that are presently extant in sub - Saharan Africa. The purpose of this paper is to fill that gap in knowledge and to define"health insurance". The paper also discusses: (a) the prevalence of health insurance; (b) the contribution of health insurance to health finance; and (c) the characteristics of the health insurance. These schemes are analyzed with respect to insurance criteria developed in the research literature on health insurance. The paper concludes by summarizing what has been learned and the conclusions that can be drawn.Health Economics&Finance,Insurance&Risk Mitigation,Health Systems Development&Reform,Insurance Law,Health Monitoring&Evaluation

The Productivity of Pharmaceuticals in Improving Health: An Analysis of the OECD Health Data

Although a number of studies have been conducted on health production functions, little attention has been given to pharmaceuticals as a separate input into the production of health. Building upon existing published work, this paper uses an alternative specification and more recent data to estimate the effect of pharmaceutical expenditures on levels of health in the member countries of the Organization for Economic Cooperation and Development (OECD). In a sample of developed countries, we found that pharmaceutical consumption, as measured by per capita drug expenditures, has a positive effect on life expectancy at advanced ages. The marginal effect of pharmaceutical consumption is consistent with estimates that have been reported previously but appears to decline with increasing age. Over the past few years, the substantial and disproportionate growth of pharmaceutical expenditures for public and private payers in the U.S. has led to calls for regulatory intervention (e.g., price controls). However, our research suggests that increases in drug spending may yield further increases in life expectancy.Health production, life expectancy, pharmaceuticals, OECD, ecological studies

Twelve Years of Stover Removal Increases Soil Erosion Potential without Impacting Yield

Corn (Zea mays L.) stover (non-grain aboveground biomass) in the US Corn Belt is used increasingly for livestock grazing and co-feed and for cellulosic bioenergy production. Continuous stover removal, however, could alter long-term agricultural productivity by affecting soil organic C (SOC) and soil physical properties, indicators of soil fertility and erosion potential. In this study, we showed that 12 consecutive yr of 55% stover removal did not affect mean grain yields at any N fertilizer rate (4.5, 6.3, and 6.0 Mg ha−1 for 60, 120, and 180 kg N ha−1 yr−1, respectively) in a marginally productive, rainfed continuous corn system under no-till (NT). Although SOC increased in the top 30 cm of all soils since 1998 (0.54–0.79 Mg C ha−1 yr−1), stover removal tended to limit SOC gains compared with no removal. Near-surface soils (0–5-cm depth) were more sensitive to stover removal and showed a 41% decrease in particulate organic matter stocks, smaller mean weight diameter of dry soil aggregates, and lower abundance of water-stable soil aggregates compared with soils with no stover removal. Increasing N fertilizer rate mitigated losses in total water-stable aggregates in near-surface soils related to stover removal. Collectively, however, our results indicated soil structure losses in surface soils due to lower C inputs. Despite no effect on crop yields and overall SOC gains with time using NT management, annually removing stover for 12 yr resulted in a higher risk of wind and water erosion at this NT continuous corn site in the western Corn Belt

Phase II trial of N-methylformamide in advanced head and neck cancer

Eighteen patients with advanced epidermoid carcinoma of the head and neck were entered into a phase II trial of N-Methylformamide (NMF), 800 mg/M 2 IV daily for 5 days every 4 weeks. Seventeen patients had received prior radiation therapy and 11 were previously treated with chemotherapy. No complete or partial responses were observed. The major toxicity was gastrointestinal. Fifty percent of patients experienced nausea and vomiting or reversible hepatotoxicity with greater than a 3-fold elevation of liver enzymes. Mild reversible myelosuppression occurred in 2 patients. NMF in this dose and schedule was not a useful agent to treat recurrent epidermoid carcinoma of the head and neck.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/45297/1/10637_2004_Article_BF00203547.pd

Exuberant fibroblast activity compromises lung function via ADAMTS4

© 2020, The Author(s), under exclusive licence to Springer Nature Limited. Severe respiratory infections can result in acute respiratory distress syndrome (ARDS)1. There are no effective pharmacological therapies that have been shown to improve outcomes for patients with ARDS. Although the host inflammatory response limits spread of and eventually clears the pathogen, immunopathology is a major contributor to tissue damage and ARDS1,2. Here we demonstrate that respiratory viral infection induces distinct fibroblast activation states, which we term extracellular matrix (ECM)-synthesizing, damage-responsive and interferon-responsive states. We provide evidence that excess activity of damage-responsive lung fibroblasts drives lethal immunopathology during severe influenza virus infection. By producing ECM-remodelling enzymes—in particular the ECM protease ADAMTS4—and inflammatory cytokines, damage-responsive fibroblasts modify the lung microenvironment to promote robust immune cell infiltration at the expense of lung function. In three cohorts of human participants, the levels of ADAMTS4 in the lower respiratory tract were associated with the severity of infection with seasonal or avian influenza virus. A therapeutic agent that targets the ECM protease activity of damage-responsive lung fibroblasts could provide a promising approach to preserving lung function and improving clinical outcomes following severe respiratory infections

Publisher Correction: Exuberant fibroblast activity compromises lung function via ADAMTS4 (Nature, (2020), 587, 7834, (466-471), 10.1038/s41586-020-2877-5)

© 2020, The Author(s), under exclusive licence to Springer Nature Limited. An amendment to this paper has been published and can be accessed via a link at the top of the paper

The Politics of Environmental Dispute Resolution

Also PCMA Working Paper #17.http://deepblue.lib.umich.edu/bitstream/2027.42/51148/1/380.pd

Compound Evolutionary History of the Rhesus Macaque Mhc Class I B Region Revealed by Microsatellite Analysis and Localization of Retroviral Sequences

In humans, the single polymorphic B locus of the major histocompatibility complex is linked to the microsatellite MIB. In rhesus macaques, however, haplotypes are characterized by the presence of unique combinations of multiple B genes, which may display different levels of polymorphism. The aim of the study was to shed light on the evolutionary history of this highly complex region. First, the robustness of the microsatellite MIB-linked to almost half of the B genes in rhesus macaques (Mamu-B)–for accurate B haplotyping was studied. Based on the physical map of an established haplotype comprising 7 MIB loci, each located next to a certain Mamu-B gene, two MIB loci, MIB1 and MIB6, were investigated in a panel of MHC homozygous monkeys. MIB1 revealed a complex genotyping pattern, whereas MIB6 analysis resulted in the detection of one or no amplicon. Both patterns are specific for a given B haplotype, show Mendelian segregation, and even allow a more precise haplotype definition than do traditional typing methods. Second, a search was performed for retroelements that may have played a role in duplication processes as observed in the macaque B region. This resulted in the description of two types of duplicons. One basic unit comprises an expressed Mamu-B gene, adjacent to an HERV16 copy closely linked to MIB. The second type of duplicon comprises a Mamu-B (pseudo)gene, linked to a truncated HERV16 structure lacking its MIB segment. Such truncation seems to coincide with the loss of B gene transcription. Subsequent to the duplication processes, recombination between MIB and Mamu-B loci appears to have occurred, resulting in a hyperplastic B region. Thus, analysis of MIB in addition to B loci allows deciphering of the compound evolutionary history of the class I B region in Old World monkeys

A snapshot of the Mamu-B genes and their allelic repertoire in rhesus macaques of Chinese origin

The major histocompatibility complex class I gene repertoire was investigated in a large panel of rhesus macaques of Chinese origin. As observed in Indian animals, subjects of Chinese derivation display Mamu-B gene copy number variation, and the sum of expressed genes varies among haplotypes. In addition, these genes display differential transcription levels. The majority of the Mamu-B alleles discovered during this investigation appear to be unique for the population studied. Only one particular Mamu-B haplotype is shared between Indian and Chinese animals, and it must have been present in the progenitor stock. Hence, the data highlight the fact that most allelic polymorphism, and most of the Mamu-B haplotypes themselves, are of relatively recent origin and were most likely generated after the separation of the Indian and Chinese rhesus macaque populations