DIAMIN: a software library for the distributed analysis of large-scale molecular interaction networks.

BACKGROUND: Huge amounts of molecular interaction data are continuously produced and stored in public databases. Although many bioinformatics tools have been proposed in the literature for their analysis, based on their modeling through different types of biological networks, several problems still remain unsolved when the problem turns on a large scale. RESULTS: We propose DIAMIN, that is, a high-level software library to facilitate the development of applications for the efficient analysis of large-scale molecular interaction networks. DIAMIN relies on distributed computing, and it is implemented in Java upon the framework Apache Spark. It delivers a set of functionalities implementing different tasks on an abstract representation of very large graphs, providing a built-in support for methods and algorithms commonly used to analyze these networks. DIAMIN has been tested on data retrieved from two of the most used molecular interactions databases, resulting to be highly efficient and scalable. As shown by different provided examples, DIAMIN can be exploited by users without any distributed programming experience, in order to perform various types of data analysis, and to implement new algorithms based on its primitives. CONCLUSIONS: The proposed DIAMIN has been proved to be successful in allowing users to solve specific biological problems that can be modeled relying on biological networks, by using its functionalities. The software is freely available and this will hopefully allow its rapid diffusion through the scientific community, to solve both specific data analysis and more complex tasks.

Fruit and vegetable consumption in the former Soviet Union: the role of individual- and community-level factors.

OBJECTIVE: To explain patterns of fruit and vegetable consumption in nine former Soviet Union countries by exploring the influence of a range of individual- and community-level determinants. DESIGN: Cross-sectional nationally representative surveys and area profiles were undertaken in 2010 in nine countries of the former Soviet Union as part of the Health in Times of Transition (HITT) study. Individual- and area-level determinants were analysed, taking into account potential confounding at the individual and area level. SETTING: Armenia, Azerbaijan, Belarus, Georgia, Kazakhstan, Kyrgyzstan, Moldova, Russia and Ukraine. SUBJECTS: Adult survey respondents (n 17 998) aged 18-95 years. RESULTS: Being male, increasing age, lack of education and lack of financial resources were associated with lower probability of consuming adequate amounts of fruit or vegetables. Daily fruit or vegetable consumption was positively correlated with the number of shops selling fruit and vegetables (for women) and with the number of convenience stores (for men). Billboard advertising of snacks and sweet drinks was negatively related to daily fruit or vegetable consumption, although the reverse was true for billboards advertising soft drinks. Men living near a fast-food outlet had a lower probability of fruit or vegetable consumption, while the opposite was true for the number of local food restaurants. CONCLUSIONS: Overall fruit and vegetable consumption in the former Soviet Union is inadequate, particularly among lower socio-economic groups. Both individual- and community-level factors play a role in explaining inadequate nutrition and thus provide potential entry points for policy interventions, while the nuanced influence of community factors informs the agenda for future research.

From social capital to health--and back.

We assess the causal relationship between health and social capital, measured by generalized trust, both at the individual and the community level. The paper contributes to the literature in two ways: it tackles the problems of endogeneity and reverse causation between social capital and health by estimating a simultaneous equation model, and it explicitly accounts for mis-reporting in self-reported trust. The inter-relationship is tested using data from the first four waves of the European Social Survey for 25 European countries, supplemented by regional data from Eurostat. Our estimates show that a causal and positive relationship between self-perceived health and social capital does exist and that it acts in both directions. In addition, the magnitude of the structural coefficients suggests that individual social capital is a strong determinant of health, whereas community level social capital plays a considerably smaller role in determining health.

European immigrant health policies, immigrants' health, and immigrants' access to healthcare.

OBJECTIVE: Evidence indicates presence of immigrant health disparities in the European Union (EU) and the United States (US). We examined the association between immigrant health policies and the gap in health status, unmet needs and service use between immigrants and citizens, in the EU and US. METHODS: We used the Migrant Integration Policy Index (MIPEX), European Health Interview Survey, and National Health Interview Survey for 2014. Our independent variables of interest were MIPEX Health strand score and citizenship. Our dependent variables were four measures of health status (self-reported poor health; severely limited in general activities; two or more comorbidities; one or more ambulatory care sensitive conditions) and four measures of health access and utilization (unmet need due to non-financial reasons; could not afford needed health care; one or more primary care visits last year; any hospitalization last year). We conducted linear probability models and presented the marginal effects of each outcome in percentage points. FINDINGS: We found that immigrant-friendly health policies were significantly associated with better health and less unmet need due to non-financial reasons. CONCLUSION: Our findings supported the promotion of immigrant-friendly and a 'Health-in-All Policies' (HiAP) approach to preserve the health of immigrants.

Education and COVID-19 excess mortality.

We study the role of education during the COVID-19 epidemic in Italy. We compare excess mortality in 2020 and 2021 compared to the pre-pandemic mortality between municipalities with different shares of educated residents. We find that education initially played a strong protective role, which however quickly faded out. After pondering several alternative explanations, we tentatively interpret this finding as the outcome of the interplay between education, information and public health communication, whose availability and coherence varied along the epidemic.

Mortality, morbidity and economic growth.

The question of whether and how changes to population health impact on economic growth has been actively studied in the literature, albeit with mixed results. We contribute to this debate by reassessing-and extending-[1], one of the most influential studies. We include a larger set of countries (135) and cover a more recent period (1990-2014). We also account for morbidity in addition to mortality and adopt the strategy of providing bounding sets for the effects of interest rather than point estimates. We find that reducing mortality and disability adjusted life years (DALYs), a measure which combines morbidity and mortality, promotes per capita GDP growth. The magnitude of the effect is moderate, but non negligible, and it is similar for mortality and DALYs.

The spectrum of thyroid function tests during hospitalization for SARS COV-2 infection.

OBJECTIVE: Alterations in thyroid function tests (TFTs) have been recorded during SARS-CoV-2 infection as associated to either a destructive thyroiditis or a non-thyroidal illness. METHODS: We studied 144 consecutive COVID-19 patients admitted to a single center in intensive or subintensive care units. Those with previous thyroid dysfunctions or taking interfering drugs were excluded. Differently from previous reports, TSH, FT3, FT4, thyroglobulin (Tg), anti-Tg autoantibodies (TgAb) were measured at baseline and every 3-7 days. C-reacting protein (CRP), cortisol and IL-6 were also assayed. RESULTS: The majority of patients had a normal TSH at admission, usually with normal FT4 and FT3. Low TSH levels were found either at admission or during hospitalization in 39% of patients, associated with low FT3 in half of the cases. FT4 and Tg levels were normal, and TgAb-negative. TSH and FT3 were invariably restored at the time of discharge in survivors, whereas were permanently low in most deceased cases, but only FT3 levels were predictors of mortality. Cortisol, CRP and IL-6 levels were higher in patients with low TSH and FT3 levels. CONCLUSIONS: Almost half of our COVID-19 patients without interfering drugs had normal TFTs both at admission and during follow-up. In this series, the transient finding of low TSH with normal FT4 and low FT3 levels, inversely correlated with CRP, cortisol and IL-6 and associated with normal Tg levels, is likely due to the cytokine storm induced by SARS-Cov-2 with a direct or mediated impact on TSH secretion and deiodinase activity, and likely not to a destructive thyroiditis.

The effect of job loss on pharmaceutical prescriptions.

We estimate the effect of job loss on the probability that long-tenured workers are prescribed anti-hypertensive and psychotropic drugs. We exploit two administrative data sources from the Veneto region in Italy and estimate an event-study model. Our results indicate that the probability of drug prescription increases among under-40 males but not among older males or female workers. We suggest that the effect on younger male workers is the combined result of their typical role as breadwinners, limited wealth buffers in case of layoff, and unfavourable employment legislative protection.

The contribution of urbanization to non-communicable diseases: Evidence from 173 countries from 1980 to 2008.

It is widely believed that the expanding burden of non-communicable diseases (NCDs) is in no small part the result of major macro-level determinants. We use a large amount of new data, to explore in particular the role played by urbanization - the process of the population shifting from rural to urban areas within countries - in affecting four important drivers of NCDs world-wide: diabetes prevalence, as well as average body mass index (BMI), total cholesterol level and systolic blood pressure. Urbanization is seen by many as a double-edged sword: while its beneficial economic effects are widely acknowledged, it is commonly alleged to produce adverse side effects for NCD-related health outcomes. In this paper we submit this hypothesis to extensive empirical scrutiny, covering a global set of countries from 1980-2008, and applying a range of estimation procedures. Our results indicate that urbanization appears to have contributed to an increase in average BMI and cholesterol levels: the implied difference in average total cholesterol between the most and the least urbanized countries is 0.40mmol/L, while people living in the least urbanized countries are also expected to have an up to 2.3kg/m2 lower BMI than in the most urbanized ones. Moreover, the least urbanized countries are expected to have an up to 3.2p.p. lower prevalence of diabetes among women. This association is also much stronger in the low and middle-income countries, and is likely to be mediated by energy intake-related variables, such as calorie and fat supply per capita.

Trust me, you will be in better health.

Along the pathway traced by few recent contribution that attempt to identify the causal effect of social capital on health, this paper analyzes whether individual social capital reduces the probability of experiencing 11 long-lasting and chronic diseases. The empirical problems related to reverse causation and unobserved heterogeneity are addressed by means of a procedure that exploits the within-individual variation between the timings of first occurrence of the 11 diseases considered. Estimates indicate that the probability of occurrence is on average 14-18 percent lower among individuals reporting to "trust most of the other people". This result is robust to two alternative specifications as well as the inclusion or omission of individual controls.

Social capital and self-reported general and mental health in nine Former Soviet Union countries.

Social capital has been proposed as a potentially important contributor to health, yet most of the existing research tends to ignore the challenge of assessing causality in this relationship. We deal with this issue by employing various instrumental variable estimation techniques. We apply the analysis to a set of nine former Soviet countries, using a unique multi-country household survey specifically designed for this region. Our results confirm that there appears to be a causal association running from several dimensions of individual social capital to general and mental health. Individual trust appears to be more strongly related to general health, while social isolation- to mental health. In addition, social support and trust seem to be more important determinants of health than the social capital dimensions that facilitate solidarity and collective action. Our findings are remarkably robust to a range of different specifications, including the use of instrumental variables. Certain interaction effects are also found: for instance, untrusting people who live in communities with higher aggregate level of trust are even less likely to experience good health than untrusting people living in the reference communities.

The effect of health on labour supply in nine former Soviet Union countries.

This paper examines for the first time the consequences of ill health on labour supply for a sample of nine countries from the former Soviet Union (FSU), using a unique multicountry household survey specifically designed for this region. We control for a wide range of individual, household, and community factors, using both standard regression techniques and instrumental variable estimation to address potential endogeneity. Specifically, we find in our baseline ordinary least squares specification that poor health is associated with a decrease in the probability of working of about 13 %. Controlling for community-level unobserved variables slightly increases the magnitude of this effect, to about 14 %. Controlling for endogeneity with the instrumental variable approach further supports this finding, with the magnitude of the effect ranging from 12 to 35 %. Taken together, our findings confirm the cost that the still considerable adult health burden in the FSU is imposing on its population, not only in terms of the disease burden itself, but also in terms of individuals' labour market participation, as well as potentially in terms of increased poverty risk. Other things being equal, this would increase the expected "return on investment" to be had from interventions aimed at improving health in this region.

The influence of social capital on health in eight former Soviet countries: why does it differ?

BACKGROUND: Previous research has identified the role of social capital in explaining variations in health in the countries of the former Soviet Union. This study explores whether the benefits of social capital vary among these countries and why. METHODS: The impact of micro social capital (trust, membership and social isolation) on individual health was estimated in each of eight former Soviet republics using instrumental variables to overcome methodological hazards such as endogeneity and reverse causality. Interactions with institutional variables (voice and accountability, effectiveness of the legal system, informal economy) and social protection variables (employment protection, old age and disability benefits, sickness and health benefits) were examined. RESULTS: Most social capital indicators, in most countries, are associated with better health but the magnitude and significance of the impact differ between countries. Some of this variation can be explained by interacting social capital indicators with measures of institutional quality, with membership of organisations bringing greater benefit for health in countries where civil liberties are stronger, whereas social isolation has more adverse consequences where there is a large informal economy. A lesser amount is explained by the interaction of social capital indicators with selected measures of social protection. CONCLUSION: When considering interventions to improve social capital as a means of improving population health, it seems advisable to take into account the influence of macrocontextual variables, in order not to overstate or understate the likely impact of the intervention.

Adult health in the Russian Federation: more than just a health problem.

In this paper we discuss the Russian adult health crisis and its implications. Although some hope that economic growth will trigger improvements in health, we argue that a scenario is more likely in which the unfavorable health status would become a barrier to economic growth. We also show that ill health is negatively affecting the economic well-being of individuals and households. We provide suggestions on interventions to improve health conditions in the Russian Federation, and we show that if health improvements are achieved, this will result in substantial economic gains in the future.

Is social capital good for health? A European perspective

The aim of the research reported here was to examine the causal impact of social capital on health in 14 European countries. Using data from the European Social Survey, supplemented by regional-level data, the authors studied whether individual and/or community-level social capital positively affects health. They controlled for other factors expected to affect health and addressed – via an instrumental variable approach – the challenge of assessing causality in the relationship between social capital and health. The large variance of the error term due to measurement errors calls for strong instruments to obtain reliable estimates in a finite sample. The data set was rich enough in information to allow the finding of a seemingly strong causal relationship between social capital and individual health. Community social capital (defined at the regional level) appears not to affect health once individual-level social capital is controlled for. Taken at face value, the findings suggest that policy interventions should be aimed at improving primarily individual social capital. This would achieve a double effect: directly improving individuals’ health and contributing to community social capital, which reinforces the beneficial role of individual social capital.

Инвестиции в здоровье: ключевое условие успешного экономического развития Восточной Европы и Центральной Азии

Крах коммунистической системы в конце двадцатого столетия дал некоторым из бывших социалистических стран возможность добиться устойчивого экономического роста и повысить благосостояние населения. Однако в других странах резкий экономический спад в начале переходного периода привел к массовому обнищанию населения. Несмотря на то что с тех пор положение отчасти улучшилось, свыше 60 млн человек в странах Центральной и Восточной Европы, а также Содружества Независимых Государств (ЦВЕ–СНГ) остаются за чертой бедности, а свыше 150 млн относятся к малообеспеченным. Эта книга – первая серьезная попытка проанализировать экономические последствия плохого здоровья населения в странах ЦВЕ–СНГ; значительная часть данных о влиянии на экономику хронических заболеваний (распространенность которых во многих странах с низкими и средними доходами населения быстро растет) имеет значение не только для данного региона. Книга исследует двустороннюю связь между здоровьем населения и экономическим развитием, внимание авторов фокусируется на значительных убытках, которые приносит странам региона плохое здоровье населения. Книга предлагает также научно обоснованные, рентабельные программы и стратегические решения на национальном и международном уровне – один из ключевых способов добиться устойчивого экономического роста и сократить уровень бедности в странах региона.

Экономические последствия неинфекционных заболеваний и травм в Российской Федерации

Появляется все больше данных, говорящих о двустороннем характере связи междуздоровьем населения и экономическим ростом в стране. Экономический ростспособствует улучшению здоровья населения; в свою очередь, более здоровоенаселение способствует экономическому росту. Полученные выводы имеютбольшое значение для разработки политики, однако о том, насколько они значимыдля стран переходного периода в Центральной и Восточной Европе и Содружественезависимых государств, перед которыми стоят особенно острые проблемы вобласти здравоохранения, в основном связанные с неинфекционнымизаболеваниями и травмами, известно мало.Наша книга – первый шаг к этому. Основное внимание сосредоточено на РоссийскойФедерации, хотя полученные выводы справедливы и для других стран с переходнойэкономикой. Рассмотрены два важных вопроса:Как влияет плохое здоровье взрослого населения, особенно неинфекционныезаболевания и травмы, на экономику Российской Федерации и материальныйдостаток ее жителей?Если заболеваемость взрослого населения Российской Федерации снизится,каких экономических выгод можно ожидать?Общий вывод совершенно однозначен: плохое здоровье взрослого населенияотрицательно сказывается на экономическом благосостоянии отдельных лиц идомохозяйств в Российской Федерации; продуманные меры, направленные наукрепление здоровья, могут сыграть важную роль в обеспечении стабильновысоких темпов экономического роста.

Появляется все больше данных, говорящих о двустороннем характере связи между здоровьем населения и экономическим ростом в стране. Экономический рост способствует улучшению здоровья населения; в свою очередь, более здоровое население способствует экономическому росту. Полученные выводы имеют большое значение для разработки политики, однако о том, насколько они значимы для стран переходного периода в Центральной и Восточной Европе и Содружестве независимых государств, перед которыми стоят особенно острые проблемы в области здравоохранения, в основном связанные с неинфекционными заболеваниями и травмами, известно мало. Наша книга – первый шаг к этому. Основное внимание сосредоточено на Российской Федерации, хотя полученные выводы справедливы и для других стран с переходной экономикой. Рассмотрены два важных вопроса: как влияет плохое здоровье взрослого населения, особенно неинфекционные заболевания и травмы, на экономику Российской Федерации и материальный достаток ее жителей?; если заболеваемость взрослого населения Российской Федерации снизится, каких экономических выгод можно ожидать? Общий вывод совершенно однозначен: плохое здоровье взрослого населения отрицательно сказывается на экономическом благосостоянии отдельных лиц и домохозяйств в Российской Федерации; продуманные меры, направленные на укрепление здоровья, могут сыграть важную роль в обеспечении стабильно высоких темпов экономического роста.

Health: a vital investment for economic development in eastern Europe and central Asia

The breakdown of the socialist system in the late 20th century gave some of the countries affected the opportunity to establish the prerequisites for sustainable economic development and improved human welfare. For others, however, the dramatic economic decline resulted in widespread poverty. Despite some improvement since, over 60 million people remain poor and over 150 million are economically vulnerable in the countries of central and eastern Europe and the Commonwealth of Independent States. This report is the first comprehensive effort to analyse the economic impact of ill health in this region, and much of the evidence it presents about the economic implications of chronic disease – growing rapidly in many low- and middle-income countries – applies equally well elsewhere. Health: a vital investment for economic development in eastern Europe and central Asia explores the interdependence of health and economic development, focusing on the region's significant economic burden of ill health. It also, simultaneously, advocates evidence-based, cost-effective interventions and strategic decisions at the national and international levels as a crucial means of achieving sustained economic growth and poverty reduction.

Economic consequences of noncommunicable diseases and injuries in the Russian Federation

This study by the European Observatory on Health Systems and Policies examines two important questions: what effect has adult ill health, particularly noncommunicable diseases and injuries, had on the Russian economy and the economic outcomes of the people living there?; if the excessive burden of adult ill health in the Russian Federation were reduced, what economic benefits would result? The answers are unambiguous: poor adult health negatively affects economic well-being and, if effective action were taken, better health would help sustain higher economic growth rates. Though based on the Russian Federation, the findings apply equally to other transitional economies and should be read with interest by policy-makers throughout the eastern part of the WHO European Region.