Relational Contracting in Pakistan’s Surgical Instrument Cluster: An Empirical Study

This paper tests an idea from relational contracting theory [Macauley (1963); North (1990); Greif (1994); Kranton (1996)] that informal relationships can substitute for formal contract enforcement through the judicial system, from the analysis of a new survey of the surgical instrument cluster in Sialkot, Pakistan. Inter-firm trust is thought to lead to reduced transaction costs (a passive benefit of a cluster). Considered here are exchanges of goods between clustered suppliers and their customers, who are either members of the cluster or firms that interact frequently with it. Inter-firm trust is measured as the amount of trade credit offered to customers. The results show that suppliers are more likely to offer trade credit when they believe in the effectiveness of formal contract enforcement and when they participate in business networks (proxied by inter-firm communication). There is also some evidence that customer lock-in helps to develop inter-firm trust since firms give more credit when relationships are of longer duration, and as locked-in customers are less able to find alternate suppliers

Gender Gaps in Child Nutritional Status in Punjab, Pakistan

Child nutritional status has improved over the period 2008 to 2014 in Punjab, Pakistan's largest province with a population of over 100 million, as rates of severe stunting have declined by 8.6 percentage points and average height-for-age (HFA) has increased by 0.19 standard deviations. However, the nutritional status of children in Punjab is still quite poor in comparison to many Sub-Saharan African countries. Recent research from India suggests eldest son preference and son-biased fertility stopping patterns negatively impacts the nutritional status of other children in the household, especially daughters. In order to test for latent gender discrimination in Punjab, Pakistan, a culturally similar neighbour, we apply a finite mixture model to a sample of couples with at least one child of each gender, though we do not find any. We do find, however, that when there is a larger share of children without an elder brother, that is, there is no son or a son is born after several daughters, that the incidence of stunting is higher and average HFA z-score of a couple’s children is lower, using an OLS analysis. This suggests that some families might be increasing their fertility beyond the number of children they can support in pursuit of sons. In this way, couples’ preferences regarding the gender composition of their children can have subsequent effects on the long- term nutritional status of their children. JEL Classification: I2, I14, I15 Keywords: Pakistan, Height-for-Age, Gender, Finite Mixture Mode

Evaluating the Effects of SARS-CoV-2 Spike Mutation D614G on Transmissibility and Pathogenicity.

Global dispersal and increasing frequency of the SARS-CoV-2 spike protein variant D614G are suggestive of a selective advantage but may also be due to a random founder effect. We investigate the hypothesis for positive selection of spike D614G in the United Kingdom using more than 25,000 whole genome SARS-CoV-2 sequences. Despite the availability of a large dataset, well represented by both spike 614 variants, not all approaches showed a conclusive signal of positive selection. Population genetic analysis indicates that 614G increases in frequency relative to 614D in a manner consistent with a selective advantage. We do not find any indication that patients infected with the spike 614G variant have higher COVID-19 mortality or clinical severity, but 614G is associated with higher viral load and younger age of patients. Significant differences in growth and size of 614G phylogenetic clusters indicate a need for continued study of this variant

Genomic epidemiology of SARS-CoV-2 in a UK university identifies dynamics of transmission

AbstractUnderstanding SARS-CoV-2 transmission in higher education settings is important to limit spread between students, and into at-risk populations. In this study, we sequenced 482 SARS-CoV-2 isolates from the University of Cambridge from 5 October to 6 December 2020. We perform a detailed phylogenetic comparison with 972 isolates from the surrounding community, complemented with epidemiological and contact tracing data, to determine transmission dynamics. We observe limited viral introductions into the university; the majority of student cases were linked to a single genetic cluster, likely following social gatherings at a venue outside the university. We identify considerable onward transmission associated with student accommodation and courses; this was effectively contained using local infection control measures and following a national lockdown. Transmission clusters were largely segregated within the university or the community. Our study highlights key determinants of SARS-CoV-2 transmission and effective interventions in a higher education setting that will inform public health policy during pandemics.</jats:p

Evaluating the Effects of SARS-CoV-2 Spike Mutation D614G on Transmissibility and Pathogenicity

Global dispersal and increasing frequency of the SARS-CoV-2 spike protein variant D614G are suggestive of a selective advantage but may also be due to a random founder effect. We investigate the hypothesis for positive selection of spike D614G in the United Kingdom using more than 25,000 whole genome SARS-CoV-2 sequences. Despite the availability of a large dataset, well represented by both spike 614 variants, not all approaches showed a conclusive signal of positive selection. Population genetic analysis indicates that 614G increases in frequency relative to 614D in a manner consistent with a selective advantage. We do not find any indication that patients infected with the spike 614G variant have higher COVID-19 mortality or clinical severity, but 614G is associated with higher viral load and younger age of patients. Significant differences in growth and size of 614G phylogenetic clusters indicate a need for continued study of this variant

LOS CLUSTERS Y EL USO DE MARCAS COLECTIVAS EN CONSORCIOS DE EXPORTACIÓN

En el presente artículo se elabora un modelo teórico para analizar las condiciones en que un grupo de empresas organizadas en cluster de un país en desarrollo puede asociarse de manera cooperativa y conformar un consorcio de exportación para comercializar colectivamente sus productos en el mercado de un país desarrollado. El consorcio elimina el papel de las empresas intermediarias en el país desarrollado. La calidad esperada de la producción de las empresas del cluster es heterogénea. Las empresas del cluster conocen el tipo de calidad de otras empresas, pero el inter-mediario extranjero, no. Sin embargo, el intermediario extranjero tiene un costo de comercialización inferior al de las empresas del cluster. Incluso al hacer suposi-ciones favorables acerca de las ganancias de la cooperación intracluster, el modelo muestra que la comercialización colectiva que se realiza en un consorcio sólo pue-de ocurrir entre empresas de alta calidad, y sólo dentro de valores de parámetros limitados. El aumento en el diferencial de la calidad entre las empresas de baja y alta calidad amplía el rango de los valores de parámetros para los cuales se presenta la comercialización colectiva de las empresas de alta calidad del cluster. Hay una mayor eficiencia social si el intermediario extranjero comercializa la producción del cluster, pero la creíble amenaza de un consorcio puede conducir a una redistri-bución del superávit a favor del cluster

Self-care management of heart failure practical recommendations from the Patient Care Committee of the Heart Failure Association of the European Society of Cardiology

Guidelines on heart failure (HF) stress the importance of lifestyle advice, although there is little evidence that such recommendations improve symptoms or prognosis. Patients experience symptoms of different intensities which impair their daily activities and reduce the quality-of-life. To cope with their clinical condition, many patients seek advice about lifestyle and self-management strategies when in contact with medical care providers, particularly specialized HF services. Self-care management is an important part of HF treatment, thus health professionals working with patients with HF have recognized the need for more specific recommendations on lifestyle advice. The present paper summarizes the available evidence, promotes self-care management, and aims to provide practical advice for health professionals delivering care to HF patients. It also defines avenues of research to optimize self-care strategies in a number of key areas to derive further benefits

Evaluating the Effects of SARS-CoV-2 Spike Mutation D614G on Transmissibility and Pathogenicity

Global dispersal and increasing frequency of the SARS-CoV-2 spike protein variant D614G are suggestive of a selective advantage but may also be due to a random founder effect. We investigate the hypothesis for positive selection of spike D614G in the United Kingdom using more than 25,000 whole genome SARS-CoV-2 sequences. Despite the availability of a large dataset, well represented by both spike 614 variants, not all approaches showed a conclusive signal of positive selection. Population genetic analysis indicates that 614G increases in frequency relative to 614D in a manner consistent with a selective advantage. We do not find any indication that patients infected with the spike 614G variant have higher COVID-19 mortality or clinical severity, but 614G is associated with higher viral load and younger age of patients. Significant differences in growth and size of 614G phylogenetic clusters indicate a need for continued study of this variant

Genomic reconstruction of the SARS-CoV-2 epidemic in England

AbstractThe evolution of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus leads to new variants that warrant timely epidemiological characterization. Here we use the dense genomic surveillance data generated by the COVID-19 Genomics UK Consortium to reconstruct the dynamics of 71 different lineages in each of 315 English local authorities between September 2020 and June 2021. This analysis reveals a series of subepidemics that peaked in early autumn 2020, followed by a jump in transmissibility of the B.1.1.7/Alpha lineage. The Alpha variant grew when other lineages declined during the second national lockdown and regionally tiered restrictions between November and December 2020. A third more stringent national lockdown suppressed the Alpha variant and eliminated nearly all other lineages in early 2021. Yet a series of variants (most of which contained the spike E484K mutation) defied these trends and persisted at moderately increasing proportions. However, by accounting for sustained introductions, we found that the transmissibility of these variants is unlikely to have exceeded the transmissibility of the Alpha variant. Finally, B.1.617.2/Delta was repeatedly introduced in England and grew rapidly in early summer 2021, constituting approximately 98% of sampled SARS-CoV-2 genomes on 26 June 2021.</jats:p