Comparative genomic analysis of toxin-negative strains of Clostridium difficile from humans and animals with symptoms of gastrointestinal disease

Background: Clostridium difficile infections (CDI) are a significant health problem to humans and food animals. Clostridial toxins ToxA and ToxB encoded by genes tcdA and tcdB are located on a pathogenicity locus known as the PaLoc and are the major virulence factors of C. difficile. While toxin-negative strains of C. difficile are often isolated from faeces of animals and patients suffering from CDI, they are not considered to play a role in disease. Toxin-negative strains of C. difficile have been used successfully to treat recurring CDI but their propensity to acquire the PaLoc via lateral gene transfer and express clinically relevant levels of toxins has reinforced the need to characterise them genetically. In addition, further studies that examine the pathogenic potential of toxin-negative strains of C. difficile and the frequency by which toxin-negative strains may acquire the PaLoc are needed. Results: We undertook a comparative genomic analysis of five Australian toxin-negative isolates of C. difficile that lack tcdA, tcdB and both binary toxin genes cdtA and cdtB that were recovered from humans and farm animals with symptoms of gastrointestinal disease. Our analyses show that the five C. difficile isolates cluster closely with virulent toxigenic strains of C. difficile belonging to the same sequence type (ST) and have virulence gene profiles akin to those in toxigenic strains. Furthermore, phage acquisition appears to have played a key role in the evolution of C. difficile. Conclusions: Our results are consistent with the C. difficile global population structure comprising six clades each containing both toxin-positive and toxin-negative strains. Our data also suggests that toxin-negative strains of C. difficile encode a repertoire of putative virulence factors that are similar to those found in toxigenic strains of C. difficile, raising the possibility that acquisition of PaLoc by toxin-negative strains poses a threat to human health. Studies in appropriate animal models are needed to examine the pathogenic potential of toxin-negative strains of C. difficile and to determine the frequency by which toxin-negative strains may acquire the PaLoc

Regulatory Capture by Foreign Corporations: Theory and Evidence from Sub-Saharan Africa

Even in today’s “epoch of globalization,” there remain economic disparities between the world’s richest and poorest countries. In 2017, foreign direct investment (FDI) inflows totaled over US$1.52 trillion globally. The same year, FDI into sub-Saharan Africa totaled just US$28.5 billion, a little over 2% of global flows. To explain these disproportionate capital flows, scholars propose a range of theories involving poor governance, weak institutions, and lack of infrastructure. Historical political economic theories posit that higher levels of corruption, in particular, directly reduce levels of FDI. However, a puzzle exists in which levels of FDI inflows are rising across sub-Saharan Africa in spite of consistently high levels of corruption. Foreign capital is not responding to corruption pressures as theory predicts. Although, compared to the developed world, absolute levels of transacted capital are lower across the continent, they are nevertheless increasing in concert with corruption. I model interactions between a regulator and a multinational firm in a developing country as a principal-agent model with asymmetric information. The formal model shows that a state plagued by a corrupt bureaucracy can experience non-decreasing FDI inflows. More specifically, under the assumption that foreign firms cannot be expropriated from host countries, FDI levels can increase as firms compete for monopolistic power. Although corruption pressures vis-à-vis regulatory capture have the paradoxical effect of crowding in foreign capital, this comes at the expense of consumer welfare. Using an ordinary least squares regression and a hierarchical linear model, the empirical analysis supports these findings for forty-four sub-Saharan African countries from 2006 through 2019

Regulatory Capture by Foreign Corporations: Theory and Evidence from Sub-Saharan Africa

Even in today’s “epoch of globalization,” there remain economic disparities between the world’s richest and poorest countries. In 2017, foreign direct investment (FDI) inflows totaled over US$1.52 trillion globally. The same year, FDI into sub-Saharan Africa totaled just US$28.5 billion, a little over 2% of global flows. To explain these disproportionate capital flows, scholars propose a range of theories involving poor governance, weak institutions, and lack of infrastructure. Historical political economic theories posit that higher levels of corruption, in particular, directly reduce levels of FDI. However, a puzzle exists in which levels of FDI inflows are rising across sub-Saharan Africa in spite of consistently high levels of corruption. Foreign capital is not responding to corruption pressures as theory predicts. Although, compared to the developed world, absolute levels of transacted capital are lower across the continent, they are nevertheless increasing in concert with corruption. I model interactions between a regulator and a multinational firm in a developing country as a principal-agent model with asymmetric information. The formal model shows that a state plagued by a corrupt bureaucracy can experience non-decreasing FDI inflows. More specifically, under the assumption that foreign firms cannot be expropriated from host countries, FDI levels can increase as firms compete for monopolistic power. Although corruption pressures vis-à-vis regulatory capture have the paradoxical effect of crowding in foreign capital, this comes at the expense of consumer welfare. Using an ordinary least squares regression and a hierarchical linear model, the empirical analysis supports these findings for forty-four sub-Saharan African countries from 2006 through 2019

Regulatory Capture by Foreign Corporations: Theory and Evidence from Sub-Saharan Africa

Even in today’s “epoch of globalization,” there remain economic disparities between the world’s richest and poorest countries. In 2017, foreign direct investment (FDI) inflows totaled over US$1.52 trillion globally. The same year, FDI into sub-Saharan Africa totaled just US$28.5 billion, a little over 2% of global flows. To explain these disproportionate capital flows, scholars propose a range of theories involving poor governance, weak institutions, and lack of infrastructure. Historical political economic theories posit that higher levels of corruption, in particular, directly reduce levels of FDI. However, a puzzle exists in which levels of FDI inflows are rising across sub-Saharan Africa in spite of consistently high levels of corruption. Foreign capital is not responding to corruption pressures as theory predicts. Although, compared to the developed world, absolute levels of transacted capital are lower across the continent, they are nevertheless increasing in concert with corruption. I model interactions between a regulator and a multinational firm in a developing country as a principal-agent model with asymmetric information. The formal model shows that a state plagued by a corrupt bureaucracy can experience non-decreasing FDI inflows. More specifically, under the assumption that foreign firms cannot be expropriated from host countries, FDI levels can increase as firms compete for monopolistic power. Although corruption pressures vis-à-vis regulatory capture have the paradoxical effect of crowding in foreign capital, this comes at the expense of consumer welfare. Using an ordinary least squares regression and a hierarchical linear model, the empirical analysis supports these findings for forty-four sub-Saharan African countries from 2006 through 2019

MSK30: a validated tool to assess clinical musculoskeletal knowledge

BackgroundMusculoskeletal (MSK) complaints comprise a large proportion of outpatient visits. However, multiple studies show that medical school curriculum often fails to adequately prepare graduates to diagnose and manage common MSK problems. Current standardised exams inadequately assess trainees’ MSK knowledge and other MSK-specific exams such as Freedman and Bernstein’s (1998) exam have limitations in implementation. We propose a new 30-question multiple choice exam for graduating medical students and primary care residents. Results highlight individual deficiencies and identify areas for curriculum improvement.Methods/ResultsWe developed a bank of multiple choice questions based on 10 critical topics in MSK medicine. The questions were validated with subject-matter experts (SMEs) using a modified Delphi method to obtain consensus on the importance of each question. Based on the SME input, we compiled 30 questions in the assessment. Results of the large-scale pilot test (167 post-clerkship medical students) were an average score of 74 % (range 53% – 90 %, SD 7.8%). In addition, the tool contains detailed explanations and references were created for each question to allow an individual or group to review and enhance learning.SummaryThe proposed MSK30 exam evaluates clinically important topics and offers an assessment tool for clinical MSK knowledge of medical students and residents. It fills a gap in current curriculum and improves on previous MSK-specific assessments through better clinical relevance and consistent grading. Educators can use the results of the exam to guide curriculum development and individual education

Deceptive Content Labeling Survey Data from Two U.S. Midwestern Universities

Intentionally deceptive online content seeks to manipulate individuals in their roles as voters, consumers, and participants in society at large. While this problem is pronounced, techniques to combat it may exist. To analyze the problem and potential solutions, we conducted three surveys relating to how news consumption decisions are made and the impact of labels on decision making. This article describes these three surveys and the data that were collected by them

Effect of Post-Exercise Whole Body Vibration with Stretching on Mood State, Fatigue, and Soreness in Collegiate Swimmers

Static stretching (SS) during whole body vibration (WBV) has been suggested for exercise recovery. The purpose was to compare post-exercise self-ratings of fatigue (FAT), mood state (BAM), soreness (SOR), and perceived exertion (RPE) between SS and WBV+SS in swimmers (9 women, mean ± SD: 19.3 ± 1.3 year, 171 ± 5.7 cm, 67.6 ± 7.2 kg, 26.6 ± 4.1 %body fat (%BF); 10 men, mean ± SD: 19.7 ± 1.0 year, 183 ± 5.5 cm, 77.1 ± 4.2 kg, 13.1 ± 2.2 %BF). Athletes were divided by sex, event (sprint, distance), and assigned to SS or WBV+SS. Both conditions consisted of SS performed on the WBV platform with or without WBV (50 Hz, 6 mm). Sessions consisted of: pre and post measures of BAM, FAT, SOR; the condition; and RPE. Mixed factorial ANOVA were run. A significant condition by pre/post interaction was observed (p = 0.035). Post hoc analyses showed WBV+SS elicited lower post-exercise ratings of FAT (p = 0.002) and the BAM affective states, of tension (p = 0.031), and fatigue (p = 0.087). RPE did not differ between conditions. Of interest is the decrease in tension and fatigue noted by the BAM. Mood state can be indicative of how athletes adapt to training volume and intensity

Blast testing of RC slabs retrofitted with NSM CFRP plates

In this paper, blast testing was performed on two reinforced concrete specimens: a plain reinforced concrete (RC) specimen; and an identical RC specimen retrofitted with near surface mounted (NSM) carbon fibre reinforced polymer (CFRP) plates. Each specimen was subjected to two separate explosive loads at a standoff distance of 0.6m, with the aim of investigating the performances of both specimens within both their elastic and plastic response ranges. The first blast (Blast 1) and second blast (Blast 2) consisted of an equivalent TNT charge weight of 0.079kg and 2.09kg respectively. The elastic-range responses of both specimens after the small shot (Blast 1), such as acceleration and deflection were obtained and comparisons were made between the specimens. The plastic performances of both specimens, such as tension face scabbing, crack patterns, plastic hinges and permanent deflection, after the large shot (Blast 2) were also analysed and compared. A number of unique failures and behaviours of both specimens were observed, investigated and analyzed. The test results provide a vital direction in the development of an optimal retrofit in future research.Chengqing Wu, Deric John Oehlers, John Wachl, Craig Glynn, Adrian Spencer, Matthew Merrigan, Ian Da

HIV prevalence and factors associated with HIV infection among men who have sex with men in Cameroon

Introduction: Despite men who have sex with men (MSM) being a key population for HIV programming globally, HIV epidemiologic data on MSM in Central Africa are sparse. We measured HIV and syphilis prevalence and the factors associated with HIV infection among MSM in Cameroon. Methods: Two hundred and seventy-two and 239 MSM aged ≥18 from Douala and Yaoundé, respectively, were recruited using respondent-driven sampling (RDS) for this cross-sectional surveillance study in 2011. Participants completed a structured questionnaire and HIV and syphilis testing. Statistical analyses, including RDS-weighted proportions, bootstrapped confidence intervals and logistic regressions, were used. Results: Crude and RDS-weighted HIV prevalence were 28.6% (73/255) and 25.5% (95% CI 19.1–31.9) in Douala, and 47.3% (98/207) and 44.4% (95% CI 35.7–53.2) in Yaoundé. Active syphilis prevalence in total was 0.4% (2/511). Overall, median age was 24 years, 62% (317/511) of MSM identified as bisexual and 28.6% (144/511) identified as gay. Inconsistent condom use with regular male partners (64.1%; 273/426) and casual male and female partners (48.5%; 195/402) was common, as was the inconsistent use of condom-compatible lubricants (CCLs) (26.3%; 124/472). In Douala, preferring a receptive sexual role was associated with prevalent HIV infection [adjusted odds ratio (aOR) 2.33, 95% CI 1.02–5.32]. Compared to MSM without HIV infection, MSM living with HIV were more likely to have ever accessed a health service targeting MSM in Douala (aOR 4.88, 95% CI 1.63–14.63). In Yaoundé, MSM living with HIV were more likely to use CCLs (aOR 2.44, 95% CI 1.19–4.97). Conclusions: High HIV prevalence were observed and condoms and CCLs were used inconsistently indicating that MSM are a priority population for HIV prevention, treatment and care services in Douala and Yaoundé. Building the capacity of MSM community organizations and improving the delivery and scale-up of multimodal interventions for MSM that are sensitive to concerns about confidentiality and the complex individual, social, community-level and policy challenges are needed to successfully engage young MSM in the continuum of HIV care. In addition to scaling up condom and CCL access, evaluating the feasibility of novel biomedical interventions, including antiretroviral pre-exposure prophylaxis and early antiretroviral therapy for MSM living with HIV in Cameroon, is also warranted

Fourteen-Genome Comparison Identifies DNA Markers for Severe-Disease-Associated Strains of Clostridium difficile▿†

Clostridium difficile is a common cause of infectious diarrhea in hospitalized patients. A severe and increased incidence of C. difficile infection (CDI) is associated predominantly with the NAP1 strain; however, the existence of other severe-disease-associated (SDA) strains and the extensive genetic diversity across C. difficile complicate reliable detection and diagnosis. Comparative genome analysis of 14 sequenced genomes, including those of a subset of NAP1 isolates, allowed the assessment of genetic diversity within and between strain types to identify DNA markers that are associated with severe disease. Comparative genome analysis of 14 isolates, including five publicly available strains, revealed that C. difficile has a core genome of 3.4 Mb, comprising ∼3,000 genes. Analysis of the core genome identified candidate DNA markers that were subsequently evaluated using a multistrain panel of 177 isolates, representing more than 50 pulsovars and 8 toxinotypes. A subset of 117 isolates from the panel had associated patient data that allowed assessment of an association between the DNA markers and severe CDI. We identified 20 candidate DNA markers for species-wide detection and 10,683 single nucleotide polymorphisms (SNPs) associated with the predominant SDA strain (NAP1). A species-wide detection candidate marker, the sspA gene, was found to be the same across 177 sequenced isolates and lacked significant similarity to those of other species. Candidate SNPs in genes CD1269 and CD1265 were found to associate more closely with disease severity than currently used diagnostic markers, as they were also present in the toxin A-negative and B-positive (A-B+) strain types. The genetic markers identified illustrate the potential of comparative genomics for the discovery of diagnostic DNA-based targets that are species specific or associated with multiple SDA strains