•We study the impacts of women’s Self-help group membership on women’s and men’s empowerment.•We measure empowerment using two alternate indices: the A-WEAI and the Pro-WEAI.•We find that SHG ...membership has a significant positive impact on aggregate measures of women’s empowerment.•We also find that SHG membership reduces the gap between men’s and women’s empowerment scores.•The impacts are driven by increase in control over income, decisionmaking over credit, and active involvement in groups.
Women’s groups are important rural social and financial institutions in South Asia. In India, a large majority of women’s groups programs are implemented through self-help groups (SHGs). Originally designed as savings and credit groups, the role of SHGs has expanded to include creating health and nutrition awareness, improving governance, and addressing social issues related to gender- and caste-based discrimination. This paper uses panel data from 1470 rural Indian women from five states to study the impact of SHG membership on women’s empowerment in agriculture, using the project-level Women’s Empowerment in Agriculture Index (pro-WEAI) and the abbreviated Women’s Empowerment in Agriculture Index (A-WEAI). Because SHG membership was not randomized and women who self-select to be SHG members may be systematically different from non-members, we employ nearest neighbor matching methods to attribute the impact of SHG membership on women’s empowerment in agriculture and intrahousehold inequality.
Our findings suggest that SHG membership has a significant positive impact on aggregate measures of women’s empowerment and reduces the gap between men’s and women’s empowerment scores. This improvement in aggregate empowerment is driven by improvements in women’s scores, not a deterioration in men’s. Greater control over income, greater decisionmaking over credit, and (somewhat mechanistically, given the treatment) greater and more active involvement in groups within the community lead to improvements in women’s scores. However, impacts on other areas of empowerment are limited. The insignificant impacts on attitudes towards domestic violence and respect within the household suggest that women’s groups alone may be insufficient to change deep-seated gender norms that disempower women. Our results have implications for the design and scale-up of women’s group-based programs in South Asia, including the possibility that involving men is needed to change gender norms.
Poor diets are a major challenge in India. Barriers to improving diets include limited knowledge, access to resources and availability of affordable nutritious foods. Bihar, a poor state in India, ...has scaled up women’s savings and credit self-help group (SHG) programs state-wide to improve livelihoods and access to resources. SHGs are now being leveraged to integrate health and nutrition discussions into their activities but rigorous evidence on the impact of integration is limited.
Cluster-randomized impact evaluation comparing 12 treatment and 12 comparison villages. Treatment area SHGs engaged in facilitated bi-monthly health/nutrition discussions, and increased coordination efforts between SHGs and their federations and health/nutrition service providers. Control SHGs conducted routine savings & credit activities. We surveyed 2000 households (1000 treatment; 1000 control) in April 2016 and again in Oct 2018. We assessed impact on diet diversity of women and their children and body mass index (BMI) of women using analysis of covariance, adjusting for sample clustering, baseline levels of outcomes & other characteristics. We did a mid-term mixed-methods process evaluation to assess implementation and uptake and a retrospective costing study to estimate implementation costs.
Sample characteristics were generally balanced across arms at baseline. The intervention led to a 7–8% increase (P < 0.05) in the number of food groups consumed by women and children but had no impact on women’s BMI. Consumption of pulses, fruits, vegetables and dairy increased significantly, but not eggs or flesh foods, suggesting resource constraints and social norms were barriers. A pathway analysis showed that the intervention worked primarily by improving awareness about diets. Process evaluation identified various implementation challenges that affected intervention exposure. The implementation cost $6/SHG member/year, comparable to other similar interventions.
SHG platforms have potential to influence awareness about nutrition and dietary practices but impact can be constrained by exposure to interventions and household-level economic and social constraints.
World Bank Strategic Impact Evaluation Fund; Bill & Melinda Gates through WINGS, managed by IFPRI.
Advertisements are a key source of revenue for companies in the broadcasting and web industries. However, because of increasing competition, advertisers and web publishers have been forced to find ...innovative ways to increase their profits and gain competitive advantages. Revenue management is a useful operations research and management science tool that may be used to do so. In this paper, we provide an updated review of revenue-management research conducted in the broadcasting and online advertisement industries, highlighting the strategies and techniques adopted to maximize advertising revenue. We also identify mobile advertising as an emerging revenue-management application and review current research on it. We conclude by identifying potential gaps that future research might address.
SARS-CoV-2 variants of concern (VOCs) have threatened COVID-19 vaccine effectiveness. We aimed to assess the effectiveness of the ChAdOx1 nCoV-19 vaccine, predominantly against the delta (B.1.617.2) ...variant, in addition to the cellular immune response to vaccination.
We did a test-negative, case-control study at two medical research centres in Faridabad, India. All individuals who had a positive RT-PCR test for SARS-CoV-2 infection between April 1, 2021, and May 31, 2021, were included as cases and individuals who had a negative RT-PCR test were included as controls after matching with cases on calendar week of RT-PCR test. The primary outcome was effectiveness of complete vaccination with the ChAdOx1 nCoV-19 vaccine against laboratory-confirmed SARS-CoV-2 infection. The secondary outcomes were effectiveness of a single dose against SARS-CoV-2 infection and effectiveness of a single dose and complete vaccination against moderate-to-severe disease among infected individuals. Additionally, we tested in-vitro live-virus neutralisation and T-cell immune responses to the spike protein of the wild-type SARS-CoV-2 and VOCs among healthy (anti-nucleocapsid antibody negative) recipients of the ChAdOx1 nCoV-19 vaccine.
Of 2379 cases of confirmed SARS-CoV-2 infection, 85 (3·6%) were fully vaccinated compared with 168 (8·5%) of 1981 controls (adjusted OR aOR 0·37 95% CI 0·28–0·48), giving a vaccine effectiveness against SARS-CoV-2 infection of 63·1% (95% CI 51·5–72·1). 157 (6·4%) of 2451 of cases and 181 (9·1%) of 1994) controls had received a single dose of the ChAdOx1 nCoV-19 vaccine (aOR 0·54 95% CI 0·42–0·68), thus vaccine effectiveness of a single dose against SARS-CoV-2 infection was 46·2% (95% CI 31·6–57·7). One of 84 cases with moderate-to-severe COVID-19 was fully vaccinated compared with 84 of 2295 cases with mild COVID-19 (aOR 0·19 95% CI 0·01–0·90), giving a vaccine effectiveness of complete vaccination against moderate-to-severe disease of 81·5% (95% CI 9·9–99·0). The effectiveness of a single dose against moderate-to-severe disease was 79·2% (95% CI 46·1–94·0); four of 87 individuals with moderate-to-severe COVID-19 had received a single dose compared with 153 of 2364 participants with mild disease (aOR 0·20 95% CI 0·06–0·54). Among 49 healthy, fully vaccinated individuals, neutralising antibody responses were lower against the alpha (B.1.1.7; geometric mean titre 244·7 95% CI 151·8–394·4), beta (B.1.351; 97·6 61·2–155·8), kappa (B.1.617.1; 112·8 72·7–175·0), and delta (88·4 61·2–127·8) variants than against wild-type SARS-CoV-2 (599·4 376·9–953·2). However, the antigen-specific CD4 and CD8 T-cell responses were conserved against both the delta variant and wild-type SARS-CoV-2.
The ChAdOx1 nCoV-19 vaccine remained effective against moderate-to-severe COVID-19, even during a surge that was dominated by the highly transmissible delta variant of SARS-CoV-2. Spike-specific T-cell responses were maintained against the delta variant. Such cellular immune protection might compensate for waning humoral immunity.
Department of Biotechnology India, Council of Scientific and Industrial Research India, and Fondation Botnar.
Rapid spread of the omicron SARS-CoV-2 variant despite extensive vaccination suggests immune escape. The neutralising ability of different vaccines alone or with natural SARS-CoV-2 infection against ...omicron is not well-known.
In this cross-sectional study, we tested the ability of vaccine and natural infection induced antibodies to neutralise omicron variant in a live virus neutralisation assay in four groups of individuals: (i) ChAdOx1 nCoV-19 vaccination, (ii) ChAdOx1 nCoV-19 vaccination plus prior SARS-CoV-2 infection, (iii) vaccination with inactivated virus vaccine (BBV152), and (iv) BBV152 vaccination plus prior SARS-CoV-2 infection. Primary outcome was fold-change in virus neutralisation titre against omicron compared with ancestral virus.
We included 80 subjects. The geometric mean titre (GMT) of the 50% focus reduction neutralisation test (FRNT50) was 380·4 (95% CI: 221·1, 654·7) against the ancestral virus with BBV152 vaccination and 379·3 (95% CI: 185·6, 775·2) with ChAdOx1 nCov-19 vaccination alone. GMT for vaccination plus infection groups were 806·1 (95% CI: 478·5, 1357·8) and 1526·2 (95% CI: 853·2, 2730·0), respectively. Against omicron variant, only 5 out of 20 in both BBV152 and ChAdOx1 nCoV-19 vaccine only groups, 6 out of 20 in BBV152 plus prior SARS-CoV-2 infection group, and 9 out of 20 in ChAdOx1 nCoV-19 plus prior SARS-CoV-2 infection group exhibited neutralisation titres above the lower limit of quantification (1:20) suggesting better neutralisation with prior infection. A reduction of 26·6 and 25·7 fold in FRNT50 titres against Omicron compared to ancestral SARS-CoV-2 strain was observed for individuals without prior SARS-CoV-2 infection vaccinated with BBV152 and ChAdOx1 nCoV-19, respectively. The corresponding reduction was 57·1 and 58·1 fold, respectively, for vaccinated individuals with prior infection. The 50% neutralisation titre against omicron demonstrated moderate correlation with serum anti-RBD IgG levels Spearman r: 0·58 (0·41, 0·71).
Significant reduction in the neutralising ability of both vaccine-induced and vaccine plus infection-induced antibodies was observed for omicron variant which might explain immune escape.
Department of Biotechnology, India; Bill & Melinda Gates Foundation, USA
To study clinical disease outcomes in both human and animal models to understand the pathogenicity of omicron compared to the delta variant.
In this cross-sectional observational study, clinical ...outcomes of adults who tested positive at 2 testing centres in Delhi National Capital Region between January 2022 and March 2022 (omicron-infected; N = 2998) were compared to a similar geographical cohort (delta-infected; N = 3292). In addition, disease course and outcomes were studied in SARS-CoV-2-infected golden Syrian hamsters and K-18 humanized ACE2 transgenic mice.
Omicron variant infection was associated with a milder clinical course 83% (95% CI 61, 94) reduced risk of severity compared against delta adjusting for vaccination, age, sex, prior infection and occupational risk. This correlated with lower disease index and vir comparing omicron with other variants in animal models.
Infections caused by the omicron variant were milder compared to those caused by the delta variant independent of previous immunity.
SARS-CoV-2 antibody detection assays are crucial for gathering seroepidemiological information and monitoring the sustainability of antibody response against the virus. The SARS-CoV-2 Spike protein's ...receptor-binding domain (RBD) is a very specific target for anti-SARS-CoV-2 antibodies detection. Moreover, many neutralizing antibodies are mapped to this domain, linking antibody response to RBD with neutralizing potential. Detection of IgG antibodies, rather than IgM or total antibodies, against RBD is likely to play a larger role in understanding antibody-mediated protection and vaccine response. Here we describe a rapid and stable RBD-based IgG ELISA test obtained through extensive optimization of the assay components and conditions. The test showed a specificity of 99.79% (95% CI: 98.82-99.99%) in a panel of pre-pandemic samples (
= 470) from different groups, i.e., pregnancy, fever, HCV, HBV, and autoantibodies positive. Test sensitivity was evaluated using sera from SARS-CoV-2 RT-PCR positive individuals (
= 312) and found to be 53.33% (95% CI: 37.87-68.34%), 80.47% (95% CI: 72.53-86.94%), and 88.24% (95% CI: 82.05-92.88%) in panel 1 (days 0-13), panel 2 (days 14-20) and panel 3 (days 21-27), respectively. Higher sensitivity was achieved in symptomatic individuals and reached 92.14% (95% CI: 86.38-96.01%) for panel 3. Our test, with a shorter runtime, showed higher sensitivity than parallelly tested commercial ELISAs for SARS-CoV-2-IgG, i.e., Euroimmun and Zydus, even when equivocal results in the commercial ELISAs were considered positive. None of the tests, which are using different antigens, could detect anti-SARS-CoV-2 IgGs in 10.5% RT-PCR positive individuals by the fourth week, suggesting the lack of IgG response.
Abstract
A recently emerged sub-lineage of Omicron, BA.5, together with BA.4, caused a fifth wave of coronavirus disease (COVID-19) in South Africa and subsequently emerged as a predominant strain ...globally due to its high transmissibility. The lethality of BA.5 infection has not been studied in an acute hACE2 transgenic (hACE2.Tg) mouse model. Here, we investigated tissue-tropism and immuno-pathology induced by BA.5 infection in hACE2.Tg mice. Our data show that intranasal infection of BA.5 in hACE2.Tg mice resulted in attenuated pulmonary infection and pathology with diminished COVID-19-induced clinical and pathological manifestations. BA.5, similar to Omicron (B.1.1.529), infection led to attenuated production of inflammatory cytokines, anti-viral response and effector T cell response as compared to the ancestral strain of SARS-CoV-2, Wuhan-Hu-1. We show that mice recovered from B.1.1.529 infection showed robust protection against BA.5 infection associated with reduced lung viral load and pathology. Together, our data provide insights as to why BA.5 infection escapes previous SARS-CoV-2 exposure induced-T cell immunity but may result in milder immuno-pathology and alleviated chances of re-infectivity in Omicron-recovered individuals.
Measuring SARS-CoV-2-specific T cell responses is crucial to understanding an individual's immunity to COVID-19. However, high inter- and intra-assay variability make it difficult to define T cells ...as a correlate of protection against COVID-19. To address this, we performed systematic review and meta-analysis of 495 datasets from 94 original articles evaluating SARS-CoV-2-specific T cell responses using three assays - Activation Induced Marker (AIM), Intracellular Cytokine Staining (ICS), and Enzyme-Linked Immunospot (ELISPOT), and defined each assay's quantitative range. We validated these ranges using samples from 193 SARS-CoV-2-exposed individuals. Although IFNγ ELISPOT was the preferred assay, our experimental validation suggested that it under-represented the SARS-CoV-2-specific T cell repertoire. Our data indicate that a combination of AIM and ICS or FluoroSpot assay would better represent the frequency, polyfunctionality, and compartmentalization of the antigen-specific T cell responses. Taken together, our results contribute to defining the ranges of antigen-specific T cell assays and propose a choice of assay that can be employed to better understand the cellular immune response against viral diseases.
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