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Background: It is uncertain if medical masks offer similar protection against COVID-19 compared with N95 respirators. Objective: To determine whether medical masks are noninferior to N95 respirators to prevent COVID-19 in health care workers providing routine care. Design: Multicenter, randomized, noninferiority trial. (ClinicalTrials.gov: NCT04296643). Setting: 29 health care facilities in Canada, Israel, Pakistan, and Egypt from 4 May 2020 to 29 March 2022. Participants: 1009 health care workers who provided direct care to patients with suspected or confirmed COVID-19. Intervention: Use of medical masks versus fit-tested N95 respirators for 10 weeks, plus universal masking, which was the policy implemented at each site. Measurements: The primary outcome was confirmed COVID-19 on reverse transcriptase polymerase chain reaction (RT-PCR) test. Results: In the intention-to-treat analysis, RT-PCR–confirmed COVID-19 occurred in 52 of 497 (10.46%) participants in the medical mask group versus 47 of 507 (9.27%) in the N95 respirator group (hazard ratio [HR], 1.14 [95% CI, 0.77 to 1.69]). An unplanned subgroup analysis by country found that in the medical mask group versus the N95 respirator group RT-PCR–confirmed COVID-19 occurred in 8 of 131 (6.11%) versus 3 of 135 (2.22%) in Canada (HR, 2.83 [CI, 0.75 to 10.72]), 6 of 17 (35.29%) versus 4 of 17 (23.53%) in Israel (HR, 1.54 [CI, 0.43 to 5.49]), 3 of 92 (3.26%) versus 2 of 94 (2.13%) in Pakistan (HR, 1.50 [CI, 0.25 to 8.98]), and 35 of 257 (13.62%) versus 38 of 261 (14.56%) in Egypt (HR, 0.95 [CI, 0.60 to 1.50]). There were 47 (10.8%) adverse events related to the intervention reported in the medical mask group and 59 (13.6%) in the N95 respirator group. Limitation: Potential acquisition of SARS-CoV-2 through household and community exposure, heterogeneity between countries, uncertainty in the estimates of effect, differences in self-reported adherence, differences in baseline antibodies, and between-country differences in circulating variants and vaccination. Conclusion: Among health care workers who provided routine care to patients with COVID-19, the overall estimates rule out a doubling in hazard of RT-PCR–confirmed COVID-19 for medical masks when compared with HRs of RT-PCR–confirmed COVID-19 for N95 respirators. The subgroup results varied by country, and the overall estimates may not be applicable to individual countries because of treatment effect heterogeneity. Primary Funding Source: Canadian Institutes of Health Research, World Health Organization, and Juravinski Research Institute.

PurposeThis paper aims at assessing the impact of a number of behavioral interventions on the willingness of informal businesses, in the Egyptian informal sector, to join the formal sector.Design/methodology/approachThis paper uses an experimental methodology to examine the impact of behavioral interventions on the formalization of the Egyptian informal sector. Specifically, it conducts a survey experiment on a total of 240 informal businesses, operating in the Egyptian informal sector. The primary data collected from the survey experiment is then analyzed using a binary logistic regression to assess the impact of the behavioral primes on the probability of joining the formal market.FindingsThe empirical findings of the survey experiment indicate that the biggest obstacle facing informal businesses is finding a formal source of finance that could help them in penetrating the market. Providing informal businesses with information on funding opportunities offered by the ministry of micro, small and medium enterprises (MSME) significantly increased the probability of joining the formal sector to benefit from this opportunity.Originality/valueThis paper is the first to apply behavioral primes, in the form of informational cues, to the Egyptian case of informal business owners. Previous research on the use of behavioral nudges and primes has focused mainly on the western economies.

We examine whether political polarization is an obstacle to common value reforms. We conduct experiments in two ideologically polarized countries, the United States and Egypt. Subjects vote between enacting a reform which yields higher expected financial payoffs than the costs of implementation for all (but has indirect differential benefits for supporters of only one group of voters) versus not enacting the reform and everyone receiving lower payoffs. We find that when the groups are polarized ideologically, subjects are less likely to vote for reform when informed that another political group would differentially benefit, and more likely to support reform should their own group benefit more. When subjects are told that one group will differentially benefit from reform, they are significantly more likely to explain their vote as being influenced by their own group membership. In contrast, we find that when subjects are organized into nonpolarized groups, group membership predicts reform support less, and when there are no differential benefits for a particular group, the effect of membership on support is significantly reduced. Hence, we find that the effect of polarization on support for common value reform is contingent on the existence of indirect differential benefits and the degree of ideological polarization of the groups who receive those benefits.

PurposeTax evasion is an economic crime that nearly all world countries suffer from. Its consequences are countless, including poor public spending on infrastructure projects and social welfare programs, low economic growth and development, institutional mistrust and fiscal deficits. For developing countries in particular, targeting development programs and infrastructural investments requires an efficient tax collection policy to generate sufficient funds for such purposes. This makes the tax evasion problem a critical one and countering it extremely policy relevant. Based on evidence that shows how the understanding of taxpayers' behavior is an essential factor in fighting evasion, this paper aims to test different factors that might incentivize citizens using a behavioral and experimental approach, in non-Western educated industrialized rich democracies (non-WEIRD) countries, to comply more.Design/methodology/approachThis paper uses a survey experiment to examine the impact of different behavioral primes on tax compliance behavior. Specifically, it observes subjects' compliance behavior in two contexts: voice and empathy. A total of 273 students from a big public university in Egypt were randomly selected to participate in this study.FindingsIn the “Voice” treatment, the explanatory variable (VOICE) was found statistically significant, thus confirming the hypothesis that democracy, through having a voice in the decision-making process, affects compliance positively. As for the “Empathy” treatment, the explanatory variable (EMPATHY) was also found significant. This confirms the second hypothesis that triggering feelings of empathy, through highlighting the good cause behind public spending that uses taxpayers' money, affects compliance behavior positively.Research limitations/implicationsDespite the fact that the experimental methodology is a methodology with high internal validity, examining the impact of a specific intervention on behavior, a replication of the experiment in other contexts might be useful in increasing the external validity of the findings. Specifically, conducting this experiment on a nonstudent sample might lead to even more powerful results by increasing the ecological validity of the results.Practical implicationsThis study advocates a more behaviorally informed public policy. Specifically, Egyptian policymakers are recommended to adopt behavioral nudges as a complement to existing policies. The authors believe the findings, if confirmed by repeated experiments (lab, lab-in-the-field and rational choice theories on both student and non-student samples) in a number of Arab countries, might also help in offering cost-effective nudges for the Arab world policymakers, where culture and the political context are to a great extent similar.Social implicationsThe findings of the study have a number of social implications. Higher tax compliance will enable higher levels of public spending on a number of social targets such as education, health and welfare programs.Originality/valueWhile the study builds on recent research examining how to incentivize tax compliance, it simultaneously seeks to make three contributions. First, the study design aims to apply recent advances in behavioral sciences (impact of voice and empathy) in a policy area that has not seen much use of such interventions in the Egyptian context (i.e. tax compliance). Second, the study is policy relevant in the sense that it aims to increase the effectiveness of existing government policies by complementing them with behavioral primes. Third, there is nearly no literature found applying this topic in a non-WEIRD country such as Egypt.

With the number of people fleeing Syria since 2011 exceeding 5 million, and unclear prospects regarding the country’s future, Syrians currently residing outside their homeland are not expected to return any time soon. The question of their integration into their respective hosting countries is, therefore, directly policy relevant. We focus on Syrians who fled to Egypt. Cultural, religious and linguistic differences between those two countries are minor, which is expected to facilitate integration. We ran three incentivized lab-in-the-field experiments pairing 114 Syrian refugees residing in Egypt with 194 Egyptian nationals to measure various behavioral dimensions such as altruism, cooperation and reciprocity, while varying the partner in each game to be either a refugee or an Egyptian. Our findings indicate that Egyptians treat Syrians more favorably than they treat each other across all games, whereas the behavior of Syrians does not depend on the identity of their interaction partner.

Background Staphylococcus aureus bacteremia (SAB) is associated with high morbidity and mortality. Infectious disease consultation (IDC) is associated with increased adherence to guideline management and improved patient outcomes. We describe the IDC rate over time and impact of IDC on the management and outcomes of patients with SAB. Methods This retrospective chart review includes adult patients (≥ 18 years) hospitalized at the University of Alberta Hospital, Edmonton, Canada who had at least 1 blood culture growing Staphylococcus aureus during two time periods (A: Jan 2010 to Dec 2012; B: Jan to Oct 2020). Patients who died or were made palliative within 48hrs following bacteremia were excluded. Descriptive statistics were used to compare appropriateness of SAB management and outcomes in patients receiving IDC and those who did not (NIDC). Results 325 patients in period A and 129 in period B were included. Baseline demographics were similar. IDC rate increased from 63% to 88% (p< 0.001) between the study periods. IDC was associated with increased odds of receiving an echocardiogram (OR=3.56, 95% CI 2.22 – 5.57; OR=20.4, 95% 4.13 – 110.6, p< 0.001) and appropriate duration of antimicrobial therapy (OR=6.74, 95% 3.93 – 11.54; OR=43.2, 95% 5.72 – 529.5, p< 0.001) between study periods. Mean length of stay decreased in patients receiving IDC (44.8 vs 28.1 days, p=0.005) and increased in NIDC patients (19.9 vs 28.7 days, p=0.216). IDC was associated with lower 30-day mortality in period A (OR=3.53, 95% 1.95 – 6.36), however this association was not observed in period B (OR=1.43, 95% 0.40 – 5.56). There was a trend towards decreased odds of mortality in patients receiving early IDC (≤2 days from bacteremia, n=65) compared to late IDC (≥3 days from bacteremia, n=45) (OR=2.59, 95% 0.95 – 7.10, p=0.077). Conclusion Our centre’s IDC rate for SAB increased over time without specific intervention. IDC increased the odds of appropriate SAB management and was associated with decreased length of stay in period B. IDC was associated with lower 30-day mortality in period A and trended towards lower mortality in period B. Specifically, early IDC decreased odds of 30-day mortality compared to late IDC. These results suggest that routine early IDC be part of SAB management. Disclosures All Authors: No reported disclosures

BRCA1/2 help maintain genomic integrity by stabilizing stalled forks for repair and thus act as tumor suppressors. Duan et al. identify the E3 ligase RFWD3 as a novel modulator of stalled fork stability in BRCA2-deficient cells and show that blocking fork degradation by depleting MRE11 is not sufficient for full fork recovery., BRCA1/2 help maintain genomic integrity by stabilizing stalled forks. Here, we identify the E3 ligase RFWD3 as an essential modulator of stalled fork stability in BRCA2-deficient cells and show that codepletion of RFWD3 rescues fork degradation, collapse, and cell sensitivity upon replication stress. Stalled forks in BRCA2-deficient cells accumulate phosphorylated and ubiquitinated replication protein A (ubq-pRPA), the latter of which is mediated by RFWD3. Generation of this intermediate requires SMARCAL1, suggesting that it depends on stalled fork reversal. We show that in BRCA2-deficient cells, rescuing fork degradation might not be sufficient to ensure fork repair. Depleting MRE11 in BRCA2-deficient cells does block fork degradation, but it does not prevent fork collapse and cell sensitivity in the presence of replication stress. No such ubq-pRPA intermediate is formed in BRCA1-deficient cells, and our results suggest that BRCA1 may function upstream of BRCA2 in the stalled fork repair pathway. Collectively, our data uncover a novel mechanism by which RFWD3 destabilizes forks in BRCA2-deficient cells.

International audience; Most animals exhibit mirror-symmetric body plans, yet the molecular constituents from which they are formed are often chiral. In planarian flatworms, centrioles are arranged in a bilaterally symmetric pattern across the ventral epidermis. Here, we found that this pattern is generated by a network of centrioles with prominent chiral asymmetric properties. We identify centriole components required for establishing asymmetric connections between centrioles and balancing their effects to align centrioles along polarity fields. SMED-ODF2, SMED-VFL1, and SMED-VFL3 affect the assembly of centriole appendages that tether cytoskeletal connectors to position the centrioles. We further show that the medio-lateral polarization of centrioles relies on mechanisms that are partly distinct on the left and right sides of the planarian body. Our findings shed light on how bilaterally symmetrical patterns can emerge from chiral cellular organizations.

How far does democracy decrease corruption? And which specific aspects of democracy help generate such effects? Corruption is famously one of the strongest obstacles to social and economic development. Whereas there has been extensive research identifying the causes of corruption, there is little experimental research on the impact of political institutions on corruption using designs that control for significant confounders. This paper uses a series of laboratory experiments conducted in 2013 Egypt in which a government official decides whether to spend tax revenues paid by subjects on a self-serving good or a good that benefits everyone equally. We have two experimental manipulations: (a) whether the official is electorally accountable to subjects or not; (b) whether subjects could send messages of protests to the official (and one another). We find evidence that electoral accountability does decrease the probability of the official choosing the self-serving good by 17% whereas voice accountability generates such outcome only in the authoritarian treatment (a reduction of corruption by 29%). We also find suggestive evidence that, in the authoritarian treatment, the likelihood of funding the self-serving good decreases by 27% when taxes paid by citizens fall short of the official’s threshold. Our contribution to the literature is two-fold: (a) we are able to single out the effect of specific democratic mechanisms on government corruption; (b) we test outcomes of democratic mechanisms on a traditionally understudied subject pool.

Key advances in the evaluation and treatment of hepatitis C virus (HCV) infection have positively transformed the management and outcomes of those living with this chronic viral infection. Previously difficult-to-cure populations, including those coinfected with HIV infection, now enjoy similarly high success rates with interferon-free, orally administered direct-acting antiviral (DAA) therapies. Nonetheless, relevant unresolved clinical questions remain. The role and impact of viral resistance testing on treatment selection and outcome remain to be fully determined. The consequences of developing resistance while on DAA treatments that ultimately prove unsuccessful requires further evaluation. Optimal HCV management strategies in decompensated liver disease are unclear, and the role for ribavirin in DAA treatment-naïve and treatment-experienced patients is uncertain. A chief concern for those with cirrhosis relates to the risk for de novo and recurrent hepatocellular carcinoma among DAA recipients. In this article, we present and interpret current data and consider pragmatic, clinically useful options.

Most animals exhibit mirror-symmetric body plans, yet the molecular constituents from which they are formed are often chiral. In planarian flatworms, centrioles are arranged in a bilaterally symmetric pattern across the ventral epidermis. Here, we found that this pattern is generated by a network of centrioles with prominent left-right asymmetric properties. We identify centriole components required for establishing left-right asymmetric connections between centrioles and balancing their effects to align centrioles along polarity fields. We show that the asymmetry of the network is also compensated by specific interactions of its components with polarity cues on the left and right sides of the planarian body. Our findings shed new light on how bilateral symmetry can emerge from chiral cellular organizations.

With the number of Syrians who have fled their country since 2011 exceeding 5 million, and no end in sight of the Syrian civil war, there is little expectation that Syrians currently residing outside of Syria are likely to go back soon. The question of their integration into their respective hosting countries is, therefore, directly policy relevant. We focus on Syrians who fled to Egypt. Cultural, religious and linguistic differences are minor, which is expected to facilitate integration. We ran three incentivized lab-in-the-field experiments with 114 Syrian refugees residing in Egypt and 194 Egyptian nationals to measure various behavioral dimensions such as altruism, cooperation and reciprocity while varying the partner in each game to be either refugee or Egyptian. Our findings indicate that Egyptians treat Syrians more favorably than they treat each other across all games, whereas the behavior of Syrians does not depend on their interaction partner. We argue that this is good news for the integration of Syrians into Egypt but worrying news for the overall development prospects of Egypt.

Egypt, a country of 82 million people with a GDP of $272 billion, is arguably one of the most important countries in the Middle East. At this stage of its transition, the structure and level of public finances are more critical than ever. Like many countries, Egypt suffers from substantial non-compliance, which undermines the entire system of public finance, yet there has been relatively little focus on addressing this issue in Egypt. This chapter is focused on a review of the recent history of Egypt's public finances and a unique experiment that aims to better understand the potential for political institutions to affect tax compliance at a time when those institutions are under development.

Organochalcogen-nitrogen heterocycles such as the 1,2,5-chalcogenadiazoles have a distinct tendency to establish intermolecular links in the solid state through secondary bonding interactions E...N (E = S, Se, Te). The association of these molecules was examined in detail using relativistic density functional theory. Although there is an important electrostatic component, the interaction between these molecules is dominated by contributions arising from orbital mixing, which can be interpreted as the donation of a nitrogen lone pair into the chalcogen-centered antibonding orbitals. Because of its more polar character and lower-lying antibonding orbitals, the tellurium derivatives possess the strongest association energies; these are so large that the binding strength is comparable to that of some hydrogen bonds. In the absence of steric constraints, telluradiazoles associate in a coplanar fashion forming ribbon polymers. However, bulky susbstituents could be used to direct the formation of either helical chains or discrete dimers. In addition to its strength, the coplanar dimer is characterized by being rigid, yet no activation barrier is expected for the association/dissociation process. These attributes strongly indicate that tellurium-nitrogen heterocycles have great potential as building blocks in supramolecular architecture.

The increasing attention of the Government of Egypt, since the 2011 revolution, to achieve sustainable and inclusive growth has given a renewed stimulus to research on economic growth from a sectoral perspective. In this paper, we investigate the main sectors that drive economic growth in Egypt in various time periods by adopting an econometric modelling strategy. In particular, we attempt to answer the following questions: what are the sectors that led economic growth in Egypt during the high-growth period? Were these sectors resilient to shocks? What are therefore the sectors of high priority that policy makers should direct efforts to in order to achieve sustainable inclusive high growth rates? The findings of the regression model reveal a significant role for both the manufacturing and the agriculture sector in promoting economic growth, with a 1% increase in the output of the manufacturing sector being capable of increasing GDP by 0.17%, while, the same increase in the output of the agriculture sector resulting in an increase in GDP by 0.15%.

The effect of the long-range Coulomb interaction on charge accumulation in antiferromagnetic vortices in high-Tc superconductors is studied within a Bogoliubov-de Gennes mean-field model of competing antiferromagnetic and d-wave superconducting orders. Antiferromagnetism is found to be associated with an accumulation of charge in the vortex core, even in the presence of the long-range Coulomb interaction. The manifestation of Pi-triplet pairing in the presence of coexisting dSC and AFM order, and the intriguing appearance of one-dimensional stripe-like ordering are discussed. The local density of states (LDOS) in the vortex core is calculated and is found to be in excellent qualitative agreement with experimental data., 14 pages, 8 figures, 2 column RevTex4 PRB format