India : why fiscal adjustment now

India's growth performance has been impressive over the last two decades. But its sustainability has been in question, first with the 1991 fiscal-balance of payments crisis (BoP), and then again after 1997/98, when fiscal deficits returned to the 10 percent of GDP range and government debt grew. This paper analyzes the deterioration in India's public finances and presents evidence suggesting that, in the absence of a fiscal adjustment, low inflation and high reserves may have been pursued at the expense of long-run growth and poverty reduction. Resolving this inflation-external vulnerability-growth policy trilemma requires fiscal adjustment. In making its case, the paper shows, first, that fiscal fundamentals have weakened after 1997/98 even when compared with the pre-1991 crisis period. This has continued in spite of the recent record lows in interest rates. Second, the fiscal stance is not conducive to long-run growth and poverty reduction because capital spending has been cut to accommodate higher interest payments and other current spending, with expenditures on the social sectors stagnating. Third, without a fiscal adjustment, the debt burden is likely to reach unmanageable levels by the end of the Tenth Plan period. In contrast, a phased adjustment beginning now and focusing on a relatively small set of reforms is likely to improve debt dynamics substantially over the same horizon, while also promoting faster growth and poverty reduction.Banks&Banking Reform,Payment Systems&Infrastructure,Public Sector Economics&Finance,Economic Theory&Research,Environmental Economics&Policies,Economic Theory&Research,Banks&Banking Reform,Economic Stabilization,Public Sector Economics&Finance,Environmental Economics&Policies

A CADAVERIC STUDY OF THE BRANCHING PATTERN OF RIGHT CORONARY ARTERY IN PAKISTANI POPULATION

Background:  It is very common for coronary arteries to vary in their origin, course and area of distribution. The knowledge about these variations is unequivocally important for a cardiac surgeon and physician. However, the prevalence of such variations varies among different populations. The already available data on variations in the anatomy of coronary arteries is mostly based on studies conducted on the western population and quite a few studies report the coronary arterial patterns of Asian population. Between the two main coronary arteries, i.e. the right coronary artery (RCA) and left coronary arteries (LCA), variation in the branching pattern of RCA is more common than LCA. The present study investigated the branching pattern of RCA in the local population in Pakistan and hence will add to the existing data on inter- and intra-population frequencies of branching pattern of RCA among non-Europeans.   Methods:  It was an observational study of six months duration and conducted on dissection cadavers available in various medical colleges of Rawalpindi and Khyber Pakhtunkhwa. The branching pattern of RCA was studied by blunt dissection method.   Results:  Right marginal, conus, Sinuatrial (SA) nodal, atrioventricular (AV) nodal and posterior descending arteries (PDA) were arising from RCA in majority of cases. However, the branching pattern varied from one heart to another as reported in other studies carried out in developed countries. The frequencies of branching patterns of RCA varied from those already reported in literature.  Conclusions:   RCA manifest anatomical variations in branching pattern as reported in international literature and this variation is different in different populations of the world which indicates that postnatal development, along with differences based on geography and ethnicities might contribute to the modification of anatomical pattern of coronary arteries in humans. 

Indoor Intruder Tracking Using Visible Light Communications

This paper proposes a comprehensive study of indoor intruder tracking using visible light communication (VLC). A realistic indoor VLC channel was developed, taking into consideration reflections, shadowing, and ambient noise. The intruder was considered smart and aiming to escape tracking. This was modelled by adding noise and disturbance to the intruder’s trajectory. We propose to extend the application of minimax filtering from state estimation in the radio frequency (RF) domain to intruder tracking using VLC. The performance of the proposed method was examined and compared with Kalman filter for both VLC and RF. The simulation results showed that the minimax filter provided marginally better tracking and was more robust to the adversary behavior of the intruder than Kalman filter, with less than 0.5 cm estimation error. In addition, minimax was significantly better than Kalman filter for RF tracking applications

Impact of Dynamic Traffic on Vehicle-to-Vehicle Visible Light Communication Systems

In this article we studies the impact of dynamic vehicular traffic density on the signal-to-noise-ratio and the associated bit-error-rate (BER) performance of vehicle-to-vehicle visible light communication (V2V-VLC) systems. The article uses traffic data from the M42 and M6 motorways in the U.K. to investigate the probability of coexistence of other vehicles in the adjacent lanes, which induce interference and act as potential reflectors. The results show that the probability of coexistence of other vehicles in the adjacent lanes is lane-independent and it increases during the rush hours to 90%, while it decays to less than 10% during the off-peak and early morning hours. The intervehicular distance and the BER performance vary widely between different lanes and different periods of the day. The results also show that the BER performance of V2V-VLC system with non-line-of-sight (NLOS) component and with LOS component are comparable at rush hours. However, high BER values are predicted during the off-peak hours for NLOS components of the channel

Impact of Vehicle Headlights Radiation Pattern on Dynamic Vehicular VLC Channel

This article develops a statistical large-scale fading (path loss) model of a dynamic vehicular visible light communication (VVLC) system. The proposed model combines the impact of inter-vehicle spacing and the radiation intensity distribution as a function of the irradiance angle which changes with the traffic conditions. Three models (Lambertian, Gaussian, and empirical) are utilized to examine the impact of vehicles headlights radiation pattern on the statistical path loss of VVLC system. The analytical model of channel path loss is validated by Monte Carlo simulation with the headlight model simulated with a raytracing software. The path loss values of the Gaussian model differ by 2 dB compared to the Lambertian model, irrespective of the traffic conditions while it differs by 24.6 dB during late night and 8.15 dB during rush hours compared to the empirical model of a Toyota Altis headlight. This variation shows that the radiation intensity distribution should be modelled for each vehicle's headlights from each manufacturer to ensure accurate VVLC channel model. The proposed Gaussian model provides a close approximation to describe such radiation pattern and can easily be adapted to model for different manufacturers' headlights

Average channel capacity bounds of a dynamic vehicle-to-vehicle visible light communication system

As vehicles trajectories are unpredictable and changing dynamically, vehicle-to-vehicle visible light communication (V2V-VLC) experiences a dynamic channel. In this work, we conduct measurements taking into account different realistic inter-vehicle distances and ambient noise levels at different times of the day in order to model and verify the dynamic V2V-VLC channel. We also derive the average channel capacity bounds by considering the impact of traffic at different times of the day, atmospheric turbulence and fog. Considering both peak and average optical power levels constraints, we derive the upper and lower bounds by using sphere packing and constraint relaxation methods, as well as truncated-exponential and truncated Gaussian distributions, respectively. The results show that the constraint relaxation method provides an improved estimation for the upper bound, whereas the truncated exponential distribution tightens the lower bound with a minimum gap of 0.4 bit/s/Hz during rush hour and in a clear weather condition. We also show that the average capacity bounds of V2V-VLC are less affected by atmospheric turbulence and fog, and that the capacity during rush hours is higher by 0.7 bit/s/Hz than during late hours

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

The Need for Precision Therapies as Determined by Genetic Signature for Cystic Fibrosis

Cystic fibrosis (CF) is a devastating genetic infant-onset disease [...

The pathogenicity of copy number variants in children with intellectual disability

Intellectual disability affects 1-3% of individuals globally, and, for half the cases, the cause is unknown. Recent studies using whole genome microarray genomic hybridization have shown that submicroscopic genomic imbalance causes intellectual disability in at least 10% of idiopathic cases with normal conventional cytogenetic analysis. I established genotype-phenotype correlations for de novo copy number variants detected by previous whole genome array genome hybridization studies performed by our group in children with intellectual disability. These genotype-phenotype correlations show that genomic imbalance of genes belonging to the epigenetic regulatory category, among others, are causative of intellectual disability. I hypothesized that dosage changes in the broad functional category of genes encoding epigenetic regulatory proteins are more likely to be pathogenic for intellectual disability than dosage changes in other kinds of genes. Epigenetic regulatory proteins include those with DNA methylation, histone modification or chromatin remodeling activity. I have selected all known genes encoding epigenetic regulatory proteins and defined probes to interrogate these candidate genes for copy number alteration as part of a custom targeted microarray design that selectively investigates all candidate genes associated with intellectual disability. We have conducted comparative genome hybridization on 177 patients with idiopathic intellectual disability using this array and on both normal parents of each affected child. We identified and independently validated 16 cases with de novo CNVs involving the epigenetic regulatory candidates. 7 of the 16 CNVs involve the same exon of the JARID2 gene, while the other 9 CNVs affect different genes. I discuss genotype-phenotype correlations for these cases and show that epigenetic perturbation by way of disruption of genes that encode epigenetic regulators is an important cause for intellectual disability.Medicine, Faculty ofMedical Genetics, Department ofGraduat