Essays in Behavioral and Experimental Economics

This dissertation comprises of essays in the field of development economics. Leveraging insights from psychology, mingling them in economic theory, and testing them through experimental (and quasi-experimental) methods, I study three policy questions: Does grading system affect student performance? Does symbolic incentive offered in a competitive game increase student attendance? Does institutional quality affect the provision of public goods and the perception of tax as a burden? In the first chapter, I study whether level of discretization of reported grades to students affect their academic performance? This is the first experimental study to test how performance reporting using a coarse grading scale: {A,B,C,D,F} (Letter Grading System or LGS - the treatment group) or a very fine grading scale: [0,100] (Numerical Grading System or NGS - the control group) affects student performance. While I find no difference in average student performance between LGS and NGS, this negligible effect, however, masks important gender-differences in student performance with female students responding more positively to NGS and male students responding more positively to LGS. The theoretical model presented in the paper throws light on a possible mechanism (risk-attitudes) causing these gender-differences. This evidence is informative of the role that the chosen grading scale may have played in the widely seen gender-gap in student learning. In the second chapter, I report the results of a field experiment conducted to study how student attendance changes when transformed into a strategic-decision using a competitive game setting. The game awarded points to students based on their daily attendance. Each student could track the weekly status of his/her game points, along with the game points of every other student in the class, thereby bringing an explicit strategic element to the intervention. The scoring rule had a novel weighting mechanism, designed to lower absenteeism by a greater degree in the weeks when students are more likely to be absent. This experiment was conducted with 217 classrooms, divided into two treatments (Group Game and Classroom Game) and one control group of a not-for-profit educational institution in India. Symbolic rewards were provided to the winners of the game in the treatment classrooms. The results show a significant positive effect on students whose attendance was greater than 75% while not much effect on the rest. This provides evidence of how the use of a simple competitive game with low-cost, symbolic rewards can efficiently and positively impact student attendance. In the third chapter, coauthor Alberto Chong and I study the role that institutional quality plays in determining government’s effectiveness in delivering public goods and in, therefore, mediating the effects of higher taxation in an economy. This study is inspired from the observation that poorer countries, despite having a much smaller public sector and correspondingly a smaller tax burden than richer countries, have mostly displayed a weaker economic performance than richer countries. Using a simple theoretical model, we show that the provision of public goods and optimal tax levels increase with improved institutional quality. Using firm level perceptions data on the quality of public services and the tax burden, consistent with the predictions of our model, we find that a higher level of institutional quality bolsters positive perception of the quality of public services while at the same time moderating the view of the taxes as an obstacle to growth

IVF laboratory management in COVID-19 pandemic

Background: Since the first report of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), widely known as COVID-19, in late December 2019, it has spread worldwide. The eventual return of new normal has started to happen in most countries where the COVID-19 curve has flattened, and Assisted reproduction technology (ART) services are eventually resuming. Well-organized ART (embryology/andrology) laboratories safeguard the wellbeing of all staff, patients, and their gametes/embryos. Main body: A well-organized pandemic management plan must be implemented in anticipation of possible subsequent COVID-19 waves. Apart from local and national guidelines, some mandatory changes need to be taken into considerations that will allow us to overcome the fear of this deadly pandemic, work smoothly and stop any possible transmission without comprising the quality control for successful treatment. These mandatory changes include conserving different supplies, reducing manpower needs, and various protective measures for non-clinical and clinical staff, patients, and gametes/embryos. Conclusion: The current pandemic of COVID-19 suggests a well-organized action-oriented emergency plan to assure the wellbeing of all stakeholders

Comparison of clinical characteristics of acute kidney injury versus acute-on-chronic renal failure: Our experience in a developing country

SummaryBackgroundFrom developing countries, there is paucity of information regarding epidemiological characteristics of acute-on-chronic renal failure (ACRF) that differs from acute kidney injury (AKI).MethodsIn this prospective study, we analyzed and compared clinical characteristics and outcome of ACRF with AKI from January 2007 to August 2012.ResultsA total of 1117 patients with community-acquired AKI were included in study (AKI = 835; ACRF = 282). Patients with ACRF were older than patients with AKI (p < 0.001). Sepsis was the main cause of acute decline in renal functions in patients with ACRF in comparison to AKI (p < 0.001). Volume depletion/renal hypoperfusion was the most common cause of AKI and the difference was statistically significant as compared to ACRF (33.9% vs. 17.7%; p < 0.001). Need for dialysis was significantly less in patients with ACRF as compared to AKI (68% vs. 77.4%; p 0.002). Lower inhospital mortality was observed in ACRF in comparison to AKI (5% vs. 8.9%, p = 0.04), while no significant difference was noted in terms of duration of hospital stay between the two groups (p = 0.67). However, a significantly higher proportion of patients with ACRF did not recover and progressed to end-stage renal disease as compared to AKI (20% vs. 7.8%; p < 0.001).ConclusionACRF constituted an important cause (25%) of AKI. An episode of superimposed AKI is associated with significantly increased risk of progression to end-stage renal disease in patients with chronic kidney disease.背景慢性腎病合併急性腎衰竭 (ACRF) 不同於急性腎損傷 (AKI)，然而在發展中國家，ACRF 的流行病學數據仍然相當有限。方法在 2007 年 1 月至 2012 年 8 月期間，我們進行了一項前瞻性研究，分析並比較了 ACRF 與 AKI 的臨床特徵和治療後果。結果研究對象為 1117 位社區性 AKI 患者 (AKI = 835；ACRF = 282)，其中 ACRF 患者較 AKI 患者年老 (p < 0.001)。相比於 AKI，ACRF 的急性腎功能下降較常歸因於敗血症 (p < 0.001)；相比於 ACRF，AKI 則較常歸因於容積匱乏/腎灌流不足 (33.9% vs. 17.7%；p < 0.001)；ACRF 患者比 AKI 患者較少需要接受透析療法 (68% vs. 77.4%；p = 0.002)；ACRF 患者的院內死亡率低於 AKI 患者 (5% vs. 8.9%；p = 0.04)，兩組間的住院期則無明顯差別 (p = 0.67)；然而，相比於 AKI 患者，明顯較多的 ACRF 患者無法康復並惡化成末期腎病 (ESRD) (20% vs. 7.8%；p < 0.001)。結論慢性腎病合併急性腎衰竭是急性腎損傷的重要病因 (25%)；在慢性腎病患者間，AKI 的發生明顯增加惡化為 ESRD 的風險

Risk factors for extubation failure in mechanically ventilated children in pediatric intensive care unit

Background: Mechanical ventilation is lifesaving in children with respiratory failure. However, its unnecessary prolongation once a child is capable of sustaining spontaneous effective ventilation is associated with significant complications. Objective: To identify the factors that lead to higher chance of extubation failure in mechanically ventilated children. Materials and Methods: A prospective, observational study was conducted over a period of 1 year. Children admitted to pediatric intensive care unit of a tertiary care hospital of Northern India aged 1 month–17 years, needing mechanical ventilation were included in the study. Predefined criteria were used to decide the timing of extubation. Relevant details were recorded to study various patient-related parameters and their association with extubation outcome. Results: Mean age of the study group was 50 months with a male:female ratio of 3:1. Extubation failure rate was 14.5%. Extubation failure was significantly higher in patients ventilated for &gt;7 days (p=0.01), those with the pediatric risk of mortality score &gt;10 at admission (p=0.009), in addition to peak inspiratory pressure &gt;16 cm H2O (p=0.009) and FiO2 ≥0.35 (p=0.01) before extubation. Accidental extubation was also associated with higher extubation failure (p&lt;0.001). Conclusion: Our study demonstrates that even though sicker patients requiring ventilation for longer duration are more prone to failed extubations, protocol based, and planned extubations lead to better extubation success

Nations within a nation: variations in epidemiological transition across the states of India, 1990–2016 in the Global Burden of Disease Study

18% of the world's population lives in India, and many states of India have populations similar to those of large countries. Action to effectively improve population health in India requires availability of reliable and comprehensive state-level estimates of disease burden and risk factors over time. Such comprehensive estimates have not been available so far for all major diseases and risk factors. Thus, we aimed to estimate the disease burden and risk factors in every state of India as part of the Global Burden of Disease (GBD) Study 2016

Vision, challenges and opportunities for a Plant Cell Atlas

With growing populations and pressing environmental problems, future economies will be increasingly plant-based. Now is the time to reimagine plant science as a critical component of fundamental science, agriculture, environmental stewardship, energy, technology and healthcare. This effort requires a conceptual and technological framework to identify and map all cell types, and to comprehensively annotate the localization and organization of molecules at cellular and tissue levels. This framework, called the Plant Cell Atlas (PCA), will be critical for understanding and engineering plant development, physiology and environmental responses. A workshop was convened to discuss the purpose and utility of such an initiative, resulting in a roadmap that acknowledges the current knowledge gaps and technical challenges, and underscores how the PCA initiative can help to overcome them.</jats:p

Difficult embryo transfer: A systematic review

We performed a systematic review on the clinical epidemiology and outcome of difficult embryo transfers (ETs) in infertility patients who present with difficult ET. We searched PubMed, ScienceDirect, and Elsevier journals from 1980 to June 2017. We aimed to determine the most successful method resulting in highest pregnancy rates (PRs) in patients with difficult ET. We identified 50 articles, in which 36 were reviewed and 15 were included. Analysis of the data collected showed that the majority of the difficult ETs were caused by cervical stenosis and the most common treatment was cervical dilation. We concluded that cervical dilation was effective at managing difficult ET. Hegar dilators used a minimum of 3 weeks before ET showed to have higher PR