Dynamic government performance: honeymoons and crises of confidence

We use a formal theoretical framework to explore the interplay between a government's longevity and its performance. Ministers perform well when their careers are valuable; this is so when the government's duration is expected to be long; the government's survival depends on its popularity; and, finally, that popularity depends on its ministers performance. The feedback loop between performance and longevity means that multiple rational-expectations equilibria can arise: Ministers work hard for a popular government, but divert efforts elsewhere if they believe the government is doomed; these alternatives are both self-fulfilling prophecies. However, the presence of (perhaps small) random events that buffet the performance and popularity of a government is sufficient to pin down a unique equilibrium. We explore the dynamics that arise: A crisis of confidence involving the rapid collapse of a government's performance is sparked when a sequence of negative shocks push the popularity of the government below a unique critical threshold

The Qualities of Leadership:Direction, Communication, and Obfuscation

Party activists wish to (i) advocate the best policy and yet (ii) unify behind a commonparty line. An activist's understanding of his environment is based on the speeches ofparty leaders. A leader's influence, measured by the weight placed on her speech,increases with her judgement on policy (sense of direction) and her ability to conveyideas (clarity of communication). A leader with perfect clarity of communication enjoysgreater influence than one with a perfect sense of direction. Activists can choose howmuch attention to pay to leaders. A necessary condition for a leader to monopolize theagenda is that she is the most coherent communicator. Sometimes leaders attract moreattention by obfuscating their messages. A concern for party unity mitigates thisincentive; when activists emphasize following the party line, they learn more about theirenvironment.

Leading the Party:Coordination, Direction, and Communication

Party activists face a coordination problem: a critical mass (a barrier tocoordination) must advocate a single policy alternative if the party is tosucceed. The need for direction is the degree to which the merits of thealternatives respond to the underlying mood of the party. An individual'sability to assess the mood is his sense of direction. These factors combine toform an index of both the desirability and the feasibility of leadership: wecall this index Michels' Ratio. A sovereign party conference gives way toleadership by an individual or oligarchy if and only if Michels' Ratio issufficiently high. Leadership enhances the clarity of intra-partycommunication, but weakens the response of policy choices to the party'smood.

The number of privately treated tuberculosis cases in India: an estimation from drug sales data

Background Understanding the amount of tuberculosis managed by the private sector in India is crucial to understanding the true burden of the disease in the country, and thus globally. In the absence of quality surveillance data on privately treated patients, commercial drug sales data offer an empirical foundation for disease burden estimation. Methods We used a large, nationally representative commercial dataset on sales of 189 anti-tuberculosis products available in India to calculate the amount of anti-tuberculosis treatment in the private sector in 2013–14. We corrected estimates using validation studies that audited prescriptions against tuberculosis diagnosis, and estimated uncertainty using Monte Carlo simulation. To address implications for numbers of patients with tuberculosis, we explored varying assumptions for average duration of tuberculosis treatment and accuracy of private diagnosis. Findings There were 17·793 million patient-months (95% credible interval 16·709 million to 19·841 million) of anti-tuberculosis treatment in the private sector in 2014, twice as many as the public sector. If 40–60% of private-sector tuberculosis diagnoses are correct, and if private-sector tuberculosis treatment lasts on average 2–6 months, this implies that 1·19–5·34 million tuberculosis cases were treated in the private sector in 2014 alone. The midpoint of these ranges yields an estimate of 2·2 million cases, two to three times higher than currently assumed. Interpretation India's private sector is treating an enormous number of patients for tuberculosis, appreciably higher than has been previously recognised. Accordingly, there is a re-doubled need to address this burden and to strengthen surveillance. Tuberculosis burden estimates in India and worldwide require revision

Identification of Novel Targetable Signaling Pathways in the Inherited Ichthyoses

PhDIn this study the non-syndromic ichthyoses were studied to evaluate any genes or biological processes common to them and to identify key genes and pathways pertaining to each ichthyosis individually. This group of monogenic diseases comprises of ichthyosis vulgaris (loss of FLG), X-linked ichthyosis (loss of STS) lamellar ichthyosis/congenital ichthyosiform erythroderma (due to mutations in ALOX12B, ICH, ABCA12) and harlequin ichthyosis (due to ABCA12). They all affect terminal differentiation and the cornified layer and manifest as scaly conditions along a spectrum ranging from mild (as in ichthyosis vulgaris) to having a major impact on quality of life (as in lamellar ichthyosis/congenital ichthyosiform erythroderma) to severe (as in harlequin ichthyosis). The aim of this study was to investigate the effect of ichthyosis gene knockdown (STS, FLG, ABCA12, TGM1, ICH and ALOX12B) using RNAi technology in primary neonatal keratinocytes. 3D in vitro cultures using primary keratinocytes for the ichthyosis of interest, from the same genetic background, were developed including a novel model (STS knockdown). All the ichthyosis gene knockdowns in this study affected terminal differentiation (change in TGM1 expression) and loss of ABCA12 altered early differentiation in addition to terminal differentiation. RNA-Seq analysis was performed in primary keratinocytes transfected with siRNA. 62 genes were significantly down-regulated and 26 genes were significantly up regulated overlapping in all the ichthyoses models. Altered gene clusters were found for cell cycle, innate immune response, keratin filament/cytoskeleton and metabolism of lipids and lipoproteins. Functional studies showed an altered cytokine profile in unstimulated primary keratinocytes and following stimulation of TLR -2, -3, -5 in all the ichthyoses. The findings suggest that several overlapping genes involved in biological processes, including innate immunity, are altered in this group of non-syndromic, monogenic ichthyoses.Medical Research Counci

Factors Associated with Tuberculosis and Rifampicin-Resistant Tuberculosis amongst Symptomatic Patients in India: A Retrospective Analysis

Background Tuberculosis remains a major public health challenge for India. Various studies have documented different levels of TB and multi-drug resistant (MDR) TB among diverse groups of the population. In view of renewed targets set under the End TB strategy by 2035, there is an urgent need for TB diagnosis to be strengthened. Drawing on data from a recent, multisite study, we address key questions for TB diagnosis amongst symptomatics presenting for care: are there subgroups of patients that are more likely than others, to be positive for TB? In turn, amongst these positive cases, are there factors—apart from treatment history—that may be predictive for multi-drug resistance? Methods We used data from a multi-centric prospective demonstration study, conducted from March 2012 to December 2013 in 18 sub-district level TB programme units (TUs) in India and covering a population of 8.8 million. In place of standard diagnostic tests, upfront Xpert MTB/RIF testing was offered to all presumptive TB symptomatics. Here, using data from this study, we used logistic regression to identify association between risk factors and TB and Rifampicin-Resistant TB among symptomatics enrolled in the study. Results We find that male gender; history of TB treatment; and adult age compared with either children or the elderly are risk factors associated with high TB detection amongst symptomatics, across the TUs. While treatment history is found be a significant risk factor for rifampicin-resistant TB, elderly (65+ yrs) people have significantly lower risk than other age groups. However, pediatric TB cases have no less risk of rifampicin resistance as compared with adults (OR 1.23 (95% C.I. 0.85–1.76)). Similarly, risk of rifampicin resistance among both the genders was the same. These patterns applied across the study sites involved. Notably in Mumbai, amongst those patients with microbiological confirmation of TB, female patients showed a higher risk of having MDR-TB than male patients. Conclusion Our results cast fresh light on the characteristics of symptomatics presenting for care who are most likely to be microbiologically positive for TB, and for rifampicin resistance. The challenges posed by TB control are complex and multifactorial: evidence from diverse sources, including retrospective studies such as that addressed here, can be invaluable in informing future strategies to accelerate declines in TB burden

Mountain-Shaped Coupler for Ultra Wideband Applications

This paper demonstrates a novel mountain-shaped design for a compact 3-dB coupler operating at ultra-wideband (UWB) frequencies from 3.1GHz to 10.6 GHz. The proposed design was accomplished using multilayer technology in which the structure is formed by three layers of conductors interleaved by a layer of substrate between each conductor layer. Simulation was carried out using CST Microwave Studio; the result was then compared with results from rectangular and star-shaped couplers that implemented the same technique. The results obtained show that the proposed new coupler has better performance compared to both rectangular and star-shaped coupler designs in terms of return loss, isolation, and phase difference. The coupler was fabricated and measured; the measurement results satisfactorily agree with the simulation results

Sound production and spectral hearing sensitivity in the Hawaiian sergeant damselfish, Abudefduf abdominalis

Sounds provide important signals for inter- and intraspecific communication in fishes, but few studies examine fish acoustic behavior in the context of coevolution of sound production and hearing ability within a species. This study characterizes the acoustic behavior in a reproductive population of the Hawaiian sergeant fish, Abudefduf abdominalis, and compares acoustic features to hearing ability, measured by the auditory evoked potential (AEP) technique. Sergeant fish produce sounds at close distances to the intended receiver (≤1-2 body lengths), with different pulse characteristics that are associated primarily with aggression, nest preparation and courtship-female-visit behaviors. Energy peaks of all sounds were between 90 and 380 Hz, whereas courtship-visit sounds had a pulse repetition rate of 125 Hz with harmonic intervals up to 1 kHz. AEP threshold, which is probably higher than the behavioral threshold, indicates best sensitivity at low frequencies (95-240 Hz), with the lowest threshold at 125 Hz (123-127 dBrms re: 1 μPa). Thus, sound production and hearing in A. abdominalis are closely matched in the frequency domain and are useful for courtship and mating at close distances. Measured hearing thresholds did not differ among males and females during spawning or non-spawning periods, which indicates a lack of sex differences and seasonal variation in hearing capabilities. These data provide the first evidence that Abudefduf uses true acoustic communication on a level similar to that of both more derived (e.g. Dascyllus, Chromis) and more basal (e.g. Stegastes) soniferous pomacentrids. This correlation between sound production and hearing ability is consistent with the sensory drive model of signal evolution in which the sender and receiver systems coevolve within the constraints of the environment to maximize information transfer of acoustic signals