bluuebunny/crossref_metadata_2025 huggingface dataset:
Efficacy of thrombus density on noninvasive computed tomography neuroimaging for predicting thrombus pathology and patient outcome after mechanical thrombectomy in acute ischemic stroke
Authors: Songsaeng Dittapong , Kaeowirun Tharathorn , Sakarunchai Ittichai , Cheunsuchon Pornsuk , Weankhanan Jaruwan , Suwanbundit Anek , Krings Timo
Published: August 2019

Background and Purpose: The aim of this study was to investigate the efficacy of thrombus density on noninvasive computed tomography (CT) neuroimaging for predicting thrombus pathology and patient outcome after mechanical thrombectomy in acute ischemic stroke. Materials and Methods: This retrospective chart and imaging review included patients that were treated by mechanical thrombectomy at Siriraj Hospital according to the American Heart Association/American Stroke Association guidelines for the early management of patients with acute ischemic stroke from March 2010 to February 2015 study period. Preintervention noncontrast CT (NCCT), CT angiography (CTA), and/or contrast-enhanced CT (CECT) images were interpreted using CT densitometry. Pathology results were classified as white, red, or mixed thrombi. The result of treatment was evaluated by the modified Rankin Scale at 90 days after treatment. Results: From 97 included patients – 97 NCCT images, 48 CTA images, 48 CECT images, and 54 pathologic results of cerebral thrombi were included in the final analysis. Mean clot Hounsfield unit values on NCCT, CTA, and CECT were significantly different between red and white thrombus (P = 0.001 on NCCT, P = 0.03 on CTA, and P = 0.001 on CECT), and between red and mixed thrombus (P = 0.043 on NCCT and P = 0.002 on CTA). However, no significant difference was observed between white thrombus and mixed thrombus (P = 0.09 on NCCT, P = 1.00 on CTA, and P = 0.054 on CECT). There was no significant correlation between type of cerebral thrombus or clot density and the result of treatment. Conclusion: Thrombus density on CT was found to be a significant predictor of thrombus pathology; however, no significant association was observed between thrombus type or clot density and patient outcome after mechanical thrombectomy.
Trigeminal neuralgia secondary to vertebrobasilar dolichoectasia treated with cyberknife stereotactic radiosurgery
Authors: Lakshman Vijay , Aal Mahalaxmi , Karumanchi Pradeep , Jaleel Ayesha , Iyer Aarthi
Published: August 2019

Trigeminal neuralgia caused by vertebrobasilar dolichoectasia is a rare condition. It is characterized by paroxysmal hemifacial pain which is lancinating in type mostly refractory to medical management. This is a report of trigeminal neuralgia secondary to vertebral dolicholectasia refractory to medical management treated with cyber knife stereotactic radiosurgery to the dose of 66 Gy in single fraction to the proximal nerve root. Pain relief was achieved immediately after the treatment and with a follow up period of 2 years, patient is pain free. Cyberknife assisted radiosurgery is relatively safe in delivering high ablative doses with precise conformality to small target regions like proximal nerve root entry of trigeminal nerve with no major toxicities and achieving early pain relief. It is an outpatient and non-invasive procedure. It can be used as a definite treatment modality for trigeminal neuralgia induced by vertebrobasilar dolichoectasia.
Initial experience with diffusion-weighted imaging to predict the tumor consistency and surgical success in solid growth hormone producing pituitary macroadenomas
Authors: Alimohamadi Maysam , Sanjari Reza , Shirani Mohamad , Alikhani Fariba , Amirjamshidi Abbas
Published: August 2019

Background: Tumor consistency is an important factor impeding transsphenoidal resection of some pituitary macroadenomas. Preoperative prediction of the tumor consistency may help neurosurgeons in preparing the patients for other therapeutic options after a subtotally resected growth hormone (GH)-producing macroadenoma. We present the preliminary results of our study about the application of the preoperative diffusion-weighted (DW) magnetic resonance imaging (MRI) to predict the consistency and resection rate of GH-producing pituitary macroadenomas. Materials and Methods: Sixteen primary patients with solid GH-producing pituitary macroadenomas were enrolled. Hormonal assays as well as standard and DW-MRI were obtained before surgery. All the patients were operated via an endoscopic transsphenoidal approach. The intraoperative tumor consistencies (suctionable versus nonsuctionable) were documented. The samples were stained for measurement of the collagen content (low, moderate, and high). Postoperative hormonal study and MRI were performed after 8 weeks to evaluate the resection ratio and the hormonal remission. Results: On DW images, the tumor diffusion was enhanced (free) in four, moderate in ten, and restricted in two patients. The tumor was suctionable in 14 cases; gross total resection and hormonal remission were achieved in 12/14 of these. All the 14 suctionable tumors had moderate to enhanced diffusion on DW imaging (DWI). The two patients with a nonsuctionable fibrous tumor had a restricted diffusion in DWI. These were the only ones to have high collagen content in the histopathologic study. Conclusion: DWI could help identify the fibrous nonsuctionable GH-producing adenomas from the others.
Intracranial malignant nerve sheath tumor in the middle cranial fossa: A rare case report with review of literature
Authors: Patankar Amey , Sheth Jwalit
Published: August 2019

Intracranial malignant nerve sheath tumors rarely arise in the central nervous system. They usually arise from the cranial nerves, though rare cases of intraparenchymal lesions have also been reported. We report a case of malignant nerve sheath tumor located in the right middle cranial fossa. Preoperatively, the lesion resembled a meningioma arising from the petrous temporal bone. The lesion was completely excised. Postoperatively, the patient developed righted-sided complete facial nerve palsy. Histopathology and immunohistochemistry revealed the lesion to be a malignant nerve sheath tumor. The development of postoperative facial nerve palsy was puzzling but could be explained if we consider the possibility of the lesion arising from the facial nerve near the geniculate ganglion. Intracranial malignant nerve sheath tumor centered over the geniculate ganglion and projecting into the middle cranial fossa is uncommon, and to the best of our knowledge, only one such case has been previously reported. We review the relevant literature, discuss the management and add to the previously reported cases of this rare condition.
“Cable suturing technique” a dural obliteration method for the prevention of cerebellar herniation through a large occipital meningocele
Authors: Alojan Abdulrazaq , Alsaad Ibtihal , Alghareeb Fatimah , Al-issawi Wisam , Ammar Ahmed
Published: August 2019

The authors present a patient who had a large occipital meningocele, which was transformed into an encephalocele after primary closure due to a large skull defect. Thus, the technical importance of classifying patients with occipital meningocele with a large skull defect and a tight dural obliteration is crucial, not to leave a wide dead space with a potential risk of cerebellar herniation. Encephalocele and meningocele are embryological anomalies, which result in intracranial structures herniation due to inborn skull defect. Acquired encephalocele may develop through the same defect with normal cerebellar tissues; since the prognosis of occipital encephalocele may worsen as the size of herniation increases, the patient underwent a modified dural obliteration technique (Cable Suturing Technique) to adjust the size of the dura and to strengthen it to prevent the risk of future herniation followed by cranioplasty and the cerebellar herniation regressed significantly after the procedure.
Use of our protocol of multimodality tools to aid in the safe microsurgical clipping of unruptured anterior circulation aneurysms
Authors: Kannan Satish , Yamada Yasuhiro , Miyatani Kyosuke , Teranishi Takao , Marathi Arun , Mohan Krishna , Kawase Tsukasa , Kato Yoko
Published: August 2019

Objectives: The aim of this study is to analyze the effectiveness of our protocol of the use of multimodality tools, namely indocyanine green-dual image video angiography, neuroendoscope, neuromonitoring with motor-evoked potential, micro-Doppler in the microsurgical clipping of unruptured anterior circulation aneurysms, operated at our institute from January 2016 to December 2018. Materials and Methods: We performed a retrospective analysis of all cases of unruptured anterior circulation aneurysms, operated at Fujita Health University Banbuntane-Hotokukai Hospital, Japan, from January 2016 to December 2018. We assessed outcome at immediate postoperative, at discharge, and at 3 months follow-up by defining permanent morbidity as drop in Modified Rankin Scale (MRS) by 1 at 3 months follow-up and transient morbidity as temporary deficit that improved at discharge or follow-up. Postoperative events, namely seizures, infection that did not affect/change. Preoperative MRS and discharge timing were excluded. We concluded poor outcome as MRS ≥3 and good outcome as MRS < 3 (0–2). All patients had a minimum of 3 months follow-up before outcome conclusion. Results: In 2016, a total of 98 cases were operated with no mortality or permanent morbidity (i.e., change in preoperative MRS), only transient morbidity was seen in (two cases) 2.04%. In 2017, a total of 119 cases were operated with no mortality or morbidity. In 2018, a total of 130 cases were operated with no mortality or permanent morbidity, only transient morbidity 0.7%. Summarizing from January 2016 to December 2018, a total of 347 cases of anterior circulation aneurysms were operated. Mostly, in the female sex (73.3%), the most common was middle cerebral artery aneurysm (39.1%). The mean size was 5.3 mm with no mortality or permanent morbidity with only transient morbidity in 0.9%. No poor outcome (MRS ≥3) was seen in our series. Conclusion: In our center for most unruptured anterior circulation aneurysms, microsurgical clipping is the treatment of choice. We believe our protocol of the intra-operative usage of multimodality tools have aided in the safe microsurgical clipping and have consistently resulted in good operative outcomes. Hence, we recommend and continue to use our Fujita-Bantane Protocol in all cases of micro-surgical clipping of aneurysms to consistently achieve good operative outcomes.
Home-based rehabilitation programs: Promising field to maximize function of patients with traumatic spinal cord injury
Authors: Rezaei Mojtaba , Sharifi Amirsina , Vaccaro Alexander , Rahimi-Movaghar Vafa
Published: August 2019

Background: Traumatic spinal cord injury (TSCI) has profound effects on the patient's health condition and function. However current treatment strategies fail in terms of cure. Thus, rehabilitative management has become the main gadget to promote patients' residual function. The most challenging aspect of rehabilitation is high costs of inpatient rehabilitation programs and poor continuity of care while patients are transferred to home. In this regard, numerous home based rehabilitation programs have been introduced. Objectives: This review is an attempt to better introduce and classify different aspects of home care programs for patients with TSCI all around the world. Methods: A literature search was conducted in the PubMed, Medline, and Google Scholar database. Studies that addressed rehabilitative programs for patients with TSCI in their home or home-like facilities were reviewed. Reference lists from retrieved articles were also reviewed. Results: Home based rehabilitation can be categorized in five different but naturally relevant fields: home aids/modification, home nursing and family help, social support, home based primary care (multidisciplinary physician groups), and novel models/methods (e.g. “transitional rehabilitation” or telemedicine). Conclusion: Since most investigators in TSCI home based rehabilitation have only introduced their findings, there are no comparative studies available. Thus future studies should be dedicated to clinical trials evaluating clinical efficacy of different strategies. A comprehensive integrated strategy with consideration to financial and other limitations should be applied to each specific area.
Patent persistent fibrous tract in a patient with disconnected lumboperitoneal shunt
Authors: Sharma Rajan , Takagi Kiyoshi , Yamada Yasuhiro , Kawase Tsukasa , Kato Yoko
Published: August 2019

Disconnection of proximal or distal catheter is seen more frequently in the complication of the lumboperitoneal (LP) shunt. A connective tissue sheath that forms around the peritoneal catheter of silicone shunt tubing is a normal biological response to foreign material. The literature did not establish whether the disconnected LP shunt can allow passage of cerebrospinal fluid (CSF) through the disconnected portion. However, proof of the passage of CSF through these sheaths has been reported in only one published study to date. We present a case of a young patient with disconnected LP shunt who reported patent persistent fibrous tract around the tube shunt. In conclusion, asymptomatic patients with shunt disconnection should be evaluated with shuntography for patency of fibrous sheath before removal of the shunt to avoid the possible complications.
Evaluation of a Hospital-Based Post-Prescription Review and Feedback Pilot in Kathmandu, Nepal
Authors: Joshi Rajesh Dhoj , Zervos Marcus , Kaljee Linda M. , Shrestha Basudha , Maki Gina , Prentiss Tyler , Bajracharya Deepak , Karki Kshitji , Joshi Nilesh , Rai Shankar Man
Published: August 2019

Capacity building is needed in low- and middle-income countries (LMICs) to combat antimicrobial resistance (AMR). Stewardship programs such as post-prescription review and feedback (PPRF) are important components in addressing AMR. Little data are available regarding effectiveness of PPRF programs in LMIC settings. An adapted PPRF program was implemented in the medicine, surgery, and obstetrics/gynecology wards in a 125-bed hospital in Kathmandu. Seven “physician champions” were trained. Baseline and post-intervention patient chart data were analyzed for changes in days of therapy (DOT) and mean number of course days for intravenous and oral antibiotics, and for specific study antibiotics. Charts were independently reviewed to determine justification for prescribed antibiotics. Physician champions documented recommendations. Days of therapy per 1,000 patient-days for courses of aminoglycoside (P < 0.001) and cephalosporin (P < 0.001) decreased. In the medicine ward, data indicate increased justified use of antibiotics (P = 0.02), de-escalation (P < 0.001), rational use of antibiotics (P < 0.01), and conforming to guidelines in the first 72 hours (P = 0.02), and for definitive therapy (P < 0.001). Physician champions documented 437 patient chart reviews and made 138 recommendations; 78.3% of recommendations were followed by the attending physician. Post-prescription review and feedback can be successfully implemented in LMIC hospitals, which often lack infectious disease specialists. Future program adaptation and training will focus on identifying additional stewardship programming and support mechanisms to optimize antibiotic use in LMICs.
Epidemiological and Evolutionary Analysis of Dengue-1 Virus Detected in Guangdong during 2014: Recycling of Old and Formation of New Lineages
Authors: Yu Jianhai , Li Xujuan , He Xiaoen , Liu Xuling , Zhong Zhicheng , Xie Qian , Zhu Li , Jia Fengyun , Mao Yingxue , Chen Zongqiu , Wen Ying , Ma Danjuan , Yu Linzhong , Zhang Bao , Zhao Wei , Xiao Weiwei
Published: August 2019

The incidence of dengue is increasing in Guangdong, China, with the largest outbreak to date in 2014. Widespread awareness of epidemiological and molecular characteristics of the dengue virus (DENV) is required. In 2014, we isolated the virus from patients and sequenced its genome. The sequences of DENV isolated from Guangdong and other countries screened since 2005 were studied to establish molecular evolutionary databases along with epidemiological data to explore its epidemiological, phylogenetic, and molecular characteristics. Causes underlying the occurrence of the dengue epidemic included importation and localization of the virus. The number of indigenous cases significantly exceeded that of imported cases. Dengue virus 1 is the most important serotype and caused the long-term epidemic locally. Based on the data available since 2005, DENV1 was divided into three genotypes (I, IV, and V). Only genotypes I and V were detected in 2014. In 2014, an epidemic involving old lineages of DENV1 genotype V occurred after 2 years of silence. The genotype was previously detected from 2009 to 2011. Genotype I, which caused recent epidemics, demonstrated a continuation of new lineages, and a predictive pattern of molecular evolution since 2005 among the four lineages was present. The DENV isolated from Guangdong was closely related to those causing large-scale epidemics in neighboring countries, suggesting the possibility of its import from these countries. The lack of sufficient epidemiological data and evidence on the local mosquito-borne DENV emphasizes the importance of studying the molecular evolutionary features and establishing a well-established phylogenetic tree for dengue prevention and control in Guangdong.
Using Short Message Service Alerts to Increase Antenatal Care and Malaria Prevention: Findings from Implementation Research Pilot in Guinea
Authors: Flueckiger Rebecca Mann , Thierno Diallo M. , Colaço Rajeev , Guilavogui Timothée , Bangoura Lamine , Reithinger Richard , Fitch Elizabeth Regan , Taton Jean-Luc , Fofana Aissata
Published: August 2019

Intermittent preventive treatment with sulfadoxine–pyrimethamine (SP) is recommended to prevent malaria in pregnancy. Treatment coverage, particularly for three or more doses, is dependent on pregnant women attending antenatal care (ANC) services as scheduled. The StopPalu project pilot tested short message services (SMSs) to remind women of upcoming ANC visits in the Conakry and Kindia regions of Guinea. Health facilities were selected as pilot and comparison facilities. All women who attended an initial ANC visit at a selected facility during the pilot period and had access to a mobile telephone were enrolled. The pilot group was sent an SMS before each appointment. Percentage of attendance and SP distribution were calculated. A log-binomial regression model determined odds ratios. Pregnant women receiving SMS were 48 times more likely to attend all visits and were 12 times more likely to receive all SP doses during pregnancy.
Characteristics and Impact of Disseminated Gonococcal Infection in the “Top End” of Australia
Authors: Birrell Johanna M. , Gunathilake Manoji , Singleton Sally , Williams Shellee , Krause Vicki
Published: August 2019

The “Top End” of Australia is presently experiencing a gonorrhea epidemic. Gonococcal infection is usually limited to mucosal tissues but can lead to disseminated gonococcal infection (DGI), joint destruction, and severe sepsis. This study aimed to explore the epidemiology, presentation, management, and health-care impact of DGI in the Top End of the Northern Territory. Health records of patients diagnosed with proven, probable, or possible DGI between January 2010 and September 2018 were analyzed retrospectively. One hundred six cases of DGI were identified. Ninety-four patients (88.7%) were Indigenous Australian. The incidence of proven and probable DGI in the Indigenous population was 27.1 per 100,000 person-years, compared with 7.1 in the Top End population overall. Of 7,540 laboratory-proven gonococcal notifications, 1.3% (n = 97) were complicated by DGI. The highest incidence was in the 15–19-year age-group. Thirteen cases (12.3%) occurred in patients younger than 15 years. High rates of comorbid alcohol misuse, diabetes, systemic lupus erythematosus, rheumatic fever, and complement deficiency were observed. The “classic triad” of tenosynovitis, dermatitis, and polyarthralgia was rare. Ninety-four patients (88.7%) presented with purulent arthritis. Disseminated gonococcal infection was estimated to cause at least 10.0% of nonpenetrating septic arthritis in the Top End and 1,234 days of hospitalization during the study period. DGI is an important cause of morbidity in the Top End, particularly in the young, remote Indigenous Australian population. Clinical presentation varies from classical teaching. Urgent action in the health and community sector is required, particularly for at-risk populations, to prevent further debilitating and costly complications of gonococcal infection.
Update on the Financing of the Fund's Concessional Assistance and Debt Relief to Low-Income Member Countries
Authors:   International Monetary Fund
Published: August 2019

New commitments under PRGT-supported programs are expected to increase to about SDR 2 billion in 2012, in part reflecting the large ECF commitment (SDR 0.6 billion) for Bangladesh approved in April. Commitments in the first eight months of 2012 amounted to SDR 1.4 billion and a further SDR 0.6 billion is expected to be committed by year end. This compares to total commitments of SDR 1.2 billion in each of 2010 and 2011. If all elements of the 2009 financing package are secured, the PRGT will have an annual average lending capacity of SDR 2.2 billion remaining under this package for the period 2013–14. Additional
Quota Formula Review - Additional Considerations
Authors:   International Monetary Fund
Published: August 2019

In July, the Executive Board held its second formal discussion on the quota formula review. Directors agreed on the principles that should guide the review and the importance of meeting the January 2013 deadline, and there were indications of an emerging consensus in a few areas. However, views continued to diverge on several other key issues, and Directors stressed that completing the review will require a spirit of flexibility and compromise on all sides.

This paper seeks to provide a basis for the next discussion, taking account of the views expressed in July. It begins by taking stock of the discussions to date. Based on this stock take, it seeks to highlight areas where a relatively broad consensus appears to be emerging. The paper also discusses possible options for addressing concerns raised about the openness variable and provides a range of simulations that seek to illustrate the effects of potential reforms to the formula. The simulations focus on those issues that have garnered the most attention in the discussions to date.
Macrofinancial Stress Testing - Principles and Practices—Background Material
Authors:   International Monetary Fund
Published: August 2019

Staff conducted a survey of stress testing practices among selected national central banks and supervisory authorities. The online survey was undertaken in November 2011 as part of the preparatory work for the paper on ?Macrofinancial Stress Testing: Principles and Practices. The survey focused on stress testing for banks, which is more widespread and better established—and practices are therefore easier to compare across countries—but also included questions on stress testing for nonbank financial institutions.
Proposed Amendment of the Extended Fund Facility - Considerations to Extend the Duration of Extended Arrangements on Approval from Three to Four Years
Authors:   International Monetary Fund
Published: August 2019

The EFF Decision currently provides that extended arrangements will be approved for periods not exceeding three years but that, where appropriate, the period of an existing arrangement may be lengthened to a duration of up to four years. This note proposes that the EFF Decision be amended to allow for extended arrangements to be approved for up to four years from the outset. The reforms to the IMF lending toolkit since 2009 have injected additional flexibility and allowed better tailoring to countries’ varying circumstances. These reforms have enabled the Fund to better respond to the wide-ranging needs of member countries by, among other things, establishing new and more tailored facilities, increasing access limits, clarifying exceptional access criteria, streamlining conditionality, and reforming charges while maintaining adequate Fund safeguards
Seventh Periodic Monitoring Report on the Status of Implementation Plans in Response to Board-Endorsed IEO Recommendations
Authors:   International Monetary Fund
Published: August 2019

The Seventh PMR includes: (i) a discussion of progress made over the last year on the actions corresponding to four Management Implementation Plans (MIPs) that were classified as still “in progress” in the previous PMR; and (ii) an assessment of the progress made in achieving the high-level objectives in three areas directly related to those MIPs. In addition, an update on substantive issues related to five older MIPs agreed since 2007 is provided at the end of the report. Three new evaluations have been completed by the IEO since March 2014. In July and August 2015, Management issued the MIPs in response to these evaluations. Given that only a short time has passed since their completion, progress in addressing the actions contemplated in those MIPs will be discussed in the next PMR.
Improving Public Investment Efficiency in the G-20
Authors:   International Monetary Fund
Published: August 2019

Through the provision of both social and economic infrastructure, public investment can serve as an important catalyst for economic growth. A significant body of theoretical and empirical research underscores the positive relationship between investment in high-quality public infrastructure and economy-wide productivity.1 Against the background of a steady decline in public investment as a share of GDP in advanced economies, evidence of infrastructure bottlenecks in emerging economies, and the sluggish global economic recovery, the G-20 has called for ramping up public investment to raise long-run economic growth (G-20, 2014).2 However, the economic and social impact of public investment crucially depends on its efficiency. Despite anecdotal evidence of projects plagued by time delays, cost overruns, and inadequate maintenance, there are few robust empirical studies of the determinants of public investment efficiency.

This paper explores the link between public investment management (PIM) institutions and the efficiency of public investment for the G-20 countries. Based on the analysis from a recent IMF study, the paper finds that better PIM enhances public infrastructure quality, and pinpoints key institutional reforms needs to boost public investment efficiency (IMF 2015). These findings and recommendations are based on a comprehensive data set on investment, infrastructure and capital stocks, and two analytical innovations: (i) a new cross-country Public Investment Efficiency Index (PIE-X); and (ii) a new Public Investment Management Assessment (PIMA) which is applied to G-20 countries.
Key Trends in Implementing the Fund's Transparency Policy
Authors:   International Monetary Fund
Published: August 2019

At the time of the 2005 Review of the Fund’s Transparency Policy, the Executive Board requested regular updates on trends in implementing the transparency policy. The tables in this report provide an overview of recent developments, reflecting information on documents considered by the Board in 2014 and updating the previous annual report on Key Trends. Deeper analysis of these trends is undertaken in the context of periodic reviews of the Fund’s Transparency Policy.
FY2015 Administrative and Capital Expenses and Output Cost Estimates
Authors:   International Monetary Fund
Published: August 2019

The administrative expenditure outturn for FY2015 reflects continued budget discipline, as new demands and initiatives were accommodated through reprioritization and better use of existing resources within an unchanged envelope. The overall budget utilization rate of 98 percent was achieved through more efficient personnel management practices and effective reallocation of resources from underutilized areas to areas of emerging pressure.

In terms of outputs, the Fund continued its focus on addressing global policy challenges and reducing vulnerabilities. Resources allocated to multilateral surveillance, oversight of the global systems and capacity development increased while bilateral surveillance and lending declined moderately, in line with easing of crisis-related work. Spending by country reflects a continued shift towards a more risk-based approach, consistent with the established priorities.

Capital expenditures mainly reflected the major renovation of the HQ1 building and improvements in information technology infrastructure and security to better support the staff’s work and protect information assets.
Proposed Amendments to the Special Data Dissemination Standard Plus and the Annex on the General Data Dissemination System
Authors:   International Monetary Fund
Published: August 2019

The Special Data Dissemination Standard Plus (SDDS Plus) was established in October 2012 to reinforce and supplement the Fund’s Data Standards Initiatives and assist Fund members who decide to adhere to the SDDS Plus with regard to the publication of comprehensive, timely, accessible, and reliable economic and financial statistical data in a world of continuing economic and financial integration. The SDDS Plus also requires adherents to disseminate metadata to promote public knowledge and understanding of their compilation practices with respect to the required data categories. During the Ninth Review of the Fund’s data Standards Initiatives in May 2015 executive directors supported changing the transition period to meet all SDDS Plus requirements to five years after the adherence date. On July 1, 2015, the Executive Board approved the proposed change. The existing rules governing the SDDS Plus are superseded by the new SDDS Plus legal text.
The Consolidated Medium-Term Income and Expenditure Framework
Authors:   International Monetary Fund
Published: August 2019

The medium-term income projections have been updated since the last estimate provided to the Executive Board in April 2014. The main changes to the outlook stem from a lower path for credit outstanding and expectations for a more gradual rise in interest rates.

The revised projections show lower levels of net operational income over the coming years. Lending income is lower compared with earlier estimates as a result of lower credit levels, including the advance repurchases by Ireland and Portugal. Non-lending income is also projected to be lower reflecting a further downward shift in SDR interest rates and, thus, returns on investments and interest-free resources. The updated expenditure path assumes the net administrative budget remains constant in real terms at the FY 2012 level. The long-run projections indicate a broad balance between income and expenditures, assuming that interest rates rise to 3.5 percent and with lending returning to pre-crisis levels.

The pace of reserve accumulation is expected to slow, reflecting the decline in Fund credit, and precautionary balances are now projected to remain slightly below the projected target of SDR 20 billion over the medium term compared with the earlier estimates.
Proposal to Enhance Fund Support for Low-Income Countries Hit by Public Health Disasters - Proposed Decisions
Authors:   International Monetary Fund
Published: August 2019

This paper sets forth the proposed decisions and related legal instruments that are needed to implement the transformation of the the Post-Catastrophe Debt Relief Trust (the “PCDR Trust”) into the < the Catastrophe Containment and Relief Trust (the “CCR Trust” or “Trust”), as described in the Proposal to Enhance Fund Support for Low-Income Countries Hit by Public Health Disasters and as presented in an informal session to brief Executive Directors on January 28, 2015. The paper summarizes key aspects of the proposed decisions and related instruments, in particular the new CCR Trust Instrument.

The proposed reforms envisage the transformation of the PCDR Trust into the CCR Trust through an amendment of the PCDR Trust Instrument.
List of IMF Member Countries with Delays in Completion of Article IV Consultations Mandatory Financial Stability Assessments Over 18 Months
Authors:   International Monetary Fund
Published: August 2019

In accordance with Executive Board Decision No. 15106-(12/21), the Fund will publish on its external website a list of member countries whose Article IV consultations or mandatory financial stability assessments have been delayed by more than 18 months, as of the date of publication, since the expected deadline for conclusion.

The latest version of this list, as shown in Appendix I, will be published on the Fund’s external website on or after December 28, 2016.
Review of the Method of Valuation of the SDR - Amendment to Rule O-1
Authors:   International Monetary Fund
Published: August 2019

This paper seeks Executive Board approval of an amendment to Rule O-1, which specifies the currency amounts in the SDR valuation basket.
Gender Diversity in the Executive Board - Draft Report of the Executive Board to the Board of Governors
Authors:   International Monetary Fund
Published: August 2019

The Report reflects discussion among Executive Directors on June 7, 2016 and responds to the April 16, 2016 Communique of the Thirty-Third Meeting of the IMFC which stated that “We reiterate the importance of maintaining the high quality and improving the regional, gender, and education diversity of the IMF’s staff, and of promoting gender diversity in the Executive Board.”
Analyzing and Managing Fiscal Risks - Best Practices
Authors:   International Monetary Fund
Published: August 2019

Comprehensive analysis and management of fiscal risks can help ensure sound fiscal public finances and macroeconomic stability. This has been underscored by the global financial crisis and the more recent collapse in commodity prices, which starkly illustrate the vulnerability of public finances to risk. Indeed, over the past quarter century, governments experienced on average an adverse fiscal shock of 6 percent of GDP once every 12 years, with some of the largest stemming from financial crises.

Countries need a more complete understanding of these potential threats to their fiscal position. Existing fiscal risk disclosure and analysis practices tend to be incomplete, fragmented, and qualitative in nature. A more comprehensive and integrated assessment of the potential shocks to government finances, in the form of a fiscal stress test, can help policymakers simulate the effects of shocks to their central forecasts and their implications for government solvency, liquidity, and financing needs. Comprehensive, reliable, and timely fiscal data covering all public entities, stocks, and flows are a necessary foundation for such analysis.

Countries should also enhance their capacity to mitigate and manage fiscal risks. Fiscal risk management practices are often blunt, ad hoc, and too focused on imposing limits on the creation of exposures. Countries need to expand their toolkits for fiscal risk management and adopt the use of instruments to transfer, share, or provision for risks. In doing so, countries need to weigh the possible benefits from reducing their exposure to shocks against the financial and other costs of the policies that may be needed.

Finally, countries should make greater use of probabilistic forecasting methods when setting long-run objectives and medium-term targets for fiscal policy. The paper illustrates how simple probabilistic tools can be used to map the uncertainty around medium-term trajectories for public debt. In combination with fiscal stress tests, these tools can provide valuable information regarding the probabilities that a country will stay within the debt ceilings embedded in their fiscal rules.

The Fund is playing an important role in supporting improvements in fiscal risk analysis and management among its members. This includes technical assistance in constructing public sector balance sheets; developing institutions and capacity to identify specific fiscal risks and to quantify their potential impact; undertaking fiscal stress tests; and integrating risks into the design of medium-term fiscal targets.
Staff Note for the G-20—A Guiding Framework for Structural Reforms
Authors:   International Monetary Fund
Published: August 2019

This note responds to a request from the G20 for IMF assistance in helping develop priorities and guiding principles for structural reforms. Structural reforms have long been a central element of the G20’s strategy of achieving job-rich growth, and G20 countries have made over 1,000 structural policy commitments in their national growth strategies. However, implementation of these commitments has been relatively weak so far. Faster progress on structural reforms is therefore needed to support growth in the near term and bolster potential growth in the medium term—and more generally to make economies more innovative, flexible, and resilient.
List of IMF Member Countries with Delays in Completion of Article IV Consultations or Mandatory Financial Stability Assessments over 18 Months
Authors:   International Monetary Fund
Published: August 2019

In line with a framework introduced in 2012 for addressing excessive delays in the completion of Article IV consultations, the following table lists the IMF members for which the Article IV consultation has been delayed by more than 18 months at March 15, 2016. The delay is counted past the stipulated date for the consultation plus any applicable grace period. There are no countries for which the mandatory financial stability assessments are delayed by more than 18 months at March 15, 2016.
Evenhandedness of Fund Surveillance - Principles and Mechanism for Addressing Concerns
Authors:   International Monetary Fund
Published: August 2019

Evenhandedness of the Fund’s analysis and advice is critical to the effectiveness of its engagement with member countries. In this regard, both actual and perceived lack of evenhandedness can be detrimental to the Fund’s credibility and legitimacy. While perceptions of evenhandedness often reflect views about the full range of Fund activities, Fund surveillance is an important contributor to perceptions. Moreover, the consistency of the Fund’s analysis and advice will likely be scrutinized more closely in an interconnected world.
Fifteenth General Review of Quotas - Report of the Executive Board to the Board of Governors
Authors:   International Monetary Fund
Published: August 2019

In completing the Fourteenth General Review of Quotas (hereafter the “Fourteenth Review”) and approving the proposed Amendment on the Reform of the Executive Board (hereafter the “Board Reform Amendment”), the Board of Governors requested the Executive Board to bring forward the timetable for completion of the Fifteenth General Review of Quotas (hereafter the “Fifteenth Review”) to January 2014.
Third Progress Report on Inclusion of Enhanced Contractual Provisions in International Sovereign Bond Contracts
Authors:   International Monetary Fund
Published: August 2019

The IMF Executive Board endorsed in October 2014 the inclusion of key features of enhanced pari passu provisions and collective action clauses (CACs) in new international sovereign bonds.1 Specifically, the Executive Board endorsed the use of (i) a modified pari passu provision that explicitly excludes the obligation to effect ratable payments, and (ii) an enhanced CAC with a menu of voting procedures, including a “single-limb” aggregated voting procedure that enables bonds to be restructured on the basis of a single vote across all affected instruments, a two-limb aggregated voting procedure, and a series-by-series voting procedure.2 Directors supported an active role for the IMF in promoting the inclusion of these clauses in international sovereign bonds.3 The IMFC and the G20 further called on the IMF to promote the use of such clauses and report on their inclusion.

Since that time, the IMF has published periodic progress reports on inclusion of the enhanced clauses.4 These reports found that since the Executive Board’s endorsement, substantial progress had been made in incorporating the enhanced clauses, with approximately 85 percent of new international sovereign bond issuances since October 2014 (in nominal principal amount) including such clauses. The reports also found that there was no observable market impact on inclusion of the enhanced clauses. However, the reports noted that the outstanding stock without the enhanced clauses remained significant, with issuers showing little appetite for liability management exercises to accelerate the turnover.

This paper provides a further update on the inclusion of the enhanced clauses and on the outstanding stock of international sovereign bonds as of September 30, 2017. Section II reports on the inclusion of these enhanced provisions, finding that the vast majority of issuers are including these clauses, with only a few countries standing out against the market trend. Section II also provides an update on the outstanding stock, indicating that while the percentage of the outstanding stock with the enhanced clauses is increasing, a significant percentage of the stock still does not and little action has been taken by issuers to increase the rate of turnover. Section III briefly reports on the use of different bond structures, and Section IV describes the staff’s ongoing outreach efforts and next steps.
Transmittal Policy
Authors:   International Monetary Fund
Published: August 2019

history of exchanging documents with other international organizations and currency unions. The practice of exchanging documents with individual organizations dates back to the 1940s, mostly conducted through bilateral arrangements with other international organizations and currency unions. In 1990, the Fund introduced a framework (the “Transmittal Policy”) for the transmittal of certain Board documents (relating to Article IV consultations, use of Fund resources and, later, technical assistance).

The Transmittal Policy has served the institution well, but some gaps have emerged over time. Many of the current bilateral document sharing arrangements were adopted in response to individual organizations’ requests, thus document sharing arrangements have not always been applied uniformly to similar organizations or kept pace with the mandates and needs of the organizations. This has resulted in similar organizations having uneven access to Fund documents. Moreover, the Fund’s Transparency Policy has also evolved and prompt publication of most Board documents is now the norm.

The proposals set forth in this paper seek to ensure a consolidated, evenhanded approach to the transmittal of Fund documents to international organizations and currency unions. In particular, this paper proposes several changes that would allow international organizations and currency unions to receive a wider range of documents. This paper also presents a proposal responding to requests by Executive Directors of European Union (EU) countries to expand access to documents and information prior to Board consideration for the European Commission (EC). Staff proposes that access be granted uniformly to the EC and other executive bodies of currency unions that have executive decision-making power over the common economic and monetary policies of currency unions. There is also an interest in more expanded sharing of Fund documents with regional financing arrangements (RFAs) in view of their importance in the Global Financial Safety Net. However, given the unique structure of RFAs and the need to develop a policy framework suited for the needs of both the Fund and RFAs, a proposal for such sharing will be put forward in a separate paper for consideration by the Board.
Negative Interest Rate Policies—Initial Experiences and Assessments
Authors:   International Monetary Fund
Published: August 2019

The depth of the crisis and the weakness of the ensuing recovery led to new ways to implement monetary policy. At the onset of the crisis, central banks in several advanced economies quickly moved policy rates to zero and initiated large-scale asset purchases. In more recent years, with inflation still below target and limited support from fiscal policy, several central banks lowered their policy rates below the previous zero lower bound, embarking on so-called negative interest rate policies (NIRPs).

This paper explores the implications of NIRPs for monetary policy transmission and banks’ behavior. It considers potential differences between interest rate cuts in positive versus negative territory on deposit and lending rates, as well as banks’ interest rate margins and profitability, and market functioning. The paper focuses on the bank transmission channel, where differences between positive and negative policy rates could arise. Finally, the paper reviews cross-country experiences through case studies.
Remote sensing of exceptional winter aerosol pollution events and representativeness of the surface – column relationship over Paris metropolitan area
Authors: Baron Alexandre , Chazette Patrick , Totems Julien
Published: August 2019

Abstract. In this study an optical parameter derived from lidar measurements is found to be relevant to monitor the evolution of near-surface particulate concentrations. This highlights the opportunities offered by future spaceborne lidar missions in air quality assessment on a global scale. This work is carried out following a dedicated field campaign in the Paris area (France) during winter 2016–2017, from 1st November to 31st January. Two of the most intense winter aerosol pollution events occurring over the last decade were sampled using a ground-based N2-Raman. The lidar operated continuously at the wavelength of 355 nm, favourable to the measurement of submicron aerosols mainly linked to traffic emissions. The data analysis uses the synergy between ground-based and spaceborne lidar observations, and data from the air quality monitoring network Airparif. The first severe aerosol pollution event occurred on 1st December 2016; it concerned a circular area of 250 km in diameter around Paris with maximum PM10 (PMx is the mass concentration of particles with an aerodynamic diameter smaller than x µm) values of 121 ± 63 µg m-3. The second event took place from 21st to 22nd January which covered all of Western Europe, with maxima of PM10 (156 ± 33 µg m-3) and aerosol extinction coefficient (AEC) between 0.6 and 1 km-1, within the winter atmospheric boundary layer. These two major aerosol pollution events share very low boundary layer height, down to 300 m above ground level. However, they did not take place in the same weather condition; moreover, they are associated with significantly different lidar ratios: 72 ± 15 sr and 56 ± 15 sr, respectively in December and January. Such results are consistent with available spaceborne lidar data (70 ± 25 sr) and values found in the literature. During these two events, the continuous temporal evolution of the aerosol extinction coefficient allows us to investigate the representativeness of optical parameters found in the planetary boundary layer to assess surface aerosol concentration. No one-to-one relationship between the aerosol optical thickness (AOT) and PM2.5 values stands out within our study. In contrast, the maximum lidar-derived aerosol extinction coefficient found within the planetary boundary layer is identified as a consistent variable to assess the evolution of ground aerosol concentration.