Global Health: After Measles Success, Rwanda to Get Rubella Vaccine

Rwanda has been so successful at fighting measles that next month it will be the first country to get donor support to move to the next stage — fighting rubella too.

On March 11, it will hold a nationwide three-day vaccination campaign with a combined measles-rubella vaccine, hoping to reach nearly five million children up to age 14. It will then integrate the dual vaccine into its national health service.

Rwanda can do so “because they’ve done such a good job on measles,” said Christine McNab, a spokeswoman for the Measles and Rubella Initiative. M.R.I. helped pay for previous vaccination campaigns in the country and the GAVI Alliance is helping to finance the upcoming one.

Rubella, also called German measles, causes a rash that is very similar to the measles rash, making it hard for health workers to tell the difference.

Rubella is generally mild, even in children, but in pregnant women, it can kill the fetus or cause serious birth defects, including blindness, deafness, mental retardation and chronic heart damage.

Ms. McNab said that Rwanda had proved that it can suppress measles and identify rubella, and it would benefit from the newer, more expensive vaccine.

The dual vaccine costs twice as much — 52 cents a dose at Unicef prices, compared with 24 cents for measles alone. (The MMR vaccine that American children get, which also contains a vaccine against mumps, costs Unicef $1.)

More than 90 percent of Rwandan children now are vaccinated twice against measles, and cases have been near zero since 2007.

The tiny country, which was convulsed by Hutu-Tutsi genocide in 1994, is now leading the way in Africa in delivering medical care to its citizens, Ms. McNab said. Three years ago, it was the first African country to introduce shots against human papilloma virus, or HPV, which causes cervical cancer.

In wealthy countries, measles kills a small number of children — usually those whose parents decline vaccination. But in poor countries, measles is a major killer of malnourished infants. Around the world, the initiative estimates, about 158,000 children die of it each year, or about 430 a day.

Every year, an estimated 112,000 children, mostly in Africa, South Asia and the Pacific islands, are born with handicaps caused by their mothers’ rubella infection.

Thanks in part to the initiative — which until last year was known just as the Measles Initiative — measles deaths among children have declined 71 percent since 2000. The initiative is a partnership of many health agencies, vaccine companies, donors and others, but is led by the American Red Cross, the United Nations Foundation, the Centers for Disease Control and Prevention, Unicef and the World Health Organization.

This article has been revised to reflect the following correction:

Correction: March 1, 2013

An article on Tuesday about a coming measles-rubella vaccination campaign in Rwanda misstated the source of the vaccine and some financing for the campaign. The vaccine and financing are being provided by the GAVI Alliance, not by the Measles and Rubella Initiative.

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Media Decoder Blog: Barnes & Noble Rethinks Its Strategy for the Nook

7:15 p.m. | Updated Barnes & Noble, reporting a sharp drop in sales of its Nook tablets, said on Thursday that it would pull back on its ambitions for its device business, shrinking it in size while focusing more on digital content.

Calling Nook sales over the holiday period an “obvious disappointment,” the bookseller’s chief executive, William Lynch, said the company was taking “significant actions to right size investments” in its digital hardware division through steep cuts in advertising and the manufacturing of devices. Mr. Lynch made his remarks in a conference call with analysts shortly after Barnes & Noble reported a 26 percent decline in the fiscal third quarter for the Nook segment, which includes digital tablets and e-readers.

The retrenching of the Nook unit represents a setback to the Barnes & Noble plan to build up its device business as a way of staying competitive in the rapidly changing e-book market. Last year, the company separated the division from the rest of its operations and struck deals with Microsoft and Pearson for hundreds of millions of dollars in financing — signs that it viewed its digital business as the linchpin of future growth.

But the Nook, while drawing favorable reviews, failed to gain traction against more popular tablets like Amazon’s Kindle Fire and Apple’s iPad, and its performance over the 2012 holiday season was tepid. Barnes & Noble warned last month that Nook sales for the quarter would fall below expectations, and executives hinted recently that the strategy of operating in the highly competitive tablet space had run its course.

“The Nook is not a failure, not technically,” said James McQuivey, an analyst at Forrester Research. “If you go back two years and ask the Nook product managers how many Nooks they would want to sell by now, I bet they have blown past that number. The problem is the fact that the overall tablet market has actually blown way past the Nook’s performance.”

While saying that Barnes & Noble remained committed to the tablet and e-reader market, Mr. Lynch said the company would adjust its strategy quickly. “We are not going to continue doing what we’re doing,” he said in the conference call.

The results announced Thursday underscored the challenges. The company said that Nook revenue declined to $316 million for the quarter that ended Jan. 26, from $426 million over the same period a year ago. Losses in the unit increased to $190 million, from $83 million last year, as measured before interest, taxes, depreciation and amortization.

Over all, the company had a net loss in the quarter of just over $6 million, compared with net income of $52 million a year ago. Revenue in all three major units — Nook, retail and college — was down.

The losses were largely because of lower-than-anticipated sales, inventory charges and higher operating expenses because of advertising costs, the company said.

Mr. Lynch said Thursday that a reformulated Nook strategy would focus more on digital content like e-books and magazines, sales of which increased by 6.8 percent in the quarter. He also said the company planned to be a leader in “digital education” and that it expected that to be a growth area.

In the call with analysts, Mr. Lynch was pressed on whether Barnes & Noble’s digital content was really proprietary. Mr. Lynch acknowledged that what the bookseller possessed was the ability to sell publishers’ content, but he insisted that it was “a strategic asset that is hard to replicate.”

Wall Street seemed heartened by the company’s acknowledgment that it needed to recalibrate its device business, perhaps anticipating that it would accelerate a breakup of the device and retail units. Shares of Barnes & Noble rose 3.35 percent, to close at $15.74.

The company said that there was clear evidence that digital trade book sales were “flattening,” meaning that the bookseller’s physical retail position would be strong in the future. Mr. Lynch said Barnes & Noble continued to take market share from other physical book retailers. The company also promoted prototypes for new stores to be opened in malls and the growth of the college bookstore business.

Combined with the announcement on Monday that Leonard Riggio, the company’s chairman and largest shareholder, was considering purchasing the retail segment, the news added a positive gloss to the brick-and-mortar business that it had not had for some time.

That notion got some support with the earnings report. Retail sales fell just more than 10 percent in the quarter, largely because of the closing of some unprofitable stores. But Barnes & Noble had largely anticipated the lower revenue and despite the sales decline, retail profits increased 7.3 percent, to $212 million, in part because of higher sales margins and “expense management,” the company said.

Despite the shift in digital strategy, Mr. Lynch emphasized that the company was not abandoning the Nook division.

“Nook Media has been financing itself since October of 2012 due to the strong investment partners we’ve been able to attract in Microsoft and Pearson,” he said. He added that the Nook segment and the physical stores drove traffic to each other and needed to remain in partnership.

But analysts sounded a skeptical note. “Barnes & Noble stands at a fork in the road and rather than choose one path, it will likely need to split into two companies and let the retail business go down one path while freeing the Nook division to go down another,” said Mr. McQuivey, of Forrester. “There’s no guarantee that either path will lead to the promised land, but the two units are facing such different challenges and such unique prospects that it doesn’t make sense for them to try to work together to solve such different problems.”

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Malaysia Said to Open Fire on Armed Filipinos

MANILA — The Malaysian police opened fire on a group from a Muslim royal clan from the Philippines that has occupied a village in Malaysia and ignored pleas to leave, the group’s leader said Friday.

The group claims the territory in Malaysia’s Sabah State as its own, and has rejected a plea from President Benigno S. Aquino III of the Philippines to leave. The group’s seizure of the coastal village has complicated relations between the Philippines and Malaysia.

The group’s leader, Prince Rajah Mudah Agbimuddin Kiram, told the Philippine radio station DZBB that the Malaysian police had opened fire on members early Friday, according to The Associated Press. He was quoted as saying that the group was fighting back and that there had been Filipino casualties.

The episode began Feb. 12, when the group, which is seeking to revive a historical claim to part of Borneo, arrived by boat from the Philippines and seized the land. The Philippines on Monday sent a navy vessel to the area with medical and diplomatic personnel to pick up the group or escort them back to the Philippines, hoping to resolve the situation.

Mr. Aquino said Tuesday that his government had sent emissaries to meet with Mr. Kiram to resolve the issue.

“These are your people, and it behooves you to recall them,” Mr. Aquino said to the leader in his Tuesday statement. “It must be clear to you that this small group of people will not succeed in addressing your grievances, and that there is no way that force can achieve your aims.”

The Philippines has been coordinating with the Malaysian government to resolve the issue peacefully, but Malaysian police officials in the area where the standoff is taking place had earlier suggested that they were prepared to use force if necessary.

Floyd Whaley reported from Manila, and Gerry Mullany from Hong Kong.

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DealBook: Heinz Case May Involve a Side Bet in London

Regulators have escalated an investigation into suspicious trades placed ahead of the $23 billion takeover of H. J. Heinz, focusing on a complex derivatives bet routed through London, according to two people briefed on the matter.

The development builds on a recent regulatory action on a Goldman Sachs account in Switzerland that bought Heinz options contracts. It also comes a week after the Federal Bureau of Investigation said it opened a criminal inquiry.

An unusual spike in trading volume in Heinz options a day before the deal was announced first attracted the scrutiny of investigators. The Securities and Exchange Commission is also examining fluctuations in ordinary stock trades. The Financial Industry Regulatory Authority, Wall Street’s self-regulatory group, recently referred suspicious stock trades to the S.E.C., a person who was briefed on the matter said.

Now the S.E.C. is looking into a more opaque corner of the investing world, examining a product known as a contract-for-difference, a derivative that allows investors to bet on changes in the price of stocks without owning the shares. Such contracts are not regulated in the United States, but are popular in Britain.

The expansion of the Heinz investigation illustrates the growing challenges facing American regulators. Charged with policing the American exchanges, authorities increasingly find themselves having to hunt through a dizzyingly complex global marketplace.

Following a number of prominent crackdowns on insider stock trading, a campaign that scared the markets, investors are seeking subtler and more sophisticated tools to seize on confidential tidbits. Trading operations also flocked overseas, a careful move that forces the S.E.C. to navigate a maze of international regulations before identifying suspect traders.

The Heinz case illustrates the shift, as the S.E.C. relies on Swiss authorities to expose the trader behind the Heinz options bets.

The suspicious options trades were routed through a Goldman Sachs account in Zurich, where laws prevent the firm from sharing details of the account holder’s identity. In a complaint filed two weeks ago, the S.E.C. froze the account of “one or more unknown traders.” A federal judge upheld that freeze last week, a move that will prevent the traders from spending their winnings or moving the money.

The series of well-timed options trades, bets that produced $1.7 million in profits, came just a day before Berkshire Hathaway and the investment firm 3G Capital announced that they had agreed to buy the ketchup maker. News of the deal sent the company’s shares, and the value of the options contracts, soaring.

The S.E.C. called the trading “highly suspicious,” given that there was scant options trading in Heinz in previous months.

“Irregular and highly suspicious options trading immediately in front of a merger or acquisition announcement is a serious red flag,” Daniel M. Hawke, head of the commission’s market abuse unit, said recently.

While the identity remains a secret, the account holder is a Goldman private wealth management client, according to a person briefed on the matter who was not authorized to speak on the record. Goldman executives in Zurich know the identity of the person, but laws prohibit those executives from sharing the name with American regulators and even Goldman executives outside of Switzerland.

Finma, the Swiss regulator, is the gatekeeper for American regulators. The S.E.C. contacted Finma in an effort to learn more about the trading, and the Swiss regulator has promised to help. It could take weeks to identify the traders.

Goldman has hired outside counsel to advise it on the situation, according to people briefed on the situation who were not authorized to speak on the record. The bank, which is not accused of wrongdoing, is cooperating with the investigation.

An S.E.C. spokesman declined to comment.

The agency’s inquiry may cast a cloud over the Heinz deal. After the traders are identified, the focus will turn to the many insiders who had information on the deal and could have leaked details. Dozens of people had confidential information about the deal, including bankers, lawyers and executives for both the buyers and the seller.

As the agency continues to build its case against the options trades, it also is examining suspicious contracts-for-difference.

Investors increasingly favor the contracts because they require little capital investment and can be traded on margin. They are popular on the London Stock Exchange, where regulators are now focusing some attention.

In essence, the derivatives contracts are a side bet on the price of a stock. They have drawn criticism for being opaque, in part because users are not actually trading the shares of a company, but rather a contract linked to those shares.

Regulators have examined the use of the contracts before when accusations of insider trading have arisen. In 2008, the British Financial Services Authority fined an investor for market abuse, saying the investor had used a contract-for-difference to profit from inside information on the Body Shop, a retailer. The person was making a bet in this case that the shares would fall in value.

Despite the focus on such complex products in the Heinz case, the S.E.C. is also examining more mundane activity in equity trades ahead of the deal.

Finra is helping the agency build its investigation. The group created an Office of Fraud Detection and Market Intelligence as a sort of clearinghouse of information.

A Finra official declined to comment on Wednesday.

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New Attention to First Lady

CLINTON, Miss. — To her admirers, Michelle Obama is the patron saint of quinoa, charged with reducing the nation’s dangerous obesity rate and helping children eat better. To her detractors, she is the fun-killer, possessed with crushing America’s cookies.

But either way Mrs. Obama has taken her message once again on the road and is making clear that her campaign for healthy school lunches and fewer fat children will not be deterred.

“Now is truly the time to double down on our efforts,” she told state officials on Wednesday at an elementary school here, where she also entertained a giant group of students with a cooking contest in the cafeteria between school chefs and the celebrity food personality Rachael Ray.

Signaling that her “Let’s Move” campaign, now in its third year, will remain a central part of her own policy agenda, Mrs. Obama began a three-city tour to promote new federal school lunch policies, beginning here in Mississippi, where childhood obesity rates have fallen even as the overall rate remains the highest in the nation. “I am beyond thrilled to be back here in Mississippi,” Mrs. Obama said as lawmakers rose with their smartphones to snap photographs of her.

In 2011, the Centers for Disease Control and Prevention said that nearly 40 percent of Mississippi residents were obese. But in 2007, with the blessing of Gov. Haley Barbour, the state began to attack the problem with legislation intended to reduce fat in school lunches and to increase exercise programs.

From 2005 to 2011, obesity declined 13.3 percent among elementary school children in the state, according to the Robert Wood Johnson Foundation. Similar new federal standards for school lunches were set by the Healthy Hunger-Free Kids Act, which began in the current school year. Promoting that federal legislation, which has been relatively hard fought, is a centerpiece of Mrs. Obama’s campaign.

“Your schools did hard work, replaced their fryers with steamers, hallelujah, and started serving more fruits and vegetables and whole grains,” Mrs. Obama said. She added, “The results of these efforts speak for themselves.”

Ms. Ray, who has worked in the White House garden and championed the healthy eating of Mrs. Obama’s campaign, said that her interest in healthy food in schools stemmed from the notion that “every American needs to be concerned about the health of our nation’s kids.” The visit to the school here will be featured on her television program.

After meeting with adults, Mrs. Obama repaired to the school cafeteria for the school chef cook-off contest, where scores of children in red shirts, which matched the bowls of apples on the tables, waited for her arrival by talking, squirming and struggling to contain their excitement.

Mrs. Obama has attracted the praise of obesity experts, chefs, nutritionists and others who applaud her White House garden, her school lunch efforts and her focus on exercise, recently demonstrated in an appearance on NBC’s “Late Night With Jimmy Fallon” doing the “mom dance.” She has also found herself in the cross hairs of conservatives and other critics who see her efforts as meddlesome, frivolous or undignified.

Recently, Mrs. Obama has come under increased scrutiny after flying largely under the radar since the end of the 2012 presidential campaign. On Sunday, she announced the winner of the best picture award at the Oscars via satellite from the White House, which caused a minor national kerfuffle as some pondered the propriety of her appearance.

In The Washington Post on Wednesday, the columnist Courtland Milloy went on a full-frontal attack of both the first lady’s agenda and the attention to her appearance, which he implied she had invited. “Enough with the broccoli and Brussels sprouts,” he wrote, “to say nothing about all the attention paid to her arms, hair, derrière and designer clothes. Where is that intellectually gifted Princeton graduate, the Harvard-educated lawyer and mentor to the man who would become the first African-American president of the United States?”

Her dancing with middle school students, doing push-ups on “The Ellen DeGeneres Show,” running out for tapas with her girlfriends and clipping her locks into modern bangs both thrill and deeply annoy a nation that projects much onto its first ladies.

She will continue her tour on Thursday in Chicago, where she will announce a physical fitness initiative in schools with the tennis player Serena Williams and Education Secretary Arne Duncan. From there, Mrs. Obama will continue on to Missouri to promote adjustments in the food offerings at Walmart and discuss changes to other food businesses. She is traveling with Sam Kass, the senior policy adviser for her White House healthy food initiative.

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New Attention to First Lady

CLINTON, Miss. — To her admirers, Michelle Obama is the patron saint of quinoa, charged with reducing the nation’s dangerous obesity rate and helping children eat better. To her detractors, she is the fun-killer, possessed with crushing America’s cookies.

But either way Mrs. Obama has taken her message once again on the road and is making clear that her campaign for healthy school lunches and fewer fat children will not be deterred.

“Now is truly the time to double down on our efforts,” she told state officials on Wednesday at an elementary school here, where she also entertained a giant group of students with a cooking contest in the cafeteria between school chefs and the celebrity food personality Rachael Ray.

Signaling that her “Let’s Move” campaign, now in its third year, will remain a central part of her own policy agenda, Mrs. Obama began a three-city tour to promote new federal school lunch policies, beginning here in Mississippi, where childhood obesity rates have fallen even as the overall rate remains the highest in the nation. “I am beyond thrilled to be back here in Mississippi,” Mrs. Obama said as lawmakers rose with their smartphones to snap photographs of her.

In 2011, the Centers for Disease Control and Prevention said that nearly 40 percent of Mississippi residents were obese. But in 2007, with the blessing of Gov. Haley Barbour, the state began to attack the problem with legislation intended to reduce fat in school lunches and to increase exercise programs.

From 2005 to 2011, obesity declined 13.3 percent among elementary school children in the state, according to the Robert Wood Johnson Foundation. Similar new federal standards for school lunches were set by the Healthy Hunger-Free Kids Act, which began in the current school year. Promoting that federal legislation, which has been relatively hard fought, is a centerpiece of Mrs. Obama’s campaign.

“Your schools did hard work, replaced their fryers with steamers, hallelujah, and started serving more fruits and vegetables and whole grains,” Mrs. Obama said. She added, “The results of these efforts speak for themselves.”

Ms. Ray, who has worked in the White House garden and championed the healthy eating of Mrs. Obama’s campaign, said that her interest in healthy food in schools stemmed from the notion that “every American needs to be concerned about the health of our nation’s kids.” The visit to the school here will be featured on her television program.

After meeting with adults, Mrs. Obama repaired to the school cafeteria for the school chef cook-off contest, where scores of children in red shirts, which matched the bowls of apples on the tables, waited for her arrival by talking, squirming and struggling to contain their excitement.

Mrs. Obama has attracted the praise of obesity experts, chefs, nutritionists and others who applaud her White House garden, her school lunch efforts and her focus on exercise, recently demonstrated in an appearance on NBC’s “Late Night With Jimmy Fallon” doing the “mom dance.” She has also found herself in the cross hairs of conservatives and other critics who see her efforts as meddlesome, frivolous or undignified.

Recently, Mrs. Obama has come under increased scrutiny after flying largely under the radar since the end of the 2012 presidential campaign. On Sunday, she announced the winner of the best picture award at the Oscars via satellite from the White House, which caused a minor national kerfuffle as some pondered the propriety of her appearance.

In The Washington Post on Wednesday, the columnist Courtland Milloy went on a full-frontal attack of both the first lady’s agenda and the attention to her appearance, which he implied she had invited. “Enough with the broccoli and Brussels sprouts,” he wrote, “to say nothing about all the attention paid to her arms, hair, derrière and designer clothes. Where is that intellectually gifted Princeton graduate, the Harvard-educated lawyer and mentor to the man who would become the first African-American president of the United States?”

Her dancing with middle school students, doing push-ups on “The Ellen DeGeneres Show,” running out for tapas with her girlfriends and clipping her locks into modern bangs both thrill and deeply annoy a nation that projects much onto its first ladies.

She will continue her tour on Thursday in Chicago, where she will announce a physical fitness initiative in schools with the tennis player Serena Williams and Education Secretary Arne Duncan. From there, Mrs. Obama will continue on to Missouri to promote adjustments in the food offerings at Walmart and discuss changes to other food businesses. She is traveling with Sam Kass, the senior policy adviser for her White House healthy food initiative.

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I.B.M. Exploring New Feats for Watson

Robert Caplin for The New York Times

I.B.M. plans to serve a breakfast pastry devised by Watson and the chef James Briscione at its meeting on Thursday.

I.B.M.’s Watson beat “Jeopardy” champions two years ago. But can it whip up something tasty in the kitchen?

That is just one of the questions that I.B.M. is asking as it tries to expand its artificial intelligence technology and turn Watson into something that actually makes commercial sense.

The company is betting that it can build a big business by taking the Watson technology into new fields. The uses it will be showing off to Wall Street analysts at a gathering in the company’s Almaden Research Center in San Jose, Calif., on Thursday include helping to develop drugs, predicting when industrial machines need maintenance and even coming up with novel recipes for tasty foods. In health care, Watson is training to become a diagnostic assistant at a few medical centers, including the Cleveland Clinic.

The new Watson projects — some on the cusp of commercialization, others still research initiatives — are at the leading edge of a much larger business for I.B.M. and other technology companies. That market involves helping corporations, government agencies and science laboratories find useful insights in a rising flood of data from many sources — Web pages, social network messages, sensor signals, medical images, patent filings, location data from cellphones and others.

Advances in several computing technologies have opened this opportunity and market, now called Big Data, and a key one is the software techniques of artificial intelligence like machine learning.

I.B.M. has been building this business for years with acquisitions and internal investment. Today, the company says it is doing Big Data and analytics work with more than 10,000 customers worldwide. Its work force includes 9,000 business analytics consultants and 400 mathematicians.

I.B.M. forecasts that its revenue from Big Data work will reach $16 billion by 2015. Company executives compare the meeting in San Jose to one in 2006, when Samuel J. Palmisano, then chief executive, summoned investment analysts to I.B.M.’s offices in India to showcase the surging business in developing markets, which has proved to be an engine of growth for the company.

I.B.M. faces plenty of competitors in the Big Data market, ranging from start-ups to major companies, including Microsoft, Oracle, SAP and the SAS Institute. These companies, like I.B.M., are employing the data-mining technology to trim costs, design new products and find sales opportunities in banking, retailing, manufacturing, health care and other industries.

Yet the Watson initiatives, analysts say, represent pioneering work. With some of those applications, like suggesting innovative recipes, Watson is starting to move beyond producing “Jeopardy” style answers to investigating the edges of human knowledge to guide discovery.

“That’s not something we thought of when we started with Watson,” said John E. Kelly III, I.B.M.’s senior vice president for research.

I.B.M.’s Watson projects are not yet big money makers. But the projects, according to Frank Gens, chief analyst for IDC, make the case that I.B.M. has the advanced technology and deep industry expertise to do things other technology suppliers cannot, which should be a high-margin business and give I.B.M. an edge as a strategic partner with major customers. And the new Watson offerings, he said, are services that future users might be able to tap into through a smartphone or tablet.

That could significantly broaden the market for Watson, Mr. Gens said, as well as ward off potential competition if question-answering technology from consumer offerings, like Apple’s Siri and Google, improve.

“It will take years for these consumerized technologies to compete with Watson, but that day could certainly come,” Mr. Gens said.

John Baldoni, senior vice president for technology and science at GlaxoSmithKline, got in touch with I.B.M. shortly after watching Watson’s “Jeopardy” triumph. He was struck that Watson frequently had the right answer, he said, “but what really impressed me was that it so quickly sifted out so many wrong answers.”

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India Ink: India’s Slowing Economy Forces Budget Decisions

NEW DELHI — Not too long ago, when India’s economy was roaring amid predictions of high growth rates for years to come, the finance minister could be forgiven for strutting during budget week. He got to march into India’s Parliament with the ceremonial briefcase bearing a budget stuffed with goodies.

But on Thursday, when the current finance minister, Palaniappan Chidambaram, arrives in Parliament, his steps will be heavier, and the mood is likely to be, too. Faced with slowing growth, persistent inflation and sagging investor confidence, India’s government is pinned between conflicting pressures: economists warn that tough steps are needed to avoid long-term fiscal problems, even as political leaders are leery of introducing unpopular measures before important elections this year.

On Wednesday, the government sought to change the pessimistic narrative, as the Finance Ministry released its annual economic survey and projected that economic growth would jump somewhere above 6 percent during the next fiscal year, predicting that the downturn was “more or less over and the economy is looking up.” Some economists were skeptical, given that similar rosy predictions in recent budgets have proved wrong.

“Let me remind you that last year the economic survey spoke of about 7.6 percent projected growth — and what we had was 5 percent growth,” said Ajay Bodke, head of investment strategy and advisory at Prabhudas Lilladher, a Mumbai brokerage. “That is not just a miss but a humongous miss.”

The consequences of the budget plans are especially high because India, once a darling of global investors and an anointed power-in-waiting, is struggling to regain its lost luster.

India’s estimated 5 percent growth rate for the current fiscal year compares with 8 percent in 2010. Ratings agencies have threatened to downgrade the country’s investment rating to “junk” status. Meanwhile, India’s political class has spent more than three years enmeshed in scandals, as a bickering Parliament has accomplished almost nothing.

“It’s a supercritical moment, actually,” said Rajiv Kumar, an economist with the Center for Policy Research in New Delhi. “If you get it right, and this is a budget that can shore up the government’s credibility, they can turn it around.”

For investors and business leaders, the question is whether the government will make tough calls to address the country’s large fiscal and account deficits, curb huge subsidies for diesel fuel and petroleum products, unclog bureaucratic bottlenecks on stalled manufacturing, energy and infrastructure projects and create incentives to entice new investment.

Only a year ago, Pranab Mukherjee, then finance minister, unveiled a budget now regarded by many analysts as a major mistake. Desperate to increase revenues, the government spooked investors by giving broad latitude for tax collectors to pursue multinationals for billions of dollars in new, unexpected taxes. Investment slowed markedly, while investors and political opponents complained that India’s coalition government, led by the Indian National Congress Party, was endangering one of the world’s fastest-growing economies.

“The economy is in a deep crisis at the moment,” said Yashwant Sinha of the opposition Bharatiya Janata Party, a former finance minister, “and I only hope the crisis doesn’t become any deeper with more pre-election sops.”

Mr. Sinha and many independent economists warn that the economy cannot afford a repeat of 2008, when the government was preparing for national elections the following year. Then, the pre-election budget was filled with big spending measures, including pay raises for government workers and the forgiveness of billions of dollars in loans to farmers. The government was easily re-elected in 2009, but the new spending contributed to a fiscal deficit that rose to roughly 6 percent, from about 2 percent the previous year.

Neha Thirani Bagri contributed reporting from Mumbai, India.

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Media Decoder Blog: SFX Entertainment Buys Electronic Dance Music Site

SFX Entertainment, the company led by the media executive Robert F. X. Sillerman, has agreed to buy the music download site Beatport, part of the company’s plan to build a $1 billion empire centered on the electronic dance music craze.

Mr. Sillerman declined on Tuesday to reveal the price. But two people with direct knowledge of the transaction, who were not authorized to speak about it, said it was for a little more than $50 million.

Beatport, founded in Denver in 2004, has become the pre-eminent download store for electronic dance music, or E.D.M., with a catalog of more than one million tracks, many of them exclusive to the service. It says it has nearly 40 million users, and while the company does not disclose sales numbers, it is said to be profitable.

The site has also become an all-purpose online destination for dance music, with features like a news feed, remix contests and D.J. profiles. Those features, and its reach, could help in Mr. Sillerman’s plan to unite the disparate dance audience through media.

“Beatport gives us direct contact with the D.J.’s and lets us see what’s popular and what’s not,” Mr. Sillerman said in an interview. “Most important, it gives us a massive platform for everything related to E.D.M.”

Since the company was revived last year, SFX has focused mostly on live events, with the promoters Disco Donnie Presents and Life in Color; recently it also invested in a string of nightclubs in Miami and formed a joint venture with ID&T, the European company behind festivals like Sensation, to put on its events in North America.

In the 1990s, Mr. Sillerman spent $1.2 billion creating a nationwide network of concert promoters under the name SFX, which he sold to Clear Channel Entertainment in 2000 for $4.4 billion; those promoters are now the basis of Live Nation’s concert division.

Matthew Adell, Beatport’s chief executive, said that being part of SFX could help the company extend its business into live events, and also into countries where the dance genre is exploding, like India and Brazil.

“We already are by far the largest online destination of qualified fans and talent in the market,” Mr. Adell said, “and we can continue to grow that.”

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Advanced Breast Cancer May Be Rising Among Young Women, Study Finds

The incidence of advanced breast cancer among younger women, ages 25 to 39, may have increased slightly over the last three decades, according to a study released Tuesday.

But more research is needed to verify the finding, which was based on an analysis of statistics, the study’s authors said. They do not know what may have caused the apparent increase.

Some outside experts questioned whether the increase was real, and expressed concerns that the report would frighten women needlessly.

The study, published in The Journal of the American Medical Association, found that advanced cases climbed to 2.9 per 100,000 younger women in 2009, from 1.53 per 100,000 women in 1976 — an increase of 1.37 cases per 100,000 women in 34 years. The totals were about 250 such cases per year in the mid-1970s, and more than 800 per year in 2009.

Though small, the increase was statistically significant, and the researchers said it was worrisome because it involved cancer that had already spread to organs like the liver or lungs by the time it was diagnosed, which greatly diminishes the odds of survival.

For now, the only advice the researchers can offer to young women is to see a doctor quickly if they notice lumps, pain or other changes in the breast, and not to assume that they cannot have breast cancer because they are young and healthy, or have no family history of the disease.

“Breast cancer can and does occur in younger women,” said Dr. Rebecca H. Johnson, the first author of the study and medical director of the adolescent and young adult oncology program at Seattle Children’s Hospital.

But Dr. Johnson noted that there is no evidence that screening helps younger women who have an average risk for the disease and no symptoms. “We’re certainly not advocating that young women get mammography at an earlier age than is generally specified,” she said.

Expert groups differ about when screening should begin; some say at age 40, others 50.

Breast cancer is not common in younger women; only 1.8 percent of all cases are diagnosed in women from 20 to 34, and 10 percent in women from 35 to 44. However, when it does occur, the disease tends to be more deadly in younger women than in older ones. Researchers are not sure why.

The researchers analyzed data from SEER, a program run by the National Cancer Institute to collect cancer statistics on 28 percent of the population of the United States. The study also used data from the past when SEER was smaller.

The study is based on information from 936,497 women who had breast cancer from 1976 to 2009. Of those, 53,502 were 25 to 39 years old, including 3,438 who had advanced breast cancer, also called metastatic or distant disease.

Younger women were the only ones in whom metastatic disease seemed to have increased, the researchers found.

Dr. Archie Bleyer, a clinical research professor in radiation medicine at the Knight Cancer Institute at the Oregon Health and Science University in Portland who helped write the study, said scientists needed to verify the increase in advanced breast cancer in young women in the United States and find out whether it is occurring in other developed Western countries. “This is the first report of this kind,” he said, adding that researchers had already asked colleagues in Canada to analyze data there.

“We need this to be sure ourselves about this potentially concerning, almost alarming trend,” Dr. Bleyer said. “Then and only then are we really worried about what is the cause, because we’ve got to be sure it’s real.”

Dr. Johnson said her own experience led her to look into the statistics on the disease in young women. She had breast cancer when she was 27; she is now 44. Over the years, friends and colleagues often referred young women with the disease to her for advice.

“It just struck me how many of those people there were,” she said.

Dr. Donald A. Berry, an expert on breast cancer data and a professor of biostatistics at the University of Texas’ M. D. Anderson Cancer Center in Houston, said he was dubious about the finding, even though it was statistically significant, because the size of the apparent increase was so small — 1.37 cases per 100,000 women, over the course of 30 years.

More screening and more precise tests to identify the stage of cancer at the time of diagnosis might account for the increase, he said.

“Not many women aged 25 to 39 get screened, but some do, but it only takes a few to account for a notable increase from one in 100,000,” Dr. Berry said.

Dr. Silvia C. Formenti, a breast cancer expert and the chairwoman of radiation oncology at New York University Langone Medical Center, questioned the study in part because although it found an increased incidence of advanced disease, it did not find the accompanying increase in deaths that would be expected.

A spokeswoman for an advocacy group for young women with breast cancer, Young Survival Coalition, said the organization also wondered whether improved diagnostic and staging tests might explain all or part of the increase.

“We’re looking at this data with caution,” said the spokeswoman, Michelle Esser. “We don’t want to invite panic or alarm.”

She said it was important to note that the findings applied only to women who had metastatic disease at the time of diagnosis, and did not imply that women who already had early-stage cancer faced an increased risk of advanced disease.

Dr. J. Leonard Lichtenfeld
, deputy chief medical officer of the American Cancer Society, said he and an epidemiologist for the society thought the increase was real.

“We want to make sure this is not oversold or that people suddenly get very frightened that we have a huge problem,” Dr. Lichtenfeld said. “We don’t. But we are concerned that over time, we might have a more serious problem than we have today.”

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