The prior authorization process starts with either a phone call, fax or accessing a web site to provide patient information. They must also provide the imaging study requested with a CPT code and clinical information. For most health plans, a clinical reviewer, usually a nurse, will initially review the clinical provided. It is matched to specific criteria or guidelines set forth by the American College of Radiology and/or physician specialists. If after reviewing the clinical and the case is approved, a prior authorization number is given. If it cannot be approved, it is sent to a physician for further review. The physician may request additional clinical or deny the study. If the study is denied, there is usually a first and second level of appeals depending on the health plan.

From the time the case is started to the final outcome, there can be obstacles along the way that could cause a delay in the prior authorization. A few of the most common will be discussed. Delays increase the amount of time a staff member or even the doctor has to spend working on the prior authorization. It means that the patient must wait before the test can be performed.

Providing an incorrect diagnosis or rule out may cause delay. If the clinical provided does not correlate to the study being requested, it is then forwarded to a physician for further review. Therefore, it is extremely important that this information is correct. And if a staff member is unfamiliar with disease processes, this could easily occur. For example, using a diagnosis of liver mass when the physician is ordering an MRA abdomen to rule out renal artery stenosis. Along the same line, if an incorrect CPT code (billing code which correlates to the test being requested) or imaging study is given, it may also cause delay. Most often it is corrected right away by the nurse reviewer, but not always.

Providing clinical is the biggest challenge for most staff. This can include symptoms, physical exam findings, medications and/or treatment with duration, prior test results and medical history. Most often, it is non-medical staff that provide clinical, as these are the most common staff members tasked with obtaining prior authorization. The medical questions asked by the nurse reviewer can sometimes be confusing, even foreign to a non-medical person. Couple that with the inability to decipher the physician’s note, laboratory and special testing and you can see how the prior authorization can be delayed, even denied.

There are changes that must take place in order to avoid these delays and denials. Non-medical office staff must have training and education. Unfortunately, there is little information and no formal training provided by the insurance companies or advanced imaging management companies to prepare staff on how to maneuver through this process. This is the solution that will save time, money and frustration, as well as improve patient care.

The machinery industry has a major bearing on China’s manufacturing industry. In 2004, China’s machinery industry accounted for 17.0% and 10.6% respectively of national sales and exports. Rapid economic development in China has led to a corresponding increase in industrial machinery. Almost all leading international players have formed joint ventures in China including John-Deere, Daewoo, Hitachi, Parker, Sanyo, ABB, Emerson, Siemens and Volvo.

Chinese machine builders are also enhancing their international participation through larger exports as well as a higher degree of internationalization. At an average annual growth rate (AAGR) of 12.0%, in 2010 consumption is estimated to reach $910.14 billion. In the near future, China will be an important player in the global industrial machinery marketplace.

Representative Machinery

1. Agriculture Machinery

Today China’s agriculture is a new era of historical development. In a long period of time from now on, expanding operating scope, industrialized management, sustainable development, and scientific and technical innovation in agriculture shall be the four tendencies and driving forces. The development and adjustment of economic construction in agriculture requires higher level and larger scope of mechanization. Now mechanization has already developed from the traditional growing wheat to rice, maize, from traditional tillage to protecting tillage, from machine for producing grain crops to oil crops and cotton economic crops, from growing to livestock farming, aquatic products industry, fruit growing, garden farmland and manufacturing agriculture products etc. So there is a bright future of market for farm machinery.

2. Construction Machinery

Construction machinery is the largest customer of hydraulic products, which makes up about more than 40% of the total market volume of hydraulic products. The percentage shall further increase in the future. China is in an extensive developing and constructing period, thus the demand of construction machinery in the coming several decades will up, and China will be the largest market in the world.

3. Metallurgical and Mining Equipment

The total demand of steel in China reached 352 million tons in 2005. Therefore steel and iron industry shall speed up the adjustment of product structure. In the next 10?15 years, put stress on manufacturing flat plate steel, especially sheet steel and products with high additional value. State should enlarge the investment for them and make the degree of self-sufficiency of steel reach 90%.

For this reason, China need to use advanced machines to replace the backward machine, to realize continuous and automatic production with equipments in large scale, and upgrade the industry. Meanwhile China will give great impetus to process of group-collection for iron and steel industry, carry out technical reform of manufacturing process for large enterprises, make every effort to raise the utilization rate of steel by 10%?20%, take further steps to save energy by 15%?20%. Consequently, many new continuous casting machine and cold/hot rolling mill etc are needed.

4. Machine Tools

Along with the progress of manufacturing technique, China’s demands for high precision, high-efficiency CNC machines, is getting more and more. By the year 2010, the yearly output of CNC machine tools will be approximately 50,000 units. Now, in China there are about 3 million machine tools in use, and it is expected that about 4 million units machine tools will be in use by the year 2010.

5. Plastic Machinery

The demand for plastic products will increase remarkably to cater for the development in the fields of agriculture, automobile, electronics, light, foodstuff, packaging and construction industries and the improved living standard of the people as well. At present, the total output value of plastic in China has come to the forefront of the world, but the annual plastic consumption per capita is only 14.5 kg, less than the 20 kg world average annual consumption per capita and far from the 50 kg to 100 kg annual consumption per capita in developed countries. It is expected by the year 2010 to be a litter bit higher than the world average annual consumption per capita. The growing consumption of plastic products provides the opportunity for developing plastic machinery. It is expected that the annual demand for plastic machinery will be about 150, 000 units by the year 2010.

6. Petrochemical Equipment

Energy problem shall be the restricted factor in a long period of time in developing national economy. Accelerating the development of energy industry is of great urgency. State need to accelerate the development of petroleum and natural gas, except the project to deliver natural gas from the west to the east and other petrochemical projects are under construction, in the period of 11th five year plan shall be built 5000 km high pressure crude oil pipeline. Besides, in this period the demand of oil refining, ethylene and three synthetic materials (synthetic resin, synthetic rubber, synthetic fibre) shall increase at the rate of 6%?9%. So, there need collection and delivery equipment for oil and gas and large-scale and high-efficiency petrochemical equipment with the emphasis laid on the development of large-scale petroleum prospecting and drilling equipment for desert and ocean, large complete equipment with a yearly output of 600 000 ton ethylene, 450 000 ton synthetic ammonia, 800, 000 ton urea and chemical fibres etc.

8. Food-stuff, Packaging, Electronics, Light-industry and Textile Equipment

The emphasis is laid on the development of various high-efficiency, energy saving, multifunctional and automated complete sets of equipment and production lines, such as various liquid filling lines, production lines of fast foods and puffed foods, sterile medicine production lines and packaging lines, bag-making and bag-filling lines, suitcase making lines, high-speed tobacco processing machinery, air-jet looms, automatic winders and production lines of various household electrical appliances and electronic apparatus.

9. Harbor Terminal Facilities

In order to meet the demand of domestic construction and enlarged export and import trade, task for building coastal port and inland port is very heavy, a great number of ship loaders, car dumpers, stacking machines and container cargo handling equipment will be additionally provided or updated.

10. Ship-building and Ocean Engineering Equipment

By the year 2010, the total yearly production capacity of ship building industry will be about 10 million ton, account for 30% of the world annual output, with the emphasis laid on the development of large ocean-going tankers, LPG ships, container ships, engineering vessels, bulk ships, high-speed passenger liners and ocean-going fishing vessels. Ocean engineering equipment shall be put stress on building large engineering facilities for recovering ocean petroleum, such as large self-rising drilling ship, deep sea drilling machine, heavy-load lift, large crane and piping erection ship.

11. Power Generating Equipment

At present, electric supply has become the bottle neck, which restricts the development of economy. In the coming 20 years, the largest power-building market will be in China. Water, coal, nuclear and gas are the four pillar for power generating in China. It is estimated that the installed capacity by the year 2020 will be 960 000 megawatt, but the installed capacity per capita only 0.67 kW, less than half of that in developed countries. In future, every year need to add new installed capacity of more than 200 000?300 000 megawatt.

12. Environmental Protection Equipment

In order to keep the development of economy, society and environment well coordinated, and make the ecological damages and environmental pollution well controlled, environmental quality and comprehensive utilization of resources are raised further, state will add the investment for ecological preservation and environmental protection. China is putting emphasis on developing: urban sewage and solid wastes disposal and comprehensive utilization equipment, urban and industrial noise control equipment and atmospheric pollution control equipment.

Machinery Trade Shows

The 12th China Xiamen Machinery and Electronics Exhibition (CXMEE)

The 12th China Xiamen Machinery and Electronics Exhibition (CXMEE), authorized by China’s Ministry of Commerce, is jointly organized by the China Chamber of Commerce for Import and Export of Machinery and Electronics Products, the Taiwan Electrical and Electronic Manufacturers Association, the Xiamen Municipal People’s Government. It will take place in Xiamen, China on April 8-11, 2008.

7th China (Hangzhou) International Machine Tool and Mould Expo

The 2008 China (Hangzhou) International Industrial Fair (formerly “Zhejiang International Industrial Fair”) was originated in 2002, it is held at Hangzhou Peace International Exhibition and Conference Center every May. It has experienced six years of persistent, healthy and stable development. It was listed in the formal exhibition of “China Hangzhou West Lake Expo” in 2006, becoming a large exhibition and conference project specially supported by the municipal government of Hangzhou.

Jawaharlal Nehru stated that India must develop atomic energy, indeed he was very clear in his thought about the use of atomic energy when he said, â??I do not know to distinguish the two (peaceful and defense purposes) I think we must develop it for peaceful purposes of course if we are compelled as a nation to use it for other purposes, possibly no pious sentiments will stop the nation from using it that way.â?Â  He along with Homi Bhabha, a distinguish physicist, played a leading role in drafting Indiaâ??s nuclear programme.  Atomic  Energy commission. (AEC) was established in 1948 this was followed by the establishment of the department of Atomic Energy (DAE) in 1954 to execute the policies and program of the AEC. Right from the beginning the Indian nuclear research spread it interest across the entire nuclear fuel cycle. Accordingly, in course of time the DAE established many subsidiaries: Five research center: Five Government owned bodies/ companies Nuclear power cooperation to design, construct and operate nuclear power plants. Uranium cooperation of India Ltd – to mine and mill the uranium, Heavy water reactor to run heavy water plants and Nuclear fuel complex to manufacture nuclear fuel for reactors. It has also established the Atomic Energy Regulatory Board in 1983 to oversee and enforce all nuclear operations.

From the beginning, there was friction between Indiaâ??s nuclear program and the larger international effort to control nuclear technology and materials In 1948, the United Nations grappled with the U.S. inspired attempt to establish international contour over fissile materials and the facilities that could mine, process, and utilize them, both for peaceful and military purposes. That proposal to create an International Atomic Development authority to own and operate all materials, technologies, and facilities with potential nuclear weapon applications caused significant consternation for newly independent India which was holding great stock of atomic future; India feared that the plans of United States and other great powers were yet another colonial strategy. At this juncture Nehru unveiled a four-year plan to begin developing Indiaâ??s nuclear capability, starting with surveying for atomic materials and processing monazite to obtain thorium Applications of atomic energy in medicine and biology were also announced, Bhabha began discreetly to seek terminal information on reactor theory, design, and technology from the United States, Canada and United Kingdom. The thrust of these activities was to move beyond theoretical research to application of technology.

Indiaâ??s movement toward nuclear independence son ran afoul of US interests. In July 1953 an Indian government owned company prepared to put two tons of Thorium Nitrate on a Polish ship in Bombay stated for eventual delivery to China.  Thorium Nitrate is a material useful as a potential nuclear fuel.  American through the Mutual Defense Assistance Act of 1951-required that the United States deny any from of military, economic, or financial assistance to a county trading such material to the Soviet Union or it satellites, which included china, Thus, U.S Ambassador to India George V. Allen informed Nehru that transfer of the Thorium Nitrate would compel the united states to cut of all its programs in India.  Nehru responded vehemently that India would never vitiate its sovereignty and allow the United States to actuate what India could trade with whom.  Nor would India accept political steins attached to aid.  The dispute brewed through the summer as Nehru remained intransigent and U.S officials confronted an unbending legal mandate. Finally, Secretary of State John foster Dulles offered a compromise, India agreeing to state that the Thorium Nitrate was going to China only for commercial purposes, and that India had contacted China without the knowledge of the U.S legislationâ??s applicability on India. The thorium nitrate episode exacerbated already-strained Indo-American relations and foreshadowed similar disputes between Indiaâ??s sovereign interests in nuclear independence and American Law and policies designed to prevent nuclear proliferation.

INDIA â?? CANADA CIVIL NUCLEAR AGREEMENT AND U.S SUPPLY OF

HEAVY WATER FOR CANDU REACTOR.

The first indigenous research reactor, Apsara a â??swimming pool reactorâ? of 1MW was established with the technical assistance of UK, which became critical in August 1950. The second reactor CIRUS â?? a 40 MWe Heavy Water moderated, Light Water cooled, natural uranium fuelled reactor was supplied by Canada during 1955, it became critical with heavy water supplied by the US subsequently. This reactor was considered an efficient producer of plutonium, for it has high nutrition economy. The plant for separating plutonium from the spent fuel irradiated at the CIRUS reactor was designed and constructed at Tomboy by an American firm. During the same period of 1954-74 as many Indian nuclear scientist, were trained in the US and another 263 were trained in Canada. The heavy water production facility built at Nangal with German assistance became functional in 1962 and seven more plants were built by 1991.

In early 1955, members of the US Joint committee on Atomic Energy visited India to promote the expansion of peaceful applications of atomic. This meeting engendered mutual interest in supplying India with heavy water that could be used to moderate the planned CIRCUS reactor, which was the source of the plutonium. Also in 1955 Prime Minister Nehru persuaded the leaders of the International community to make Homi Bhabha the president of the first UN conference on the peaceful uses of Atomic Energy, held, in Geneva in July and August.  This conference facilitated the dissemination of newly declassified technical papers on atomic energy.  This background indicates how inconsequential nonproliferation concerns were for U.S. and Canadian policymakers in this period.

TARAPUR AGREEMENT, POKHRAN  I & THE ESTRANGEMENT OF INDIA â??

UNITED STATES RELATIONS

The differences between India and US on the continued supply of low enriched uranium to the Tarapur Atomic power station (TAPS) based on the Indo-US agreement of 1963 would be unrealistic to underestimate. The Planning Commission of the government of India approved the construction of Indiaâ??s first Atomic power station under the countryâ??s Third Five-year plan.  It was decided to install this plant in the Western region and to supply the power generated to the states Gujarat and Maharastra.  In August 1960 the decision to build the first Atomic Power Reactors at Tarapur, 100 kilometers north of Bombay, was made. Global tenders were invited by the Department of Atomic energy for this project and the one submitted by the International General Electric Company of the U.S. was found to be the most suitable.  An Indo-US bilateral agreement relating specifically to this project was signed on August 8, 1963.  Under a loan Agreement dated December 1963, the U.S agency for International Development made the grant available for the project. Further, the U.S AEC India contract signed on May 17, 1966, agreed to provide fuel throughout the life of this station, The Tarapur Atomic power station (TAPS) consists of two reactors of the Boiling Water Type, each generating over 200 MWe.  The reactors are fuelled with LEU and moderated by light water.

The 1963 agreement has rightly been characterized as â??unique among U.S bilateral agreements in that it provides for the exclusive use of US. Fuel Tarapur reactors, and in exchange for a U.S. guarantee of it supply. This provision played a central role in securing initial Indian acceptance of safeguards at Tarapurâ?. The applicable domestic laws or polices of the United States of America with respect to ownership and supply of special nuclear material for use by the sellerâ??s domestic distributes may be changed according to the agreement.  In 1971 the contract was amended at Washingtonâ??s request precisely because the U.S law regarding ownership was changed.  The private ownership of special Nuclear Material Act was amended to permit private ownership of nuclear fuel

POKHRAN  I

In May 18, 1974, the desert village of Lokhari, near Pokhran (also spelled Pokharan) in the western Indian state of Rajasthan shook with the detonation of a nuclear explosive device 107 meters below to ground.

The Indian government declared it â??a peaceful nuclear explosion experiment.â?Â  The Atomic Energy Commission stated that India had â??no intention of producing nuclear weapons.â?Â  Indira Gandhi told a press conference â??thereâ??s nothing to get excited about.  This is our normal research and study.  But we are firmly committed to only peaceful uses of atomic energy.â?

Prime Minister India Gandhi, while repeating to platefuls of non-alignment, reoriented Indiaâ??s foreign policy, basing it less on adherence to moral principles and more on the imperatives of statecraft.  Some Indian analysts argue that US pressure on India during the 1971 Indo-Pakistani war also convinced Indira Gandhi of the signal importance of developing Indiaâ??s military nuclear capabilities. No authoritative public chronology exists of Indian decision-making regarding the 1974 explosion.

FUEL PROBLEMS IN TARAPUR AGREEMENT

In 1963 agreement gains the US the right to require the return of equipment transferred and the special nuclear material produced that from in the event of non-complianceâ? with the guarantees of safeguards on Indiaâ??s part.  In 1963 Agreement provides that when the nuclear material â??Utilized in Tarapur requires reprocessing, such reprocessing may be performed in Indian facilities upon a point determination of the parties that the provisional agreement correlating to safeguards may be effectively applied.â?

The U.S built Tarapur facility, which played no role in Indiaâ??s 1974 underground explosion, was initially under international safeguards following the passage of to1978 Nuclear Non-proliferation Act (NNPA) and then the United States terminated nuclear cooperation with India in 1980. The NNPA required scientist receiving US nuclear technology or materials to accept full scope safeguards, placing all of their facilities under international inspection.  This action included termination of sales of fuel and spare parts fuel Tarapur. Indiaâ??s commitment to maintain safeguards on the Tarapur reactors and spent fuel, the Reagan Administration concluded a tripartite agreement with India and France in 1983 under which low enriched Uranium from China was supplied to Tarapur under IAEA safeguards.

INDIAâ??S 1998 NUCLEAR EXPLOSION THE REACTION OF US: -

The years 1997-1998 proved momentous for India in term of its domestic policies within the span of one year. With the collapse of the shaky united front government in December 1997, new national elections were called for February -March 1998.  The BJP emerged as the latest single party within parliament and, with the support of a number of regional parties it assumed power.

The BJPâ??s election manifesto had spoken of the perceived need to â??inductâ? nuclear weapons into Indiaâ??s arsenal along with a â??strategic reviewâ? of Indiaâ??s security environment.  This trigger came in the fuel of Pakistanâ??s test of an intermediate-range ballistic missile, code-named Ghauri, on April 6, 1998 that was built with Chinese assistance. Its range would enable Pakistan to target twenty size cities of India.

Three factors drove Indiaâ??s decision to test it nuclear weapons in 1998.  The first was the incremental and fitful acquisition of the capability to manufacture nuclear weapons.

The evolution of the nuclear program and the 1998 test were product of calculated practical choices based upon considerations of national security.  Perceived threats form China and Pakistan was also key factors in Indiaâ??s decision to test. Many foreign and several Indian political commentators have dismissed the security impetrations underlying the Indian nuclear weapons program as well as the Indian tests, while privileging other explanations based on considerations of status, prestige, and the short-term exigencies to domestic policies woes, still much of the conventional wisdom dismiss Indiaâ??s felt security needs and blithely asserts that India would be better of without nuclear weapons.

NEXT STEP IN STRATEGIC PARTNERSHIP (NSSP) INDIA & US

AGREEMENT: –

The Relations between India and their US in the nuclear area have large been based on suspicion and mutual distrust after Pokhran I  resulting in Indiaâ??s isolation from the global civil nuclear energy cooperation regime. Even though by Pokhran II, the would order had changed with the end of the cold war and the demise of the Soviet Union, this distrust of Indian continued.  In the aftermath of the September 11th event there was a change in the US altitude towards India.  The proposed nuclear deal with US is the culmination and result of the process of mutual understanding set in motion in the aftermath Pokhran II.  Mutual appreciation of each otherâ??s energy and security needs in the changing world was identified as one of the key areas of possible cooperation in the Next Step In Strategic Partnership (NSSP) between the United States

Civil nuclear cooperation was identified as one of the key areas of possible cooperation in the Next step in strategic partnership (NSSP) between India and the United States. This process is to end Indiaâ??s isolation from global nuclear trade regimes.

In January 2004 the United States and India agreed it expand cooperation in three specific areas: – civilian nuclear activities, civilian space programs, and high technology trade. â??In November 2001, Prime Minister Vajpayee committed our countries to strategic partnership, since then, two countries have strengthened bilateral cooperation significantly in several areas.

This has included implementation of measures to address proliferation concerns and to ensure compliance with U.S export controls. The efforts have enabled the United States to make modifications to US export licensing policies that will foster cooperation in commercial space programs and permit certain exports to power plant at safeguarded nuclear facilities. These Modifications, including removing the Indian space Research organization (ISRO) Headquarters from the department of commence Entity list, are fully consistent with US government non-proliferation laws, obligations, and objectives.                 Indo-US relations in general were on an upward suring after Bill Clintonâ??s visit to India in March 2000.

INDO-US NUCLEAR DEAL:

The Indian Prime Minister Manmohan Singh and US President George W. Bush put joint statement of July 18, 2005 to enable fuel civil nuclear energy cooperation with India covering aspects of the associated nuclear fuel cycle.

COMPREHENSIVE COVERAGE OF THE INDO-US NUCLEAR DEAL:

(a) Birth of the Deal: -

The India and United States of America put agreement was during the former Prime Minister A.B. Vajpayee, under the Next Step in Strategic Partnership (NSSP) but after the 14th Lok Sabha Election BJP government was defeated by Congress.

(b) Joint â?? statement:

After several years of negotiations by the NDA Government and later by the UPA government, the prime minister of India and the president of United States of America signed an agreement on the strategic relationship between the two countries on July 18, 2005.  That agreement devoted three paragraphs to cooperation in civil nuclear energy.  Specifically, it said that â??as a responsible state with advanced nuclear technology, India should acquire the same benefits and advantages as other such states, president Bush promised that he would â??also seek agreement form congress to adjusts US laws and policies, and the United States will work with friends and allies to adjust international regimes to enable full civil nuclear energy cooperation and trade with India.â? In return India agreed to separate its civilian and military nuclear.  Facilities and programmes in a phased manner, to place most of the civilian facilities under IAEA safeguards.  To sign an additional protocol with the IAGA, to continue its unilateral moratorium on testing, and to work with the US on concluding at a multilateral level the fissile material cut off Treaty. (FMCT)

Though there was some concern about the statement regarding the FMCT, the statement about adjusting, US laws and international regimes suggested that this agreement would being us to the nuclear table as a de-facto nuclear power, in recognition of the realities of the day.  It would also allow us to agreement our indigenous nuclear power programme with imported reactors, sued as the Russian WER reactor already under construction at Kudankalam.

C. The separation plan: -

The problems with the nuclear deal commend with the very next step- the separation plan .

Finally, the separation plan also spells out that, to further guard against any disruption of fuel supplies, the united states is prepared to take the following additional steps� These include

(1)    The united states is willing to incorporate assurances regarding fuel supply in the bilateral US- India agreement:

(2)    The United States will join India in seeking to negotiate with the IAEA and India-specific fuel supply agreement.

We know that the US has reneged on both points.  The bilateral 123 Agreement contains only vague reassurances and no concrete assurances and India is negotiation with the IAEA alone, not jointly with the U.S if the US has already. Before the deal is done, turned it back on us, it argues ill for the future of the relationship.

d. The Hyde Act: -

The Henry J. Hyde United States-India Peaceful Atomic Energy Cooperation Act of 2006 is known as the Hyde Act. It is the parent act of 123 Agreement. Hyde Act is the legal framework for a bilateral pact between the United States and India under which the US will provide access to civilian nuclear technology and access to nuclear fuel in exchange for IAEA safeguards on civilian Indian reactors. This act provides the legal basis for a 123 Agreement with India. The 123 Agreement requires approval from US Congress as well as Indian Cabinet. It will define the exact terms and conditions for bilateral civilian nuclear cooperation. Signatories to the Nuclear Non-Proliferation Treaty (NPT) are granted access to civilian nuclear technology from each other as well as nuclear fuel via the Nuclear Suppliers Group in exchange for International Atomic Energy Agency-verified compliance of the NPT tenets. India, Israel, and Pakistan, however, have not signed the NPT, arguing that instead of addressing the central objective of universal and comprehensive non-proliferation, the treaty creates a club of “nuclear haves” and a larger group of “nuclear have-nots” by restricting the legal possession of nuclear weapons to those states that tested them before 1967.This Act provides the legal basis for the 123 Agreement with India, even though the provisions of both the acts are not entirely similar. It was necessary to pen down this Act because under the US Atomic Energy Act, it cannot have nuclear cooperation with a country that is not a signatory of the Non Proliferation Treaty. The Hyde Act enables US to sign a pact with India, which hasn’t signed the NPT.

After this, the US produced a document and submitted it to their Congress for amendment of their Atomic Energy Act. This was deeply debated in the US with testimonies from several experts in that country.  Going through all these statements, the Indian public was worried that the US Congress may prescribe condition not intended in the July 2005 agreement.  By Nov. 2005 the US passed the Hyde Act for Indo-US cooperation in civil nuclear energy.

e. The 123 Agreement: -

A â??123 Agreementâ?? refers to Section 123 of the U.S. Atomic Energy Act of 1954, which indicates the terms that must be included in U.S. agreements for nuclear cooperation with other states.  An Agreement for Cooperation must be established under the criteria outlined in the Atomic Energy Act in order for the U.S. to authorize the transfer of civil nuclear technology to other nations.  The United States has entered into agreements with the following states or groups of states:

Argentina, Australia, Bangladesh, Brazil, Canada, China, Colombia, Egypt, European Atomic Energy Community (Euratom) 1, Indonesia International Atomic Energy Agency (IAEA), Japan, Kazakhstan, Republic of Korea, Morocco, Norway, South Africa, Switzerland, Taiwan and Thailand.

This important of the Indo- US nuclear relations after a series of negotiations the government of India announced that it has initiated a 123 Agreement, without publishing the detail.  This aerated political protests it was made public.  The text of the agreement state that: each party shall implement this agreement in accordance with its respective applicable national, laws, regulations, and license requirements concerning the use of nuclear energy for peaceful purposes�.  By agreeing to the present draft of the 123 Agreement, India has agreed to accept all the provisions of the Hyde Act.

Further, the 123 Agreement also states â??India will place its civilian nuclear facilities under India-specific safeguards in perpetuity and negotiate and appropriate safeguards agreement to this end with the IAEA.â? The 123 Agreement seems to allow India the right to reprocess irradiated Uranium, and carry out several processes towards a closed fuel â??cycle, though the details as enumerated are not well thought-out. Naturally the political upheaval against this agreement was intense.  There were debates in public force, in the committees of the political parties as well as amongst some concerned scientists.

(f) International Atomic Energy Agency (IAEA) Specific safeguards: -

The 123 Agreement clearly states that: The US will join India in seeking to negotiate with the IAEA an India- specific fuel supply agreement.  The negotiations with IAEA completed six rounds of talks and then it was announced that the text of the agreement was almost finial.. The Indian case is unique in the sense that it is neither a nuclear weapon state nor a non-weapon state as envisaged by the NPT.  Hence the safeguardsâ? and the â??additional protocolâ? has to be India specific. Now the Board of Governors has approved the India specific IAEA safeguards agreement. The agreement that will open India’s 14 of the 22 existing and future nuclear reactors for inspections by the UN nuclear watchdog got the green signal from the 35-member Board of Governors of the IAEA after a three-hour meeting.

(g) Nuclear Suppliers Group (NSG) clearance: -

NSG is a team of 45 members and as a cartel to prevent proliferation of nuclear weapons, it was created as a reaction to Indiaâ??s 1974 peaceful nuclear explosion. Technological sanctions imposed upon India after Indiaâ??s nuclear test and the its non accession to the NPT and CTBT created a sense of estrangement in Indiaâ??s nuclear industry. To avail the full benefits of the proposed Indo-US nuclear deal, the 45 membersâ?? cartel has to approve and sanction a waiver for India. After a hard diplomatic struggle, the Nuclear Suppliers Group reportedly gave a clean waiver to India to the full satisfaction of the Manmohan Singh Government. The opponents of the Indo-US civilian nuclear cooperation initiative, however, continued to find fault with the outcome of the NSG deliberations. The US has, by amending the NSG rule, ensured a level playing field for its own.

How Indo- US Deal will increase nuclear power generation:

India has a flourishing and largely indigenous nuclear power program and expects to have 20,000-MWe nuclear capacities online by 2020, subject to an opening of international trade.  It aims to supply 25% of electricity from nuclear power by 2050. Because India is outside the nuclear non-proliferation Treaty, due to its weapons program, it is largely excluded from trade in nuclear plant of materials, which has hampered its development of civil nuclear energy. The nuclear weapons capability of India has arisen independently of tits civil nuclear fuel cycle and uses indigenous Uranium. Because of its relative isolation in International trade and lack of indigenous uranium, India has uniquely been developing a nuclear fuel cycle to exploit it reserves of thorium.

INDIAâ??S NUCLEAR TRADE ISOLATION ENDS

India signed a nuclear agreement with French nuclear giant Areva to build a nuclear power plant and supply of nuclear fuel on Feb. 4th this year. Areva will supply two Europian  Pressurised Reacters (EPRs) of 1650 MWe each for the plant to be built at Jathiapur in Maharashtra. Chairman of Atomic Energy Commission  Anil Kakodkar said this was just the  beginning.

This study provided a comprehensive overview of the Indiaâ??s nuclear relationship with the United States. Historically, the United States with its non proliferation agenda targeted threshold states like India so that nuclear weapons could be a complete prerogative of the super powers alone. However with the changes in the structures of world politics, the United States has come to accommodate Indiaâ??s civilian nuclear preferences. Indiaâ??s indigenous nuclear power programme was a challenge to the established locus of powers. It can be safely assumed that the United States has now come to accept the importance of India and the IAEA clearance and the NSG waiver is a testimony to this fact. It gives a historical picture of the relationship between two countries. History if deconstructed shows that United States is accepting a transition from the conventional superpower acronym to the more accommodative superpower. This shows that if Indiaâ??s indigenous nuclear power programme could progress with success, the Indo-US nuclear deal is a clear improvement from the estrangement suffered. Contemporary history shows that India â?? US relations is taking a broader assignment hitherto underdone.

ENDNOTES

George Perkovich Indiaâ??s Nuclear bomb.The impact on Global proliferation, University of California press, London, 1999

A.G. Noorani, â??Indo-Us Nuclear Relationsâ?, Asian Survey Vol. XXI. No.4. April 1989,

Mohammed B.Alam, Indiaâ??s Nuclear Policy, Mital Publications Delhi-110035 1988

George perkovich, Indiaâ??s Nuclear bomb,The impact on Global proliferation, university of California press, London, 1999.

V.N.Khanna, Indiaâ??s Nuclear Doctrine Samskriti, New Delhi-2000.

Ganguly Sumit, â?? Indiaâ??s Pathway to Pokhran-II, The prospects and Sources of New Delhiâ??s Nuclear Weapons Programâ?, International Security, Vol-23, No.4, 1999.

1. Definition
Antinuclear antibody is defined as specific class of auto antibodies that have the ability to attack structures in the nucleus of cells instead of performing the normal antibody function. It can be detected through blood sample withdrawn from the patient vein.

2. Causes
a) Infection and inflammation
Infection and inflammation caused by bacteria or virus speeding up the body immune system function, but in some cases, bacteria and virus induce the immune system to produce antibodies which directed against the tissues of the body including antinuclear antibody.
b) Medication
i) Phenytoin
Pheytoin may increase the risk of production of antinuclear antibody, leading to increasing the risk of malformations and birth defects.
ii) Antibotics
Long term uses of antibody may increase the rick of the production of antinuclear antibody as the medication causes abnormal reaction to the immune system.
iii) Methyldopa
The medication is used to dilate blood vessels for treating high blood pressure, but long term use of this type of medication may decrease the risk of immune disorder in production of antinuclear antibody.
c) Aging
As we age, the levels of antinuclear antibody increases and in some older adults (5% to 40%) may have mildly elevated levels caused by weakening immune function.
d) Diseases
Some diseases such as lupus erythematosus and rheumatoid arthritis may also increase the rick of the production of antinuclear antibody.

3. How antinuclear antibody effects infertility
Under normal conditions, when a woman becomes pregnant, the white blood cells in her uterus produce protective, blocking antibodies. In case of antinuclear antibody, the white blood cells recognize the fetus as a foreign invasion and attack it, leading to miscarriage.

4. Treatment
a) Heparin
Heparin is a member of anticoagulants,it is a purified preparation derived from animal tissue. It helps to increase the blood in transportation of nutrients to the reproductive organs leading to high chance of fertility and lessening the risk of pregnancy loss.
b) Aspirin
Aspirin is an anti-inflammatory and blood thinner agent, it helps to increase the blood circulating to the reproductive organs, thereby reducing the risk of antinuclear antibody attacking the fetus or the women reproductive tissues. It is recommendation to take 80 mg per day, which is equivalent to a baby aspirin. if necessary.

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