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Part one: A virologist’s tale of Africa’s first encounter with Ebola

first_imgPeter Piot grew up in Belgium dreaming of exotic adventures and helping the poor. He saw medicine as the passport to both goals. But at one point in his medical education, Piot recalls in his 2012 memoir No Time to Lose, a professor offered a bit of advice:“There’s no future in infectious diseases,” he stated flatly, in a tone that bore no argument. “They’ve all been solved.” But I wanted to go to Africa. I wanted to help save the world. And it seemed to me that infectious disease might be just the ticket and full of unresolved scientific questions. So I ignored him.Piot would become one of the world’s most respected epidemiologists because of his work on the viruses that cause AIDS and Ebola—he is a former under secretary-general of the United Nations, former president of the International AIDS Society, and now director of the London School of Hygiene & Tropical Medicine. In part one of this edited excerpt from his memoir, Piot describes how he and colleagues, with what now seem crude and risky methods, became co-discoverers of the deadly virus now on the rampage again.A Blue Flask of VirusesAll this work was done with no more precautions than if we had been handling a routine case of salmonella or tuberculosis. It never occurred to us that something far more rare and much more powerful might have just entered our lives.On the last Tuesday in September 1976 my boss at the microbiology lab was alerted that a special package was on its way to us from Zaire. It was flying in from Kinshasa: samples of blood from an unusual epidemic that seemed to be stirring in the distant Équateur region, along the river Congo.Sign up for our daily newsletterGet more great content like this delivered right to you!Country *AfghanistanAland IslandsAlbaniaAlgeriaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBolivia, Plurinational State ofBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongoCongo, The Democratic Republic of theCook IslandsCosta RicaCote D’IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland Islands (Malvinas)Faroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and Mcdonald IslandsHoly See (Vatican City State)HondurasHong KongHungaryIcelandIndiaIndonesiaIran, Islamic Republic ofIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People’s Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People’s Democratic RepublicLatviaLebanonLesothoLiberiaLibyan Arab JamahiriyaLiechtensteinLithuaniaLuxembourgMacaoMacedonia, The Former Yugoslav Republic ofMadagascarMalawiMalaysiaMaldivesMaliMaltaMartiniqueMauritaniaMauritiusMayotteMexicoMoldova, Republic ofMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorwayOmanPakistanPalestinianPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalQatarReunionRomaniaRussian FederationRWANDASaint Barthélemy Saint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint Martin (French part)Saint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint Maarten (Dutch part)SlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwazilandSwedenSwitzerlandSyrian Arab RepublicTaiwanTajikistanTanzania, United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuela, Bolivarian Republic ofVietnamVirgin Islands, BritishWallis and FutunaWestern SaharaYemenZambiaZimbabweI also wish to receive emails from AAAS/Science and Science advertisers, including information on products, services and special offers which may include but are not limited to news, careers information & upcoming events.Required fields are included by an asterisk(*)Nothing quite like this had happened in the two years I had so far been working in a junior position at a lab at the Prince Leopold Institute of Tropical Medicine in Antwerp, Belgium. But I knew it was part of the job. We sometimes took in strange samples of bodily fluids and tried to work out what they were. Our lab was certified to diagnose all kinds of diseases, including arbovirus infections like yellow fever, and the working hypothesis for this epidemic was reported to be “yellow fever with hemorrhagic manifestations.”I never actually worked with any suspected yellow fever. It wasn’t every day we received samples from as far away as equatorial Zaire. And it was clear this was an unusual sample, and that something pretty curious had occurred, because several Belgian nuns apparently died of the disease even though their vaccinations were completely up to date.The next day—September 29—the package arrived: a cheap plastic thermos flask, shiny and blue. I settled down with Guido Van DerGroen—a shy, funny, fellow Belgian aged about thirty, a few years older than I—and René Delgadillo, a Bolivian postdoc student, to open it up on the lab bench. Nowadays it makes me wince just to think of it. Sure, we were wearing latex gloves—our boss insisted on gloves in the lab but we used no other precautions, no suits or masks of any kind.We didn’t even imagine the risk we were taking. Indeed, shipping those blood samples in a simple thermos, without any kind of precautions, was an incredibly perilous act. Maybe the world was a simpler, more innocent place in those days, or maybe it was just a lot more reckless.Unscrewing the thermos, we found a soup of half-melted ice: it was clear that subzero temperatures had not been constantly maintained. And the thermos itself had taken a few knocks, too. One of the test tubes was intact, but there were pieces of a broken tube—its lethal content now mixed up with the ice water—as well as a handwritten note, whose ink had partially bled away into the icy wet.It was from Dr. Jacques Courteille, a Belgian physician who worked at the Clinique Ngaliema in Kinshasa. He described the thermos’s contents as two vials, each containing 5 milliliters of clotted blood from a Flemish nun who was too ill to be evacuated out of Zaire. (Once a Belgian colony known as the Belgian Congo, the country was named Zaire in 1971, before being renamed the “Democratic Republic of Congo” in 1997.) She was suffering from a mysterious epidemic that had so far evaded identification, possibly yellow fever.I was still trying to find my way in the labyrinth of infectious diseases research, and this kind of thing made my heart beat faster. Guido and René picked out the one remaining test tube of blood from the thermos and set to work. We needed to look for antibodies against the yellow fever virus, and other causes of hemorrhagic or epidemic fever such as typhoid. To isolate any virus material, we injected small amounts of the blood samples into VERO cells, an easily replicable cell lineage that is used a lot in labs. We also injected some into the brains of adult mice and newborn baby mice. (I never liked this aspect of the work. Sometimes we needed to inject patient tissue into the testicles of rats, to isolate Mycobacterium ulcerans, the cause of Buruli ulcers, and it made me cringe.)All this work was done with no more precautions than if we had been handling a routine case of salmonella or tuberculosis. It never occurred to us that something far more rare and much more powerful might have just entered our lives.In the next few days, the antibody tests for yellow fever, Lassa fever, and several other candidates all came up negative, and it seemed likely that the samples had been fatally damaged by their transportation at a semi-thawed temperature. We bustled nervously around the mice and checked our cell cultures four times a day instead of two. On the weekend, each of us popped in to check the samples. All of us,I think, were hoping something would grow.Then it happened. On Monday morning, October 4, we found that several adult mice had died. Three days later all the baby mice had also died—a sign that a pathogenic virus was probably present in the blood samples that we had used to inoculate them.By this time our boss, Professor Stefaan Pattyn, had also gleaned a little more information about the epidemic in Zaire. It seemed to be centered on a village called Yambuku, where there was a mission outpost run by Flemish nuns—the Sisters of the Sacred Heart of Our Lady of s’Gravenwezel. (S’Gravenwezel is a small town north of Antwerp.) The epidemic had been raging for three weeks, since September 5, and at least 200 people had died. Although two Zairean doctors who had been to the region had diagnosed the malady yellow fever, the patients suffered violent hemorrhagic symptoms, including extensive bleeding from the anal passage, nose, and mouth as well as high fever, headache, and vomiting.Hemorrhagic manifestations are quite unusual in yellow fever. Although Pattyn could be a bit of a bully, he was hardworking and knew his stuff. He had worked in Zaire for six or seven years, and exotic viral illnesses were right up his alley, though his specialty was mycobacteria—tuberculosis and leprosy. I recall him telling us that this had to be that strange and lethal phenomenon: a hemorrhagic fever.I was just a recently graduated physician; none of the rare hemorrhagic fevers had ever crossed my path. Nor had they featured at all during my medical training. So I made a quick run to the institute’s library to try to absorb as much as I could. It was a small but diverse group of viruses, from mosquito-borne dengue to exotic, recently discovered rodent-borne South American viruses with names like Junin and Machupo. All, by definition, caused high fevers and massive bleeding, and their fatality rate was often in excess of 30 percent.Previously I had been excited about the work we were doing; now I was inflamed. If we were hunting for signs of a hemorrhagic virus, this was outbreak investigation of the most stirring variety. I truly loved the detective thrill of working in infectious disease. You came in and figured out what the problem was. And if you managed to figure it out quickly enough—before the patient died, basically—then you could almost always solve it, because, just like my medical school professor of social medicine had said, solutions had by this time been found for almost every kind of infectious illness.On September 30, the Flemish nun who was the source of the original blood samples died in Dr. Courteille’s clinic in Kinshasa. He sent us some fragments of her liver for pathologic examination. (Again, the samples were flown to Belgium on a passenger aircraft.) To add to the diagnostic confusion, microscopic examination of the samples showed swollen “Councilman bodies”—lesions considered typical of yellow fever. However, as Pattyn knew, they may also feature in Lassa virus, an African hemorrhagic fever whose transmission by rats is either gastrointestinal or respiratory. So although Pattyn’s hypothesis that the samples from Kinshasa contained a hemorrhagic virus was not confirmed, it was not disproven either.By this point for him to keep us working on those samples was sheer folly; he knew we were not equipped to do the work in safety. In 1974 there were only three labs outside the Soviet Union that could handle hemorrhagic viruses: Fort Detrick, a military lab in Maryland that did high-security bioterrorism work on anthrax and other highly lethal diseases; the Army High Security Laboratory in Porton Down, in England; and the so-called hot lab at the Centers for Disease Control (CDC), in Atlanta.Nonetheless, we continued to bustle around like amateurs in our cotton lab coats and latex gloves, checking our VERO cell lines. The cells began detaching from the glass sides of their containers: it was either a toxic effect or an infection, but either way, cytotoxicity had kicked in. That meant we might be close to isolating a virus, and we began extracting cells to cultivate them in a second line of VERO cells. And Pattyn had been told we should expect more samples from Zaire in the next few days.But just as we were beginning to cultivate the second VERO cell line, Pattyn intervened. He had received instructions from the Viral Diseases Unit of the World Health Organization (WHO) to ship all samples and biological material from the new mystery epidemic to Porton Down in Britain. (In fact, a few days later Porton Down sent them on to the Centers for Disease Control in Atlanta, which was the world’s reference lab for hemorrhagic viruses.)Pattyn was furious, and I too was upset. It looked as though our outbreak investigation was over before it had even begun. Glumly, we prepared to pack everything in tightly sealed containers: the patient serum, the inoculated cell lines, and the autopsied mouse brains and samples. But then Pattyn told us to keep some of the material back. He claimed that we needed a few more days to ready it for transport. So we kept a few tubes of VERO cells, as well as some of the newborn mice, which were dying. Perhaps it was a stubborn rebellion against the whole Belgian history of constantly being forced to grovel to greater powers. That material was just too valuable, too glorious to let it go. It was new, it was exciting—just too exciting to hand it over to the Brits or, in particular, to the Americans.Pattyn was a colorful character, with a razor-sharp brain. He didn’t have the smug, colonial attitude of so many men of his generation; he wore funky eyeglasses and collected contemporary art. And although he could be contemptuous I never felt his scorn was connected to skin color or social class—only to stupidity. But he certainly had an outsized ego.There was a rack of secondary tubes in the lab, which we had inoculated after the first VERO cell line was killed. We knew there was something in there—something that was trouble—but still, we had taken out the rack so we could examine the tubes under the microscope. Doing that kind of work wasn’t Pattyn’s job. He was a micro-manager but he wasn’t a technician, and in fact he could be rather clumsy. But impulsively he reached for one of the precious tubes, to check it out himself under the scope, and as he did so it slipped from his hand and crashed on the floor.Little René Delgadillo was the one who got his shoes splashed. They were good, solid leather shoes but René bleated, “Madre de Dios” (Mother of God!) while Pattyn swore, “Godverdomme” (Goddamn!)—and there was a moment, just a beat, of blank fear. Immediately we whisked into action: the floor was disinfected and the shoes removed. It was just a small incident. But it struck me only then how lethal this thing really might be and the huge risks we had been taking in handling it so cavalierly.On October 12, our semiclandestine secondary cell line was ready for analysis. Guido took a sample and treated it so an ultrathin slice could be examined under an electron microscope. Then we took it over to Pattyn’s friend Wim Jacob, who handled electron microscopy in the university hospital lab. A few hours later he came over to our lab with the photographs.“What the hell is this?” said Pattyn.There was a long pause as he glared at the photographs, at us, at the walls of the corridor. I peered over his shoulder and saw what were by virus standards very large, long, wormlike structures: nothing like yellow fever. Pattyn’s excitement, or irritation, was rising. “This looks like Marburg!” he exploded. I didn’t know much about Marburg. Everyone else in the lab seemed to know about Marburg, and today of course all you’d need to do to find out would be to check the Internet. But back then I needed an atlas of infectious diseases. So I went to the institute’s library and sure enough our virus did look like Marburg. In those days Marburg was the only known virus that was this long—up to 14,000 nanometers, or 0.000014 millimeters. Huge. (In comparison, polio is up to 50 nanometers.) It had been identified just nine years before, in Germany, when a number of pharmaceutical workers became infected by a batch of monkeys imported from Uganda. It appeared to be extremely virulent and swiftly lethal. Seven of the 25 people infected by direct contact with the monkeys died with hemorrhagic fever, and six more individuals fell ill following contact with those primary infections.Marburg was clearly a very scary illness, and as we did not have Marburg virus–specific antibodies, we could not definitely conclude whether our isolate was Marburg. Perhaps it was a different virus with similar morphology.Pattyn was not suicidal. Once he had established that “our” virus was—at the very least—closely related to the terrifying Marburg, he had the sense to shelve all further work on it and sent the remaining samples directly to the high-security lab at the CDC.I was still very excited. It felt as though my childhood fantasy of exploration was almost within my reach. I kept arguing that we had to follow up our work, go to Zaire and check out the epidemic. I felt strongly that we shouldn’t hand this world-class discovery over to some other team. We had identified this virus, after all, so we should be the ones to establish its lethality and its real effects on the ground.Pattyn was not immune to this line of argument himself, but our lab had no budget to pay for anything so bold and unscripted as an expedition to Zaire. He went to the Ministerial Department for Development Aid, and was told they funded programs to help poor people, not programs to assist medical research. It was my first encounter with the sobering reality of fund-raising: how crucial it is and how difficult it can be to raise money when you wait until the crisis arises. It was also the first of a long series of confrontations with bureaucracies, a major lifelong source of irritation.Even if safety demanded that all the research had to be done in an expensively equipped, high-security lab, why should we leave it to the Americans and WHO to do the epidemiological work on the ground, where the epidemic was certainly still underway? How often does a small research institute in Belgium have the opportunity to make medical history? It’s not often that a twenty-seven-year-old comes within reach of the discovery of a new virus, and it looked as though the virus we cultivated had a fighting chance of being just that.On Thursday October 14, the answer came by telex: it was indeed a new virus. Karl Johnson, chief of Special Pathogens at the CDC, reported that his team had isolated a similar virus from other samples of blood from the same Flemish nun in Kinshasa. Pushing our information one step further, he added that this virus did not react with Marburg antibodies. Therefore it was different from Marburg, though we did not know how different it was.As for my impossible dream of taking our outbreak investigation to Zaire, I figured it was over. It was time to go back to looking for salmonella in the stool samples of patients with a nonspecific bellyache. I was crestfallen.But Pattyn was not a bad guy. I think he saw how despondent I was, and on Friday, October 15, he sent me to Paris for the weekend to a conference organized by Beecham, the pharmaceutical company, about some new antibiotic they were bringing out. However, when I walked into the conference room at the Hotel Nikko on that Friday afternoon, my name was on a screen, with a message: I should urgently contact a phone number in Brussels. What the heck?Before doing anything, I called Pattyn, who was still at the lab. He said the Department for Development Aid and the Ministry for Foreign Affairs had been ringing his phone off the hook: we had to get to Kinshasa. The Americans were going there to take a look at the epidemic, and there was some kind of French delegation already in place; even a South African was on his way. Also, Belgian expatriates in Kinshasa had begun panicking, sending their children to Europe because of the epidemic.“The Belgian government is under pressure to do something,” he told me. I thought, surely that “something” can’t be just me, a recent graduate from medical school? But I kept my mouth shut.“This is now a political priority!” Pattyn continued, and I thought: So, that’s how it goes. Unless something is a political priority, figuring out how to save lives is not a big issue.“It’s our Congo, you know,” he said, and I had no idea whether he meant it ironically or straight up, no ice.So I phoned a Dr. Kivits at the Department of Development Aid. There was minimal discussion. He said I should leave the next day on a 10-day mission. I asked if it would it be OK if I waited untilSunday, and Dr. Kivits said fine. So I said yes. I didn’t think about it for a second but asked my then-wife Greta, who was three months’ pregnant and immediately agreed.In a sense, it would be a voyage of self-discovery as much as discovery. In that classic way of the Grand Tour, I was leaving my home, at the age of twenty-seven, to discover myself. Leaving the plain, hard-headed Flemish world of no bullshit—head down, nose clean, hard work, low profile—and heading to a place of big, apocalyptic emotions: despair and exuberance and tragedy and fear. A place that was really coming apart at the seams; a slow-moving disaster scene that had just once again hit a new catastrophe. It was my dream: I was going to the heart of Africa—Zaire—to explore the outbreak of a new virus.Next, part two: ZaireI examined her blood, and it was a catastrophe. The platelet count was terrifyingly low. As green and unimaginative as I was, the real lethality of this virus began to sink in, and my hands shook a little as I handled her blood. Who knew how this virus was transmitted—by insects, or body fluids, or dust … .Adapted from No Time to Lose: A Life in Pursuit of Deadly Viruses by Peter Piot. Copyright © 2012 by Peter Piot. With permission of the publisher, W. W. Norton & Company Inc. All rights reserved.*The Ebola Files: Given the current Ebola outbreak, unprecedented in terms of number of people killed and rapid geographic spread, Science and Science Translational Medicine have made a collection of research and news articles on the viral disease freely available to researchers and the general public.last_img read more

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Updated: Editor quits journal over pay-for-expedited peer-review offer

first_imgWith a tweet yesterday, an editor of Scientific Reports, one of Nature Publishing Group’s (NPG’s) open-access journals, has resigned in a very public protest of NPG’s recent decision to allow authors to pay money to expedite peer review of their submitted papers. “My objections are that it sets up a two-tiered system and instead of the best science being published in a timely fashion it will further shift the balance to well-funded labs and groups,” Mark Maslin, a biogeographer at University College London, tells ScienceInsider. “Academic Publishing is going through a revolution and we should expect some bumps along the way. This was just one that I felt I could not accept.”Resigned as an editor for Nature Scientific Reports as new system means authors can pay for quicker review by a private company @NatureNews — Mark Maslin (@ProfMarkMaslin) March 26, 2015The flap shines a light on a fledgling industry where several companies are now making millions of dollars by privatizing peer review. This niche is being exploited because journal peer review is usually a slow process. After all, it is typically an anonymous, volunteer effort for which scientists receive nothing more than thanks from journal editors and the good feeling of contributing to the scientific community. But for a price at some journals, authors now have the option of fast-tracking their submitted papers through an accelerated peer-review process.Sign up for our daily newsletterGet more great content like this delivered right to you!Country *AfghanistanAland IslandsAlbaniaAlgeriaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBolivia, Plurinational State ofBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongoCongo, The Democratic Republic of theCook IslandsCosta RicaCote D’IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland Islands (Malvinas)Faroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and Mcdonald IslandsHoly See (Vatican City State)HondurasHong KongHungaryIcelandIndiaIndonesiaIran, Islamic Republic ofIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People’s Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People’s Democratic RepublicLatviaLebanonLesothoLiberiaLibyan Arab JamahiriyaLiechtensteinLithuaniaLuxembourgMacaoMacedonia, The Former Yugoslav Republic ofMadagascarMalawiMalaysiaMaldivesMaliMaltaMartiniqueMauritaniaMauritiusMayotteMexicoMoldova, Republic ofMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorwayOmanPakistanPalestinianPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalQatarReunionRomaniaRussian FederationRWANDASaint Barthélemy Saint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint Martin (French part)Saint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint Maarten (Dutch part)SlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwazilandSwedenSwitzerlandSyrian Arab RepublicTaiwanTajikistanTanzania, United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuela, Bolivarian Republic ofVietnamVirgin Islands, BritishWallis and FutunaWestern SaharaYemenZambiaZimbabweI also wish to receive emails from AAAS/Science and Science advertisers, including information on products, services and special offers which may include but are not limited to news, careers information & upcoming events.Required fields are included by an asterisk(*)NPG announced earlier this week that it was trying out the peer-review service, called Rubriq, provided by Research Square, a company based in Durham, North Carolina. For a $750 payment to NPG, authors are guaranteed a review within 3 weeks or they get their money back. NPG declined to say how much of that money goes to Research Square.How does the company perform such quick reviews? “We have about 100 employees with Ph.D.s,” says Research Square’s CEO, Shashi Mudunuri. That small army of editors recruits scientists around the world as reviewers, guiding the papers through the review process. The reviewers get paid $100 for each completed review. The review process itself is also streamlined, using an online “scorecard” instead of the traditional approach of comments, questions, and suggestions. The company also offers services directly to authors, saying it can help them improve papers and find placement with a journal. Business is bustling for Research Square. So far, Mudunuri says, the company has about 1400 active reviewers who have scored 920 papers. The company pulled in $20 million in revenue last year. Mudunuri declined to name the other publishers with which the company has cut deals.NPG was quick to defend its use of Rubriq after Maslin’s tweet went out. The publisher replied with several tweets—“It is a small pilot to understand if this is a solution that works for authors & reviewers,” noted one. In a blog post by Nandita Quaderi, NPG’s publishing director, she wrote: “Needless to say, an author choosing the fast-track option is only benefiting from a quicker decision. The introduction of this service has no bearing on our editorial decision process.”“It is worth noting that a number of other publishers offer fast track peer review services,” an NPG representative added in an e-mail exchange with ScienceInsider. “We have rigorously assessed the quality of service that Rubriq provides and feel confident that the peer review reports they will deliver will be of a comparable standard to NPG’s own.”Maslin is unconvinced. “Deep consideration and a well thought out review is much more important than its speed. I have had brilliant reviews which have considerably improved my papers and I really appreciated all the time taken.”*Update: A commenter on this story notes that he and additional editors of Scientific Reports have sent NPG a letter detailing concerns about the new peer-review approach.last_img read more

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Total proctocolectomy with ileostomy

first_imgDefinitionTotal proctocolectomy with ileostomy is surgery to remove all of the colon (large intestine)and rectum.DescriptionYou will receive general anesthesia right before your surgery. This will make you be asleep and unable to feel pain.For your proctocolectomy:Your surgeon will make surgical cut about 6 inches long in your lower belly.Then your surgeon will remove your large intestine and rectum.Your surgeon may also look at your lymph nodes and may remove some of them, if needed.Next your surgeon will create an ileostomy:Your surgeon will make a small surgical cut in your belly. Usually this is made in the lower right part of your belly.The last part of your small intestine (ileum) is pulled through this surgical cut, and sewn onto your belly.This opening in your belly formed by your ileum is called the stoma. Stool will come out of this opening and collect in a drainage bag that will be attached to you.Why the Procedure Is PerformedTotal proctocolectomy with ileostomy surgery is done when other medical treatment does not help problems with your large intestine.It is most commonly done in people who have inflammatory bowel disease, which includes ulcerative colitis or Crohns disease.This surgery may also be done if you have:Colon or rectum cancerFamilial polyposisBleeding in your intestineBirth defects that have damaged your intestinesIntestinal damage from an accident or injuryRisksTotal proctocolectomy with ileostomy is usually safe. Your risk will depend on your general overall health. Ask your doctor about these possible complications:advertisementRisks for any surgery are:Wound infectionsBlood clots in the legs that may travel to the lungsBreathing problemsHeart attack or strokeRisks for this surgery are:Bleeding inside your bellyDamage to nearby organs in the body and to the nerves in the pelvisInfection, including in the lungs, urinary tract, and bellyScar tissue may form in your belly and causes blockage of your intestinesYour wound may break open or heal poorlyPoor absorption of nutrients from foodPhantom rectum, a feeling that your rectum is still there (similar to people who have amputation of a limb)Before the ProcedureAlways tell your doctor or nurse what drugs you are taking, even drugs, supplements, or herbs you bought without a prescription. Ask your doctor which drugs you should still take on the day of your surgery.Talk with your doctor or nurse about these things before you have surgery:Intimacy and sexualitySportsWorkPregnancyDuring the 2 weeks before your surgery:You may be asked to stop taking drugs that make it harder for your blood to clot. These include aspirin, ibuprofen (Advil, Motrin), clopidogrel (Plavix), Naprosyn (Aleve, Naproxen), and others.If you smoke, try to stop. Ask your doctor for help.Always tell your doctor if you have a cold, flu, fever, herpes breakout, or other illnesses before your surgery.Eat high fiber foods and drink 6 to 8 glasses of water every day.The day before your surgery:Eat a light breakfast and lunch.You may be asked to drink only clear liquids, such as broth, clear juice, and water, after noontime.Do NOT drink anything after midnight, including water. Sometimes you will not be able to drink anything for up to 12 hours before surgery.Your doctor or nurse may ask you to use enemas or laxatives to clear out your intestines. They will give you instructions for this.On the day of your surgery:Take your drugs your doctor told you to take with a small sip of water.Your doctor or nurse will tell you when to arrive at the hospital.After the ProcedureYou will be in the hospital for 3 to 7 days. You may have to stay longer if you had this surgery because of an emergency.You may be given ice chips to ease your thirst on the same day as your surgery. By the next day, you will probably be allowed to drink clear liquids. Your doctor or nurse will slowly add thicker fluids and then soft foods as your bowels begin to work again. You may be eating a soft diet 2 days after your surgery.While you are in the hospital, your nurse and doctor will teach you how to care for your ileostomy.You will have an ileostomy pouch that is fitted for you. Drainage into your pouch will be constant. You will need to wear the pouch at all times.Outlook (Prognosis)Most people who have total proctocolectomy with ileostomy are able to do most activities they were doing before their surgery. This includes most sports, travel, gardening, hiking, and other outdoor activities, and most types of work.advertisementIf you have a chronic condition, such as Crohns disease or ulcerative colitis, you may need ongoing medical treatment.ReferencesCima RR, Pemberton JH. Ileostomy, colostomy, and pouches. In: Feldman M, Friedman LS, Sleisenger MH, eds. Sleisenger & Fordtrans Gastrointestinal and Liver Disease. 9th ed. Philadelphia, Pa: Saunders Elsevier; 2010:chap 113.Cunningham D, Atkin W, Lenz HJ, et al. Colorectal cancer. Lancet. 2010 Mar 20;375(9719):1030-47.Fry RD, Mahmoud N, Maron DJ, Ross HM, Rombeau J. Colon and rectum. In: Townsend CM, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 19th ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 52.Review Date:12/10/2012Reviewed By:Robert A. Cowles, MD, Associate Professor of Surgery, Yale University School of Medicine, New Haven, CT. Review provided by VeriMed Healthcare Network. Also reviewed by A.D.A.M. Health Solutions, Ebix, Inc., Editorial Team: David Zieve, MD, MHA, David R. Eltz, and Stephanie Slon.last_img read more

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SPORT-ZIDANE 2 LAST

first_imgZidane, wearing an Indian-style band-gala, was cautious Zidane, wearing an Indian-style band-gala, was cautious when talking about politics, FIFA scandal or racism in football. “Euro is a great competition. Its a moment of unity (for the continent),” he said when asked about the terrorist attack on Paris some months ago. “I dont want to talk about it. I dont want to be disturbed by what we hear every day,” was the way he put it to the interpreter in French while answering queries on the corruption scandal that has enveloped the world governing body for the game. On racism, Zidane — nicknamed Zizou — said he had not experienced it, though it did exist in the football world. “It exists, but I have not faced it. But I cannot imagine life without a mix of origins (in and out of football),” said the France-born son of Algerian immigrants. He steered clear of the controversy over racism surrounding the French team picked for Euro 2016 that commenced today in his home country. “I respect the selection of the team. France team may be young, but the players in it are experienced playing in different leagues. They have the capacity to win the tournament. “I dont think they will be under any additional pressure playing at home,” he added. He also did not commit himself when asked who he would back to win the Euro 2016 although he indicated that Belgium appeared to be well-balanced. “It depends on how the teams begin in the competition. Everybody is ready to go. Belgium is one of the excellent teams,” he remarked. Asked what he had seen in Mumbai, he said he had come only yesterday and was committed to the task on hand till today. “I am happy with the welcome we received on arrival here. It was on expected lines. I am free (to explore) from tomorrow. Its an opportunity to discover India as this is my first visit,” he said. PTI SSR NP PDS PDSadvertisementlast_img read more

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Andy Murray optimistic he can play this year, says mother Judy

first_imgAndy Murray is “cautiously optimistic” he will be able to play tennis again this season after successfully undergoing hip surgery, his mother Judy has said.The three-times Grand Slam champion said at this year’s Australian Open that constant pain in his hip had brought him to the verge of quitting tennis but revealed last month that he was pain free after the procedure in January.Murray posted an Instagram video of himself on an outdoor court earlier this month, describing the footage of him hitting a tennis ball for the first time since the surgery as “a start”.He followed that up with a video of himself playing a round of golf that reinforced the message that he was on the mend.”It’s still early days so we will have to wait and see what happens. He is cautiously optimistic about getting back on the match court perhaps at some point over the summer,” Judy was quoted as saying by British media.”He was told not to do impact work, which basically means running around the garden hitting a ball, for three months but he’s been hitting against a wall from a static position.”Murray hoped to make his comeback at Wimbledon and said in March that he would consider playing doubles because it would put less stress on his hip.The 31-year-old twice Wimbledon champion has compared his situation to that of American doubles player Bob Bryan, who returned to competitive tennis 5 and 1/2 months after undergoing a similar procedure.advertisementAlso Read | Ankita Raina stuns former US Open champion Samantha StosurAlso Read | Fognini lands maiden Masters title in Monte CarloAlso See:last_img read more

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What Added Costs Will Sulphur Directive Bring?

first_imgzoom Ships’ costs structures will change as increased bunker costs are unavoidable due to the latest 0.1% Sulphur Directive for the Emission Control Areas (ECAs), which came into effect January 1, according to Karen Jacques, Dryad Maritime’s Director for Asia Pacific.There will inevitably also be additional costs associated with the requirement for additional bunkering to carry the necessary volumes of the different grades of bunkers, as well as the requirement for engine modifications (due mainly to difference in oil viscosity) and the considerable costs of these projects across shipping fleets.As there are no means by which the sulphur content of the fuel oil once loaded can be altered on board, it is necessary to ensure that the fuel oils loaded meet the required limits and that, in the case of ECA compliant fuel oils, this compliance is not compromised by mixing with other, higher-sulphur fuel oils either in bunker tanks or in the transfer system. There are complications associated with dual storage (in order to cater for the storage of different grades of bunkers on board). In many cases there will likely be a requirement for a sub-division of tanks and possibly the need for more frequent bunkering.The administrative burden of managing the operational changes associated with the introduction of the new sulphur limits will also have a significant impact. With such a strict restriction, the ship’s crew will need to ensure that they avoid loading compliant fuel oils into otherwise part filled storage, settling or service tanks, and be certain that in the course of transfer operations such fuel oils do not become mixed with other higher-sulphur content fuel oils, so that only the fuel oil actually used within the applicable limit is used within the ECA.Prior to entry into the ECA, a full change-over to ECA compliant fuel oil will need to be implemented. There will be requirements for new on board written procedures as to how these routines will be undertaken, as well as record keeping at each change-over to record the fuel oil quantities, the date, time and position of the ship when either completing the change-over prior to entry or commencing change-over after exit from such areas. These records will need to be entered in a logbook or as prescribed by the ship’s Flag State.Jaques believes that IMO regulations on sulphur emissions are essential and timely but that they are certainly not without complication. Patience, time and significant financial and management resource will be required, throughout the short and medium term, to accommodate their introduction.Source: Dryad Maritimelast_img read more

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Drewry: Post-Alliance Restructure Well-Balanced

first_imgThe Asia-North Europe trade post-alliance restructure is generally well-balanced in terms of geographical coverage with strong competition in the key lanes, shipping consultant Drewry said commenting on the launch of the new carrier mega-alliances in the East-West container trades.Drewry believes that accusations that the industry is completely homogenised are unfair as a broad range of options has been made available to shippers.Maersk and MSC’s 2M is in the box seat, controlling 31% of the “effective” weekly capacity, following by the CKYHE and G6, both with 24%, and finally the Ocean Three on 21%.According to Drewry, the total number of weekly Asia-North Europe services has been reduced from 22 to 21 compared with December 2014. The number of ships required to keep these services in a fixed-day weekly pattern has subsequently come down from 245 last month to 232 with smaller unwanted ships having been cascaded away from the trade.Despite these changes, the available capacity has largely been maintained with westbound slots of 218,500 teu per week, down just 1% on December. This has been achieved by the introduction of more new Ultra Large Container Vessels (ULCVs) – the average size of ship has increased from 12,400 teu to 12,600 – while the new schedules are more dedicated to North Europe with fewer wayport deductions.“Many feared that the formation of the mega-alliances would intensify the homogenisation of the industry whereby carriers can only compete with one another on price as they all have the same services. However, closer inspection of the schedules reveals that the alliances are far from uniform and between them they have created a pretty well-balanced network with wide port coverage at both ends of the trade,” Drewry said.Inevitably, as befitting a country that is origin to around 70% of all the container traffic to North Europe, the main battle ground is China. Collectively, the alliances depart from 10 mainland China ports every week to North Europe, with a total of 74 weekly voyages. The 2M carriers have a clear advantage with 27 China to North Europe departures per week, well ahead of Ocean Three (18), CKYHE (17) and the lagging G6 (12).The geographical spread of service calls naturally reflects the trade flows out of China as carriers essentially have to follow the cargo. Central China is the best served with a total of 37 weekly departures with Shanghai getting the most calls on 17, followed by Ningbo on 14 and Xiamen on 6. It is from this region that the 2M claims its dominance with 14 departures per week spread between the three ports, five more than its nearest rivals Ocean Three.Ports in South China are also well served with 24 weekly departures, the majority from Yantian in the Shenzhen port complex, which has 16 loading calls. Again, 2M has the ascendancy with 9 weekly departures, compared with five each for the other alliances.Perhaps surprisingly, North China ports are not better covered considering their rapid growth of late. Container traffic from the North has been outpacing the other Chinese regions as more manufacturing has moved there to take advantage of lower labour costs. Data from Drewry’s Container Trades Statistics (CTS) shows that demand from North China to North Europe was up by 12% in the 11 months through November 2014, compared with 9% for the two other regions.“So far, the allure of North China is not reflected in the alliances’ schedules, where there are currently only 13 weekly departures to North Europe. Strikingly, the G6 carriers only make one North China-North Europe call (Qingdao on Loop 7) while the other three groups each make four calls. The region’s present coverage is commensurate with its volumes to North Europe, but carriers will need to find room for more North China calls in the future if they want to take advantage of the region’s potential,” Drewry added.Japan and South Korea only have 7 and 9 weekly departures to North Europe, respectively. In Japan’s case, the paucity of direct services seems to be a fair a reflection of its declining volumes and contribution to the trade that saw no boost from the yen’s depreciation, Drewry said. CTS had Japan to North Europe box traffic down by 1% after 11 months last year. With around 6% of the total Asia departures to North Europe, but only 5% of the volumes, it seems unlikely that carriers will want to add more Japanese calls in a rush.While the outlook for more traffic from Japan/South Korea is weaker than other parts of Asia, the benefit of weaker competition does mean that incumbent carriers can charge a freight rate premium. Drewry’s Container Freight Rate Insight reports that 40ft spot rates ex Japan are currently around USD 1,000 above those from South China.According to Drewry, importers and exporters can have little complaint about the range of options available. For example, there are 14 weekly services from Shanghai to Rotterdam, the two busiest ports in the trade. That means shippers can call upon 16 carriers (not to mention non-alliance slot charterers) to get the most competitive freight rate quotes.For the more time-sensitive shippers, the alliances also provide a wide array of transit times to suit their needs. Looking at Shanghai to Rotterdam again, transit times range from a quickest of 28 days to a slowest of 36 days.“Interestingly, the advent of the new alliances looks to have increased the average speeds of ships on the trade, which is probably a consequence of both dramatically lower bunker fuel costs and the desire of carriers to make their new services more attractive to customers,” the shipping consultant said.Drewry estimates that average westbound service speeds have sped up to 18.5 knots; versus 17.8kts as measured in December. The 2M again leads the way with an average speed of 19.8kts, while the G6 brings up the rear on 17.5kts.Source: Drewrylast_img read more

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Bureaucratic reshuffle Mamata rings in changes

first_imgKolkata: Alapan Bandyopadhyay has been appointed as the new Home Secretary replacing Atri Bhattacharya who was transferred by the Election Commission of India (ECI) and Chief Secretary Malay De was looking after the Home department.Bandyopadhyay, who was in charge of the MSME & Textiles department with the additional charge of Industry, Commerce and Enterprises will also look after these departments, a notification issued by the state government said. Also Read – City bids adieu to Goddess DurgaAccording to the order published on Monday, Atri Bhattacharya has been made the Principal Secretary of the state Tourism department. Apart from Bandyopadhyay, former Additional Chief Secretary of state Panchayats and Rural Development department Sourav Das has been made the state Election Commissioner, replacing Amarendra Nath Singh who had been appointed in 2015. As per the regulations, a person can hold the post of Election Commissioner for up to six years from the date of appointment or till 65 years of age. This month, Singh will be completing 65 years and hence, he has been replaced. Also Read – Centuries-old Durga Pujas continue to be hit among revellersSeveral other IAS officers’ postings have also been reshuffled on Monday. Principal Secretary of Youth Services and Sports Ajit Ranjan Bardhan has been posted as the Principal Secretary of North Bengal Development Department (NBDD) along with the additional charge of Commissioner of Jalpaiguri which was already there. He has been replaced with P B Salim who was holding the charge of Secretary in Minority Affairs. Barun Kumar Ray who was posted as Principal Secretary of NBDD has been made the Commissioner of Malda. Choten D Lama who was holding the post of Secretary in the Panchayats and Rural Development Department with additional charge of Managing Director (MD) and Chief Executive Officer (CEO) of West Bengal State Rural Livelihoods Mission (WBSRLM) has been posted as the Secretary of Backward Classes Welfare with additional charge of Secretary, Tribal Development. P Ulganathan has been made the District Magistrate of South 24-Parganas who was earlier DM Murshidabad. J P Meena, who was holding the post of DM Hooghly, replaced Ulganathan and has been made DM Murshidabad. DM South 24-Parganas Y Ratnakara Rao has been posted as DM Hooghly. Chaitali Chakraborty who was posted as DM Howrah has now been made DM North 24-Parganas. She will be replaced by Mukta Arya who was posted as DM, Bankura under the order of the Election Commission. DM North 24-Parganas Antara Acharya has been posted as Additional Secretary in the state Finance department. Chief Minister Mamata Banerjee stated that Acharya did not want to continue as DM for personal reasons. Another IAS officer, Vijay Bharti, who was holding the post of Director in MSME & Textiles has been made the DM of East Burdwan. Anurag Srivastava who was holding the charge of DM East Burdwan has now been made the Director of MSME & Textiles. Vishwanath who was posted as DM Kalimpong has been appointed as the Director of Census Operations. Lalita Lakshmi will be joining as DM Kalimpong. Umashankar S who was removed by the EC has been reinstated as DM Bankura.last_img read more

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Triple talaq bill Govt and Oppn in sparring match

first_imgNew Delhi: The government on Friday introduced the fresh triple talaq bill in the Lok Sabha amid vehement protests by opposition members who claimed that it was violative of the Constitution.The Muslim Women (Protection of Rights on Marriage) Bill 2019 became the first legislation to be tabled in Parliament by the Narendra Modi dispensation in its second term, with Law Minister Ravi Shankar Prasad asserting the legislation was a must for gender equality and justice. Also Read – IAF receives its first Rafale fighter jet from FranceThe bill was introduced following a division of votes, with 186 members supporting and 74 opposing it. “This is not a question of religion but about justice to women,” Prasad said. Seeking to justify the need to bring in the legislation, Prasad said there were 543 cases of triple talaq reported in the country. After the Supreme Court judgement banning triple talaq practise, Prasad said more than 200 cases were reported. “This is a question of dignity of women and we are committed to (safeguard) it,” he said. Also Read – Cosmology trio win Nobel Physics PrizeHe said the job of Parliament was to legislate and it was up to courts to interpret the law. As soon as Speaker Om Birla asked Prasad to move the bill, several opposition members rose in protest and Birla allowed them to put forth their point of view. Shashi Tharoor of the Congress said he was opposed to triple talaq (instant divorce) but was against this bill as it conflates civil and criminal laws. He claimed it was a textbook example of class legislation as it was pointed at one community -Muslims- even though abandoning wives is not unique to it. Tharoor said there should be a law universally applicable to all in case of abandoning wives. Asaduddin Owaisi of the AIMIM took a dig at the BJP, saying it has so much affection for Muslim women but is opposed to rights of Hindu women to enter Sabarimala Temple in Kerala. The triple talaq bill violates constitutional rights as it stipulates three-year jail term for guilty Muslim men while non-Muslim men get only one year of jail term for a similar offence, he said. N K Premchandran of the RSP also opposed the bill. The Bill, which proposes to make the practice of instant triple talaq (talaq-e-biddat) a penal offence, had faced objections from opposition parties from the beginning which claimed that jail term for a man for divorcing his wife was legally untenable.last_img read more

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Trudeau announces plans to ban singleuse plastics by 2021

first_imgMONTREAL – The federal government has announced its intention to ban single-use plastics as early as 2021.Prime Minister Justin Trudeau made the announcement today at a nature reserve in Mont St-Hilaire, south of Montreal.Prime Minister @JustinTrudeau says plastic pollution is a global problem. Says how does he explain to his kids why dead whales are washing up on shore with bellies filled with plastic bags #cdnpoli— Cormac Mac Sweeney (@cmaconthehill) June 10, 2019The details of how such a ban would be implemented remain unknown, but the government will conduct research to determine the best course of action, which it says will be grounded in scientific evidence.Trudeau says the situation of plastic overflowing in landfills and polluting oceans and waterways has reached a breaking point, and action is needed.Less than 10 per cent of plastic used in Canada gets recycled, and without any change in habits, Canadians will be throwing out $11 billion worth of plastic products by 2030.”If we want to let our kids be kids we have to ensure the environment they’re playing in is clean and safe,” says @JustinTrudeau who says the new policy will protect wildlife and make oceans, lakes and rivers cleaner.— Ash Kelly (@AshDKelly) June 10, 2019The products could include such single-use items as drinking straws, water bottles, plastic bags, cutlery, stir sticks and fast food containers.last_img read more

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MoroccanIvorian Consortium to Build Thermal Power Plant in Abidjan

Casablanca – A Moroccan-Ivorian consortium will join efforts with an energy firm to build a MAD 450 million thermal power plant in the Ivory Coast’s economic capital, Abidjan. The consortium, Vinci Energies Côte d’Ivoire / CGELEC Morocco, and the company, Starenergie 2073, signed an agreement on Friday, December 16 for the first phase of infrastructure construction associated with the Songon thermal power plant. The plant is set to be constructed in the northern suburbs of Abidjan, with an investment exceeding MAD 450 million.This thermal power plant will have an energy discharge capacity of 720 MW and 470 MW N1 safety, for an output of 372 MW ISO. The construction is scheduled to begin in February 2017. According to Starenergie 2073, which will be in charge of the construction of the thermal power plant, the infrastructure construction will last for 18 months and will include a high voltage section, which will supply around 150,000 inhabitants of Songon by 2025.The Ivorian Press Agency (AIP) quoted director general of Starenergie 2073, Venance Guessend, saying that the new project will be in two parts. The first phase, construction of the combined cycle 372 MW power plant, will be powered either by primary fuel natural gas delivered or by Ivorian block exploitation.The second phase will integrate the evacuation network, including the elevation and source stations, as well as the 225 KV lines from Songon to Akoupé-Zédjn, Dabou and other cities.The choice of the Vinci Energies-CI / CEGELEC Maroc consortium is justified for the Chairman of the Board of Directors of Starenergie 2073, Amon Richard, by the conformity of its technical and financial offer. “No country can emerge without energy,” he noted, inviting the government and donors to invest in the project.It is worthy to recall that on December 18, 2013, Starenergie 2073 signed an agreement with the State of Côte d’Ivoire authorizing it to build a thermal power plant at Songon. This future project will include two steam turbines with a capacity of 126 MW each and a third steam turbine of 120 MW. read more

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Report National Enquirer paid 200K for private Bezos texts

SAN FRANCISCO — The Wall Street Journal reports that the National Enquirer’s publisher paid $200,000 to obtain intimate texts between Amazon CEO Jeff Bezos and his mistress Lauren Sanchez. American Media Inc., the supermarket tabloid’s publisher, reportedly paid that sum to Michael Sanchez, Lauren’s brother.The Journal’s finding, attributed to people familiar with the matter, parallels the conclusion reached by private investigators working for Bezos as of early February. Those investigators reportedly found that Michael Sanchez had leaked the texts to the Enquirer, although they didn’t appear to conclude who might have paid for them.Bezos has said AMI threatened to publish explicit photos of him unless he stopped investigating how the Enquirer obtained his private exchanges and publicly declared that the Enquirer’s coverage of him was not politically motivated.The Associated Press read more

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UN agency issues new locust warning for northeast Africa

28 March 2007In a new offensive against locusts, the United Nation Food and Agriculture Organization (FAO) today called on countries in northeast Africa to intensify surveys and control operations against the crop-devouring insects, particularly on the Red Sea coast of Eritrea and Sudan and in northwest Somalia. If the swarms are not controlled on the Red Sea coast, they are likely to migrate to cropping areas in the Tokar Delta on the coast of Sudan and to the Eritrean Highlands where it will be difficult to stop them from attacking pastures and crops. “Once the locusts invade the Highlands, there is a slight risk that some swarms could migrate towards the summer breeding areas in the interior of Sudan before the rainy season starts,” FAO Desert Locust expert Keith Cressman said. “In this case, they could continue westwards in search of favourable green vegetation in Chad, Niger and Mali. “Swarms could even reach Mauritania next June, in time for the beginning of the summer rains,” he added, recalling that a similar movement towards West Africa from the Red Sea occurred in 1993. FAO and the Desert Locust Control Organization for Eastern Africa (DLCO-EA) have already launched aerial control operations on the Red Sea coast near the Sudanese and Eritrean border to eliminate small swarms forming from a local outbreak that has been underway since the end of last year. Ground control operations against hopper and adult infestations have been in progress in both countries for several months. DLCO-EA aerial operations will also start this week on the coast of northwest Somalia near Djibouti. This new offensive against an old enemy is being conducted in close cooperation with local anti-locust teams.FAO urged all concerned countries to keep monitoring the situation carefully, especially in the coastal plains in northwest Somalia as well in neighbouring areas in Djibouti, Ethiopia and Yemen.Small immature swarms that escape control operations in northwest Somalia could move in any direction – up the escarpment towards the Ethiopian border, northwest towards the Eritrean highlands, east along the coast, across the Gulf of Aden to southern Yemen, or simply stay on the coast and eventually breed once the long rains commence. So far, a few swarms have crossed the Ethiopian border and were seen near Jigjiga. FAO is also following the situation carefully in two other important areas, the Red Sea coastal plains of Saudi Arabia and in the spring breeding areas of Southwest Asia. Local breeding occurred on the Saudi coast south of Jeddah and, earlier this week, reports were received of small swarms. National teams have been deployed to the infested areas to conduct the necessary control operations. Unusually good rains fell earlier this month over a large area of northern Oman, southeast Iran and western Pakistan, and locusts are expected to increase due to breeding during the spring. There is a slight risk that if more swarms form in northwest Somalia, some could reach these breeding areas. Iran and Pakistan are conducting a joint ground survey on both sides of their border in Baluchistan during April to clarify the situation. read more

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UN prepares to feed Kenyas drought victims

20 May 2009The United Nations World Food Programme (WFP) has begun pre-positioning supplies in eastern Kenya to feed an estimated 3.5 million people who are facing food shortages as a result poor harvest caused by inadequate rainfall. The United Nations World Food Programme (WFP) has begun pre-positioning supplies in eastern Kenya to feed an estimated 3.5 million people who are facing food shortages as a result poor harvest caused by inadequate rainfall.According to the UN Office for the Coordination of Humanitarian Affairs (OCHA), trucks have begun rolling out of warehouses, filled with foodstuff in preparation for increased needs. Last month, WFP delivered food to selected health facilities in eastern Kenya and supported training to district health staff on supplementary feeding for children under the age of five and pregnant and nursing mothers, OCHA said.An inter-agency group of humanitarian organizations and government ministries is concerned that the delayed onset of the current long rains will affect crop yield in the grain basket areas of the Rift Valley, Western and Nyanza provinces, which produce over 90 per cent of the national food output.There is also increasing morbidity among livestock in the arid areas that is leading to loss of breeding stock, OCHA added. The UN Children’s Fund (UNICEF) is assisting on health issues, including with assessments and the response to cholera outbreaks in northern and western Kenya. read more

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TSX Wall Street rally after Irma damage less than expected loonie less

TORONTO — North American stock market indexes jumped Monday after hurricane Irma weakened without causing as much damage as feared, while the loonie slowed its pace of recent gains.On Bay Street, the Toronto Stock Exchange’s S&P/TSX composite index advanced 54.98 points to 15,040.30, with most sectors climbing.In New York, the Dow Jones industrial average soared 259.58 points to 22,057.37. The S&P 500 index was up 26.68 points to 2,488.11 and the Nasdaq composite index gained 72.07 points to 6,432.26.“I think today is really a bit of relief rally coming on the weakness from last week that we some in reaction to the anticipation of the hurricane over the weekend,” said Craig Fehr, a Canadian markets strategist at Edward Jones in St. Louis.“A good portion of today’s upside is just related to the fact that despite the clear devastation that the hurricane did cause, it was perhaps a little bit less than the expectations.”Irma weakened shortly before it came ashore Sunday, and while the damage is still being assessed, insurers anticipate they won’t have to pay out as much in claims as it looked like they would last week.Global investors were also relieved after a North Korean national holiday passed without any other actions that would raise tensions between that country and the U.S.In currency markets, the Canadian dollar was trading at an average price of 82.45 cents US, up 0.02 of a U.S. cent.While that’s the seventh straight day of gains for the loonie, Fehr said the dollar appears to be settling down after surging more than three cents U.S. over the past six sessions.“We’ve seen a huge surge in the loonie over the last couple of months,” said Fehr, who attributed the upward movement to the Bank of Canada hiking interest rates twice in two months and U.S. data suggesting the Federal Reserve may not be quite as aggressive with upcoming rate hikes and winding down its balance sheet.“I think now we’ve found a point where the market is just gaining a little bit of a footing after some of these expectations recalibrated,” he said. “So I wouldn’t be surprised to see the loonie flatten out a bit from here.”In another sign investors were willing to take more risks, the December gold contract fell $15.50 to US$1,335.70 an ounce.Elsewhere in commodities, the October crude contract advanced 59 cents to US$48.07 per barrel.The October natural gas contract gained six cents to US$2.95 per mmBTU and the December copper contract added two cents to US$3.07 a pound.Follow @DaveHTO. read more

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Hamilton Mountain gas station robbed at gunpoint

(Photo Courtesy Google Maps)Hamilton police are investigating following an armed robbery at a gas station on Hamilton Mountain.Police say a man entered the Pioneer gas station located on Upper James St. around 11:00 p.m. last night.The suspect pointed what was believed to be a handgun at the employee and tried to grab cash from the register.The employee knocked the gun away from the man and the suspect ran from the store with a small amount of cash.Police believe the firearm was actually a BB or Pellet gun. No one was seriously injured during the robberyDetectives are looking for a South Asian man, 19 to 23 years old, with a thin build. He was wearing dark coloured clothing with a hood over his head.Police are also looking for the man pictured below who was caught on camera  during the robbery.Anyone with information is asked to contact Hamilton Police Service. read more

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Afghanistan will need international help to build future beyond elections Security Council

Afghanistan will need sustained international help way beyond September’s legislative elections marking the completion of the Bonn accord that set up the country’s transitional phase after the ouster of the Taliban regime in 2001, United Nations Secretary-General Kofi Annan says in his latest report delivered today.This need “is rooted in the realization that a number of post-conflict peace-building tasks have yet to be fulfilled, including the restoration of countrywide security, full resettlement of refugees and internally displaced persons (IDPs), the rehabilitation of key economic and social infrastructure and the establishment of functional state institutions across the country,” he writes, seeking a 12-month extension of the UN mission there until 25 March 2006.“The consensus on the need to extend the common endeavour that began in 2001 also rests on a keen awareness that the degree of destruction visited upon Afghanistan in the past three decades has been so high that nothing less than the close partnership established during the implementation of the Bonn agreement will measure up to the challenge,” he adds.Presenting the report to the Security Council today, Mr. Annan’s Special Representative for the country, Jean Arnault, called on the 15-member body to extend the mandate of the UN Assistance Mission in Afghanistan (UNAMA) as requested and to urge donors “to respond timely and generously” with the $110 million still outstanding from the $148.67 million needed for September’s elections.Mr. Annan outlines a list of important lessons learned after more than three years of intensive UN engagement, among them the need for an extended presence of international forces to tackle terrorism, insurgency and factionalism which, although waning, will remain a threat. “A credible international military deterrent will therefore remain a key component of the post-Bonn framework until Afghan security institutions are fully established and functional,” he writes.A “massive skills deficit” in such sectors as police, teachers, engineers and qualified labour must also be remedied, state institution need to be re-created, and “a bold strategy for economic development is necessary,” he adds.He will submit to the Council definitive recommendations on UNAMA’s future role following consultations with the Afghan leadership and the new parliament to be elected in September.Despite a relative calm in the security situation, partly due to winter as well as a disarmament programme, an increase in strength of the Afghan army and police and an expanded presence of the International Security Assistance Force (ISAF), “these positive developments should not lead to complacency,” he warns.“The determination of extremist elements to take advantage of the open political environment of the parliamentary elections should not be underestimated,” he adds, noting that disarmament of Afghan militias remains insufficient to guarantee security. Illegal armed groups which perpetuate the drug industry must also be dealt with, according to the report.Illicit narcotics dominates Afghanistan’s economy with more than 350,000 families, some 10 per cent of the population, estimated to depend on opium poppy cultivation, which generates income equivalent to 60 per cent of the legal gross domestic product and 87 per cent of global supply, he writes.“There is a consensus among Afghan and international experts that Afghanistan’s position as a leading narcotics supplier must be turned back in 2005.”Meanwhile, in his briefing to the Council, Mr. Arnault noted that two roadside bomb attacks directed against UN convoys had taken place since the report was compiled, killing six people and injuring 31. “Protecting the life of UN staff will remain a priority for us, with the benefit of the strengthened security arrangements that have been put in place since last year,” he said.“The agenda of the next nine months is a heavy one. It will place demands on all human and material resources of the United Nations in Afghanistan, including those of UNAMA,” he added. read more

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Feds ban some types of Medicare providers from enrolling in Miami Chicago

Feds ban some types of Medicare providers from enrolling in Miami, Chicago, Houston AddThis Sharing ButtonsShare to TwitterTwitterShare to FacebookFacebookShare to RedditRedditShare to 電子郵件Email MIAMI – For the first time in history, federal health officials said Friday they will ban certain types of Medicare and Medicaid providers in three high-fraud cities from enrolling in the taxpayer-funded programs for the poor as part of an effort to prevent scams.The strict moratoriums, which start Tuesday, give federal health officials unprecedented power to choose any region and industry with high fraud activity and ban new Medicare and Medicaid providers from joining the programs for six months. They wouldn’t ban existing providers.The administrator of the Centers for Medicare and Medicaid Services said the agency is targeting providers of home health care in eight counties in the Miami and Chicago areas. All ambulance providers would be banned in eight counties in the Houston area.The moratorium, which was first reported by The Associated Press, will also extend to Children’s Health Insurance Program providers in the same areas, agency administrator Marilyn Tavenner said in a statement.It’s unclear how many providers will be shut out of the programs.There were 662 home health agencies in Miami-Dade in 2012 and the ratio of home health agencies to Medicare beneficiaries was 1,960 per cent greater in Miami Dade County than other counties, according to figures from federal health officials.South Florida, long known as ground-zero for Medicare fraud, has also had several high profile prosecutions involving that industry.In February, the owners and operators of two Miami home health agencies were sentenced for their participation in a $48 million Medicare fraud scheme.The number of home health providers in Cook County, Ill., increased from 301 to 509 between 2008 and 2012. There were 275 ambulance suppliers in Harris County, Texas, in 2012. The ratio of providers to patients in both regions was also several hundred times greater than in other counties, federal health officials said.Top Senate Republicans have criticized the agency for not using the powerful moratoriums sooner as a tool to combat an estimated $60 billion a year in Medicare fraud. Senators Chuck Grassley, who is the ranking Republican on the Judiciary Committee, and Orrin Hatch, who is the ranking Republican on the Finance Committee, sent a letter to federal health officials in 2011 urging them to use the bans.“While it’s certainly better late than never, it’s unfortunate that it took CMS three years to use the tools it’s had to protect seniors,” Hatch said in a statement Friday, adding he hoped “to see more action like this.”Officials for the Department of Health and Services inspector general lobbied hard to ensure moratorium power was included under the Affordable Care Act as the Obama administration focuses on cleaning up fraud on the front end by preventing crooks from getting into the program in the first place.“There’s no shortage of bad actors to defraud the taxpayers, and the number gets bigger all the time, so it’s good to see the administration at last using this new tool to fight fraud,” Grassley said in a statement.In the past, federal health officials tried to stall new provider applications from being processed, hoping to slow the number flocking to high-fraud sectors. But when providers inevitably complained, the agency had to process their paperwork.The federal agency can also revoke the IDs of suspicious providers, but those are temporary and many companies are able to reenroll later or enrol under a different name.Federal health officials have been reluctant to use one of its most powerful new tools, worrying moratoriums may harm legitimate providers and hamper patients’ access to care. Tavenner said in the statement that would not happen, but the agency didn’t elaborate. Agency officials said they intend to consider other moratoriums in different industries in other cities going forward.The ability to target certain industries and cities is especially helpful as Medicare fraud has morphed into complex schemes over the years, moving from medical equipment and HIV infusion fraud to ambulance scams, as crooks try to stay one step ahead of authorities. Fraudsters have also spread out across the country, bringing their scams to new cities once authorities catch onto them.The scams have also grown more sophisticated, using recruiters who are paid kickbacks for finding patients, while doctors, nurses and company owners co-ordinate to appear to deliver medical services that they are not.The moratoriums come as budget cuts are forcing federal health officials to retract its watchdog arm as it launches its largest health care expansion since the Medicare program.Health and Human Services inspector general officials said they are in the process of cutting 20 per cent of its staff, from 1,800 at its peak to 1,400, and cancelling several high profile projects, including an audit that would have investigated technology security in the federal and state health exchanges launching in October. The project was slated to examine issue including whether patient information was secure from hackers on the online marketplace, where individuals and small businesses can shop for health insurance. T__Follow Kelli Kennedy on Twitter: http://twitter.com/kkennedyAP by Kelli Kennedy, The Associated Press Posted Jul 26, 2013 4:27 pm MDT read more

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UN expert group urges new Icelandic authorities to sustain gender empowerment efforts

“There is no room for complacency regarding the gains achieved by Iceland, as equality guarantees in the law are still far from being fully implemented on the ground,” said Kamala Chandrakirana, who currently heads the UN Working Group on discrimination against women in law and in practice. The country was designated number one in the world for gender equality by the World Economic Forum during the years it was dealing with the worst economic crisis in its history.The UN experts praised the Government for integrating gender equality throughout its policy making, but noted that “persistent gaps” remain on employment and gender based violence, “In both these areas, implementation of laws is lacking and women do not have sufficient trust in the system to seek redress for violations of their rights.”Despite the fact that an act on equal pay for equal work has been in force since 1961, the gender pay gap still persists, noted human rights expert Frances Raday, the other member of the Group’s eight-day delegation visiting Iceland.“The gender pay gap cannot be divorced from the highly segregated job market in Iceland,” Ms. Raday stressed. “Women’s work is concentrated in public service jobs, most prominently nursing and elementary teaching, both notably low paid. Women hold a low percentage of leadership positions, especially in the private sector.”Regarding the issue of Gender-based violence, the experts highlighted that there is no specific and separate provision targeting domestic violence in the Penal Code.In addition, the Working Group noted that disparities between the number of prosecutions and convictions related to the UN Committee on the Elimination of Discrimination against Women have not been addressed sufficiently.The Working Group also encouraged the Icelandic authorities to pass an anti-discrimination bill and to provide adequate support for organizations which enable persons of foreign origin, particularly women, to participate fully in economic, social, public and political life.During its eight-day mission, the Group’s delegation met with Government officials at national and local levels, representatives of civil society organisations, as well as experts and academics and other stakeholders in Reykjavík, Akureyri and Dalvík.Special rapporteurs are appointed by the Human Rights Council to examine and report back on a country situation or a specific human rights theme. The positions are honorary and the experts are not UN staff, nor are they paid for their work. Their report will be presented to the UN Human Rights Council in June of next year. read more

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UN to begin polio and measles vaccinations as Ebola transmissions plummet in

“On 9 May, 42 days will have elapsed since the burial of the last confirmed case and the outbreak of Ebola Virus Disease will be declared over in [Liberia],” according to the World Health Organization in its latest update on the outbreak.The vaccination campaign in Liberia “aims to vaccinate more than 683,000 children against polio and 603,000 against measles,” according to a joint press release by Liberia’s Ministry of Health and Social Welfare, the Centers for Disease Control (CDC), the UN Children’s Fund (UNICEF) and the World Health Organization (WHO) issued in Monrovia, Liberia.“The polio vaccines will be given to children aged up to 59 months, and the measles vaccine to children between the ages of six and 59 months,” said the release. “Children aged 12-59 months will also receive deworming medicine.”The massive vaccination campaign had been scheduled for last year, but was suspended due to the Ebola outbreak in West Africa, which has affected more than 26,500 people, including over 11,000 deaths in the most-affected countries Guinea and Sierra Leone, as well as Liberia.But because there is still a risk of reintroduction from Guinea and Sierra Leone – where transmission continues – infection prevention measures will be heightened during the campaign, including temperature checks and the use of single-use syringes and new gloves for each child vaccinated, according to the agencies involved in the campaign.Measles is a highly contagious viral disease and one of the leading causes of death among young children globally. Polio, also a highly infectious viral disease, can lead to paralysis and sometimes death, with children under the age of five the most vulnerable. Both diseases are easily preventable as vaccines are effective and inexpensive.“A major social mobilization effort has been deployed to convince communities of the need to have their children vaccinated and to explain the measures being taken to minimize any risk of infection,” the press release said.Later Friday, WHO issued interim advice on the sexual transmission of Ebola, that said “sexual transmission of the Ebola virus, from males to females is a strong possibility, but has not yet been proven. Less probable, but theoretically possible, is female to male transmission.” read more