Only one-third of the people said it was a good time, the leading US opinion poll organisation said on Monday releasing the results of Gallup surveys conducted in 146 countries in 2011.
Indians were only a little more optimistic than the average adult worldwide with 52 percent saying it was a bad time and only 36 percent saying it was a good time. Europeans were the most pessimistic, with 72 percent saying it was a bad time. Optimism was highest in the Americas, where a still dismal 38 per cent said it was a good time.
All of the top 10 countries where residents were most positive about the job market were developing countries, except Singapore.
Oil-rich Middle Eastern nations took four of the top spots; Saudi Arabia and Oman led internationally with 69 per cent of residents saying it was a good time to find a job, despite relatively high unemployment rates.
Six of the 10 countries with the most negative outlooks were EU countries, with Greeks and the Irish nearly universally saying it was a bad time to find a job.
Residents in eight of the world's 10 largest economies did not think it was a good time to find a job in 2011. Brazil and Germany were the two bright spots in an otherwise gloomy outlook on the availability of jobs; about half of residents in each country said it was a good time to find a job.
Results are based on telephone and face-to-face interviews with approximately 1,000 adults per country, aged 15 and older, conducted in 146 countries and areas in 2011, Gallup said.
( Press Trust of India )
The study, from Ernst & Young and a collection of pro-business groups that includes the National Federation of Independent Business and the U.S. Chamber of Commerce, looked at the impact of raising taxes on capital gains and dividends and hiking the top two individual tax rates to 36 percent and 39.6 percent respectively. It also included the tax hikes for health-care reform.
The report found that all of the hikes combined would cause output to fall by 1.3 percent and capital stock and invetsments to fall by between 1.4 percent to 2.4 percent. It said employment “in the long run” would fall by half a percent, or by about 710,000 jobs. Wages would fall 1.8 percent.
“This report finds that these higher marginal tax rates result in a smaller economy, fewer jobs, less investment, and lower wages,” the report stated.
President Obama and his fellow Democrats have proposed extending the Bush tax cuts for everyone except those making more than $250,000 in annual income. Republicans advocate extending the tax cuts for everyone.
While the debate over taxes has been framed around wealthy Americans, the study said that flow-through businesses are also in the two top income brackets. The study said that flow-through companies employ half of the private sector work force and pay 44 percent of federal taxes.
The study said that if the tax cuts expire, the top tax rate will rise to 40.9 percent from 35 percent, while the top tax rate on dividends will rise to 44.7 percent from 15 percent and the rate for capital gains will rise to 24.7 percent from 15 percent.
( CNBC )
The poll also found that more than half said these sites had altered their behaviour, especially suffering a negative impact from social media. Two-thirds said they were unable to relax or to doze off after spending time on the sites.
And one quarter of those polled said they had been left facing difficulties in their relationships or workplace after becoming confrontational online, the Telegraph reported.
In total, 298 people were polled by Salford Business School at the University of Salford, for the charity Anxiety UK. Of those, 53 percent said the launch of social networking sites had changed their behaviour and of those, 51 percent said the impact had been negative.
The research also demonstrated the addictive powers of internet, with 55 percent of people saying they felt "worried or uncomfortable" when they could not access their Facebook or e-mail accounts.
More than 60 percent of people said they felt compelled to turn off electronic gadgets in order to have a break, with one in three of those surveyed saying they switched the devices off several times each day.
The findings about behaviour changes after using social networking sites came from smaller in-depth research which was then carried out by Anxiety UK.
Nicky Lidbetter, the charity's chief executive said: "If you are predisposed to anxiety it seems that the pressures from technology act as a tipping point, making people feel more insecure and more overwhelmed."
Linda Blair, a clinical psychologist said many people suffered increased anxiety because they failed to take charge of the demands being placed on them. She said: "I think one of the key things is that people have begun to behave as though technology is in control of them, instead of the other way round. We can switch the gadgets off but a lot of us have forgotten how to."
Popular South Indian dish Masala Dosa has made it to the list of '10 foods to try before you die', compiled by the Huffington Post. The list, prepared by travel blog viator for the newspaper, includes dishes from around the world as a must-try for travellers.
Masala dosa features in the list alongside the Peking duck from China, BBQ ribs from the US and Teppanyaki from Japan. "The plate-covering, paper-thin pancake is made from rice and lentils, cooked to lacy perfection on a hot griddle. What creates the more-ish flavor is a spiced concoction of mashed cooked potatoes and fried onions, served with a liberal dose of garlicky chutney," the website describes masala dosa.
The list also includes France's Escargots, which are actually snails generally eaten as an appetizer, served in the shell and cooked in a delicious melange of garlicky parsley butter.
Moussaka on the list is described as the Greek answer to the Italian lasagne. "The dish is made by smothering layers of ingredients in a cheese bechamel sauce, and baking until creamily melted and golden." Other foods on the list are Zucchini flowers from Italy, Seafood curry laksa from Malaysia, Thai dish Som tam or green papaya salad and Pavlova from Australia-New Zealand.
"Sampling the local cuisine can help you make friends, understand the history, politics or religion of the place you're visiting and provide a lasting memory of your trip. Food and travel go hand in hand, and there's no better way to
delve deep into a destination than to try its most famous dishes," said the newspaper.
She has beaten the likes of her Bollywood contemporaries including Deepika Padukone, Priyanka Chopra, Anushka Sharma and Hollywood stars like Megan Fox, Angelina Jolie and Blake Lively.
"Being sexy is not about clothes. For me to wear a cotton sari without any make-up and still be desirable is sexy," Katrina said in a statement here. On being voted sexy, Katrina says, "I am really excited with the news. It feels nice. It means that people are not voting for me only based on physical looks, they are also looking at me in entirety."
If you're watching this right now, you're probably a liar — about something. It doesn't make you bad. It just makes you human. That's what Dan Ariely, behavioral economist at Duke University and author of the best-seller Predictably Irrational, argues in his new book The (Honest) Truth About Dishonesty: How We Lie to Everyone—Especially Ourselves.
In his book, Ariely describes a series of experiments and studies that undermine a core belief among economists and law enforcement about crime, bad behavior, and cheating. The system tends to believe that people make rational cost-benefit analyses about what they'll gain from outside-the-lines behavior and the potential consequences. And so it follows that the way to forestall bad behavior is to put tough punishments in place. Ariely says that's the wrong way to think about it. "Our behavior is driven by two opposing motivations. On the one hand, we want to view ourselves as honest, honorable people. On the other hand, we want to benefit from cheating and get as much money as possible." Human behavior is the balance between those two forces.
While there is a very small population of sociopaths that cheats all the time, most people tend to cheat just a little bit. At the core of his book lies a study that he repeated in different iterations with college students. They were asked to solve simple math problems, but given a short amount of time to do them. They were told they'd get a certain amount of money for each correct answer. Some students were asked to put the tests in a paper shredder after they finished and then report the number of problems they completed correctly. When Ariely looked into the shredder bin (he lied about actually shredding the paper), he found that students routinely over-reported the number of answers they solved correctly. "If you look across all our experiments, about 30,000 people, a handful cheated in a big way, and 18,000 cheated" in much smaller ways.The (Honest) Truth About Dishonesty contains plenty of other great insights. People are much less squeamish about cheating when they can distance themselves from what seems to be immoral behavior. People are much more likely to take a can of coke out of a common refrigerator than they are to take a dollar bill off a plate. Golfers are much less likely to say it's ok to physically move a ball four inches with their hands than they are likely to say it's ok to nudge it with their club — even though both actions are violations of rules.
Fatigue seems to play a role. A concept called "depletion" holds that people who are emotionally or physically exhausted are more likely to cheat, whether it's cheating on their diet or cheating on one of Ariely's controlled tests. "You try to resist temptation all day, and you get tired," he said. "So people are prone to cheat more in the evening than in the morning."
In another experiment, Ariely and researchers found that people are more likely to cheat on his mathematical tests when they were wearing fake designer sunglasses. "We take cues from the environment about who we are," he said. "When you wear a set of fake glasses, you think of yourself as slightly more of a cheater. And then you're more likely to take the next step."
There's lots more in the book. Ariely argues that cheating can spread like a virus within organizations — think of Enron, or the many instances of mortgage fraud. When he did a paired, not-so-scientific test, he found that Wall Streeters were more likely to cheat than politicos on the self-reporting mathematical test.
He also notes that cheating and lying is part of life. And it's not always about personal gain. "We routinely don't tell people how they really look and really smell," he notes. People tend to value truthfulness highly, but they also value loyalty. "When other people you care about tend to gain from you being dishonest, you're more likely to be dishonest." In other words, people are more likely to post a positive review about a book written by a friend even if they don't think it is so great.
I've known Ariely for several years. But you can take it from me (honestly) that The (Honest) Truth About Dishonesty is a fun, highly engaging read.
The online poll also found that 34 per cent of Facebook users surveyed were spending less time on the website than six months ago, whereas only 20 per cent were spending more.
The findings underscore investors' worries about Facebook's money-making abilities that have pushed the stock down 29 per cent since its initial public offering last month, reducing its market value by $30 billion to roughly $74 billion.
About 44 per cent of respondents said the botched market debut has made them less favourable toward Facebook, according to the survey conducted from May 31 to June 4. The poll included 1,032 Americans, 21 per cent of whom had no Facebook account.
Facebook's 900 million users make it among the most popular online destinations, challenging entrenched Internet players such as Google Inc and Yahoo Inc. But not everyone is convinced that the company has figured out how to translate that popularity into a business that can justify its lofty valuation.
Shares of Facebook closed on Monday's regular trading session down 3 per cent at $26.90. Facebook did not have an immediate comment on the survey.
While the survey did not ask how other forms of advertising affected purchasing behaviour, a February study by research firm eMarketer suggests that Facebook fared worse than email or direct-mail marketing in terms of influencing consumers' purchasing decisions.
"It shows that Facebook has work to do in terms of making its advertising more effective and more relevant to people," eMarketer analyst Debra Williamson said.
Those concerns were exacerbated last month when General Motors Co, the third largest advertiser in the United States, said it would stop paid-advertising on Facebook.
Measuring the effectiveness of advertising can be tricky, particularly for brand marketing in which the goal is to influence future purchases rather than generate immediate sales.
And the success of an ad campaign must be considered in relation to the product, said Steve Hasker, president of Global Media Products and Advertiser Solutions at Nielsen.
"If you are advertising Porsche motor cars and you can get 20 per cent of people to make a purchase, that's an astonishingly high conversion rate," said Hasker.
"If you are selling instant noodles, maybe it's not," he said.
Wanting engagement
About two out of five people polled by Reuters and Ipsos Public Affairs said they used Facebook every day. Nearly half of the Facebook users polled spent about the same amount of time on the social network as six months ago.
The survey provides a look at the trends considered vital to Facebook's future at a time when the company has faced a harsh reception on Wall Street.
Facebook's $16 billion IPO, one the world's largest, made the US company founded by Mark Zuckerberg the first to debut on markets with a capitalisation of more than $100 billion.
Its coming out-party, which culminated years of breakneck growth for the social and business phenomenon, was marred by trading glitches on the Nasdaq exchange. A decision to call certain financial analysts ahead of the IPO and caution them about weakness in its business during the second quarter has triggered several lawsuits against Facebook and its underwriters.
Forty-six per cent of survey respondents said the Facebook IPO had made them less favourable towards investing in the stock market in general.
While Facebook generated $3.7 billion in revenue in 2011, mostly from ads on its website, sales growth is slowing.
Consumers' increasing use of smartphones to access Facebook has been a drag on the company's revenue. It offers only limited advertising on the mobile version of its site, and analysts say the company has yet to figure out the ideal way to make money from mobile users.
Facebook competes for online ads with Google, the world's No 1 Web search engine, which generated roughly $38 billion in revenue in 2011. Google's search ads, which appear alongside the company's search results, are considered among the most effective means of marketing.
The most frequent Facebook users are aged 18 to 34, according to the Reuters/Ipsos survey, with 60 per cent of that group being daily users. Among people aged 55 years and above, 29 per cent said they were daily users.
Of the 34 per cent spending less time on the social network, their chief reason was that the site was "boring," "not relevant" or "not useful," while privacy concerns ranked third.
The survey has a "credibility interval" of plus or minus 3.5 percentage points.
In the study, University of Texas at Austin graduate student Cari Goetz and her team focused on the so-called sexual exploitability hypothesis, which is based on the different ways in which men and women approach reproduction.
The goal of the study was to test out the hypothesis that a woman who appears silly or inert, or in other words more 'sexually exploitable,' is a turn-on for the average straight man, the Daily Mail reported.
In the evolutionary psychology sense, the word 'exploitable' simply indicates that a woman is willing or can be more easily pressured into having sex, even if she is a prostitute or a nymphomaniac.
The researchers began testing their model by asking a large group of undergraduate students to nominate some specific actions, body postures, attitudes and personality traits that might signal vulnerability, such as exhaustion, intoxication, or low intelligence.
In the end, the participants of the study had produced a list of 88 signs that a woman might by especially receptive to a man's advances.
Among the chosen red flags were: lip lick/bite; over-the-shoulder look; sleepy; intoxicated; tight clothing; fat; short; unintelligent; punk; attention-seeking and touching breast.
Next, Goetz and her colleagues scoured the Internet for publicly available images of women displaying each of these 88 cues.
Once they had pictures of women licking their lips, partying, wearing sexy clothing, etc., the researchers cross-checked them with a separate group of students who presumed that the photos indeed matched the cues.
The researchers then invited a fresh group of 76 male students and presented them with the images of presumably 'ripe-for-the-picking' women, asking them what they thought of each woman's overall attractiveness, how easy it would be to 'exploit' her using anything from a pickup line to physical force, and her appeal to them as either a short-term or a long-term partner.
The study revealed that the images of fat or short women had no effect. The participants of the study did not view them as either easy to bed or appealing as partners.
But when it came to reading the more psychological and contextual cues-pictures of silly or childish-looking women, or of women who looked sleepy or drunk, men rated them as being easy to 'score' with.
More importantly, the dumb-looking and inert women were also perceived as being more attractive than their more lucid or intelligent-looking peers, but only when it came to short-term relationships.
When the men were asked to judge the same liquored-up, silly-looking women in the photos as potential girlfriends and wives, they had entirely lost their appeal on them.
A follow-up study has also found that the more promiscuous men who happened also to have deficiencies in personal empathy and warmth were the ones most attuned to female 'exploitability' cues.
An article describing the findings will soon be published in the journal Evolution and Human Behaviour.
According to a the survey, feuding couples are increasingly complaining about their spouse's behaviour on Facebook in divorce filings, with inappropriate messages to the opposite sex being the biggest cause for complaint.
More than 33 per cent of divorces last year listed Facebook as a contributing factor, a study of 5000 divorce petitions by UK law firm Divorce-Online found.
The figure has shot up from just 20 per cent in 2009. "If someone wants to have an affair or flirt with the opposite sex then Facebook is the easiest place to do it," Divorce-Online spokesman Mark Keenan was quoted by the 'DailyMail' as saying.
Incriminating status updates, suspicious check-ins at restaurants and inappropriate photographs being posted online were all increasingly being used as evidence in divorces.
"People need to be careful what they write on their walls as the courts are seeing these posts being used in financial disputes and children cases as evidence," Keenan said.
According to the American Academy of Matrimonial Lawyers, 80 per cent of US divorce attorneys said the number of cases using the social network had increased.
K Jason Krafsky, co-author of 'Facebook and Your Marriage', said office romances and out-of-town affairs that took months or even years to develop in the real world happened "with a lightning speed" on Facebook.
"On Facebook they happen in just a few clicks," he said. Krafsky said the social networking website differed from traditional dating websites in that it both re-connected old flames and allowed people to 'friend' someone they may have only met once or twice.
"It puts temptation in the path of people who would never in a million years risk having an affair," he said.
Even when affairs develop offline, Facebook provides a forum for couples to inadvertently arouse the suspicions of their partners.
The UK study also found couples who had already split up were using Facebook to vent about each other, posting nasty comments for all their friends to see.
Twitter only appeared in 20 of the petitions as part of behaviour allegations. Couples complained their spouses were using twitter to make insensitive comments about them.
Low-dose computerized tomography may cut the risk of dying from lung cancer by 20 percent, according to a report presented today at the American Thoracic Society International Conference and published in the Journal of the American Medical Association. For every person diagnosed with lung cancer, there were 20 with suspicious findings that needed biopsies or other follow-up to rule out a malignancy, the researchers said.
The risk of cancer is great enough in heavy smokers 55 to 74 years old to justify annual CT scans, according to guidelines from the American College of Chest Physicians and the American Society of Clinical Oncology based on the study results. They aren’t recommended for older and younger smokers, people who quit more than 15 years ago, patients with limited life expectancies or those who light up less frequently.
“Low-dose computed tomography screening may benefit individuals at an increased risk for lung cancer, but uncertainty exists about the potential harms,” said researchers led by Peter Bach, from Memorial Sloan-Kettering Cancer Center in New York. Because most patients are diagnosed with advanced disease, there is renewed enthusiasm for the CT screening, “which is able to identify smaller nodules,” the researchers said.
Lung cancer is the leading cause of cancer-related death, killing an estimated 160,000 people in the U.S. each year, according to the American Cancer Society.
Minority babies outnumbered white newborns in 2011 for the first time in U.S. history, the latest milestone in a demographic shift that’s transforming the nation.
The percentage of white newborns fell to 49.6 percent of children younger than a year old from April 2010 to July 2011, the U.S. Census Bureau said today.
The trend is likely to have a far-reaching impact on the country’s political alignment, the nature of its workforce and on its economic future. Predominantly white, older enclaves in the Northeast and Midwest will increasingly rely on an expanding population of young Asians and Hispanics in the West and Sun Belt to support Social Security and other retirement programs.
“This is a fundamental tipping point signaling a change in our demographic structure for decades to come,” William Frey, a demographer and senior fellow at the Brookings Institution in Washington, said in an e-mail.
The figures highlight the rapid growth in the Hispanic and Asian populations, both of which have surged by more than 40 percent since 2000. Hispanics were 16.7 percent of the population in July 2011 and Asians were 4.8 percent. The black population has grown 12.9 percent since 2000 and makes up 12.3 percent of the nation. Non-Hispanic whites rose only 1.5 percent from 2000 to 2011, slower than the national growth of 9.7 percent, and are now 63.4 percent of the population.
Becoming a Minority
Four states -- Hawaii, California, New Mexico and Texas, plus the District of Columbia -- now have majority-minority populations.
A 2009 Census report estimated that non-Hispanic whites will become a minority of the total population after the 2040 Census, making up 48.5 percent in 2045. The government plans to release revised projections later this year, said Alexa Jones- Puthoff, chief of the bureau’s population estimates branch.
The Hispanic growth rate is being driven more by native births than immigration, according to the Pew Hispanic Center, which reported last month that the net migration from Mexico to the U.S. has stopped and may be reversing. The growth of Latino residents is the result of a younger population and higher fertility rates, said Jeffrey Passel, senior demographer for the Washington-based center.
“The younger the age group, the less white it is,” he said.
Accelerating Trend
In Georgia, the number of Hispanic babies grew 20.9 percent from April 2010 to July 2011, the fastest rate of any state. It will probably become majority-minority by 2025, said Matt Hauer, director of the University of Georgia’s Applied Demography Program.
“It’s been on this path for the last 10 or 20 years,” Hauer, a former Census Bureau statistician, said in a telephone interview. “But it’s been accelerating over the past decade. And it’s not just any one area -- this is a statewide phenomenon.”
The differences have become stark in Texas, said Mark Fossett, director of the Texas Census Research Data Center at Texas A&M University. The state added more Hispanic babies during the 15-month period to July 2011 than any other.
“If you’re 60 years old, this is an Anglo state,” he said. “That’s where you see the wealth, income, home ownership, and high-voting patterns. Anything else, especially below 18, the school-age population, looks Latino.”
Fossett said the increase in children is putting pressure on the school system in the state, where the legislature last year cut more than $5 billion in education funding from its two- year budget of $172.3 billion.
Inopportune Cuts
“Now, you’ve got all your standard requirements for meeting the needs of an urban economy and a large school population whose parents have lower educational levels and lower incomes,” he said. “This is occurring right at a time when Texas is cutting down on education spending.”
Texas is home to the nation’s two most minority counties -- Maverick at 96.8 percent and Webb at 96.4 percent.
The transition to a majority-minority nation won’t be smooth, said Passel, the Pew demographer. Even so, he said, the U.S. has proven its ability to absorb new racial and ethnic groups in the past.
“If you go back 100 years, groups that are now considered part of the majority white population were perceived as minorities,” he said. “Over time, we’ll change the way we perceive these categories.”
Social Security
That perception may change even faster with the realization that younger non-white workers will play a bigger role in helping shore up financially strapped retirement and other social- welfare programs.
The Social Security trust funds that pay retirement, disability and survivor’s benefits to one in four U.S. households will be exhausted by 2033, the program’s trustees said in a report released last month. The main fund that pays for the federal Medicare health-insurance program for the elderly will run out of money in 2024, the report said.
Currently, there are 4.8 working-age Americans for every person older than 65. By 2035, that number will fall to 2.8 people per retiree.
The percentage of white newborns fell to 49.6 percent of children younger than a year old from April 2010 to July 2011, the U.S. Census Bureau said today.
The trend is likely to have a far-reaching impact on the country’s political alignment, the nature of its workforce and on its economic future. Predominantly white, older enclaves in the Northeast and Midwest will increasingly rely on an expanding population of young Asians and Hispanics in the West and Sun Belt to support Social Security and other retirement programs.
“This is a fundamental tipping point signaling a change in our demographic structure for decades to come,” William Frey, a demographer and senior fellow at the Brookings Institution in Washington, said in an e-mail.
The figures highlight the rapid growth in the Hispanic and Asian populations, both of which have surged by more than 40 percent since 2000. Hispanics were 16.7 percent of the population in July 2011 and Asians were 4.8 percent. The black population has grown 12.9 percent since 2000 and makes up 12.3 percent of the nation. Non-Hispanic whites rose only 1.5 percent from 2000 to 2011, slower than the national growth of 9.7 percent, and are now 63.4 percent of the population.
Becoming a Minority
Four states -- Hawaii, California, New Mexico and Texas, plus the District of Columbia -- now have majority-minority populations.
A 2009 Census report estimated that non-Hispanic whites will become a minority of the total population after the 2040 Census, making up 48.5 percent in 2045. The government plans to release revised projections later this year, said Alexa Jones- Puthoff, chief of the bureau’s population estimates branch.
The Hispanic growth rate is being driven more by native births than immigration, according to the Pew Hispanic Center, which reported last month that the net migration from Mexico to the U.S. has stopped and may be reversing. The growth of Latino residents is the result of a younger population and higher fertility rates, said Jeffrey Passel, senior demographer for the Washington-based center.
“The younger the age group, the less white it is,” he said.
Accelerating Trend
In Georgia, the number of Hispanic babies grew 20.9 percent from April 2010 to July 2011, the fastest rate of any state. It will probably become majority-minority by 2025, said Matt Hauer, director of the University of Georgia’s Applied Demography Program.
“It’s been on this path for the last 10 or 20 years,” Hauer, a former Census Bureau statistician, said in a telephone interview. “But it’s been accelerating over the past decade. And it’s not just any one area -- this is a statewide phenomenon.”
The differences have become stark in Texas, said Mark Fossett, director of the Texas Census Research Data Center at Texas A&M University. The state added more Hispanic babies during the 15-month period to July 2011 than any other.
“If you’re 60 years old, this is an Anglo state,” he said. “That’s where you see the wealth, income, home ownership, and high-voting patterns. Anything else, especially below 18, the school-age population, looks Latino.”
Fossett said the increase in children is putting pressure on the school system in the state, where the legislature last year cut more than $5 billion in education funding from its two- year budget of $172.3 billion.
Inopportune Cuts
“Now, you’ve got all your standard requirements for meeting the needs of an urban economy and a large school population whose parents have lower educational levels and lower incomes,” he said. “This is occurring right at a time when Texas is cutting down on education spending.”
Texas is home to the nation’s two most minority counties -- Maverick at 96.8 percent and Webb at 96.4 percent.
The transition to a majority-minority nation won’t be smooth, said Passel, the Pew demographer. Even so, he said, the U.S. has proven its ability to absorb new racial and ethnic groups in the past.
“If you go back 100 years, groups that are now considered part of the majority white population were perceived as minorities,” he said. “Over time, we’ll change the way we perceive these categories.”
Social Security
That perception may change even faster with the realization that younger non-white workers will play a bigger role in helping shore up financially strapped retirement and other social- welfare programs.
The Social Security trust funds that pay retirement, disability and survivor’s benefits to one in four U.S. households will be exhausted by 2033, the program’s trustees said in a report released last month. The main fund that pays for the federal Medicare health-insurance program for the elderly will run out of money in 2024, the report said.
Currently, there are 4.8 working-age Americans for every person older than 65. By 2035, that number will fall to 2.8 people per retiree.
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| Online Romance Scam |
Forget your broken heart and wounded pride. The true cost of Internet romance scams is $50,399,536.16, the amount of losses reported by Americans in 2011 to the The Internet Crime Complaint Center (IC3), a low-key quasi-project of the FBI and the National White Collar Crime Center.
Women constituted more than $39 million of the losses, with the most vulnerable segments of the population being specifically women in their fifties and over the age of 60; however, even within that group, women in their fifties are more likely to hand over large sums of money to scammers than their older counterparts. As the IC3 soberly puts it, the scammers “use poetry, flowers and other gifts to reel in victims, while declaring 'undying love.'" Then, of course, the PayPal payments and checks start arriving.
The IC3 is one of the nation's top authorities on cybercrime, and each year it releases an annual report that details the latest trends in online fraud. Unlike most government reports, the IC3's annual Internet crime report is an engrossing read that melds the craziest parts of Elmore Leonard, David Pogue, and inbox spam into a coherent whole.
In addition to outlining details of complaints about online romance schemes, the report states that work-from-home scams are the most prevalent form of Internet fraud in America after stolen credit card numbers. More than 17,000 Americans reported victimization by work-from-home scams last year--and lost over $20 million in the process. Unscrupulous criminals, often based in Nigeria, Russia, or elsewhere, use Craigslist, Monster.com, newspaper classifieds, and other outlets to rope the naïve unemployed into envelope-stuffing or financial services “jobs” that are really fronts for money laundering and identity theft. In one case highlighted by the IC3, a woman in Long Beach, California was arrested by police on suspicion of facilitating the U.S. operations of a Nigerian work-from-home scam. The woman would allegedly accept packages, sell the contents, retain 20% of the profits and then wire the remaining funds back to unknown suspects in Nigeria. All the victims “had posted their resumes or ads online seeking job opportunities.”
Other scams are just plain ingenious. More than 70 New York residents received emails from a spoofed nyc.gov email address that claimed to be from the New York State Police. The New Yorkers, who apparently failed to realize that the New York State Police were unlikely to send mail from a New York City government Internet email addresses, were told they had an outstanding traffic ticket to pay. Payment was supposed to be sent to an address in the upstate town of Chatham Hall--which does not exist. What did exist, however, were the malware-loaded file attachments recipients were instructed to download for “antivirus” purposes.
The Internet is also the perfect place to build a sketchy business empire with numerous fraud opportunities. IC3 officials noted the bizarre saga of Donald Lapre, whose infomercials for “the greatest vitamin in the world” regularly appeared on late-night television. Lapre encouraged out-of-work Americans or folks seeking to start home businesses to sell his vitamins over the Internet; more than 226,000 victims lost a collective $51.8 million in investments. Lapre, who later committed suicide in federal custody, was accused of 41 counts of conspiracy, mail fraud, wire fraud, promotional money laundering, and transactional money laundering. Participants in Lapre's home business projects were essentially hustled into buying expensive online advertising and marketing products.
One of the fastest-growing Internet scams is also tied to the ongoing economic crisis. Nearly 10,000 loan intimidation scams were reported to the IC3 in 2011. In these scams, callers--armed with a person's date of birth, address, employer phone number, bank account numbers, and names and telephone numbers of relatives and friends--call victims' homes, mobile phones, and workplaces demanding that they repay a delinquent payday loan.
Of course, the payday loan in question never existed. The fake debt collectors often claim to be representatives of the FBI or ”Federal Legislative Department,” and threaten arrest or physical violence if the mark doesn't pay up. Although the IC3 doesn't specify how the extortionists obtained detailed personal information on their victims, they strongly suggest that the scam architects built fraudulent online applications for loans and credit cards that the unsuspecting victims filled out.
The IC3 compiles their data through complaints filed directly by victims with the organization, complaints filed by Internet crime analysts working with open- and closed-source public information databases, and complaints filed by law enforcement personnel. Their annual reports are believed to underestimate the amount of annual Internet fraud due to the “shame factor” many scam victims feel.
Men like to push to make kisses sloppier, while women want to keep them long, suggest a new study.
Also, a kiss shared between a man and a woman seems more like a clash of spirits than a meeting of souls.
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| Kiss: Men like it wet, while women like it long |
And that end is sex.
"Males are kissing primarily to increase arousal for their partner," she said.
Hughes and her colleagues researchers probed the kissing preferences and opinions of more than 1,000 males and females in their sexual prime - college undergraduates - who were asked to mark their answers to a series of detailed kissing questions on a 5-point scale.
The results showed that both men and women consider kissing an important and highly intimate interaction. Both sexes use kissing to gauge the relationship compatibility of themselves and their partners.
Furthermore, both may become more or less attracted to their partners based solely on their experience kissing them, a result that lends support to the theory that pheromones and other important biochemical signals get exchanged when people kiss.
But the similarities end there. While women usually consider a bad kiss to be a deal-breaker, men reported that they would more than likely still have sex with a woman even if she were a bad kisser.
In fact, the data showed that males feel much more strongly that kissing should lead to sex than females do.
"Whereas females felt there was a greater likelihood that kissing should lead to sex with a long-term partner than a short-term partner, males felt that in either instance, kissing should lead to sex," wrote the researchers.
Men also like significantly wetter kisses. The gender divide becomes drastic when the kissing involves short-term partners, who presumably hold primarily sexual rather than romantic appeal. In the short-term, men like kisses to be wet, while women do not.
Psychologists hypothesize that males "perceive a greater wetness or salivary exchange during kissing as an index of the female's sexual arousal/receptivity, similar to the act of sexual intercourse," wrote Hughes.
Follow-up research conducted by Helen Fisher, an anthropologist at Rutgers University, in 2009 even found that men pass testosterone to women via their saliva, which may momentarily increase the women's sex drive.
The findings were published in the journal Evolutionary Psychology.
Dr Aniruddh Malpani, an infertility expert in Mumbai, often invokes playwright George Bernard Shaw's conversation with French actress Sarah Bernhardt when inundated with elitist requests from couples seeking sperm donors. "Just think Monsieur... a child with my looks and your brains!" Bernhardt is said to have told Shaw. To which he had famously quipped, "But Madam, what if he is born with my looks and your brains?"
In India, it's well known that couples shopping for sperm demand both looks and brains. What isn't so well known, despite being fairly commonplace, is a more outrageous request: caste-based sperm. Three years ago, Dr Saurav Kumar, a Patna gynaecologist, created a furore when he told a newspaper that childless couples insisted on knowing the caste of sperm donors. But while one may be tempted to assume that caste biases are entrenched only in states like Bihar, the city's infertility experts insist otherwise.
Dilip Patil, founding president of Trivector, an infertility solutions firm, says there is a definite preference for Brahim donors in Mumbai. "Even among Muslims, couples want to know whether the donor is Sunni or Shiite," he says. "However, going by Indian Council of Medical Researchguidelines, we reveal only the religion of the donor, not the caste."
Patil, who dismisses requests about caste as "byproducts of the Indian mindset", happily obliged varying queries about educational and professional backgrounds, extra-curricular preferences and linguistic skills until a woman perched on stilettos tick-tocked into his clinic with a bizarre request a few months ago. "A Page 3 personality walked in with a strange chart in her hand. There was a list of Bollwyood actors such as John Abraham and Emraan Hashmi and each of them was graded as A+, A, B+ and so on. She asked my staff if there were donors in these graded categories and insisted that she was ready to pay anything. We told her that we could not accept such demands; this was not a clinic for designer babies," says Patil, who was on the medical research team for the recent film on sperm donation called Vicky Donor.
Perhaps the designer baby syndrome is inspired in elite sperm shoppers by what happens abroad, where, says Dr Malpani, couples have the option of going through a whole "shopping catalogue" with details of various sperm donors. In India, however, the donor remains anonymous. All that couples are told is that it is "a young, healthy and fertile physical match". Yet, they persist. "They want to match the primary characteristics such as height, skin and colour with their husband. Mostly, they want someone who is taller and a shade fairer than their husband," says Malpani, who points out that this may be a "very consumeristic" approach.
While most couples are concerned about medical history of the donor (Patil's clinic produces the medical history of three generations of the donor's family), skin colour is another priority. "Certain communities prefer a fair-skinned donor," says Dr Pai, adding that couples want them to find the closest skin, hair and eye colour match. During his fellowship in a semen bank in Australia around ten years ago, he had observed that they would bear the race of the donor in mind as the physical characteristics could differ depending on this. Similarly, in India, where the physical features of people from the North-East may differ from other regions, "we have to isolate donors based on these considerations", he says.
While in a majority of cases, it is the gynaecologists who contact sperm banks and request for semen samples based on the client's height, skin and hair colour preferences, some high-flying couples, especially NRIs, visit the sperm bank personally in their desperation. Infertility specialist Dr Arun Patil, partner at Medilabs, a leading sperm bank, says that around ten per cent of his clients, who come from a higher socio-economic strata, are curious about the donor's background. Among these are people who ask for "the name of the college the donor went to" and tend to favour prestigious institutions such as IIT and IIM. Then there are also those who leave their photograph at the sperm bank so that the doctor can find the closest match.
In 2008, when Dilip Patil tried to popularise the concept of sperm donation in India through an awareness booth at IIT's annual Mood Indigo festival, it was, he says, "an anti-climax". "The students were so shy that they changed their lanes while passing by the stall," he says. Patil, whose real-life anecdotes about convincing people to donate sperm made it to Vicky Donor, says that he used references about sperm donation in ancient mythology, props and money (Rs 500 per sample) to convert donors.
The success of the film, says Patil, has vindicated Mumbai's community of sperm donors. One indication is in the increasing number of walk-in donations. "We had a 43-year-old father who was keen to donate his sperm. We told him he was too old to be a donor," says Patil, "so he sent his son the next day."
In India, it's well known that couples shopping for sperm demand both looks and brains. What isn't so well known, despite being fairly commonplace, is a more outrageous request: caste-based sperm. Three years ago, Dr Saurav Kumar, a Patna gynaecologist, created a furore when he told a newspaper that childless couples insisted on knowing the caste of sperm donors. But while one may be tempted to assume that caste biases are entrenched only in states like Bihar, the city's infertility experts insist otherwise.
Dilip Patil, founding president of Trivector, an infertility solutions firm, says there is a definite preference for Brahim donors in Mumbai. "Even among Muslims, couples want to know whether the donor is Sunni or Shiite," he says. "However, going by Indian Council of Medical Researchguidelines, we reveal only the religion of the donor, not the caste."
Patil, who dismisses requests about caste as "byproducts of the Indian mindset", happily obliged varying queries about educational and professional backgrounds, extra-curricular preferences and linguistic skills until a woman perched on stilettos tick-tocked into his clinic with a bizarre request a few months ago. "A Page 3 personality walked in with a strange chart in her hand. There was a list of Bollwyood actors such as John Abraham and Emraan Hashmi and each of them was graded as A+, A, B+ and so on. She asked my staff if there were donors in these graded categories and insisted that she was ready to pay anything. We told her that we could not accept such demands; this was not a clinic for designer babies," says Patil, who was on the medical research team for the recent film on sperm donation called Vicky Donor.
Perhaps the designer baby syndrome is inspired in elite sperm shoppers by what happens abroad, where, says Dr Malpani, couples have the option of going through a whole "shopping catalogue" with details of various sperm donors. In India, however, the donor remains anonymous. All that couples are told is that it is "a young, healthy and fertile physical match". Yet, they persist. "They want to match the primary characteristics such as height, skin and colour with their husband. Mostly, they want someone who is taller and a shade fairer than their husband," says Malpani, who points out that this may be a "very consumeristic" approach.
While most couples are concerned about medical history of the donor (Patil's clinic produces the medical history of three generations of the donor's family), skin colour is another priority. "Certain communities prefer a fair-skinned donor," says Dr Pai, adding that couples want them to find the closest skin, hair and eye colour match. During his fellowship in a semen bank in Australia around ten years ago, he had observed that they would bear the race of the donor in mind as the physical characteristics could differ depending on this. Similarly, in India, where the physical features of people from the North-East may differ from other regions, "we have to isolate donors based on these considerations", he says.
While in a majority of cases, it is the gynaecologists who contact sperm banks and request for semen samples based on the client's height, skin and hair colour preferences, some high-flying couples, especially NRIs, visit the sperm bank personally in their desperation. Infertility specialist Dr Arun Patil, partner at Medilabs, a leading sperm bank, says that around ten per cent of his clients, who come from a higher socio-economic strata, are curious about the donor's background. Among these are people who ask for "the name of the college the donor went to" and tend to favour prestigious institutions such as IIT and IIM. Then there are also those who leave their photograph at the sperm bank so that the doctor can find the closest match.
In 2008, when Dilip Patil tried to popularise the concept of sperm donation in India through an awareness booth at IIT's annual Mood Indigo festival, it was, he says, "an anti-climax". "The students were so shy that they changed their lanes while passing by the stall," he says. Patil, whose real-life anecdotes about convincing people to donate sperm made it to Vicky Donor, says that he used references about sperm donation in ancient mythology, props and money (Rs 500 per sample) to convert donors.
The success of the film, says Patil, has vindicated Mumbai's community of sperm donors. One indication is in the increasing number of walk-in donations. "We had a 43-year-old father who was keen to donate his sperm. We told him he was too old to be a donor," says Patil, "so he sent his son the next day."
Pointing to a collusive nexus between drug manufacturers, officials of Drugs Control Organisation and medical experts in granting approvals to new drugs, a Parliamentary Panel said drugs banned, discarded or withdrawn in developed countries are in circulation in India.
The Parliamentary Standing Committee on Health and Family Welfare also pointed to serious lapses and irregularities on the approvals of new drugs and pointed out that 33 such drugs were approved without conducting clinical trials on Indian patients.
Alarmed at concerns of safety of Indian patients using such new drugs approved by the Central Drugs Standard Control Organisation (CDSCO), the top body handling approval of drugs, the Committee held "this matter needs to be reviewed to ensure safety of patients, fair play, transparency and accountability."
The Committee said scrutiny of 42 drugs picked up randomly involving grant of drug approvals in utter disregard of regulatory procedures and violation of rules and pointed out to files of approval of three controversial drugs (pefloxacin, lomefloxacin and sparfloxacin) found missing and untraceable.
These drugs were either never marketed or withdrawn in the US, Canada, Britain, Australia and other countries.
The Committee also pointed to a nexus between drug industry and medical experts who give their opinion on "personal perception" to push "unsafe" drugs for use.
"The Committee expresses its deep concern, extreme displeasure and disappointment at the state of affairs...The Ministry should ensure that the staff at CDSCO does not indulge in irregularities in approval process of new drugs that can potentially have adverse effect on the lives of people. It is difficult to believe that these irregularities on the part of CDSCO were merely due to oversight or unintentional. Hence, all cases should be investigated," the Committee held.
On the three drugs whose files went missing, the Panel held "all these drugs were approved on different dates and years creating doubts if their disappearances were accidental.
In India, these drugs are on sale. It is not posible to monitor if manufacturers are abiding by conditions of approval."
Citing the example of Deanxit, the Panel pointed out that the drug continued to be prohibited for sale and use in Denmark, the country of its origin, and thus permission to import and market it in India was given unlawfully.
"There must be some very good reasons for Danish Medical Agency not to approve a domestically developed drug where an anti-depressant drug would be in greater demand as compared to India. Curiously, Deanxit is allowed to be produced and exported but not allowed to be used in Denmark," it said.
The panel cited another example of Letrozole by Novartis, used as an anti-cancer drugs used only in post-menopausal women, is used only in India where it is permitted for use in female infertility.
The Panel also found that in some drugs like Buclizine administered to babies for appetite stimulation was unlawfully approved in India without clinical trials and without consulting experts. Latest scientific evidence from countries like Belgium, where the drug originated, was sought by the panel while seeking review of its approval.
After scrutiny of 39 drugs documented, the panel said 13 drugs (33 per cent) like buxlizine for appetite stimulation, nimuselid injection, Dozoflylline, Foxed Dose Combination of of Pregabalin with other agents, FDC of Ofloxacin with Ornodazole did not have permission for sale in any major developed countries like US, Canada, Australia, UK or EU and none had special relevance to medical needs here.
It held that in 11 drugs (28 per cent) like Everolimus of Novartis, Colistimethate of Cipla, Exemestane of Pharmacia, Ademetionine of Akums, Pemetrexid of Eli Lilly, Ambrisentan of GlaxoSmithKline, mandatory Phase III clinical trials were not conducted.
The Parliamentary Standing Committee on Health and Family Welfare also pointed to serious lapses and irregularities on the approvals of new drugs and pointed out that 33 such drugs were approved without conducting clinical trials on Indian patients.
Alarmed at concerns of safety of Indian patients using such new drugs approved by the Central Drugs Standard Control Organisation (CDSCO), the top body handling approval of drugs, the Committee held "this matter needs to be reviewed to ensure safety of patients, fair play, transparency and accountability."
The Committee said scrutiny of 42 drugs picked up randomly involving grant of drug approvals in utter disregard of regulatory procedures and violation of rules and pointed out to files of approval of three controversial drugs (pefloxacin, lomefloxacin and sparfloxacin) found missing and untraceable.
These drugs were either never marketed or withdrawn in the US, Canada, Britain, Australia and other countries.
The Committee also pointed to a nexus between drug industry and medical experts who give their opinion on "personal perception" to push "unsafe" drugs for use.
"The Committee expresses its deep concern, extreme displeasure and disappointment at the state of affairs...The Ministry should ensure that the staff at CDSCO does not indulge in irregularities in approval process of new drugs that can potentially have adverse effect on the lives of people. It is difficult to believe that these irregularities on the part of CDSCO were merely due to oversight or unintentional. Hence, all cases should be investigated," the Committee held.
On the three drugs whose files went missing, the Panel held "all these drugs were approved on different dates and years creating doubts if their disappearances were accidental.
In India, these drugs are on sale. It is not posible to monitor if manufacturers are abiding by conditions of approval."
Citing the example of Deanxit, the Panel pointed out that the drug continued to be prohibited for sale and use in Denmark, the country of its origin, and thus permission to import and market it in India was given unlawfully.
"There must be some very good reasons for Danish Medical Agency not to approve a domestically developed drug where an anti-depressant drug would be in greater demand as compared to India. Curiously, Deanxit is allowed to be produced and exported but not allowed to be used in Denmark," it said.
The panel cited another example of Letrozole by Novartis, used as an anti-cancer drugs used only in post-menopausal women, is used only in India where it is permitted for use in female infertility.
The Panel also found that in some drugs like Buclizine administered to babies for appetite stimulation was unlawfully approved in India without clinical trials and without consulting experts. Latest scientific evidence from countries like Belgium, where the drug originated, was sought by the panel while seeking review of its approval.
After scrutiny of 39 drugs documented, the panel said 13 drugs (33 per cent) like buxlizine for appetite stimulation, nimuselid injection, Dozoflylline, Foxed Dose Combination of of Pregabalin with other agents, FDC of Ofloxacin with Ornodazole did not have permission for sale in any major developed countries like US, Canada, Australia, UK or EU and none had special relevance to medical needs here.
It held that in 11 drugs (28 per cent) like Everolimus of Novartis, Colistimethate of Cipla, Exemestane of Pharmacia, Ademetionine of Akums, Pemetrexid of Eli Lilly, Ambrisentan of GlaxoSmithKline, mandatory Phase III clinical trials were not conducted.
• Along with the Great Recession of 2007, in our working lifetime we have seen other examples of misguided extrapolative thinking that ended in the severe mis-pricing of assets ahead of a crash technology stocks at the end of the 1990s, the emerging Asia miracle in 1997 and Japan in 1989 are all examples where there were clear bubbles about to burst. In each case, any attempt to warn clients was met with a steaming dollop of derision.
The charts and tables are rather instructive
Worlds Most Expensive Cities
>
Housing Affordability Ratings by Nation
Source: The 2012 Demographia International Housing Affordability Survey
(See also the US National City affordability table after the jump)
>
Note that in the US, Florida is often used as an example if where prices have fallen so greatly as to produce enormous bargains. The data suggests otherwise. Miami for example has still yet to revert to pre credit bubble levels:
>
Rumors of Affordability in Florida have Been greatly Exaggerated
Source: The 2012 Demographia International Housing Affordability Survey
>
Source:
The biggest bubble in recent history is heading for the mother of all hard landings
Albert Edwards
Société Générale, May 3 2012
>
Note that in the US, Florida is often used as an example if where prices have fallen so greatly as to produce enormous bargains. The data suggests otherwise. Miami for example has still yet to revert to pre credit bubble levels:
>
Rumors of Affordability in Florida have Been greatly Exaggerated
Source: The 2012 Demographia International Housing Affordability Survey
>
Source:
The biggest bubble in recent history is heading for the mother of all hard landings
Albert Edwards
Société Générale, May 3 2012
National US City affordability
Source: The 2012 Demographia International Housing Affordability Survey
Besides generally making you healthy, a new study found that eating yogurt has some surprising benefits (at least in mice) including making their testicles, er, quite impressive.
In the mid-2000s, when scientists questioned whether the campaign to rid the world of polio could succeed, skeptics pointed to a problem that some called PAIN. Last summer a team of researchers from the Massachusetts Institute of Technology set out to better understand the effects of yogurt on obesity. They were following up on the results of a long-term study from the Harvard School of Public Health that had suggested yogurt, more than any other food, helped to prevent age-related weight gain. The M.I.T. team, led by cancer biologist Susan Erdman and evolutionary geneticist Eric Alm, wanted to replicate the work in mice. The researchers took a group of 40 males and 40 females and either fed the animals a high-fat, low-fiber, low-nutrient diet meant to mimic junk food or fed them standard mouse meals. They then supplemented half of each diet group with vanilla-flavored yogurt.
Their goal was to understand how a probiotic diet affects rates of obesity and its related complications, including cancer. But "the most entertaining aspects of all this were things we didn’t anticipate," Erdman says.
First, the scientists noticed that the yogurt-eating mice were incredibly shiny. Using both traditional histology techniques and cosmetic rating scales, the researchers showed that these animals had 10 times the active follicle density of other mice, resulting in luxuriantly silky fur.The mice projected their testes outward, which endowed them with a certain "mouse swagger."
Then the researchers spotted something particular about the males: they projected their testes outward, which endowed them with a certain "mouse swagger," Erdman says. On measuring the males, they found that the testicles of the yogurt consumers were about 5% heavier than those of mice fed typical diets alone and around 15 percent heavier than those of junk-eating males.
Yogurt might be good for you as is, but imagine if you dropped a little Prozac in it.
More important, that masculinity pays off. In mating experiments, yogurt-eating males inseminated their partners faster and produced more offspring than control mice. Conversely, females that ate the yogurt diets gave birth to larger litters and weaned those pups with greater success. Reflecting on their unpublished results, Erdman and Alm think that the probiotic microbes in the yogurt help to make the animals leaner and healthier, which indirectly improves sexual machismo.
The findings could have implications for human fertility. In ongoing work, a team led by Harvard nutritional epidemiologist Jorge Chavarro has looked at the association between yogurt intake and semen quality in men. "So far our preliminary findings are consistent with what they see in the mice," Chavarro says.
This article was published in print as "Mice That Eat Yogurt Have Larger Testicles."
From ScientificAmerican.com Click here for the original article
In the mid-2000s, when scientists questioned whether the campaign to rid the world of polio could succeed, skeptics pointed to a problem that some called PAIN. Last summer a team of researchers from the Massachusetts Institute of Technology set out to better understand the effects of yogurt on obesity. They were following up on the results of a long-term study from the Harvard School of Public Health that had suggested yogurt, more than any other food, helped to prevent age-related weight gain. The M.I.T. team, led by cancer biologist Susan Erdman and evolutionary geneticist Eric Alm, wanted to replicate the work in mice. The researchers took a group of 40 males and 40 females and either fed the animals a high-fat, low-fiber, low-nutrient diet meant to mimic junk food or fed them standard mouse meals. They then supplemented half of each diet group with vanilla-flavored yogurt.
Their goal was to understand how a probiotic diet affects rates of obesity and its related complications, including cancer. But "the most entertaining aspects of all this were things we didn’t anticipate," Erdman says.
First, the scientists noticed that the yogurt-eating mice were incredibly shiny. Using both traditional histology techniques and cosmetic rating scales, the researchers showed that these animals had 10 times the active follicle density of other mice, resulting in luxuriantly silky fur.The mice projected their testes outward, which endowed them with a certain "mouse swagger."
Then the researchers spotted something particular about the males: they projected their testes outward, which endowed them with a certain "mouse swagger," Erdman says. On measuring the males, they found that the testicles of the yogurt consumers were about 5% heavier than those of mice fed typical diets alone and around 15 percent heavier than those of junk-eating males.
Yogurt might be good for you as is, but imagine if you dropped a little Prozac in it.
More important, that masculinity pays off. In mating experiments, yogurt-eating males inseminated their partners faster and produced more offspring than control mice. Conversely, females that ate the yogurt diets gave birth to larger litters and weaned those pups with greater success. Reflecting on their unpublished results, Erdman and Alm think that the probiotic microbes in the yogurt help to make the animals leaner and healthier, which indirectly improves sexual machismo.
The findings could have implications for human fertility. In ongoing work, a team led by Harvard nutritional epidemiologist Jorge Chavarro has looked at the association between yogurt intake and semen quality in men. "So far our preliminary findings are consistent with what they see in the mice," Chavarro says.
This article was published in print as "Mice That Eat Yogurt Have Larger Testicles."
From ScientificAmerican.com Click here for the original article
Lill-Karin Skaret, a 67-year-old grandmother from Namsos, Norway, was traveling to a lakeside vacation villa near India’s port city of Kochi in March 2010 when her car collided with a truck. She was rushed to the Amrita Institute of Medical Sciences, her right leg broken and her artificial hip so damaged that replacing it required 12 hours of surgery.
Three weeks later and walking with the aid of crutches, Skaret was relieved to be home. Then her doctor gave her upsetting news. Mutant germs that most antibiotics can’t kill had entered her bladder, probably from a contaminated hospital catheter in India. She risked a life-threatening infection if the bacteria invaded her bloodstream -- a waiting game over which she had limited control, Bloomberg Markets magazine reports in its June issue.
Klebsiella pneumoniae, the bacterium in which NDM-1 was first identified. Photograph: CDC
May 8 (Bloomberg) -- India's overuse of antibiotics, coupled with the nation's poor sanitation, has led to a new type of superbug, mutated bacteria that even the most high-powered antibiotics can't kill. Scientists warn this superbug is spreading faster, further and in more alarming ways than any they’ve encountered. Bloomberg's Adi Narayan reports on the story featured in the June issue of Bloomberg Markets magazine. (Source: Bloomberg)
Karthikeyan K. Kumarasamy in Chennai worked with international doctors to identify the NDM-1 gene causing untreatable bacterial infections in India. Photographer: Anay Mann/Bloomberg Markets via Bloomberg
“I got a call from my doctor who told me they found this bug in me and I had to take precautions,” Skaret remembers. “I was very afraid.”
Skaret was lucky. Eventually, her body rid itself of the bacteria, and she escaped harm from a new type of superbug that scientists warn is spreading faster, further and in more alarming ways than any they’ve encountered. Researchers say the epicenter is India, where drugs created to fight disease have taken a perverse turn by making many ailments harder to treat.
India’s $12.4 billion pharmaceutical industry manufactures almost a third of the world’s antibiotics, and people use them so liberally that relatively benign and beneficial bacteria are becoming drug immune in a pool of resistance that thwarts even high-powered antibiotics, the so-called remedies of last resort.
Medical Tourism
Poor hygiene has spread resistant germs into India’s drains, sewers and drinking water, putting millions at risk of drug-defying infections. Antibiotic residues from drug manufacturing, livestock treatment and medical waste have entered water and sanitation systems, exacerbating the problem.
As the superbacteria take up residence in hospitals, they’re compromising patient care and tarnishing India’s image as a medical tourism destination.
“There isn’t anything you could take with you traveling that would be useful against these superbugs,” says Robert Moellering Jr., a professor of medical research at Harvard Medical School in Boston.
The germs -- and the gene that confers their heightened powers -- are jumping beyond India. More than 40 countries have discovered the genetically altered superbugs in blood, urine and other patient specimens. Canada, France, Italy, Kosovo and South Africa have found them in people with no travel links, suggesting the bugs have taken hold there.
Post-Antibiotic Era
Drug resistance of all sorts is bringing the planet closer to what the World Health Organizationcalls a post-antibiotic era.
“Things as common as strep throat or a child’s scratched knee could once again kill,” WHO Director-General Margaret Chan said at a March medical meeting in Copenhagen. “Hip replacements, organ transplants, cancer chemotherapy and care of preterm infants would become far more difficult or even too dangerous to undertake.”
Already, current varieties of resistant bacteria kill more than 25,000 people in Europe annually, the WHO said in March. The toll means at least 1.5 billion euros ($2 billion) in extra medical costs and productivity losses each year.
“If this latest bug becomes entrenched in our hospitals, there is really nothing we can turn to,” says Donald E. Low, head of Ontario’s public health lab in Toronto. “Its potential is to be probably greater than any other organism.”
Promiscuous Plasmids
The new superbugs are multiplying so successfully because of a gene dubbed NDM-1. That’s short for New Delhi metallo-beta- lactamase-1, a reference to the city where a Swedish man was hospitalized in 2007 with an infection that resisted standard antibiotic treatments.
The superbugs are proving to be not only wily but also highly sexed. The NDM-1 gene is carried on mobile loops of DNA called plasmids that transfer easily among and across many types of bacteria through a form of microbial mating. This means that unlike previous germ-altering genes, NDM-1 can infiltrate dozens of bacterial species. Intestine-dwelling E. coli, the most common bacterium that people encounter, soil-inhabiting microbes and water-loving cholera bugs can all be fortified by the gene.
What’s worse, germs empowered by NDM-1 can muster as many as nine other ways to destroy the world’s most potent antibiotics.
Untreatable Killers
NDM-1 is changing common bugs that drugs once easily defeated into untreatable killers, says Timothy Walsh, a professor of medical microbiology at Cardiff University in Wales. Or as in Skaret’s case, the gene is creating silent stowaways poised to attack if they find a weakness -- or that can pass harmlessly when the body’s conventional microbes win out.
Cancer patients whose chemotherapy inadvertently ulcerates their gastrointestinal tract are especially vulnerable, says Lindsay Grayson, director of infectious diseases and microbiology at Melbourne’s Austin Hospital.
“These bugs go straight into their bloodstream,” Grayson says. Newborns, transplant recipients and people with compromised immune systems are at higher risk, he says.
Six infants died in a small hospital in Bijnor in northern India from April 2009 to August 2010 after NDM-1-containing bacteria resisted all commonly used antibiotics.
India Vulnerable
India is susceptible because it has many sick people to begin with. The country accounts for more than a quarter of the world’s pneumonia cases. It has the most tuberculosis patients globally and Asia’s highest incidence of cholera.
Most of India’s 5,000-plus drugmakers produce low-cost generic antibiotics, letting users and doctors switch around to find ones that work. While that’s happening, the germs the antibiotics are targeting accumulate genes for evading each drug. That enables the bugs to survive and proliferate whenever they encounter an antibiotic they’ve already adapted to.
India’s inadequate sanitation increases the scope of antibacterial resistance. More than half of the nation’s 1.2 billion residents defecate in the open, and 23 percent of city dwellers have no toilets, according to a 2012 report by the WHO and Unicef.
Uncovered sewers and overflowing drains in even such modern cities as New Delhi spread resistant germs through feces, tainting food and water and covering surfaces in what Dartmouth Medical School researcher Elmer Pfefferkorn describes as a fecal veneer.
Tap Water
Germs with the NDM-1 gene existed in 51 of 171 open drains along the capital’s streets and in two of 50 samples of public tap water, Walsh found in 2010.
Abdul Ghafur, an infectious diseases doctor in Chennai, southern India’s largest city, sees patients every week who suffer from multidrug-resistant infections. He and others who used to successfully combat infections with such common antibiotics as amoxicillin now must use more-expensive ones that target a broader range of germs but typically cause greater side effects. Some infections don’t respond to any treatment, evading all antibiotics, he says.
That’s bad news because the more frequently the NDM-1 gene is inserted into different bacteria, the more likely it will enter virulent forms of E. coli, sparking outbreaks that may be impossible to subdue, says David Livermore, who heads antibiotic resistance monitoring at the U.K.’s Health Protection Agency in London.
Three weeks later and walking with the aid of crutches, Skaret was relieved to be home. Then her doctor gave her upsetting news. Mutant germs that most antibiotics can’t kill had entered her bladder, probably from a contaminated hospital catheter in India. She risked a life-threatening infection if the bacteria invaded her bloodstream -- a waiting game over which she had limited control, Bloomberg Markets magazine reports in its June issue.
Klebsiella pneumoniae, the bacterium in which NDM-1 was first identified. Photograph: CDC
May 8 (Bloomberg) -- India's overuse of antibiotics, coupled with the nation's poor sanitation, has led to a new type of superbug, mutated bacteria that even the most high-powered antibiotics can't kill. Scientists warn this superbug is spreading faster, further and in more alarming ways than any they’ve encountered. Bloomberg's Adi Narayan reports on the story featured in the June issue of Bloomberg Markets magazine. (Source: Bloomberg)
Karthikeyan K. Kumarasamy in Chennai worked with international doctors to identify the NDM-1 gene causing untreatable bacterial infections in India. Photographer: Anay Mann/Bloomberg Markets via Bloomberg
“I got a call from my doctor who told me they found this bug in me and I had to take precautions,” Skaret remembers. “I was very afraid.”
Skaret was lucky. Eventually, her body rid itself of the bacteria, and she escaped harm from a new type of superbug that scientists warn is spreading faster, further and in more alarming ways than any they’ve encountered. Researchers say the epicenter is India, where drugs created to fight disease have taken a perverse turn by making many ailments harder to treat.
India’s $12.4 billion pharmaceutical industry manufactures almost a third of the world’s antibiotics, and people use them so liberally that relatively benign and beneficial bacteria are becoming drug immune in a pool of resistance that thwarts even high-powered antibiotics, the so-called remedies of last resort.
Medical Tourism
Poor hygiene has spread resistant germs into India’s drains, sewers and drinking water, putting millions at risk of drug-defying infections. Antibiotic residues from drug manufacturing, livestock treatment and medical waste have entered water and sanitation systems, exacerbating the problem.
As the superbacteria take up residence in hospitals, they’re compromising patient care and tarnishing India’s image as a medical tourism destination.
“There isn’t anything you could take with you traveling that would be useful against these superbugs,” says Robert Moellering Jr., a professor of medical research at Harvard Medical School in Boston.
The germs -- and the gene that confers their heightened powers -- are jumping beyond India. More than 40 countries have discovered the genetically altered superbugs in blood, urine and other patient specimens. Canada, France, Italy, Kosovo and South Africa have found them in people with no travel links, suggesting the bugs have taken hold there.
Post-Antibiotic Era
Drug resistance of all sorts is bringing the planet closer to what the World Health Organizationcalls a post-antibiotic era.
“Things as common as strep throat or a child’s scratched knee could once again kill,” WHO Director-General Margaret Chan said at a March medical meeting in Copenhagen. “Hip replacements, organ transplants, cancer chemotherapy and care of preterm infants would become far more difficult or even too dangerous to undertake.”
Already, current varieties of resistant bacteria kill more than 25,000 people in Europe annually, the WHO said in March. The toll means at least 1.5 billion euros ($2 billion) in extra medical costs and productivity losses each year.
“If this latest bug becomes entrenched in our hospitals, there is really nothing we can turn to,” says Donald E. Low, head of Ontario’s public health lab in Toronto. “Its potential is to be probably greater than any other organism.”
Promiscuous Plasmids
The new superbugs are multiplying so successfully because of a gene dubbed NDM-1. That’s short for New Delhi metallo-beta- lactamase-1, a reference to the city where a Swedish man was hospitalized in 2007 with an infection that resisted standard antibiotic treatments.
The superbugs are proving to be not only wily but also highly sexed. The NDM-1 gene is carried on mobile loops of DNA called plasmids that transfer easily among and across many types of bacteria through a form of microbial mating. This means that unlike previous germ-altering genes, NDM-1 can infiltrate dozens of bacterial species. Intestine-dwelling E. coli, the most common bacterium that people encounter, soil-inhabiting microbes and water-loving cholera bugs can all be fortified by the gene.
What’s worse, germs empowered by NDM-1 can muster as many as nine other ways to destroy the world’s most potent antibiotics.
Untreatable Killers
NDM-1 is changing common bugs that drugs once easily defeated into untreatable killers, says Timothy Walsh, a professor of medical microbiology at Cardiff University in Wales. Or as in Skaret’s case, the gene is creating silent stowaways poised to attack if they find a weakness -- or that can pass harmlessly when the body’s conventional microbes win out.
Cancer patients whose chemotherapy inadvertently ulcerates their gastrointestinal tract are especially vulnerable, says Lindsay Grayson, director of infectious diseases and microbiology at Melbourne’s Austin Hospital.
“These bugs go straight into their bloodstream,” Grayson says. Newborns, transplant recipients and people with compromised immune systems are at higher risk, he says.
Six infants died in a small hospital in Bijnor in northern India from April 2009 to August 2010 after NDM-1-containing bacteria resisted all commonly used antibiotics.
India Vulnerable
India is susceptible because it has many sick people to begin with. The country accounts for more than a quarter of the world’s pneumonia cases. It has the most tuberculosis patients globally and Asia’s highest incidence of cholera.
Most of India’s 5,000-plus drugmakers produce low-cost generic antibiotics, letting users and doctors switch around to find ones that work. While that’s happening, the germs the antibiotics are targeting accumulate genes for evading each drug. That enables the bugs to survive and proliferate whenever they encounter an antibiotic they’ve already adapted to.
India’s inadequate sanitation increases the scope of antibacterial resistance. More than half of the nation’s 1.2 billion residents defecate in the open, and 23 percent of city dwellers have no toilets, according to a 2012 report by the WHO and Unicef.
Uncovered sewers and overflowing drains in even such modern cities as New Delhi spread resistant germs through feces, tainting food and water and covering surfaces in what Dartmouth Medical School researcher Elmer Pfefferkorn describes as a fecal veneer.
Tap Water
Germs with the NDM-1 gene existed in 51 of 171 open drains along the capital’s streets and in two of 50 samples of public tap water, Walsh found in 2010.
Abdul Ghafur, an infectious diseases doctor in Chennai, southern India’s largest city, sees patients every week who suffer from multidrug-resistant infections. He and others who used to successfully combat infections with such common antibiotics as amoxicillin now must use more-expensive ones that target a broader range of germs but typically cause greater side effects. Some infections don’t respond to any treatment, evading all antibiotics, he says.
That’s bad news because the more frequently the NDM-1 gene is inserted into different bacteria, the more likely it will enter virulent forms of E. coli, sparking outbreaks that may be impossible to subdue, says David Livermore, who heads antibiotic resistance monitoring at the U.K.’s Health Protection Agency in London.
Black Death
The gene may even spread to the microbial cause of bubonic plague, the medieval scourge known as Black Death that still persists in pockets of the globe.
“It’s a matter of time and chance,” says Mark Toleman, a molecular geneticist at Cardiff University. Plasmids carrying the NDM-1 gene can easily be inserted into the genetic material of Yersinia pestis, the cause of plague, making the infection harder to treat, Toleman says.
“There is a tsunami that’s going to happen in the next year or two when antibiotic resistance explodes,” says Ghafur, 40, seated at a polished wooden table in a consulting room in Chennai as patients fill 20 metal chairs in the waiting area, forcing others into the corridor. “We need wartime measures to deal with this now.”
R.K. Srivastava, India’s former director general of health services, says the government is giving top priority to antimicrobial resistance, including increasing surveillance of hospitals’ antibiotics use.
Name Shame
At the same time, it’s trying to preserve the country’s health-tourism industry. Bristling that foreigners coined a name that singles out their capital to describe an emerging health nightmare, officials say the world is picking on India for troubles that impede all developing nations.
When Indian researchers joined international teams studying the NDM-1 gene, the government questioned the data and methods of the scientists, among them Chennai microbiologist Karthikeyan K. Kumarasamy.
“These bacteria were present globally,” says Nirmal K. Ganguly, a former director general of the Indian Council of Medical Research and one of 13 members of a government task force created in September 2010 to respond to the NDM-1 threat.
“When you are blamed, the only reaction is that you put your back to the wall and fight.”
Ulterior Motive?
S.S. Ahluwalia, a former deputy opposition leader in the upper house of India’s parliament and a member of the Bharatiya Janata Party, says Western rivals want to muscle in on the medical tourism industry. Josef Woodman, founder of the guidebook “Patients Beyond Borders,” values the industry globally at $54 billion a year.
“These reports are meant to destabilize India’s emergence as a health destination,” says Ahluwalia, whose term ended in April.
About 850,000 medical tourists traveled to India in 2010 for treatments from lifesaving cancer operations to cosmetic surgeries, generating $872 million in revenue, according to the Associated Chambers of Commerce and Industry of India, or Assocham. The number of foreign patients is predicted to almost quadruple by 2015, the trade body says.
Manish Kakkar, a doctor researching infectious diseases at the New Delhi-based Public Health Foundation of India and a task force member, says the government has its priorities wrong.
“We have been in a phase of denial,” he says. “Rather than responding to the situation scientifically, we’ve completely diverted attention, saying that it’s attacking our medical tourism.”
‘That’s What’s Scary’
Kakkar and others worry about NDM-1 because unlike germs such as VRE, short for the vancomycin-resistant enterococci bug that can cause infection around a patient’s surgical incision, NDM-1 is spreading beyond hospitals.
Two travelers from the Netherlands picked up an NDM-1 bug in their bowels after visiting India in 2009 although they hadn’t received medical care there, says Maurine Leverstein-van Hall, a clinical microbiologist at the University Medical Center in the Dutch city of Utrecht.
“That’s what’s scary,” she says. “It’s not just surgery or being near a hospital. In some way, you get it through the food chain or through the water.”
For now, it’s impossible to tell how common NDM-1 infections are or how often the mutant germs kill because testing and surveillance are inadequate in developing countries, says Keith Klugman, the William H. Foege chair of global health at Emory University’s Rollins School of Public Health in Atlanta.
‘Perfect Breeding Ground’
Cardiff’s Walsh estimates 100 million Indians carry germs that harbor the NDM-1 gene, based on an extrapolation of studies in New Delhi and from neighboring Pakistan.
“It’s not measured, and that’s the problem,” says Klugman, who pinpoints India as the epicenter.
India’s jammed cities, poor sanitation and abundant antibiotics produce an ideal incubator, Harvard’s Moellering says.
“You have almost no control over the prescription of antibiotics,” says Moellering, who has studied drug resistance for four decades. “You have horrible sanitation problems in many parts of the country. You have incredible poverty, and you have crowding. When you put those four things together, it’s the perfect breeding ground for multidrug-resistant bacteria.”
Antibiotics even pollute India’s rivers, streams and soil. The bacteria that thrive in these places do so because they’ve developed resistance to the drugs they encounter. People or animals who ingest the water or soil may become colonized by the resistant germs.
Mining Cipro
Until the government built a pipeline to a modern sewage plant in 2010, the Patancheru Enviro Tech Ltd. treatment facility on some days released the equivalent of 45,000 daily doses of ciprofloxacin into the Isakavagu stream outside Hyderabad in southern India, Swedish researchers reported in 2007. The plant treated wastewater from drug-making factories.
Residue from ciprofloxacin, a mainstay treatment for E. coli infections, was so prevalent in river sediment downstream that lead researcher Joakim Larsson of the University of Gothenburg jokes, “Had ciprofloxacin been a little bit more expensive, we could probably mine it from the ground.”
India’s antibiotics overload is forcing doctors to rely on ever-more-powerful drugs. Many now turn to a class called penicillin-based carbapenems to treat ailments as routine as urinary tract infections, says Grayson, who was editor-in-chief of medical text “Kucer’s The Use of Antibiotics” (Hodder Arnold/ASM Press, 2010).
‘Antibiotic Stewardship’
NDM-1 has rendered even carbapenems useless, sometimes leaving no way to fight infections. Two drugs potentially capable of treating NDM-1 bacteria have toxic side effects in some patients that include an increased risk of death.
“It’s an example of why we need to have good surveillance and why we need to have good antibiotic stewardship,” says Thomas R. Frieden, director of the U.S. Centers for Disease Control and Prevention in Atlanta. “We are looking at the specter of untreatable illness.”
Drugmakers have been slow to respond with new medicines. Most abandoned antibiotic discovery during the past decade, says Karen Bush, a microbiologist at Indiana University in Bloomington. She led teams that developed five bacteria-fighting drugs beginning in the 1970s in laboratories that are now part of AstraZeneca Plc (AZN), Bristol-Myers Squibb Co. (BMY), Johnson & Johnson and Pfizer Inc. (PFE)
Companies instead pursued hypertension and high-cholesterol drugs that patients take for a lifetime rather than a few weeks, she says.
International Uproar
Kumarasamy, the Chennai microbiologist, says he thought he was doing his country a favor when he helped track down the cause of unexplained deaths inside India. Instead, he sparked an international uproar over NDM-1.
Beginning in June 2000, Kumarasamy, now 36, studied bacteria and went from hospital to hospital in Chennai to collect specimens. He says he witnessed a steady increase in difficult-to-treat infections. Patients were dying, and doctors couldn’t identify what type of resistant germs killed them, he says.
“No matter how skilled or intelligent the doctor is, they are helpless when it comes to these infections,” he says over lunch of rice and curry in a noisy Chennai food court. He didn’t keep a tally of the deaths.
Kumarasamy, who received a Bachelor of Science degree from Navarasam Arts & Science College in Tamil Nadu state in 1997, says he began isolating bacteria from the blood, sputum, pus and urine of patients and freezing the samples. He quit his lab job in 2007 to study resistant germs for a doctorate in microbiology at the University of Madras. He’s winding up his thesis on carbapenem-resistant bacteria.
Festering Bedsores
Kumarasamy’s curiosity spiked in 2008 when he realized he was dealing with something totally new. He reached out to Walsh, whose Cardiff lab was at the forefront of international antibiotic resistance research.
Around that time, Walsh was studying the case of a diabetic stroke patient of Indian origin. The man had festering bedsores and had been transferred from New Delhi to his home in Sweden for treatment. When bacteria cultured from his urine and feces evaded more than a dozen drugs, including last-resort carbapenems, Christian G. Giske, a clinical microbiologist at Stockholm’s Karolinska University Hospital, sent the samples to Walsh’s lab.
Stockholm Hotel
In a hotel room in the Swedish capital, Walsh and Giske named the gene that made the bacteria immune to virtually all these antibiotics New Delhi metallo-beta-lactamase-1.
Beta-lactams are a class of antibiotics that includes penicillins, cephalosporins and carbapenems. Beta-lactamase is an enzyme that destroys those drugs. Metallo-beta-lactamases are so named because they contain zinc and destroy carbapenems, the most powerful beta-lactams.
Kumarasamy, suspecting something similar in his own specimens, asked Walsh to share the DNA sequence of this new bacterial gene. Walsh did -- and Kumarasamy got a match.
Kumarasamy began visiting Chennai hospitals anew to look for drug-resistant specimens. He also got samples from researchers in India’s northern Haryana state.
When his collection was added to those Walsh and his colleagues were studying, the researchers discovered the same NDM-1 gene from four countries: India, Pakistan, Bangladesh and the U.K. For most of the British patients, the link was recent travel to India or neighboring Pakistan.
In Kumarasamy’s samples from inside India, many cases emerged in people who hadn’t recently been hospitalized. That suggested the bacteria were spreading in the community.
‘Unsung Hero’
“He is India’s unsung hero,” Walsh says.
The University of Madras initially thought so, too. It feted Kumarasamy after he became the youngest scholar from the 155-year-old institution to have research appear in any publication of the British medical journal “The Lancet.” His August 2010 paper, in “The Lancet Infectious Diseases,” became that publication’s most-read article that year.
The mood soured a few days later. Officials at India’s Ministry of Health & Family Welfarebalked at the gene’s name, which threatened medical tourism’s public image.
“There was a lot of stress and tension, and I could not sleep properly for two months,” says Kumarasamy, who says he developed gastric reflux and heartburn.
The next month, authorities at the ministry grilled the eight Indian contributors to the “Lancet” report, including lead author Kumarasamy, according to two co-authors who declined to be identified because their employers don’t permit them to speak to the media.
‘Batten Down the Hatches’
Officials questioned their data and chastised them for sending specimens overseas without approval, saying the researchers had violated a 13-year-old regulation, according to two in the group.
The Indian Council of Medical Research says it requires researchers to submit detailed proposals to send any bacterial collections abroad. The process may take at least four months.
“The regulations were already in place,” says Sandhya Visweswariah, a professor at the Indian Institute of Science in Bangalore.
The researchers countered that the rules were nebulous and were rarely enforced.
“It is suppression of scientific freedom,” Walsh says of the government behavior. “They just try to batten down the hatches and make everything very, very difficult and pretend nothing has happened.”
Front-Page News
After front-page stories on the superbug appeared in Indian newspapers, the government formed an antibiotic resistance task force. It recommended in April 2011 that antibiotic use be tracked in the country’s 100,000 hospitals to find excessive prescribing. The group advised making it harder to get antibiotics without a prescription by requiring pharmacists to keep records for two years to aid audits and inspections.
Current rules make a prescription mandatory, but regulations are rarely enforced and it’s easy to get potent antibiotics, even intravenous ones, without a doctor’s assent. The group advised enacting rules allowing drug inspectors to immediately cancel the license of pharmacists dispensing unprescribed antibiotics.
Task force member Ganguly says tracking antibiotic use will be difficult.
“How do you regulate 1.2 billion people with so much diversity?” he asks.
Dying Babies
While Kumarasamy was documenting NDM-1 in Chennai hospitals, pediatrician Vipin Vashishtha was discovering how deadly the gene can be.
In June 2010, new father Sanjeev Thakran, 28, rushed his half-hour-old son in a car through monsoon-soaked streets to Vashishtha’s Mangla Children’s Hospital in Bijnor. His wife, Lalita, had delivered baby Tapas in a maternity hospital across town three weeks early, and the infant was laboring for air.
Nurses in green scrubs warmed the 4-pound (1.8-kilogram) newborn in a dome-covered crib and fed him milk and medicines through a nasal tube. About 2 feet away, a frail-looking baby was connected to a ventilator, Sanjeev Thakran says.
Vashishtha, seated on a leather swivel chair in his consulting room, recalls thinking that Tapas might need only a few days of intensive care. Instead, the baby spent weeks in and out of the unit. Blood sometimes trickled from his nose and shriveling umbilicus, according to medical records.
Even though he was being treated with a carbapenem, the most powerful class of antibiotic, bacteria raged inside his tiny lungs and bloodstream, eventually attacking membranes covering his brain and spinal cord.
Incurable Scourge
Other infants in the eight-crib neonatal intensive care unit were suffering, too. Vashishtha, 48, had tried several antibiotics without success. When carbapenems didn’t work, he says, he felt helpless because he knew he was dealing with a potentially incurable scourge.
Tapas died 11 weeks after he was admitted. Lab results identified the culprit a month later: NDM-1. The gene was in bacteria known as Klebsiella pneumoniae. The germ exists in people’s gastrointestinal tract and can cause pneumonia and urinary-tract infections in hospital patients.
The lab also found two soil-borne species that normally cause trivial infections but that were suddenly becoming killers.
Tapas was one of 14 infants at the hospital who were infected with NDM-1-containing bacteria over the course of 17 months. Six of the babies died. Among the eight survivors, half developed meningitis, arthritis or water on the brain, Vashishtha wrote to an Indian medical journal in February 2011.
‘Horrific Period’
“It was the most horrific period,” Vashishtha says as he fixes his eyes on the playpen where he amuses children in his office. “I was losing neonates at regular intervals. I suspected we were dealing with something quite different, something quite new.”
Vashishtha says he has improved infection control, walling off part of the ICU for contagious, complicated cases.
He can’t, however, control what happens outside his hospital. Sewage from nearby homes flows in an open drain along one wall of the two-story building.
Bijnor, like other small cities in Uttar Pradesh, lacks a modern underground drainage system. During the rainy season, it’s impossible not to wade through sewage water, the doctor says.
‘Wash Hands Properly’
So far, Vashishtha has prevented more NDM-1 deaths. He fumigates his wards every four weeks and applies fresh paint every three months. He keeps hand-sanitizing liquid in his office, along the corridors and next to every bed in intensive care. Nurses must wash their hands with running water and soap and scrub with an antimicrobial sanitizer before handling patients.
“The first and foremost step to avoiding hospital-acquired infection is to wash hands properly,” he says.
India’s major hospitals are marshaling tactics from common cleanliness to computerized databases to outsmart resistant bacteria and prevent more tragedies.
Artemis Health Institute, a private, 300-bed specialty hospital in Gurgaon, southwest of New Delhi, employs an infection-control officer who collects data every month on the hospital’s four most troublesome bacteria to review patterns of drug resistance. The officer, Namita Jaggi, also serves as national secretary of a Buenos Aires-based group that collates infection information worldwide.
‘Infection Surveillance 24/7’
About 3 miles (4.8 kilometers) away, cardiac surgeon Naresh Trehan’s medical complex,Medanta-The Medicity, requires patients transferring from other hospitals to be screened for resistant bacteria. This procedure, routine in some Nordic countries, isn’t standard in India.
Medanta has a strict hand-washing policy and a 40-member team to monitor infections, says Trehan, 65, who trained in cardiac surgery at New York University and worked at Bellevue Hospital in Manhattan before returning to India in 1988.
“We have a very senior person whose sole responsibility is to keep the whole hospital under infection surveillance 24/7,” he says.
Livermore at the U.K.’s Health Protection Agency says these efforts may not be enough in a country where 626 million people defecate in the open and that treats only 30 percent of the 10.1 billion gallons of sewage generated each day. Even the most modern hospitals can’t exist as islands of cleanliness, he says.
“How does the hospital -- however good its surgeons and physicians -- isolate itself when its patients, staff and food all come from outside, where they are exposed to this soup of resistance?” he asks.
‘Hope for the Future’
Bush, the antibiotics researcher, has been investigating novel ways to fight bacteria since 1977. She says combinations of existing drugs, including an experimental compound from AstraZeneca in late-stage patient studies, may neutralize some carbapenem-destroying enzymes.
Should these mixtures pan out, they may help the superdrugs regain at least some of their potency, potentially extending their usefulness for a decade or more, she says.
A drug candidate from Basel, Switzerland-based Basilea Pharmaceutica AG (BSLN) in early-stage trials shows some promise against NDM-1, she says.
“What’s frustrating is to see that companies refused to address the issue until the last few years,” Bush says. “There are still some that are trying, and that’s the hope for the future.”
‘Very Cautious’
Drugs that could once again tackle the world’s most resistant germs would be a relief for people worldwide, Norway’s Skaret among them. She spent more than six months fearing a microbial time bomb until she learned that the NDM-1 supergerms had passed from her system.
Even though she escaped physical harm, Skaret says, NDM-1 made her feel isolated. She says therapists, concerned about their own exposure, refused to help her with rehabilitation to recover from the car accident. Neighbors who delivered food were careful not to get too close.
“When they heard about it, they were very cautious,” she says.
If Walsh’s projection is accurate, 100 million Indians may be carrying the NDM-1 gene unwittingly and doing little to contain its spread. The number of countries reporting NDM-1 will continue to grow as more bacteria pick up the gene and people transport it around the globe.
To prevent a worldwide catastrophe, microbiologists Kumarasamy and Walsh -- along with scores of scientists and doctors inside and outside India -- are sounding an alarm.
“Combine sophisticated medicine, poor sanitation and heavy antibiotic usage, and you have a rocket fuel to drive the accumulation of resistance,” Livermore says. “That surely is what India has created.”
The gene may even spread to the microbial cause of bubonic plague, the medieval scourge known as Black Death that still persists in pockets of the globe.
“It’s a matter of time and chance,” says Mark Toleman, a molecular geneticist at Cardiff University. Plasmids carrying the NDM-1 gene can easily be inserted into the genetic material of Yersinia pestis, the cause of plague, making the infection harder to treat, Toleman says.
“There is a tsunami that’s going to happen in the next year or two when antibiotic resistance explodes,” says Ghafur, 40, seated at a polished wooden table in a consulting room in Chennai as patients fill 20 metal chairs in the waiting area, forcing others into the corridor. “We need wartime measures to deal with this now.”
R.K. Srivastava, India’s former director general of health services, says the government is giving top priority to antimicrobial resistance, including increasing surveillance of hospitals’ antibiotics use.
Name Shame
At the same time, it’s trying to preserve the country’s health-tourism industry. Bristling that foreigners coined a name that singles out their capital to describe an emerging health nightmare, officials say the world is picking on India for troubles that impede all developing nations.
When Indian researchers joined international teams studying the NDM-1 gene, the government questioned the data and methods of the scientists, among them Chennai microbiologist Karthikeyan K. Kumarasamy.
“These bacteria were present globally,” says Nirmal K. Ganguly, a former director general of the Indian Council of Medical Research and one of 13 members of a government task force created in September 2010 to respond to the NDM-1 threat.
“When you are blamed, the only reaction is that you put your back to the wall and fight.”
Ulterior Motive?
S.S. Ahluwalia, a former deputy opposition leader in the upper house of India’s parliament and a member of the Bharatiya Janata Party, says Western rivals want to muscle in on the medical tourism industry. Josef Woodman, founder of the guidebook “Patients Beyond Borders,” values the industry globally at $54 billion a year.
“These reports are meant to destabilize India’s emergence as a health destination,” says Ahluwalia, whose term ended in April.
About 850,000 medical tourists traveled to India in 2010 for treatments from lifesaving cancer operations to cosmetic surgeries, generating $872 million in revenue, according to the Associated Chambers of Commerce and Industry of India, or Assocham. The number of foreign patients is predicted to almost quadruple by 2015, the trade body says.
Manish Kakkar, a doctor researching infectious diseases at the New Delhi-based Public Health Foundation of India and a task force member, says the government has its priorities wrong.
“We have been in a phase of denial,” he says. “Rather than responding to the situation scientifically, we’ve completely diverted attention, saying that it’s attacking our medical tourism.”
‘That’s What’s Scary’
Kakkar and others worry about NDM-1 because unlike germs such as VRE, short for the vancomycin-resistant enterococci bug that can cause infection around a patient’s surgical incision, NDM-1 is spreading beyond hospitals.
Two travelers from the Netherlands picked up an NDM-1 bug in their bowels after visiting India in 2009 although they hadn’t received medical care there, says Maurine Leverstein-van Hall, a clinical microbiologist at the University Medical Center in the Dutch city of Utrecht.
“That’s what’s scary,” she says. “It’s not just surgery or being near a hospital. In some way, you get it through the food chain or through the water.”
For now, it’s impossible to tell how common NDM-1 infections are or how often the mutant germs kill because testing and surveillance are inadequate in developing countries, says Keith Klugman, the William H. Foege chair of global health at Emory University’s Rollins School of Public Health in Atlanta.
‘Perfect Breeding Ground’
Cardiff’s Walsh estimates 100 million Indians carry germs that harbor the NDM-1 gene, based on an extrapolation of studies in New Delhi and from neighboring Pakistan.
“It’s not measured, and that’s the problem,” says Klugman, who pinpoints India as the epicenter.
India’s jammed cities, poor sanitation and abundant antibiotics produce an ideal incubator, Harvard’s Moellering says.
“You have almost no control over the prescription of antibiotics,” says Moellering, who has studied drug resistance for four decades. “You have horrible sanitation problems in many parts of the country. You have incredible poverty, and you have crowding. When you put those four things together, it’s the perfect breeding ground for multidrug-resistant bacteria.”
Antibiotics even pollute India’s rivers, streams and soil. The bacteria that thrive in these places do so because they’ve developed resistance to the drugs they encounter. People or animals who ingest the water or soil may become colonized by the resistant germs.
Mining Cipro
Until the government built a pipeline to a modern sewage plant in 2010, the Patancheru Enviro Tech Ltd. treatment facility on some days released the equivalent of 45,000 daily doses of ciprofloxacin into the Isakavagu stream outside Hyderabad in southern India, Swedish researchers reported in 2007. The plant treated wastewater from drug-making factories.
Residue from ciprofloxacin, a mainstay treatment for E. coli infections, was so prevalent in river sediment downstream that lead researcher Joakim Larsson of the University of Gothenburg jokes, “Had ciprofloxacin been a little bit more expensive, we could probably mine it from the ground.”
India’s antibiotics overload is forcing doctors to rely on ever-more-powerful drugs. Many now turn to a class called penicillin-based carbapenems to treat ailments as routine as urinary tract infections, says Grayson, who was editor-in-chief of medical text “Kucer’s The Use of Antibiotics” (Hodder Arnold/ASM Press, 2010).
‘Antibiotic Stewardship’
NDM-1 has rendered even carbapenems useless, sometimes leaving no way to fight infections. Two drugs potentially capable of treating NDM-1 bacteria have toxic side effects in some patients that include an increased risk of death.
“It’s an example of why we need to have good surveillance and why we need to have good antibiotic stewardship,” says Thomas R. Frieden, director of the U.S. Centers for Disease Control and Prevention in Atlanta. “We are looking at the specter of untreatable illness.”
Drugmakers have been slow to respond with new medicines. Most abandoned antibiotic discovery during the past decade, says Karen Bush, a microbiologist at Indiana University in Bloomington. She led teams that developed five bacteria-fighting drugs beginning in the 1970s in laboratories that are now part of AstraZeneca Plc (AZN), Bristol-Myers Squibb Co. (BMY), Johnson & Johnson and Pfizer Inc. (PFE)
Companies instead pursued hypertension and high-cholesterol drugs that patients take for a lifetime rather than a few weeks, she says.
International Uproar
Kumarasamy, the Chennai microbiologist, says he thought he was doing his country a favor when he helped track down the cause of unexplained deaths inside India. Instead, he sparked an international uproar over NDM-1.
Beginning in June 2000, Kumarasamy, now 36, studied bacteria and went from hospital to hospital in Chennai to collect specimens. He says he witnessed a steady increase in difficult-to-treat infections. Patients were dying, and doctors couldn’t identify what type of resistant germs killed them, he says.
“No matter how skilled or intelligent the doctor is, they are helpless when it comes to these infections,” he says over lunch of rice and curry in a noisy Chennai food court. He didn’t keep a tally of the deaths.
Kumarasamy, who received a Bachelor of Science degree from Navarasam Arts & Science College in Tamil Nadu state in 1997, says he began isolating bacteria from the blood, sputum, pus and urine of patients and freezing the samples. He quit his lab job in 2007 to study resistant germs for a doctorate in microbiology at the University of Madras. He’s winding up his thesis on carbapenem-resistant bacteria.
Festering Bedsores
Kumarasamy’s curiosity spiked in 2008 when he realized he was dealing with something totally new. He reached out to Walsh, whose Cardiff lab was at the forefront of international antibiotic resistance research.
Around that time, Walsh was studying the case of a diabetic stroke patient of Indian origin. The man had festering bedsores and had been transferred from New Delhi to his home in Sweden for treatment. When bacteria cultured from his urine and feces evaded more than a dozen drugs, including last-resort carbapenems, Christian G. Giske, a clinical microbiologist at Stockholm’s Karolinska University Hospital, sent the samples to Walsh’s lab.
Stockholm Hotel
In a hotel room in the Swedish capital, Walsh and Giske named the gene that made the bacteria immune to virtually all these antibiotics New Delhi metallo-beta-lactamase-1.
Beta-lactams are a class of antibiotics that includes penicillins, cephalosporins and carbapenems. Beta-lactamase is an enzyme that destroys those drugs. Metallo-beta-lactamases are so named because they contain zinc and destroy carbapenems, the most powerful beta-lactams.
Kumarasamy, suspecting something similar in his own specimens, asked Walsh to share the DNA sequence of this new bacterial gene. Walsh did -- and Kumarasamy got a match.
Kumarasamy began visiting Chennai hospitals anew to look for drug-resistant specimens. He also got samples from researchers in India’s northern Haryana state.
When his collection was added to those Walsh and his colleagues were studying, the researchers discovered the same NDM-1 gene from four countries: India, Pakistan, Bangladesh and the U.K. For most of the British patients, the link was recent travel to India or neighboring Pakistan.
In Kumarasamy’s samples from inside India, many cases emerged in people who hadn’t recently been hospitalized. That suggested the bacteria were spreading in the community.
‘Unsung Hero’
“He is India’s unsung hero,” Walsh says.
The University of Madras initially thought so, too. It feted Kumarasamy after he became the youngest scholar from the 155-year-old institution to have research appear in any publication of the British medical journal “The Lancet.” His August 2010 paper, in “The Lancet Infectious Diseases,” became that publication’s most-read article that year.
The mood soured a few days later. Officials at India’s Ministry of Health & Family Welfarebalked at the gene’s name, which threatened medical tourism’s public image.
“There was a lot of stress and tension, and I could not sleep properly for two months,” says Kumarasamy, who says he developed gastric reflux and heartburn.
The next month, authorities at the ministry grilled the eight Indian contributors to the “Lancet” report, including lead author Kumarasamy, according to two co-authors who declined to be identified because their employers don’t permit them to speak to the media.
‘Batten Down the Hatches’
Officials questioned their data and chastised them for sending specimens overseas without approval, saying the researchers had violated a 13-year-old regulation, according to two in the group.
The Indian Council of Medical Research says it requires researchers to submit detailed proposals to send any bacterial collections abroad. The process may take at least four months.
“The regulations were already in place,” says Sandhya Visweswariah, a professor at the Indian Institute of Science in Bangalore.
The researchers countered that the rules were nebulous and were rarely enforced.
“It is suppression of scientific freedom,” Walsh says of the government behavior. “They just try to batten down the hatches and make everything very, very difficult and pretend nothing has happened.”
Front-Page News
After front-page stories on the superbug appeared in Indian newspapers, the government formed an antibiotic resistance task force. It recommended in April 2011 that antibiotic use be tracked in the country’s 100,000 hospitals to find excessive prescribing. The group advised making it harder to get antibiotics without a prescription by requiring pharmacists to keep records for two years to aid audits and inspections.
Current rules make a prescription mandatory, but regulations are rarely enforced and it’s easy to get potent antibiotics, even intravenous ones, without a doctor’s assent. The group advised enacting rules allowing drug inspectors to immediately cancel the license of pharmacists dispensing unprescribed antibiotics.
Task force member Ganguly says tracking antibiotic use will be difficult.
“How do you regulate 1.2 billion people with so much diversity?” he asks.
Dying Babies
While Kumarasamy was documenting NDM-1 in Chennai hospitals, pediatrician Vipin Vashishtha was discovering how deadly the gene can be.
In June 2010, new father Sanjeev Thakran, 28, rushed his half-hour-old son in a car through monsoon-soaked streets to Vashishtha’s Mangla Children’s Hospital in Bijnor. His wife, Lalita, had delivered baby Tapas in a maternity hospital across town three weeks early, and the infant was laboring for air.
Nurses in green scrubs warmed the 4-pound (1.8-kilogram) newborn in a dome-covered crib and fed him milk and medicines through a nasal tube. About 2 feet away, a frail-looking baby was connected to a ventilator, Sanjeev Thakran says.
Vashishtha, seated on a leather swivel chair in his consulting room, recalls thinking that Tapas might need only a few days of intensive care. Instead, the baby spent weeks in and out of the unit. Blood sometimes trickled from his nose and shriveling umbilicus, according to medical records.
Even though he was being treated with a carbapenem, the most powerful class of antibiotic, bacteria raged inside his tiny lungs and bloodstream, eventually attacking membranes covering his brain and spinal cord.
Incurable Scourge
Other infants in the eight-crib neonatal intensive care unit were suffering, too. Vashishtha, 48, had tried several antibiotics without success. When carbapenems didn’t work, he says, he felt helpless because he knew he was dealing with a potentially incurable scourge.
Tapas died 11 weeks after he was admitted. Lab results identified the culprit a month later: NDM-1. The gene was in bacteria known as Klebsiella pneumoniae. The germ exists in people’s gastrointestinal tract and can cause pneumonia and urinary-tract infections in hospital patients.
The lab also found two soil-borne species that normally cause trivial infections but that were suddenly becoming killers.
Tapas was one of 14 infants at the hospital who were infected with NDM-1-containing bacteria over the course of 17 months. Six of the babies died. Among the eight survivors, half developed meningitis, arthritis or water on the brain, Vashishtha wrote to an Indian medical journal in February 2011.
‘Horrific Period’
“It was the most horrific period,” Vashishtha says as he fixes his eyes on the playpen where he amuses children in his office. “I was losing neonates at regular intervals. I suspected we were dealing with something quite different, something quite new.”
Vashishtha says he has improved infection control, walling off part of the ICU for contagious, complicated cases.
He can’t, however, control what happens outside his hospital. Sewage from nearby homes flows in an open drain along one wall of the two-story building.
Bijnor, like other small cities in Uttar Pradesh, lacks a modern underground drainage system. During the rainy season, it’s impossible not to wade through sewage water, the doctor says.
‘Wash Hands Properly’
So far, Vashishtha has prevented more NDM-1 deaths. He fumigates his wards every four weeks and applies fresh paint every three months. He keeps hand-sanitizing liquid in his office, along the corridors and next to every bed in intensive care. Nurses must wash their hands with running water and soap and scrub with an antimicrobial sanitizer before handling patients.
“The first and foremost step to avoiding hospital-acquired infection is to wash hands properly,” he says.
India’s major hospitals are marshaling tactics from common cleanliness to computerized databases to outsmart resistant bacteria and prevent more tragedies.
Artemis Health Institute, a private, 300-bed specialty hospital in Gurgaon, southwest of New Delhi, employs an infection-control officer who collects data every month on the hospital’s four most troublesome bacteria to review patterns of drug resistance. The officer, Namita Jaggi, also serves as national secretary of a Buenos Aires-based group that collates infection information worldwide.
‘Infection Surveillance 24/7’
About 3 miles (4.8 kilometers) away, cardiac surgeon Naresh Trehan’s medical complex,Medanta-The Medicity, requires patients transferring from other hospitals to be screened for resistant bacteria. This procedure, routine in some Nordic countries, isn’t standard in India.
Medanta has a strict hand-washing policy and a 40-member team to monitor infections, says Trehan, 65, who trained in cardiac surgery at New York University and worked at Bellevue Hospital in Manhattan before returning to India in 1988.
“We have a very senior person whose sole responsibility is to keep the whole hospital under infection surveillance 24/7,” he says.
Livermore at the U.K.’s Health Protection Agency says these efforts may not be enough in a country where 626 million people defecate in the open and that treats only 30 percent of the 10.1 billion gallons of sewage generated each day. Even the most modern hospitals can’t exist as islands of cleanliness, he says.
“How does the hospital -- however good its surgeons and physicians -- isolate itself when its patients, staff and food all come from outside, where they are exposed to this soup of resistance?” he asks.
‘Hope for the Future’
Bush, the antibiotics researcher, has been investigating novel ways to fight bacteria since 1977. She says combinations of existing drugs, including an experimental compound from AstraZeneca in late-stage patient studies, may neutralize some carbapenem-destroying enzymes.
Should these mixtures pan out, they may help the superdrugs regain at least some of their potency, potentially extending their usefulness for a decade or more, she says.
A drug candidate from Basel, Switzerland-based Basilea Pharmaceutica AG (BSLN) in early-stage trials shows some promise against NDM-1, she says.
“What’s frustrating is to see that companies refused to address the issue until the last few years,” Bush says. “There are still some that are trying, and that’s the hope for the future.”
‘Very Cautious’
Drugs that could once again tackle the world’s most resistant germs would be a relief for people worldwide, Norway’s Skaret among them. She spent more than six months fearing a microbial time bomb until she learned that the NDM-1 supergerms had passed from her system.
Even though she escaped physical harm, Skaret says, NDM-1 made her feel isolated. She says therapists, concerned about their own exposure, refused to help her with rehabilitation to recover from the car accident. Neighbors who delivered food were careful not to get too close.
“When they heard about it, they were very cautious,” she says.
If Walsh’s projection is accurate, 100 million Indians may be carrying the NDM-1 gene unwittingly and doing little to contain its spread. The number of countries reporting NDM-1 will continue to grow as more bacteria pick up the gene and people transport it around the globe.
To prevent a worldwide catastrophe, microbiologists Kumarasamy and Walsh -- along with scores of scientists and doctors inside and outside India -- are sounding an alarm.
“Combine sophisticated medicine, poor sanitation and heavy antibiotic usage, and you have a rocket fuel to drive the accumulation of resistance,” Livermore says. “That surely is what India has created.”
