Clinton receiving blood thinners to dissolve clot

WASHINGTON (AP) — Doctors treating Secretary of State Hillary Rodham Clinton for a blood clot in her head said blood thinners are being used to dissolve the clot and they are confident she will make a full recovery.

Clinton didn’t suffer a stroke or neurological damage from the clot that formed after she suffered a concussion during a fainting spell at her home in early December, doctors said in a statement Monday.

Clinton, 65, was admitted to New York-Presbyterian Hospital on Sunday when the clot turned up on a follow-up exam on the concussion, Clinton spokesman Phillipe Reines said.

The clot is located in the vein in the space between the brain and the skull behind the right ear. She will be released once the medication dose for the blood thinners has been established, the doctors said.

In their statement, Dr. Lisa Bardack of the Mount Kisco Medical Group and Dr. Gigi El-Bayoumi of George Washington University said Clinton was making excellent progress and was in good spirits.

Clinton’s complication “certainly isn’t the most common thing to happen after a concussion” and is one of the few types of blood clots in the skull or head that are treated with blood thinners, said Dr. Larry Goldstein, a neurologist who is director of Duke University’s stroke center. He is not involved in Clinton’s care.

The area where Clinton’s clot developed is “a drainage channel, the equivalent of a big vein inside the skull. It’s how the blood gets back to the heart,” Goldstein said.

Blood thinners usually are enough to treat the clot and it should have no long-term consequences if her doctors are saying she has suffered no neurological damage from it, Goldstein said.

Clinton returned to the U.S. from a trip to Europe, then fell ill with a stomach virus in early December that left her severely dehydrated and forced her to cancel a trip to North Africa and the Middle East. Until then, she had canceled only two scheduled overseas trips, one to Europe after breaking her elbow in June 2009 and one to Asia after the February 2010 earthquake in Haiti.

Her condition worsened when she fainted, fell and suffered a concussion while at home alone in mid-December as she recovered from the virus. It was announced Dec. 13.

This isn’t the first time Clinton has suffered a blood clot. In 1998, midway through her husband’s second term as president, Clinton was in New York fundraising for the midterm elections when a swollen right foot led her doctor to diagnose a clot in her knee requiring immediate treatment.

Clinton had planned to step down as secretary of state at the beginning of President Barack Obama’s second term. Whether she will return to work before she resigns remained a question.

Democrats are privately if not publicly speculating: How might her illness affect a decision about running for president in 2016?

After decades in politics, Clinton says she plans to spend the next year resting. She has long insisted she had no intention of mounting a second campaign for the White House four years from now. But the door is not entirely closed, and she would almost certainly emerge as the Democrat to beat if she decided to give in to calls by Democratic fans and run again.

Her age — and thereby health — would probably be a factor under consideration, given that Clinton would be 69 when sworn in, if she were elected in 2016. That might become even more of an issue in the early jockeying for 2016 if what started as a bad stomach bug becomes a prolonged, public bout with more serious infirmity.

Not that Democrats are willing to talk openly about the political implications of a long illness, choosing to keep any discussions about her condition behind closed doors. Publicly, Democrats reject the notion that a blood clot could hinder her political prospects.

“Some of those concerns could be borderline sexist,” said Basil Smikle, a Democratic strategist who worked for Clinton when she was a senator. “Dick Cheney had significant heart problems when he was vice president, and people joked about it. He took the time he needed to get better, and it wasn’t a problem.”

It isn’t uncommon for presidential candidates’ health — and age — to be an issue. Both in 2000 and 2008, Sen. John McCain, R-Ariz., had to rebut concerns he was too old to be commander in chief or that his skin cancer could resurface.

Two decades after Clinton became the first lady, signs of her popularity — and her political strength — are ubiquitous.

Obama had barely declared victory in November when Democrats started zealously plugging Clinton as their strongest White House contender four years from now, should she choose to take that leap.

“Wouldn’t that be exciting?” House Democratic leader Nancy Pelosi declared in December. “I hope she goes. Why wouldn’t she?”

Even Republicans concede that were she to run, Clinton would be a force to be reckoned with.

“Trying to win that will be truly the Super Bowl,” Newt Gingrich, the former House Speaker and 2012 GOP presidential candidate, said in December. “The Republican Party today is incapable of competing at that level.”

Americans admire Clinton more than any other woman in the world, according to a Gallup poll released Monday — the 17th time in 20 years that Clinton has claimed that title. And a recent ABC News/Washington Post poll found that 57 percent of Americans would support Clinton as a candidate for president in 2016, with just 37 percent opposed. Websites have already cropped up hawking “Clinton 2016″ mugs and tote bags.

Beyond talk of future politics, Clinton’s three-week absence from the State Department has raised eyebrows among some conservative commentators who questioned the seriousness of her ailment after she canceled planned Dec. 20 testimony before Congress on the deadly attack on the U.S. diplomatic mission in Benghazi, Libya.

Clinton had been due to discuss with lawmakers a scathing report she had commissioned on the attack. It found serious failures of leadership and management in two State Department bureaus were to blame for insufficient security at the facility. Clinton took responsibility for the incident before the report was released, but she was not blamed. Four officials cited in the report have either resigned or been reassigned.

___

Associated Press writer Ken Thomas in Washington and AP Chief Medical Writer Marilynn Marchione in Milwaukee contributed to this report.

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Senate passes 'fiscal cliff' deal, House up next

With 2013 just over two hours old, the Senate voted 89-8 on Tuesday to
approve a last-minute deal to avert income tax hikes on all but the
richest Americans and stall painful spending cuts as part of a
hard-fought compromise to avoid the economically toxic “fiscal cliff.”

The country had already technically tumbled over the cliff by the time the gavel came down on the vote at 2:07 a.m.. The House of Representatives was not due to return to work to take up the measure until midday on Tuesday. But with financial markets closed for New Year's Day, quick action by lawmakers would likely limit the economic damage.

The lopsided margin belied anxiety on both sides about the deal, which emerged from barely two days of talks between Vice President Joe Biden and Republican Senate Minority Leader Mitch McConnell. Among the “no” votes: Republican Senator Marco Rubio, widely thought to have his eye on the 2016 presidential race.

In remarks just before the vote, McConnell repeatedly called the agreement “imperfect” but said it beat allowing income tax rates rise across the board.

“I know I can speak for my entire conference when I say we don’t think taxes should be going up on anyone, but we all knew that if we did nothing they’d be going up on everyone today,” he said. “We weren’t going to let that happen.”

“Our most important priority was to protect middle-class families. This legislation does that,” Democratic Senate Majority Leader Harry Reid said. But Reid cautioned that “passing this agreement does not mean negotiations halt. Far from it.”

Compromises on tax rates

Under the compromise arrangement, taxes would rise on income above $400,000 for individuals and $450,000 for households, while exemptions and deductions the wealthiest Americans use to reduce their tax bill would face new limits. The accord would also raise the taxes paid on large inheritances from 35% to 40% for estates over $5 million. And it would extend by one year unemployment benefits for some two million Americans. It would also prevent cuts in payments to doctors who treat Medicare patients and spare tens of millions of Americans who otherwise would have been hit with the Alternative Minimum Tax.

The middle class will still see its taxes go up: The final deal did not include an extension of the payroll tax holiday. And the overall package will deepen the deficit by hundreds of billions of dollars by extending the overwhelming majority of the Bush tax cuts. Many Democrats had opposed those measures in 2001 and 2003. Obama agreed to extend them in 2010.

Efforts to modify the first installment of $1.2 trillion in cuts to domestic and defense programs over 10 years -- the other portion of the “fiscal cliff,” known as sequestration -- had proved a sticking point late in the game. Democrats had sought a year-long freeze but ultimately caved to Republican pressure and signed on to just a two-month delay while broader deficit-reduction talks continue.

Debt-limit battle looms

That would put the next major battle over spending cuts right around the time that the White House and its Republican foes are battling it out over whether to raise the country's debt limit. Republicans have vowed to push for more spending cuts, equivalent to the amount of new borrowing. Obama has vowed not to negotiate as he did in 2011, when a bruising fight threatened the first-ever default on America's obligations and resulted in the first-ever downgrade of the country's credit rating. Biden sent that message to Democrats in Congress, two senators said.

Experts had warned that the fiscal cliff's tax increases and spending cuts, taken together, could plunge the still-fragile economy into a new recession.

Biden, evidently in good spirits after playing a central role in crafting the deal, said little on his way into or out of a roughly one hour and 45 minute meeting behind closed doors with Senate Democrats. "Happy New Year," he said on the way in. Asked on the way out what his chief selling point had been, the vice president reportedly replied: "Me."

Biden's intervention; hurdles in the House

Hours earlier, a Democratic Senate aide told Yahoo News that "the White House and Republicans have a deal," while a source familiar with the negotiations said President Barack Obama had discussed the compromise with Reid and Democratic House Minority Leader Nancy Pelosi and "they both signed off."

But the House’s Republican leaders, including Speaker John Boehner, hinted in an unusual joint statement that they might amend anything that clears the Senate – a step that could kill the deal.

“Decisions about whether the House will seek to accept or promptly amend the measure will not be made until House members -- and the American people -- have been able to review the legislation,” they said.

Biden, a 36-year Senate veteran, worked out the agreement with McConnell after talks between Obama and Boehner collapsed and a similar effort between McConnell and Reid followed suit shortly thereafter. With the deal mostly done, Obama made a final push at the White House.

“Today, it appears that an agreement to prevent this New Year's tax hike is within sight, but it's not done,” Obama said in hastily announced midday remarks at the White House. “There are still issues left to resolve, but we're hopeful that Congress can get it done – but it’s not done.”

"One thing we can count on with respect to this Congress is that if there is even one second left before you have to do what you’re supposed to do, they will use that last second," he said.

Obama’s remarks – by turns scolding, triumphant, and mocking of Congress – came after talks between McConnell and Biden appeared to seal the breakthrough deal.

“I can report that we’ve reached an agreement on all of the tax issues,” McConnell said on the Senate floor moments later. “We are very, very close to an agreement.”

The Kentucky Republican later briefed Republicans on the details of the deal. Lawmakers emerged from that closed-door session offered hopeful appraisals that, after clearing a few last-minute hurdles, they could vote on New Year’s Eve or with 2013 just hours old.

“Tonight, I hope,” Republican Senator Bob Corker of Tennessee told reporters. “It may be at 1, 2, 3, 4 in the morning. Oh, I guess that’s technically tomorrow.”

Reckoning with the 'sequester'

Republican Senators said negotiators were still working on a way to forestall two months of the “sequester” spending cuts, about $20 billion worth. And some expressed disquiet that the tentative compromise ran high on tax increases and low on spending cuts -- while warning that failure to act, triggering some $600 billion in income tax increases on all Americans who pay it and draconian spending cuts, was the worse option.

McConnell earlier had called for a vote on the tax component of the deal.

“Let me be clear: We’ll continue to work on finding smarter ways to cut spending, but let’s not let that hold up protecting Americans from the tax hike,” McConnell urged. “Let’s pass the tax relief portion now. Let’s take what’s been agreed to and get moving.”

House passage was not a sure thing: Both the AFL-CIO labor union and the conservative Heritage Action organization argued against the package.

The breakthrough came after McConnell announced Sunday that he had started to negotiate with Biden in a bid to "jump-start" stalled talks to avoid the fiscal cliff.

Under their tentative deal, the top tax rate on household income above $450,000 would rise from 35 percent to 39.6 percent -- where it was under Bill Clinton, before the reductions enacted under George W. Bush in 2001 and 2003.

Some congressional liberals had expressed objections to extending tax cuts above the $250,000 income threshold Obama cited throughout the 2012 campaign. Democrats were huddling in private as well to work out whether they could support the arrangement.

Obama responds to critics

Possibly with balking progressives in mind, Obama trumpeted victories dear to the left of his party. "The potential agreement that’s being talked about would not only make sure the taxes don’t go up on middle-class families, it also would extend tax credits for families with children. It would extend our tuition tax credit that’s helped millions of families pay for college. It would extend tax credits for clean energy companies that are creating jobs and reducing our dependence on foreign oil. It would extend unemployment insurance to 2 million Americans who are out there still actively looking for a job."

Obama said he had hoped for "a larger agreement, a bigger deal, a grand bargain," to stem the tide of red ink swamping the country’s finances – but shelved that goal.

"With this Congress, that was obviously a little too much to hope for at this time," he said. "It may be we can do it in stages. We’re going to solve this problem instead in several steps."

The president also looked ahead to his next budgetary battle with Republicans, warning that “any future deficit agreement” will have to couple spending cuts with tax increases. He expressed a willingness to reduce spending on popular programs like Medicare, but said entitlement reform would have to go hand in hand with new tax revenues.

“If Republicans think that I will finish the job of deficit reduction through spending cuts alone … then they’ve another thing coming,” Obama said defiantly. “That’s not how it’s going to work.”

“If we’re serious about deficit reduction and debt reduction, then it’s going to have to be a matter of shared sacrifice. At least as long as I’m president. And I’m going to be president for the next four years, I hope,” he said.

The other “no” votes were: Michael Bennet (D-Col.), Tom Carper (D-Del.), Chuck Grassley (R-Iowa), Tom Harkin (D-Iowa), Mike Lee (R-Utah), Rand Paul (R-Ken.), and Richard Shelby (R-Ala.). Republicans Jim DeMint of South Carolina and Mark Kirk of Illinois as well as Democrat Frank Lautenberg of New Jersey did not vote.

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Canadian job creation seen sharply lower in December

OTTAWA (Reuters) – Canada‘s job market is expected to slow markedly in December to reflect the sluggish economy and employers’ fears about the U.S. fiscal crisis following outsized gains of over 50,000 jobs in two of the previous three months.

The median forecast in a Reuters poll is for the economy to add just 5,000 jobs in the month, with forecasts ranging from a loss of 20,000 positions to a gain of 21,000.

The forecast compares with employment growth of 59,600 in November, 1,800 in October and 52,100 in September.

The unemployment rate is seen ticking higher in the final month of the year to 7.3 percent from 7.2 percent.

Derek Holt, vice president of economics at Scotiabank, said he’s been surprised by the strength of job growth which he estimates to be the equivalent in the United States of about 1.5 million non-farm payroll jobs over the last three months.

“Here we are with the conundrum where we have zero growth in the Canadian economy, long predating the appearance of the greatest fiscal-cliff risks and yet we’re heaping on jobs like there’s no tomorrow,” Holt said.

Unlike the United States, Canada has long recovered all the jobs lost during the 2008-09 recession but the pace of hiring in 2012 was unsteady.

Benjamin Reitzes, economist at BMO Capital Markets, said if the 5,000-job forecast was accurate, it would put 2012 job growth at just 1.1 percent, “the weakest non-recession year since 1996.”

Canadian employers have faced uncertainty in one form or another during the recovery and are now fretting about the U.S. fiscal cliff, a set of tax hikes and spending cuts that will automatically take effect and could throw the United States into recession unless the White House and Congress reach an alternative agreement.

“For as long as Washington cannot agree on the new tax rules and spending focus, they’re not going to give business the confidence to go out and hire and engage in capital spending projects and that’s going to impede the pace of recovery until we get more clarity,” said Holt.

With the Canadian economy now expected to grow by far less in the fourth quarter than the Bank of Canada‘s projection of 2.5 percent, annualized, the blockbuster jobs growth of recent months looks suspect. The six-month trend shows more sustainable gains of about 21,000 a month.

The moderation means the Bank of Canada will be in no hurry to raise its benchmark interest rate, which it has held at 1.0 percent since September 2010.

Market players surveyed by Reuters in late November predicted the bank would resume hiking rates in the fourth quarter of 2013.

(Reporting by Louise Egan; Editing by Kenneth Barry)

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Vomiting Larry battles “Ferrari of the virus world”

LONDON (Reuters) – Poor Larry isn’t looking too good. He’s pale and clammy and he’s been projectile vomiting over and over again while his carers just stand by and watch.

Yet their lack of concern for Larry is made up for by their intense interest in how far splashes of his vomit can fly, and how effectively they evade attempts to clean them up.

Larry is a “humanoid simulated vomiting system” designed to help scientists analyze contagion. And like millions around the world right now, he’s struggling with norovirus – a disease one British expert describes as “the Ferrari of the virus world”.

“Norovirus is one of the most infectious viruses of man,” said Ian Goodfellow, a professor of virology at the department of pathology at Britain‘s University of Cambridge, who has been studying noroviruses for 10 years.

“It takes fewer than 20 virus particles to infect someone. So each droplet of vomit or gram of feces from an infected person can contain enough virus to infect more than 100,000 people.”

Norovirus is hitting hard this year – and earlier too.

In Britain so far this season, more than a million people are thought to have suffered the violent vomiting and diarrhea it can bring. The Health Protection Agency (HPA) said this high rate of infection relatively early in the winter mirrors trends seen in Japan and Europe.

“In Australia the norovirus season also peaks during the winter, but this season it has gone on longer than usual and they are seeing cases into their summer,” it said in a statement.

In the United States, the Centers for Disease Control and Prevention (CDC) say norovirus causes 21 million illnesses annually. Of those who get the virus, some 70,000 require hospitalization and around 800 die each year.

PROFUSE AND PROJECTILE

Norovirus dates back more than 40 years and takes its name from the U.S. city of Norwalk, Ohio, where there was an outbreak of acute gastroenteritis in school children in November 1968.

Symptoms include a sudden onset of vomiting, which can be projectile, and diarrhea, which may be profuse and watery. Some victims also suffer fevers, headaches and stomach cramps.

John Harris, an expert on the virus at Britain’s HPA, puts it simply: “Norovirus is very contagious and very unpleasant.”

What makes this such a formidable enemy is its ability to evade death from cleaning and to survive long periods outside a human host. Scientists have found norovirus can remain alive and well for 12 hours on hard surfaces and up to 12 days on contaminated fabrics such as carpets and upholstery. In still water, it can survive for months, maybe even years.

At the Health and Safety Laboratory in Derbyshire, northern England, where researcher Catherine Makison developed the humanoid simulated vomiting system and nicknamed him “Vomiting Larry”, scientists analyzing his reach found that small droplets of sick can spread over three meters.

“The dramatic nature of the vomiting episodes produces a lot of aerosolized vomit, much of which is invisible to the naked eye,” Goodfellow told Reuters.

Larry’s projections were easy to spot because he had been primed with a “vomitus substitute”, scientists explain, which included a fluorescent marker to help distinguish even small splashes – but they would not be at all easily visible under standard white hospital lighting.

Add the fact that norovirus is particularly resistant to normal household disinfectants and even alcohol hand gels, and it’s little wonder the sickness wreaks such havoc in hospitals, schools, nursing homes, cruise ships and hotels.

During the two weeks up to December 23, there were 70 hospital outbreaks of norovirus reported in Britain, and last week a cruise ship that sails between New York and Britain’s Southampton docked in the Caribbean with about 200 people on board suffering suspected norovirus.

MOVING TARGET

The good news, for some, is that not everyone appears to be equally susceptible to norovirus infection. According to Goodfellow, around 20 percent of Europeans have a mutation in a gene called FUT2 that makes them resistant.

For the rest the only likely good news will have to wait for the results of trials of a potential norovirus vaccine developed by U.S. drugmaker LigoCyte Pharmaceuticals Inc, or from one of several research teams around the world working on possible new antiviral drugs to treat the infection.

Early tests in 2011 indicated that around half of people vaccinated with the experimental shot, now owned by Japan’s Takeda Pharmaceutical Co, were protected from symptomatic norovirus infection.

The bad news, virologists say, is that the virus changes constantly, making it a moving target for drug developers. There is also evidence that humans’ immune response to infection is short-lived, so people can become re-infected by the same virus within just a year or two.

“There are many strains, and the virus changes very rapidly – it undergoes something virologists call genetic drift,” Harris said in a telephone interview. “When it makes copies of itself, it makes mistakes in those copies – so each time you encounter the virus you may be encountering a slightly different one.”

This means that even if a vaccine were to be fully developed – still a big ‘if’ – it would probably need to be tweaked and repeated in a slightly different formula each year to prevent people getting sick.

Until any effective drugs or vaccines are developed, experts reckon that like the common cold, norovirus will be an unwelcome guest for many winters to come. Their advice is to stay away from anyone with the virus, and use soap and water liberally.

“One of the reasons norovirus spreads so fast is that the majority of people don’t wash their hands for long enough,” said Goodfellow. “We’d suggest people count to 15 while washing their hands and ensure their hands are dried completely.”

(Reporting by Kate Kelland; Editing by Will Waterman)

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'Fiscal cliff' disputes remain as deadline nears

WASHINGTON (AP) — The White House and Senate Republicans sorted through stubborn disputes over taxing the wealthy and cutting the budget to pay for Democratic spending proposals as Monday's midnight deadline for an accord avoiding the "fiscal cliff" drew to within hours.

Senate Minority Leader Mitch McConnell, R-Ky., spoke repeatedly Sunday to Vice President Joe Biden, a former Senate colleague, in hopes of settling remaining differences and clinching a breakthrough that has evaded the two sides since President Barack Obama's November re-election. In one indication of the eleventh-hour activity, aides said the president, Biden and top administration bargainer Rob Nabors were all working late at the White House, and McConnell was making late-night phone calls as well.

Unless an agreement is reached and approved by Congress by the start of New Year's Day, more than $500 billion in 2013 tax increases will begin to take effect and $109 billion will be carved from defense and domestic programs. Though the tax hikes and budget cuts would be felt gradually, economists warn that if allowed to fully take hold, their combined impact — the so-called fiscal cliff — would rekindle a recession.

"There is still significant distance between the two sides, but negotiations continue," Senate Majority Leader Harry Reid, D-Nev., said shortly before the Senate ended an unusual Sunday session. "There is still time to reach an agreement, and we intend to continue negotiations."

The House and Senate planned to meet Monday, a rarity for New Year's Eve, in hopes of having a tentative agreement to consider. Yet despite the flurry of activity, there was still no final pact.

"This whole thing is a national embarrassment," Sen. Bob Corker, R-Tenn., said Monday on MSNBC, adding that any solution Congress would swallow at this late stage would be inconsequential. "We still haven't moved any closer to solving our nation's problems."

In a move that was sure to irritate Republicans, Reid was planning — absent a deal — to force a Senate vote Monday on Obama's campaign-season proposal to continue expiring tax cuts for all but those with income exceeding $200,000 for individuals and $250,000 for couples.

Attached to the measure — which the GOP seemed likely to block — would be an extension of jobless benefits for around 2 million long-term unemployed people. The plan was described by Sen. Richard Durbin of Illinois, the chamber's No. 2 Democrat.

The House and Senate met Sunday ready to debate an agreement or at least show voters they were trying. But the day produced alternating bursts of progress and pitfalls, despite Senate chaplain Barry Black's opening prayer in which he asked the heavens, "Look with favor on our nation and save us from self-inflicted wounds."

In one sign of movement, Republicans dropped a demand to slow the growth of Social Security and other benefits by changing how those payments are increased each year to allow for inflation.

Obama had offered to include that change, despite opposition by many Democrats, as part of earlier, failed bargaining with House Speaker John Boehner, R-Ohio, over a larger deficit reduction agreement. But Democrats said they would never include the new inflation formula in the smaller deal now being sought to forestall wide-ranging tax boosts and budget cuts, and Republicans relented.

"It's just acknowledging the reality," Sen. Susan Collins, R-Maine, said of the GOP decision to drop the idea.

There was still no final agreement on the income level above which decade-old income tax cuts would be allowed to expire. While Obama has long insisted on letting the top 35 percent tax rate rise to 39.6 percent on earnings over $250,000, he'd agreed to boost that level to $400,000 in his talks with Boehner. GOP senators said they wanted the figure hoisted to at least that level.

Senators said disagreements remained over taxing large inherited estates. Republicans want the tax left at its current 35 percent, with the first $5.1 million excluded, while Democrats want the rate increased to 45 percent with a smaller exclusion.

The two sides were also apart on how to keep the alternative minimum tax from raising the tax bills of nearly 30 million middle-income families and how to extend tax breaks for research by business and other activities.

Republicans were insisting that budget cuts be found to pay for some of the spending proposals Democrats were pushing.

These included proposals to erase scheduled defense and domestic cuts exceeding $200 billion over the next two years and to extend unemployment benefits. Republicans complained that in effect, Democrats would pay for that spending with the tax boosts on the wealthy.

"We can't use tax increases on anyone to pay for more spending," said Sen. Kay Bailey Hutchison, R-Texas.

Both parties also want to block an immediate 27 percent cut in reimbursements to doctors who treat Medicare patients. Republicans wanted to find savings from Obama's health care bill as well as from Medicare providers, while Democrats want to protect the health care law from cuts.

Both sides agree that a temporary 2-percentage-point cut in the Social Security payroll tax was likely to expire. That reduction — to 4.2 percent — was initiated by Obama two years ago to help spur the economy and has meant $1,000 annual savings to families earning $50,000.

A senior defense official said if the spending cuts were triggered, the Pentagon would soon begin notifying its 800,000 civilian employees to expect furloughs — mandatory unpaid leave, not layoffs. It would take time for the furloughs to be implemented, said the official, who requested anonymity because the official was not authorized to discuss the preparations

___

Associated Press writers David Espo, Julie Pace, Robert Burns and Josh Lederman contributed to this report.

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Suspected US drone kills 3 al-Qaida men in Yemen

SANAA, Yemen (AP) — Three al-Qaida militants were killed in a suspected U.S. drone strike in southern Yemen, Yemeni security officials said, the fourth such attack this week and a sign attacks from unmanned aircraft are on the upswing in the country.

The officials said the three men were hit as they were riding in a Land Cruiser in el-Manaseh village on the outskirts of Radda in Bayda province. Dozens of local al-Qaida-linked fighters protested the drone strikes after traditional Islamic Friday prayers.

Earlier this week another suspected U.S. drone strike killed two militants in Radda itself, Yemeni security officials say, and seven were killed in two other strikes in the southeastern province of Hadramawt. Four suspected drone strikes a week is uncommon in Yemen.

According to statistics gathered by the Long War Journal before Saturday’s attacks, the United States “is known to have carried out 41 airstrikes” this year against al-Qaida in the Arabian Peninsula (AQAP), as the group’s branch in Yemen is known. That makes for an average of around three to four strikes per month.

The Journal, a product of the Foundation for Defense of Democracies that was founded by former U.S. officials, says that since December 2009, the CIA and the US military’s Joint Special Operations Command are known to have conducted at least 54 air and missile strikes inside Yemen, excluding Saturday’s suspected attack.

AQAP overran entire towns and villages — including Radda — last year by taking advantage of a security lapse during nationwide protests that eventually ousted the country’s longtime ruler. Backed by the U.S. military, Yemen’s army was able to regain control of the southern region but al-Qaida militants continue to launch deadly attacks on security forces that have killed hundreds.

Also on Saturday, two gunmen on a motorbike shot and killed an intelligence officer in the southeast, security officials said. They said that the officer, Mutea Baqutian, was on his way to work in Mukalla, capital of Hadramawt province, when the men stopped his car, gunned him down, and fled.

The government has blamed al-Qaida militants for similar assassinations of several senior military and intelligence officials this year. The bullet-riddled body of Major al-Numeiry Abdo al-Oudi, deputy director of the security department of al-Qitten in Hadramawt, was found in the town’s suburbs last week. He had been kidnapped earlier in the month.

All officials spoke on condition of anonymity according to regulations.

Meanwhile, Maj. Gen. Ahmed Seif, who is commander of Yemen’s central military region, said the Defense Ministry has deployed an infantry brigade in the northeastern province of Marib to stop armed tribesmen who maintain cordial ties with al-Qaida from attacking oil pipelines and power generating stations, as well as to counter al-Qaida militants.

State TV meanwhile aired a meeting between President Abed Rabbo Mansour Hadi and eight Yemeni sailors who were rescued last week by forces of Somalia’s semiautonomous Puntland region after being held for nearly three years by Somali pirates.

The Puntland government says that its forces captured the hijacked Panama-flagged MV Iceberg 1 on Sunday after a siege that lasted two weeks. They freed the eight Yemeni sailors together with five Indians, two Pakistanis, four Ghanaians, two Sudanese and a Filipino. The ship was hijacked March 29, 2010.

Hadi congratulated the eight sailors for their safety and ordered the government to compensate them for their suffering.

Eqbal Yassin, a relative of one of the freed sailors, told The Associated Press that the hijackers had allowed some sailors to phone their relatives and convey the pirates’ demand for $ 5 million ransom. He said he was told by his relative that the hijackers killed a Yemeni sailor who tried to escape. He gave no further details.

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Nintendo’s Wii U wobbles as sales sink

According to Famitsu, Nintendo’s (NTDOY) portable 3DS console continued to see huge success during the week ahead of Christmas. It racked up sales of 433,000 units in Japan, up from 333,000 units in the prior week. But weirdly enough, the brand new and heavily promoted Wii U home console wobbled badly as its weekly sales slipped to 122,000 units from 130,000 units in the previous week. This may have been the biggest week in Japanese console market in 2012, so the stakes were high.

[More from BGR: Google names 12 best Android apps of 2012]

To put Wii U performance in context, the old PSP portable console sold 58,000 units in Japan during the same week. It is not an encouraging sign that the more than half-decade old PSP (which was displaced by the PlayStation Vita a year ago) managed to sell nearly half as many units as the brand new Wii U during the holidays. Of course, PS Vita continues to miss sales expectations dramatically — it sold only 19,000 units last week, barely more than a quarter of what its predecessor managed.

[More from BGR: Smartphones will replace keys on upcoming Hyundai cars]

Wii U performance may improve dramatically once compelling titles arrive. But during December, it did have “New Super Mario Brothers” and “Nintendo Land” to boost it in Japan. This clearly wasn’t enough. The aging PlayStation 3 sold only 30,000 units and Microsoft’s (MSFT) Xbox 360 barely cleared a thousand units, so the Wii U should have had a clear shot at strong sales performance in the Japanese home console market.

Overall, Japanese game console sales were down sharply from the week ahead of Christmas in 2011. The 3DS is a big hit in 2012 but instead of buoying the entire console market, it seems to be sapping energy from the Wii U and PS Vita.

It’s still early days for the Wii U, but Nintendo has probably started sweating a bit.

This article was originally published by BGR

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Michigan hospital blazes trail in fight against fungal meningitis

CHICAGO (Reuters) – After his first day working at St Joseph Mercy Ann Arbor hospital’s newly created Fungal Outbreak Clinic, Dr David Vandenberg struggled to describe to his boss the enormity of what lay ahead. He settled on a line from the movie Jaws.

“We’re going to need a bigger boat,” Vandenberg told Dr Lakshmi Halasyamani, chief medical officer of the Michigan hospital, echoing the film’s local police chief after he first eyes a 25-foot (7.5-metre) killer shark.

The St Joseph Mercy clinic has been at the front line of the fight against one of the biggest ever U.S. outbreaks of fungal meningitis, a killer infection that has been traced to tainted steroid shots from a Massachusetts pharmacy.

So far, 620 Americans have developed serious infections related to the outbreak, including 367 cases of deadly meningitis, and 39 people have died. Of the 19 U.S. states affected, Michigan has been worst hit, handling more than one third of the total cases in the outbreak.

St Joseph Mercy – a 537-bed Catholic hospital located in Ypsilanti, on the doorstep of the University of Michigan – has treated 169 of the state’s 223 cases of infections that can cause meningitis, including 7 people who died.

At one point it was so overrun that 87 of its 537 beds, which are usually occupied by patients with cancer or heart ailments and the like, were occupied by patients with fungal meningitis and related infections.

Dr Tom Chiller, the fungal disease expert at the U.S. Centers for Disease Control and Prevention, who has been overseeing the outbreak, praised the work of the hospital in helping to limit deaths from the outbreak.

“They have been incredibly creative in dealing with these complicated patients,” he said.

In all, almost 14,000 people seeking relief from back and joint pain received injections from moldy steroid shots made at the now-bankrupt New England Compounding Center in Massachusetts before they were recalled in late September.

CDC experts initially feared death rates in the 40 to 50 percent range; instead, only about 6 percent of those infected have died, and the CDC credits the creative and dogged efforts of state and local health officials for keeping the death rates so low.

The first wave of the outbreak involved the most severe cases of meningitis – an inflammation of the membranes that cover the brain and spinal cord. But starting in mid-October, patients who had been recovering from meningitis were developing potentially fatal localized infections near the site where contaminated drug was injected to treat back or neck pain.

As they started seeing more cases of these local, secondary infections, the staff at St Joseph‘s devised a bold plan to screen all patients in their database looking for potential new infections that might have been missed in the first wave.

On December 20, the CDC issued an alert to doctors incorporating some of lessons learned by the efforts of doctors at St Joseph’s and other hospitals, calling for increased screening of patients who may be harboring localized infections.

A BEWILDERING FUNGI

Among the patients who developed secondary infections was Bonita Robbins, a 72-year-old retired nurse from Pinckney, Michigan, who received doses of the tainted drug at the Michigan Pain Specialists clinic in the nearby town of Brighton while seeking relief for lower-back pain.

The first shot brought some relief, the second did little to ease her aches, and the third was contaminated. In October, Robbins went to St Joseph’s with a severe headache, back pain and pain in her thighs.

She spent 37 days in the hospital taking two kinds of antifungal drugs.

Dr Anurag Malani, an infectious disease specialist treating Robbins, said the challenge with the outbreak was that there was no medical literature to fall back on.

“No one has ever seen anything of this magnitude related to fungal infections, ever,” he said.

Chiller said U.S. doctors had never treated meningitis caused by Exserohilum rostratum, the environmental mold causing most of the infections.

“It’s just a rare, rare cause of infection.” Seeing that mold in the meninges – membranes covering the brain and spinal cord – is “completely new.”

Initially, St Joseph’s Fungal Outbreak Clinic was started in order to coordinate the care of patients after their discharge, which included overseeing the administration of a complex regime of anti-fungal drugs.

It morphed into something bigger when some of its 53 patients with meningitis started returning with infections near the site in their back or neck where the contaminated drug was injected.

Then came a wave of patients like Robbins, who had been ruled out for meningitis with a spinal tap, but were still complaining of pain near their injection site.

GETTING THE ‘BIGGER BOAT’

“When it became obvious that the number of patients would be a much higher percentage than anticipated by the CDC, we expanded our clinic and started enlisting the help of several other hospitals,” Vandenberg said.

Many of the patients had spinal abscesses, an infection in the space between the outside covering of the spinal cord and the bones of the spine. Others developed arachnoiditis, an infection of nerves within the spinal canal.

The decision to screen all patients in the hospital database who might have received tainted injections was not taken at the recommendation of the CDC.

“That was our own decision,” said Vandenberg, a specialist in internal medicine overseeing the screening effort.

He admitted that the strategy was aggressive, but said that, especially early on, doctors feared the local infections might be precursors to meningitis, making catching them early a potentially life-saving move.

Excluding patients who had already been screened and those who had injections in areas other than the spine, the hospital targeted about 500 patients for MRI scans.

Most so far have had private insurance that covers the screening. For the uninsured, the hospital’s Patient Financial Services department has been helping them to apply for financial support.

“We did over 400 MRIs in about a 4-week period,” Vandenberg said. The hospital screened so many patients, in fact, that the state of Michigan sent in an emergency mobile MRI unit to help.

Vandenberg got the task of reading stacks of MRI reports, sometimes as many as 30 a day.

So far, about 20 percent of the MRIs have shown up as abnormal, meaning that patients have to come back for surgery and treatment.

Vandenberg makes all of those calls personally. Not all of them go smoothly. He likens the gravity of the conversation – learning you have a potentially deadly new disease that requires months of treatment with risky drugs – to telling someone they have cancer.

After one especially tough call, in which a heart patient feared he would not survive the surgery he would need to clear his infection, Vandenberg cracked.

“I started crying. I probably haven’t cried for 15 years.”

SIGNS OUTBREAK IS EASING

But at last, after months of onslaught, there are signs the outbreak is easing.

Attendance at the hospital’s daily support group has begun to taper off. And since the beginning of December, more than 50 patients with fungal infections have been discharged, while only 20 have been admitted, bringing the total number of fungus-related inpatient to 30.

Vandenberg nevertheless cautions that the outbreak is still far from over.

“Every single day of this screening program, we’re finding one or two cases that are abnormal and need to be admitted,” he said.

Vandenberg gave the CDC access to the clinic’s database so the agency could see how the effort turned out, and this month, the CDC issued the alert to doctors incorporating some of the results of the MRI screening program.

The alert warned that some patients who got tainted injections but did not develop meningitis may still be at risk of localized infections.

And it urged doctors to consider ordering an MRI for all patients who still have pain, even if the pain is similar to what sent them in for treatment in the first place.

Chiller said the United States had not yet reached the end of the outbreak.

“Unfortunately, with fungi, the incubation periods are so long and they can remain indolent. I’m definitely concerned that we’re going to continue to see more cases.”

(Reporting by Julie Steenhuysen; Editing by Jilian Mincer, Mary Milliken and David Brunnstrom)

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Last-minute fiscal cliff talks in Senate

WASHINGTON (AP) — Senate leaders groped for a last-minute compromise Saturday to avoid middle-class tax increases and possibly prevent deep spending cuts at the dawn of the new year as President Barack Obama warned that failure could mean a "self-inflicted wound to the economy."

Obama chastised lawmakers in his weekly radio and Internet address for waiting until the last minute to try and avoid a "fiscal cliff," yet said there was still time for an agreement. "We cannot let Washington politics get in the way of America's progress," he said as the hurry-up negotiations unfolded.

For all the recent expressions of urgency, bargaining took place by phone, email and paper in a Capitol nearly empty except for tourists. Alone among top lawmakers, Senate Republican leader Mitch McConnell spent the day in his office.

In the Republicans' weekly address, Sen. Roy Blunt of Missouri cited a readiness to compromise. "Divided government is a good time to solve hard problems — and in the next few days, leaders in Washington have an important responsibility to work together and do just that," he said.

Even so, there was no guarantee of success, and a dispute over the federal tax on large estates emerged as yet another key sticking point alongside personal income tax rates.

In a blunt challenge to Republicans, Obama said that barring a bipartisan agreement, he expected both houses to vote on his own proposal to block tax increases on all but the wealthy and simultaneously preserve expiring unemployment benefits.

Political calculations mattered as much as deep-seated differences over the issues, as divided government struggled with its first big challenge since the November elections.

Speaker John Boehner remained at arms-length, juggling a desire to avoid the fiscal cliff with his goal of winning another term as speaker when a new Congress convenes next Thursday. Any compromise legislation is certain to include higher tax rates on the wealthy, and the House GOP rank and file rejected the idea when he presented it to them as part of a final attempt to strike a more sweeping agreement with Obama.

Lawmakers have until the new Congress convenes to pass any compromise, and even the calendar mattered. Democrats said they had been told House Republicans might reject a deal until after Jan. 1, to avoid a vote to raise taxes before they had technically gone up and then vote to cut taxes after they had risen.

Nor was any taxpayer likely to feel any adverse impact if legislation is signed and passed into law in the first two or three days of 2013 instead of the final hours of 2012.

Gone was the talk of a grand bargain of spending cuts and additional tax revenue in which the two parties would agree to slash deficits by trillions of dollars over a decade.

Now negotiators had a more cramped goal of preventing additional damage to the economy in the form of higher taxes across the board — with some families facing increases measured in the thousands of dollars — as well as cuts aimed at the Pentagon and hundreds of domestic programs.

Republicans said they were willing to bow to Obama's call for higher taxes on the wealthy as part of a deal to prevent them from rising on those less well-off.

Democrats said Obama was sticking to his campaign call for tax increases above $250,000 in annual income, even though he said in recent negotiations he said he could accept $400,000. There was no evidence of agreement even at the higher level.

There were indications from Republicans that estate taxes might hold more significance for them than the possibility of higher rates on income.

One senior Republican, Sen. Jon Kyl of Arizona, said late Friday he was "totally dead set" against Obama's estate tax proposal, and as if to reinforce the point, Blunt mentioned the issue before any other in his broadcast remarks. "Small businesses and farm families don't know how to deal with the unfair death tax_a tax that the president and congressional leaders have threatened to expand to include even more family farms and even more small businesses," he said.

Several officials said Republicans want to leave the tax at 35 percent after exempting the first $5 million in estate value. Officials said the White House wants a 45 percent tax after a $3.5 million exemption. Without any action by Congress, it would climb to a 55 percent tax after a $1 million exemption on Jan. 1.

Democrats stressed their unwillingness to make concessions on both income taxes and the estate tax, and said they hoped Republicans would choose which mattered more to them.

Officials said any compromise was likely to ease the impact of the alternative minimum tax, originally designed to make sure that millionaires did not escape taxation. If left unchanged, it could hit an estimated 28 million households for the first time in 2013, with an average increase of more than $3,000.

Taxes on dividends and capital gains are also involved in the talks, as well as a series of breaks for businesses and others due to expire at the first of the year.

Obama and congressional Democrats are insisting on an extension of long-term unemployment benefits that are expiring for about 2 million jobless individuals.

Leaders in both parties also hope to prevent a 27 percent fee cut from taking effect on Jan. 1 for doctors who treat Medicare patients.

There was also discussion of a short-term extension of expiring farm programs, in part to prevent a spike in milk prices at the first of the year. It wasn't clear if that was a parallel effort to the cliff talks or had become wrapped into them.

Across-the-board spending cuts that comprise part of the cliff were a different matter.

Republicans say Boehner will insist that they will begin to take effect unless negotiators agreed to offset them with specified savings elsewhere.

That would set the stage for the next round of brinkmanship — a struggle over Republican calls for savings from Medicare, Medicaid and other federal benefit programs.

The Treasury's ability to borrow is expected to expire in late winter or early spring, and without an increase in the $16.4 trillion limit, the government would face its first-ever default. Republicans have said they will use administration requests for an extension as leverage to win cuts in spending.

Ironically, it was just such a maneuver more than a year ago that set the stage for the current crisis talks over the fiscal cliff.

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C. African Republic neighbors to send help

BANGUI, Central African Republic (AP) — Central African Republic’s neighbors agreed on Friday to dispatch a contingent of soldiers to intervene in the troubled country, where a coalition of rebel groups is seeking to overthrow the president of nearly a decade.

Representatives from the 10-nation Economic Community of Central African States meeting in Gabon, though, did not specify how many troops they could contribute nor did they outline how quickly the military assistance would arrive.

President Francois Bozize had pleaded for international help Thursday as fears grew that the rebels would attack the capital of 600,000 next. Former colonial power France already has said that its forces in the country are there to protect French interests and not Bozize’s government.

“We are now thinking about the arrangements to make so that this mission can be deployed as quickly as possible, said Gabon’s Foreign Affairs Minister Emmanuel Issoze-Ngondet.

The announcement came as military officials in Central African Republic reported renewed fighting in the third largest city of Bambari, which fell under rebel control five days ago.

The military said it had taken country of the town, located about 385 kilometers (240 miles) from the capital, a claim that could not be immediately corroborated.

The ongoing instability prompted the United States to evacuate about 40 people, including the U.S. ambassador, on an U.S. Air Force plane bound for Kenya, said U.S. officials who insisted on anonymity because they weren’t authorized to discuss the operation.

The United States has special forces troops in the country who are assisting in the hunt for Joseph Kony, the fugitive rebel leader of another rebel group known as the Lord’s Resistance Army. The U.S. special forces remain in the country, the U.S. military’s Africa Command said from its headquarters in Stuttgart, Germany.

The evacuation of the U.S. diplomats came in the wake of criticism of how the U.S. handled diplomatic security before and during the attack on its consulate in Benghazi, Libya, on Sept. 11. The ambassador and three other Americans were killed in that attack.

French diplomats are staying despite a violent demonstration outside its embassy earlier this week. Dozens of protesters, angry about a lack of help against rebel forces, threw rocks at the French Embassy in Bangui and stole a French flag. French Foreign Minister Laurent Fabius spoke via phone with Bozize, asking him to take responsibility for the safety of French nationals and diplomatic missions in Central African Republic.

Bozize on Thursday urgently called on former colonial ruler France and other foreign powers to help his government fend off rebels who are quickly seizing territory and approaching the capital. But French President Francois Hollande said France wants to protect its interests in Central African Republic and not Bozize’s government.

This landlocked nation of some 4.4 million people has suffered decades of army revolts, coups and rebellions since gaining independence in 1960 and remains one of the poorest countries in the world. The current president himself came to power nearly a decade ago in the wake of a rebellion in this resource-rich yet deeply poor country.

Speaking to crowds in Bangui, a city of some 600,000, Bozize pleaded with foreign powers to do what they could. He pointed in particular to France. About 200 French soldiers are already in the country, providing technical support and helping to train the local army, according to the French defense ministry.

“France has the means to stop (the rebels) but unfortunately they have done nothing for us until now,” Bozize said.

Bozize’s government earlier reached out to longtime ally Chad, which pledged to send 2,000 troops to bolster Central African Republic’s own forces.

The rebels behind the most recent instability signed a 2007 peace accord allowing them to join the regular army, but insurgent leaders say the deal wasn’t fully implemented. The rebel forces have seized at least 10 towns across the sparsely populated north of the country, and residents in the capital now fear the insurgents could attack at any time, despite assurances by rebel leaders that they are willing to engage in dialogue instead of attacking Bangui.

The rebels have claimed that their actions are justified in light of the “thirst for justice, for peace, for security and for economic development of the people of Central African Republic.”

Despite Central African Republic’s wealth of gold, diamonds, timber and uranium, the government remains perpetually cash-strapped.

The rebels also are demanding that the government make payments to ex-combatants, suggesting that their motives may also be for personal financial gain.

Paris is encouraging peace talks between the government and the rebels, with the French Foreign Ministry noting in a statement that negotiations are due to “begin shortly in Libreville (Gabon).” But it was not immediately clear if any dates have been set for those talks.

The U.N.’s most powerful body condemned the recent violence and expressed concern about the developments.

“The members of the Security Council reiterate their demand that the armed groups immediately cease hostilities, withdraw from captured cities and cease any further advance towards the city of Bangui,” the statement said.

___

Goma reported from Libreville, Gabon. Associated Press writers Krista Larson in Dakar, Senegal; and Jason Straziuso in Nairobi, Kenya contributed to this report.

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