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Excessive surgeries swell Medicare costs in United States

Wednesday, October 15, 2008

At least 10% of the increase in Medicare expenditures since the mid-1990s is due to increased rates of one type of elective surgery, according to a recent study, and many of the patients may not need it. University of California, San Francisco found that only 44% of patients who undergo an elective cardiac surgery called angioplasty get the recommended test to determine whether the procedure is appropriate.

As a result, patients may be receiving a procedure that they either do not need or for which the risk outweighs the benefit. The operation opens partially clogged arteries in patients with heart disease and the annual rate of elective angioplasties has tripled in the United States during the last decade.

Angioplasties are currently being performed at a rate of over 800,000 per year in the U.S. The average cost was $44,110 per procedure in 2004. Since the operation tends to be performed on older Americans, Medicare covers most patients and compensates US$10,000 to $15,000 for each case.

Reuters reporter Julie Steenhuysen writes that angioplasty is “big business for medical device makers including Boston Scientific Corp, Medtronic Inc, Abbott Laboratories Inc and Johnson & Johnson”. Dr. Raymond Gibbons, a professor of medicine who specializes in cardiology at the Mayo Clinic in Rochester, Minnesota, criticizes the current U.S. health care system for compensating doctors based upon procedures performed rather than for following recommended practices.

We didn’t expect to find 100 percent, but we expected a much higher percentage than 44

A stress test in which the patient walks on a treadmill is recommended to determine whether a partial obstruction impairs heart function. Although not all patients who need angioplasty are strong enough to undergo the stress test, UC San Francisco researchers were surprised that testing preceded so few of the surgeries.

Professor of medicine Dr. Rita F. Redberg told U.S. News and World Report, “We didn’t expect to find 100 percent, but we expected a much higher percentage than 44”. Dr. Redberg co-authored a report on the findings for the Journal of the American Medical Association this month.

Dr. Grace Lin, another co-author of the study, noted: “What really matters is whether or not that blockage is affecting blood flow to the heart. That is why the stress test is important.” Their research analyzed over 23,000 Medicare cases and over 1,600 commercial insurance cases.

American Heart Association president Timothy Gardner called the study “a good wake-up call” to remind medical doctors to make sure they do not perform unnecessary procedures. Dr. Gardner regards the study as evidence that many unnecessary angioplasties are being performed.

You can do a stress test every year to be sure things are normal. That is an important baseline that is being ignored all too frequently.

The study found great variation in the rate of stress testing. Geographic areas ranged from 22% to 76% with the highest rate of testing in the Northeastern and Midwestern states. Testing rates also varied by gender, with men more likely to receive a stress test than women, and by other factors including the age of the physician. Dr. Gibbons points to some of these variances as indications that some physicians may be performing angioplasties indiscriminately.

Not all physicians agree. Although the various types of stress testing usually cost a few hundred dollars instead of tens of thousands, the chief cardiologist at University of Wisconsin Hospital and Clinics Dr. Matthew Wolff notes that stress tests yield false negative results in about 10% of cases. In his opinion, doctors who rely on stress tests “are going to be missing people with severe disease.” Although he agrees that some angioplasties are unnecessary, he contends that the new study does not offer a solution to the dilemma.

The American College of Cardiology plans to release new guidelines soon to help doctors determine when a stress test is appropriate, yet the payment system lacks a financial incentive to abide by testing guidelines. Dr. Eric Topol of Scripps Translational Science Institute in La Jolla, California noted the underuse of stress tests in a study of private insurance records 14 years ago. Dr. Topol agrees that testing guidelines “should be much more clear-cut”, and adds that stress tests ought to be performed annually. “You can do a stress test every year to be sure things are normal. That is an important baseline that is being ignored all too frequently.”

Cardiologist, Dr. Anthony DeFranco of Aurora St. Luke’s Medical Center, considers stress testing to be appropriate in at most 65% of cases, since a substantial minority of patients have other health problems that prevent them from undergoing the test.



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Four killed, dozens injured in Jerusalem attack on bus

Wednesday, July 2, 2008

A Palestinian from Jerusalem today killed three and injured dozens by driving a front-end loader into a passenger bus. The incident occurred today at noon local time.

The father of the attacker told press that he did not know of his son’s plans. “My son never spoke of plans to carry out such an attack, if he had I would have tried to prevent it,” he told The Media Line before he was questioned by police.

Local police have stated that the incident was an act of terrorism. “There is no doubt at all that this was a terrorist attack,” said a police spokesperson, speaking to media on the scene of the attack.

Jabr Duwait, the perpetrator of the attack was shot and killed on site by local police in the minutes after the officials arrived on the scene.

The incident occurred on Jaffa Road, which is one of the longest roads in Jerusalem.



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Inquiry ordered into video of US troops urinating on Taliban fighters

Thursday, January 12, 2012

The United States Defense Secretary Leon Panetta has ordered an investigation into a video allegedly showing US Marines urinating on dead Taliban fighters. Panetta has called the videos “utterly deplorable” and not appropriate conduct for United States armed forces personnel. Afghan president Hamid Karzai called for “the most severe punishment for anyone found guilty in this crime.”

The video shows four men apparently dressed in US Marine uniforms urinating on three dead bodies. In it the men are heard saying “Have a great day, buddy” and “hope you like your shower“. The exact date the video was taken is unknown. It appeared on internet sites, including YouTube. The photographing or video taking of human casualties is specifically forbidden by the US military’s code of conduct.

A statement by Coalition Forces said the men in uniform probably aren’t in Afghanistan anymore; the US Marine Corps has since stated they aren’t. The coalition statement also reiterated the Department of Defense’s stance, saying “this behavior dishonors the sacrifices and core values of every service member representing the 50 nations of the coalition…. Any individuals with confirmed involvement will be held fully accountable.”

The incident will be investigated by the Naval Criminal Investigative Service (NCIS) which investigates criminal matters for the US Navy.

The Taliban responded by saying “First they killed the Afghans with mortars, and they then urinated on their bodies. We strongly condemn this inhumane action by the wild American soldiers.”



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CEO of GM outlines plan for “New GM” after auto company declared bankruptcy

Thursday, June 4, 2009

In a New York press conference at 16:15 UTC, June 1st, Fritz Henderson, the Chief Executive Officer of General Motors, which filed for bankruptcy and Chapter 11 protection from its creditors earlier today, outlined a plan for what he called a “New GM”.

Speaking to the press under safe harbor provisions of U.S. law, Henderson described the events of today as a “defining moment” in the history of General Motors. Speaking to the public he said that “The GM that let you down is history,” and described a “New GM” that he expected to result from the bankruptcy process.

Henderson stated that he envisioned the bankruptcy process would take between 60 and 90 days. He stressed several times his view that the process would be one that is executed quickly, saying that not just a sense of urgency but “pure unadulterated speed” was his expectation of the process. He emphasized that “GM remains open for business” during the bankruptcy period, continuing to sell and to support its products, and that day one motions had been filed in the bankruptcy court in order to allow this.

Regarding the bankruptcy process he said, “We will do it right. And we will do it once.”

He stated that the plan for General Motors had the support of the United Auto Workers union, the Canadian Auto Workers union, the GM VEBA, and a majority of the unsecured bondholders of GM. He also mentioned that GM had already received €1.5 million in bridge financing from the German government.

In response to questions about the possibility of the United States federal government, a majority shareholder in the restructured company, dictating future product development and strategy, such as the sale of more fuel-efficient and green vehicles; he first observed that the federal government had already stated to him that it had “no real interest in running our business” and that he expected that still to be his job. Of the specific hypothetical scenario where the management of GM wants to make one type of car, because it thinks that it is the right thing for the business, and the U.S. government wants to make another type of car, he stated that “I don’t think it’s going to happen.” Expanding on that point he stated that he expected the “New GM” to focus upon “highly fuel-efficient and green technology”, and that operating both in accordance with U.S. environmental laws and in response to customer demand would naturally result in the New GM producing the types of vehicles that the U.S. government would encourage.

The “New GM” he also expected to focus on “four core brands”, and will size its dealership to match that. He stated that GM would offer a “deferred termination” package to dealers, to allow them to cease dealing in GM vehicles in a managed and gradual way.

He stated that the bankruptcy filings did not cover General Motors’ businesses in Latin America, Europe and the Middle East, and Asia and the Pacific. Of GM’s profitable ventures in China, specifically, he stated that they were “a critical part of the New GM”. In response to questions of whether the New GM would import cars from China to the U.S., he stated the formative company’s core principle that “We build where we sell” applied in both directions, with GM building in China to sell in China and building in the U.S. to sell in the U.S., stating that this shortened supply chains.

He declined to predict when the New GM would return to profitability, stating that the goal was rather to lower the break-even EBIT point for the company. He also declined to speculate upon when the U.S. government would sell its stake in the company, saying that that was a question “better addressed to the U.S. Treasury”, and merely saying that he expected it to be “years, not months” when the U.S. Treasury felt it would give “the right return for taxpayers.”



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Car bomb explodes near MI5 army base in Northern Ireland

Monday, April 12, 2010

A car bomb has exploded outside an army base in Northern Ireland that is the headquarters for MI5 domestic security services. The attack has been claimed by dissidents from the Real Irish Republican Army, a more radical splinter group of the IRA.

According to police, Real IRA members hijacked a vehicle from a taxi driver in Belfast; Al Jazeera reports it was commandeered at gunpoint. A bomb was planted in the car, which was then driven to the rear of the Palace Barracks.

The explosion comes several hours before the Northern Ireland Assembly was scheduled to appoint its first justice minister, and only minutes after the Belfast power-sharing administration regained control over justice and policing in the province for the first time in nearly four decades.

An Ulster Unionist member of the Belfast Policing Board, Basil McCrea, commented on the explosion, saying: “It’s obviously people trying to make a statement about the transfer of policing and justice powers. We are going to have to expect more of this over the next period of time […] There will be people who will try to disrupt the process,” as quoted by the BBC.

He commented that he believed the incident was a “one-off” occurrence, and said he tried to reassure concerned locals in the area.

Police said IRA dissidents held a Belfast taxi driver at gunpoint in his home and used his vehicle to carry the bomb to the rear of Palace Barracks. Witnesses report hearing an explosion shortly after midnight local time; Al Jazeera puts the precise time of the detonation at 00.24 local time (23.24 UTC). One man was hospitalised following the bombing, although there are no reports of deaths.

According to a local journalist, security has cordoned off the area near the explosion.



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San Francisco Museum of Modern Art buys Edward Hopper valued at over $25 million

Monday, March 26, 2012

The San Francisco Museum of Modern Art (SFMOMA) has purchased the painting Intermission, by American artist Edward Hopper. The piece, created in 1963, is one of the last paintings created by Hopper.

Hopper’s realist style, which visually examined American urban and rural life in the first half of the 20th century, made him one of the most influential and important American artists of the modern era. The painting, which was sold by a private collector, is believed to be valued at over $25 million.

Intermission shows a woman sitting alone in the front row of a theater. The theater is empty, and is described, by San Francisco Chronicle art critic Kenneth Baker as expressing emotion and social isolation, a standard theme in Hopper’s works. The inspiration for the painting came to Hopper while he was watching a film.

Hopper’s wife, Josephine, had scheduled Hopper to create the painting in a theater, however Hopper would complete the painting at his studio in New York City. Original sketches of Intermission show a second person sitting in the third row — a figure that never made it into the final painting. Baker calls Intermission a “prime example of Hopper’s austere realist vision”.

[This is] a necessary practice in an art market where prices for historically important art continue to rise steeply.

SFMOMA will not disclose how much they paid for Intermission. When the painting Hotel Window, which is of similar size and from the same period, sold at auction in 2006, it sold for $26.9 million. It is believed that “Inspiration” is worth just as much, if not more. Intermission was purchased with the help of donor funds, and acquired through the San Francisco-based Fraenkel Gallery, which sold if on behalf of a private collector.

In exchange for the acquisition of Intermission, SFMOMA is selling another Hopper painting: Bridal Path, from 1939. A lesser known work of Hopper’s, Bridal Path shows a horseback riding path in Central Park. By selling Bridal Path, SFMOMA is able to help fund the acquisition of the more well known Intermission. This practice is slowly gaining popularity within a museum and art market that previously disapproved of the sale of lesser known works for more popular acquisitions. Baker acknowledges the past practices, but believes that this is “a necessary practice in an art market where prices for historically important art continue to rise steeply.”

Intermission goes on display for the public on Friday, at SFMOMA.



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Owner and manager of Moroccan factory arrested over 55-fatality fire

Sunday, April 27, 2008

Police have arrested the owner of a mattress factory in Hay Hassini, Casablanca, Morocco which burned down in a disaster that claimed 55 lives. His son, who was the factory’s manager, was also arrested.

Those killed — 35 of whom were women — were trapped inside by locked fire exits, which were barricaded to stop theft during working hours. “The people who died were either asphyxiated or burned,” commented a firefighter. 17 were wounded. Moustapha Taouil of the Casablanca civil protection service said the blaze was triggered by an inadequatly maintained electric saw on the ground floor. The initial fire quickly engulfed all four storeys of the building.

The Rosamor factory was clearly operating unsafely, officials said. “It’s a building with a ground floor and three upper floors specialising in making furniture, therefore there were highly inflammable products,” said Taouil. “We confirmed during our examination that the owners of the premises failed to respect legal requirements for this kind of industry including staff training… the owner in contravention of the law, locked staff inside the plant apparently to prevent theft of raw material. It was this that prevented them getting out. The fire was caused by lack of proper maintenance of certain machines and electrical installations.” He said a short circuit on the ground floor, which was filled with power saws, triggered the disaster.

As a result of the investigatons, “The plant’s owner, Adil Moufarreh, and his son Abdelali Moufarreh, who was the manager, have been taken into custody after having been questioned by police,” said an official.

28-year-old factory employee Fadila Khadija said “There was no emergency exit, the extinguishers were empty and the working conditions were difficult.” One source said that windows were also unusable as they were covered with iron bars. 20-year-old survivor Omar Elaaz said “I was working on the first floor as an upholsterer. The smoke came up from the ground floor where the foam rubber, wood and glue are stored. I used a gas bottle to break the wire mesh that protects every window.” 31-year-old upholsterer Hakim Hakki told of his own lucky escape and its effect on him from hospital: “I jumped from the third floor with four other colleagues while the women, who didn’t dare to follow us, perished in the inferno. God saved me but I’ll never forget those who died.”

The father of deceased 19-year-old Abdelazziz Darif said his son was paid 250 dirhams (20 euro/31 US dollars) per week and did not have social insurance.



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Colorado College Tigers win 41st annual Great Lakes Invitational tournament

Friday, December 30, 2005

The Colorado College Tigers beat the Spartans of Michigan State University in men’s ice hockey on Friday, for the title of champions of the 41st annual Great Lakes Invitational ice hockey tournament at Joe Louis Arena in Detroit.

The Tigers, the team chosen to be invited into the tournament and appearing for the first time since 1965 in the tournament, led with a 5-0 lead during the second period, after which Michigan State switched goalies. The Spartans put freshmen Jeff Lerg into net, replacing Dominic Vicari, who was earlier given a penalty for his contact with a member of Colorado’s team in front of the net. Michigan State junior Tyler Howells scored two goals during the second period, and Colorado student Brett Sterling made the Tiger’s final goal for the night.

Colorado College took first place in the invitational, and Michigan State ended in second place, after their previous win over Michigan Tech at a score of 3-2. The Tigers previously beat the University of Michigan on Thursday, at a score of 6-1.

Meanwhile, the University of Michigan beat GLI co-sponsor Michigan Tech University with a score of 5-3 for a third place finish in the invitational earlier in the day.

With 2 minutes remaining in the third period, the University of Michigan went one up over Michigan Tech, breaking the 3-3 tie. Michigan Tech pulled their goalie with one minute remaining to gain a man advantage, but the strategy failed and allowed the University of Michigan to get another goal resulting in the final 5-3 score.

The game secured the third place position in the invitational for University of Michigan, and fourth place for Michigan Tech.

This article features first-hand journalism by Wikinews members. See the collaboration page for more details.
This article features first-hand journalism by Wikinews members. See the collaboration page for more details.

The final standings in the tournament are:

  1. Colorado College
  2. Michigan State University
  3. University of Michigan
  4. Michigan Tech


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Cassini spacecraft collects sample from geyser on Saturn’s moon Enceladus

Saturday, March 15, 2008

Space probe Cassini performed a close flyby of Saturn‘s icy moon Enceladus on Wednesday. The fate of the $3.5 billion mission was in the balance as the bus-sized spacecraft swooped to just 50 km (30 mi) above the surface of Enceladus to sample the frozen spray issuing from geysers on the moon’s surface. The “water” spraying from these geysers is in the form of dust-sized, frozen water particles, which are ejected into space by gaseous water vapors that build up pressure deep within icy fissures on Enceladus.

Cassini’s cosmic dust analyzer was unavailable due to a glitch in the updated software that was supposed to provide an increased hit count of the geyser dust particles. However, dust samples were collected before and after the closest approach and the mass spectrometer functioned throughout the flyby, providing useful data which is now being analyzed.

Mission controllers will have a chance to capture more geyser dust on October 9, 2008 when they may choose to steer Cassini even closer to the surface of Enceladus.

Tidal flexing of this moon due to the gravitational proximity of its host planet, Saturn, continually heaves and cracks the icy surface. This suggests that Enceladus may have a squishy, liquid-water ocean beneath an icy crust. Deep, parallel fissures in the ice crust, dubbed the “Tiger Stripes”, measure warmer than uncracked, stationary surfaces nearby. Friction of these massive, moving plates of ice is thought to provide the heat responsible for the pressurized geysers of sublimated water and ice dust. The presence of these geysers amounts to more empirical evidence of a large, liquid water ocean below the surface of Enceladus.

The Cassini-Huygens space probe is an international mission involving the cooperative efforts of NASA, the European Space Agency, and the Italian Space Agency. Launched in 1997, Cassini has orbited Saturn since 2004 but has never before flown so close to a moon. On 14 January 2005, the Huygens lander successfully explored the atmosphere and surface conditions of Saturn’s biggest moon, Titan.



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Fiat plans to buy majority stake in Chrysler

Sunday, May 29, 2011

Fiat announced on Friday that it intends to purchase the six percent of automaker Chrysler that the US government currently owns, which would give the Italian company a 52 percent majority stake in Chrysler.

According to Fiat’s announcement, the company has told the US Treasury that it intends to use its option to buy the share in Chrysler held by the US government, a deal that will be finalized by June 10. If a price is not agreed on by that time, Fiat will pay the average of the estimates of two investment banks.

In 2009, Fiat bought a twenty percent stake in Chrysler, which had just exited bankruptcy, and has since increased its holding to 46 percent, expected to increase to 57% by the end of this year.

According to analyst Maryann Keller, the deal is a good one for both companies, as “[n]either one has the ability to compete alone in the kind of global environment that they face.” Analyst Rebecca Lindland said that the move will also benefit the companies by getting “them out from underneath any hint of government ownership and any of that negativity that went along with the bailout.”