INTERNATIONAL LOANS The Countries Most in Debt to China


According to research recently published by the Kiel Institute for the World Economy, there are seven countries in the world whose external loan debt to China surpasses 25 percent of their GDP. Three (Djibouti, Niger and The Republic of the Congo) are located in Africa, while four (Kyrgyztan, Laos, Cambodia and the Maldives) are in Asia.

Yet, the world map of debt to China amassed through direct loans (excluding debt holdings and short-term trade debt) shows that a majority of countries heavily in debt to China are in Africa, but that Central Asia and Latin America follow close behind.

While China’s overseas lending is coordinated by the country’s centralized government, it is often poorly documented, which the researchers of the paper were trying to change. They found that debt by direct loans started to grow immensely only around 2010 and that loans by China often come at higher rates and with shorter grace periods for the receiving country than comparable loans from the OECD or the World Bank. The authors also caution that countries heavily in debt to China are at risk of defaulting. In the 1970s, a lending boom which consisted of similar contracts offered by U.S., European and Japanese banks had led to this outcome for a number of developing countries which were trying to improve their infrastructure, according to the research.

Meanwhile, external debt to China through portfolio holdings is concentrated in developed nations and passes the threshold of 10 percent of GDP for Germany and the Netherlands. It amounts to between 5 and 10 percent of GDP in the U.S., Canada,France, the UK and Australia.

Infographic: The Countries Most in Debt to China | Statista


This chart shows global debt levels cause by direct loans from China (as percentage of GDP) in 2017.

CVS buys Target pharm biz for $1.9B

By: Nathan Bomey, USA TODAY

Drugstore chain CVS Health (CVS) will acquire big-box retailer Target’s (TGT) pharmacy and clinic business for $1.9 billion, the companies said Monday.

More than 1,660 Target pharmacies in 47 states will be rebranded as CVS/pharmacy. Target’s clinics, nearly 80 in total, will be renamed MinuteClinic.

The retailers are getting cozier on another front, too. Target will seek five to 10 locations for new small-format Target Express stores that would also have a CVS/pharmacy inside.

“This long-term strategic relationship will certainly benefit the patients, the employees and the shareholders of both companies,” CVS Health CEO Larry Merlo said in a conference call.

CVS will offer comparable positions to all of Target’s 14,000 pharmacy and clinic workers. Target appeared to leave the door open for cuts at the corporate level, however, saying it will “further evaluate the business impact and related support needs at its headquarters locations.”

The deal comes as Target is reassessing its business priorities in a bid to sharpen its strategy in a dynamic competition with online retailers such as and big-box rivals such as Walmart.

Target CEO Brian Cornell said the exceedingly complex health care business is not a good fit for Target, which lacks the scale and expertise to thrive in the pharmacy world.

“Everything we do and how we do it has been on the table and up for review,” he said on a conference call, adding that it’s critical Target becomes a “faster-moving, more agile organization.”

Cornell clarified, however, that Target is not currently seeking to sell any of its other core businesses. He also said he expects Target’s foot traffic to increase following the deal.

CVS also said it would open 20 new clinics in Target stores within three years of the deal’s closing.

The deal is worth $1.2 billion to Target after taxes. The company said it would use the cash to boost its “long-standing capital priorities,” including share buybacks.

Target’s pharmacy business has about $4 billion annual sales. Target said its profit margins would rise following the deal.

CVS said it would increase its debt load to do the deal and pledged to start chopping its debt over time. But the company said it would reduce its share buyback plan for 2015 by $1 billion to help fuel the transaction.

To finalize the deal, the retailers will have to secure regulatory approval from the U.S. government. Officials suggested the deal could be finished by about the end of 2015, though they said the timing is uncertain.

Spokespeople for both companies declined to say whether CVS would accept all insurance plans that Target accepts. Nothing changes for now.

“Target guests will receive communication prior to any changes taking effect,” CVS spokeswoman Carlyn Castel said in an email.

Merlo said his personal relationship with Target’s Cornell helped make the deal possible.

“I have always been a fan of his,” Merlo said. “That relationship helped to create a level of trust and confidence.”

Merlo downplayed the suggestion that the relationship could spawn brand confusion. CVS customers purchase an average of three items per trip, he noted.

“The customer is using Target and CVS/pharmacy very differently,” Merlo said.

By positioning CVS in Target stores, he believes the chain can reach more consumers. The deal puts CVS in several new markets, including Seattle, Denver and Portland, Ore.

CVS will pay $20 million to $25 million in annual rent to Target for the pharmacy and clinic space, CVS Chief Financial Officer Dave Denton said.

Follow USA TODAY reporter Nathan Bomey on Twitter @NathanBomey.

Two Separate Sharks Attach Two Separate Kids in NC

By Kathryn Robinson and M. Alex Johnson

A 16-year-old boy and a 12-year-old girl lost their left arms and suffered other serious injuries in separate shark attacks in Oak Island, North Carolina, authorities said Sunday night.

The kids, who weren’t identified, were upgraded from critical to fair condition after surgery and were stable at New Hanover Regional Medical Center in Wilmington, said Martha Harlan, a spokeswoman for the hospital. The girl’s left arm was amputated below the elbow, and she suffered lower leg tissue damage, Harlan said, while the boy’s left arm was amputated below the shoulder.

The second incident was reported at 5:51 p.m. only about 2 miles away, Anselmo said.

Oak Island Town Manager Tim Holloman said that visitors were encouraged to stay out of the water but that the beaches would be open Monday. The Brunswick County Sheriff’s Department will have patrol the coastline by helicopter to watch for any dangerous activity, he said.

“Oak Island is still a safe place,” Holloman said. “This is highly unusual.”

Anselmo agreed.

“I’ve been here 16 years,” he said. “This is the first time something this major has happened.”

The girl was bitten by a shark while visiting family at a Brunswick County island about 4:40 p.m. ET, Oak Island Fire Chief Chris Anselmo said.

‘Cannibal disease’ study revels gene that produces CJD resistance

Researchers studying a neurological disease associated with cannibalism have discovered a natural genetic variation that produces resistance to brain diseases such as Creutzfeldt-Jakob disease and bovine spongiform encephalopathy, also known as “mad cow disease.”

Their discovery could be the first step toward understanding how neurodegenerative disorders such as Creutzfeldt-Jakob disease (CJD) and others dementias could be prevented and treated.

The study, published in Nature, was conducted by researchers from the UK Medical Research Council’s (MRC) Prion Unit at University College London (UCL) in the UK.

Prions are infectious proteins that can cause lethal neurodegenerative diseases. In addition to causing diseases such as CJD and mad cow disease (BSE), prions are also a rare cause of dementia.

These proteins damage the brain by changing shape and forming misshapen chains. This process has also been identified in Parkinson’s disease and common forms of dementia such as Alzheimer’s disease.

One disease caused by prions that has been studied at the MRC’s Prion Unit is kuru, a rare disease that was typically found in a remote region of Papua New Guinea, among a community that consumed the brains of their dead as part of a funeral ritual.

In the late 1950s, at the height of a kuru epidemic, up to 2% of the population was killed by the disease each year. The mortuary feasts of the Fore people stopped in 1960, yet cases of the disease were reported in subsequent years, indicating that kuru has a long incubation period. It is now believed that the average incubation period for kuru is 10-13 years.

Experts believe that those who survived exposure to kuru may have a genetic resistance to the disease, and that the identification of any genetic changes that may have occurred could provide insight into how similar diseases such as CJD could be prevented or treated.

‘A striking example of Darwinian evolution in humans’

Working alongside colleagues at the Papua New Guinea Institute, the researchers discovered a specific gene – the prion protein gene – carried by some of the survivors of kuru that they believed might confer protection from the disease.

To investigate, the team bred mice with the same genetic change as that found in the kuru survivors. They achieved this by altering one of the amino acids that the prion protein is comprised of. The researchers then exposed the mice to kuru and CJD to test for resistance.

The team discovered that the mice were completely resistant not only to kuru but all forms of CJD too, including a form caused by human infection with BSE.

“From the human genetic work the Unit has carried out in Papua New Guinea we were expecting the mice to show some resistance to disease,” says study leader Dr. Emmanuel Asante. “However, we were surprised that the mice were completely protected from all human prion strains. The result could not have been clearer or more dramatic.”

The researchers believe that if they can work out how this change to the prion protein structure prevents it from changing shape and forming damaging chains, they may be able to discover a way to prevent CJD and other dementias caused by these chains of misshapen proteins.

“This is a striking example of Darwinian evolution in humans – the epidemic of prion disease selecting a single genetic change that provided complete protection against an invariably fatal dementia,” states Prof. John Collinge, leader of the kuru research program.

“Much work is now ongoing in the MRC Unit to understand the molecular basis of this effect which we expect to provide key insights into how seeds of other misshapen proteins develop in the brain and cause the common forms of dementia, thereby guiding us to new treatments in the years ahead.”

Last year, Medical News Today reported on a study suggesting that there could be a way to harness the brain’s capacity to self-repair and preserve brain function in brain-wasting prion diseases.

Written by James McIntosh

Copyright: Medical News Today

Veterans say VA Policy on Marijuana and Painkillers Lacking Consistency

Austin American-Statesman | Jun 15, 2015 | by Jeremy Schwartz

Since early 2013, Vietnam veteran Bill Williams had received daily doses of hydrocodone to help him deal with chronic leg and back pain. For more than 30 years, he has taken anti-anxiety drugs like Valium to help with the post-traumatic stress disorder he developed after a lengthy tour on a Navy submarine.

Occasionally, the 62-year-old Brackettville resident would smoke marijuana, which he said provided relief for his pain and PTSD in ways the pharmaceuticals could not. His experience with that drug, which he said also helped him sleep, mirrors that of a growing number of veterans who have turned to medical marijuana as an alternative to traditional treatments.

At first, he said, his Department of Veterans Affairs doctors tolerated his marijuana use, telling him that if it helped his symptoms he should continue. But that changed with the introduction of stricter VA policies on narcotic painkillers, the result of new Drug Enforcement Administration rules on hydrocodone and a VA push to reduce the number of patients receiving the medications.

In April, after he tested positive for marijuana, the VA canceled his hydrocodone prescription.

The incident is emblematic of a brewing battle over marijuana use among veterans suffering with chronic pain and anxiety disorders and the VA’s evolving, sometimes confusing, position as more states legalize the drug.

“There is no consistency, even in the states where it’s legal,” said Roger Martin, executive director of Grow4Vets, which advocates for marijuana treatment of pain and PTSD.

As a federal agency, the VA is in an unusual position. It recognizes marijuana possession as a federal offense, but its policy doesn’t prohibit veterans who get state-sanctioned medical marijuana from participating in VA pain control programs.

And officials say a positive marijuana test doesn’t automatically result in an opioid prescription cancellation, but should cause doctors to assess patients for “misuse, adverse effects and withdrawal.” The decision to halt opioid drugs when a patient uses marijuana “need(s) to be made by individual providers in partnership with their patients,” the agency’s policy states.

But in states such as Texas, where marijuana isn’t legal, the VA’s policy is less clear. Asked specifically about marijuana use by Texas patients, VA officials couldn’t provide clarification.

Williams’ doctor at the San Antonio VA, for example, told him that the agency’s policies provided no wiggle room. “Due to the presence of the marijuana, based on current VA practice guidelines, I am unable to prescribe further controlled substances (hydrocodone) at this time,” he wrote in a letter to Williams.

Martin said his group has heard from a number of veterans like Williams who say their painkiller prescriptions have been abruptly canceled in recent months because of marijuana use.

“It’s a flat-out violation of the Hippocratic oath,” he said. “It puts veterans and the people around them in danger.”

Pain specialist Dr. C.M. Schade, director emeritus of the Texas Pain Society, said that civilian doctors in Texas must halt narcotic prescriptions for patients who test positive for controlled substances; they can be resumed once the patient stops taking the illegal drug or enters treatment.

Williams said he stopped smoking marijuana months before his positive test, which he blamed on secondhand smoke from toking friends, but he acknowledged previous positive tests. But he said that shouldn’t disqualify him from receiving the pain medication he needs to function on a daily basis, especially if it is allowed in states like Colorado and Washington.

He recently underwent a procedure to burn the nerve endings in his back, which should give him relief for several months, but he fears for the future.

“What’s scaring me is that in (the coming) months, when I’m going to need pain medication, are they going to give it to me?” he said. “I’m not a person that’s going to go beg the VA for pain meds. I have a high tolerance for pain. But once those nerves grow back I won’t be able to live with it.”

Related Topics
Department of Veteran Affairs, PTSD

© Copyright 2015 Austin American-Statesman. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

North Korean teenager crosses DMZ to defect

By Jen Kwon, Asia Producer

A North Korean soldier has made a rare bid to defect to South Korea by crossing the demilitarised zone (DMZ) separating the two countries.

The teenager walked up to a South Korean guard post in Gangwon province’s Hwacheon county around 8.00am local time (23.00 GMT) after walking across the world’s most heavily militarised border.

No gunfire was exchanged as the soldier approached guards and expressed his wish to defect, officials from the South Korean Defence Ministry said.

“We’ve confirmed his will to defect after he reached our guard post,” a ministry spokesman said.

The soldier was taken into custody and an investigation has been launched by South Korean officials.

More than 1,000 North Korean soldiers defect to the South every year, although it is rare for anybody to attempt to cross the heavily mined DMZ.

Most defectors travel to South Korea via China. The last crossing via the DMZ took place in 2012.

Lee Yun-keol, chairman of the North Korea Strategy Information Service, said: “We had recently heard news that North Korea has been installing mines around the DMZ to prevent people from fleeing to South Korea.

“Also, since the 38th parallel was drawn, only a little over 10 people have succeeded to cross over to the South through the DMZ.”

The DMZ is 4km (2.49 miles) wide and is fortified with landmines and barbed wire.

Defectors have previously told Sky News of their lives inside North Korea and their difficult journeys to flee the country.

Casey Lartigue is the co-founder of the volunteer organisation Teach North Korean Refugees (TNKR), an NGO that connects North Korean refugees with people who can help them.

Mr Lartigue told Sky News many defectors struggle to adjust to South Korean society.

“They have made it to South Korea – a challenging process, not everyone survives – and they often suffer hardship along the way,” he said.

“From what I hear, South Korea certainly welcomes them, but after getting out of North Korea, they don’t consider themselves to be limited to South Korea.

“While saying they are thankful to have escaped North Korea and to have been accepted by South Korea, they will still say that South Korea is more of a struggle than they imagined.”

The defection comes as North Korean leader Kim Jong-Un witnessed the testing of a new anti-ship rocket.

South Korea announced that the North had fired three KN-01 missiles from its eastern border town of Wonsan in to the East Sea on Sunday.

Mr Kim hailed the rocket as “another fresh milestone” in bolstering the country’s naval power following the testing of a submarine-launched ballistic missile (SLBM).

The South’s defence ministry said the North had tested three short-range missiles with a range of nearly 62 miles (100km) on Sunday off its east coast.

“North Korea appears to be developing new missiles that would replace its old Soviet-designed anti-ship missiles,” ministry spokesman Kim Min-Seok told reporters.

Fusion Cells Leading to Cancer?

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Copyright: Medical News Today

As the number two leading cause of death in the US, cancer touches just about everyone in some way. There are many factors involved in the formation of cancer, and genetic changes are a key culprit. Now, a new study sheds light on how the fusion of one normal cell with another can trigger genomic events that turn normal cells cancerous, allowing tumors to form.

According to the American Cancer Society, in the US in 2015, around 1.6 million new cancer cases will be diagnosed, and over 589,000 individuals will die from the disease.

To further investigate causes for this ubiquitous condition, researchers from the University of Michigan and the Mayo Clinic undertook a study that is published in The American Journal of Pathology.

They note that exposure to carcinogens and infectious agents can trigger spontaneous genetic mutations that arise when cells divide. Some researchers, however, believe that the link between carcinogens and genetic changes are too uncertain to account fully for the development of common cancers.

However, researchers have suspected that cell fusion – the process whereby one or more cells combine to form a new cell with multiple nuclei – is a potential cause for some cancers, providing a reason why multiple genetic changes appear to underpin cancer development.

But there has been a lack of clear evidence that normal cell fusion alone could trigger cancer – until now, that is. In their latest study, the researchers show the missing link between cell fusion and the multiple genetic changes that transform normal cells into cancerous cells.

Additionally, the team has been able to show how, when injected into live animals, these fused cells form tumors.

‘Cell fusion generates chromosomal instability’

To conduct their study, the researchers used rat IEC-6 intestinal epithelial cells. They explain that these cells maintain a “stable diploid genomic structure” (one with two sets of chromosomes), replicate normally and lack the cellular features of cancer cells. These cells also do not form tumors when observed over several generations.

The team labeled the IEC-6 cells with either red or green dyes and then exposed them to 50% polyethylene glycol to facilitate cell fusion. The researchers could then determine if the cells had fused by noting the presence of both the red and green dyes within one cell.

While non-fused cells only contained one color, the researchers also noted that fused cells were larger than their non-fused counterparts.

Results reveal that fused cells can replicate – 19% of fused IEC-6 cells generated clones – and with replication, the chromosomes from the two separate cells fused together.

Additionally, the researchers found that 41% of the clones had abnormal numbers of chromosomes, 56% were near-diploid and 4% were tetraploid. In contrast, 86% of the non-fused cells were diploid.

Dr. Jeffrey L. Platt, from the University of Michigan-Ann Arbor, says their results “indicate that cell fusion generates chromosomal instability,” which refers to changes in the appearance and number of chromosomes. Because such abnormalities are typically observed in cancer, the team looked for DNA damage in the fused clones and found such damage in significantly more fused clones than non-fused clones.

They say their findings suggest that after cells fuse, a chromosomal instability might result in DNA damage and, therefore, genetic changes that underpin cancer.

Commenting on their findings, cancer specialist William B. Coleman, PhD, from the University of North Carolina Comprehensive Cancer Center in Chapel Hill, says:

“The frequency of cell fusion events in vivo is not known, although cell fusion is thought to occur under some circumstances such as cell injury, inflammation and viral infection. Although fusion of normal cells in vitro and in vivo may be a rare event, this study shows that cell fusion between normal cells can have pathological consequences.”

He adds that their results “provide evidence for another molecular mechanism driving neoplastic transformation – genomic catastrophe.”

Fused cells form tumors in mice

Interestingly, the team also found that when they transplanted IEC-6 cells into immunodeficient mice, during 12 weeks, they generated tumors in 61% of the hosts. In contrast, no tumors formed from the cells that did not fuse.

“We believe one cell fusion event can both initiate malignancy and fuel evolution of the tumor that ensues,” says lead author Xiaofeng Zhou, from the University of Michigan-Ann Arbor.

Dr. Coleman also adds that most cases of human spontaneous cancer are believed to come from cells that underwent random DNA damage or random errors during replication.

He calls for further research to determine whether cell fusion events between normal human cell types can bring about genomic catastrophe and neoplastic transformation.

Last week, Medical News Today reported on two studies that suggested immunotherapy is highly effective against cancer.

Supreme Court says no in Jerusalem passport case.

By Ariane de Vogue, CNN Supreme Court Reporter
Updated 12:48 PM ET, Mon June 8, 2015
(CNN)—The Supreme Court struck down part of a federal statute Monday that allowed Americans born in Jerusalem to record in their passport “Israel” as the place of birth.

The 6-3 decision is a victory for the Executive, and a loss for Congress and the 12-year-old boy caught in the middle of a separation of powers dispute.

For the last 60 years, the United States policy has been to recognize no state as having sovereignty over Jerusalem.

Justice Anthony Kennedy, who wrote the opinion, held that “over the last 100 years, there has been scarcely any debate over the President’s power to recognize foreign states.” Kennedy said that it was “clear” that in the statute at issue in the case,” Congress wanted to express its displeasure with the President’s policy, by among other things, commanding the Executive to contradict his own, early stated position on Jerusalem. This Congress cannot do.”

Kennedy said that the President has the exclusive power to grant formal recognition to a foreign sovereign and said that the law infringes on the Executive’s “consistent” decision to withhold recognition with respect to Jerusalem.

“Recognition is an act with immediate and powerful significance for international relations, so the President’s position must be clear. Congress cannot require him to contradict his own statement regarding a determination of formal recognition,” Kennedy wrote for the Court’s majority.

In dissent were Chief Justice John Roberts, Justice Antonin Scalia and Justice Samuel Alito.

READ: SCOTUS rules in favor of man convicted of posting threatening messages on Facebook

Roberts, in a dissent joined by Alito, said “Today’s decision is a first: Never before has this Court accepted a President’s direct defiance of an Act of Congress in the field of foreign affairs.”

Roberts said “the statue at issue does not implicate recognition” but “simply gives an American citizen born in Jerusalem the option to designate his place of birth as Israel for the purposes of passports and other documents.”

Scalia took the rare step of reading part of his dissent from the bench, which was joined by Roberts and Alito, saying that the law at issue “merely requires the State Department to list a citizen’s birthplace as Israel” and does not require the President to make “any other kind of legal commitment.”

“Today, the Supreme Court confirmed something that lower courts and scholars had long assumed—that the power to recognize foreign governments (and their territory) resides exclusively with the Executive Branch,” said Stephen I. Vladeck, an analyst for CNN and a law professor of the American University Washington College of Law. “This is not only a landmark win for presidential power over foreign affairs, but a rather decisive loss for Congress—which passed the statute at issue entirely to thwart a half-century-old Executive Branch policy,” he said.

Legal experts have been closely watching the case eager to see how the Court would resolve the separation of powers dispute.

Caught in the middle was a 12-year-old boy, Menachem Zivotofsky. When he was born his parents sought to have “Israel” listed on his U.S. passport as his place of birth pursuant to a federal law. But the State Department refused.

For the last 60 years, the United States policy has been to recognize no state as having sovereignty over Jerusalem. In 2002 when Congress passed the Foreign Relations Authorization Act, President George W. Bush signed the law but issued a statement saying he objected to section 214 at issue in today’s case.

In Court, Solicitor General Donald B. Verrilli said that Congress can’t use its authority to regulate passports “to command the Executive branch to issue diplomatic communication that contradicts the government’s official position on recognition.”

He noted that the question of the status of Jerusalem “is the most vexing and volatile and difficult diplomatic issue that this nation has faced for decades.”

“The nations in the region, and frankly people around the world and governments around the world scrutinize every word that comes out of the United States Government and every action that the United States Government takes in order to see whether we can continue to be trusted as an honest broker who could stand apart from this conflict and help bring it to resolution,” he said.

But Zivotofsky’s lawyers framed the case differently. Alyza D. Lewin said the case is not about formal recognition, but simply how an American is identified on his or her passport.

“We do not claim this is recognition,” she said at oral arguments.

Justice Elena Kagan seemed to side with the State Department at oral arguments.

“History suggests,” she said, “that everything is a big deal with respect to the status of Jerusalem. And right now, Jerusalem is a tinderbox because of issues about the status of and access to a particular holy site there.”

Scalia argued the other side saying that Congress is entitled to do what is authorized under the Constitution and “the fact that the State Department doesn’t like the fact that it makes the Palestinians angry is irrelevant.”

The 12-year-old boy was in court to hear arguments on the major separation of powers case that featured his name. After arguments he told reporters, “I’m an Israeli, and I want people to know that I’m glad to be an Israeli.”