Day: February 5, 2020


End of trial to leave deep scars…

The bruising battle over President TrumpDonald John TrumpDemocrats tear into Trump’s speech: It was a ‘MAGA rally’ READ: Speaker Pelosi’s response to Trump’s State of the Union address Pelosi hammers Trump’s speech: ‘A manifesto of mistruths’ MORE’s impeachment will come to an end Wednesday afternoon, and senators who have clashed for weeks over trial procedures say it will leave deep scars that may take months to heal.

Former President Clinton’s 1999 impeachment trial was an intensely divisive affair, but senators say Trump’s trial has set a new standard for partisan warfare in a chamber once known for its collegiality.

The Senate is scheduled to vote at 4 p.m. Wednesday on two articles of impeachment, with every Republican expected to vote for acquittal. However, the votes of three centrist Democrats — Sens. Joe ManchinJoseph (Joe) ManchinCollins: It would be ‘helpful’ for Trump to apologize GOP senators label Trump’s behavior ‘shameful’ but not impeachable Collins will vote to acquit Trump MORE (W.Va.), Doug Jones (Ala.) and Kyrsten Sinema (Ariz.) — remain up in the air.

But even if all three vote to convict, Democrats will fall far short of the 67 votes needed to remove Trump from office. Republicans hold a 53-47 majority in the chamber.

Sen. Susan CollinsSusan Margaret CollinsCollins: It would be ‘helpful’ for Trump to apologize Susan Collins challenger: ‘I would vote to remove’ Trump GOP senators label Trump’s behavior ‘shameful’ but not impeachable MORE (R-Maine), a key moderate, announced Tuesday afternoon that she would vote against both articles of impeachment, calling the second Senate trial of a sitting president in just 21 years a trend that “reflects the increasingly acrimonious partisanship facing our nation.”

Her announcement wasn’t surprising to Democrats, who argued last week that a largely partisan vote defeating a motion to call additional witnesses and documents was evidence that Republicans weren’t interested in conducting a fair trial. Collins was one of only two Republicans who voted with Democrats to review additional evidence.

“The Republicans refused to get the evidence because they were afraid of what it would show and that’s all that needs to be said,” said Senate Minority Leader Charles SchumerCharles (Chuck) Ellis SchumerMichigan governor to focus on health care, wages in State of the Union response Overnight Health Care — Presented by Partnership for America’s Health Care Future — Democrats seek to preempt Trump message on health care | E-cigarette executives set for grilling | Dems urge emergency funding for coronavirus Pelosi invites head of disability advocacy group to State of the Union MORE (D-N.Y.) on Tuesday.

Senate Majority Leader Mitch McConnellAddison (Mitch) Mitchell McConnellDemocrats tear into Trump’s speech: It was a ‘MAGA rally’ Omar: Trump address reads ‘as if a coequal branch of government doesn’t exist’ Trump bashes ‘Medicare for All’ in swipe at Sanders MORE (R-Ky.) accused Democrats of wanting to impeach Trump ever since he defeated former Secretary of State Hillary ClintonHillary Diane Rodham ClintonClinton advises checking your voter registration during Trump’s State of the Union Hillicon Valley: Iowa chaos highlights misinformation threat | Officials blame app for delayed results | Company offers ‘regret’ | Nevada officials drop plans to use app | Ohio ramps up election security Biden allies spin after disappointing results trickle in from Iowa MORE in a stunning 2016 upset.

“This fever led to the most rushed, least fair, and least thorough presidential impeachment inquiry in American history,” he said on the Senate floor.

Democrats are fuming over what they characterized as McConnell’s thoroughly partisan and unfair handling of the trial.

“McConnell clearly just cares about power. McConnell doesn’t care about this institution,” said Sen. Sherrod BrownSherrod Campbell BrownTrump bashes ‘Medicare for All’ in swipe at Sanders Senate faces hours of late-night votes without agreement on ending impeachment trial Senate moves to impeachment endgame MORE (D-Ohio).

Republicans countered that Schumer approached the trial as a partisan fight from the start. They pointed to his decision to immediately make public a letter to McConnell asking for four witnesses to testify at the trial and a marathon series of votes he forced until 2 a.m. before opening arguments were set to begin.

“I’m a pretty optimistic person. I’m pretty upbeat. And I feel pretty dejected about where we are right now as a Congress and as a country. I’m just not in a very uplifted mood,” Sen. Lisa MurkowskiLisa Ann MurkowskiGOP senators label Trump’s behavior ‘shameful’ but not impeachable Overnight Energy: BLM weighs plan to cut environmental reviews | Meet the woman who wants to reinvent recycling | Murkowski says energy plan coming soon Collins will vote to acquit Trump MORE (R-Alaska) said Tuesday.

On Friday, the Senate spent the day wrangling over a resolution to set the schedule for the trial’s end. Senators also defeated a motion to debate subpoenas for additional witnesses and documents, with Murkowski calling it “the worst day ever.”

The Alaska Republican and many other GOP senators said they were turned off by what they considered aggressive tactics by Democrats, such as accusing Republicans of a “cover-up” if they voted against calling witnesses like former national security adviser John BoltonJohn BoltonOn The Money: Democrats urge emergency funding for coronavirus | Kudlow says outbreak will have ‘minimal impact’ on economy | Top Dem demands Barr recuse himself from case against Turkish bank Giuliani: Trump should ‘absolutely, 100 percent’ keep investigating Biden Now it’s all about the election MORE.

“The Senate should be ashamed by the rank partisanship that has been on display,” Murkowski said on the floor Monday.

“We cannot be the greatest deliberative body when we kick things off by issuing letters to the media instead of coming together to set the parameters of the trial and negotiate in good faith how we should proceed,” she added, alluding to Schumer’s letter to McConnell in December.

Democrats on Tuesday shot back, arguing Republicans were afraid of Trump and retreated in fear of being targeted by one of the president’s infamous tweets.

While Sen. Richard Blumenthal (D-Conn.) noted that “the polarization is tearing us apart,” he said it wasn’t a reason to vote against hearing from additional witnesses and reviewing key documents at an impeachment trial.

“Give me a break,” he said.

“You can’t blame it on this vague, amorphous phenomenon of lack of collegiality. She had a decision and she decided to buckle under to the president and Leader McConnell. I think history will judge her harshly,” Blumenthal said.

Other Democrats accused their GOP colleagues of being too scared of Trump to vote their conscience.

“They have let their political party become the party of Trump. Whether they know better, whether they’re scared to death, whether they don’t care, whether they’re all going to retire with their pensions, I don’t know,” said Brown.

And while the trial is nearly over, both parties are vowing to fight on.

Senate Homeland Security Committee Chairman Ron JohnsonRonald (Ron) Harold JohnsonMurkowski asks why should Bolton not testify before Senate Live coverage: Senators enter second day of questions in impeachment trial Overnight Energy: Environment takes center stage in House infrastructure plan | Iowans push 2020 candidates on climate | Sanders offers bill on ‘forever chemicals’ MORE (R-Wis.) said his committee will continue to investigate Ukraine’s possible intervention in the 2016 campaign, an allegation that Democrats have panned as Russian propaganda, as well as the FBI’s investigation of the Trump campaign in 2016.

Senate Judiciary Committee Chairman Lindsey GrahamLindsey Olin GrahamHuawei threatens the US-UK ‘special relationship’ Trump poised to make case for reelection in State of the Union Senate drama surrounding Trump trial starts to fizzle MORE (R-S.C.), meanwhile, has called for an investigation of Hunter Biden’s business dealings in Ukraine.

House Democrats, who have subpoena power, plan to continue their investigations of Trump and his administration.

Senators remarked on the rift between McConnell and Schumer during the trial and how little talk there was between Republicans and Democrats in general.

With the center aisle creating a gulf between the two parties, Senate Democrats spent much of the trial scanning the faces of their GOP colleagues in hopes of gleaning some hints from their expressions and body language.

McConnell and Schumer weren’t spotted talking together on the Senate floor until Friday afternoon, after the Democratic leader threatened to make the chamber debate a second organizing resolution into the wee hours of the night by forcing multiple motions to close the Senate doors for deliberations.

“I think they need to go out for dinner or something,” said one Republican senator, who was left shaking his head over the lack of collegiality between McConnell and Schumer.

Senators who sat as jurors in the 1999 Clinton trial said the relations between then-Majority Leader Trent Lott (R-Miss.) and then-Democratic Leader Tom Daschle (D-S.D.) were much better.

“There was much more openness at that time and more open conversation,” said Senate Minority Whip Dick DurbinRichard (Dick) Joseph DurbinTrump bashes ‘Medicare for All’ in swipe at Sanders Iowa meltdown threatens future of state’s caucuses Illinois senators meet with Amtrak CEO over ,000 price tag for wheelchair users MORE (D-Ill.).

Senators gathered privately in the Old Senate Chamber before the Clinton trial and emerged with a bipartisan deal that passed 100-0, establishing the rules for the proceedings.

Democrats complain that McConnell refused to negotiate with Schumer on the organizing resolution for the trial and didn’t reveal what the rules would be until the Martin Luther King Jr. holiday, giving them almost no heads-up about what to expect.

When the resolution was released, Democrats discovered to their anger that the House impeachment managers would have to cram 24 hours’ worth of arguments into two days, forcing them to speak late into the night.

McConnell later relented, to allow the House managers and Trump’s lawyers three days each after getting pushback from moderate Republicans.

Democrats were also upset that Republicans broke with precedent by not allowing any witnesses to testify, something that had been allowed in the other two Senate impeachment trials. President Andrew Johnson’s 1868 impeachment trial included testimony from 41 witnesses, while three witnesses testified at Clinton’s trial.

Senators say the viciousness of the fighting surrounding Trump’s trial could be a sign of worse things to come, or it could mark rock bottom for bipartisan relations with better times ahead.

“There are two roads: One is this is another step down a very dark stairway to a very bad ending and the other is, as Sen. Murkowski proposed, that with this we will have hit bottom and a concerted effort to try to rebuild will be inspired by what just took place,” Sen. Sheldon WhitehouseSheldon WhitehouseCBO’s newest spending report is an abyss of red ink Live coverage: Senators query impeachment managers, Trump defense Democrats urge Supreme Court to save consumer agency from chopping block MORE (D-R.I.) said Tuesday.

Sen. Rob PortmanRobert (Rob) Jones PortmanGOP senators label Trump’s behavior ‘shameful’ but not impeachable GOP senator: Trump’s actions to withhold Ukraine aid ‘wrong’ but not impeachable Rubio: Impeachable actions don’t necessarily mean a president should be removed MORE (R-Ohio), speaking on the floor Tuesday afternoon, said he hoped Republicans and Democrats could reunite in the months ahead on bipartisan bills.

“I think we heal in part by surprising the people and coming out from our partisan corners and getting stuff done,” he said.

Rebecca Beitsch contributed.

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First head rolls…

“We had precinct captains who didn’t know how to run a caucus. And a few didn’t even show. We lost friggin’ people on the second ballot of voting in the caucus! Someone’s head had to roll,” said a top-level Biden campaign staffer.

Some of the precinct tallies from election night showed Biden losing support after the first alignment, a sign of weak support or poorly trained precinct captains or both.

With 71 percent of caucus precincts reporting, Biden appears on track to finish in fourth place, behind Pete Buttigieg, Bernie Sanders and Elizabeth Warren.

Bogen’s departure is the first sign that the campaign is under pressure to address deficiencies after Biden’s poor Iowa showing. The partial numbers out of Iowa show him with just under 16 percent of the raw vote. That’s just three percentage points ahead of Amy Klobuchar, who surged in the last week of the campaign.

The preliminary caucus results show that Biden struggled to gain viability in counties across the state. That’s despite the former vice president’s high name recognition and the campaign’s focus on the state in the closing months before the caucuses.

Bogen last worked as the field director for the Florida gubernatorial campaign of former Miami Beach Mayor Philip Levine, who lost in a crowded Democratic primary to Andrew Gillum. Some of her friends from Florida said she was being scapegoated and that she had privately complained about the dysfunction of the campaign, which she blamed on higher-ups.

“The Biden campaign is desperate to blame everyone for his problems in Iowa — the state party, Donald Trump, Adrienne — and that’s bullshit,” a friend, a Democrat who is not aligned with another party but did not want to discuss her separation from the campaign without her knowledge, said.

Another friend said that Bogen —who is getting married April 4 in St. Petersburg to the Florida state director of Michael Bloomberg’s presidential campaign — wanted more time off for her wedding and honeymoon than the campaign could afford.

Bogen did not reply to requests for comment.

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Lesotho's first lady charged with murdering husband's ex-wife…

Lipolelo Thabane was shot dead outside her home in the capital Maseru just two days before Prime Minister Thomas Thabane’s inauguration in June 2017.

Maesaiah Thabane, 42, appeared in court Wednesday and was remanded in custody after the murder charge.

She was also charged with the attempted murder of a second woman who was with the former first lady the night she was killed.

The murder has shocked the small kingdom surrounded entirely by South Africa.

With political pressure mounting, the 80-year-old Prime Minister announced last month that he would respect the wishes of the ruling party and would resign from office. A date for his resignation has not yet been announced.

Police in Lesotho want to question Prime Minister Thabane in ex-wife's killing

CNN has made repeated attempts to reach Maesaiah Thabane’s lawyer but has been unsuccessful.

Police told CNN the first lady became a prime suspect after she failed to appear for questioning in January in connection to Lipolelo Thabane’s killing.

She later turned herself in on Tuesday morning at a police station close to the border with South Africa.

Before the shooting, the Prime Minister and his first wife were negotiating their divorce.

The Prime Minister remarried less than three months after her death, according to local media reports.

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Eight-year-old rapper strikes chord in Uganda with songs about poverty…

The eight-year-old rapper has become a household name in Uganda, a country mired in poverty and corruption, for singing about his parents’ struggles to provide for him and his four siblings

By Elias Biryabarema

KAMPALA, Feb 5 (Reuters) – Ugandan rapper “Fresh Kid” has racked up hundreds of thousands of hits on YouTube, won a U.S. music award and emerged victorious from a tussle with the government – all before his eighth birthday.

The rapper, real name Patrick Ssenyonjo, has become a household name in Uganda, a country mired in poverty and corruption, for singing about his parents’ struggles to provide for him and his four siblings.

“Don’t send me back to the village where there’s no help, I remember a time when money was scarce, Getting fees and food was so difficult,” he sings in his hit single “Bambi”, which means “Please” in the Luganda language and has had more than 200,000 YouTube views.

Fresh Kid discovered his talent while growing up in Luwero, a coffee-growing area 60 km (37 miles) north of the capital Kampala.

“He could listen to a song on radio and immediately memorise it and start singing it,” said his father, Paul Mutabaazi, 40, an illiterate manicurist.

One day a singer he idolized held a show near their home. Fresh Kid asked to perform as a warm-up act, earning 500,000 shillings ($136) for his efforts – a month’s salary for a teacher in Uganda.

Mutabaazi approached a talent spotter who started booking performances and producing his songs.

Ironically, the boy’s career really took off when Uganda’s minister for children’s affairs sought to bar him last year from singing under laws prohibiting child labour.

The spat generated national headlines, with Ugandans criticising the minister for blocking the rapper’s rise.

Fresh Kid then wrote “Bambi”, his plea to be allowed to sing. It became ubiquitous on the radio and in bars, and won the Best International Video from the U.S.-based Carolina Music Video Awards.

“Children should work hard. If you have a talent, use it,” Fresh Kid told Reuters.

Eventually his parents, his manager and the government struck a deal.

Fresh Kid now lives in Kampala with his family in an apartment he bought and he attends an elite school on a full bursary. His father has opened a beauty salon in Kampala.

Outside Bad Man Records studio on Kampala’s outskirts, the young rapper is just another kid playing with his friends, albeit with an NBA-branded silver chain dangling over his purple track suit.

Inside the studio, he is all focus. He can record a song in under an hour with barely any rehearsing, his producers say.

“He has a very strong memory,” said Aggrey Akena, one of his producers. “His vocals are very amazing.” (Reporting by Elias Biryabarema Editing by Katharine Houreld and Gareth Jones)

Our Standards: The Thomson Reuters Trust Principles.

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PORNHUB Mainstream March as Stars Debut at Fashion Week…

PornHub’s march to the mainstream continues with the news that performers on the site are to walk the New York Fashion Week runway for the first time.

Page Six reports that porn stars made famous by the “YouTube of Porn,” including Asa Akira, Marica Hase and Jade Kush (note, these may not be the names they were given at birth), are set to strut their stuff in a show Sunday for Berlin designers Nan Li and Emilia Pfohl of Namilia.

The designers’ collection is called Herotica, and the designers say their runway guests are a feminist statement.

“The cosmos of sexual pleasure has been restricted to a few boring and chauvinistic narratives for the pleasure of the male gaze,” Li told Page Six, “Porn isn’t something existentially male. Most women just have been excluded from determining the narrative.”

The arrival of porn stars in the once-exclusive environs of Fashion Week is just the latest evidence of the porn giant’s increasingly successful quest to conquer the mainstream.

Last year, more people (141 million) voted for their favorite videos on Pornhub than voted in the 2016 U.S. presidential election (139 million).

Since at least 2014, the company has pursued a strategy of marketing itself to the mainstream via “SFW” ad campaigns, including billboards in Times Square and tongue-in-cheek Christmas ads.

Conservative estimates value the porn industry at around $2 billion, and Worth of Web has estimated that PornHub makes around a million dollars a day in revenue. It was founded by a Japanese entrepreneur Keishi Kameyama whose company still owns it.

Last year, former Disney Channel star Bella Thorne directed a pornographic take on Romeo and Juliet for the site entitled Her & Him, which featured music from Thorne’s ex-boyfriend, the rapper Mod Sun.

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Far-right backing for regional politician shocks Germany…

Berlin (AFP) – The small state of Thuringia broke a German political taboo Wednesday after a candidate for the regional premiership was heaved into office with help from the far right for the first time, sending shockwaves to Berlin.

Chancellor Angela Merkel’s centre-right CDU party immediately called for fresh regional elections as a way out of the crisis, a call echoed by other mainstream parties.

Thomas Kemmerich, a politician from the economically liberal Free Democratic Party (FDP), was elected as state premier after lawmakers from the far-right AfD gave him their backing.

As a result, 54-year-old Kemmerich beat incumbent Bodo Ramelow of the Left party 45 to 44.

“This is the first time in the history of modern Germany that a state premier has been elected with AfD votes,” political scientist Andre Brodocz told broadcaster MDR.

While the ballot was secret, Kemmerich must have also had support from CDU MPs, as well as his FDP stablemates.

Media were quick to describe the event as a “political earthquake”, as mainstream parties had previously refused to countenance working with anti-immigration, anti-Islam and anti-EU AfD at any level.

– ‘Bad day for Germany’ –

The result sparked widespread outrage, with Norbert Walter-Borjans, co-leader of Merkel’s junior coalition partner the Social Democratic Party (SPD), calling for a “clear position” distancing Merkel’s conservatives from the AfD.

“What has happened in Thuringia is not just a matter for Thuringia” but for federal politics too, he told broadcaster ZDF.

“This is a bad day for Thuringia, a bad day for Germany,” CDU president Annegret Kramp-Karrenbauer said in French city Strasbourg.

She called for new elections in the state and blasted regional politicians for breaching the party’s policy of no cooperation with the AfD.

“New elections would be the best thing for Thuringia,” the CDU’s secretary general Paul Ziemiak added.

Members of the two government parties, CDU and he SPD, organised a crisis meeting in Berlin on Saturday to discuss the issue.

“The republic is in danger,” said Katja Kipping, a leader of the far-left Linke party,

– ‘Bad day for liberals’ –

Addressing the local parliament in Erfurt, Kemmerich sought to assuage concerns by insisting he would stick to a pre-election pledge not to partner with the far right.

“You have in me a bitter opponent of anything that even hints at radicalism, from the right or left, or fascism,” he said, to jeers from local MPs and shouts of “Hypocrite!” and “Charlatan!”

In a news conference, national FDP leader Christian Lindner said if other parties refused to work with Kemmerich to form a government there should be new elections.

AfD’s support for the liberal politician had been “purely tactical” and the FDP “does not share this party’s aims and values,” he insisted.

But the party’s deputy leader Wolfgang Kubicki welcomed Kemmerich’s election as state premier.

Protestors quickly gathered outside the state parliament in Erfurt, with some holding signs recalling that it was in Thuringia that a Nazi minister was first allowed into government in 1930.

Demonstrations were planned for other cities around Germany Wednesday evening, including Frankfurt, Leipzig and outside FDP headquarters in Berlin.

– Jewish leader ‘horrified’ –

Thuringia belongs to Germany’s former communist east, where rejection of the far right has not taken such deep roots as in the west in the decades since the country’s 1990 reunification.

But the dam breaking there is all the more surprising to observers as the AfD’s regional leader, Bjoern Hoecke, is one of the party’s most radical figures, heading a loose movement within the party known as the “Wing”.

He has in the past called for a “180 degree turn” in Germany’s culture of remembrance for the Holocaust and other crimes of the Nazis, which form a central pillar of the country’s post-World War II political life.

Wednesday marked a “new start for Thuringian politics,” Hoecke said, adding the AfD had helped stop it becoming a “left-wing state”.

The CDU’s Ziemiak lamented that Kemmerich had accepted “votes from Nazis like Mr Hoecke”.

AfD co-leader Joerg Meuthen told the Frankfurter Allgemeine daily the vote showed there was “less distance” between the CDU, FDP and AfD than other parties.

Central Council of Jews in Germany president Josef Schuster said he was “horrified” by the vote outcome.

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Robot could call last orders on human bartenders…

TOKYO (Reuters) – Japan’s first robot bartender has begun serving up drinks in a Tokyo pub in a test that could usher in a wave of automation in restaurants and shops struggling to hire staff in an aging society.

The repurposed industrial robot serves drinks in is own corner of a Japanese pub operated by restaurant chain Yoronotaki. An attached tablet computer face smiles as it chats about the weather while preparing orders.

The robot, made by the company QBIT Robotics, can pour a beer in 40 seconds and mix a cocktail in a minute. It uses four cameras to monitors customers to analyze their expressions with artificial intelligence (AI) software.

“I like it because dealing with people can be a hassle. With this you can just come and get drunk,” Satoshi Harada, a restaurant worker said after ordering a drink.

“If they could make it a little quicker it would be even better.”

Finding workers, especially in Japan’s service sector, is set to get even more difficult.

The government has eased visa restrictions to attract more foreign workers but companies still face a labor shortage as the population shrinks and the number of people over 65 increases to more than a third of the total.

Service companies that can’t relocate overseas or take advantage of automation are more vulnerable than industrial firms. In health care alone, Japan expects a shortfall of 380,000 workers by 2025.

Japan wants to use the Tokyo 2020 Olympic Games beginning on July 27 to showcase service robot technology, with organizers planning to use robots built by Toyota Motor and Panasonic Corp to help visitors, workers and athletes.

The robot bartender trial at the pub, which employs about 30 people, will last two months after which Yoronotaki will assess the results.

Slideshow (3 Images)

“We hope it’s a solution,” Yoshio Momiya, a Yoronotaki manager, said as the robot bartender served drinks behind him.

“There are still a number of issues to work through, such as finding enough space for it, but we hope it will be something we can use.”

At about 9 million yen ($82,000), the robot cost as much as employing a human bartender for three years.

Reporting by Tim Kelly and Akira Tomoshige; Editing by Robert Birsel

Our Standards:The Thomson Reuters Trust Principles.

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Massive genome study unlocks secrets of how cancers form…

Tokyo (AFP) – A massive, decade-long study sequencing the genomes of dozens of cancers has revealed the secrets of how tumours form and may pave the way for better and more targeted treatment.

The Pan-Cancer Project brought together over 1,300 researchers globally to tackle the mammoth task of sequencing the genomes of 38 types of cancer in nearly 2,800 patients.

Their work produced a host of new discoveries — from the number and location of so-called driver mutations that push cells to reproduce uncontrollably, to the surprising similarities between cancers found in different types of tissue.

The results were published Thursday in nearly two dozen papers in Nature and other Nature Research journals and represent the largest and most comprehensive study of whole cancer genomes ever.

“With the knowledge we have gained about the origins and evolution of tumours, we can develop new tools and therapies to detect cancer earlier, develop more targeted therapies and treat patients more successfully,” said Lincoln Stein, a member of the project steering committee, in a statement issued by the Ontario Institute for Cancer Research.

Among the key findings of the work is the massive variety in cancer genomes, said Peter Campbell of the Wellcome Sanger Institute, another steering committee member.

“The most striking finding is just how different one person’s cancer genome is from another person’s,” he told AFP.

The study found thousands of combinations of mutations in individual cancers, as well as over 80 processes that cause the mutations, some of them age-related and others inherited or linked to lifestyle factors such as smoking.

– ‘Exciting themes’ –

But within the enormous variety there were “exciting themes”, Campbell said.

For example, the work found the early development of some cancers can occur decades before diagnosis, sometimes even in childhood.

“This shows that the window of opportunity for early intervention is much wider than we expected,” Campbell said.

The research also found that patterns of mutations, and where they occur, can help identify the approximately 1-5 percent of cancers that cannot be identified through regular diagnostics.

A sequenced genome can even reveal occasional misdiagnosis of a cancer type.

Most work on sequencing the cancer genome has focused on the approximately two percent known as the protein-coding genes.

But the Pan-Cancer Study sequenced entire genomes, uncovering new cancer-causing driver mutations in the other 98 percent, known as non-coding genes.

The researchers found enormous variation in the number of mutations in a given cancer, from very few in some cancers seen in children, to up to 100,000 in lung cancer samples.

And in around five percent of cases, no known driver mutations were found at all, implying there are mutations that have not yet been identified.

– ‘Enormous spectrum’ –

The sequencing helps map out the many types of mutations — from changes in single DNA letters to much larger insertions or deletions of genetic code — that can cause cancer.

It also revealed that cancers in different parts of the body are sometimes much more alike than had been thought.

“We may have a type of breast cancer and prostate cancer where the driver mutations are similar,” said Joachim Weischenfeldt, a co-author and associate professor at the University of Copenhagen.

“This means that the patient with prostate cancer may benefit from the same treatment as the one you would give the breast cancer patient,” he said in a statement issued by the university.

In practical terms, the findings will help identify difficult-to-diagnose cancers, allow more targeted treatment based on the specific driver mutations behind a particular cancer, and potentially allow earlier diagnosis of developing tumours.

“We are finding that cancer represents the far end of an enormous spectrum of change,” said Campbell.

“If we can understand the forces at play in our normal organs as we age, what causes mutations to accumulate, what causes some clones to expand and others to fade, what lifestyles do to tilt this balance, then we can think about ways to intervene early, with a view to preventing or slowing the emergence of untreatable cancers.”

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Madoff says he's dying, seeks early release from prison…

Bernie Madoff, the notorious Ponzi schemer, says that he is dying from kidney disease, and is seeking an early release from prison on compassionate grounds so that he can die at home.

A lawyer for Madoff, in a new legal filing Wednesday, says the fraudster has “less than 18 months to live,” and is suffering from “numerous other serious medical conditions” including cardiovascular disease and hypertension.

Madoff, 81, currently is serving a 150-year prison sentence in a North Carolina federal facility for orchestrating the largest Ponzi scheme in history, to which he pleaded guilty in 2009.

Madoff, while running Bernard L. Madoff Investment Securities in New York City, swindled thousands of investors out of billions of dollars in the decades-long scam.

“I’m terminally ill,” Madoff told The Washington Post in an article published Wednesday about his request.

“There’s no cure for my type of disease. So, you know, I’ve served. I’ve served 11 years already, and, quite frankly, I’ve suffered through it,” Madoff told the newspaper, which noted that he has been moved to palliative care in the Federal Medical Center prison in Butner, N.C.

His attorney, Brandon Sample, in a filing Wednesday in U.S. District Court in Manhattan, said, “Madoff does not dispute the severity of his crimes nor does he seek to minimize the suffering of his victims. Madoff has expressed remorse for his crimes.”

Financier Bernard Madoff leaves Manhattan Federal court March 10, 2009 in New York City.

Mario Tama | Getty Images

“Now, after over ten years of incarceration and with less than 18 months to live, Madoff humbly asks this Court for a modicum of compassion.”

Sample said in the filing that the U.S. Bureau of Prisons had recognized that Madoff “meets the criteria for a reduction of sentence based on his end-stage renal disease,” but has denied his request for compassionate release.

The BOP said in a letter that, “in light of the nature and circumstances of his offense, his release at this time would minimize the severity of his offense.”

The U.S. Attorney’s Office for the Southern District of New York, which prosecuted Madoff declined to comment on the request, as did the Madoff Trustee, who is responsible for recovering funds for victims of his scheme.

To date, the Madoff Trustee has recovered more than $14.3 billion for Madoff customers, or more than 75 cents for ever dollar of claims filed by victims of the scam.

Peter Chavkin, a lawyer for Madoff’s wife, Ruth Madoff, declined to comment.

The couple’s two sons died in the years after Bernie Madoff leaded guilty to 11 crimes.

One of them, Mark, killed himself in December 2010 on the second anniversary of his father’s arrest.

The other son, Andrew, died in 2014 from cancer.

Sample told CNBC, “Mr. Madoff has terminal kidney disease.”

“The federal prison system acknowledges that he has only months left to live. The compassionate release statute is precisely for situations like Mr. Madoff’s,” Sample said.

“Mr. Madoff has been punished significantly for his crimes. He has been in prison for over 10 years and holds deep remorse for his conduct. He should be allowed to spend the few remaining moments he has on this earth with the people who — despite his mistakes — still love and care for him.”

Madoff’s request comes nearly seven months after he asked President Donald Trump to reduce his sentence.

And it came three days after the death of former WorldCom CEO Bernard Ebbers, whom a judge ordered released on compassionate grounds in December from federal prison in Texas, where he had been serving a 25-year sentence for overseeing one of the largest accounting frauds in U.S. history.

Sample, in his filing, cited Ebbers’ release, which came at the behest of a judge in the same New York federal district where Madoff was convicted.

Sample said in that filling that a prison term that was “just and proportionate at the time of sentencing may become disproportionately severe based on changed circumstances, such as terminal illness.”

“This Court must now consider whether keeping Madoff incarcerated, in light of his terminal kidney failure and a life expectancy of less than 18 months, is truly in furtherance of statutory sentencing goals and our society’s value and understanding of compassion,” the lawyer wrote.

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Beyond burnout: Doctors decry 'moral injury' from financial pressures of health care…

Dr. Keith Corl was working in a Las Vegas emergency room when a patient arrived with chest pain. The patient, wearing his street clothes, had a two-minute exam in the triage area with a doctor, who ordered an X-ray and several other tests. But later, in the treatment area, when Corl met the man and lifted his shirt, it was clear the patient had shingles. Corl didn’t need any tests to diagnose the viral infection that causes a rash and searing pain.

All those tests? They turned out to be unnecessary and left the patient with over $1,000 in extra charges.

The excessive testing, Corl said, stemmed from a model of emergency care that forces doctors to practice “fast and loose medicine.” Patients get a battery of tests before a doctor even has time to hear their story or give them a proper exam.

“We’re just shotgunning,” Corl said.

The shingles case is one of hundreds of examples that have led to his exasperation and burnout with emergency medicine. What’s driving the burnout, he argued, is something deeper — a sense of “moral injury.”

Corl, a 42-year-old assistant professor of medicine at Brown University, is among a growing number of physicians, nurses, social workers and other clinicians who are using the phrase “moral injury” to describe their inner struggles at work.

The term comes from war: It was first used to explain why military veterans were not responding to standard treatment for post-traumatic stress disorder. Moral injury, as defined by researchers from veterans hospitals, refers to the emotional, physical and spiritual harm people feel after “perpetrating, failing to prevent, or bearing witness to acts that transgress deeply held moral beliefs and expectations.”

Drs. Wendy Dean and Simon Talbot, a psychiatrist and a surgeon, were the first to apply the term to health care. Both wrestled with symptoms of burnout themselves. They concluded that “moral injury” better described the root cause of their anguish: They knew how best to care for their patients but were blocked from doing so by systemic barriers related to the business side of health care.

That idea resonates with clinicians across the country: Since they penned an op-ed in Stat in 2018, Dean and Talbot have been flooded with emails, comments, calls and invitations to speak on the topic.

Burnout has long been identified as a major problem facing medicine: 4 in 10 physicians report feelings of burnout, according to a 2019 Medscape report. And the physician suicide rate is more than double that of the general population.

Dean said she and Talbot have given two dozen talks on moral injury. “The response from each place has been consistent and surprising: ‘This is the language we’ve been looking for for the last 20 years.’”

Dean said that response has come from clinicians across disciplines, who wrestle with what they consider barriers to quality care: insurance preauthorization, trouble making patient referrals, endless clicking on electronic health records.

Those barriers can be particularly intense in emergency medicine.

Corl said he has been especially frustrated by a model of emergency medicine called “provider-in-triage.” It aims to improve efficiency but, he said, prioritizes speed at the cost of quality care. In this system, a patient who shows up to an ER is seen by a doctor in a triage area for a rapid exam lasting less than two minutes. In theory, a doctor in triage can more quickly identify patients’ ailments and get a head start on solving them. The patient is usually wearing street clothes and sitting in a chair.

These brief encounters may be good for business: They reduce the “door to doc” time — how long it takes to see a doctor — that hospitals sometimes boast about on billboards and websites. They enable hospitals to charge a facility fee much earlier, the minute a patient sees a doctor. And they reduce the number of people who leave the ER without “being seen,” which is another quality measure.

But “the real priority is speed and money and not our patients’ care,” Corl said. “That makes it tough for doctors who know they could be doing better for their patients.”

Dean said people often frame burnout as a personal failing. Doctors get the message: “If you did more yoga, if you ate more salmon salad, if you went for a longer run, it would help.” But, she argued, burnout is a symptom of deeper systemic problems beyond clinicians’ control.

Emergency physician Dr. Angela Jarman sees similar challenges in California, including ER overcrowding and bureaucratic hurdles to discharging patients. As a result, she said, she must treat patients in the hallways, with noise, bright lights and a lack of privacy — a recipe for hospital-acquired delirium.

“Hallway medicine is such a [big] part of emergency medicine these days,” said Jarman, 35, an assistant professor of emergency medicine at UC-Davis. Patients are “literally stuck in the hallway. Everyone’s walking by. I know it must be embarrassing and dehumanizing.”

For example, when an older patient breaks an arm and cannot be released to their own care at home, they may stay in the ER for days as they await evaluation from a physical therapist and approval to transfer to rehab or a nursing home, she said. Meanwhile, the patient gets bumped into a bed in the hallway to make room for new patients who keep streaming in the door.

Being responsible for discharging patients who are stuck in the hallway is “so frustrating,” Jarman said. “That’s not what I’m good at. That’s not what I’m trained to do.”

Jarman said many emergency physicians she knows work part time to curtail burnout.

“I love emergency medicine, but a lot of what we do these days is not emergency medicine,” she said. “I definitely don’t think I’ll make it 30 years.”

Also at UC-Davis, Dr. Nick Sawyer, an assistant professor of emergency medicine, has been working with medical students to analyze systemic problems. Among those they’ve identified: patients stuck in the ER for up to 1,000 hours while awaiting transfer to a psychiatric facility; patients who are not initially suicidal, but become suicidal while awaiting mental health care; patients who rely on the ER for primary care.

Sawyer, 38, said he has suffered moral injury from treating patients like this one: A Latina had a large kidney stone and a “huge amount of pain” but could not get surgery because the stone was not infected and therefore her case wasn’t deemed an “emergency” by her insurance plan.

“The health system is not set up to help patients. It’s set up to make money,” he said.

The best way to approach this problem, he said, is to help future generations of doctors understand “how decisions made at the systems level impact how we care about patients” — so they can “stand up for what’s right.”

Whether these experiences amount to moral injury is open for discussion.

Cynda Rushton, a nurse and professor of clinical ethics at Johns Hopkins University, who has studied the related notion of “moral distress” for 25 years, said there isn’t a base of research, as there is for moral distress, to measure moral injury among clinicians.

But “what both of these terms signify,” Rushton said, “is a sense of suffering that clinicians are experiencing in their roles now, in ways that they haven’t in the past.”

Dean grew interested in moral injury from personal experience: After a decade of treating patients as a psychiatrist, she stopped because of financial pressures. She said she wanted to treat her patients in longer visits, offering both psychotherapy and medication management, but that became more difficult. Insurers would rather pay her for only a 15-minute session to manage medications and let a lower-paid therapist handle the therapy.

Dean and Talbot created a nonprofit advocacy group called Moral Injury of Healthcare, which promotes public awareness and aims to bring clinicians together to discuss the topic.

Their work is attracting praise from a range of clinicians:

In Cumberland County, Pennsylvania, Mary Franco, who is now 65, retired early from her job as a nurse practitioner after a large corporation bought out the private practice she worked in. She said she saw “a dramatic shift” in the culture there, where “revenue became all-important.” The company cut in half the time for each patient’s annual exam, she said, down to 20 minutes. She spent much of that time clicking through electronic health records, she said, instead of looking the patient in the face. “I felt I short-shrifted them.”

In southern Maine, social worker Jamie Leavitt said moral injury led her to take a mental health break from work last year. She said she loves social work, but “I couldn’t offer the care I wanted to because of time restrictions.” One of her tasks was to connect patients with mental health services, but because of insurance restrictions and a lack of quality care providers, she said, “often my job was impossible to do.”

In Chambersburg, Pennsylvania, Dr. Tate Kauffman left primary care for urgent care because he found himself spending half of each visit doing administrative tasks unrelated to a patient’s ailment — and spending nights and weekends slogging through paperwork required by insurers.

“There was a grieving process, leaving primary care,” he said. “It’s not that I don’t like the job. I don’t like what the job has become today.”

Corl said he was so fed up with the provider-in-triage model of emergency medicine that he moved his ER clinical work to smaller, community hospitals that don’t use that method.

He said many people frame burnout as a character weakness, sending doctors messages like, “Gee, Keith, you’ve just got to try harder and soldier on.” But Corl said the term “moral injury” correctly identifies that the problem lies with the system.

“The system is flawed,” he said. “It’s grinding us. It’s grinding good docs and providers out of existence.”

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