Thursday, April 25, 2024

U$A
FTC Chief Says Tech Advancements Risk Health Care Price Fixing

2024/04/23

New technologies are making it easier for companies to fix prices and discriminate against individual consumers, the Biden administration’s top consumer watchdog said Tuesday.

Algorithms make it possible for companies to fix prices without explicitly coordinating with one another, posing a new test for regulators policing the market, said Lina Khan, chair of the Federal Trade Commission, during a media event hosted by KFF.

“I think we could be entering a somewhat novel era of pricing,” Khan told reporters.

Khan is regarded as one of the most aggressive antitrust regulators in recent U.S. history, and she has paid particular attention to the harm that technological advances can pose to consumers. Antitrust regulators at the FTC and the Justice Department set a record for merger challenges in the fiscal year that ended Sept. 30, 2022, according to Bloomberg News.

Last year, the FTC successfully blocked biotech company Illumina’s over $7 billion acquisition of cancer-screening company Grail. The FTC, Justice Department, and Health and Human Services Department launched a website on April 18, healthycompetition.gov, to make it easier for people to report suspected anticompetitive behavior in the health care industry.

The American Hospital Association, the industry’s largest trade group, has often criticized the Biden administration’s approach to antitrust enforcement. In comments in September on proposed guidance the FTC and Justice Department published for companies, the AHA said that “the guidelines reflect a fundamental hostility to mergers.”

Price fixing removes competition from the market and generally makes goods and services more expensive. The agency has argued in court filings that price fixing “is still illegal even if you are achieving it through an algorithm,” Khan said. “There’s no kind of algorithmic exemption to the antitrust laws.”

By simply using the same algorithms to set prices, companies can effectively charge the same “even if they’re not, you know, getting in a back room and kind of shaking hands and setting a price,” Khan said, using the example of residential property managers.

Khan said the commission is also scrutinizing the use of artificial intelligence and algorithms to set prices for individual consumers “based on all of this particular behavioral data about you: the websites you visited, you know, who you had lunch with, where you live.”

And as health care companies change the way they structure their businesses to maximize profits, the FTC is changing the way it analyzes behavior that could hurt consumers, Khan said.

Hiring people who can “help us look under the hood” of some inscrutable algorithms was a priority, Khan said. She said it’s already paid off in the form of legal actions “that are only possible because we had technologists on the team helping us figure out what are these algorithms doing.”

Traditionally, the FTC has policed health care by challenging local or regional hospital mergers that have the potential to reduce competition and raise prices. But consolidation in health care has evolved, Khan said.

Mergers of systems that don’t overlap geographically are increasing, she said. In addition, hospitals now often buy doctor practices, while pharmacy benefit managers start their own insurance companies or mail-order pharmacies — or vice versa — pursuing “vertical integration” that can hurt consumers, she said.

The FTC is hearing increasing complaints “about how these firms are using their monopoly power” and “exercising it in ways that’s resulting in higher prices for patients, less service, as well as worse conditions for health care workers,” Khan said.

Policing Noncompetes

Khan said she was surprised at how many health care workers responded to the commission’s recent proposal to ban “noncompete” clauses — agreements that can prevent employees from moving to new jobs. The FTC issued its final rule banning the practice on Tuesday. She said the ban was aimed at low-wage industries like fast food but that many of the comments in favor of the FTC’s plan came from health professions.

Health workers say noncompete agreements are “both personally devastating and also impeded patient care,” Khan said.

In some cases, doctors wrote that their patients “got really upset because they wanted to stick with me, but my hospital was saying I couldn’t,” Khan said. Some doctors ended up commuting long distances to prevent the rest of their families from having to move after they changed jobs, she said.

KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.
POST-PANDEMIC

Biden Administration Sets Higher Staffing Mandates. Most Nursing Homes Don’t Meet Them.

2024/04/22


The Biden administration finalized nursing home staffing rules Monday that will require thousands of them to hire more nurses and aides — while giving them years to do so.

The new rules from the Centers for Medicare & Medicaid Services are the most substantial changes to federal oversight of the nation’s roughly 15,000 nursing homes in more than three decades. But they are less stringent than what patient advocates said was needed to provide high-quality care.

Spurred by disproportionate deaths from covid-19 in long-term care facilities, the rules aim to address perennially sparse staffing that can be a root cause of missed diagnoses, severe bedsores, and frequent falls.

“For residents, this will mean more staff, which means fewer ER visits potentially, more independence,” Vice President Kamala Harris said while meeting with nursing home workers in La Crosse, Wisconsin. “For families, it’s going to mean peace of mind in terms of your loved one being taken care of.”

When the regulations are fully enacted, 4 in 5 homes will need to augment their payrolls, CMS estimated. But the new standards are likely to require slight if any improvements for many of the 1.2 million residents in facilities that are already quite close to or meet the minimum levels.

“Historically, this is a big deal, and we’re glad we have now established a floor,” Blanca Castro, California’s long-term care ombudsman, said in an interview. “From here we can go upward, recognizing there will be a lot of complaints about where we are going to get more people to fill these positions.”

The rules primarily address staffing levels for three types of nursing home workers. Registered nurses, or RNs, are the most skilled and responsible for guiding overall care and setting treatment plans. Licensed practical nurses, sometimes called licensed vocational nurses, work under the direction of RNs and perform routine medical care such as taking vital signs. Certified nursing assistants are supposed to be the most plentiful and help residents with daily activities like going to the bathroom, getting dressed, and eating.

While the industry has increased wages by 27% since February 2020, homes say they are still struggling to compete against better-paying work for nurses at hospitals and at retail shops and restaurants for aides. On average, nursing home RNs earn $40 an hour, licensed practical nurses make $31 an hour, and nursing assistants are paid $19 an hour, according to the most recent data from the Bureau of Labor Statistics.

CMS estimated the rules will ultimately cost $6 billion annually, but the plan omits any more payments from Medicare or Medicaid, the public insurers that cover most residents’ stays — meaning additional wages would have to come out of owners’ pockets or existing facility budgets.

The American Health Care Association, which represents the nursing home industry, called the regulation “an unreasonable standard” that “creates an impossible task for providers” amid a persistent worker shortage nationwide.

“This unfunded mandate doesn’t magically solve the nursing crisis,” the association’s CEO, Mark Parkinson, said in a statement. Parkinson said the industry will keep pressing Congress to overturn the regulation.

Richard Mollot, executive director of the Long Term Care Community Coalition, a New York City-based advocacy nonprofit, said “it is hard to call this a win for nursing home residents and families” given that the minimum levels were below what studies have found to be ideal.

The plan was welcomed by labor unions that represent nurses — and whom President Joe Biden is counting on for support in his reelection campaign. Service Employees International Union President Mary Kay Henry called it a “long-overdue sea change.” This political bond was underscored by the administration’s decision to have Harris announce the rule with SEIU members in Wisconsin, a swing state.

The new rules supplant the vague federal mandate that has been in place since the 1980s requiring nursing homes to have “sufficient” staffing to meet residents’ needs. In practice, inspectors rarely categorized inadequate staffing as a serious infraction resulting in possible penalties, federal records show.

Starting in two years, most homes must provide an average of at least 3.48 hours of daily care per resident. Homes won’t be required to give that level of attention to every resident, or every day; regulators will judge the average for the whole facility over several months. About 6 in 10 nursing homes are already operating at that level, a KFF analysis found.

The rules give homes breathing room before they must comply with more specific requirements. Within three years, most nursing homes will need to provide daily RN care of at least 0.55 hours per resident and 2.45 hours from aides.

CMS also mandated that within two years an RN must be on duty at all times in case of a patient crisis on weekends or overnight. Currently, CMS requires at least eight consecutive hours of RN presence each day and a licensed nurse of any level on duty around the clock. An inspector general report found that nearly a thousand nursing homes didn’t meet those basic requirements.

Nursing homes in rural areas will have longer to staff up. Within three years, they must meet the overall staffing numbers and the round-the-clock RN requirement. CMS’ rule said rural homes have four years to achieve the RN and nurse aide thresholds, although there was some confusion within CMS, as its press materials said rural homes would have five years.

Under the new rules, the average nursing home, which has around 100 residents, would need to have at least two RNs working each day, and at least 10 or 11 nurse aides, the administration said. Homes could meet the overall requirements through two more workers, who could be RNs, vocational nurses, or aides.

Homes can get a hardship exemption from the minimums if they are in regions with low populations of nurses or aides and demonstrate good-faith efforts to recruit.

Democrats praised the rules, though some said the administration did not go nearly far enough. Rep. Lloyd Doggett (D-Texas), the ranking member of the House Ways and Means Health Subcommittee, said the changes were “modest improvements” but that “much more is needed to ensure sufficient care and resident safety.” A Republican senator from Nebraska, Deb Fischer, said the rule would “devastate nursing homes across the country and worsen the staffing shortages we are already facing.”

Advocates for nursing home residents have been pressing CMS for years to adopt a higher standard than what it ultimately settled on. A CMS-commissioned study in 2001 found that the quality of care improved with increases of staff up to a level of 4.1 hours per resident per day — nearly a fifth higher than what CMS will require. The consultants CMS hired in preparing its new rules did not incorporate the earlier findings in their evaluation of options.

CMS said the levels it endorsed were more financially feasible for homes, but that assertion didn’t quiet the ongoing battle about how many people are willing to work in homes at current wages and how financially strained homes owners actually are.

“If states do not increase Medicaid payments to nursing homes, facilities are going to close,” said John Bowblis, an economics professor and research fellow with the Scripps Gerontology Center at Miami University. “There aren’t enough workers and there are shortages everywhere. When you have a 3% to 4% unemployment rate, where are you going to get people to work in nursing homes?”

Researchers, however, have been skeptical that all nursing homes are as broke as the industry claims or as their books show. A study published in March by the National Bureau of Economic Research estimated that 63% of profits were secretly siphoned to owners through inflated rents and other fees paid to other companies owned by the nursing homes’ investors.

Charlene Harrington, a professor emeritus at the nursing school of the University of California-San Francisco, said: “In their unchecked quest for profits, the nursing home industry has created its own problems by not paying adequate wages and benefits and setting heavy nursing workloads that cause neglect and harm to residents and create an unsatisfactory and stressful work environment.”

© Kaiser Health News
Tire Toxicity Faces Fresh Scrutiny After Salmon Die-Offs

2024/04/24



For decades, concerns about automobile pollution have focused on what comes out of the tailpipe. Now, researchers and regulators say, we need to pay more attention to toxic emissions from tires as vehicles roll down the road.

At the top of the list of worries is a chemical called 6PPD, which is added to rubber tires to help them last longer. When tires wear on pavement, 6PPD is released. It reacts with ozone to become a different chemical, 6PPD-q, which can be extremely toxic — so much so that it has been linked to repeated fish kills in Washington state.

The trouble with tires doesn’t stop there. Tires are made primarily of natural rubber and synthetic rubber, but they contain hundreds of other ingredients, often including steel and heavy metals such as copper, lead, cadmium, and zinc.

As car tires wear, the rubber disappears in particles, both bits that can be seen with the naked eye and microparticles. Testing by a British company, Emissions Analytics, found that a car’s tires emit 1 trillion ultrafine particles per kilometer driven — from 5 to 9 pounds of rubber per internal combustion car per year.

And what’s in those particles is a mystery, because tire ingredients are proprietary.

“You’ve got a chemical cocktail in these tires that no one really understands and is kept highly confidential by the tire manufacturers,” said Nick Molden, CEO of Emissions Analytics. “We struggle to think of another consumer product that is so prevalent in the world and used by virtually everyone, where there is so little known of what is in them.”

Regulators have only begun to address the toxic tire problem, though there has been some action on 6PPD.

The chemical was identified by a team of researchers, led by scientists at Washington State University and the University of Washington, who were trying to determine why coho salmon returning to Seattle-area creeks to spawn were dying in large numbers.

Working for the Washington Stormwater Center, the scientists tested some 2,000 substances to determine which one was causing the die-offs, and in 2020 they announced they’d found the culprit: 6PPD.

The Yurok Tribe in Northern California, along with two other West Coast Native American tribes, have petitioned the Environmental Protection Agency to prohibit the chemical. The EPA said it is considering new rules governing the chemical. “We could not sit idle while 6PPD kills the fish that sustain us,” said Joseph L. James, chairman of the Yurok Tribe, in a statement. “This lethal toxin has no place in any salmon-bearing watershed.”

California has begun taking steps to regulate the chemical, last year classifying tires containing it as a “priority product,” which requires manufacturers to search for and test substitutes.

“6PPD plays a crucial role in the safety of tires on California’s roads and, currently, there are no widely available safer alternatives,” said Karl Palmer, a deputy director at the state’s Department of Toxic Substances Control. “For this reason, our framework is ideally suited for identifying alternatives to 6PPD that ensure the continued safety of tires on California’s roads while protecting California’s fish populations and the communities that rely on them.”

The U.S. Tire Manufacturers Association says it has mobilized a consortium of 16 tire manufacturers to carry out an analysis of alternatives. Anne Forristall Luke, USTMA president and CEO, said it “will yield the most effective and exhaustive review possible of whether a safer alternative to 6PPD in tires currently exists.”

Molden, however, said there is a catch. “If they don’t investigate, they aren’t allowed to sell in the state of California,” he said. “If they investigate and don’t find an alternative, they can go on selling. They don’t have to find a substitute. And today there is no alternative to 6PPD.”

California is also studying a request by the California Stormwater Quality Association to classify tires containing zinc, a heavy metal, as a priority product, requiring manufacturers to search for an alternative. Zinc is used in the vulcanization process to increase the strength of the rubber.

When it comes to tire particles, though, there hasn’t been any action, even as the problem worsens with the proliferation of electric cars. Because of their quicker acceleration and greater torque, electric vehicles wear out tires faster and emit an estimated 20% more tire particles than the average gas-powered car.

A recent study in Southern California found tire and brake emissions in Anaheim accounted for 30% of PM2.5, a small-particulate air pollutant, while exhaust emissions accounted for 19%. Tests by Emissions Analytics have found that tires produce up to 2,000 times as much particle pollution by mass as tailpipes.

These particles end up in water and air and are often ingested. Ultrafine particles, even smaller than PM2.5, are also emitted by tires and can be inhaled and travel directly to the brain. New research suggests tire microparticles should be classified as a pollutant of “high concern.”

In a report issued last year, researchers at Imperial College London said the particles could affect the heart, lungs, and reproductive organs and cause cancer.

People who live or work along roadways, often low-income, are exposed to more of the toxic substances.

Tires are also a major source of microplastics. More than three-quarters of microplastics entering the ocean come from the synthetic rubber in tires, according to a report from the Pew Charitable Trusts and the British company Systemiq.

And there are still a great many unknowns in tire emissions, which can be especially complex to analyze because heat and pressure can transform tire ingredients into other compounds.

One outstanding research question is whether 6PPD-q affects people, and what health problems, if any, it could cause. A recent study published in Environmental Science & Technology Letters found high levels of the chemical in urine samples from a region of South China, with levels highest in pregnant women.

The discovery of 6PPD-q, Molden said, has sparked fresh interest in the health and environmental impacts of tires, and he expects an abundance of new research in the coming years. “The jigsaw pieces are coming together,” he said. “But it’s a thousand-piece jigsaw, not a 200-piece jigsaw.”

This article was produced by KFF Health News, which publishes California Healthline, an editorially independent service of the California Health Care Foundation.

KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.


Most bees don’t die after stinging – and other surprising bee facts


Australian teddy bear bees are cute and fluffy, but get a look at that massive (unbarbed) stinger! 

James Dorey Photography


THE CONVERSATION
Published: April 24, 2024




Most of us have been stung by a bee and we know it’s not much fun. But maybe we also felt a tinge of regret, or vindication, knowing the offending bee will die. Right? Well, for 99.96% of bee species, that’s not actually the case.

Only eight out of almost 21,000 bee species in the world die when they sting. Another subset can’t sting at all, and the majority of bees can sting as often as they want. But there’s even more to it than that.

To understand the intricacies of bees and their stinging potential, we’re going to need to talk about the shape of stingers, bee genitals, and attitude.
Our beloved, and deadly, honey bees

What you most likely remember getting stung by is the European honey bee (Apis mellifera). Native to Europe and Africa, these bees are today found almost everywhere in the world.

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They are one of eight honey bee species worldwide, with Apis bees representing just 0.04% of total bee species. And yes, these bees die after they sting you.

But why?

We could say they die for queen and colony, but the actual reason these bees die after stinging is because of their barbed stingers. These brutal barbs will, most of the time, prevent the bee from pulling the stinger out.
The European honeybee has a barbed stinger (left), while a native Fijian bee’s stinger is unbarbed (right). Sam Droege (left) / James Dorey (right)

Instead, the bee leaves her appendage embedded in your skin and flies off without it. After the bee is gone, to later die from her wound, the stinger remains lodged there pumping more venom.

Beyond that, bees and wasps (probably mostly European honey bees) are Australia’s deadliest venomous animals. In 2017–18, 12 out of 19 deaths due to venomous animals were because of these little insects. (Only a small proportion of people are deathly allergic.)

Talk about good PR.
So what is a stinger?

A stinger, at least in most bees, wasps and ants, is actually a tube for laying eggs (ovipositor) that has also been adapted for violent defence. This group of stinging insects, the aculeate wasps (yes, bees and ants are technically a kind of wasp), have been stabbing away in self-defence for 190 million years.

You could say it’s their defining feature.
A Sycoscapter parasitoid wasp laying eggs into a fig through her ovipositor (bottom middle). Her ovipositor sheath, which usually surrounds the ovipositor, is curved behind her and to the right. Sycoscapter wasps are sister to the aculeate wasps (they don’t sting). James Dorey Photography

With so much evolution literally under their belts they’ve also developed a diversity of stinging strategies. But let’s just get back to the bees.

The sting of the European honey bee is about as painful as a bee sting gets, scoring a 2 out of 4 on the Schmidt insect sting pain index.

But most other bees don’t pack the same punch — though I have heard some painful reviews from less-than-careful colleagues. On the flipside, most bee species can sting you as many times as they like because their stingers lack the barbs found in honey bees. Although, if they keep at it, they might eventually run out of venom.

Even more surprising is that hundreds of bee species have lost their ability to sting entirely.
Can you tell who’s packing?

Globally, there are 537 species (about 2.6% of all bee species) of “stingless bees” in the tribe Meliponini. We have only 11 of these species (in the genera Austroplebeia and Tetragonula) in Australia. These peaceful little bees can also be kept in hives and make honey.

Stingless bees can still defend their nests, when offended, by biting. But you might think of them more as a nuisance than a deadly stinging swarm.
An Australian stingless bee, Tetragonula carbonaria, foraging on a Macadamia flower. James Dorey Photography

Australia also has the only bee family (there are a total of seven families globally) that’s found on a single continent. This is the Stenotritidae family, which comprises 21 species. These gentle and gorgeous giants (14–19mm in length, up to twice as long as European honey bees) also get around without a functional stinger.
The long ovipositor of this parasitoid, and non-stinging, wasp is essentially a hypodermic needle for injecting an egg. James Dorey Photography

The astute reader might have realised something by this point in the article. If stingers are modified egg-laying tubes … what about the boys? Male bees, of all bee species, lack stingers and have, ahem, other anatomy instead. However, some male bees will still make a show of “stinging” if you try to grab them.

Some male wasps can even do a bit of damage, though they have no venom to produce a sting.
Why is it always the honey bees?

So, if the majority of bees can sting, why is it always the European honey bee having a go? There are a couple of likely answers to that question.

First, the European honey bee is very abundant across much of the world. Their colonies typically have around 50,000 individuals and they can fly 10km to forage.

Read more: Help, bees have colonised the walls of my house! Why are they there and what should I do?

In comparison, most wild bees only forage very short distances (less than 200m) and must stay close to their nest. So those hardworking European honey bees are really putting in the miles.

Second, European honey bees are social. They will literally die to protect their mother, sisters and brothers. In contrast, the vast majority of bees (and wasps) are actually solitary (single mums doing it for themselves) and lack the altruistic aggression of their social relatives.

A complicated relationship

We have an interesting relationship with our European honey bees. They can be deadly, are non-native (across much of the world), and will aggressively defend their nests. But they are crucial for crop pollination and, well, their honey is to die for.

But it’s worth remembering these are the tiny minority in terms of species. We have thousands of native bee species (more than 1,600 found so far in Australia) that are more likely to simply buzz off than go in for a sting.


Authors
James B. Dorey

Lecturer in Biological Sciences, University of Wollongong
Amy-Marie Gilpin

Lecturer in Invertebrate Ecology, Western Sydney University
Rosalyn Gloag

School of Life and Environmental Sciences Research Fellow, University of Sydney
Disclosure statement

James B. Dorey has received funding from organisations like the University of Wollongong, Flinders University, the Playford Trust, and the Department of Foreign Affairs and Trade (New Colombo Plan); but none in relation to this article.

Amy-Marie Gilpin receives funding from Western Sydney University and Horticulture Innovation Australia. She is also a member of the IUCN Wild Bee Specialist Group Oceania.

Rosalyn Gloag receives funding from The Australian Research Council, but not in relation to this article. She is affiliated with The University of Sydney. She is also a member of the IUCN Wild Bee Specialist Group Oceania.

The Myanmar 'water brothers' salvaging shipwrecks on the tide

Yangon (Myanmar) (AFP) – Diving into the darkness of the Yangon River, Than Nyunt starts another murky sortie in his months-long mission to salvage a sunken ship using the power of the moon.


Issued on: 25/04/2024
A diver in Myanmar works to recover a sunken ship in the Yangon River, plunging down to attach cables to the wreck and using the power of the tides to bring the boat to shore
 © Sai Aung MAIN / AFP

His target is a 53-metre (174-foot) long cargo vessel resting on the silty riverbed in Myanmar's commercial hub, whose steel carcass will fetch a tidy sum as scrap -- if he can get it to shore.

A hose running from his mask up to an oxygen pump on the boat is his lifeline and only means of communication -- one tug on it from a colleague means "come up quickly".

He stays in the dark depths for up to three hours at a time, attaching cables to the wreck.

The cables run up to the team's boat on the surface, and then to shore. When it rises on the next tide, it will drag the shipwreck a few metres along the bed.

The work is slow and dangerous but addictive, said Than Nyunt, 58.

He says he has salvaged around 40 ships, from cargo boats to passenger ferries, since he started diving over four decades ago.

"After I excavate one ship I always want to do it again and again," he told AFP from the river, wearing a Manchester United jersey and a pair of gardening gloves.

A man swims after a dive to recover a sunken ship in the Yangon River; scrap dealers buy the metal and melt it down to be used again 
© Sai Aung MAIN / AFP

"Besides making money, I want to know the condition of the wreck... I also talk with ship owners about the ship's history, and we both are delighted when we can salvage them."

The team's current shipwreck -- the Mya Nadi (Emerald River) -- is an old friend for Than Nyunt.

He salvaged the vessel in 1981 for its owner, who fitted it with a new engine and set it back to work.

Around eight years ago it sank again.
'Water brothers'

There are between 20 and 30 wrecks on the bed of the Yangon, according to Than Nyunt.

During the British colonial era, the water thronged with ships taking away teak wood and rice from the hinterlands and bringing in workers from abroad.

Workers attach cables to the sunken ships, then slowly tighten them after each tide raises the wreck, bringing it into shallower waters nearer the shore 
© Sai Aung MAIN / AFP

In World War II, fierce fighting between Japan and Allied forces sent many vessels to the riverbed.

Cyclone Nargis, which devastated Myanmar's Irrawaddy Delta in 2008, killing at least 138,000 people, sent more to the bottom.

It left the riverbed a rich, if risky, hunting ground for salvagers.

Wrapping a metal chain around his body to weigh himself down, Thet Oo, 38, prepares for a shift unclogging silt from the 'Emerald River'.

The job is risky; divers spend hours underwater breathing through a hose attached to a pump on the boat above
 © Sai Aung MAIN / AFP

Working in the darkness, as much as 25 metres (80 feet) down and buffeted by strong currents is risky, he says.

"My life is in the hands of the man holding the oxygen pipe... If something happens to the oxygen machine, I can only know if he gives a signal to me."

That signal is a tug on the oxygen tube, warning the diver to come up.

"However much we argue on the boat, we have to act like brothers when we are under the water," said Than Nyunt.
Tidal cranes

Pulling the wrecks using the tidal surges of the river is organic but plodding and requires much patience.
In the last stage of the salvage, the team fix tyres and sandbags to the wreck to anchor it in place © Sai Aung MAIN / AFP

"We don't have a heavy-duty crane to pull the ships," says Than Nyunt.

"When the tide rises by up to 12 feet, we can expect the ship to move up to 10 feet and we can pull it to land."

After more than four months work, the skeleton of the Emerald River is visible in the shallows.

In the last stage of the salvage, the team fix tyres and sandbags to the wreck to anchor it in place.

Another team then moves in to dismember the wreck, working with blowtorches in knee-deep water.

A scrap dealer will buy the metal and melt it down to be used again.

Divers in Than Nyunt's team can earn 25,000 to 30,000 kyat each day ($12 - 14).

Once the wreck is out of the water, another team moves in to cut away the metal with blowtorches 
© Sai Aung MAIN / AFP

He has salvaged boats all over Myanmar, and doesn't want to stop.

"I don't smoke, drink or use drugs in my life... and I have the ambition to work for as many years as possible," he said.

"I'm 58 years old right now and I can work for the next 10 years, because I'm like a sportsperson who is always active."

© 2024 AFP
US aid for Taiwan 'will only increase tensions,' China says


US President Joe Bidensigned off on fresh assistance for Taiwan, allowing the island to upgrade its military hardware. Taiwan's president-elect says it will "safeguard peace," but China says it raises the risk of war.

China on Wednesday decried a fresh package of US military aid for Taiwan, which is intended to boost the island's defenses in the case of a possible Chinese invasion.

The US Senate passed the $8 billion (€7.48 billion) military aid package late Tuesday, as part of larger legislation that includes fresh assistance for Israel and Ukraine. Having already passed the House, US President Joe Biden later on Wednesday signed the package into law.

China: US aid to Taiwan raises 'risk of conflict'

"I'd like to emphasize that the United States and Taiwan strengthening military ties will not bring about security for Taiwan," Chinese Foreign Ministry spokesperson Wang Wenbin said. He said the assistance "will only increase tensions and the risk of conflict across the Taiwan Strait."

A Chinese spokesperson for the mainland's Taiwan Affairs Office, Zhu Fenglian, said the aid violates US commitments to China and "sends a wrong signal to the Taiwan independence separatist forces."

China does not view Taiwan as a separate country, but rather as a breakaway province. The Chinese Civil War ended in 1949, with the communists taking control of the Chinese mainland and the nationalist Kuomintang retreating to Taiwan.
Taiwan 'very happy' with aid package

Taiwanese incumbent President Tsai ing-Wen, meanwhile, was pleased with the aid package.



"We are also very happy that the Senate has just passed these bills," Tsai said during a meeting with a US congressional delegation in Taipei. Tsai belongs to the center-left Democratic Progressive Party (DPP), which emphasizes Taiwan's separate identity from the mainland.

A day earlier, Taiwan's incoming president, Lai Ching-te, said the US assistance would "strengthen the deterrence against authoritarianism in the West Pacific ally chain" and "help ensure peace and stability across the Taiwan Strait and also boost confidence in the region." Lai is also a member of the DPP.

The US aid package will help modernize Taiwan's forces as China frequently conducts military maneuvers near the island.

Western leaders such as Biden have expressed concerns that China may take control of Taiwan by force in the coming years.

A Chinese invasion would not only cost human lives, but it could be a massive blow to the global economy — the island is a major producer of semiconductor chips which are used in everything from cellphones to automobiles.

China-Taiwan conflict: How it could ruin the global economy

The fresh US aid to Taiwan comes as US Secretary of State Antony Blinken visits China on Wednesday.

Blinken is expected to meet his Chinese counterpart Wang Yi on Friday, with Taiwan near the top of the agenda. The top US diplomat may also meet with Chinese President Xi Jinping, who has earlier suggested that Chinese reunification with Taiwan is "inevitable."

wd/sms (AP, AFP)

How Thai 'boy-love' series raise LGBTQ+ awareness

Emmy Sasipornkarn in Bangkok

Thai-produced gay-romance TV dramas are becoming increasingly popular across Asia. Are they also creating more acceptance of LGBTQ+ people?



Critics have pointed out that these series don't reflect the real diversity of the LGBTQ+ community in Thailand
Image: Andre Malerba/ZUMA/dpa/picture alliance

When the protagonists of gay-romance drama "Cutie Pie," Lian Kilen Wang and Kuea Keerati, tied the knot at the end of the series, they did so knowing that their marriage would not be legally recognized, even in the fictional world of Thailand's "boy-love" TV shows.

But now, in real life, that is about to change, as Thailand is set to join Taiwan and Nepal as the only places in Asia to allow same-sex marriage.

Cutie Pie, which has an assertive pro-LGBTQ+ stance, is one of many shows in a genre called Boy's Love (BL).

These shows focus on romantic relationships between two male characters, and are mainly enjoyed by a primarily straight female audience.

"What the Thai BL industry is already working on is increasing the visibility of LGBTQ+ people," said Natthanai Prasannam, associate professor of Thai literary and cultural studies at Kasetsart University in Bangkok.
Huge commercial appeal

Thailand's BL series have attracted a large following internationally, especially in Asia — including China where the government bans the genre — and even in South America.

Last year, rom-com "My School President" starring Gemini Norawit Titicharoenrak and Fourth Nattawat Jirochtikul racked up at least 150 million views on different streaming platforms.

Given the main actors' chemistry on and off screen, the cast held live meet-and-greets with fans all over Asia — from South Korea and Japan to the Philippines and Singapore.

Some fans have even started learning Thai. "I started learning the language myself several months ago because I wanted to understand what my favorite 'couple pairing' says," Rose, a 19-year-old fan in China, told DW.

Thailand now has a reputation as an exporter of "boy-love" series. In 2020, when the breakout show "2gether" was aired, there were only 24 BL shows. Last year, over 60 series were released, according to local media.

"The popularity of the Thai BL industry is closely linked to the fact that we produce more than other countries due to legal, religious and cultural factors," Natthanai told DW.

He added that the actors' charisma, coupled with the extensive interactions between the actors and their fans through meet-and-greet events, and social media also contribute to its success.


Perpetuating gender stereotypes?

While portraying the lives of queer communities gives them more representation, there are concerns over stereotypical gender roles assigned to the lead couples in the Thai BL shows.

Many of them follow traditional heterosexual norms, with one person taller and more masculine while the other is usually smaller and more feminine, according to Bangkok-based data center Rocket Media Lab, which studied 13 Thai BL series aired between 2020 and early 2021.

Critics have also pointed out that these series don't reflect the real diversity of the LGBTQ+ community in Thailand.

"You don't really see flamboyantly gay people in the shows. When you do, they exist as props or funny characters," said Jason, who has been a BL fan for a decade.

But some experts say this trend is gradually changing.

"Effeminate gays are being shown more in the media and portrayed as empowered individuals. This is a significant development," Nattanai told DW.

"But we must not forget that BL series' role to increase LGBTQ+ awareness cannot take place without other changes such as the attitude of the audience or the public and that of the government," he added.


Mixed feelings from LGBTQ+ community


While Thailand enjoys a welcoming reputation for these BL series, some say the characters are free of the real-life obstacles that many queer people have to go through.

Instead, the majority focus more on marketable scenes and romantic tensions between the leading couples.

"I like watching these boy-love series because, for me, they have become a source of escapism, everything is so easy," said Jason, who is part of the Thai LGBTQ+ community.

Nearly 60% of the Thai BL series produced in the past decade do not address real-world problems faced by LGBTQ+ community, according to Thailand's online newspaper The Matter.

"Sometimes some scenes are oversimplified, for example, when they come out to their family and friends, they are either immediately accepted for who they are or people would say 'I've known for a while, no big deal.' But in real life, it's not that simple, especially when you are not from a big city," Jason said.

But he admits that reinforcing the normalization of the queer experience — even if current portrayals can still be problematic — does help change public perceptions, especially those of more conservative older generations.

Edited by: Srinivas Mazumdaru
ESCAPE FROM STALAG 13
Germany: Camel leads circus animal breakout

A camel made two bids for freedom from a circus in Germany on Wednesday, and took several other animals with it. All the escaped creatures were quickly and safely rounded up.
















An official police press photo shows the escaped animals being rounded up
Image: Polizeipräsidium Westpfalz


A camel escaped from a circus near the southwestern German city of Kaiserslautern on Wednesday and enabled a dozen further animals to break out in the process, according to local police.

Officers were first alerted to the situation when drivers spotted the camel walking down Entersweilerstrasse, just to the east of Kaiserslautern city center.

The single-humped dromedary had escaped from a nearby circus while staff had been dismantling tents, but it was quickly rounded-up and returned to the site.

However, the four-legged mammal appeared to get the hump at being recaptured and managed to slip away a second time, tearing a hole in a tent, through which other animals also made a bid for freedom, including at least one sheep and one cow.

All the want-away animals were eventually enticed back to the circus by police and animal carers with the help of food.

The breakout came on the same day that two British Army horses caused havoc by galopping through the streets of central London after getting spooked during a training exercise. Fortunately in Kaiserslautern, however, none of the animals were hurt.
Copy-camel escape attempt from Austria

Camels aren't native to Germany, but its not the first time they have been spotted roaming the streets of western Europe.

In October 2023, eight camels took advantage of a midnight power cut to escape from a circus in the Austrian town of Hallein, just south of Salzburg.

The camels, double-humped Bactrians in this case, were en route to the local train station when they were rounded up after 15 minutes of freedom.
Camel babies in Bamberg

Indeed, it's been a busy few months for circus camels in German-speaking countries.

In February 2024, a circus in the small town of Hallstadt just outside the south-eastern German city of Bamberg celebrated the birth of two baby camels.

"Robert" and "Roberta" were named after the founder of a local medication company and have yet to make any spontaneous bids for freedom.

2018 was also a busy year for German circus camels, seven of which paid a Monday night visit to a discount supermarket near the northern city of Celle.

A few months earlier, two camels had approached a McDonald's restaurant near Bremen, but the vegetarians opted for the grass outside instead.

mf/wmr (dpa, AFP)
Australia: 160 pilot whales stranded on western beach


Several pilot whales — known for their tight-knit bonds — were stranded on a Western Australian coast. Officials were concerned many of them would have to be euthanized.




Experts say four pods that make up about 160 whales were stranded on the beach
Image: Department of Biodiversity, Conservation and Attractions via AP/picture alliance

Marine biologists on Thursday raced to save dozens of pilot whales stranded in shallow waters on a Western Australian coast.

As many as 160 whales became trapped in shallow water at Toby's Inlet in Geographe Bay, about a three-hour drive south of Perth, the Western Australia Department of Biodiversity, Conservation and Attractions said.


Pilot whales are known for maintaining tight-knit social bonds, so when one gets into difficulty and strands, the rest often follow, according to the university.

"We understand there are four pods of up to 160 pilot whales in total spread across about 500 meters. Unfortunately, 26 whales that stranded on the beach have died," a department spokesperson said in a statement.

"A team of experienced staff including wildlife officers, marine scientists, veterinarians are on site or on their way," the Parks and Wildlife Service said in a statement. They will try to guide the pilot whales back to deep waters.

However, officials were worried many of the creatures would have to be euthanized.

"These events usually result in the beached animals having to be euthanized as the most humane outcome," the Wildlife Service said. "We always hope for the best outcome."

While scientists do not fully understand why they occur, mass strandings of pilot whales are not uncommon in Australia and New Zealand.

In 2022, around 500 pilot whales died after beaching on New Zealand's remote Chatham Islands.

Officials urged the public not to try to rescue the whales on their own.
EU membership on the table as North Macedonia holds first round of presidential vote

North Macedonia on Wednesday held the first round of a presidential election – the first in a series of votes that could decide whether the Balkan country will join the European Union.

24/04/2024 - 
A woman casts her ballot for the presidential elections at a polling station in Skopje, North Macedonia, on Wednesday, April 24, 2024. 
© Boris Grdanoski, AP


It will be followed by a presidential run-off and a parliamentary poll on May 8.

President Stevo Pendarovski of the ruling centre-left Social Democrats (SDSM) is in danger of being unseated by Gordana Siljanovska-Davkova, who is backed by the right-wing VMRO-DPMNE.

The elections come amid a two-year standoff between the government and the opposition over how to deal with neighbouring Bulgaria blocking its path to EU membership.

Relations with Bulgaria have been strained for years by disputes over the two countries' languages and history.

Sofia has refused to back the opening of accession talks between Skopje and the EU until North Macedonia recognises its tiny Bulgarian minority in the constitution.

Pendarovski and the SDSM are prepared to make the amendments but lack the numbers to win a parliamentary vote.

The opposition VMRO-DPMNE party says constitutional changes can only come after North Macedonia joins the EU, a stance the government says is unrealistic.

Wednesday's vote puts the two opposing views on the ballot.

According to the State Electoral Commission, with 94 percent of polling stations processed by 6:30pm, turnout was over 48 percent, seven points higher than the first round of the presidential elections in 2019.

About 1.8 million people – including a large diaspora – were eligible to vote, while more than 800,000 cast their ballots in 3,480 polling stations around the country, which closed at 7:00pm.

Old rivals

The long-time political rivals, who also faced off in the last presidential election in 2019, lead a crowded field of seven candidates.

Pendarovski and the SDSM have vowed to unlock the stalled talks with the EU and shepherd the constitutional changes through parliament.

"The priority of the new parliament will be adopting the constitutional changes and I expect that process to start immediately after the elections," he said.

Siljanovska-Davkova and the VMRO-DPMNE said North Macedonia – which had to change its name in 2018 from Macedonia to settle a separate long-running dispute with Greece – will not be pushed around on the issue.

Read more‘A moving target’: North Macedonia’s foreign minister on EU accession

"Only unity can push us forward... and make us feel proud," the retired law professor and former MP told a rally on Monday night.

After voting, Siljanovska-Davkova remained confident saying, "the hour has come for this government to go".

The message appears to resonate with many who are looking for a change.

"From these elections I expect total change of the government and finally the interests of Macedonia to be protected," Filip Zdraveski, 38, told AFP after voting in the capital Skopje.

Wednesday's vote will be closely monitored as a barometer for the parliamentary elections, said analyst Ana Petruseva, head of the North Macedonia branch of regional investigative reporting outlet BIRN.

"The presidential elections' first round will be a dress-rehearsal for the parliamentary elections on May 8 and will reveal the major political parties' standings," she told AFP.
Eventual Albanian president?

Opinion polls have suggested Pendarovski is heading for defeat.

Siljanovska-Davkova leads in the polls with 26 percent support followed by Pendarovski on 16 percent.

The support of the five other candidates may be vital for the runoff, Petruseva added.

The five include Foreign Minister Bujar Osmani, supported by the ethnic Albanian DUI party – a partner in the ruling coalition – and Arben Taravari of the opposition ethnic Albanian coalition.

The DUI has offered its backing in the second round on condition that future presidents be elected by MPs, which it hopes would one day lead to an ethnic Albanian holding the position.

Albanians make up more than a quarter of the country's population of 1.8 million.

Pendarovski and Siljanovska-Davkova have dismissed the idea, saying it is more democratic for the head of state to be selected through a direct vote.

Ordinary voters, however, seem more interested in making ends meet.

"I hope that whoever wins will improve living standards and make a better future, especially for young people," civil servant Sanja Jovanovic-Damjanovska told AFP.

(AFP)


North Macedonia presidential election heads to runoff

Opposition candidate Gordana Siljanovska-Davkova is in the lead after winning almost almost 40% of the first-round vote. The election comes as North Macedonia seeks EU membership.

North Macedonia will enter into a presidential runoff, after no candidate secured enough votes to win outright in Wednesday's first round of balloting.

Right-wing candidate Gordana Siljanovska-Davkova, claimed a comprehensive victory in the first round, securing almost 40% of the votes according to the state electoral commission.

Siljanovska-Davkova is backed by the main opposition center-right party VMRO-DPMNE.

Current President Stevo Pendarovski of the ruling center-left Social Democrats (SDSM), only managed to claim close to 20 percent of the votes

The second round is scheduled for May 8.

Approach to joining European Union at heart of election

The election is being fought as North Macedonia attempt to join the European Union.

Although both the SDSM and VMRO-DPMNE harbor a desire to join the EU, they differ on how that can be achieved.

Neighboring Bulgaria, an EU member, has refused to back the opening of accession talks between Skopje and the bloc until North Macedonia recognizes its ethnic Bulgarian minority in the constitution.

Pendarovski and the SDSM are prepared to make the amendments, while the VMRO-DPMNE party says constitutional changes can only come after North Macedonia joins the EU.

How the candidates reacted to the results

"It is clear that this result is incredibly inspirational for me," Siljanovska-Davkova said.

"I only know that what I promise I will implement in my own way. This is a beginning of a new era."

Meanwhile, Pendarovski explained he was surprised, adding: "We expected less (difference), but tomorrow is a new day. We are starting from the beginning."

"My assignment is to promote the concept I believe in: a state that is not isolated and that is integrated in Europe."

km/fb (AFP, AP, dpa)

N. Macedonia's right-wing candidate wins first round presidential election

North Macedonia's right-wing candidate Gordana Siljanovska-Davkova claimed a comprehensive victory in the first round of presidential elections on Wednesday -- the first in a series of votes that could decide whether the Balkan country will join the European Union.



Issued on: 25/04/2024 -
Presidential candidate of the biggest opposition party VMRO DPMNE Gordana Siljanovska-Davkova celebrates her victory in the first round of the presidential elections in Skopje on April 24, 2024. 
© Robert Atanasovski, AFP

According to the state electoral commission, with 90 percent of vots counted, Siljanovska-Davkova had romped to victory with almost 40 percent.

That put her way ahead of President Stevo Pendarovski of the ruling centre-left Social Democrats (SDSM), who claimed close to 20 percent of the votes.

The two will face off in the second round run-off on May 8 but the outlook is bleak for Pendarovski.

There will also be a parliamentary poll that same day.

Turnout was over 49 percent, according to the electoral commission, some eight points higher than the first round of the presidential elections in 2019.

About 1.8 million people -- including a large diaspora -- were eligible to vote, while more than 810,000 cast their ballots at 3,480 polling stations around the country.

"It is clear that this result is incredibly inspirational for me," Siljanovska-Davkova, who is supported by the main opposition party VMRO-DPMNE, told reporters on Wednesday evening.

"I only know that what I promise I will implement in my own way. This is a beginning of a new era."

Pendarovski admitted he was surprised by the wide gap.

"We expected less (difference), but tomorrow is a new day. We are starting from the beginning," Pendarovski told reporters.

"My assignment is to promote the concept I believe in: a state that is not isolated and that is integrated in Europe."

The elections came amid a two-year standoff between the government and the opposition over how to deal with neighbouring Bulgaria blocking its path to EU membership.

Relations with Bulgaria have been strained for years by disputes over the two countries' languages and history.

Sofia has refused to back the opening of accession talks between Skopje and the EU until North Macedonia recognises its tiny Bulgarian minority in the constitution.

Pendarovski and the SDSM are prepared to make the amendments but lack the numbers to win a parliamentary vote.

The VMRO-DPMNE party says constitutional changes can only come after North Macedonia joins the EU, a stance the government says is unrealistic.
Old rivals

Long-time political rivals Pendarovski and Siljanovska-Davkova, who also faced off in the last presidential election in 2019, led a crowded field of seven candidates.

Pendarovski and the SDSM vowed to unlock the stalled talks with the EU and shepherd the constitutional changes through parliament.

Siljanovska-Davkova and the VMRO-DPMNE said North Macedonia -- which had to change its name in 2018 from Macedonia to settle a separate long-running dispute with Greece -- will not be pushed around on the issue.

The message appeared to resonate with many who are looking for a change.

"From these elections I expect total change of the government and finally the interests of Macedonia to be protected," Filip Zdraveski, 38, told AFP after voting in the capital Skopje.

Wednesday's vote was closely watched as a barometer for the parliamentary elections, analyst Ana Petruseva, head of the North Macedonia branch of regional investigative reporting outlet BIRN, told AFP.

The support of the five other candidates may be vital for the runoff, Petruseva added.

The five include Foreign Minister Bujar Osmani, supported by the ethnic Albanian DUI party -- a partner in the ruling coalition who won 13 percent -- and Arben Taravari of the opposition ethnic Albanian coalition, with over nine percent of the votes.

The DUI has offered its backing in the second round on condition that future presidents be elected by MPs, which it hopes would one day lead to an ethnic Albanian holding the office.

Albanians make up more than a quarter of the country's population of 1.8 million.

Pendarovski and Siljanovska-Davkova have dismissed the idea, saying it is more democratic for the head of state to be selected through a direct vote.

(AFP)