Indian-origin woman doctor held for female circumcision in US

Washington/Seoul, Apr 26: A special train possibly belonging to North Korean leader Kim Jong Un was spotted this week at a resort town in the country, according to satellite images reviewed by a Washington-based North Korea monitoring project, amid conflicting reports about Mr. Kim's health and whereabouts.

The monitoring project, 38 North, said in its report on Saturday that the train was parked at the “leadership station” in Wonsan on April 21 and April 23. The station is reserved for the use of the Kim family, it said.

Though the group said it was probably Kim Jong Un's train, Reuters has not been able to confirm that independently, or whether he was in Wonsan.

“The train's presence does not prove the whereabouts of the North Korean leader or indicate anything about his health but it does lend weight to reports that Kim is staying at an elite area on the country's eastern coast,” the report said.

Speculation about Mr. Kim's health first arose due to his absence from the anniversary of the birthday of North Korea's founding father and Mr. Kim's grandfather, Kim Il Sung, on April 15.

North Korea's state media last reported on Mr. Kim's whereabouts when he presided over a meeting on April 11.

China has dispatched a team to North Korea including medical experts to advise on Kim Jong Un, according to three people familiar with the situation.

A third-generation hereditary leader who came to power after his father's death in 2011, Kim has no clear successor in a nuclear-armed country, which could present major international risk.

On Thursday, U.S. President Donald Trump downplayed reports that Mr. Kim was ill. “I think the report was incorrect,” Mr. Trump told reporters, but he declined to say if he had been in touch with North Korean officials.

Mr. Trump has met Mr. Kim three times in an attempt to persuade him to give up a nuclear weapons program that threatens the United States as well as its Asian neighbors. While talks have stalled, Mr. Trump has continued to hail Mr. Kim as a friend.

Reporting from inside North Korea is notoriously difficult because of tight controls on information.

A Trump administration official said continuing days of North Korean media silence on Mr. Kim's whereabouts had heightened concerns about his condition, and that information remained scant from a country U.S. intelligence has long regarded as a ”black box.”

The U.S. State Department did not immediately respond to questions about the situation on Saturday.

Daily NK, a Seoul-based website that reports on North Korea, cited one unnamed source in North Korea on Monday as saying that Kim had undergone medical treatment in the resort county of Hyangsan north of the capital Pyongyang.

It said that Mr. Kim was recovering after undergoing a cardiovascular procedure on April 12.

Since then, multiple South Korean media reports have cited unnamed sources this week saying that Mr. Kim might be staying in the Wonsan area.

On Friday, local news agency Newsis cited South Korean intelligence sources as reporting that a special train for Mr. Kim's use had been seen in Wonsan, while Mr. Kim's private plane remained in Pyongyang.

Newsis reported Mr. Kim may be sheltering from COVID-19, the respiratory disease caused by the novel coronavirus.

Mr. Kim, believed to be 36, has disappeared from coverage in North Korean state media before. In 2014, he vanished for more than a month and North Korean state TV later showed him walking with a limp.

Speculation about his health has been fanned by his heavy smoking, apparent weight gain since taking power and family history of cardiovascular problems.

United Nations, Apr 28: UN chief Antonio Guterres has warned that extremist groups are taking advantage of the COVID-19 lockdowns and intensifying efforts on social media to recruit youths online by exploiting their anger and despair, asserting that the world cannot afford a lost generation due to the unprecedented global health crisis.

The UN Secretary-General made the remarks on Monday during a video conference to review the five years since its adoption of a landmark resolution on youth, peace and security.

We can already see such groups taking advantage of the COVID-19 lockdowns, intensifying their efforts on social media to spread hatred and to recruit young people who may be spending more time at home and online, he said.

Guterres told the Security Council that even before the current crisis, young people were facing enormous challenges.

Listing startling numbers, he said one of every five young people was already not in education, training or employment and one of every four is affected by violence or conflict. Every year, 12 million girls become mothers while they themselves are still children.

These frustrations and, frankly, failures to address them by those in power today, fuel declining confidence in political establishments and institutions. And when such a cycle takes hold, it is all too easy for extremist groups to exploit the anger and despair, and the risk of radicalisation climbs, he said.

Issuing a call to action on youth, peace and security, Guterres said the world cannot afford a lost generation of youth, their lives set back by COVID-19 and their voices stifled by a lack of participation. Let us do far more to tap their talents as we tackle the pandemic and chart a recovery that leads to a more peaceful, sustainable and equitable future for all.

With over 1.54 billion children and youth out-of-school and young people acutely feeling the impact of the COVID-19 crisis, Guterres said countries must do more to harness the talents of young people to address the crisis and its aftermath.

In presenting his first report on the Security Council resolution, the UN chief said youth were already confronting numerous challenges even before the pandemic, including in accessing education, or through being affected by violence and conflict. Those pressing for peace or upholding human rights have been threatened.

Despite these obstacles, young people across the world have joined the common fight against the coronavirus disease, supporting both frontline workers and people in need. And they continue to push for change.

UN Youth Envoy Jayathma Wickramanayake spoke of the need for more meaningful partnerships between young people and the civil society organisations and government institutions that work on the youth, peace and security (YPS) agenda.

To date, there are no national action plans on YPS but I'm pleased to note that in some countries, these are in the process of development, she said.

For a national roadmap to be successful, a participatory, transparent and youth-led process with adequate resources are needed, she said.

Issuing his four-point call to action for the Council, Guterres urged members to do more to address the various challenges facing young people.

He also called for investment in youth participation, but also in their organisations and initiatives.

We must strengthen human rights protections and protect the civic space on which youth participation depends, he said. And fourth, we must emerge from the COVID-19 crisis with a determination to recover better - massively increasing our investment in young people's capacities as we deliver the Sustainable Development Goals.

Washington, Apr 28: After nearly three weeks in an intensive care unit in Los Angeles, doctors treating 41-year-old Broadway actor Nick Cordero for COVID-19 were forced to amputate his right leg.

The flow of blood had been impeded by a blood clot: yet another dangerous complication of the disease that has been bubbling up in frontline reports from China, Europe and the United States.

To be sure, so-called "thrombotic events" occur for a variety of reasons among intensive care patients, but the rates among COVID-19 patients are far higher than would be otherwise expected.

"I have had 40-year-olds in my ICU who have clots in their fingers that look like they'll lose the finger, but there's no other reason to lose the finger than the virus," Shari Brosnahan, a critical care doctor at NYU Langone said.

One of these patients is suffering from a lack of blood flow to both feet and both hands, and she predicts an amputation may be necessary, or the blood vessels may get so damaged that an extremity could drop off by itself.

Blood clots aren't just dangerous for our limbs, but can make their way to the lungs, heart or brain, where they may cause lethal pulmonary embolisms, heart attacks, and strokes.

A recent paper from the Netherlands in the journal Thrombosis Research found that 31 percent of 184 patients suffered thrombotic complications, a figure that the researchers called "remarkably high" -- even if extreme consequences like amputation are rare.

Behnood Bikdeli, a doctor at New York-Presbyterian Hospital, assembled an international consortium of experts to study the issue. Their findings were published in the Journal of The American College of Cardiology.

The experts found the risks were so great that COVID-19 patients "may need to receive blood thinners, preventively, prophylactically," even before imaging tests are ordered, said Bikdeli.

What exactly is causing it? The reasons aren't fully understood, but he offered several possible explanations.

People with severe forms of COVID-19 often have underlying medical conditions like heart or lung disease -- which are themselves linked to higher rates of clotting.

Next, being in intensive care makes a person likelier to develop a clot because they are staying still for so long. That's why for example people are encouraged to stretch and move around on long haul flights.

It's also now clear the COVID-19 illness is associated with an abnormal immune reaction called "cytokine storm" -- and some research has indicated this too is linked to higher rates of clotting.

There could also be something about the virus itself that is causing coagulation, which has some precedent in other viral illnesses.

A paper in the journal The Lancet last week showed that the virus can infect the inner cell layer of organs and of blood vessels, called the endothelium. This, in theory, could interfere with the clotting process.

According to Brosnahan, while thinners like Heparin are effective in some patients, they don't work for all patients because the clots are at times too small.

"There are too many microclots," she said. "We're not sure exactly where they are."

Autopsies have in fact shown some people's lungs filled with hundreds of microclots.

The arrival of a new mystery however helps solve a slightly older one.

Cecilia Mirant-Borde, an intensive care doctor at a military veterans hospital in Manhattan, told AFP that lungs filled with microclots helped explain why ventilators work poorly for patients with low blood oxygen.

Earlier in the pandemic doctors were treating these patients according to protocols developed for acute respiratory distress syndrome, sometimes known as "wet lung."

But in some cases, "it's not because the lungs are occupied with water" -- rather, it's that the microclotting is blocking circulation and blood is leaving the lungs with less oxygen than it should.

It has just been a little under five months since the virus emerged in Wuhan, China, and researchers are learning more about its impact every day.

"While we react surprised, we shouldn't be as surprised as we were. Viruses tend to do weird things," said Brosnahan.

While the dizzying array of complications may seem daunting, "it's possible there'll be one or a couple of unifying mechanisms that describe how this damage happens," she said.

"It's possible it's all the same thing, and that there'll be the same solution."