Clinton's blood clot: Was concussion to blame?

Update: 10:20 P.M. EST -- Secretary of State Hillary Clinton's physicians released more information about her condition in a statement Monday afternoon:

"In the course of a routine follow-up MRI on Sunday, the scan revealed that a right transverse sinus venous thrombosis had formed. This is a clot in the vein that is situated in the space between the brain and the skull behind the right ear," Clinton's doctors Dr. Lisa Bardack of Mt. Kisco Medical Group, and Dr. Gigi El-Bayoumi of George Washington University, said in a statement. "It did not result in a stroke, or neurological damage. To help dissolve this clot, her medical team began treating the Secretary with blood thinners. She will be released once the medication dose has been established. In all other aspects of her recovery, the Secretary is making excellent progress and we are confident she will make a full recovery. She is in good spirits, engaging with her doctors, her family, and her staff."


Secretary of State Hillary Clinton remains hospitalized at New York-Presbyterian Hospital in Manhattan on Monday for a blood clot.

Clinton reportedly suffered a concussion Dec. 13 after falling and hitting her head after fainting from a stomach virus that caused serious dehydration. She hasn't been seen in public since, but was expected to return to work this week before being hospitalized for the blood clot.





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How serious is Hillary Clinton's condition?






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Hillary Clinton has blood clot in her head




"She is being treated with anti-coagulants and is at New York-Presbyterian Hospital so that they can monitor the medication over the next 48 hours," Spokesperson Philippe Reines said in a statement. There has been no announcement on the location of the clot, which was discovered during the course of a follow-up exam.

Doctors are expected to decide soon whether any further action is required, Reines said, adding that they will continue to assess Clinton's condition, "including other issues associated with her concussion."

A blood clot is a clump that occurs when blood hardens from a liquid to a solid.

Dr. Jack Ansell, chairman of the department of medicine at Lenox Hill Hospital in New York, who has no special knowledge of the secretary's case, tells CBSNews.com he suspects Clinton is either experiencing a clot that originated in a blood vessel in the brain, called cerebral venous thrombosis, or one that could have occurred in one of the veins in the leg, called deep venous thrombosis (DVT).

Ansell's field of study is thrombosis, which is the formation of a blood clot inside a vessel.

Where does Clinton's concussion come in?

Ansell said the brain is rich in substances that stimulate clotting, so in general, people with a brain injury may face a higher risk for having a blood clot. Therefore it's possible a clot could have originated in a nearby vessel in the brain. However, if someone is lying around recuperating following a concussion or stomach virus, that increase in inactivity could also raise risk for DVT, he said. A person who experiences this dangerous blood clot deep in the leg could be at risk if the clot travels to the lung, becoming what's called a pulmonary embolism.

Dr. Richard Figler, a primary care sports medicine specialist at the Cleveland Clinic, told CBSNews.com that he doesn't believe Clinton's head injury was a direct cause of the blood clot, but said timing and other factors could have contributed. He also suspects that Clinton may have rested more following the stomach virus and concussion than she typically does, and going from an active to sedentary lifestyle may have combined with other factors that can influence blood clotting, like age and genetics.

"I'd have a hard time blaming the concussion for the clot itself," he said.

Ansell said these types of clots are easily treatable and respond well to therapy, so while there is potential harm from complications, he would give the secretary a good prognosis. Patients typically receive anti-coagulant therapy for three to six months, he said, and are monitored up to every week with a blood test to ensure they aren't having any blood flow irregularities.

"I would expect her to recover and not have a problem," he said.




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How serious is Secretary Clinton's condition?




One potential complication from treatment with an anti-coagulant, such as Coumadin (warfarin), is an increased risk for bleeding. That presents a problem for head injury suffers, according to CBS News medical correspondent Dr. Jon LaPook, who is affiliated with the hospital where Clinton is receiving care but has no knowledge of her case.

LaPook says that it is unusual for someone to be given blood thinners after suffering a head injury, because more bleeding in the brain can be deadly.

"The reason is when somebody falls and hits their head, you're worried about bleeding into the skull, into the brain, like Natasha Richardson had, so the last thing you would want to do is thin their blood," he said. "At this point the reason to give anti-coagulation, blood thinner, would be to prevent another clot from forming," he said.

Actress Natasha Richardson hit her head while skiing in Quebec in 2009 and later died from bleeding underneath the skull. That type of clot in the brain is called a subdural hematoma.

LaPook said the doctors treating Clinton may be between a rock and a hard place.

"They want to thin her blood to prevent a further clot, on the other hand they're afraid to give her blood thinners because that could increase bleeding in somebody who's smacked their head recently, so they're going to observe her very closely in the hospital," he said. That observation could also rule out other potential causes for the blood clot, such as heart problems.

Figler said a brain bleed from a head injury is only a major risk within 48 hours of the initial injury, and if the blood clot originated in the secretary's leg, as some suspect, the anti-coagulant therapy shouldn't present a major risk.

Ansell said that while doctors may have balanced Clinton's underlying head injury initially, such as by waiting a few days to make sure brain tissues healed, he also said it's likely safe to treat her with anti-coagulants, adding that many patients with brain injuries or strokes take these types of medication and it's not even certain if the secretary's concussion caused bleeding in the brain.

"I don't think there's any concern for any special risks for bleeding in the brain," he said.

Both doctors also said that anti-coagulants are not typically prescribed for brain bleeds caused by head injuries.

To Figler, the fact that doctors separately diagnosed a clot in addition to the secretary's other recent health woes, speaks to the doctors' ability to find other potential symptoms of a blood clot, such as leg swelling or calf soreness.

"Some docs may say don't worry about it, it could be soreness," he said, noting that a leg ultrasound isn't a typical test given following a concussion. "To be honest, it takes an astute physician to figure those things out."

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Fiscal Cliff Deal Reached; Biden Pitches It to Dems













The so-called "fiscal cliff" came tonight -- but now there is a specific deal on the table to try to soften it after the fact, according to congressional sources.


Senate Majority Leader Harry Reid said the deal would get a vote in the Senate tonight. The House would not vote before Tuesday, having adjourned for the evening before word of the agreement spread.


"It is a compromise, so we don't love it," said a senior White House official. "But it is the right thing to do for the economy."


Vice President Joe Biden met this evening with Senate Democrats in order to convince them to support the proposal, which would extend Bush-era tax cuts permanently for people making less than $400,000 per year and households making less than $450,000, the sources said.


The steep "sequester" budget cuts scheduled to go into effect with the new year would be postponed two months, said sources. They said half the money would come from cuts elsewhere, and the other half from new revenue.


The deal also would affect taxes on investment income and estates, and extend unemployment benefits for a year, the congressional sources added.


Biden was asked to confirm the deal as he entered a meeting with Senate Democrats tonight, but only smiled and said, "Happy New Year." Senators later were seen leaving the meeting later, but made few comments.


"We're waiting to see how the vice president brings his party along," a McConnell aide said.


"The end is in sight," said a Democratic aide with the office of Senate Majority Leader Harry Reid, D-Nev. "If everyone cooperates, it's possible things can move pretty quickly."


After the midnight deadline passes, lawmakers could still prevent a tax hike by making retroactive any legislation that passes in the weeks ahead, experts said. The IRS said it has not yet advised employers to withhold more from their employees' paychecks, pending a deal.






Chip Somodevilla/Getty Images











'Fiscal Cliff': Lawmakers Scramble for Last-Minute Deal Watch Video









But the deal, if it can pass through Congress, does not entirely solve the problem of the "fiscal cliff." In fact, it could set up a new showdown over the same spending cuts in just two months that would be amplified by a brewing fight over how to raise the debt ceiling beyond $16.4 trillion. That new fiscal battle has the potential to eclipse the "fiscal cliff" in short order.


Earlier, during a midday news conference, Obama said he was optimistic about compromise.


"It appears that an agreement to prevent this New Year's tax hike is within sight, but it's not done," he said. "There are still issues left to resolve, but we're hopeful that Congress can get it done."


Congressional and White House negotiators worked out a tentative plan that, in addition to extending current tax rates for households making $450,000 or less, would raise the estate tax from 35 to 40 percent for estates larger than $5 million; and prevent the alternative minimum tax from hammering millions of middle-class workers, according to sources familiar with the talks.


Capital gains taxes would rise to 20 percent from 15, according to a senior White House official.


The deal would also extend for one year unemployment insurance benefits set to expire Tuesday, and avert a steep cut to Medicare payments for doctors, congressional sources said.


"I can report that we've reached an agreement on the all the tax issues," said Senate Minority Leader Mitch McConnell in an afternoon speech on the Senate floor.


At the time, McConnell said that federal spending cuts remained a sticking point. That hurdle later appeared to be cleared by postponing the debate two more months.


The White House had proposed a three-month delay of the cuts to allow more time to hash out details for deficit reduction, while many Senate Democrats wanted a flat one-year delay. Republicans insisted that some spending cuts should be implemented now as part of any deal.


"In order to get the sequester moved, you're going to have to have real, concrete spending cuts," said Rep. Mike Rogers, R-Mich. Without that, he said, "I don't know how it passes the House."


Some Republicans also said Obama unduly complicated progress toward an agreement by seeming to take a victory lap on taxes at his campaign-style event at the White House.


"Keep in mind that just last month Republicans in Congress said they would never agree to raise tax rates on the wealthiest Americans," Obama said, raising the ire of several Republicans. "Obviously, the agreement that's currently discussed would raise those rates, and raise them permanently."


Those words drew a sharp retort from Republican Sen. John McCain.


Rather than staging a "cheerleading rally," McCain said, the president should have been negotiating the finishing touches of the deal.


"He comes out and calls people together and has a group standing behind him, laughs and jokes and ridicules Republicans. Why?" said McCain.


Several Democrats also voiced disappointment with the president and the emerging deal.






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Stories for 2013: Syria to 'post-Gangnam'




Among the few virtual certainties of 2013 is the ongoing anguish of Syria and the decline of its president, Bashar al-Assad.




STORY HIGHLIGHTS


  • Look for more unrest amid power transitions in the Middle East

  • Disputes and economic worries will keep China, Japan, North Korea in the news

  • Europe's economy will stay on a rough road, but the outlook for it is brighter

  • Events are likely to draw attention to cyber warfare and climate change




(CNN) -- Forecasting the major international stories for the year ahead is a time-honored pastime, but the world has a habit of springing surprises. In late 1988, no one was predicting Tiananmen Square or the fall of the Berlin Wall. On the eve of 2001, the 9/11 attacks and the subsequent invasion of Afghanistan were unimaginable. So with that substantial disclaimer, let's peer into the misty looking glass for 2013.


More turmoil for Syria and its neighbors


If anything can be guaranteed, it is that Syria's gradual and brutal disintegration will continue, sending aftershocks far beyond its borders. Most analysts do not believe that President Bashar al-Assad can hang on for another year. The more capable units of the Syrian armed forces are overstretched; large tracts of north and eastern Syria are beyond the regime's control; the economy is in dire straits; and the war is getting closer to the heart of the capital with every passing week. Russian support for al-Assad, once insistent, is now lukewarm.


Amid the battle, a refugee crisis of epic proportions threatens to become a catastrophe as winter sets in. The United Nations refugee agency says more than 4 million Syrians are in desperate need, most of them in squalid camps on Syria's borders, where tents are no match for the cold and torrential rain. Inside Syria, diseases like tuberculosis are spreading, according to aid agencies, and there is a danger that hunger will become malnutrition in places like Aleppo.


The question is whether the conflict will culminate Tripoli-style, with Damascus overrun by rebel units; or whether a political solution can be found that involves al-Assad's departure and a broadly based transitional government taking his place. U.N. envoy Lakhdar Brahimi has not been explicit about al-Assad's exit as part of the transition, but during his most recent visit to Damascus, he hinted that it has to be.









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"Syria and the Syrian people need, want and look forward to real change. And the meaning of this is clear to all," he said.


The international community still seems as far as ever from meaningful military intervention, even as limited as a no fly-zone. Nor is there any sign of concerted diplomacy to push all sides in Syria toward the sort of deal that ended the war in Bosnia. In those days, the United States and Russia were able to find common ground. In Syria, they have yet to do so, and regional actors such as Turkey, Qatar, Saudi Arabia and Iran also have irons in the fire.


Failing an unlikely breakthrough that would bring the regime and its opponents to a Syrian version of the Dayton Accords that ended the Bosnian war, the greatest risk is that a desperate regime may turn to its chemical weapons, troublesome friends (Hezbollah in Lebanon and the Kurdish PKK in Turkey) and seek to export unrest to Lebanon, Iraq and Jordan.


The Syrian regime has already hinted that it can retaliate against Turkey's support for the rebels -- not by lobbing Scud missiles into Turkey, but by playing the "Kurdish" card. That might involve direct support for the PKK or space for its Syrian ally, the Democratic Union Party. By some estimates, Syrians make up one-third of the PKK's fighting strength.


To the Turkish government, the idea that Syria's Kurds might carve out an autonomous zone and get cozy with Iraq's Kurds is a nightmare in the making. Nearly 800 people have been killed in Turkey since the PKK stepped up its attacks in mid-2011, but with three different sets of elections in Turkey in 2013, a historic bargain between Ankara and the Kurds that make up 18% of Turkey's population looks far from likely.


Many commentators expect Lebanon to become more volatile in 2013 because it duplicates so many of the dynamics at work in Syria. The assassination in October of Lebanese intelligence chief Brig. Gen. Wissam al-Hassan -- as he investigated a pro-Syrian politician accused of obtaining explosives from the Syrian regime -- was an ominous portent.


Victory for the overwhelmingly Sunni rebels in Syria would tilt the fragile sectarian balance next door, threatening confrontation between Lebanon's Sunnis and Hezbollah. The emergence of militant Salafist groups like al-Nusra in Syria is already playing into the hands of militants in Lebanon.


Iraq, too, is not immune from Syria's turmoil. Sunni tribes in Anbar and Ramadi provinces would be heartened should Assad be replaced by their brethren across the border. It would give them leverage in an ever more tense relationship with the Shia-dominated government in Baghdad. The poor health of one of the few conciliators in Iraqi politics, President Jalal Talabani, and renewed disputes between Iraq's Kurds and the government over boundaries in the oil-rich north, augur for a troublesome 2013 in Iraq.


More worries about Iran's nuclear program


Syria's predicament will probably feature throughout 2013, as will the behavior of its only friend in the region: Iran. Intelligence sources say Iran continues to supply the Assad regime with money, weapons and expertise; and military officers who defected from the Syrian army say Iranian technicians work in Syria's chemical weapons program. Al-Assad's continued viability is important for Iran, as his only Arab ally. They also share sponsorship of Hezbollah in Lebanon, which, with its vast supply of rockets and even some ballistic missiles, might be a valuable proxy in the event of an Israeli strike against Iran's nuclear program.


Speaking of which, there are likely to be several more episodes in the behind-closed-doors drama of negotiations on Iran's nuclear sites. Russia is trying to arrange the next round for January. But in public, at least, Iran maintains it has every right to continue enriching uranium for civilian purposes, such as helping in the treatment of more than 1 million Iranians with cancer.


Iran "will not suspend 20% uranium enrichment because of the demands of others," Fereydoun Abbasi-Davani, head of Iran's Atomic Energy Organization, said this month.


International experts say the amount of 20% enriched uranium (estimated by the International Atomic Energy Agency in November at 297 pounds) is more than needed for civilian purposes, and the installation of hundreds more centrifuges could cut the time needed to enrich uranium to weapons-grade. The question is whether Iran will agree to intrusive inspections that would reassure the international community -- and Israel specifically -- that it can't and won't develop a nuclear weapon.


This raises another question: Will it take bilateral U.S.-Iranian talks -- and the prospect of an end to the crippling sanctions regime -- to find a breakthrough? And will Iran's own presidential election in June change the equation?


For now, Israel appears to be prepared to give negotiation (and sanctions) time to bring Iran to the table. For now.


Egypt to deal with new power, economic troubles


Given the turmoil swirling through the Middle East, Israel could probably do without trying to bomb Iran's nuclear program into submission. Besides Syria and Lebanon, it is already grappling with a very different Egypt, where a once-jailed Islamist leader is now president and Salafist/jihadi groups, especially in undergoverned areas like Sinai, have a lease on life unimaginable in the Mubarak era.



The U.S. has an awkward relationship with President Mohamed Morsy, needing his help in mediating with Hamas in Gaza but concerned that his accumulation of power is fast weakening democracy and by his bouts of anti-Western rhetoric. (He has demanded the release from a U.S. jail of Sheikh Omar Abdel Rahman, convicted of involvement in the first bombing of the World Trade Center in 1993.)


The approval of the constitution removes one uncertainty, even if the opposition National Salvation Front says it cements Islamist power. But as much as the result, the turnout -- about one-third of eligible voters -- indicates that Egyptians are tired of turmoil, and more concerned about a deepening economic crisis.


Morsy imposed and then scrapped new taxes, and the long-expected $4.8 billion loan from the International Monetary Fund is still not agreed on. Egypt's foreign reserves were down to $15 billion by the end of the year, enough to cover less than three months of imports. Tourism revenues are one-third of what they were before street protests erupted early in 2011. Egypt's crisis in 2013 may be more about its economy than its politics.


Libya threatens to spawn more unrest in North Africa


Libya's revolution, if not as seismic as anything Syria may produce, is still reverberating far and wide. As Moammar Gadhafi's rule crumbled, his regime's weapons found their way into an arms bazaar, turning up in Mali and Sinai, even being intercepted off the Lebanese coast.


The Libyan government, such as it is, seems no closer to stamping its authority on the country, with Islamist brigades holding sway in the east, tribal unrest in the Sahara and militias engaged in turf wars. The danger is that Libya, a vast country where civic institutions were stifled for four decades, will become the incubator for a new generation of jihadists, able to spread their influence throughout the Sahel. They will have plenty of room and very little in the way of opposition from security forces.


The emergence of the Islamist group Ansar Dine in Mali is just one example. In this traditionally moderate Muslim country, Ansar's fighters and Tuareg rebels have ejected government forces from an area of northern Mali the size of Spain and begun implementing Sharia law, amputations and floggings included. Foreign fighters have begun arriving to join the latest front in global jihad; and terrorism analysts are seeing signs that al Qaeda in the Islamic Maghreb (AQIM) and groups like Boko Haram in Nigeria are beginning to work together.


There are plans for an international force to help Mali's depleted military take back the north, but one European envoy said it was unlikely to materialize before (wait for it) ... September 2013. Some terrorism analysts see North Africa as becoming the next destination of choice for international jihad, as brigades and camps sprout across a vast area of desert.


A bumpy troop transition for Afghanistan


The U.S. and its allies want to prevent Afghanistan from becoming another haven for terror groups. As the troop drawdown gathers pace, 2013 will be a critical year in standing up Afghan security forces (the numbers are there, their competence unproven), improving civil institutions and working toward a post-Karzai succession.



In November, the International Crisis Group said the outlook was far from assuring.


"Demonstrating at least will to ensure clean elections (in Afghanistan in 2014) could forge a degree of national consensus and boost popular confidence, but steps toward a stable transition must begin now to prevent a precipitous slide toward state collapse. Time is running out," the group said.


Critics have also voiced concerns that the publicly announced date of 2014 for withdrawing combat forces only lets the Taliban know how long they must hold out before taking on the Kabul government.


U.S. officials insist the word is "transitioning" rather than "withdrawal," but the shape and role of any military presence in 2014 and beyond are yet to be settled. Let's just say the United States continues to build up and integrate its special operations forces.


The other part of the puzzle is whether the 'good' Taliban can be coaxed into negotiations, and whether Pakistan, which has considerable influence over the Taliban leadership, will play honest broker.


Private meetings in Paris before Christmas that involved Taliban envoys and Afghan officials ended with positive vibes, with the Taliban suggesting they were open to working with other political groups and would not resist girls' education. There was also renewed discussion about opening a Taliban office in Qatar, but we've been here before. The Taliban are riven by internal dissent and may be talking the talk while allowing facts on the ground to work to their advantage.


Where will North Korea turn its focus?


On the subject of nuclear states that the U.S.-wishes-were-not, the succession in North Korea has provided no sign that the regime is ready to restrain its ambitious program to test nuclear devices and the means to deliver them.



Back in May 2012, Peter Brookes of the American Foreign Policy Council said that "North Korea is a wild card -- and a dangerous one at that." He predicted that the inexperienced Kim Jong Un would want to appear "large and in charge," for internal and external consumption. In December, Pyongyang launched a long-range ballistic missile -- one that South Korean scientists later said had the range to reach the U.S. West Coast. Unlike the failure of the previous missile launch in 2009, it managed to put a satellite into orbit.


The last two such launches have been followed by nuclear weapons tests -- in 2006 and 2009. Recent satellite images of the weapons test site analyzed by the group 38 North show continued activity there.


So the decision becomes a political one. Does Kim continue to appear "large and in charge" by ordering another test? Or have the extensive reshuffles and demotions of the past year already consolidated his position, allowing him to focus on the country's dire economic situation?


China-Japan island dispute to simmer


It's been a while since East Asia has thrown up multiple security challenges, but suddenly North Korea's missile and nuclear programs are not the only concern in the region. There's growing rancor between China and Japan over disputed islands in the East China Sea, which may be aggravated by the return to power in Japan of Shinzo Abe as prime minister.


Abe has long been concerned that Japan is vulnerable to China's growing power and its willingness to project that power. Throughout 2012, Japan and China were locked in a war of words over the Senkaku or Diaoyu islands, with fishing and Coast Guard boats deployed to support claims of sovereignty.


In the days before Japanese went to the polls, Beijing also sent a surveillance plane over the area, marking the first time since 1958, according to Japanese officials, that Bejing had intruded into "Japanese airspace." Japan scrambled F-15 jets in response.


The islands are uninhabited, but the seas around them may be rich in oil and gas. There is also a Falklands factor at play here. Not giving in to the other side is a matter of national pride. There's plenty of history between China and Japan -- not much of it good.


As China has built up its ability to project military power, Japan's navy has also expanded. Even a low-level incident could lead to an escalation. And as the islands are currently administered by Japan, the U.S. would have an obligation to help the Japanese defend them.


Few analysts expect conflict to erupt, and both sides have plenty to lose. For Japan, China is a critical market, but Japanese investment there has fallen sharply in the past year. Just one in a raft of problems for Abe. His prescription for dragging Japan out of its fourth recession since 2000 is a vast stimulus program to fund construction and other public works and a looser monetary policy.


The trouble is that Japan's debt is already about 240% of its GDP, a much higher ratio than even Greece. And Japan's banks hold a huge amount of that debt. Add a shrinking and aging population, and at some point the markets might decide that the yield on Japan's 10-year sovereign bond ought to be higher than the current 0.77%.


Economic uncertainty in U.S., growth in China


So the world's third-largest economy may not help much in reviving global growth, which in 2012 was an anemic 2.2%, according to United Nations data. The parts of Europe not mired in recession hover close to it, and growth in India and Brazil has weakened. Which leaves the U.S. and China.


At the time of writing, the White House and congressional leadership are still peering over the fiscal cliff. Should they lose their footing, the Congressional Budget Office expects the arbitrary spending cuts and tax increases to be triggered will push the economy into recession and send unemployment above 9%.



A stopgap measure, rather than a long-term foundation for reducing the federal deficit, looks politically more likely. But to companies looking for predictable economic policy, it may not be enough to unlock billions in investment. Why spend heavily if there's a recession around the corner, or if another fight looms over raising the federal debt ceiling?


In September, Moody's said it would downgrade the U.S. sovereign rating from its "AAA" rating without "specific policies that produce a stabilization and then downward trend in the ratio of federal debt to GDP over the medium term." In other words, it wants action beyond kicking the proverbial can.


Should the cliff be dodged, most forecasts see the U.S. economy expanding by about 2% in 2013. That's not enough to make up for stagnation elsewhere, so a great deal depends on China avoiding the proverbial hard landing.


Until now, Chinese growth has been powered by exports and infrastructure spending, but there are signs that China's maturing middle class is also becoming an economic force to be reckoned with. Consultants PwC expect retail sales in China to increase by 10.5% next year -- with China overtaking the U.S. as the world's largest retail market by 2016.


Europe's economic outlook a little better


No one expects Europe to become an economic powerhouse in 2013, but at least the horizon looks a little less dark than it did a year ago. The "PIGS' " (Portugal, Ireland/Italy, Greece, Spain) borrowing costs have eased; there is at least rhetorical progress toward a new economic and fiscal union; and the European Central Bank has talked tough on defending the Eurozone.


Mario Draghi, president of the European Central Bank, fended off the dragons with the declaration in July that "Within our mandate, the ECB is ready to do whatever it takes to preserve the euro. And believe me, it will be enough."



Draghi has promised the bank has unlimited liquidity to buy sovereign debt, as long as governments (most likely Spain) submit to reforms designed to balance their budgets. But in 2013, the markets will want more than brave talk, including real progress toward banking and fiscal union that will leave behind what Draghi likes to call Europe's "fairy world" of unsustainable debt and collapsing banks. Nothing can be done without the say-so of German Chancellor Angela Merkel, renowned for a step-by-step approach that's likely to be even more cautious in a year when she faces re-election.


Elections in Italy in February may be more important -- pitching technocrat Prime Minister Mario Monti against the maverick he replaced, 76-year old Silvio Berlusconi. After the collapse of Berlusconi's coalition 13 months ago, Monti reined in spending, raised the retirement age and raised taxes to bring Italy back from the brink of insolvency. Now he will lead a coalition of centrist parties into the election. But polls suggest that Italians are tired of Monti's austerity program, and Berlusconi plans a populist campaign against the man he calls "Germano-centric."


The other tripwire in Europe may be Greece. More cuts in spending -- required to qualify for an EU/IMF bailout -- are likely to deepen an already savage recession, threatening more social unrest and the future of a fragile coalition. A 'Grexit' from the eurozone is still possible, and that's according to the Greek finance minister, Yannis Stournaras.


Expect to see more evidence of climate change


Hurricane Sandy, which struck the U.S. East Coast in November, was the latest indicator of changing and more severe weather patterns. Even if not repeated in 2013, extreme weather is beginning to have an effect -- on where people live, on politicians and on the insurance industry.


After Sandy, New York Gov. Andrew Cuomo said that after "the last few years, I don't think anyone can sit back anymore and say, 'Well, I'm shocked at that weather pattern.' " The storm of the century has become the storm of every decade or so, said Michael Oppenheimer, professor of geosciences at Princeton.


"Climate change will probably increase storm intensity and size simultaneously, resulting in a significant intensification of storm surges," he and colleagues wrote in Nature.


In the U.S., government exposure to storm-related losses in coastal states has risen more than 15-fold since 1990, to $885 billion in 2011, according to the Insurance Information Institute. The Munich RE insurance group says North America has seen higher losses from extreme weather than any other part of the world in recent decades.


"A main loss driver is the concentration of people and assets on the coast combined with high and possibly growing vulnerabilities," it says.


Risk Management Solutions, which models catastrophic risks, recently updated its scenarios, anticipating an increase of 40% in insurance losses on the Gulf Coast, Florida and the Southeast over the next five years, and 25% to 30% for the mid-Atlantic and Northeastern states. Those calculations were done before Sandy.



Inland, eyes will be trained on the heavens for signs of rain -- after the worst drought in 50 years across the Midwest. Climatologists say that extended periods of drought -- from the U.S. Midwest to Ukraine -- may be "the new normal." Jennifer Francis at the Institute of Marine and Coastal Sciences at Rutgers University has shown that a warmer Arctic tends to slow the jet stream, causing it to meander and, in turn, prolong weather patterns. It's called Arctic amplification, and it is probably aggravating drought in the Northwest United States and leading to warmer summers in the Northern Hemisphere, where 2012 was the hottest year on record.


It is a double-edged sword: Warmer temperatures may make it possible to begin cultivating in places like Siberia, but drier weather in traditional breadbaskets would be very disruptive. The U.N. Food and Agriculture Organization reports that stocks of key cereals have tightened, contributing to volatile world markets. Poor weather in Argentina, the world's second-largest exporter of corn, may compound the problem.


More cyber warfare


What will be the 2013 equivalents of Flame, Gauss and Shamoon? They were some of the most damaging computer viruses of 2012. The size and versatility of Flame was unlike nothing seen before, according to anti-virus firm Kaspersky Lab.



Gauss stole online banking information in the Middle East. Then came Shamoon, a virus that wiped the hard drives of about 30,000 computers at the Saudi oil company Aramco, making them useless. The Saudi government declared it an attack on the country's economy; debate continues on whether it was state-sponsored.


Kaspersky predicts that in 2013, we will see "new examples of cyber-warfare operations, increasing targeted attacks on businesses and new, sophisticated mobile threats."


Computer security firm McAfee also expects more malware to be developed to attack mobile devices and apps in 2013.


U.S. Defense Secretary Leon Panetta is more concerned about highly sophisticated attacks on infrastructure that "could be as destructive as the terrorist attack on 9/11."


"We know that foreign cyber actors are probing America's critical infrastructure networks. They are targeting the computer control systems that operate chemical, electricity and water plants and those that guide transportation throughout this country," he said in October.


Intellectual property can be stolen, bought or demanded as a quid pro quo for market access. The U.S. intelligence community believes China or Chinese interests are employing all three methods in an effort to close the technology gap.


In the waning days of 2012, the interagency Committee on Foreign Investment in the United States said "there is likely a coordinated strategy among one or more foreign governments or companies to acquire U.S. companies involved in research, development, or production of critical technologies."


It did not name the country in its unclassified report but separately noted a growing number of attempts by Chinese entities to buy U.S. companies.


Who will be soccer's next 'perfect machine'?



There's room for two less serious challenges in 2013. One is whether any football team, in Spain or beyond, can beat Barcelona and its inspirational goal machine Lionel Messi, who demolished a record that had stood since 1972 for the number of goals scored in a calendar year. (Before Glasgow Celtic fans start complaining, let's acknowledge their famous win against the Spanish champions in November.)


Despite the ill health of club coach Tito Vilanova, "Barca" sits imperiously at the top of La Liga in Spain and is the favorite to win the world's most prestigious club trophy, the European Champions League, in 2013. AC Milan is its next opponent in a match-up that pits two of Europe's most storied clubs against each other. But as Milan sporting director Umberto Gandini acknowledges, "We face a perfect machine."


Will Gangnam give it up to something sillier?



Finally, can something -- anything -- displace Gangnam Style as the most watched video in YouTube's short history? As of 2:16 p.m. ET on December 26, it had garnered 1,054,969,395 views and an even more alarming 6,351,871 "likes."


Perhaps in 2013 the YouTube audience will be entranced by squirrels playing table tennis, an octopus that spins plates or Cistercian nuns dancing the Macarena. Or maybe Gangnam will get to 2 billion with a duet with Justin Bieber.







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Gang hits gem-cutting plant in Brazil, takes hostages






BRASILIA: Military police killed the leader of a gang that had spectacularly blasted its way into a gem-cutting plant on Sunday, traded fire with police and made off with nine hostages who were later safely freed.

Three of the assailants died in the assault in the state of Rio Grande do Sul, a military police official told AFP on condition of anonymity.

The dead included Elisandro Falcao, 31, one of the state's most wanted men. He led a gang that specializes in robberies using explosives to target banks and automated teller machines, reports said.

Surviving attackers fled with their hostages -- one of whom was a 12-year-old girl -- into a wooded area of the town of Cotipora, with police pursuing in cars and helicopters, the official said.

At least 100 military police, backed by helicopters, worked into the night in the search for five assailants and their captives.

After an hours-long operation, police freed all nine hostages safely, but also exchanged more fire with the assailants, killing three more of them, while two police officers were injured, officials said.

The area where the strike was carried out is in the heart of the gem-cutting industry in Brazil, which is a world leader in exporting many semi-precious stones such as topaz, aquamarine and amethyst.

The robbers detonated dynamite to storm into the plant, then ran into police on their way out, the military police official said.

"There was an intense firefight. Three assailants died and two police were injured," Rio Grande do Sul state military chief Sergio Abreu told reporters.

Police have recovered part of the loot, but gave no figure for its value.

As they made their escape, the attackers split into two groups. One took two people who were in a bar hostage, and the other broke into a home and abducted seven people, apparently all members of the same family.

The forest where the gang fled is thick and hard to navigate, but police surrounded it, said state deputy military commander Altair de Freitas.

Helicopters and special operations teams with sniffer dogs took part in the search, he added. News reports said the remaining gang was made up of nine men armed with rifles.

Governor Tarso Genro stressed that the hostages' lives were the top priority.

- AFP/al



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Opinion: 12 lessons

















What we learned in 2012


What we learned in 2012


What we learned in 2012


What we learned in 2012


What we learned in 2012


What we learned in 2012


What we learned in 2012


What we learned in 2012


What we learned in 2012


What we learned in 2012








STORY HIGHLIGHTS


  • Dean Obeidallah: You are smarter today than 365 days ago

  • Obeidallah: You probably learned a few Korean words like "Gangnam Style"

  • He says we found out poultry can be a political tool and some people talk to chairs

  • Obeidallah: The good news is that we'll soon forget the inane lessons of 2012




Editor's note: Dean Obeidallah, a former attorney, is a political comedian and frequent commentator on various TV networks including CNN. He is the editor of the politics blog "The Dean's Report" and co-director of the upcoming documentary, "The Muslims Are Coming!" Follow him on Twitter: @deanofcomedy


(CNN) -- You are smarter today than 365 days ago. You know more than you did at the end of 2011.


And here's the kicker, you may not even be aware of how much you learned this past year. It's analogous to how you're affected by the hit songs of boy bands. No matter how much you might try to avoid them, you can't, because these songs are everywhere. Consequently, the words are subtly drilled into your head and the next thing you know, you find yourself unconsciously singing along to the songs when they play on the radio.


So regardless if you were paying attention or not, there's a lot of new information from this past year trapped inside your brain. Here are just some of the things we collectively learned in 2012:



Dean Obeidallah

Dean Obeidallah




1. Mitt Romney had binders full of women


During the second presidential debate, Romney shared with us that when he was governor of Massachusetts, he had binders filled with information about women he was considering hiring. (When I was a teenager, I, too, had binders full of women. But mine I hid under my bed so my mom wouldn't find them.)


2. We picked up some Korean


We're not fluent yet, but thanks to the Korean pop singer PSY and his song "Gangnam Style," we all learned a few Korean words. And because of the song's ubiquitous music video -- which broke the record as the first video to get more than 1 billion views on YouTube -- some of us even have a vague idea of how to do his famous "horse dance."


3. Women love to read "porn"


The runaway hit book, "Fifty Shades of Grey," created a sensation across the country as women -- many over 30 years old -- bought this sexually provocative book, thus coining the term "mommy porn." In contrast, most men are waiting for the movie because we are more traditional in our "porn" tastes.


4. Poultry can be a political tool


Fast food chain Chick-fil-A went from just serving chicken to serving a political message as the head of the company announced publicly that he opposed marriage equality. Consequently, ordering a chicken sandwich at this chain came with a side dish of right-wing politics.


5. Some people talk to chairs


Clint Eastwood taught us at this year's Republican National Convention that you can have a full conversation on national television with your furniture. Hey, Clint made it OK for you to have a conversation with your couch or end table.


6. "James Bond" met the "The Real Housewives"


CIA Director David Petraeus resigned from his job because his extramarital affair was discovered. This is especially shocking because Petraeus' job as the nation's top spy chief was to keep secrets.


7. Cliffs are not just in nature


As we get closer to a precipitous "fiscal cliff" -- a term more overexposed than "Gangnam Style," it seems -- we have all learned that Congress has truly earned its low approval rating -- any lower and certain infectious diseases may become more popular than Congress.


8. What's the big deal with silver?


U.S. Olympian McKayla Maroney made it clear at the London Olympics that she was not impressed by winning the silver medal with her famous "I'm not impressed" face.


9. The way to reduce gun violence is more guns


At least this is what we were told by NRA's Vice President Wayne LaPierre in December as he called for armed guards to be placed in each of the roughly 100,000 public schools in the country.


10. Reality stars are not just for dysfunctional adults


Child star Alana "Honey Boo Boo" Thompson proved that children can be just as self-absorbed and horribly demanding as adult reality show stars.


11. Calendars are not always reliable


The fact you're reading this means that the Mayan apocalypse did not come to pass. That's good news. The bad news is that I now have to pay late fees on the credit cards I didn't pay because I thought there was a chance the Mayans were right.


12. America is the best democracy money can buy


This year's presidential election saw roughly $2 billion spent by the two campaigns and their supporters. That's more than the annual GDP of numerous countries.


You probably recalled more of these things than you guessed you would. While old acquaintances should not be forgot, the good news is that we will likely soon forget the details of the more inane lessons of 2012. Of course, the bad news is that they may be replaced by even more ridiculous ones in 2013.


Follow us on Twitter @CNNOpinion


Join us on Facebook/CNNOpinion


The opinions expressed in this commentary are solely those of Dean Obeidallah.






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Nine killed in Oregon tour bus crash

Updated 9:09 p.m. ET



LA GRANDE, Ore. A tour bus careened through a guardrail along an icy Oregon highway and several hundred feet down a steep embankment Sunday, killing nine people and injuring more than 20 others, authorities said.

The charter bus carrying about 40 people lost control around 10:30 a.m. on the snow- and ice-covered lanes of Interstate 84, according to the Oregon State Police.

The bus came to rest at the bottom of a snowy slope. More than a dozen rescue workers descended the hill and used ropes to help retrieve people from the wreckage in freezing weather. The bus driver was among the survivors, but had not yet spoken to police because of the severity of the injuries the driver had suffered.

Lt. Greg Hastings said the bus crashed along the west end of the Blue Mountains, and west of an area called Deadman Pass. Stretches of highway in the rural and agricultural area of east Oregon tend to be icy in winter months.

The bus slid down the hill and landed upright, with little or no debris visible around the crash site.

St. Anthony Hospital in Pendleton treated 26 people from the accident, including some who were treated and then transported to other medical facilities, said hospital spokesman Larry Blanc.

In addition to the people who were transferred from St. Anthony to La Grand and Hermiston, Ore., and Walla Walla, Wash., Hastings said. Others were taken directly to hospitals further away, including Boise, Idaho, and Portland, Ore.

I-84 is a major east-west highway through Oregon that follows the Columbia River Gorge.

Umatilla County Emergency Manager Jack Remillard said the bus was owned by Mi Joo travel in Vancouver, B.C., and state police said the bus was en route from Las Vegas to Vancouver.

A woman who answered the phone at a listing for the company confirmed with The Associated Press that it owned the bus and said it was on a tour of the Western U.S. She declined to give her name.

A bus safety website run by the U.S. Department of Transportation said Mi Joo Tour & Travel has six buses, none of which have been involved in any accidents in at least the past two years.

The bus crash was the second fatal accident in Oregon on Sunday morning due to icy conditions. A 69-year-old man died in a single-vehicle rollover accident. CBS affiliate KOIN-TV in Portland reports both the 26-year-old driver, who is expected to survive, and the deceased passenger were wearing safety restraints.

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Hillary Clinton Hospitalized With Blood Clot


gty hillary clinton jt 121209 wblog Hillary Clinton Hospitalized With Blood Clot

(MICHAL CIZEK/AFP/Getty Images)


By DANA HUGHES and DEAN SCHABNER


Secretary Hillary Clinton was hospitalized today after a doctors doing a follow-up exam discovered a blood clot had formed, stemming from the concussion she sustained several weeks ago.


She is being treated with anti-coagulants and is at NewYork-Presbyterian Hospital so that they can monitor the medication over the next 48 hours, Deputy Assistant Secretary Philippe Reines said.


Her doctors will continue to assess her condition, including other issues associated with her concussion. They will determine if any further action is required, Reines said.


Clinton, 65, originally fell ill from a stomach virus following a whirlwind trip to Europe at the beginning of the month, which caused such severe dehydration that she fainted and fell at home, suffering a concussion. No ambulance was called and she was not hospitalized, according to a state department official.


The stomach virus had caused Clinton to cancel a planned trip to North Africa and the United Arab Emirates, and also her scheduled testimony before Congress at hearings on the attack on the U.S. consulate in Benghazi, Libya.


According to a U.S. official, the secretary had two teams of doctors, including specialists, examine her after the fall.  They also ran tests to rule out more serious ailments beyond the virus and the concussion. During the course of the week after her concussion, Clinton was on an IV drip and being monitored by a nurse, while also recovering from the pain caused by the fall.


Medical experts consulted by ABC News said that it was impossible to know for sure the true nature or severity of Clinton’s condition, given the sparse information provided by the State Department. However, most noted that the information available could indicate that Clinton had a deep venous thrombosis,which is a clot in the large veins in the legs.


“A concussion (traumatic brain injury) in itself increases risk of this clot. Likely the concussion has increased her bed rest,” said Dr. Brian D. Greenwald, Medical Director JFK Jonson Rehabilitation Center for Head Injuries. “Immobility is also a risk for DVT. Long flights are also a risk factor for DVT but the recent concussion is the most likely cause.


“Anticoagulants are the treatment,” he said. “If DVT goes untreated it can lead to pulmonary embolism (PE). PE is a clot traveling from veins in legs to lungs which is life threatening. Many people die each year from this.


“Now that she is being treated with blood thinners her risks of PE are decreased,” he said. “Blood thinners carry risk of bleeding but are common and can be safely used.”


Dr. Allen Sills, associate professor of Neurological Surgery at Vanderbilt University Medical Center, said it was most likely that the clot was not located in Clinton’s brain, since she is being treated with anticoagulants.


“This is certainly not a common occurrence after a concussion, and is most likely related to either inactivity or some other injury suffered in the fall,” he said.


Dr. Neil Martin, the head of Neurovascular Surgery at the University of California, Los Angeles, Medical Center, said blood thinners are often given for blood clots in the legs, and it is “very unusual” for anticoagulants to be given for blood clots in the head.


But he cautioned about speculating too much about Clinton’s condition before more information is available.


“If we don’t know where it is, there is the possibility of several different indications,” he said. “I don’t know if there is any connection between what she’s got now and the concussion. All I can tell you is, at this point, it’s almost impossible to speculate unless we know what’s going on there.”

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Stories for 2013: Syria to 'post-Gangnam'




Among the few virtual certainties of 2013 is the ongoing anguish of Syria and the decline of its president, Bashar al-Assad.




STORY HIGHLIGHTS


  • Look for more unrest amid power transitions in the Middle East

  • Disputes and economic worries will keep China, Japan, North Korea in the news

  • Europe's economy will stay on a rough road, but the outlook for it is brighter

  • Events are likely to draw attention to cyber warfare and climate change




(CNN) -- Forecasting the major international stories for the year ahead is a time-honored pastime, but the world has a habit of springing surprises. In late 1988, no one was predicting Tiananmen Square or the fall of the Berlin Wall. On the eve of 2001, the 9/11 attacks and the subsequent invasion of Afghanistan were unimaginable. So with that substantial disclaimer, let's peer into the misty looking glass for 2013.


More turmoil for Syria and its neighbors


If anything can be guaranteed, it is that Syria's gradual and brutal disintegration will continue, sending aftershocks far beyond its borders. Most analysts do not believe that President Bashar al-Assad can hang on for another year. The more capable units of the Syrian armed forces are overstretched; large tracts of north and eastern Syria are beyond the regime's control; the economy is in dire straits; and the war is getting closer to the heart of the capital with every passing week. Russian support for al-Assad, once insistent, is now lukewarm.


Amid the battle, a refugee crisis of epic proportions threatens to become a catastrophe as winter sets in. The United Nations refugee agency says more than 4 million Syrians are in desperate need, most of them in squalid camps on Syria's borders, where tents are no match for the cold and torrential rain. Inside Syria, diseases like tuberculosis are spreading, according to aid agencies, and there is a danger that hunger will become malnutrition in places like Aleppo.


The question is whether the conflict will culminate Tripoli-style, with Damascus overrun by rebel units; or whether a political solution can be found that involves al-Assad's departure and a broadly based transitional government taking his place. U.N. envoy Lakhdar Brahimi has not been explicit about al-Assad's exit as part of the transition, but during his most recent visit to Damascus, he hinted that it has to be.









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"Syria and the Syrian people need, want and look forward to real change. And the meaning of this is clear to all," he said.


The international community still seems as far as ever from meaningful military intervention, even as limited as a no fly-zone. Nor is there any sign of concerted diplomacy to push all sides in Syria toward the sort of deal that ended the war in Bosnia. In those days, the United States and Russia were able to find common ground. In Syria, they have yet to do so, and regional actors such as Turkey, Qatar, Saudi Arabia and Iran also have irons in the fire.


Failing an unlikely breakthrough that would bring the regime and its opponents to a Syrian version of the Dayton Accords that ended the Bosnian war, the greatest risk is that a desperate regime may turn to its chemical weapons, troublesome friends (Hezbollah in Lebanon and the Kurdish PKK in Turkey) and seek to export unrest to Lebanon, Iraq and Jordan.


The Syrian regime has already hinted that it can retaliate against Turkey's support for the rebels -- not by lobbing Scud missiles into Turkey, but by playing the "Kurdish" card. That might involve direct support for the PKK or space for its Syrian ally, the Democratic Union Party. By some estimates, Syrians make up one-third of the PKK's fighting strength.


To the Turkish government, the idea that Syria's Kurds might carve out an autonomous zone and get cozy with Iraq's Kurds is a nightmare in the making. Nearly 800 people have been killed in Turkey since the PKK stepped up its attacks in mid-2011, but with three different sets of elections in Turkey in 2013, a historic bargain between Ankara and the Kurds that make up 18% of Turkey's population looks far from likely.


Many commentators expect Lebanon to become more volatile in 2013 because it duplicates so many of the dynamics at work in Syria. The assassination in October of Lebanese intelligence chief Brig. Gen. Wissam al-Hassan -- as he investigated a pro-Syrian politician accused of obtaining explosives from the Syrian regime -- was an ominous portent.


Victory for the overwhelmingly Sunni rebels in Syria would tilt the fragile sectarian balance next door, threatening confrontation between Lebanon's Sunnis and Hezbollah. The emergence of militant Salafist groups like al-Nusra in Syria is already playing into the hands of militants in Lebanon.


Iraq, too, is not immune from Syria's turmoil. Sunni tribes in Anbar and Ramadi provinces would be heartened should Assad be replaced by their brethren across the border. It would give them leverage in an ever more tense relationship with the Shia-dominated government in Baghdad. The poor health of one of the few conciliators in Iraqi politics, President Jalal Talabani, and renewed disputes between Iraq's Kurds and the government over boundaries in the oil-rich north, augur for a troublesome 2013 in Iraq.


More worries about Iran's nuclear program


Syria's predicament will probably feature throughout 2013, as will the behavior of its only friend in the region: Iran. Intelligence sources say Iran continues to supply the Assad regime with money, weapons and expertise; and military officers who defected from the Syrian army say Iranian technicians work in Syria's chemical weapons program. Al-Assad's continued viability is important for Iran, as his only Arab ally. They also share sponsorship of Hezbollah in Lebanon, which, with its vast supply of rockets and even some ballistic missiles, might be a valuable proxy in the event of an Israeli strike against Iran's nuclear program.


Speaking of which, there are likely to be several more episodes in the behind-closed-doors drama of negotiations on Iran's nuclear sites. Russia is trying to arrange the next round for January. But in public, at least, Iran maintains it has every right to continue enriching uranium for civilian purposes, such as helping in the treatment of more than 1 million Iranians with cancer.


Iran "will not suspend 20% uranium enrichment because of the demands of others," Fereydoun Abbasi-Davani, head of Iran's Atomic Energy Organization, said this month.


International experts say the amount of 20% enriched uranium (estimated by the International Atomic Energy Agency in November at 297 pounds) is more than needed for civilian purposes, and the installation of hundreds more centrifuges could cut the time needed to enrich uranium to weapons-grade. The question is whether Iran will agree to intrusive inspections that would reassure the international community -- and Israel specifically -- that it can't and won't develop a nuclear weapon.


This raises another question: Will it take bilateral U.S.-Iranian talks -- and the prospect of an end to the crippling sanctions regime -- to find a breakthrough? And will Iran's own presidential election in June change the equation?


For now, Israel appears to be prepared to give negotiation (and sanctions) time to bring Iran to the table. For now.


Egypt to deal with new power, economic troubles


Given the turmoil swirling through the Middle East, Israel could probably do without trying to bomb Iran's nuclear program into submission. Besides Syria and Lebanon, it is already grappling with a very different Egypt, where a once-jailed Islamist leader is now president and Salafist/jihadi groups, especially in undergoverned areas like Sinai, have a lease on life unimaginable in the Mubarak era.



The U.S. has an awkward relationship with President Mohamed Morsy, needing his help in mediating with Hamas in Gaza but concerned that his accumulation of power is fast weakening democracy and by his bouts of anti-Western rhetoric. (He has demanded the release from a U.S. jail of Sheikh Omar Abdel Rahman, convicted of involvement in the first bombing of the World Trade Center in 1993.)


The approval of the constitution removes one uncertainty, even if the opposition National Salvation Front says it cements Islamist power. But as much as the result, the turnout -- about one-third of eligible voters -- indicates that Egyptians are tired of turmoil, and more concerned about a deepening economic crisis.


Morsy imposed and then scrapped new taxes, and the long-expected $4.8 billion loan from the International Monetary Fund is still not agreed on. Egypt's foreign reserves were down to $15 billion by the end of the year, enough to cover less than three months of imports. Tourism revenues are one-third of what they were before street protests erupted early in 2011. Egypt's crisis in 2013 may be more about its economy than its politics.


Libya threatens to spawn more unrest in North Africa


Libya's revolution, if not as seismic as anything Syria may produce, is still reverberating far and wide. As Moammar Gadhafi's rule crumbled, his regime's weapons found their way into an arms bazaar, turning up in Mali and Sinai, even being intercepted off the Lebanese coast.


The Libyan government, such as it is, seems no closer to stamping its authority on the country, with Islamist brigades holding sway in the east, tribal unrest in the Sahara and militias engaged in turf wars. The danger is that Libya, a vast country where civic institutions were stifled for four decades, will become the incubator for a new generation of jihadists, able to spread their influence throughout the Sahel. They will have plenty of room and very little in the way of opposition from security forces.


The emergence of the Islamist group Ansar Dine in Mali is just one example. In this traditionally moderate Muslim country, Ansar's fighters and Tuareg rebels have ejected government forces from an area of northern Mali the size of Spain and begun implementing Sharia law, amputations and floggings included. Foreign fighters have begun arriving to join the latest front in global jihad; and terrorism analysts are seeing signs that al Qaeda in the Islamic Maghreb (AQIM) and groups like Boko Haram in Nigeria are beginning to work together.


There are plans for an international force to help Mali's depleted military take back the north, but one European envoy said it was unlikely to materialize before (wait for it) ... September 2013. Some terrorism analysts see North Africa as becoming the next destination of choice for international jihad, as brigades and camps sprout across a vast area of desert.


A bumpy troop transition for Afghanistan


The U.S. and its allies want to prevent Afghanistan from becoming another haven for terror groups. As the troop drawdown gathers pace, 2013 will be a critical year in standing up Afghan security forces (the numbers are there, their competence unproven), improving civil institutions and working toward a post-Karzai succession.



In November, the International Crisis Group said the outlook was far from assuring.


"Demonstrating at least will to ensure clean elections (in Afghanistan in 2014) could forge a degree of national consensus and boost popular confidence, but steps toward a stable transition must begin now to prevent a precipitous slide toward state collapse. Time is running out," the group said.


Critics have also voiced concerns that the publicly announced date of 2014 for withdrawing combat forces only lets the Taliban know how long they must hold out before taking on the Kabul government.


U.S. officials insist the word is "transitioning" rather than "withdrawal," but the shape and role of any military presence in 2014 and beyond are yet to be settled. Let's just say the United States continues to build up and integrate its special operations forces.


The other part of the puzzle is whether the 'good' Taliban can be coaxed into negotiations, and whether Pakistan, which has considerable influence over the Taliban leadership, will play honest broker.


Private meetings in Paris before Christmas that involved Taliban envoys and Afghan officials ended with positive vibes, with the Taliban suggesting they were open to working with other political groups and would not resist girls' education. There was also renewed discussion about opening a Taliban office in Qatar, but we've been here before. The Taliban are riven by internal dissent and may be talking the talk while allowing facts on the ground to work to their advantage.


Where will North Korea turn its focus?


On the subject of nuclear states that the U.S.-wishes-were-not, the succession in North Korea has provided no sign that the regime is ready to restrain its ambitious program to test nuclear devices and the means to deliver them.



Back in May 2012, Peter Brookes of the American Foreign Policy Council said that "North Korea is a wild card -- and a dangerous one at that." He predicted that the inexperienced Kim Jong Un would want to appear "large and in charge," for internal and external consumption. In December, Pyongyang launched a long-range ballistic missile -- one that South Korean scientists later said had the range to reach the U.S. West Coast. Unlike the failure of the previous missile launch in 2009, it managed to put a satellite into orbit.


The last two such launches have been followed by nuclear weapons tests -- in 2006 and 2009. Recent satellite images of the weapons test site analyzed by the group 38 North show continued activity there.


So the decision becomes a political one. Does Kim continue to appear "large and in charge" by ordering another test? Or have the extensive reshuffles and demotions of the past year already consolidated his position, allowing him to focus on the country's dire economic situation?


China-Japan island dispute to simmer


It's been a while since East Asia has thrown up multiple security challenges, but suddenly North Korea's missile and nuclear programs are not the only concern in the region. There's growing rancor between China and Japan over disputed islands in the East China Sea, which may be aggravated by the return to power in Japan of Shinzo Abe as prime minister.


Abe has long been concerned that Japan is vulnerable to China's growing power and its willingness to project that power. Throughout 2012, Japan and China were locked in a war of words over the Senkaku or Diaoyu islands, with fishing and Coast Guard boats deployed to support claims of sovereignty.


In the days before Japanese went to the polls, Beijing also sent a surveillance plane over the area, marking the first time since 1958, according to Japanese officials, that Bejing had intruded into "Japanese airspace." Japan scrambled F-15 jets in response.


The islands are uninhabited, but the seas around them may be rich in oil and gas. There is also a Falklands factor at play here. Not giving in to the other side is a matter of national pride. There's plenty of history between China and Japan -- not much of it good.


As China has built up its ability to project military power, Japan's navy has also expanded. Even a low-level incident could lead to an escalation. And as the islands are currently administered by Japan, the U.S. would have an obligation to help the Japanese defend them.


Few analysts expect conflict to erupt, and both sides have plenty to lose. For Japan, China is a critical market, but Japanese investment there has fallen sharply in the past year. Just one in a raft of problems for Abe. His prescription for dragging Japan out of its fourth recession since 2000 is a vast stimulus program to fund construction and other public works and a looser monetary policy.


The trouble is that Japan's debt is already about 240% of its GDP, a much higher ratio than even Greece. And Japan's banks hold a huge amount of that debt. Add a shrinking and aging population, and at some point the markets might decide that the yield on Japan's 10-year sovereign bond ought to be higher than the current 0.77%.


Economic uncertainty in U.S., growth in China


So the world's third-largest economy may not help much in reviving global growth, which in 2012 was an anemic 2.2%, according to United Nations data. The parts of Europe not mired in recession hover close to it, and growth in India and Brazil has weakened. Which leaves the U.S. and China.


At the time of writing, the White House and congressional leadership are still peering over the fiscal cliff. Should they lose their footing, the Congressional Budget Office expects the arbitrary spending cuts and tax increases to be triggered will push the economy into recession and send unemployment above 9%.



A stopgap measure, rather than a long-term foundation for reducing the federal deficit, looks politically more likely. But to companies looking for predictable economic policy, it may not be enough to unlock billions in investment. Why spend heavily if there's a recession around the corner, or if another fight looms over raising the federal debt ceiling?


In September, Moody's said it would downgrade the U.S. sovereign rating from its "AAA" rating without "specific policies that produce a stabilization and then downward trend in the ratio of federal debt to GDP over the medium term." In other words, it wants action beyond kicking the proverbial can.


Should the cliff be dodged, most forecasts see the U.S. economy expanding by about 2% in 2013. That's not enough to make up for stagnation elsewhere, so a great deal depends on China avoiding the proverbial hard landing.


Until now, Chinese growth has been powered by exports and infrastructure spending, but there are signs that China's maturing middle class is also becoming an economic force to be reckoned with. Consultants PwC expect retail sales in China to increase by 10.5% next year -- with China overtaking the U.S. as the world's largest retail market by 2016.


Europe's economic outlook a little better


No one expects Europe to become an economic powerhouse in 2013, but at least the horizon looks a little less dark than it did a year ago. The "PIGS' " (Portugal, Ireland/Italy, Greece, Spain) borrowing costs have eased; there is at least rhetorical progress toward a new economic and fiscal union; and the European Central Bank has talked tough on defending the Eurozone.


Mario Draghi, president of the European Central Bank, fended off the dragons with the declaration in July that "Within our mandate, the ECB is ready to do whatever it takes to preserve the euro. And believe me, it will be enough."



Draghi has promised the bank has unlimited liquidity to buy sovereign debt, as long as governments (most likely Spain) submit to reforms designed to balance their budgets. But in 2013, the markets will want more than brave talk, including real progress toward banking and fiscal union that will leave behind what Draghi likes to call Europe's "fairy world" of unsustainable debt and collapsing banks. Nothing can be done without the say-so of German Chancellor Angela Merkel, renowned for a step-by-step approach that's likely to be even more cautious in a year when she faces re-election.


Elections in Italy in February may be more important -- pitching technocrat Prime Minister Mario Monti against the maverick he replaced, 76-year old Silvio Berlusconi. After the collapse of Berlusconi's coalition 13 months ago, Monti reined in spending, raised the retirement age and raised taxes to bring Italy back from the brink of insolvency. Now he will lead a coalition of centrist parties into the election. But polls suggest that Italians are tired of Monti's austerity program, and Berlusconi plans a populist campaign against the man he calls "Germano-centric."


The other tripwire in Europe may be Greece. More cuts in spending -- required to qualify for an EU/IMF bailout -- are likely to deepen an already savage recession, threatening more social unrest and the future of a fragile coalition. A 'Grexit' from the eurozone is still possible, and that's according to the Greek finance minister, Yannis Stournaras.


Expect to see more evidence of climate change


Hurricane Sandy, which struck the U.S. East Coast in November, was the latest indicator of changing and more severe weather patterns. Even if not repeated in 2013, extreme weather is beginning to have an effect -- on where people live, on politicians and on the insurance industry.


After Sandy, New York Gov. Andrew Cuomo said that after "the last few years, I don't think anyone can sit back anymore and say, 'Well, I'm shocked at that weather pattern.' " The storm of the century has become the storm of every decade or so, said Michael Oppenheimer, professor of geosciences at Princeton.


"Climate change will probably increase storm intensity and size simultaneously, resulting in a significant intensification of storm surges," he and colleagues wrote in Nature.


In the U.S., government exposure to storm-related losses in coastal states has risen more than 15-fold since 1990, to $885 billion in 2011, according to the Insurance Information Institute. The Munich RE insurance group says North America has seen higher losses from extreme weather than any other part of the world in recent decades.


"A main loss driver is the concentration of people and assets on the coast combined with high and possibly growing vulnerabilities," it says.


Risk Management Solutions, which models catastrophic risks, recently updated its scenarios, anticipating an increase of 40% in insurance losses on the Gulf Coast, Florida and the Southeast over the next five years, and 25% to 30% for the mid-Atlantic and Northeastern states. Those calculations were done before Sandy.



Inland, eyes will be trained on the heavens for signs of rain -- after the worst drought in 50 years across the Midwest. Climatologists say that extended periods of drought -- from the U.S. Midwest to Ukraine -- may be "the new normal." Jennifer Francis at the Institute of Marine and Coastal Sciences at Rutgers University has shown that a warmer Arctic tends to slow the jet stream, causing it to meander and, in turn, prolong weather patterns. It's called Arctic amplification, and it is probably aggravating drought in the Northwest United States and leading to warmer summers in the Northern Hemisphere, where 2012 was the hottest year on record.


It is a double-edged sword: Warmer temperatures may make it possible to begin cultivating in places like Siberia, but drier weather in traditional breadbaskets would be very disruptive. The U.N. Food and Agriculture Organization reports that stocks of key cereals have tightened, contributing to volatile world markets. Poor weather in Argentina, the world's second-largest exporter of corn, may compound the problem.


More cyber warfare


What will be the 2013 equivalents of Flame, Gauss and Shamoon? They were some of the most damaging computer viruses of 2012. The size and versatility of Flame was unlike nothing seen before, according to anti-virus firm Kaspersky Lab.



Gauss stole online banking information in the Middle East. Then came Shamoon, a virus that wiped the hard drives of about 30,000 computers at the Saudi oil company Aramco, making them useless. The Saudi government declared it an attack on the country's economy; debate continues on whether it was state-sponsored.


Kaspersky predicts that in 2013, we will see "new examples of cyber-warfare operations, increasing targeted attacks on businesses and new, sophisticated mobile threats."


Computer security firm McAfee also expects more malware to be developed to attack mobile devices and apps in 2013.


U.S. Defense Secretary Leon Panetta is more concerned about highly sophisticated attacks on infrastructure that "could be as destructive as the terrorist attack on 9/11."


"We know that foreign cyber actors are probing America's critical infrastructure networks. They are targeting the computer control systems that operate chemical, electricity and water plants and those that guide transportation throughout this country," he said in October.


Intellectual property can be stolen, bought or demanded as a quid pro quo for market access. The U.S. intelligence community believes China or Chinese interests are employing all three methods in an effort to close the technology gap.


In the waning days of 2012, the interagency Committee on Foreign Investment in the United States said "there is likely a coordinated strategy among one or more foreign governments or companies to acquire U.S. companies involved in research, development, or production of critical technologies."


It did not name the country in its unclassified report but separately noted a growing number of attempts by Chinese entities to buy U.S. companies.


Who will be soccer's next 'perfect machine'?



There's room for two less serious challenges in 2013. One is whether any football team, in Spain or beyond, can beat Barcelona and its inspirational goal machine Lionel Messi, who demolished a record that had stood since 1972 for the number of goals scored in a calendar year. (Before Glasgow Celtic fans start complaining, let's acknowledge their famous win against the Spanish champions in November.)


Despite the ill health of club coach Tito Vilanova, "Barca" sits imperiously at the top of La Liga in Spain and is the favorite to win the world's most prestigious club trophy, the European Champions League, in 2013. AC Milan is its next opponent in a match-up that pits two of Europe's most storied clubs against each other. But as Milan sporting director Umberto Gandini acknowledges, "We face a perfect machine."


Will Gangnam give it up to something sillier?



Finally, can something -- anything -- displace Gangnam Style as the most watched video in YouTube's short history? As of 2:16 p.m. ET on December 26, it had garnered 1,054,969,395 views and an even more alarming 6,351,871 "likes."


Perhaps in 2013 the YouTube audience will be entranced by squirrels playing table tennis, an octopus that spins plates or Cistercian nuns dancing the Macarena. Or maybe Gangnam will get to 2 billion with a duet with Justin Bieber.







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