firehose

NBC News is reporting that retired Marine Gen. James "Hoss" Cartwright, the former second highest ranking officer in the US military, is currently under investigation for leaking classified information about Stuxnet, the US-Israeli computer virus which sabotaged an Iranian nuclear facility in 2010.

According to the New York Times report from last year, Gen. Cartwright, a four-star general and former vice chairman of the Joint Chiefs of Staff, was responsible for conceiving and executing "Olympic Games," the operation begun under the Bush administration which eventually built and unleashed the Stuxnet virus in collaboration with Israel. Security researchers first discovered the virus in 2010, when it began spreading to computers across Europe, India and the Middle East. Further investigation revealed it contained more than 20 zero-day exploits, and was reportedly loaded into Iran's industrial control systems by undercover agents carrying USB sticks. Cartwright accelerated the operation under direction from President Obama, resulting in a cyber attack which damaged 1,000 centrifuges used for uranium enrichment at Iran's Natanz nuclear facility.

If indicted, Gen. Cartwright would join Bradley Manning, Edward Snowden, and others as the ninth person to be charged under the 1917 Espionage Act by the Obama administration, which has invoked the law more times than all previous US administrations combined.

Instagram video may be putting a dent in Vine's growth. As noted by MarketingLand, in the week since Instagram added video, Vine links on Twitter seem to have dropped precipitously. Data from the analytics firm Topsy, which has access to the full firehose of Twitter data, showed the number of shared Vine links declining from almost 2.5 million on June 19 to just over 1.5 million on June 20, when Facebook-owned Instagram added video. It comes just weeks after Topsy data showed that Vine shares had surpassed Instagram shares.

As of yesterday, Vine links on Twitter had declined to 900,000 per day — or about 70 percent fewer than their peak earlier this month. When he announced Instagram video, CEO Kevin Systrom took pains to distinguish the product from its competitors, noting the 15-second clips and easy edit features. For its part, Twitter's Vine team has been cranking out updates, most recently adding a self-facing camera to the Android app today. But Topsy's numbers suggest the mobile video apps are in head-to-head competition for users' attention — and for now, the momentum may have shifted to Instagram.

Twitter declined comment.

Seth Rogen and Evan Goldberg have been approached to write a film based on Naughty Dog's Uncharted series, the pair explained in a recent IGN video interview.

The co-directors and co-writers of This Is the End told IGN that they'd been approached multiple times by Naughty Dog over the last few years to write the movie, but that they've turned down the offer because the movie "is just gonna be Indiana Jones," Goldberg said.

"They've been asking us to write it for years," Rogen said.

A silver screen adaptation of Naughty Dog's action game franchise has been in the works for several years, though progress has been slow. David O'Russell (The Fighter, Three Kings) was set to direct the film and was later replaced by Neil Burger (The Illusionist), who left the project last year.

We've reached out to Naughty Dog for confirmation and will update this story with more information as we receive it.

I have been a practicing OB/GYN for fourteen years. I live in Frisco, Texas, one of the fastest growing cities in the United States, and I truly enjoy living and working here.  It is a great place for my family and, for the first time, my office is attached to the actual hospital I practice in.  This is the third and final place I will practice medicine.  I trained with some of the most respected academic OB/GYN’s in the country.  These physicians have contributed to books on Obstetrics, created practice guidelines for the American Congress of Obstetricians and Gynecologists (ACOG), and taught me to practice medicine based on scientific evidence.

I follow a few simple rules: do no harm, give your patients options, and provide information so they can make informed decisions.  So, last night I was sitting in my office looking at the fourth Cesarean Section (C/S) operative report of the day for yet another patient who wants to have a vaginal delivery following a previous C/S. I am frustrated and feel like I am fighting a losing battle.

When did Cesarean Sections (C/S) and elective inductions at 39 weeks become the standard of care? That is not what I was taught, and that is not in any textbook or ACOG practice bulletins.  So why in Dallas, Texas do people have to drive more than an hour to find a doctor who actually has no desire to do an unnecessary C/S?  It has become obvious that I cannot attend every vaginal birth a patient wants to have after their traumatizing C/S experience.  If close to 50% of the patients are getting a C/S each day and there are hundreds of practicing OB/GYN’s in the Dallas Metroplex, the math is not difficult.  I know at least one physician who only does C/S’s, and vaginal delivery is not even an option.  If one of his patients delivers vaginally it is only because the baby came faster than he could get to the hospital.

This is the only place I have lived where C/S and elective inductions are king.  So, women of the world, I am giving you the knowledge to stand up for yourself before you get that first C/S!

Top Ten Signs Your Doctor Is Planning To Perform an Unnecessary Cesarean Section on You

1. Arrives to L&D immediately after office hours and says, “I just don’t think this baby is going to fit.”

2. Third Trimester, Routine Office Visit, “I think this is going to be a big baby. You should just have a C/S” – Did you know?  ACOG has very specific guidelines for when it is appropriate to offer a patient an elective C/S for MACROSOMIA (fancy word for large baby).  ‘Prophylactic (elective) cesarean delivery may be considered for suspected fetal macrosomia with estimated fetal weights greater than 5,000 gms (11 pounds) in women without diabetes and greater than 4,500 gms (9.9 pounds) in women with diabetes.

3. “We should induce at 39 weeks because your baby is getting too big” – Did you know that, according to ACOG:

‘Induction of labor at least doubles the risk of cesarean delivery without reducing shoulder dystocia (rare situation where baby’s shoulder can get stuck at delivery) or newborn morbidity(complications).  Suspected fetal macrosomia is not an indication for induction of labor, because induction does not improve maternal or fetal outcomes.’

4. Performs routine ultrasounds at end of pregnancy to see how big your baby is. Did you know that ultrasounds at the end of the pregnancy can be 1-2 pounds off?  Ask some VBAC patients who were talked into a C/S for this, then had a vaginal delivery of a bigger baby the next time.

5. “You have a positive herpes titer (or history of herpes); the baby will get it if you deliver vaginally.” Try some Valtrex for the last month of the pregnancy that is pretty much standard of care now.  It prevents outbreaks and allows for a normal vaginal delivery.

6. “Your baby is breech. You need to have a C/S” Ever heard of or performed an External Cephalic Version (process by which a breech baby is turned to the proper position)?  It really does work.

7. “You have pushed for 2 hours” (with an epidural that prevents you from feeling anything so you are probably not pushing effectively; this is evident on exam because the baby’s head is still perfectly round, but you do not need to know that) “It’s just not going to come out”

8. “I scheduled you for an induction at 39 weeks. It is just soooo… much more convenient for you!” (and so much higher risk of ending in a C/S, especially if you are not dilated when you start the induction).  At least 80% of my VBAC patients were induced the previous pregnancy.  For whose convenience was the induction?

9. First Visit (7 weeks), “Congratulations you are having twins.  I will go ahead and schedule your C/S at 38 weeks, but don’t worry if you go in to labor early I will cut you right away!” Translation, “I am scared out of my mind for you to deliver your babies vaginally because I am not trained on what to do when the second baby is coming, plus it pays more to cut you open.  Oh yeah, I don’t have that great a rapport with you because I only spend 2 minutes (fundal height, heart beat and ‘I’ll see you next time’) with you each visit, so I am afraid I will be sued for trying to do the right thing.”

10. First Pelvic Exam in Office (7 weeks), “Hmm, your pelvis is pretty narrow”.

Bonus Tip:

11. 38-week visit, “Your blood pressure is a little high today. You are probably developing preeclampsia or toxemia.  That can cause you to have a SEIZURE!  The treatment is to deliver the baby.  You need a Cesarean Section, as this is the quickest way to resolve it.  Let’s get you up to L&D NOW!” Translation – Preeclampsia or Pregnancy Induced High Blood Pressure is a pain in the butt.  If I induce you, it could take 24 hours or more and then I would have to manage your blood pressure, and put you on Magnesium.  This is way too inconvenient.  Do not worry you can try to have the baby vaginally next time.  Yeah right!

Well, I hope you future moms find use for these tidbits of info.  If anyone wants to add anything, please feel free.  Your experience may help other women in the future. Remember, there are only a few emergent reasons for a C/S such as fetal distress, unexplained heavy vaginal bleeding, etc.  It is okay to ask your doctor questions.  We are not supposed to bite.

Jonathan Weinstein, MD, FACOG

Obstetrician/Gynecologist

Husband to a Labor and Delivery Nurse with 27-years’ experience

Father to two beautiful children, Zoe and Ashton