Copyright 2016 NPR. To see more, visit http://www.npr.org/.

After an international tribunal invalidated Beijing's claims to the South China Sea, Chinese authorities have declared in no uncertain terms that they will be ignoring the ruling.

The Philippines brought the case to arbitration at the Hague, objecting to China's claims to maritime rights in the disputed waters. The tribunal agreed that China had no legal authority to claim the waters, and was infringing on the sovereign rights of the Philippines.

Donald Trump is firing back at Supreme Court Justice Ruth Bader Ginsburg after she made disparaging comments about him in several media interviews. He tweeted late Tuesday that she "has embarrassed all" with her "very dumb" comments about the candidate. Trump ended his tweet with "Her mind is shot - resign!":

Donald Trump wrapped up his public tryout of potential vice presidential candidates in Indiana Tuesday night with Gov. Mike Pence giving the final audition.

The Indiana governor's stock as Trump's possible running mate is believed to be on the rise, with New Jersey Gov. Chris Christie and former House Speaker Newt Gingrich also atop the list. Sources tell NPR the presumptive GOP presidential nominee is close to making a decision, which he's widely expected to announce by Friday.

Copyright 2016 NPR. To see more, visit http://www.npr.org/.

The unassuming hero of Jonas Karlsson's clever, Kafkaesque parable is the opposite of a malcontent. Despite scant education, a limited social life, and no prospects for success as it is usually defined, he's that rarity, a most happy fella with an amazing ability to content himself with very little. But one day, returning to his barebones flat from his dead-end, part-time job at a video store, he finds an astronomical bill from an entity called W.R.D. He assumes it's a scam. Actually, it is more sinister-- and it forces him to take a good hard look at his life and values.

Copyright 2016 NPR. To see more, visit http://www.npr.org/.

Donald Trump picked a military town — Virginia Beach, Va. — to give a speech Monday on how he would go about overhauling the Department of Veterans Affairs if elected.

He blamed the Obama administration for a string of scandals at the VA during the past two years, and claimed that his rival, Hillary Clinton, has downplayed the problems and won't fix them.

Copyright 2016 NPR. To see more, visit http://www.npr.org/.

The season for blueberries used to be short. You'd find fresh berries in the store just during a couple of months in the middle of summer.

Now, though, it's always blueberry season somewhere. Blueberry production is booming. The berries are grown in Florida, North Carolina, New Jersey, Michigan and the Pacific Northwest — not to mention the southern hemisphere.

But in any one location, the season is still short. And this means that workers follow the blueberry harvest, never staying in one place for long.

Pages

A Dozen Cases Of Tuberculosis That Resists All Drugs Found In India

Jan 11, 2012

Tuberculosis specialists in India have diagnosed infections in a dozen patients in Mumbai that are unfazed by the three first-choice TB drugs and all nine second-line drugs.

The doctors are calling them "totally drug-resistant TB," and the infections are essentially incurable with all available medicines.

It's a sobering development. Infectious disease specialists say there will surely be more such cases in India and other countries where cases of TB that resist some but not all drugs are being inadequately treated.

Poor care is fueling the development of the superbugs. "The vast majority of these unfortunate patients seek care from private physicians in a desperate attempt to find a cure for their tuberculosis," the Indian specialists write in Clinical Infectious Diseases. "The majority of these prescriptions were inappropriate and would only have served to further amplify resistance."

The team did a study that showed only five of 106 private practitioners "wrote the correct prescription for treating TB," Dr. Zarir F Udwadia, one of the study authors, told Daily News and Analysis, an Indian publication.

"The other TB challenge is diagnosis, especially of resistant strains, and here again the news is not good," writes infectious disease blogger Maryn McKenna. "The World Health Organization said last spring that only two-thirds of countries with resistant TB epidemics have the lab capacity to detect the resistant strains."

Johns Hopkins TB researcher Dr. Richard Chiasson tells Shots that "total resistance is a new phenomenon that is entirely predictable."

It's predictable, he says, because hundreds of thousands of people in India have what's called multidrug-resistant TB, or MDR-TB. And a growing number have "extensively resistant TB," or XDR-TB. And very, very few of them are getting the expensive, hard-to-take drugs that might cure their infections.

"If you don't provide supervised second-line drugs, this is what you're going to see," agrees Dr. Carol Dukes Hamilton of Duke University. "People go to practitioners who aren't TB experts. They don't give the right doses or make sure people take them."

Still, the development of these cases of totally resistant TB doesn't necessarily mean epidemics will sweep through India, or anywhere else, right away. For one thing, there's no evidence so far that patients with these defiant TB strains are transmitting them to others.

Most likely, Hamilton says, these patients didn't catch the maximally resistant TB strain from someone else. Rather each patient probably incubated his or her own totally resistant strain after being inadequately treated. That allows the TB bacterium to develop resistance to one drug after another.

Technically, the Indian cases might not really be totally resistant. The Mumbai specialists didn't try some so-called third-line experimental drugs that U.S. doctors might use in such cases. At least one of the Mumbai patients did have surgery to remove diseased lung tissue, but she died anyway.

But practically speaking, such treatments aren't usually available in India or many other places where totally drug-resistant cases may arise.

The problem of evolving TB drug resistance has been brewing for years. In the early 1990s, multidrug-resistant TB began spreading in New York City, abetted by homelessness, prison outbreaks and HIV. Aggressive identification and treatment of these cases, including the direct observation of patients taking their pills, snuffed out that epidemic.

In 2005, extensively drug-resistant TB — strains untreatable with the three first-line drugs and several second-choice medications — cropped up in the South African province of Kwazulu-Natal, again abetted by HIV, which devastates immune defenses.

Chiasson says South Africa has since mounted an effective program of treatment with the few drugs that work against XDR-TB. "But they have more patients than they have treatment slots," he says.

Two Italian women with HIV were the first recognized cases of "totally drug-resistant TB" back in 2003. Another 15 patients with totally resistant infections were discovered in 2009 in Iran.

So nobody expects the new Mumbai cases will be the end of this troubling new phenomenon.

"I have a sense it's inevitable this will occur," Chiasson says. "I don't have a sense that it will become a big problem. It will grow. The question is at what pace it will grow."

Copyright 2012 National Public Radio. To see more, visit http://www.npr.org/.