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Rate of caesarean deliveries varies widely across US

The rate of Caesarean deliveries, the most common operating-room procedure performed in the United States, varies dramatically among hospitals across the country, a new study has found, ranging from seven percent of all births at the hospital with the lowest share of Caesarean deliveries to 70 percent at the hospital with the highest rate.

The study, published in the journal Health Affairs on Monday, was based on federal data of more than 800,000 deliveries at 593 hospitals in 2009. Conducted by researchers at the University of Minnesota in Minneapolis and the University of British Columbia in Vancouver, the study did not identify the hospitals because their names were not included in the data.

Caesarean deliveries are often performed to improve birth outcomes in high-risk pregnancies, but they can also be performed for the convenience of the mother or doctor. The rate has increased significantly in recent years, to 33 percent of all births in 2011, up from 21 percent in 1996, the study said, citing numbers from the Centers for Disease Control and Prevention.

Katy B. Kozhimannil, an assistant professor of health policy and management at the University of Minnesota School of Public Health, said she suspected that the vast patchwork of health management techniques was driving the variation, including how patients are admitted, how their labor is managed and how hospitals and clinicians are paid for the work.

—Sabrina Tavernise, The New York Times

Queen Elizabeth II hospitalized

LONDON — Queen Elizabeth II, who is 86, was admitted to a London hospital Sunday after experiencing symptoms of gastroenteritis, according to a statement issued by Buckingham Palace.

The statement said that all the queen’s engagements for the next week would be postponed or canceled, including a two-day visit to Italy that was scheduled to begin Wednesday. She had already skipped one event, a military parade in the Welsh city of Swansea on Friday, because of the illness.

A palace spokesman described the queen’s hospitalization on Sunday as “a precautionary measure.” The BBC’s royal correspondent, citing palace officials, said the queen was expected to remain in the hospital for about two days.

Emphasizing that there had been no emergency, the palace said that the queen was taken to the King Edward VII Hospital in central London from Windsor Castle, a distance of 20 miles, by private car. Other than the gastroenteritis symptoms, the spokesman said, the queen was in good health and “in good spirits,” and she was moved to the hospital “simply to enable doctors to better assess her.”

In 61 years on the throne, the queen has generally enjoyed sturdy health. She was last hospitalized in 2003 for an operation to repair damaged cartilage in her knee, which she twisted when visiting the Newmarket racecourse 75 miles north of London.

—John F. Burns, The New York Times

US weighs risks and motives of hacking by China or Iran

SAN FRANCISCO — When Telvent, a company that monitors utilities, water treatment plants, and more than half the oil and gas pipelines in North America, discovered last September that the Chinese had hacked into its computer systems, it immediately shut down remote access to its clients’ systems to assure that no outsider could seize control of them.

Company officials and American intelligence agencies then grappled with a fundamental question: Why had the Chinese done it?

Was the People’s Liberation Army, which is suspected of being behind the hacking group, trying to plant bugs into the system so they could cut off energy supplies and shut down the power grid if the United States and China ever confronted each other in the Pacific? Or were the Chinese hackers just trolling for industrial secrets?

“We are still trying to figure it out,” a senior U.S. intelligence official said last week. “They could have been doing both.”

U.S. intelligence officials believe that the greater danger to the nation’s infrastructure may not even be China, but Iran, because of its avowal to retaliate for the Stuxnet virus created by the United States and Israel and unleashed on one of its nuclear sites. But for now, these officials say, that threat is limited by gaps in Iranian technical skills.

—Nicole Perlroth, David E. Sanger and Michael S. Schmidt,
The New York Times

New Chinese leader burnishing his military support

HONG KONG — On the eve of the National People’s Congress, the chief of China’s Communist Party, Xi Jinping, is emphasizing his role as a champion of the military, using the armed forces to cement his political authority and present a tough stance in growing territorial disputes with American allies in the Pacific region.

Xi will be appointed president at the end of the Congress, the party-run parliament that opens Tuesday for an annual session of about 10 days.

On Monday, a spokeswoman for the parliament, Vice Foreign Minister Fu Ying, broke with recent precedent and declined to announce Chinese military outlays for the year at a news conference about the Congress session. The number will be disclosed in a budget released when the session opens, she said.

“We in China have endured the grievous lessons of having a weak national defense and suffering bullying by others,” Fu told reporters. The Chinese military owes its paramount loyalty to the party and its leader, not the civilian government. In private, Xi has said absolute military obedience to the party is essential to ensuring the Chinese Communist Party is not wiped out like its Soviet counterpart.

—Chris Buckley, The New York Times