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HIT NEWS India's diabetes epidemic has triggered surging demand for dialysis For nearly two years, Manoramani has made the three-hour bus journey on the first Sunday of the month to sit on a tiny plastic chair in a crowded hall and wait. Wrapped in a green sari, the portly 41-year-old was diagnosed with diabetes seven years ago. Her health deteriorated until a relative, and fellow diabetic, recommended she come here, to the Jnana Sanjeevini Medical Center in southern Bangalore, a long way from her small town in a neighboring state. The reason? Supplies of insulin and four other medicines, all free of charge.In recent years, thetwo-decade-old clinic has seen more and more Indians like Manoramani pass through its doors —patients who reflect theshifting demographics of thedisease nationwide. They areyounger and poorer. Theycome from rural areas. Andthey often have alarminglyminimal health education. Ata small table in the clinic, acounselor reminds a diabeticfrom a nearby village, whosesugar levels remainpersistently high, that sheshould eat more fresh fruitand vegetables. ―We repeatthe same thing every month,‖says Vidula Krishnaswamy, avolunteer. ―They’re not usedto taking care of themselves.‖While people in some parts ofIndia continue to battlemalnutrition, many residentsin the wealthier states have,during the past two decadesof the nation’s boom, faced amenace of excess. Risingincomes paired withsedentary lifestyles andstarchy, sugary diets havehelped diabetes spreadfuriously. For years, mostIndian diabetics fit one profile:urban, educated, with a cozyoffice job. Now that’schanging. More and more,Indians in lower incomebrackets, often living in ruralareas, are being diagnosedwith the disease. With theirincomes rising and jobopportunities broadening,Indians have beenperforming less manual laborand have been turning morereadily to Western-style fastfoods and sugar-laden drinksthat were not available twodecades ago. Also, whilephysical activity has fallen,consumption of polishedwhite rice, a staple foodstrongly linked to the disease,has remained steady.In 1998, researchers in thesouthern city of Chennaitracking the disease foundthat rates were high in themiddle class and negligibleamong the poor. By 2008,however, the MadrasDiabetes ResearchFoundation (MDRF) foundthat diabetes rates amongpeople earning less than $94a month more than doubledfrom 6.5% to 15.3%. Otherrural areas with virtually zeroprevalence a decade ago areclocking in at 10% or more.―The rural transition is very,very worrisome for us,‖ saysDr. V. Mohan, director of theMDRF.Research on diabetes in Indiahas meanwhile been scant,making it hard to build up atrue picture of the crisis and,in turn, formulate anadequate national response.The first comprehensivestudy was not published untilDecember 2011. The report,produced by Mohan and hiscolleagues at the MDRF,estimated that there were62.4 million diabetics acrossthe country — a 65% leapfrom their 2004 estimate. Thestudy also hypothesized thatan additional 77.2 millionIndians could be prediabetic,and that, by 2030, 100 millionIndians could suffer from the disease. The World Health Organization predicts that by 2015,India’s losses from diabetes and other noncommunicable diseases will top $236 billion, just$73 billion less than this year’s national budget.As a proportion of the population, diabetics make up about 8% of India’s total — less than theU.S. figure of 10.3%, according to the International Diabetes Federation. Gulf nations haveproportions hovering around 20%, among the highest in the world, and several Pacific-islandcountries exceed that. But what makes India different is the untold number of diabetics that fallthrough the net. Researchers believe there are nearly five times the total of undiagnosedpatients and diabetes-related deaths in India than in the U.S. That’s especially alarming nowthat diabetes is moving to the villages, where health resources are rudimentary.Patients are also getting younger. Mohan’s team recently examined teenagers in Chennai,where young people had no signs of onset diabetes two decades ago. Now 12% of girlsscreened between the ages of 12 and 19 show clear traits of the disease. ―That can actuallydestroy a country if it reaches epidemic proportions,‖ Mohan says.Officials in New Delhi have acknowledged the problem but have been slow in implementingremedial measures. In July 2010, the government unveiled a $230 million program fornoncommunicable diseases — the first of its kind in India. Minister of Health Ghulam Nabi Azadpromised diabetes screenings for some 200 million adults over the age of 30 in the program’sfirst year. That target was promptly scaled back to 70 million, and as of mid-March, the Ministryof Health and Family Welfare reported screening a mere 17 million. The problem is that theprofessionals needed for such an ambitious program simply aren’t there: just 693 medicalofficers of a hoped-for 32,000 have been trained in diabetes screening. Especially in ruralareas, finding medically educated staffers, and affording to keep them, is a near impossibletask. The situation is so acute that ordinary citizens are being trained instead. Sucre Blue, anew Bangalore social enterprise, has trained residents in two villages outside the city to screenother villagers. They found prevalence rates approaching a third of all adults.Creative approaches like this — alongside dietary changes and education programs — aresorely needed. But even if they could be executed on a national scale, the real dilemma lies inwhether a country with such an acute shortage of medical professionals and resources caneven treat such a large number of diabetics. As Mohan says: ―Screening is nice, but then whatdo you do after that?‖ India’s health officials had better come up with answers, and fast.How Do You Take Over for a Legend?I’ll admit that I knew fairly little about Manchester United soccer manager Sir Alex Fergusonuntil this week. Despite my hopeless ignorance of the world’s most popular sport, however, Iwas intrigued by Ferguson’s retirement — and even more so by the trials that lay ahead for hissuccessor, David Moyes.Moyes has had a successful career himself, both as a player and manager, but surely takingover the role of manager of Manchester United from Ferguson — who ran the club for 27 yearswith an unprecedented record of success that is unlikely ever to be matched — represents oneof the biggest challenges of his career. As my TIME colleague Bill Saporito mused a few daysago, ―No one can actually succeed Sir Alex, only follow him.‖How do you take over for a legend?Of course, this question isn’t limited to sports. In every discipline there are icons that come and eventually go — and then there are the poor saps who have to take over. Pondering this phenomenon, I was reminded of what President Harry Truman reportedly told a group of journalists the day after his assumption of the Presidency from the man who held that role far longer than any in history: ―Boys, if you pray, pray for me now. I don’t know if you fellows ever had a load of hay fall on you, but when they told me yesterday what had happened, I felt like the moon, the stars, andall the planets had fallen onme.‖Harry Truman is one of myfavorite examples of a manwho had to succeed a legendbecause he was such ahumble figure both indisposition and, in somerespects, ability. Regardlessof what you think of hispresidency, his allure as ahistorical figure is undeniable,as he’s the quintessentialeveryman who had greatnessthrust upon him. In 1934,Truman was a 50-year-oldfailed farmer, speculator, andhaberdasher. Ten years laterhe had the fate of the planet –and the most awful weapon inhuman history – in his hands.There is a world of differencebetween coaching a soccerteam and leading the freeworld through an existentialstruggle, to be sure. But on ahuman level, there areparallels. Whether you are aneconomist like Ben Bernanketaking over for AlanGreenspan — therecession-addled among usmight forget that whenGreenspan stepped down asFed chairman in 2006, hewas being hailed as a―Maestro‖ beyond compare— or a comedian like JayLeno succeeding JohnnyCarson, these represent thefew moments in life wherefate taps you on the shoulderand says, ―Alright, you’re up.Let’s see what you can do.‖And in this sense, we can allrelate to the stories of Moyes,Truman, Leno, and the rest.Whatever your vocation orcalling, there will be moments,and probably no more than afew, where your success orfailure will determine whetheryou advance or stagnate.These are the hours in lifewhere time seems to slowbecause of the gravity of thesituation, but also quickenbecause you know you willhave but a few of thesechances in your life.Moyes now has theopportunity to also ascend togreatness. As the handpickedsuccessor of one of the mostdistinguished managers inthe history of the sport, hesurely has the talent to rise tothe occasion. Unfortunately,however, he’ll be judged notjust on his own merits, butalso against the idealizedperformance of hispredecessor. And just as isthe case for all of us, fate willnot be fully in Moyes hands.He will rely those whoassemble his team to providehim with the necessary talent.He will rely on that talent toplay to the best of its ability.And lastly he’ll rely on thatmysterious variable – call itluck or the divine – that canmake or break any venture.And so in that sense,regardless of their previoussuccess, Moyes and his ilkare the ultimate underdogs.Whether, like Truman, yourchance at greatness falls in your lap, or like Moyes, you have been preparing for this chanceyour whole life, watching these men attempt to climb that very last rung on the ladder is theultimate drama. Soccer fan or no, how can you resist watching to see if Moyes makes it?\Earth’s Great Gift to the Moon: WaterThe moon is home to some of the most lyrically named bodies of water that never existed. The Sea of Tranquility is familiar enough, but what about the Ocean of Storms, the Sea of Nectar, the Lake of Forgetfulness, the Bay of Rainbows? Altogether, the lunar map features 20 seas, 14 bays, 20 lakes and one ocean. That’s both poetic and ironic, because a world that’s positively drenched in aquatic names has not a drop of actual water.Or that’s what we always thought. In recent years, however, evidence for a watery moon has been mounting—particularly from NASA’s Lunar Reconnaissance Orbiter and its sister probe, the Lunar Crater Observation and Sensing Satellite. The moon is hardly a sodden place—it’s wetter than the Sahara Desert, but that’s about it. Still, that’s huge compared to what we once believed. Now, a paper in Science explains in greater detail than everhow water got to so unlikely a place and how it survived the fiery violence that gave birth to the moon in the first place.The prevailing—and now all-but universally accepted—theory for how the Earth-moon system came to be was first proposed in 1975 and quickly became known as the Big Whack theory. About 4.5 billion years ago, aMars-sized planetesimal careered through the solar system and collided with the infant Earth, sending up a massive cloud of molten and vaporous debris. The hit-and-run world sailedon its way and the cloud of debris slowly accreted into the moon, eventually retreatingto a stable orbit roughly 239,000 mi. (385,000km) away, where it has remained ever since.―The angular momentum, the distance, thesize of the moon,‖ says Brown Universitygeochemist Alberto Saal, the lead author ofthe Science paper, ―there is no other modelthat can explain the physics of the Earth-Moonsystem than the Big Whack.‖Physics isn’t chemistry, however, and none ofthis explained with any precision the elementsand compounds—particularly water—thatwould have survived aboard the early moon.The inner solar system as a whole ought to bea very dry place. When the planets and moonsthat orbit the sun were first accreting, it took avery particular environment for watermolecules to form. Anything too close to thesun would simply be too hot and energetic forH2O molecules to assemble themselves.You’d have to get about 3 astronomical unitsaway (1 AU is the distance from the sun to theEarth) to reach what Saal calls the ―snowline,‖ the place water could form. Thatboundary is roughly between Mars andJupiter.Nothing, however, would prevent water frombeing imported from the wet zone into the dryzone aboard comets or water-rich meteorsknown as carbonaceous chondrites. In recentyears, comets have gained traction as thesource of Earthly water. They’re mostly madeof water ice and rock after all, and we nowunderstand just how many billions—perhapstrillions—of them there are surrounding thesolar system in the formations known as theKuiper Belt and the Oort Cloud.But there’s a good case to make for thecarbonaceous chondrites too. They’re hardlythe sodden snowballs comets are, and thelittle bit of water they do contain is integrateddeep in their matrices. But there are a great,great many of the meteors flying around outthere, and there’s nothing to say a downpourof rocks, rather than two or three comets,could not have watered us too. The growingstudy of exoplanets is helping to explain justhow this could happen.―In 2011,‖ Saal says, ―there were observationsin other solar systems of large planets likeJupiter that probably migrated in towards theirsuns and then migrated back out, due togravitational resonance. This would affectoverall gravitational fields causing materialsfrom deeper out to move in.‖ That materialwould likely include meteors. That samescenario could have played out here too, andthere’s a relatively straightforward way toprove it.Water comes in more than one form. So-calledheavy water is not simple H2O, but 2H2O,containing a hydrogen isotope, known asdeuterium. Unlike ordinary hydrogen, with justa proton in its nucleus, deuterium alsocontains a neutron. Heavy water and ordinarywater are present on comets, carbonaceouschondrite meteors and Earth, but in differentratios, known as their deuterium/hydrogen, orD/H ratio. Studies since 1998 have shown thatEarth’s D/H ratio is more similar to that of themeteors than of the comets, making a strongcase for meteoric origins for Earth’s water.That case is not closed: a 2011 study of CometHartley 2 drew the opposite conclusion. Still, atthe moment, the meteor camp is winning.What Saal and his colleagues succeeded indoing was analyzing the D/H ratios in tinybeads of volcanically cooked glass in lunarsamples brought back by Apollo 15 and Apollo17 to see how closely they parallel Earth’s.The answer: exceedingly closely. ―The moon’sD/H rations are similar to Earth’s and they’reboth similar to the chondrites’,‖ says Saal.―What difference there is is probably due tothe impact.‖So the moon’s water came from the Earth and maybe the impactor. But the fact that any water at all survived that collision is something of a surprise, sincewater’s extreme volatility should have caused it simply to vanish into space. Saal, however, cites research by Caltech astrophysicist David Stevenson and othersthat the blast might have created a sort of envelope of hot gasses, protecting the water while the moon accreted.Of course, just as the Earth and moon drew apart in distance over time, so too did they part ways developmentally. The Earth’s greater gravity allowed it to retainan atmosphere, protecting the water that was there, as well as any that barreled in later. The moon could keep enough only to achieve its decidedly humblerwetter-than-the-Sahara status. Lunar gravity may turn the tides in our distant oceans, but the moon’s own seas and lakes and bays were—and always willbe—mere phantasms.Is Not Voting For LeBron James As NBA MVP Defensible?As expected, LeBron James won his fourth MVP award on Sunday afternoon. The only surprise: he didn’t receive every first place vote.James had a stunning statistical season. He became the fifth player in NBA history to average at least 26 points, eight rebounds, and seven assists in a season (Oscar Robertson did it 5 times, John Havlicek did it twice, and both Larry Bird and Michael Jordan did it once). But only James has registered these numbers while shooting better than 55 percent from the field.These stats, however, didn’t stop one writer from casting a first-place MVP vote for Carmelo Anthony, denying James the opportunity to become the first unanimous league MVP in NBA history. On Monday morning, Boston Globe writer Gary Washburn came clean, explaining in a column why he voted forAnthony.If you were to take Anthonyoff the Knicks, they are alottery team. James playswith two other All-Stars, theleague’s all-time 3-pointleader, a defensive stalwart,and a fearless point guard.The Heat are loaded.If LeBron was taken awayfrom the Heat, they stillwould be a fifth or sixth seed.He is the best player of thisgeneration, a multifacetedsuperstar with the physicalprowess of Adonis, but Ichose to reward a playerwho has lifted his team tonew heights.Washburn makes clear thathe didn’t vote for Anthonybecause he was seekingpublicity:The perception that I knewthe other 120 voters casttheir first-place votes forLeBron and that I wentagainst the grain as somekind of statement isinaccurate…For the most part, MVPcontroversies are tiredphilosophical debates. Howdo you define ―valuable?‖Do you vote for the bestplayer — even Washburncalls ―James unquestionablyis the best player in thegame‖– or do you vote forthe player who means themost to his given team? InWashburn’s mind, a Knicksteam without Anthony wouldbe bottom-feeders, while aMiami Heat team withDwyane Wade and ChrisBosh would still be a toughout.Today, basketball fans andMVP voters have new toolsthat can help settle thesedebates: advanced analytics.And even if you’re stillskeptical of metrics thatpurport to boil down aplayer’s value into a singlenumber, via some hopelesslycomplicated formula, it’seasy to see that Washburn islikely very wrong aboutAnthony.Moneyball godfather BillJames first developed the―Win Shares‖ statistic forbaseball, and basketballanalysts have adapted theformula for their sport. WinShares, according to theexcellent stats site, isthe ―estimate of the numberof wins contributed by aplayer.‖ The formula iscomplex. A primer on howit’s calculated is here. Inshort, the stat considersefficiency to be the key towinning games, and rewardsplayers whose efficiencyrankings outperform theleague average by widemargins. Win Shares alsohas a defensive component.James led the NBA in Win Shares, at 19.3. So contrary to Washburn’s thinking, if you took James offthe Heat, Miami would suffer more losses than any other team would, if that team also lost a starplayer. Where does Anthony rank? Anthony produced 9.5 wins for the Knicks. That was 14th best inthe NBA (Kevin Durant was second, at 18.9 Win Shares). And lest you think Anthony’s numberssuffer because he missed 15 games this season, when you look at the stat on a per 48minutes-played basis, the results are identical: James is first, at .322 win shares per 48 minutes.Anthony is 14th, at .184.Even if you don’t completely trust these advanced metrics, the James-Anthony gap has to sound analarm. How can you justify giving the Most Valuable Player award to someone who finished 14th in astat that measures total wins, on the basis that player is responsible for more team wins than anyoneelse?And you know who is buying into these stats? The teams themselves. Most NBA teams haveanalytics gurus. In December, the Memphis Grizzlies hired columnist John Hollinger asVP of Basketball Operations. Hollinger is the creator of the Player Efficiency Rating (PER) statistic,another advanced metric that assigns value to a player (James finished first in PER, Anthony 4th).So if stats like Win Shares and PER are inaccurate, a lot of teams are making bad investments. I’dlike to give NBA franchises more credit. LeBron James is this year’s NBA MVP, without question.Carmelo Anthony, as lethal of a scorer as he is, should barely be in the conversation.Man City: Manuel Pellegrini denies deal to replace Roberto ManciniMalaga's Manuel Pellegrini has denied he has agreed a deal to replace Roberto Mancini as Manchester City manager.After losing the FA Cup final to Wigan on Saturday, Mancini criticised City's owners for not quashing reports that a deal with Pellegrini, 59, was done.But Chilean Pellegrinitold Malaga's website:"I categorically denythat I am the newManchester Citycoach."On Monday morning,Mancini took trainingahead of the matchagainst Reading onTuesday.He made no commentas he arrived at LoftusRoad, where City arebased following the FACup final.In his statementPellegrini said: "I havean agreement withMalaga not to talk toanyone and nothinghas been agreed withany other outfit."He added: "Nothinghas been signed andno agreement reached.I've been fortunateenough, and veryproud, that every yearthe big clubs areinterested in me."I hope the future ofthis club will becomesomewhat clearer inthe next few days."Mancini took over fromMark Hughes inDecember 2009,leading City to the FACup in 2011 and thePremier League title ayear later.City officials met with with Pellegrini's agent, Jesus Martinez, in April. Martinezalso represents Malaga midfielder Isco, a reported target for the Blues.Mancini said he did not know why the meeting had taken place.Pellegrini, who has previously had spells in charge of Real Madrid and Villarreal,took charge of Malaga in November 2010.In his first full season in charge, he guided Malaga to fourth in La Liga andChampions League qualification for the first time.Malaga reached the last eight of the Champions League, before being knockedout by Dortmund. They are currently sixth in La Liga.They will not play in European competition next term after being banned by Uefaover unpaid bills.Malaga's Manuel Pellegrini has denied he has agreed a deal to replace Roberto Mancini as Manchester City manager. After losing the FACup final to Wigan onSaturday, Mancinicriticised City'sowners for notquashing reports thata deal with Pellegrini,59, was done.But Chilean Pellegrinitold Malaga's website:"I categorically deny that I am the newManchester Citycoach."On Monday morning,Mancini took trainingahead of the matchagainst Reading onTuesday.He made nocomment as hearrived at LoftusRoad, where City arebased following theFA Cup final.In his statementPellegrini said: "Ihave an agreementwith Malaga not totalk to anyone andnothing has beenagreed with any otheroutfit."He added: "Nothinghas been signed andno agreementreached. I've beenfortunate enough,and very proud, thatevery year the bigclubs are interestedin me."I hope the future ofthis club will becomesomewhat clearer inthe next few days."Mancini took overfrom Mark Hughes inDecember 2009,leading City to the FACup in 2011 and thePremier League titlea year later.City officials met with with Pellegrini's agent, Jesus Martinez, in April.Martinez also represents Malaga midfielder Isco, a reported target for theBlues.Mancini said he did not know why the meeting had taken place.Pellegrini, who has previously had spells in charge of Real Madrid andVillarreal, took charge of Malaga in November 2010.In his first full season in charge, he guided Malaga to fourth in La Liga andChampions League qualification for the first time.Malaga reached the last eight of the Champions League, before beingknocked out by Dortmund. They are currently sixth in La Liga.They will not play in European competition next term after being banned byUefa over unpaid bills.Cheers for Iker Casillas and whistles for Jose Mourinho Ronaldo's double overshadowed by growing disquiet among Real fans Cristiano Ronaldo headed in two goals to help Real Madrid beat Valladolid 4-3 in the Spanish league, but the entertaining win was overshadowed by growing disquiet over controversial coach Jose Mourinho.Madrid's ninth straight home-ground win in the league means runaway leaders Barcelona will have to wait at least a few more days before sealing the championship.Madrid fans appeared to give their backing to Iker Casillas over Mourinho on Saturday when they cheered their benched goalkeeper and captain and whistled at the Portuguese coach.A hero to Real fans and club captain for more than a decade, Casillas has barely featured since recovering from a broken hand, with Mourinho preferring to stick with Diego Lopez, who wasbrought in as cover fromSevilla in January.Mourinho has hinted he mayleave at the end of theseason and appeared toconfirm reports hisrelationship with Casillas hadbroken down with a series ofbarbed comments on Friday.He said he regretted notbuying Lopez earlier in histhree-year stint in Madridand that he could not workwith players who "think theyare above the rest".Fans at the Bernabeu madetheir feelings clear whenCasillas' name was loudlycheered when it was readout among the list ofsubstitutes, while Mourinhowas whistled by a significantsection of the crowd.The sense that all was notwell at the club following lastTuesday's elimination fromthe Champions League washeightened after the gamewhen Pepe, Mourinho'sPortuguese compatriot,criticised the coach in atelevision interview.Pepe's comments wereparticularly surprising giventhat he and Mourinho sharethe same agent."In my opinion, maybe thecoach's words [on Friday]were not entirelyappropriate," he said. "Wehave to show a bit morerespect for Iker. Heis aplayer who is part of Madrid,he is an institution in this cluband in Spain. He has to knowthat we, the players, are withhim."As has become customarywhen Real win a leaguematch, Mourinho sent out hisassistant Aitor Karanka togive the post-match newsconference.Asked about the fans'reaction to Mourinho,Karanka said: "We have torespect the fans' decision.We have done our jobs forthe past three years, somepeople have liked it morethan others. We have torespect that."Club spokesman EmilioButragueno refused to talkabout Mourinho. "We arehere to talk about the match,not about Mourinho," hesaid.With Barcelona closing in onthe La Liga title and RealMadrid's reign as championsall but over, Real still haveone more chance forsilverware this season in theKing's Cup final againstAtletico Madrid on May 17.Elsewhere, third-placedAtletico Madrid booked theirspot in next season'sChampions League with a0-0 draw at Deportivo La Coruna.Valencia eased to a 4-0 win over nine-man Osasuna to stay in the hunt for a top-four finish, whileMalaga lost 1-0 at Granada to slip three points behind Valencia in sixth place.。