FDA approves new targeted breast cancer drug

WASHINGTON (AP) — The Food and Drug Administration has approved a first-of-a-kind breast cancer medication that targets tumor cells while sparing healthy ones.

The drug Kadcyla from Roche combines the established drug Herceptin with a powerful chemotherapy drug and a third chemical linking the medicines together. The chemical keeps the cocktail intact until it binds to a cancer cell, delivering a potent dose of anti-tumor poison.

Cancer researchers say the drug is an important step forward because it delivers more medication while reducing the unpleasant side effects of chemotherapy.

"This antibody goes seeking out the tumor cells, gets internalized and then explodes them from within. So it's very kind and gentle on the patients — there's no hair loss, no nausea, no vomiting," said Dr. Melody Cobleigh of Rush University Medical Center. "It's a revolutionary way of treating cancer."

Cobleigh helped conduct the key studies of the drug at the Chicago facility.

The FDA approved the new treatment for about 20 percent of breast cancer patients with a form of the disease that is typically more aggressive and less responsive to hormone therapy. These patients have tumors that overproduce a protein known as HER-2. Breast cancer is the second most deadly form of cancer in U.S. women, and is expected to kill more than 39,000 Americans this year, according to the National Cancer Institute.

The approval will help Roche's Genentech unit build on the blockbuster success of Herceptin, which has long dominated the breast cancer marketplace. The drug had sales of roughly $6 billion last year.

Genentech said Friday that Kadcyla will cost $9,800 per month, compared to $4,500 per month for regular Herceptin. The company estimates a full course of Kadcyla, about nine months of medicine, will cost $94,000.

FDA scientists said they approved the drug based on company studies showing Kadcyla delayed the progression of breast cancer by several months. Researchers reported last year that patients treated with the drug lived 9.6 months before death or the spread of their disease, compared with a little more than six months for patients treated with two other standard drugs, Tykerb and Xeloda.

Overall, patients taking Kadcyla lived about 2.6 years, compared with 2 years for patients taking the other drugs.

FDA specifically approved the drug for patients with advanced breast cancer who have already been treated with Herceptin and taxane, a widely used chemotherapy drug. Doctors are not required to follow FDA prescribing guidelines, and cancer researchers say the drug could have great potential in patients with earlier forms of breast cancer

Kadcyla will carry a boxed warning, the most severe type, alerting doctors and patients that the drug can cause liver toxicity, heart problems and potentially death. The drug can also cause severe birth defects and should not be used by pregnant women.

Kadcyla was developed by South San Francisco-based Genentech using drug-binding technology licensed from Waltham, Mass.-based ImmunoGen. The company developed the chemical that keeps the drug cocktail together and is scheduled to receive a $10.5 million payment from Genentech on the FDA decision. The company will also receive additional royalties on the drug's sales.

Shares of ImmunoGen Inc. rose 2 cents to $14.32 in afternoon trading. The stock has ttraded in a 52-wek range of $10.85 to $18.10.

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Las Vegas Strip Shooting Suspect ID'd

Las Vegas police identified a suspect today in a shooting on the strip that caused a Maserati to hit a taxi and burst into flames, killing three people.

Ammar Harris, 26, has been named a suspect in the Thursday skirmish that killed three people, including rapper Kenny Clutch.

The altercation between Harris and Clutch, 27, whose legal name was Kenneth Cherry Jr., is believed to have originated in the valet area of a Las Vegas hotel, police said.

Police said Harris fired several rounds into a Maserati that was being driven by Cherry as both vehicles continued northbound on glitzy Las Vegas Boulevard.

The rapper's expensive sports car careened out of control after he was shot, slamming into several cars, including a taxi. The impact caused the cab to burst into flames, killing the driver, Michael Boldon and a female passenger. Witnesses said it looked like the car exploded.

"He was a number one guy," Carolyn Jean Trimble, Boldon's sister, told ABC News.

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"I looked out my window and I could see one vehicle down here on the corner of the intersection totally engulfed in flames," witness John Lamb told ABC News.

Boldon, 62, and his passenger, who has not yet been identified, were both killed, as was Clutch.

Timble said her brother loved driving his taxi around Vegas.

"He came to live with me in Las Vegas last year to help take care of our mother, and the first day he got here he said, 'I have to get a job.' The second day, I came home from work, and he said he got a job," she recalled.

"He says, 'You'll never guess what it is,' and I said, 'what,' and he said, 'taxi cab driver,' and we both fell out laughing," Trimble said. "He loved that job. He never complained. He'd come home and tell me stories about what happened, who he picked up."

Boldon was a single father who raised a 36-year-old son and was a new grandfather. His grandson was named after him, Trimble said.

"Of all the people to take from this earth," she said. "But I guess the Lord needed him."

A passenger in the Maserati was hit and sustained only a minor injury to his arm. Clutch died at University Medical Center.

His father, Kenneth Cherry Sr., expressed his grief for the loss of his son while speaking with ABC News.

"This is something you never really, really ever want to experience as a parent, to lose a child before you go," he said.

Harris is described as 5-foot-11 and 180 pounds. Anyone with information is asked to contact the Las Vegas Metro Police Department's homicide division.

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Italians head to polls in crucial vote for euro zone

ROME (Reuters) - Italians vote on Sunday in one of the most closely watched elections in years with markets nervous about whether it will produce a strong government to pull Italy out of recession and help resolve the euro zone debt crisis.

A huge final rally by anti-establishment-comedian-turned-politician Beppe Grillo on Friday before a campaigning ban kicked in has highlighted public anger at traditional parties and added to uncertainty about the election outcome.

Polling booths will open between 02:00 am-04:00 pm EST on Sunday and 01:00 am-09:00 am EST on Monday. Exit polls will come out soon after voting ends and official results are expected by early Tuesday.

The election will be followed closely by financial markets with memories still fresh of the potentially catastrophic debt crisis that brought technocrat Prime Minister Mario Monti to power more than a year ago.

Italy, the euro zone's third-largest economy, is stuck in deep recession, struggling under a public debt burden second only to Greece's in the 17-member currency bloc and with a public weary of more than a year of harsh austerity policies.

Italy's Interior Ministry has urged some 47 million eligible voters to not let bad weather forecasts put them off, and said it was prepared to handle even snowy conditions in some northern regions to ensure everyone had a chance to vote.

Final polls published two weeks ago showed center-left leader Pier Luigi Bersani with a five-point lead, but analysts disagree about whether he will be able to form a stable majority that can push though the economic reforms Italy needs.

Bersani is now thought to be just a few points ahead of center-right rival Silvio Berlusconi, the four-times prime minister who has promised tax refunds and staged a media blitz in an attempt to win back voters in recent weeks.

While the center left is still expected to gain control of the lower house thanks to rules that guarantee a strong majority to whichever party wins the most votes nationally, a much closer battle will be fought in the Senate, which any government also needs to control in order to be able to pass laws.

Seats in the upper house are awarded on a region-by-region basis, meaning that support in key regions can decisively influence the overall result.

Pollsters still believe the most likely outcome is a center-left government headed by Bersani and possibly backed by Monti, who is leading a centrist coalition.

But strong campaigning by Berlusconi and the fiery Grillo, who has drawn tens of thousands to his election rallies, have thrown the election wide open, causing concern that there may be no clear winner.

Whatever government emerges from the vote will have the task of pulling Italy out of its longest recession for 20 years and reviving an economy largely stagnant for two decades.

The main danger for Italy and the euro zone is a weak government incapable of taking firm action, which would rattle investors and could ignite a new debt crisis.

Monti replaced Berlusconi in November 2011 after the euro zone's third-largest economy came close to Greek-style financial meltdown while the center-right government was embroiled in scandals.

The former European Commissioner launched a tough program of spending cuts, tax hikes and pension reforms which won widespread international backing and helped restore Italy's credibility abroad after the scandals of the Berlusconi era.

Italy's borrowing costs have since fallen sharply after the European Central Bank pledged it was prepared to support countries undertaking reforms by buying unlimited quantities of their bonds on the markets.

But economic austerity has fuelled anger among Italians grappling with rising unemployment and shrinking disposable incomes, encouraging many to turn to Grillo, who has tapped into a national mood of disenchantment.

(Reporting by Catherine Hornby; Editing by Jason Webb)

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China gold output up nearly 12% in 2012: report

SHANGHAI: Gold production in China, the world's second largest market for the precious metal, surged nearly 12 percent year-on-year last year despite a slowdown in the domestic economy, state media reported.

Output rose to 403.1 tonnes in 2012, up 11.66 percent from 2011, the official Xinhua news agency said late Saturday, quoting figures from the Ministry of Industry and Information Technology.

China is the world's second largest consumer of gold after India. A global industry group, the World Gold Council, has put China's consumer demand for gold at 776.1 tonnes last year, flat from 2011.

The council attributed the stable Chinese demand to a slowdown in the domestic economy and consolidation in gold prices which discouraged investors, according to its latest report released this month.

China's economy -- the world's second largest -- grew at its slowest pace in 13 years in 2012, expanding 7.8 percent from the year before.

But the economy has been showing renewed vigour since late last year, with growth accelerating in the final three months of 2012 to 7.9 percent, snapping seven straight quarters of weakening expansion.

"The signs of economic improvement bode well for gold demand in China, although the indications are for a steady firming of demand rather than for strong growth," the World Gold Council said.

China's Ministry of Industry said domestic gold prices dropped in December last year as worries over the US "fiscal cliff" caused uncertainty.

US lawmakers clinched a last-gasp deal to avoid the fiscal cliff of tax hikes and spending cuts.

China's gold producers recorded a combined 35 billion yuan ($5.6 billion) in profits last year, up just 4.0 percent from 2011, the ministry said.

- AFP

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300% rise in terror financing cases: Report

NEW DELHI: Over 1,400 instances of terror financing in country's economic channels were red-flagged by intelligence and security agencies last year, a latest report of the finance ministry says, marking a 300% jump in such suspicious transactions.

The Financial Intelligence Unit (FIU), which functions under the ministry, has reported that it had received 1,444 reports during 2011-12 from agencies like the intelligence bureau, the Research and Analysis Wing and those in the economic domain and affiliated to the Income Tax and Customs departments.

The figure of such reports from these agencies stood at 428 during 2010-11, the agency says.

"The FIU also supports the efforts of domestic intelligence and law enforcement agencies against terror financing by providing information specifically requested by them, either by searching its database or by calling specific information from the reporting entities," the report says.

The FIU is the national agency responsible for receiving, analyzing and disseminating suspicious transaction reports (STRs) to security and anti-money laundering and tax evasion departments of the country.

The agency also reported a more than 100 per cent rise in the number of STRs received during 2011-12 as it collected a total of 69,224 such reports during this period as compared to 20,698 STRs during 2010-11.

The instances of reportage of fake currency in Indian banking channels are also on the rise, the FIU says.

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FDA approves new targeted breast cancer drug

WASHINGTON (AP) — The Food and Drug Administration has approved a first-of-a-kind breast cancer medication that targets tumor cells while sparing healthy ones.

The drug Kadcyla from Roche combines the established drug Herceptin with a powerful chemotherapy drug and a third chemical linking the medicines together. The chemical keeps the cocktail intact until it binds to a cancer cell, delivering a potent dose of anti-tumor poison.

Cancer researchers say the drug is an important step forward because it delivers more medication while reducing the unpleasant side effects of chemotherapy.

"This antibody goes seeking out the tumor cells, gets internalized and then explodes them from within. So it's very kind and gentle on the patients — there's no hair loss, no nausea, no vomiting," said Dr. Melody Cobleigh of Rush University Medical Center. "It's a revolutionary way of treating cancer."

Cobleigh helped conduct the key studies of the drug at the Chicago facility.

The FDA approved the new treatment for about 20 percent of breast cancer patients with a form of the disease that is typically more aggressive and less responsive to hormone therapy. These patients have tumors that overproduce a protein known as HER-2. Breast cancer is the second most deadly form of cancer in U.S. women, and is expected to kill more than 39,000 Americans this year, according to the National Cancer Institute.

The approval will help Roche's Genentech unit build on the blockbuster success of Herceptin, which has long dominated the breast cancer marketplace. The drug had sales of roughly $6 billion last year.

Genentech said Friday that Kadcyla will cost $9,800 per month, compared to $4,500 per month for regular Herceptin. The company estimates a full course of Kadcyla, about nine months of medicine, will cost $94,000.

FDA scientists said they approved the drug based on company studies showing Kadcyla delayed the progression of breast cancer by several months. Researchers reported last year that patients treated with the drug lived 9.6 months before death or the spread of their disease, compared with a little more than six months for patients treated with two other standard drugs, Tykerb and Xeloda.

Overall, patients taking Kadcyla lived about 2.6 years, compared with 2 years for patients taking the other drugs.

FDA specifically approved the drug for patients with advanced breast cancer who have already been treated with Herceptin and taxane, a widely used chemotherapy drug. Doctors are not required to follow FDA prescribing guidelines, and cancer researchers say the drug could have great potential in patients with earlier forms of breast cancer

Kadcyla will carry a boxed warning, the most severe type, alerting doctors and patients that the drug can cause liver toxicity, heart problems and potentially death. The drug can also cause severe birth defects and should not be used by pregnant women.

Kadcyla was developed by South San Francisco-based Genentech using drug-binding technology licensed from Waltham, Mass.-based ImmunoGen. The company developed the chemical that keeps the drug cocktail together and is scheduled to receive a $10.5 million payment from Genentech on the FDA decision. The company will also receive additional royalties on the drug's sales.

Shares of ImmunoGen Inc. rose 2 cents to $14.32 in afternoon trading. The stock has ttraded in a 52-wek range of $10.85 to $18.10.

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Cyberattacks Bring Attention to Security Reform

Recent accusations of a large-scale cyber crime effort by the Chinese government left many wondering what immediate steps the president and Congress are taking to prevent these attacks from happening again.

On Wednesday, the White House released the administration's Strategy on Mitigating the Theft of U.S. Trade Secrets as a follow-up to the president's executive order. The strategy did not outwardly mention China, but it implied U.S. government awareness of the problem.

"We are taking a whole of government approach to stop the theft of trade secrets by foreign competitors or foreign governments by any means -- cyber or otherwise," U.S. Intellectual Property Enforcement Coordinator Victoria Espinel said in a White House statement.

As of now, the administration's strategy is the first direct step in addressing cybersecurity, but in order for change to happen Congress needs to be involved. So far, the Cyber Intelligence Sharing and Protection Act (CISPA) is the most notable Congressional legislation addressing the problem, despite its past controversy.

Last April, CISPA was introduced by House Intelligence Committee Chairman Mike Rogers, R-Mich., and Rep. Dutch Ruppersberger, D-Md. The act would allow private companies with consumer information to voluntarily share those details with the NSA and the DOD in order to combat cyber attacks.

Peter Parks/AFP/Getty Images

The companies would be protected from any liabilities if the information was somehow mishandled. This portion of the act sounded alarm bells for CISPA's opponents, like the ACLU, which worried that this provision would incentivize companies to share individuals' information with disregard.

CISPA passed in the House of Representatives, despite a veto threat from the White House stemming from similar privacy concerns. The bill then died in the Senate.

This year, CISPA was reintroduced the day after the State of the Union address during which the president declared an executive order targeting similar security concerns from a government standpoint.

In contrast to CISPA, the executive order would be initiated on the end of the government, and federal agencies would share relevant information regarding threats with private industries, rather than asking businesses to supply data details. All information shared by the government would be unclassified.

At the core of both the executive order and CISPA, U.S. businesses and the government would be encouraged to work together to combat cyber threats. However, each option would clearly take a different route to collaboration. The difference seems minimal, but has been the subject of legislative debates between the president and Congress for almost a year, until now.

"My response to the president's executive order is very positive," Ruppersberger told ABC News. "[The president] brought up how important information sharing is [and] by addressing critical infrastructure, he took care of another hurdle that we do not have to deal with."

Addressing privacy roadblocks, CISPA backers said the sharing of private customer information with the government, as long as personal details are stripped, is not unprecedented.

"Think of what we do with HIPAA in the medical professions; [doctors do not need to know] the individual person, just the symptoms to diagnose a disease," Michigan Gov. John Engler testified at a House Intelligence Committee hearing in an attempt to put the problem into context.

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Abe vows to revive Japanese economy, sees no escalation with China

WASHINGTON (Reuters) - Japanese Prime Minister Shinzo Abe told Americans on Friday "I am back and so is Japan" and vowed to get the world's third biggest economy growing again and to do more to bolster security and the rule of law in an Asia roiled by territorial disputes.

Abe had firm words for China in a policy speech to a top Washington think-tank, but also tempered his remarks by saying he had no desire to escalate a row over islets in the East China Sea that Tokyo controls and Beijing claims.

"No nation should make any miscalculation about firmness of our resolve. No one should ever doubt the robustness of the Japan-U.S. alliance," he told the Center for Strategic and International Studies.

"At the same time, I have absolutely no intention to climb up the escalation ladder," Abe said in a speech in English.

After meeting U.S. President Barack Obama on his first trip to Washington since taking office in December in a rare comeback to Japan's top job, he said he told Obama that Tokyo would handle the islands issue "in a calm manner."

"We will continue to do so and we have always done so," he said through a translator, while sitting next to Obama in the White House Oval Office.

Tension surged in 2012, raising fears of an unintended military incident near the islands, known as the Senkaku in Japan and the Diaoyu in China. Washington says the islets fall under a U.S.-Japan security pact, but it is eager to avoid a clash in the region.

Abe said he and Obama "agreed that we have to work together to maintain the freedom of the seas and also that we would have to create a region which is governed based not on force but based on an international law."

Abe, whose troubled first term ended after just one year when he abruptly quit in 2007, has vowed to revive Japan's economy with a mix of hyper-easy monetary policy, big spending, and structural reform. The hawkish leader is also boosting Japan's defense spending for the first time in 11 years.

"Japan is not, and will never be, a tier-two country," Abe said in his speech. "So today ... I make a pledge. I will bring back a strong Japan, strong enough to do even more good for the betterment of the world."

'ABENOMICS' TO BOOST TRADE

The Japanese leader stressed that his "Abenomics" recipe would be good for the United States, China and other trading partners.

"Soon, Japan will export more, but it will import more as well," Abe said in the speech. "The U.S. will be the first to benefit, followed by China, India, Indonesia and so on."

Abe said Obama welcomed his economic policy, while Deputy Chief Cabinet Secretary Katsunobu Kato said the two leaders did not discuss currencies, in a sign that the U.S. does not oppose "Abenomics" despite concern that Japan is weakening its currency to export its way out of recession.

The United States and Japan agreed language during Abe's visit that could set the stage for Tokyo to join negotiations soon on a U.S.-led regional free trade agreement known as the Trans-Pacific Partnership.

In a carefully worded statement following the meeting between Obama and Abe, the two countries reaffirmed that "all goods would be subject to negotiations if Japan joins the talks with the United States and 10 other countries.

At the same time, the statement envisions a possible outcome where the United States could maintain tariffs on Japanese automobiles and Japan could still protect its rice sector.

"Recognizing that both countries have bilateral trade sensitivities, such as certain agricultural products for Japan and certain manufactured products for the United States, the two governments confirm that, as the final outcome will be determined during the negotiations, it is not required to make a prior commitment to unilaterally eliminate all tariffs upon joining the TPP negotiations," the statement said.

Abe repeated that Japan would not provide any aid for North Korea unless it abandoned its nuclear and missile programs and released Japanese citizens abducted decades ago to help train spies.

Pyongyang admitted in 2002 that its agents had kidnapped 13 Japanese in the 1970s and 1980s. Five have been sent home, but Japan wants better information about eight who Pyongyang says are dead and others Tokyo believes were also kidnapped.

Abe also said he hoped to have a meeting with new Chinese leader Xi Jinping, who takes over as president next month, and would dispatch Finance Minister Taro Aso to attend the inauguration of incoming South Korean President Park Geun-hye next week.

(Additional reporting by Jeff Mason and Doug Palmer; Editing by David Brunnstrom and Paul Simao)

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Taiwan ex-president's prison term extended

TAIPEI: Taiwan's former president Chen Shui-bian, jailed for corruption in 2009, has had his prison term extended by 18 months to 20 years due to a further bribery conviction.

Chen, 62, was already serving an 18 1/2-year term for corruption and money-laundering convictions relating to his 2000-2008 presidency -- charges he says stem from a vendetta by the current Beijing-friendly government.

The high court ruled Friday that Chen should serve the extra time for taking bribes from businessmen in a high-profile financial merger case. He was convicted of the offences in December.

Chen's wife Wu Shu-chen also saw her jail term extended to 20 years, although she has been spared from serving her sentence due to poor health.

The couple were also ordered to pay a total fine of Tw$450 million (US$15 million), the court said in a statement.

They face further charges in other cases, but legal experts say their sentences are unlikely to be extended again as individuals can only serve a maximum of 20 years in jail unless a life term is imposed.

Chen's supporters have urged the government to grant him parole for medical treatment saying he is suffering from depression and other health problems. He has been undergoing treatment in a Taipei public hospital since September.

Chen and his family have been accused of laundering millions of dollars by sending political donations and secret diplomatic funds abroad, and taking kickbacks on government contracts.

Chen insists that the charges against him are part of a politically motivated vendetta carried out by Taiwan's current government in retaliation for his eight years in power, when he promoted Taiwan's independence from China.

-AFP/fl

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59-hour countdown for Isro's PSLV-C20 begins

CHENNAI: The 59-hour countdown for the February 25 launch of Polar Satellite Launch Vehicle to put into orbit seven satellites, including Indo-French spacecraft SARAL, commenced at 6.56am today at the Satish Dhawan Space Centre in the spaceport of Sriharikota.

The Launch Authorisation Board earlier cleared the launch schedule for February 25 at 5.56 PM from the first launch pad in Sriharikota, about 90 kms from here, Isro sources said.

PSLV-C20, the 23rd PSLV Mission of Isro, would put the 400 kg Indo-French satellite and six others into orbit.

SARAL refers to Satellite with ARgos and ALtika. The French space agency CNES has developed ARgos and ALtikameter for analysing the ocean.

The rehearsal launch of PSLV - C20 with the primary satellite SARAL and six other foreign satellites has been completed satisfactorily, the sources said.

The other six auxiliary payloads are - two each from Canada, Austria and one each from Denmark and the United Kingdom.

President Pranab Mukherjee is likely to witness the launch along with Andhra Pradesh chief minister Kiran Kumar Reddy.

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APNewsBreak: Govs to hear Oregon health care plan

SALEM, Ore. (AP) — Oregon Gov. John Kitzhaber will brief other state leaders this weekend on his plan to lower Medicaid costs, touting an overhaul that President Barack Obama highlighted in his State of the Union address for its potential to lower the deficit even as health care expenses climb.

The Oregon Democrat leaves for Washington, D.C., on Friday to pitch his plan that changes the way doctors and hospitals are paid and improves health care coordination for low income residents so that treatable medical problems don't grow in severity or expense.

Kitzhaber says his goal is to win over a handful of other governors from each party.

"I think the politics have been dialed down a couple of notches, and now people are willing to sit down and talk about how we can solve the problem" of rising health care costs, Kitzhaber told The Associated Press in a recent interview.

Kitzhaber introduced the plan in 2011 in the face of a severe state budget deficit, and he's been talking for two years about expanding the initiative beyond his state. Now, it seems he's found people ready to listen.

Hospital executives from Alabama visited Oregon last month to learn about the effort. And the U.S. Department of Health and Human Services announced Thursday that it's giving Oregon a $45 million grant to help spread the changes beyond the Medicaid population and share information with other states, making it one of only six states to earn a State Innovation Model grant.

Kitzhaber will address his counterparts at a meeting of the National Governors Association. His talk isn't scheduled on the official agenda, but a spokeswoman confirmed that Kitzhaber is expected to present.

"The governors love what they call stealing from one another — taking the good ideas and the successes of their colleagues and trying to figure out how to apply that in their home state," said Matt Salo, director of the National Association of Medicaid Directors.

There's been "huge interest" among other states in Oregon's health overhaul, Salo said, not because the concepts are brand new, but because the state managed to avoid pitfalls that often block health system changes.

Kitzhaber persuaded state lawmakers to redesign the system of delivering and paying for health care under Medicaid, creating incentives for providers to coordinate patient care and prevent avoidable emergency room visits. He has long complained that the current financial incentives encourage volume over quality, driving costs up without making people healthier.

Obama, in his State of the Union address this month, suggested that changes such as Oregon's could be part of a long-term strategy to lower the federal debt by reigning in the growing cost of federally funded health care.

"We'll bring down costs by changing the way our government pays for Medicare, because our medical bills shouldn't be based on the number of tests ordered or days spent in the hospital — they should be based on the quality of care that our seniors receive," Obama said.

The Obama administration has invested in the program, putting up $1.9 billion to keep Oregon's Medicaid program afloat over the next five years while providers make the transition to new business models and incorporate new staff and technology.

In exchange, though, the state has agreed to lower per-capita health care cost inflation by 2 percentage points without affecting quality.

The Medicaid system is unique in each state, and Kitzhaber isn't suggesting that other states should adopt Oregon's specific approach, said Mike Bonetto, Kitzhaber's health care policy adviser. Rather, he wants governors to buy into the broad concept that the delivery system and payment models need to change.

That's not a new theory. But Oregon has shown that under the right circumstances massive changes to deeply entrenched business models can gain wide support.

What Oregon can't yet show is proof the idea is working — that it's lowering costs without squeezing on the quality or availability of care. The state is just finishing compiling baseline data that will be used as a basis of comparison.

One factor driving the Obama administration's interest in Oregon's success is the president's health care overhaul. Under the Affordable Care Act, millions more Americans will join the Medicaid rolls after Jan. 1, and the health care system will have to be able to absorb the influx of patients in a logistically and financially sustainable way.

The federal government will pay 100 percent of the costs for those additional patients in the first three years before scaling back to 90 percent in 2020 and beyond.

"There are a lot of governors who are facing the same challenges we're facing in Oregon," Kitzhaber said. "They recognize that the cost of health care is something they're going to have to get their arms around."

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Arias Challenged On Pedophilia Claim

Accused murderer Jodi Arias was challenged today by phone records, text message records, and her own diary entries that appeared to contradict her claim that she caught her ex-boyfriend, Travis Alexander, looking at pictures of naked boys.

Arias had said during her testimony that one afternoon in January 2008, she walked in on Alexander masturbating to pictures of naked boys. She said she fled from the home, threw up, drove around aimlessly, and ignored numerous phone calls from Alexander because she was so upset at what she had seen.

The claim was central to the defense's accusation that Alexander was a "sexual deviant" who grew angry and abusive toward Arias in the months after the incident, culminating in a violent confrontation in June that left Alexander dead.

Arias claimed she killed him in self-defense. She could face the death penalty if convicted of murder.

Catching Up on the Trial? Check Out ABC News' Jodi Arias Trial Coverage

Today, prosecutor Juan Martinez, who has been aggressive in questioning witnesses throughout the trial, volleyed questions at her about the claim of pedophilia, asking her to explain why her and Alexander's cell phone records showed five calls back and forth between the pair throughout the day she allegedly fled in horror. Some of the calls were often initiated Arias, according to phone records.

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She and Alexander also exchanged text messages throughout the afternoon and evening at a time when Arias claims the pedophilia incident occurred. In those messages they discuss logistics of exchanging one another's cars that night. Alexander sends her text messages about the car from a church social event he attended that night that she never mentioned during her testimony.

Arias stuck by her claim that she saw Alexander masturbating to the pictures, and her voice remained steady under increasingly-loud questioning by Martinez.

But Martinez also sparred with Arias on the stand over minor issues, such as when he asked Arias detailed questions about the timing and order of events from that day and Arias said she could not remember them.

"It seems you have problems with your memory. Is this a longstanding thing? Since you started testifying?" Martinez asked.

"No it goes back farther than that. I don't know even know if I'd call it a problem," Arias said.

"How far back does it go? You don't want to call them problems, are they issues? Can we call them issues? When did you start having them?" he asked in rapid succession. "You say you have memory problems, that it depends on the circumstance. Give me the factors that influence that."

"Usually when men like you or Travis are screaming at me," Arias shot back from the stand. "It affects my brain, it makes my brain scramble."

"You're saying it's Mr. Martinez's fault?" Martinez asked, referring to himself in the third person.

"Objection your honor," Arias' attorney finally shouted. "This is a stunt!"

Timeline of the Jodi Arias Trial

Martinez dwelled at one point about a journal entry where Arias wrote that she missed the Mormon baptism of her friend Lonnie because she was having kinky sex with Alexander. He drew attention to prior testimony that she and Alexander used Tootsie Pops and Pop Rocks candy as sexual props.

"You're trying to get across (in the diary entry) that this involved a sexual liaison with Mr. Alexander right?" he asked. "And you're talking about Tootsie Pops and Pop Rocks?"

"That happened also that night," Arias said.

"You were there, enjoying it, the Tootsie Pops and Pop Rocks?" he asked again, prompting a smirk from Arias.

"I enjoyed his attention," Arias said.

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French, Malian forces fight Islamist rebels in Gao

GAO, Mali (Reuters) - French and Malian troops fought Islamists on the streets of Gao and a car bomb exploded in Kidal on Thursday, as fighting showed little sign of abating weeks before France plans to start withdrawing some forces.

Reuters reporters in Gao in the country's desert north said French and Malian forces fired at the mayor's office with heavy machineguns after Islamists were reported to have infiltrated the Niger River town during a night of explosions and gunfire.

French Defense Minister Jean-Yves Le Drian told a news conference in Brussels that Gao was back under control after clashes earlier in the day.

"Malian troops supported by French soldiers killed five jihadists and the situation is back to normal," he said.

In Kidal, a remote far north town where the French are hunting Islamists, residents said a car bomb killed two. A French defense ministry source reported no French casualties.

French troops dispatched to root out rebels with links to al Qaeda swiftly retook northern towns last month. But they now risk being bogged down in a guerrilla conflict as they try to help Mali's weak army counter bombings and raids.

"There was an infiltration by Islamists overnight and there is shooting all over the place," Sadou Harouna Diallo, Gao's mayor, told Reuters by telephone earlier in the day, saying he was not in his office at the time.

Gao is a French hub for operations in the Kidal region, about 300 km (190 miles) northeast, where many Islamist leaders are thought to have retreated and foreign hostages may be held.

"They are black and two were disguised as women," a Malian soldier in Gao who gave his name only as Sergeant Assak told Reuters during a pause in heavy gunfire around Independence Square.

Six Malian military pickups were deployed in the square and opened fire on the mayor's office with the heavy machineguns. Two injured soldiers were taken away in an ambulance.

French troops in armored vehicles later joined the battle as it spilled out into the warren of sandy streets, where, two weeks ago, they also fought for hours against Islamists who had infiltrated the town via the nearby river.

Helicopters clattered over the mayor's office, while a nearby local government office and petrol station was on fire.

A Gao resident said he heard an explosion and then saw a Malian military vehicle on fire in a nearby street.

Paris has said it plans to start withdrawing some of its 4,000 troops from Mali next month. But rebels have fought back against Mali's weak and divided army, and African forces due to take over the French role are not yet in place.

Islamists abandoned the main towns they held but French and Malian forces have said there are pockets of Islamist resistance across the north, which is about the size of France.

CAR BOMB

Residents reported a bomb in the east of Kidal on Thursday.

"It was a car bomb that exploded in a garage," said one resident who went to the scene but asked not to be named.

"The driver and another man were killed. Two other people were injured," he added.

A French defense ministry official confirmed there had been a car bomb but said it did not appear that French troops, based at the town's airport, had been targeted.

Earlier this week, a French soldier was killed in heavy fighting north of Kidal, where French and Chadian troops are hunting Islamists in the Adrar des Ifoghas mountains, which border Algeria.

Operations there are further complicated by the presence of separatist Tuareg rebels, whose rebellion triggered the fighting in northern Mali last year but were sidelined by the better-armed Islamists.

Having dispatched its forces to prevent an Islamist advance south in January, Paris is eager not to become bogged down in a long-term conflict in Mali. But their Malian and African allies have urged French troops not to pull out too soon.

(Additional reporting by Emanuel Braun in Gao, Adama Diarra in Bamako, David Lewis and John Irish in Dakar and Adrian Croft in Brussels; Writing by David Lewis; Editing by Jason Webb and Roger Atwood)

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Man charged with outraging modesty of girl

SINGAPORE: A man has been charged with outraging the modesty of a 16-year-old girl.

Toh Boon Cheong, 52, is accused of rubbing his groin area against the girl's hip on board the MRT train travelling from Choa Chu Kang station to Bukit Gombak station.

The alleged incident occurred on 15 January, at about 6:50am.

If convicted, Toh faces up to two years' jail and caning.

- CNA/ck

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BJP calls for shutdown in Andhra Pradesh

HYDERABAD: The Bharatiya Janata Party (BJP) has called for a shutdown in Andhra Pradesh on Friday to condemn the twin bomb blasts, which killed 14 people and injured over 100.

The Bharatiya Janata Party today demanded the suspension of question hour and said that in the wake of the Hyderabad blasts there should be a discussion the the Parliament over terror.

BJP state president G Kishan Reddy appealed to all people to voluntarily observe the shutdown to protest the blasts and show their sympathies with the victims' families.

Talking to reporters, he said the state government failed to take steps to prevent the blasts despite warnings from the intelligence agencies. He demanded the government to act firmly against terrorists.

Police have stepped up security in the city and other major towns in view of the shutdown call and Friday prayers.

The Bharatiya Janata Party today demanded the suspension of question hour and said that in the wake of the Hyderabad blasts there should be a discussion the the Parliament over terror.

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Doc groups issue list of overused tests, therapies

WASHINGTON (AP) — Don't be afraid to question your doctor and ask, "Do I really need that?"

That's the advice from leading medical groups who came up dozens of tests and treatments that physicians too often prescribe when they shouldn't.

No worrisome stroke signs? Then don't screen a healthy person for a clogged neck artery, the family physicians say. It could lead to risky surgery for a blockage too small to matter.

Don't routinely try heartburn medicine for infants with reflux, the pediatric hospitalists say. It hasn't been proven to work in babies, and could cause side effects.

Don't try feeding tubes in people with advanced dementia, say the hospice providers. Helping them eat is a better option.

These are examples of potentially needless care that not only can waste money and time, but sometimes can harm, says the warning being issued Thursday from medical specialty groups that represent more than 350,000 doctors.

Too many people "think that more is better, that more treatment, more testing somehow results in better health care," said Dr. Glen Stream, former president of the American Academy of Family Physicians, which contributed to the list. "That really is not true."

The recommendations are part of a coalition called Choosing Wisely, formed by the American Board of Internal Medicine Foundation. Participating medical societies were asked to identify five tests or treatments that are commonly overused in their specialty. The list is aimed at doctors and includes references to published studies. Consumers Reports and other consumer groups are publicizing the information in more patient-friendly terms.

Last year, the coalition listed 45 overused tests and treatments. It included some of the best known examples, such as too much imaging for back pain and repeating colonoscopies too frequently.

This year's list adds 90 more overused kinds of care. Some are the result of doctors' habits, hard to overcome despite new evidence, Stream said. Others come about because patients demand care they think they need.

Some other examples:

—Don't use opioid painkillers for migraines except as a last resort, say the neurologists. There are better, more migraine-specific drugs available without the addictive risk of narcotics. Plus, frequent use of opioids actually can worsen migraines, a concept known as rebound headache.

—Just because a pregnant woman misses her due date, don't race to induce labor if mom and baby are doing fine, say the obstetricians. Inducing before the cervix is ready often fails, leading to an unneeded C-section. "Just being due by the calendar doesn't mean your body says you're due," Stream notes.

—Don't automatically give a child a CT scan after a minor head injury, say the pediatricians. About half of children who go to the ER with head injuries get this radiation-heavy scan, and clinical observation first could help some who don't really need a CT avoid it.

—And don't leave an implanted heart-zapping defibrillator turned on when a patient is near death, say the hospice providers. This technology clearly saves lives by guarding against an irregular heartbeat. But if someone is dying of something else, or is in the terminal stages of heart disease, it can issue repeated painful shocks, to no avail. Yet fewer than 10 percent of hospices have formal policies on when to switch off the implants.

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Arias Leaves Stand After Describing Killing, Her Lies

Jodi Arias stepped down from the witness stand today after mounting an emotional effort to save herself from death row, insisting to the Arizona jury that an explosive fight with ex-boyfriend Travis Alexander led to his death, and that her lies about killing him masked deep regret and plans to commit suicide.

Arias, 32, will now face what is expected to be a withering cross-examination beginning Thursday from prosecutor Juan Martinez, who has been aggressive to many witnesses throughout the trial and who is expected to go after Arias' claim that she was forced to kill Alexander or be killed herself.

She is charged with murder for her ex-boyfriend's death and could face the death penalty if convicted.

Catching Up on the Trial? Check Out ABC News' Jodi Arias Trial Coverage

The day's dramatic testimony started with Arias describing the beginning of the fight on June 4, 2008 when she and Alexander were taking nude photos in his shower and she claims she accidentally dropped his new camera, causing Alexander to lose his temper. Enraged, he picked her up and body slammed her onto the tile floor, screaming at her, she told the jury.

Arias said she ran to his closet to get away from him, but could hear Alexander's footsteps coming after her down the hall. She grabbed a gun from his shelf and tried to keep running, but Alexander came after her, she said.

"I pointed it at him with both of my hands. I thought that would stop him, but he just kept running. He got like a linebacker. He got low and grabbed my waist, and as he was lunging at me the gun went off. I didn't mean to shoot. I didn't even think I was holding the trigger," she said.

"But he lunged at me and we fell really hard toward the tile wall, so at this point I didn't even know if he had been shot. I didn't see anything different. We were struggling, wrestling, he's a wrestler.

"So he's grabbing at my clothes and I got up, and he's screaming angry, and after I broke away from him. He said 'f***ing kill you bitch,'" she testified.

Asked by her lawyer whether she was convinced Alexander intended to kill her, Arias answered, "For sure. He'd almost killed me once before and now he's saying he was going to." Arias had earlier testified that Alexander had once choked her.

Timeline of the Jodi Arias Trial

Jodi Arias Describes Violent Sex Before Shooting Watch Video

Jodi Arias Testifies Ex Assaulted Her, Broke Her Fingers Watch Video

Jodi Arias Gives Explicit Details About Doomed Relationship Watch Video

But Arias' story of the death struggle ended there as she told the court that she has no memory of stabbing or slashing Alexander whose body was later found with 27 stab wounds, a slit throat and two bullets in his head. She said she only remembered standing in the bathroom, dropping the knife on the tile floor, realizing the "horror" of what had happened, and screaming.

"I have no memory of stabbing him," she said. "There's a huge gap. I don't know if I blacked out or what, but there's a huge gap. The most clear memory I have after that point is driving in the desert."

Arias said that she decided in the desert not to admit to killing Alexander, a decision that would last for two years as Arias lied to friends, family, investigators and reporters about what really happened in Alexander's bathroom.

During that time she initially claimed she got lost that night while driving to a friend's house and never went to Alexander's home in Mesa,Ariz. She later changed her story and said two masked people, a man and a woman, burst into the home and killed Alexander and threatened to kill her family if she told anyone what happened.

She eventually confessed to killing her ex-boyfriend, but insisted it was self defense.

"The main reason (for lying) is because I was very ashamed of what happened. It's not something I ever imagined doing. It's not the kind of person I was. It was just shameful," she said. "I was also very scared of what might happen. I didn't want my family to know that I had done that, and I just couldn't bring myself to say that I did that."

"From day one there was a part of me that always wanted to (tell the truth) but didn't dare do that. I would rather have gone to my grave than admit I had done something like that," she said.

Arias said that she continued to lie because she figured she would never get caught; she was planning to kill herself before trial.

"I was concerned with how it would affect my family. I wanted to die. I was going to definitely kill myself," she said. "That was my plan. You can purchase different things in jail and I bought a bunch of Advil... and took it all in the next few days so it was in my system. They have razors for shaving, so I got one and took it apart one night with intentions to slit my wrists."

Arias said she balked at slitting her wrists after accidentally cutting herself, but that she still planned to commit suicide sometime in the future. When she told news reporters that "no jury would convict her," she claims she said it believing that she would be dead before they'd have a chance to put her on trial, Arias testified.

Arias said support from the public and her family eventually led her to change her mind.

"My family remained very supportive, and told me 'it doesn't matter what happens, we love you anyway.' I realized even if I told the truth they would still be there and wouldn't walk away," she testified.

"By the time spring, 2010, rolled around, I confessed. I basically told everyone what I could remember of the day and that the intruder story was all BS pretty much."

She said that her testimony today, a third version of events, was the truth.

Arias was arrested a month after Alexander's death, and prosecutors have argued that her behavior during those weeks showed a lack of remorse for the killing and an attempt to get away with murder.

Arias said today that after she killed Alexander and drove away from his Mesa, Ariz., home in a panic, it dawned on her that police would soon be looking for Alexander's killer, and she decided that she would pretend the bloody confrontation had never happened.

"I knew that it was really bad, that my life was probably done now. I wished it was just a nightmare I could wake up from, but I knew I had messed up pretty badly and the inevitable was going to be something I could not really run from," she testified.

"I didn't want anyone to know that that had happened or that I did it, so I started taking steps in the aftermath to cover it up. I did a whole bunch of things to try to make it seem like I was never there," she said.

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French general urges EU to equip "impoverished" Mali army

BAMAKO, Mali (Reuters) - The European Union should complement a mission to train Mali's army, routed by rebels last year, by providing equipment from uniforms to vehicles and communications technology, a French general said on Wednesday.

General Francois Lecointre, appointed to head the EU training mission to Mali (EUTM) that was formally launched this week, said in Bamako equipping the "very impoverished" and disorganized Malian army was as important as training it.

Europe, along with the United States, has backed the French-led military intervention in Mali which since January 11 has driven al Qaeda-allied Islamist insurgents out of the main northern towns into remote mountains near Algeria's border.

European governments have ruled out sending combat troops to join French and African soldiers pursuing the Islamist rebels.

But the EU is providing a 500-strong multinational training force that will give military instruction to Malian soldiers for an initial period of 15 months at an estimated cost of 12.3 million euros ($16.45 million).

While hailing what he called the EU's "courageous, novel, historic" decision to support Mali, Lecointre told a news conference the Malian army's lack of equipment was a problem.

"I know the Malian state is poor, but the Malian army is more than poor," the French general told a news conference, adding that it urgently needed everything from uniforms and weapons to vehicles and communications equipment.

Last year, when Tuareg separatist forces swelled by weapons and fighters from the Libyan conflict swept out of the northern deserts, a demoralized and poorly-led Malian army collapsed and fled before them, abandoning arms and vehicles.

Mali's military was further shaken by a March 22 coup by junior officers who toppled President Amadou Toumani Toure, sowing division among rival army factions. Islamist radicals allied to al Qaeda later hijacked the victorious Tuareg rebellion to occupy the northern half of the country.

In a fast-charging military campaign led by Paris, French and African troops have driven the jihadists out of principal northern towns like Gao and Timbuktu, and are fighting the rebels in the Adrar des Ifoghas mountains.

HUMAN RIGHTS INSTRUCTION

Flanked by Mali's armed forces chief, General Ibrahima Dembele, Lecointre said he was disappointed that a meeting of international donors last month pledged funds for an African military force, known as AFISMA, being deployed in Mali, but included "very few" contributions for the Malian army itself.

"The European Union needs to invest today in the equipping of the Malian army and not just in its training," the general said, adding he would make this point strongly in a report to EU member state representatives early next month.

Asked how much re-equipping the army would cost, he said it would be "much more" than the 12 million euros of EU financing for the training mission, but could not give a precise estimate.

Starting early in April, the EU mission will start instructing Malian soldiers with a plan to train four new battalions of 600-700 members each, formed from existing enlisted men and new recruits.

Lecointre said the EU training would include instruction in human rights. Demands for this increased after allegations by Malian civilians and international human rights groups that Malian soldiers were executing Tuaregs and Arabs accused of collaborating with Islamist rebels.

The European training contingent is drawn from a range of European countries, but the main contributors would be France, Germany, Italy, Spain and Britain, EUTM officers said.

Mali's army has received foreign training before - several battalions that fled before the rebels last year were trained by the U.S. military and the leader of the March 22 coup, Captain Amadou Sanogo, attended training courses in the United States.

Dembele said U.S. training failed to forge cohesion among Malian units and he hoped the EU training would achieve this.

The United States, which halted direct support for the Malian military after last year's coup, could eventually resume aid if planned national elections in July fully restore democracy to the West African country.

Washington is providing airlift, refuelling and intelligence support to the French-led military intervention in Mali. ($1 = 0.7479 euros)

(Reporting by Pascal Fletcher; Editing by Jason Webb)

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Del Piero signs for second season Down Under

MELBOURNE: Italian World Cup winner Alessandro Del Piero has signed on for a second season in Australia's A-League as his Sydney FC side push for a play-off place.

"I'm very happy about this news," the Juventus and Italy legend told a press conference after agreeing to activate the second year of a reported US$2 million-a-season contract.

"For sure it's a great moment for me, for Sydney FC," he said, thanking the club for trusting him.

The 38-year-old said he would not carry on if he could not play at a high level.

"In my age, I want to be very honest. We have to see year by year."

Del Piero has already scored 11 goals in 18 matches, a record haul by a Sydney FC player in a single season and been a hit off the pitch too, helping to boost crowds, shirt sales and television ratings.

Sydney FC has fought back from the bottom of the league to fifth place -- within reach of qualification for the playoffs, largely thanks to Del Piero's goals.

"We have a good position but it's not enough, we have six games remaining but we have to push our energy to take a play-off," he said.

"We want to improve for the next year and do better and better every week," he added.

The team's charge for the finals gathered steam, with a 2-1 win over Adelaide United following the signing of Socceroos captain Lucas Neill on Saturday.

An early-season collapse was halted by the December arrival of former Australia coach Frank Farina, quickly turning Sydney FC into the form team.

- AFP/sf

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Day 2 of nationwide strike: Cops on alert in Noida; several states affected

NEW DELHI: Normal life in several parts of the country continued to remain affected on Day 2 of the nationwide strike called by the trade unions.

Cops in Noida are on high alert, after widespread violence on the first day of the strike. According to TV reports, several schools and offices in Noida have been closed.

The UP government has formed a two-member panel to probe the violence in Noida on the first day of the two-day nationwide shutdown.

The state government late on Wednesday named additional director general of police (Law and Order) Arun Kumar and home secretary Rakesh as members of the probe committee and asked them to submit a fact finding report within three days.

Principal secretary (Home) RM Srivastava told IANS that "toughest action" would be taken against those found guilty of violence.

The committee has been asked to look into the state of preparedness of the Noida police to handle the shutdown and identify district officials guilty of dereliction of duty.

"The government has taken a serious note of the whole episode, wherein properties were gutted, people were beaten up and several vehicles were set on fire. There should be no doubt that the government would crack down on all found guilty," Srivastava said.

Violence erupted on Wednesday in Noida and Greater Noida where factories were targeted and set on fire. Violent clashes took place and several vehicles were set afire.

Officials have started screening the video footage of the violence in order to identify and book the perpetrators.

"We are also exploring possibilities of slapping the National Security Act (NSA) on the rioters," a senior official said.

State government sources said chief minister Akhilesh Yadav was particularly miffed at the Noida violence as he views it as a big blow to his efforts to create a pro-investment climate in Uttar Pradesh.

"The chief minister has taken a serious note of the clashes as it could send a wrong signal that industries are not safe in UP," an official said.

Bank operations hit

Normal banking operations were hit for the second day on Thursday as public sector bank employees continued their strike.

It is, however, business as usual at private sector banks like ICICI Bank and HDFC Bank.

Employees of public sector insurance companies, including LIC and New India Assurance, are also participating in the strike.

Shutdown in Kerala

In Kerala, workers from most sectors ranging from transport to banking keeping away from work.

Reports from across the state said buses and taxis were off the roads and markets remained shut. Train and air services were not affected.

Attendance in government offices was thin and educational institutions remained closed as pro-Left service and teachers unions joined the strike. Universities have cancelled examinations scheduled for the last two days.

Barring stray incidents of minor violence, the state has remained peaceful since Wednesday.

Police in their vehicles facilitated the short-distance travels of train and air passengers, who arrived in the state unaware of the hartal atmosphere.

Emergency services like healthcare, milk supply and media have been exempted from the strike.

Schools, colleges closed in Karnataka

The two-day nationwide strike by trade unions had no major impact in most parts of Karnataka on Thursday.

Though banking services were hit, many buses, taxis and autos plied and shops and hotels remained opened here. However, schools and colleges were closed.

No violence was reported from any part of the state, police said.

Services at many hospitals in the city were not hit, as also in IT companies. Several PSUs including HAL, BHEL and BEL, besides a host of other industrial units in Bangalore were functioning normally.
No impact in Mangalore

In Mangalore, however, there has been no effect of strike on Day 2. The buses are plying normally and the schools are functioning as usual.

(With inputs from PTI, IANS)

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Drug overdose deaths up for 11th consecutive year

CHICAGO (AP) — Drug overdose deaths rose for the 11th straight year, federal data show, and most of them were accidents involving addictive painkillers despite growing attention to risks from these medicines.

"The big picture is that this is a big problem that has gotten much worse quickly," said Dr. Thomas Frieden, head of the Centers for Disease Control and Prevention, which gathered and analyzed the data.

In 2010, the CDC reported, there were 38,329 drug overdose deaths nationwide. Medicines, mostly prescription drugs, were involved in nearly 60 percent of overdose deaths that year, overshadowing deaths from illicit narcotics.

The report appears in Tuesday's Journal of the American Medical Association.

It details which drugs were at play in most of the fatalities. As in previous recent years, opioid drugs — which include OxyContin and Vicodin — were the biggest problem, contributing to 3 out of 4 medication overdose deaths.

Frieden said many doctors and patients don't realize how addictive these drugs can be, and that they're too often prescribed for pain that can be managed with less risky drugs.

They're useful for cancer, "but if you've got terrible back pain or terrible migraines," using these addictive drugs can be dangerous, he said.

Medication-related deaths accounted for 22,134 of the drug overdose deaths in 2010.

Anti-anxiety drugs including Valium were among common causes of medication-related deaths, involved in almost 30 percent of them. Among the medication-related deaths, 17 percent were suicides.

The report's data came from death certificates, which aren't always clear on whether a death was a suicide or a tragic attempt at getting high. But it does seem like most serious painkiller overdoses were accidental, said Dr. Rich Zane, chair of emergency medicine at the University of Colorado School of Medicine.

The study's findings are no surprise, he added. "The results are consistent with what we experience" in ERs, he said, adding that the statistics no doubt have gotten worse since 2010.

Some experts believe these deaths will level off. "Right now, there's a general belief that because these are pharmaceutical drugs, they're safer than street drugs like heroin," said Don Des Jarlais, director of the chemical dependency institute at New York City's Beth Israel Medical Center.

"But at some point, people using these drugs are going to become more aware of the dangers," he said.

Frieden said the data show a need for more prescription drug monitoring programs at the state level, and more laws shutting down "pill mills" — doctor offices and pharmacies that over-prescribe addictive medicines.

Last month, a federal panel of drug safety specialists recommended that Vicodin and dozens of other medicines be subjected to the same restrictions as other narcotic drugs like oxycodone and morphine. Meanwhile, more and more hospitals have been establishing tougher restrictions on painkiller prescriptions and refills.

One example: The University of Colorado Hospital in Aurora is considering a rule that would ban emergency doctors from prescribing more medicine for patients who say they lost their pain meds, Zane said.

___

Stobbe reported from Atlanta.

___

Online:

JAMA: http://www.jama.ama-assn.org

CDC: http://www.cdc.gov

___

AP Medical Writer Lindsey Tanner can be reached at http://www.twitter.com

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Former Navy SEAL on Coming Out of Shadows

It used to be that Navy SEALs didn't just operate in the shadows. They trained in them too. Their whole story stayed shrouded in mystery. Their secret missions stayed secret to the rest of us.

But when they got Osama Bin Laden, snatched back an American cargo ship taken by pirates and rescued two air workers held hostage in Somalia, then suddenly, it seemed that SEALs were headline-makers.

Add to that some SEALs wrote books about SEAL adventures and even acted in a movie about the SEAL experience using live ammunition when they made "Act of Valor." They can't quite be called "the military unit that no one ever talked about" any longer.

Watch the full story on "Nightline" TONIGHT at 12:35 a.m. ET

Rorke Denver played Lt. Commander Rorke in "Act of Valor," a film that used dozens of SEALs and went on to gross $80 million at the box office. Now, with the help of a writer, Denver is doing some pretty decent storytelling in a new book, "Damn Few: Making the Modern SEAL Warrior."

He agrees that with SEALs like him telling their stories that these guys are out in the open like never before.

"We are, at this moment in our history, when the heat is on, the missions are getting press and coverage," Denver said.

Acts of Valor: Four Boyfriends Took Bullets to Save Girlfriends Watch Video

'Zero Dark Thirty' Screenwriter Responds to Film's Controversy Watch Video

When asked if it was a good thing, he said, "time will tell."

"We are in the public eye and I think that mythology is something that people are hugely, hugely interested in and they have an appetite for it," Denver said. "So for us with the movie and then also with 'Damn Few' I had an opportunity, I feel, to authentically represent and hopefully do it from an honorable point of view and accurately do so."

It's mostly his own story Denver tells in "Damn Few," how he joined the SEALs after college -- they didn't want him at first.

"I put in my first application and they said no, and I am glad it went that way. I think the community really values resiliency and toughness and focus and a 'never quit' attitude. For me, when they said no I thought, that ain't going to cut it."

Denver didn't quit. He reapplied and went on to survive the SEALs brutal Hell Week and training, joined the team and deployed all over the world, including the deadly Al Anbar province in Iraq when the war there was at its hottest. His family waited for him to return stateside.

"The families, I feel, are the ones who pay the price of our choices," Denver said. "But I didn't appreciate how much I was asking my family to bear and experience it with me. They really are every bit a part of our experience and frankly they are the ones who are back home and praying and believing that you are going to come home."

But even his family didn't quite know what Denver did at work every day.

"I never ask questions about what he does," said his wife, Tracy.

But "Act of Valor" was revealing in that way, and Denver's wife watched the film.

"For me it was incredibly eye-opening to actually see a submarine mission or running around in the jungle, jumping out of a plane, shooting his weapons," she said. "For me, it was like, oh, so this is what you are doing when you are away. I appreciated it actually."

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Tunisian PM quits after failing to form new government

TUNIS (Reuters) - Tunisian Prime Minister Hamadi Jebali resigned on Tuesday after failing to replace a government pulled apart by acrimony between his Islamist allies and their secular opponents.

Jebali had threatened to quit if his plan for a non-partisan cabinet of technocrats to lead the north African country into early elections foundered.

In the end it was his own party, Ennahda, that rejected the proposal, prolonging the political stand-off that has cast a shadow over Tunisia's fledgling democracy and deepened an economic crisis.

"I vowed that if my initiative did not succeed, I would resign and ... I have already done so," Jebali told a news conference after meeting with President Moncef Marzouki.

Tunisia's deepest political crisis since the 2011 Arab Spring uprising that toppled President Zine El Abidine Ben Ali began when leading secular opposition politician Chokri Belaid was gunned down outside his home in Tunis on February 6.

No one claimed responsibility for the killing, but it deepened the misgivings of secularists who believe Jebali's government has failed to deal firmly enough with religious extremists threatening the country's stability.

Protesters poured onto the streets in the following days and Marzouki's secularist party threatened to quit the coalition government.

Jebali said he would try to form a cabinet of apolitical technocrats to restore calm and take Tunisia to elections, but did not consult his Ennahda allies or their secular coalition partners before making the proposal.

Several secular politicians backed the plan but Ennahda, winner of most parliamentary seats in elections that followed Ben Ali's overthrow, opposed the idea, fearing it would be sidelined from power.

Jebali bet his own job on the outcome, saying he would quit if he was rebuffed, and lost.

He quits 15 months into the job, although political experts said Marzouki was likely to re-appoint him as caretaker premier before a new leader is appointed.

Ennahda leader Rached Ghannouchi has said he wants to see Jebali head a new coalition. President Marzouki was due to meet Ghannouchi on Wednesday to ask him to name a prime minister.

But Jebali, announcing his resignation late on Tuesday, said he would not lead another government without assurances on the timing of fresh elections and a new constitution.

No government would be viable without Ennahda's blessing given its strength in parliament.

Ghannouchi has said it is essential that Islamists and secular parties share power now and in the future, and that his party was willing to compromise over control of important ministries such as foreign affairs, justice and interior.

"Ennahda is in negotiations with political parties to form a national coalition government", said Fethi Ayadi, a senior Ennahda official.

Iyed Dahmani, a leader of the secular Republican Party, said some kind of agreement was vital.

"We are in real trouble, politically and economically," he said.

The crisis has disrupted efforts to revitalize an economy hit hard by the disorder that followed the overthrow of veteran strongman Ben Ali.

Tunisia has been negotiating with the International Monetary Fund for a $1.78 billion loan and politicians said Jebali's inability to re-establish a functioning government had slowed efforts to restore normality.

Credit rating service Standard and Poor's said on Tuesday it had lowered its long-term foreign and local currency sovereign credit rating on Tunisia, citing "a risk that the political situation could deteriorate further amid a worsening fiscal, external and economic outlook".

(Reporting By Tarek Amara; Editing by Tom Pfeiffer)

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Swimming: Trickett urges healing after "toxic" Games

SYDNEY: Australian swimmer Libby Trickett called for healing within the sport after reports exposed a "toxic" atmosphere at the London Olympics including drunkenness, deceit and bullying.

Swimming Australia has vowed to restore its standing with the public after the country's much vaunted swimmers disappointed at the 2012 Olympics and inquiries into its culture revealed discipline was loose and the squad lacked leadership.

Trickett, who has won four gold medals at three Olympics, welcomed the news that officials would further investigate allegations against the team, including that some athletes misused prescription drugs as a prank in London.

"That issue has been left unresolved and it needs to be dealt with in order for us to move on," she told the Australian newspaper.

"It probably has gone too long without being dealt with. It certainly does need to be addressed because... if we let this one go, it's a precedent for the future."

She said all swimmers had been "under a cloud" because no individuals had so far been named.

"But if names are named, we will need to support them through the difficult times that lie ahead for them -- and they will be difficult," she said, The Australian reported.

"We need to come together again as a team and what better way to do that than by embracing these swimmers?"

Australia endured its worst swimming haul in decades in London, winning just one gold medal, six silver and three bronze for its lowest tally in the pool since Barcelona in 1992.

The lacklustre performance, in which no individual swimming gold medal was won for the first time since the 1976 Montreal Games, resulted in the commissioning of two independent reports released on Tuesday.

They revealed that morale within the swimming team was so low one athlete referred to London as the "lonely Olympics" as individuals looked after themselves ahead of the team.

- AFP/al

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Britain's Cameron visits Jallianwala Bagh massacre site, Golden Temple

AMRITSAR: British Prime Minister David Cameron laid a wreath on Wednesday at a memorial for the notorious Jallianwala Bagh massacre where he is reportedly set to express regret for the loss of life.

Cameron, dressed in a dark suit and bowing his head, laid the flowers at the Jallianwala Bagh memorial in Amritsar, where hundreds of unarmed protesters were gunned down by British troops in 1919.

Earlier, he paid obeisance at the holiest shrine of Sikh religion Golden Temple where he was presented a robe of honour.

Amid tight security arrangements, Cameron paid obeisance inside the sanctum sanctorum at 10:25am.

Clad in a dark suit and a tie with head covered with a blue-coloured cloth, Cameron was presented a robe of honour inside the sanctum sanctorum of Harmandir Sahib, popularly known as the Golden Temple.

The British prime minister also mingled with a couple of devotees and chatted with them for a brief period as Gurbani played in the backdrop. This is the first visit by a high-profile British dignitary to Amritsar after 1997, when Queen Elizabeth II and her husband Prince Philip, the Duke of Edinburgh, had visited the holy City.

Inside the temple, he was accompanied by Punjab chief minister Parkash Singh Badal, who earlier received the British dignitary at the Sri Guru Ram Dasji International Airport, Shiromani Gurdwara Prabandhak Committee (SGPC) President Avtar Singh Makkar, among others.

The British prime minister reached the Golden Temple at about 9:50am and spend nearly an hour inside.

Before paying obeisance by bowing his head inside the sanctum sanctorum, the British leader was taken around the temple by officials of the SGPC, apex religious body of the Sikhs, and was also shown Shri Guru Ram Dass Langar Hall.

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Hip implants a bit more likely to fail in women

CHICAGO (AP) — Hip replacements are slightly more likely to fail in women than in men, according to one of the largest studies of its kind in U.S. patients. The risk of the implants failing is low, but women were 29 percent more likely than men to need a repeat surgery within the first three years.

The message for women considering hip replacement surgery remains unclear. It's not known which models of hip implants perform best in women, even though women make up the majority of the more than 400,000 Americans who have full or partial hip replacements each year to ease the pain and loss of mobility caused by arthritis or injuries.

"This is the first step in what has to be a much longer-term research strategy to figure out why women have worse experiences," said Diana Zuckerman, president of the nonprofit National Research Center for Women & Families. "Research in this area could save billions of dollars" and prevent patients from experiencing the pain and inconvenience of surgeries to fix hip implants that go wrong.

Researchers looked at more than 35,000 surgeries at 46 hospitals in the Kaiser Permanente health system. The research, published Monday in JAMA Internal Medicine, was funded by the U.S. Food and Drug Administration.

After an average of three years, 2.3 percent of the women and 1.9 percent of the men had undergone revision surgery to fix a problem with the original hip replacement. Problems included instability, infection, broken bones and loosening.

"There is an increased risk of failure in women compared to men," said lead author Maria Inacio, an epidemiologist at Southern California Permanente Medical Group in San Diego. "This is still a very small number of failures."

Women tend to have smaller joints and bones than men, and so they tend to need smaller artificial hips. Devices with smaller femoral heads — the ball-shaped part of the ball-and-socket joint in an artificial hip — are more likely to dislocate and require a surgical repair.

That explained some, but not all, of the difference between women and men in the study. It's not clear what else may have contributed to the gap. Co-author Dr. Monti Khatod, an orthopedic surgeon in Los Angeles, speculated that one factor may be a greater loss of bone density in women.

The failure of metal-on-metal hips was almost twice as high for women than in men. The once-popular models were promoted by manufacturers as being more durable than standard plastic or ceramic joints, but several high-profile recalls have led to a decrease in their use in recent years.

"Don't be fooled by hype about a new hip product," said Zuckerman, who wrote an accompanying commentary in the medical journal. "I would not choose the latest, greatest hip implant if I were a woman patient. ... At least if it's been for sale for a few years, there's more evidence for how well it's working."

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Online:

Journal: http://www.jamainternalmed.com

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Obama's Speech on Guns Doesn't Stop Ill. Killing

A Chicago teenager was shot and killed Friday only hours after her sister attended President Obama's speech on the city's rampant gun violence.
Janay McFarlane, 18, was killed while walking with a friend during a visit to her dad, Herbert McFarlane, in North Chicago.

"All this gun violence going on, you never think it would be your child," he told ABC's Chicago station WLS. "This is the hardest thing for me in my life."

Herbert McFarlane told WLS that the loss of Janay is especially hard because she leaves behind a 3-month old son, who likes to wear an "I love Mommy" shirt. The shooting occurred in Lake County, a northern suburb miles from the epicenter of the gun violence on the city's South Side.

"I'm in Lake County to get away from violence and now it happened in Lake County where I moved to," he told WLS.

McFarlane and her child spent time both in Lake County and on the South Side where her mother lives.

Janay Proudmommie Mcfarlane/Facebook

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Only hours before McFarlane was shot and killed, President Obama returned to his hometown to speak on the South Side at a Hyde Park high school. McFarlane's sister, Destini Warren, 14, sat behind the president during the speech.

More than 500 people were shot and killed here last year, and this year the situation has worsened with the most deadly January the city has seen in over a decade. The shooting death of Hadiya Pendleton, a 15-year old who performed in Washington, D.C. at events connected to the president's inauguration last month, garnered national attention.

"Too many of our children are being taken away from us," Obama said in Hyde Park, with McFarlane's sister in the audience.

"Last year there were 443 murders with a firearm on the streets of this city, and 65 of those victims were 18 and under," he said. "So that's the equivalent of a Newtown every four months." He was referring to Newtown, Conn., where 20 first graders were gunned down by Adam Lanza along with seven adults.

Only hours later in Chicago, another 18-year old was shot and killed.

"I felt like someone took a knife and stabbed me in the heart, and a piece of my heart I will never get back," Angela Blakely, Janay McFarlane's mother, told WLS.

North Chicago Police on Sunday reportedly questioned two people in connection to McFarlane's death. Her family said McFarlane was an unintended target of the shooting.

Messages left by ABC News with the North Chicago Police Department and the Lake County Coroner's Office went unreturned Monday.

Another Chicago teenager, Frances Colon, was also shot and killed Friday just hours after she had told her father that she saw President Obama's helicopter fly over her neighborhood.

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