Fewer health care options for illegal immigrants

ALAMO, Texas (AP) — For years, Sonia Limas would drag her daughters to the emergency room whenever they fell sick. As an illegal immigrant, she had no health insurance, and the only place she knew to seek treatment was the hospital — the most expensive setting for those covering the cost.

The family's options improved somewhat a decade ago with the expansion of community health clinics, which offered free or low-cost care with help from the federal government. But President Barack Obama's health care overhaul threatens to roll back some of those services if clinics and hospitals are overwhelmed with newly insured patients and can't afford to care for as many poor families.

To be clear, Obama's law was never intended to help Limas and an estimated 11 million illegal immigrants like her. Instead, it envisions that 32 million uninsured Americans will get access to coverage by 2019. Because that should mean fewer uninsured patients showing up at hospitals, the Obama program slashed the federal reimbursement for uncompensated care.

But in states with large illegal immigrant populations, the math may not work, especially if lawmakers don't expand Medicaid, the joint state-federal health program for the poor and disabled.

When the reform has been fully implemented, illegal immigrants will make up the nation's second-largest population of uninsured, or about 25 percent. The only larger group will be people who qualify for insurance but fail to enroll, according to a 2012 study by the Washington-based Urban Institute.

And since about two-thirds of illegal immigrants live in just eight states, those areas will have a disproportionate share of the uninsured to care for.

In communities "where the number of undocumented immigrants is greatest, the strain has reached the breaking point," Rich Umbdenstock, president of the American Hospital Association, wrote last year in a letter to Obama, asking him to keep in mind the uncompensated care hospitals gave to that group. "In response, many hospitals have had to curtail services, delay implementing services, or close beds."

The federal government has offered to expand Medicaid, but states must decide whether to take the deal. And in some of those eight states — including Texas, Florida and New Jersey — hospitals are scrambling to determine whether they will still have enough money to treat the remaining uninsured.

Without a Medicaid expansion, the influx of new patients and the looming cuts in federal funding could inflict "a double whammy" in Texas, said David Lopez, CEO of the Harris Health System in Houston, which spends 10 to 15 percent of its $1.2 billion annual budget to care for illegal immigrants.

Realistically, taxpayers are already paying for some of the treatment provided to illegal immigrants because hospitals are required by law to stabilize and treat any patients that arrive in an emergency room, regardless of their ability to pay. The money to cover the costs typically comes from federal, state and local taxes.

A solid accounting of money spent treating illegal immigrants is elusive because most hospitals do not ask for immigration status. But some states have tried.

California, which is home to the nation's largest population of illegal immigrants, spent an estimated $1.2 billion last year through Medicaid to care for 822,500 illegal immigrants.

The New Jersey Hospital Association in 2010 estimated that it cost between $600 million and $650 million annually to treat 550,000 illegal immigrants.

And in Texas, a 2010 analysis by the Health and Human Services Commission found that the agency had provided $96 million in benefits to illegal immigrants, up from $81 million two years earlier. The state's public hospital districts spent an additional $717 million in uncompensated care to treat that population.

If large states such as Florida and Texas make good on their intention to forgo federal money to expand Medicaid, the decision "basically eviscerates" the effects of the health care overhaul in those areas because of "who lives there and what they're eligible for," said Lisa Clemans-Cope, a senior researcher at the Urban Institute.

Seeking to curb expenses, hospitals might change what qualifies as an emergency or cap the number of uninsured patients they treat. And although it's believed states with the most illegal immigrants will face a smaller cut, they will still lose money.

The potential impacts of reform are a hot topic at MD Anderson Cancer Center in Houston. In addition to offering its own charity care, some MD Anderson oncologists volunteer at a county-funded clinic at Lyndon B. Johnson General Hospital that largely treats the uninsured.

"In a sense we've been in the worst-case scenario in Texas for a long time," said Lewis Foxhall, MD Anderson's vice president of health policy in Houston. "The large number of uninsured and the large low-income population creates a very difficult problem for us."

Community clinics are a key part of the reform plan and were supposed to take up some of the slack for hospitals. Clinics received $11 billion in new funding over five years so they could expand to help care for a swell of newly insured who might otherwise overwhelm doctors' offices. But in the first year, $600 million was cut from the centers' usual allocation, leaving many to use the money to fill gaps rather than expand.

There is concern that clinics could themselves be inundated with newly insured patients, forcing many illegal immigrants back to emergency rooms.

Limas, 44, moved to the border town of Alamo 13 years ago with her husband and three daughters. Now single, she supports the family by teaching a citizenship class in Spanish at the local community center and selling cookies and cakes she whips up in her trailer. Soon, she hopes to seek a work permit of her own.

For now, the clinic helps with basic health care needs. If necessary, Limas will return to the emergency room, where the attendants help her fill out paperwork to ensure the government covers the bills she cannot afford.

"They always attended to me," she said, "even though it's slow."

___

Sherman can be followed on Twitter at https://twitter.com/chrisshermanAP .

Plushnick-Masti can be followed on Twitter at https://twitter.com/RamitMastiAP .

Read More..

School Shooting: Officials Seek Details on Gunman

The FBI is in at least three states interviewing relatives and friends of the elementary school gunman who killed 20 children, seven adults and himself, trying to put together a better picture of the shooter and uncover any possible explanation for the massacre, ABC News has learned.

The authorities have fanned out to New Jersey, Connecticut and Massachusetts to interview relatives of Adam Lanza, 20, and his mother, who was one of Lanza's shooting victims.

CLICK HERE for full coverage of the tragedy at the elementary school.

The victims died Friday when Lanza invaded Sandy Hook Elementary School in Newtown, Conn., and sprayed staff and students with bullets, officials said. Lanza also was found dead in the school.

Lt. Paul Vance said 18 children died in the school and two more died later in a hospital.

Six adults also were slain, bringing the total to 26. Among them was the school's principal, Dawn Hochsprung, multiple sources told ABC News. Another adult victim was teacher Vicki Soto, her cousin confirmed.

In addition to the casualties at the school, Lanza's mother, Nancy Lanza, was killed in her home, federal and state sources told ABC News.

According to sources, Lanza shot his mother in the face, then left his house armed with at least two semi-automatic handguns, a Glock and a Sig Sauer, and a semi-automatic rifle. He was also wearing a bulletproof vest.

READ: Connecticut Shooter Adam Lanza: 'Obviously Not Well'

Newtown Teacher Kept 1st Graders Calm During Massacre Watch Video

Newtown School Shooting: What to Tell Your Kids Watch Video

Lanza then drove to the elementary school and continued his rampage, authorities said.

It appeared that Lanza died from what was believed to be a self-inflicted gunshot wound. The rifle was found in his car.

"Evil visited this community today," Gov. Dan Malloy said at a news conference Friday evening.

CLICK HERE for more photos from the scene.

In the early confusion surrounding the investigation, federal sources initially identified the suspect as Adam's older brother Ryan Lanza, 24. Identification belonging to Ryan Lanza was found at the shooting scene, federal sources told ABC News.

Ryan Lanza soon took to Facebook to say he was alive and not responsible for the shooting. He later was questioned by police.

During the rampage, first-grade teacher Kaitlin Roig, 29, locked her 14 students in a class bathroom and listened to "tons of shooting" until police came to help.

"It was horrific," Roig said. "I thought we were going to die."

She said that the terrified kids were saying, "I just want Christmas. ... I don't want to die. I just want to have Christmas."

A tearful President Obama said Friday that there was "not a parent in America who doesn't feel the overwhelming grief that I do."

The president had to pause to compose himself after saying these were "beautiful little kids between the ages of 5 and 10."

As he continued with his statement, Obama wiped away tears from each eye. He has ordered flags flown as half staff.

It is the second worst mass shooting in U.S. history, exceeded only by the Virginia Tech shooting in 2007 when 32 were killed before the shooter turned the gun on himself. The carnage in Connecticut exceeded the 1999 Columbine High School shooting in which 13 died and 24 were injured.

Friday's shooting came three days after masked gunman Jacob Roberts opened fire in a busy Oregon mall, killing two before turning the gun on himself.

The Connecticut shooting occurred at the Sandy Hook Elementary School, which includes 450 students in grades K-4. The town is located about 12 miles east of Danbury, Conn.

The massacre prompted the town of Newtown to lock down all its schools and draw SWAT teams to the school, authorities said.

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Egyptians vote on divisive constitution

CAIRO/ALEXANDRIA (Reuters) - Egyptians queued to vote on Saturday on a constitution promoted by its Islamist backers as the way out of a prolonged political crisis and rejected by opponents as a recipe for further divisions in the Arab world's biggest nation.

Soldiers joined police to secure the referendum after deadly protests during the buildup. Street brawls erupted again on Friday in Alexandria, Egypt's second city, but voting proceeded quietly there, with no reports of violence elsewhere.

President Mohamed Mursi provoked angry demonstrations when he issued a decree last month expanding his powers and then fast-tracked the draft constitution through an assembly dominated by his Muslim Brotherhood group and its allies. At least eight people were killed in clashes last week outside the presidential palace.

The liberal, secular and Christian opposition says the constitution is too Islamist and tramples on minority rights. Mursi's supporters say the charter is needed if progress is to be made towards democracy nearly two years after the fall of military-backed strongman Hosni Mubarak.

"The sheikhs (preachers) told us to say 'yes' and I have read the constitution and I liked it," said Adel Imam, a 53-year-old queuing to vote in a Cairo suburb. "The president's authorities are less than before. He can't be a dictator."

Opposition politician and Nobel Peace Prize laureate Mohamed ElBaradei wrote on Twitter: "Adoption of (a) divisive draft constitution that violates universal values and freedoms is a sure way to institutionalize instability and turmoil."

Official results will not be announced until after a second round of voting next Saturday. But partial results and unofficial tallies are likely to emerge soon after the first round, giving an idea of the overall trend.

In order to pass, the constitution must be approved by more than 50 percent of voters who cast ballots. A little more than half of Egypt's electorate of 51 million are eligible to vote in the first round in Cairo and other cities.

TRANSITION

Christians, making up about 10 percent of Egypt's 83 million people and who have long grumbled of discrimination, were among those waiting at a polling station in Alexandria to oppose the basic law. They fear Islamists, long repressed by Mubarak, will restrict social and other freedoms.

"I voted 'no' to the constitution out of patriotic duty," Michael Nour, a 45-year-old Christian teacher in Alexandria. "The constitution does not represent all Egyptians," he said.

Islamists are counting on their disciplined ranks of supporters and the many Egyptians who may fall into line in a desperate bid to end turmoil that has hammered the economy and sent Egypt's pound to eight-year lows against the dollar.

"I voted 'yes' for stability," said shopkeeper Ahmed Abou Rabu, 39. "I cannot say all the articles of the constitution are perfect but I am voting for a way forward. I don't want Egyptians to go in circles, for ever lost in this transition."

Mursi was among the early voters after polls opened at 8 a.m. (1:00 a.m. Eastern Time). He was shown on television casting his ballot shielded by a screen and then dipping his finger in ink - a measure to prevent people voting twice.

One senior official in the committee overseeing the referendum said Saturday's vote could extend to Sunday if crowds were too heavy to allow everyone cast ballots in one day. Voting for Egyptians abroad that began on Wednesday has been extended to Monday, the state news agency reported.

After weeks of turbulence, there has been limited public campaigning. Opposition politicians and parties, beaten in two elections since Mubarak's overthrow, only announced on Wednesday they backed a "no" vote instead of a boycott.

Flag-waving Islamists gathered peacefully at one of the main mosques on Friday, some shouting "Islam, Islam" and "We've come here to say 'yes' to the constitution".

PALACE SIT-IN

Opposition supporters assembled outside the presidential palace, where there has been a sit-in for days. The walls of the palace, ringed by tanks, are scrawled with anti-Mursi graffiti.

The referendum will be held on two days covering different regions, with the second round on December 22, because there are not enough judges willing to monitor all polling stations after some in the judiciary said they would boycott the vote.

Egyptians are being asked to accept or reject a constitution that must be in place before a parliamentary election can be held next year to replace an Islamist-led parliament dissolved this year. Many hope this will lead Egypt towards stability.

If the constitution is voted down, a new assembly will have to be formed to draft a revised version, a process that could take up to nine months.

The army has deployed about 120,000 troops and 6,000 tanks and armored vehicles to protect polling stations and other government buildings. While the military backed Mubarak and his predecessors, it has not intervened in the present crisis.

(Writing by Edmund Blair and Giles Elgood; Editing by Andrew Heavens)

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Youths have similar ideals to govt, says ESM Goh

SINGAPORE: Singapore youths generally have the same ideals as that of the government, observed Emeritus Senior Minister Goh Chok Tong at the end of a national conversation session at the Marine Parade constituency.

Mr Goh said this will make it easier for the government to work together with the generation of the future.

"Supposing they come up with very different ideals from what we think should be for the prosperity and stability of Singapore. It's going to be very troublesome," he said.

"Supposing they had all argued about welfare state and so on, then that's very troublesome for us because we know that without resources, without economic growth and so on, a welfare state will lead us to ruins."

Some of the goals set by participants during the conversation with Marine Parade residents included a more cohesive society and more sustainable economic growth.

The 45 participants comprised youths and working adults.

Mr Goh felt that the society has, in recent years, been drifting without a clear sense of direction.

He added that having the same ideals does not mean goals can be reached if the society is divided.

Mr Goh said Singapore has never been more politically divided, so the Singapore Conversation is a very serious effort to build a new compact between the people and the government.

"The worry is as we emphasise more freedom for the people, (society) becomes more cosmopolitan, takes in more foreigners, immigrants and so on, (and) our society begins to loosen as a result of these new trends," he said.

"The old (generation) is getting smaller in proportion. The young (generation) is getting bigger, with different experiences... and if they don't get a new sense of bonding in working as a group, can you imagine how we move into the future?"

Mr Goh also pointed out even though ideals may be similar, young Singaporeans may disagree with the processes and priorities in policy-making.

Youths felt that at this stage of the conversation, ideals that surface would naturally be similar to the government. But they believed there is still space for disagreements.

"When the conversation is couched in very generic themes and terms, of course, we have the same broad general ideals and there is a consensus," said Chris Lim, a participant at the session.

"But when the minute details of policies are discussed, that's when differences will start to appear, in the ways of how we do it. This is a question that remains to be answered in the course of our national conversation."

This is the first time Mr Goh has attended the national conversation session.

He has been conducting several community conversations with his residents at Marine Parade.

Mr Goh explained that these conversations were more unstructured, where residents could discuss policy issues.

Lawrence Wong, committee member of Our Singapore Conversation, said he is satisfied with the progress and outreach, three months after the initiative started.

Mr Wong was also present at the session in Marine Parade.

He said: "We've been trying to reach out to as broad spectrum of society as possible, and I think we've had very good representation of people who come enthusiastically to share, and we've got very good ideas. There's certainly more that we can do."

Separately, at a session of Our Singapore Conversation held with the Malay Muslim community at Bukit Batok East, participants raised the issue of cultivating patriotism in every Singaporean, especially the younger generation.

"What is important to me also is that they talk about patriotism, which is something I did not find in the other conversations," said Minister of State for Social and Family Development Halimah Yacob.

"In this conversation, they say it is important within the context of building a strong national identity, reinforcing multi-culturalism, multi-racialism, that we are patriotic Singaporeans and how we continue to project that."

- CNA/xq

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Tension in UP town over construction of religious structure

LAKHIMPUR KHERI (UP): Tension prevailed in Nighasan area of the district over construction of a religious structure on a disputed piece of land.

Members of one of the groups were against the construction work in Dubha village which led to the rival members staging demonstration against them, resulting in arguments between the two factions, SDM RP Singh said.

"It also came to the fore that a legal suite involving the same land was pending in the court. Also, no permission was obtained for construction of the structure," the SDM said.

In view of this, the construction work has been stopped and both the parties have been asked to maintain peace, he said, adding that adequate police and PAC men have been deployed in the village to avert any further tension.

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Fewer health care options for illegal immigrants

ALAMO, Texas (AP) — For years, Sonia Limas would drag her daughters to the emergency room whenever they fell sick. As an illegal immigrant, she had no health insurance, and the only place she knew to seek treatment was the hospital — the most expensive setting for those covering the cost.

The family's options improved somewhat a decade ago with the expansion of community health clinics, which offered free or low-cost care with help from the federal government. But President Barack Obama's health care overhaul threatens to roll back some of those services if clinics and hospitals are overwhelmed with newly insured patients and can't afford to care for as many poor families.

To be clear, Obama's law was never intended to help Limas and an estimated 11 million illegal immigrants like her. Instead, it envisions that 32 million uninsured Americans will get access to coverage by 2019. Because that should mean fewer uninsured patients showing up at hospitals, the Obama program slashed the federal reimbursement for uncompensated care.

But in states with large illegal immigrant populations, the math may not work, especially if lawmakers don't expand Medicaid, the joint state-federal health program for the poor and disabled.

When the reform has been fully implemented, illegal immigrants will make up the nation's second-largest population of uninsured, or about 25 percent. The only larger group will be people who qualify for insurance but fail to enroll, according to a 2012 study by the Washington-based Urban Institute.

And since about two-thirds of illegal immigrants live in just eight states, those areas will have a disproportionate share of the uninsured to care for.

In communities "where the number of undocumented immigrants is greatest, the strain has reached the breaking point," Rich Umbdenstock, president of the American Hospital Association, wrote last year in a letter to Obama, asking him to keep in mind the uncompensated care hospitals gave to that group. "In response, many hospitals have had to curtail services, delay implementing services, or close beds."

The federal government has offered to expand Medicaid, but states must decide whether to take the deal. And in some of those eight states — including Texas, Florida and New Jersey — hospitals are scrambling to determine whether they will still have enough money to treat the remaining uninsured.

Without a Medicaid expansion, the influx of new patients and the looming cuts in federal funding could inflict "a double whammy" in Texas, said David Lopez, CEO of the Harris Health System in Houston, which spends 10 to 15 percent of its $1.2 billion annual budget to care for illegal immigrants.

Realistically, taxpayers are already paying for some of the treatment provided to illegal immigrants because hospitals are required by law to stabilize and treat any patients that arrive in an emergency room, regardless of their ability to pay. The money to cover the costs typically comes from federal, state and local taxes.

A solid accounting of money spent treating illegal immigrants is elusive because most hospitals do not ask for immigration status. But some states have tried.

California, which is home to the nation's largest population of illegal immigrants, spent an estimated $1.2 billion last year through Medicaid to care for 822,500 illegal immigrants.

The New Jersey Hospital Association in 2010 estimated that it cost between $600 million and $650 million annually to treat 550,000 illegal immigrants.

And in Texas, a 2010 analysis by the Health and Human Services Commission found that the agency had provided $96 million in benefits to illegal immigrants, up from $81 million two years earlier. The state's public hospital districts spent an additional $717 million in uncompensated care to treat that population.

If large states such as Florida and Texas make good on their intention to forgo federal money to expand Medicaid, the decision "basically eviscerates" the effects of the health care overhaul in those areas because of "who lives there and what they're eligible for," said Lisa Clemans-Cope, a senior researcher at the Urban Institute.

Seeking to curb expenses, hospitals might change what qualifies as an emergency or cap the number of uninsured patients they treat. And although it's believed states with the most illegal immigrants will face a smaller cut, they will still lose money.

The potential impacts of reform are a hot topic at MD Anderson Cancer Center in Houston. In addition to offering its own charity care, some MD Anderson oncologists volunteer at a county-funded clinic at Lyndon B. Johnson General Hospital that largely treats the uninsured.

"In a sense we've been in the worst-case scenario in Texas for a long time," said Lewis Foxhall, MD Anderson's vice president of health policy in Houston. "The large number of uninsured and the large low-income population creates a very difficult problem for us."

Community clinics are a key part of the reform plan and were supposed to take up some of the slack for hospitals. Clinics received $11 billion in new funding over five years so they could expand to help care for a swell of newly insured who might otherwise overwhelm doctors' offices. But in the first year, $600 million was cut from the centers' usual allocation, leaving many to use the money to fill gaps rather than expand.

There is concern that clinics could themselves be inundated with newly insured patients, forcing many illegal immigrants back to emergency rooms.

Limas, 44, moved to the border town of Alamo 13 years ago with her husband and three daughters. Now single, she supports the family by teaching a citizenship class in Spanish at the local community center and selling cookies and cakes she whips up in her trailer. Soon, she hopes to seek a work permit of her own.

For now, the clinic helps with basic health care needs. If necessary, Limas will return to the emergency room, where the attendants help her fill out paperwork to ensure the government covers the bills she cannot afford.

"They always attended to me," she said, "even though it's slow."

___

Sherman can be followed on Twitter at https://twitter.com/chrisshermanAP .

Plushnick-Masti can be followed on Twitter at https://twitter.com/RamitMastiAP .

Read More..

Critics Faulted Rice's Work on Benghazi, Africa

United Nations Ambassador Susan Rice removed herself from possible consideration as secretary of state after becoming yet another player in the divide between the left and right.

Rice, who withdrew her name Thursday, has faced months of criticism over how she characterized the Sept. 11 attack on a U.S. consulate in Benghazi, Libya. She also has come under fire for her approach to dealing with African strongmen.

Rice became a target for conservatives when she went on Sunday morning current affairs shows such as ABC News' "This Week" following the Benghazi attack and failed to characterize it as a pre-meditated act of terror. Instead, she said it was a spontaneous response to an anti-Islam film produced in the United States and cited in the region as an example of anti-Islamicism in the West.

After it became clear that Rice's assertions were untrue and elements of the Obama administration may have known that to be the case, Republican Sens. Lindsey Graham, John McCain and Kelly Ayotte said they would do whatever they could to block Rice's possible nomination to replace Hillary Clinton as secretary of state.

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"This is about the role she played around four dead Americans when it seems to be that the story coming out of the administration -- and she's the point person -- is so disconnected to reality, I don't trust her," Graham said. "And the reason I don't trust her is because I think she knew better. And if she didn't know better, she shouldn't be the voice of America."

Members of the administration defended Rice. At his testimony before Congress, Gen. David Petraeus, the former CIA director, said Rice was speaking from unclassified talking points given to her by the CIA.

Senate Intelligence Committee Chairwoman Dianne Feinstein, D-Calif., reiterated what Petraeus said outside his closed-door hearing before the Senate.

"The key is that they were unclassified talking points at a very early stage. And I don't think she should be pilloried for this. She did what I would have done or anyone else would have done that was going on a weekend show," Feinstein said. "To say that she is unqualified to be secretary of state, I think, is a mistake. And the way it keeps going, it's almost as if the intent is to assassinate her character."

Minutes after she announced her withdrawal from the process, Graham tweeted, "I respect Ambassador Rice's decision."

McCain's office released a paper statement saying, "Senator McCain thanks Ambassador Rice for her service to the country and wishes her well. He will continue to seek all the facts surrounding the attack on our consulate in Benghazi that killed four brave Americans."

Over the last few weeks, criticism of Rice had grown beyond her response to Benghazi to include a closer scrutiny of her work in Africa, where she had influence over U.S. policy during the Clinton administration.

Critics of her Africa dealings were not partisan -- but included human rights workers, journalists and some Africans themselves.

Among the most serious critiques was the accusation that she actively protected Rwandan President Paul Kagame and senior members of his government from being sanctioned for funding and supporting the rebels that caused Eastern Congo's recent violence.

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U.S., rebels urge gloomy Moscow to help oust Assad

BEIRUT (Reuters) - Syria's rebel leadership and the United States seized on Russian pessimism over President Bashar al-Assad's future to urge Moscow to help push its ally into ceding power and end the battles closing in around his capital.

"We want to commend the Russian government for finally waking up to the reality and acknowledging that the regime's days are numbered," the U.S. State Department spokeswoman said after a senior Kremlin envoy conceded publicly on Thursday that Assad's opponents could win the 20-month-old civil war.

"The question now is, will the Russian government join those of us in the international community who are working with the opposition to try to have a smooth democratic transition?" U.S. spokeswoman Victoria Nuland added in Washington.

In Marrakech, where his new coalition won recognition from other international powers as the legitimate leadership of Syria, rebel political leader Mouaz al-Khatib said he believed Russia, ally and arms supplier to the Assad dynasty since Soviet times, was looking for ways out of its support for a lost cause.

"I believe that the Russians have woken up and are sensing that they have implicated themselves with this regime, but they don't know how to get out," al-Khatib told Reuters. He held them "particularly responsible" for helping Assad with arms but said Moscow need not "lose everything" in Syria if it changed tack.

Under President Vladimir Putin, wary since last year's Libyan war of what Russia sees as a Western drive to use the United Nations to overthrow national leaders it dislikes, Russia has blocked U.N. efforts to squeeze Assad, who has also had strong support from his long-time sponsor Iran.

But Mikhail Bogdanov, a deputy foreign minister and the Kremlin's special envoy for Middle East affairs, was quoted as saying in Moscow: "One must look the facts in the face."

"Unfortunately, the victory of the Syrian opposition cannot be ruled out." The Syrian government, he said, was "losing control of more and more territory" and Moscow was preparing to evacuate Russian citizens if necessary.

Nuland said Bogdanov's comments demonstrated that Moscow now "sees the writing on the wall" on Syria and said Russia should now rally behind U.N. efforts to prevent a wider bloodbath.

"They can withdraw any residual support for the Assad regime, whether it is material support (or) financial support," she said. "They can also help us to identify people who might be willing, inside of Syria, to work on a transitional structure."

DIPLOMACY

International envoy Lakhdar Brahimi, who has met Russian and U.S. officials twice in the past week, is seeking a solution based on an agreement reached in Geneva in June that called for the creation of a transitional government in Syria.

But Russia has repeated warnings that recognition of al-Khatib's coalition, notably by the United States, is undermining diplomacy, and rejected U.S. contentions that the Geneva agreement sent a clear message that Assad should step down.

Nuland said the Brahimi meetings could lay the framework for a political structure to follow Assad:

"We've said all along to the Russians that we are concerned that the longer that this goes on, and the longer it takes us to get to an alternative political path for Syria, the only path is going to be the military one and that is just going to bring more violence.

"We all ought to be working together."

Bogdanov, whose government has suggested that Assad himself should be allowed to see through a transition he has promised, suggested the rebels and their allies were set on a military solution and he gave little hint of detente with Washington.

"The fighting will become even more intense and (Syria) will lose tens of thousands and, perhaps, hundreds of thousands of civilians," Bogdanov was quoted as saying. "If such a price for the removal of the president seems acceptable to you, what can we do? We, of course, consider it absolutely unacceptable."

The head of NATO, Anders Fogh Rasmussen, said elsewhere: "I think the regime in Damascus is approaching collapse."

A U.S. official said: "Assad probably still believes that Syria is his and illusions can die hard. But Assad and those closest to him have got to be feeling the psychological strain of fighting a long war that is not going their way."

DAMASCUS BATTLES

But Al-Khatib, who played down Western concerns of sectarian Sunni Islamists in rebel ranks, warned that the fighting was far from over, even as it has begun to rattle the heart of Assad's power in Damascus. On Wednesday, a car bomb killed at least 16 people in a nearby town which is home to many military families.

"The noose is tightening around the regime," al-Khatib said.

"(But) the regime still has power. People think that the regime is finished, but it still has power left, but it is demoralized and however long it lasted its end is clear."

Day and night, Damascenes can hear the thunderous sound of bombardment aimed at rebel-held and contested neighborhoods.

The city's streets have now turned into a labyrinth of checkpoints and road blocks, with several major roads permanently closed off to traffic by concrete barriers.

"We escape from one place and trouble follows," said one grandmother, Um Hassan, as she described to Reuters her family's flight from one neighborhood to another as fighting seeps into the capital. "I don't know where we can keep running to."

Nonetheless, al-Khatib played down demands for their allies to provide heavier weaponry - a request long resisted by governments wary of anti-aircraft missiles and other hardware reaching Islamist rebels who might turn them against the West.

"The Syrian people ... no longer need international forces to protect them," he said, not specifying whether he meant a no-fly zone, arms supplies or other military support.

The opposition chief said he was willing to listen to proposals for Assad to escape with his life - "The best thing is that he steps down and stops drinking the blood of the Syrian people" - and outlined three scenarios for a change of power:

Al-Khatib ruled out the Russian proposal suggesting Assad hand over power to a transitional government while remaining president, saying it was "disgraceful for a slaughtered nation to accept to have a killer and criminal at its head".

The British-based Syrian Observatory said war planes bombed rebel-held eastern suburbs of Damascus on Thursday and artillery was hitting Daraya and Moadamiyeh, southwestern areas near the centre where rebels have been fighting for a foothold.

Syria has relied on war planes and helicopters to bombard rebel districts but Damascus denied accusations by U.S. and NATO officials that it had fired Scud missiles in recent days. The foreign ministry said the long-range missiles were not used against "terrorist groups," a term it uses for the rebels.

At least 40,000 people have been killed in Syria's uprising, which started in March 2011 with street protests which were met with gunfire by Assad's security forces, and which spiraled into the most enduring and destructive of the Arab revolts.

(Additional reporting by Steve Gutterman in Moscow and Andrew Quinn in Washington; Writing by Alastair Macdonald; Editing by Michael Roddy) For an interactive look at the uprising in Syria, please click on http://link.reuters.com/rut37s

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Two dead, 10 missing after South Korea barge capsizes

SEOUL: Two construction workers were confirmed killed late Friday and 10 others missing after a barge carrying a crane capsized off South Korea's southeast coast, the coastguard said.

The 2,600-ton barge sank off the city of Ulsan after the 80-metre (264-foot) crane collapsed, Yonhap news agency quoted coastguard officials as saying.

Twelve people have so far been rescued with two others confirmed dead, and a search is underway for the 10 missing workers.

The accident happened during construction of a new port.

- AFP/lp

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Pakistan jail staff suspects Indian prisoners and bars them from writing letters

AMRITSAR: Many Indian prisoners lodged in Pakistani jails are still suspected and are even not allowed to write letters to their dear ones in India.

Revealing this, Pakistani advocate Awaish Sheikh , who is also contesting the case of Sarabjit Singh, informed TOI on Friday that during his meeting with Indian prisoner Kuldeep Singh in Central jail on December 13th the deputy superintendent of central jail refused Kuldeep Singh to write a message for his family.

Kuldeep Singh was reportedly arrested from Shakargarh area of Pakistan in 1992 on charges of spying and was sentenced to life imprisonment by a military court on May 1996 and had already spent 20 years in Pak jail. Sheikh informed that he met Kuldeep Singh in jail after approval of home secretary .

"But to my surprise a major of Pakistan army and his junior were unofficially present in the meeting along with deputy superintendent of jail", said Sheikh adding that representatives of special branch(CID) and counter terrorism departments also accompanied him. He said this was for the first time that any lawyer met him in jail in all these years and he also gave him some eatables.

He said he handed over him a draft of mercy petition for his release on humanitarian grounds in Urdu language and also two papers for writing messages for his mother, wife and son back home so that they could be delivered to them."A jail staffer took those papers from him and gave to deputy superintendent of jail who refused to handover to me after reading them" said Sheikh adding that he was informed that he couldn't take these papers on the plea that correspondence of inmates were not allowed.

"I tried to convince him but he d idn't listen to me" said Sheikh. However he said that Kuldeep gave him a hand made key ring and asked him to convey his well being to his family members.

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Dozens sue pharmacy, but compensation uncertain

NASHVILLE, Tenn. (AP) — Dennis O'Brien rubs his head as he details ailments triggered by the fungal meningitis he developed after a series of steroid shots in his neck: nausea, vomiting, dizziness, drowsiness, blurred vision, exhaustion and trouble with his speech and attention.

He estimates the disease has cost him and his wife thousands of dollars in out-of-pocket expenses and her lost wages, including time spent on 6-hour round trip weekly visits to the hospital. They've filed a lawsuit seeking $4 million in damages from the Massachusetts pharmacy that supplied the steroid injections, but it could take years for them to get any money back and they may never get enough to cover their expenses. The same is true for dozens of others who have sued the New England Compounding Center.

"I don't have a life anymore. My life is a meningitis life," the 59-year-old former school teacher said, adding that he's grateful he survived.

His is one of at least 50 federal lawsuits in nine states that have been filed against NECC, and more are being filed in state courts every day. More than 500 people have gotten sick after receiving injections prepared by the pharmacy.

The lawsuits allege that NECC negligently produced a defective and dangerous product and seek millions to repay families for the death of spouses, physically painful recoveries, lost wages and mental and emotional suffering. Thirty-seven people have died in the outbreak.

"The truth is the chance of recovering damages from NECC is extremely low," said John Day, a Nashville attorney who represents several patients who have been sickened by fungal meningitis.

To streamline the process, attorneys on both sides are asking to have a single judge preside over the pretrial and discovery phases for all of the federal lawsuits.

This approach, called multidistrict litigation, would prevent inconsistent pretrial rulings and conserve resources of all parties. But unlike a class-action case, those lawsuits would eventually be returned to judges in their original district for trial, according to Brian Fitzpatrick, a law professor at Vanderbilt University Law School in Nashville.

Even with this approach, Fitzpatrick noted that federal litigation is very slow, and gathering all the evidence, records and depositions during the discovery phase could take months or years.

"Most of the time what happens is once they are consolidated for pretrial proceedings, there is a settlement, a global settlement between all the lawyers and the defendants before anything is shipped back for trial," he said.

A lawyer representing NECC, Frederick H. Fern, described the consolidation process as an important step.

"A Boston venue is probably the best scenario," Fern said in an email. "That's where the parties, witnesses and documents are located, and where the acts subject to these complaints occurred."

Complicating efforts to recover damages, attorneys for the patients said, NECC is a small private company that has now recalled all its products and laid off its workers. The company's pharmacy licenses have been surrendered, and it's unclear whether NECC had adequate liability insurance.

Fern said NECC has insurance, but they were still determining what the policy covers.

But Day says, "It's clear to me that at the end of the day, NECC is not going to have sufficient assets to compensate any of these people, not even 1 percent."

As a result, many attorneys are seeking compensation from other parties. Among the additional defendants named in lawsuits are NECC pharmacist and co-founder Barry Cadden; co-founder Greg Conigliaro; sister company Ameridose and its marketing and support arm, Medical Sales Management.

Founded in 2006 by Cadden and Conigliaro, Ameridose would eventually report annual revenue of $100 million. An NECC spokesman didn't respond to a request for the pharmacy's revenue.

While Federal Drug Administration regulators have also found contamination issues at Westborough, Mass.-based Ameridose, the FDA has said it has not connected Ameridose drugs to infection or illness.

Under tort law, a lawsuit has to prove a defendant has a potential liability, which in this case could be anyone involved in the medical procedure. However, any such suit could take years and ultimately may not be successful.

"I would not be surprised if doctors, hospitals, people that actually injected the drugs, the people that bought the drugs from the compounding company, many of those people will also be sued," said Fitzpatrick.

Plaintiffs' attorneys said they're considering that option but want more information on the relationships between the compounding pharmacy and the hundreds of hospitals and clinics that received its products.

Day, the attorney in Tennessee, said the clinics and doctors that purchase their drugs from compounding pharmacies or manufacturers could be held liable for negligence because they are in a better position to determine the safety of the medicine than the patients.

"Did they use due care in determining from whom to buy these drugs?" Day said.

Terry Dawes, a Michigan attorney who has filed at least 10 federal lawsuits in the case, said in traditional product liability cases, a pharmaceutical distributor could be liable.

"We are looking at any conceivable sources of recovery for our clients including pharmaceutical supply places that may have dealt with this company in the past," he said.

Ten years ago, seven fungal meningitis illnesses and deaths were linked to injectable steroid from a South Carolina compounding pharmacy. That resulted in fewer than a dozen lawsuits, a scale much smaller than the litigations mounting up against NECC.

Two companies that insured the South Carolina pharmacy and its operators tried unsuccessfully to deny payouts. An appellate court ruled against their argument that the pharmacy willfully violated state regulations by making multiple vials of the drug without specific prescriptions, but the opinion was unpublished and doesn't set a precedent for the current litigation.

The lawsuits represent a way for patients and their families recover expenses, but also to hold the pharmacy and others accountable for the incalculable emotional and physical toll of the disease.

A binder of snapshots shows what life is like in the O'Briens' rural Fentress County, Tenn., home: Dennis hooked up to an IV, Dennis in an antibiotics stupor, bruises on his body from injections and blood tests. He's had three spinal taps. His 11-day stay in the hospital cost over $100,000, which was covered by health insurance.

His wife said she sometimes quietly checks at night to see whether her husband of 35 years is still breathing.

"In my mind, I thought we were going to fight this and get over it. But we are not ever going to get over it," said Kaye O'Brien.

Marjorie Norwood, a 59-year-old grandmother of three who lives in Ethridge, Tenn., has spent just shy of two months total in the hospital in Nashville battling fungal meningitis after receiving a steroid injection in her back. She was allowed to come home for almost a week around Thanksgiving, but was readmitted after her symptoms worsened.

Family members are still dealing with much uncertainty about her recovery, but they have not filed a lawsuit, said their attorney Mark Chalos. He said Norwood will likely be sent to a rehabilitation facility after her second stay in the hospital rather than return home again.

Marjorie Norwood's husband, an autoworker, has taken time off work to care for her and they depend on his income and insurance.

"It doesn't just change her life, it changes everyone else's life around her because we care about her and want her to be happy and well and have everything that she needs," said her daughter, Melanie Norwood.

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Mall Shooter Quit Job, Was Hawaii Bound

In the days before he stole a semiautomatic weapon and stormed into an Oregon shopping mall, killing two people in a shooting spree, Jacob Roberts quit his job, sold his belongings and began to seem "numb" to those closest to him.

Roberts' ex-girlfriend, Hannah Patricia Sansburn, 20, told ABC News today that the man who donned a hockey mask and opened fire on Christmas shoppers was typically happy and liked to joke around, but abruptly changed in the week before the shooting.

Roberts unleashed a murderous volley of gunfire on the second floor of the Clackamas Town Center on Tuesday while wearing the mask and black clothing, and carrying an AR-15 semiautomatic weapon and "several" magazines full of ammunition. He ended his barrage by walking down to the first floor of the mall and committing suicide.

READ: Why Mass Shooters Wear Masks

"I don't understand," Sansburn said. "I was just with him. I just talked to him. I didn't believe it was him at all. Not one part of me believed it."

She said that in recent weeks, Roberts quit his job at a gyro shop in downtown Portland and sold all of his belongings, telling her that he was moving to Hawaii. He had even purchased a ticket.

She now wonders if he was really planning to move.

Oregon Mall Shooting: Gunman Identified as Jacob Tyler Roberts Watch Video

Oregon Mall Shooting: Suspect Jacob Tyler Roberts Identified Watch Video

Oregon Mall Shooting: 2 Dead in Clackamas Town Center Watch Video

"He was supposed to catch a flight Saturday and I texted him, and asked how his flight went, and he told me, 'oh, I got drunk and didn't make the flight,'" she said. "And then this happens... It makes me think, was he even planning on going to Hawaii? He quit his job, sold all of his things."

Roberts described himself on his Facebook page as an "adrenaline junkie," and said he is the kind of person who thinks, "I'm going to do what I want."

Roberts, who attended Clackamas Community college, posted a picture of himself on his Facebook page firing a gun at a target. His Facebook photo showed graffiti in which the words "Follow Your Dreams" were painted over with the word "Cancelled."

Sansburn said the pair had dated for nearly a year but had broke up over the summer. Throughout their relationship, she had never seen him act violently or get angry.

"Jake was never the violent type. He didn't go out of his way to try to hurt people or upset people. His main goal was to make you laugh, smile, make you feel comfortable. I never would have guessed him to do anything like this ever," she said.

"You can't reconcile the differences. I hate him for what he did, but I can't hate the person I knew because it was nothing like the person who would go into a mall and go on a rampage. I would never associate the two at all."

The last time she saw him, which was last week, he "seemed numb," and she didn't understand why, she said.

"I just talked to him, stayed the night with him, and he just seemed numb if anything. He's usually very bubbly and happy, and I asked him why, what had changed, and said 'nothing.' He just had so much he had to do before he went to Hawaii that he was trying to distance himself from Portland," Sansburn said.

Sansburn said the last message she sent Roberts was a text, asking him to stay, and saying she didn't want him to leave. He replied "I'm sorry," with a sad face emoticon.

Police are still seeking information about what Roberts was doing in the days leading up to the shooting. They said today they believe Roberts stole the gun he used in the rampage from someone he knew. They have searched his home and his car for other clues into his motive.

Read ABC News' full coverage of the Oregon Mall Shooting

Clackamas County Sheriff Craig Roberts said earlier today on "Good Morning America" that he believes Roberts went into the mall with the goal of killing as many people as he could.

"I believe, at least from the information that's been provided to me at this point in time, it really was a killing of total strangers. To my knowledge at this point in time he was really trying, I think, to kill as many people as possible."

Sansburn said she has not talked to police.

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Russia says Syrian rebels might win

MOSCOW/BEIRUT (Reuters) - Syrian rebels are gaining ground and might win, Russia's Middle East envoy said on Thursday, in the starkest such admission from a major ally of President Bashar al-Assad in 20 months of conflict.

"One must look the facts in the face," Russia's state-run RIA quoted Mikhail Bogdanov as saying. "Unfortunately, the victory of the Syrian opposition cannot be ruled out."

Bogdanov, a deputy foreign minister and the Kremlin's special envoy for Middle East affairs, said the Syrian government was "losing control of more and more territory" and Moscow was preparing to evacuate Russian citizens if necessary.

Advancing rebels now hold an almost continuous arc of territory from the east to the southeast of Damascus, despite fierce army bombardments designed to drive them back.

The head of NATO said he thought Assad's government was nearing collapse and the new leader of Syria's opposition told Reuters the people of Syria no longer needed international forces to protect them.

"The horrific conditions which the Syrian people endured prompted them to call on the international community for military intervention at various times," said Mouaz al-Khatib, a preacher who heads Syria's National Coalition.

"Now the Syrian people have nothing to lose. They handled their problems by themselves. They no longer need international forces to protect them. The international community has been in a slumber, silent and late (to react) as it saw the Syrian people bleeding and their children killed for the past 20 months," he added in the interview on Wednesday night.

He did not specify whether by intervention he meant a no-fly zone that rebels have been demanding for month, a ground invasion - which the opposition has warned against - or arms shipments.

He said the opposition would consider any proposal from Assad to surrender power and leave the country, but would not give any assurances until it saw a firm proposal.

In the latest blow to the government, a car bomb killed at least 16 men, women and children in Qatana, a town about 25 km (15 miles) southwest of Damascus where many soldiers live, activists and state media said.

The explosion occurred in a residential area for soldiers in Qatana, which is near several army bases, said Rami Abdelrahman, head of the pro-opposition Syrian Observatory for Human Rights.

He put the death toll as 17, including seven children and two women. State news agency SANA said 16 people had died.

State television blamed the blast on "terrorists" - its term for rebels - and showed footage of soldiers walking by a partly collapsed building, with rubble and twisted metal on the road.

The attack follows three bombs at the Interior Ministry on Wednesday evening, in which state news agency SANA said five people were killed, including Abdullah Kayrouz, a member of parliament from the Syrian Social Nationalist Party.

Apart from gaining territory in the outskirts of Damascus in recent weeks, rebels have also made hit-and-run attacks or set off bombs within the capital, often targeting state security buildings or areas seen as loyal to Assad, such as Jaramana, where twin bombs killed 34 people in November.

The Pakistani Foreign Office said on Thursday security concerns had prompted it to withdraw the ambassador and all Pakistani staff from the embassy in the central suburb of East Mezzeh, a couple miles from the Interior Ministry.

BACK TO THE WALL

Insurgents launched an offensive on Damascus after a July 18 bombing that killed four of Assad's closest aides, including his feared brother-in-law Assef Shawkat, but were later pushed back.

With his back to the wall, Assad is reported to be turning ever deadlier weapons on his adversaries.

"I think the regime in Damascus is approaching collapse," NATO Secretary-General Anders Fogh Rasmussen said on Thursday.

U.S. NATO officials said on Wednesday the Syrian military had fired Scud-style ballistic missiles, which are powerful but not very accurate, against rebels in recent days.

Human Rights Watch said some populated areas had been hit by incendiary bombs, containing flammable materials such as napalm, thermite or white phosphorous, which can set fire to buildings or cause severe burns and respiratory damage.

The British-based Syrian Observatory said war planes were bombing rebel-held eastern suburbs of Damascus on Thursday and artillery was hitting Daraya and Moadamiyeh, southwestern areas near the centre where rebels have been fighting for a foothold.

At least 40,000 people have been killed in Syria's uprising, which started in March 2011 with street protests which were met with gunfire by Assad's security forces, and which spiraled into the most enduring and destructive of the Arab revolts.

The United States, European powers and Arab states bestowed their official blessing on Syria's newly-formed opposition coalition on Wednesday, despite increasing signs of Western unease at the rise of militant Islamists in the rebel ranks.

Western nations at "Friends of Syria" talks in Marrakech, Morocco rallied around a new opposition National Coalition formed last month under moderate Islamist cleric Mouaz Alkhatib.

Russia, which along with China has blocked any U.N. Security Council measures against Assad, criticized Washington's decision to grant the coalition formal recognition, saying it appeared to have abandoned any effort to reach a political solution.

Bogdanov's remarks were the clearest sign yet that Russia is preparing for the possible defeat of Assad's government.

"We are dealing with issues of preparations for an evacuation. We have mobilization plans and are clarifying where our citizens are located," Bogdanov said.

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US retail sales rebound in November

WASHINGTON: US retail sales rebounded in November, reversing October's decline as auto sales surged, the Commerce Department said on Thursday.

Retail sales rose 0.3 percent after a 0.3 percent drop the prior month.

Excluding automobile sales, up 1.4 percent after a 1.9 percent tumble in October, retail sales were unchanged from October.

The Commerce Department said that Hurricane Sandy, which wreaked havoc on the Northeast in late October and early November, had both positive and negative effects on the two months' data.

The data, which is not adjusted for price changes, showed a mixed performance across sectors in November.

Sales gains for automobiles, furniture and home furnishings, building materials, electronics and other sectors were offset by a sharp drop in gasoline sales.

Year-over-year growth in retail sales was 3.7 percent, unchanged from October.

The retail sales data, which includes restaurant and bar sales, is a key indicator of consumer spending that accounts for about 70 percent of US economic activity.

The modest rise in the headline number masked the true direction of consumer demand, said Joel Naroff of Naroff Economic Advisors.

"Gasoline prices were down sharply over the month and if you exclude them, spending increased sharply," he said.

- AFP/de

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Punish those who dirty streets: Himachal HC

SHIMLA: The green bench of Himachal Pradesh high court has ordered imposition of up to Rs.200 as fine for first-time offenders littering public spaces and asked the government to consider imposing a higher penalty.

The court, in a recent judgment, also ordered that for subsequent offences, week-long community service could be imposed as punishment.

The judgment, which could go a long way in making for cleaner streets, came as the court was hearing a petition filed by Abhishek Rai of Kullu, on the pollution of rivers Beas and Sarwari.

"The time has come for harsh measures against those members of the public who violate municipal laws. We are also of the view that penal provisions should include forcing the offender to do community service," observed Justices Deepak Gupta and Sanjay Karol in their order copies of which were made available to the media Thursday.

"Some of our citizens do not hesitate to dirty the streets and the areas around their houses, but when they go abroad they comply with all the civic laws of that country."

"Now, the time has come when the penalty for dirtying should not be less than Rs.2,500 and the government should seriously consider imposing the minimum penalty of Rs.2,500 for violation of such municipal laws."

The court directed the government to take a call on the issue by March 31 next year.

Till the government takes a decision in the matter, the court authorised the municipal councils of Kullu and Manali and the nagar panchayat of Bhuntar to levy a fine ranging from Rs.25 to Rs.200 on commission of the first offence.

"In case of a repeat offender, he can be punished by directing him to personally render community service by personally cleaning the public area in and around his premises in question under the supervision of a senior officer of the municipal council for a period of at least one week. Video of this shall be taken to be produced in the court," it said.

The bench said: "If a person continues to pollute and dirty the area outside his house or shop or other premises and does not improve despite two opportunities given to him, the municipal council can stop the provision of municipal facilities, like water etc. In case of offences relating to commercial establishments, i.e. shops etc., their licences shall be cancelled."

The court said the government might consider the framing of penal provisions to suitably deter littering.

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DA investigating Texas' troubled $3B cancer agency

AUSTIN, Texas (AP) — Turmoil surrounding an unprecedented $3 billion cancer-fighting effort in Texas worsened Tuesday when its executive director offered his resignation and the state's chief public corruption prosecutor announced an investigation into the beleaguered agency.

No specific criminal allegations are driving the latest probe into the Cancer Prevention and Research Institute of Texas, said Gregg Cox, director of the Travis County district attorney's public integrity unit. But his influential office opened a case only weeks after the embattled agency disclosed that an $11 million grant to a private company bypassed review.

That award is the latest trouble in a tumultuous year for CPRIT, which controls the nation's second-largest pot of cancer research dollars. Amid the mounting problems, the agency announced Tuesday that Executive Director Bill Gimson had submitted his letter of resignation.

"Unfortunately, I have also been placed in a situation where I feel I can no longer be effective," Gimson wrote in a letter dated Monday.

Gimson said the troubles have resulted in "wasted efforts expended in low value activities" at the agency, instead of a focused fight against cancer. Gimson offered to stay on until January, and the agency's board must still approve his request to step down.

His departure would complete a remarkable house-cleaning at CPRIT in a span of just eight months. It began in May, when Dr. Alfred Gilman resigned as chief science officer in protest over a different grant that the Nobel laureate wanted approved by a panel of scientists. He warned it would be "the bomb that destroys CPRIT."

Gilman was followed by Chief Commercialization Officer Jerry Cobbs, whose resignation in November came after an internal audit showed Cobbs included an $11 million proposal in a funding slate without a required outside review of the project's merits. The lucrative grant was given to Dallas-based Peloton Therapeutics, a biomedical startup.

Gimson chalked up Peloton's award to an honest mistake and has said that, to his knowledge, no one associated with CPRIT stood to benefit financially from the company receiving the taxpayer funds. That hasn't satisfied some members of the agency's governing board, who called last week for more assurances that no one personally profited.

Cox said he has been following the agency's problems and his office received a number of concerned phone calls. His department in Austin is charged with prosecuting crimes related to government officials; his most famous cases include winning a conviction against former U.S. House Majority Leader Tom DeLay in 2010 on money laundering charges.

"We have to gather the facts and figure what, if any, crime occurred so that (the investigation) can be focused more," Cox said.

Gimson's resignation letter was dated the same day the Texas attorney general's office also announced its investigation of the agency. Cox said his department would work cooperatively with state investigators, but he made clear the probes would be separate.

Peloton's award marks the second time this year that a lucrative taxpayer-funded grant authorized by CPRIT instigated backlash and raised questions about oversight. The first involved the $20 million grant to M.D. Anderson Cancer Center in Houston that Gilman described as a thin proposal that should have first been scrutinized by an outside panel of scientific peer-reviewers, even though none was required under the agency's rules.

Dozens of the nation's top scientists agreed. They resigned en masse from the agency's peer-review panels along with Gilman. Some accused the agency of "hucksterism" and charting a politically-driven path that was putting commercial product-development above science.

The latest shake-up at CPRIT caught Gilman's successor off-guard. Dr. Margaret Kripke, who was introduced to reporters Tuesday, acknowledged that she wasn't even sure who she would be answering to now that Gimson was stepping down. She said that although she wasn't with the agency when her predecessor announced his resignation, she was aware of the concerns and allegations.

"I don't think people would resign frivolously, so there must be some substance to those concerns," Kripke said.

Kripke also acknowledged the challenge of restocking the peer-review panels after the agency's credibility was so publicly smeared by some of the country's top scientists. She said she took the job because she felt the agency's mission and potential was too important to lose.

Only the National Institutes of Health doles out more cancer research dollars than CPRIT, which has awarded more than $700 million so far.

Gov. Rick Perry told reporters in Houston on Tuesday that he wasn't previously aware of the resignation but said Gimson's decision to step down was his own.

Joining the mounting criticism of CPRIT is the woman credited with brainstorming the idea for the agency in the first place. Cathy Bonner, who served under former Texas Gov. Ann Richards, teamed with cancer survivor Lance Armstrong in selling Texas voters in 2007 on a constitutional amendment to create an unprecedented state-run effort to finance a war on disease.

Now Bonner says politics have sullied an agency that she said was built to fund research, not subsidize private companies.

"There appears to be a cover-up going on," Bonner said.

Peloton has declined comment about its award and has referred questions to CPRIT. The agency has said the company wasn't aware that its application was never scrutinized by an outside panel, as required under agency rules.

___

Follow Paul J. Weber on Twitter: www.twitter.com/pauljweber

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Mall Gunman Wanted to Kill 'Total Strangers'

The masked gunman who opened fire in the crowded Clackamas Town Center mall in suburban Portland, Ore., killing two and seriously injuring a third before killing himself, was trying to "kill as many people as possible."

The shooter, wearing a white hockey mask, black clothing and a bullet proof vest, tore through the mall just before 3:30 p.m. Tuesday, entering through a Macy's store and heading to the food court and public areas spraying bullets, according to witness reports.

Police have identified the gunman, but have not released his name, Sheriff Craig Roberts told "Good Morning America."

"We have been able to identify the shooter over this last night," Roberts said. "I believe, at least from the information that's been provided to me at this point in time, it really was a killing of total strangers. To my knowledge at this point in time he was really trying, I think, to kill as many people as possible."

Police have not released the names of the shooter's victims. Clackamas County Sheriff's Department Lt. James Rhodes said authorities are in the process of notifying victims' families.

The injured victim, identified by hospital officials as Kristina Shevchenko, has been taken to a hospital, according to Roberts.

PHOTOS: Oregon Mall Shooting

Craig Mitchelldyer/Getty Images

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Nadia Telguz, who said she was a friend of Shevchenko, told ABC News affiliate KATU-TV in Portland that the woman was expected to recover.

"My friend's sister got shot," Teleguz told KATU. "She's on her way to (Oregon Health and Science University Hospital). They're saying she got shot in her side and so it's not life-threatening, so she'll be OK."

Witnesses from the shooting rampage said that a young man who appeared to be a teenager, ran through the upper level of Macy's to the mall food court, firing multiple shots, one right after the other, with what is believed to be a black, semi-automatic rifle.

By 4:40 p.m., police reported finding a group of people hiding in a storeroom. In a surreal moment, even the mall Santa was seen running for his life.

"I didn't know where the gunman was, so I decided to kind of eased my way out," said the mall Santa, who the AP identified as 68-year-old Brance Wilson.

More than 10,000 shoppers were at the mall during the day, according to police. Roberts said that officers responded to the scene of the shooting within minutes, and four SWAT teams swept the 1.4 million-square-foot building searching for the shooter. He was eventually found dead, an apparent suicide.

"I can confirm the shooter is dead of an apparent self-inflicted gunshot wound," Rhodes said. "By all accounts there were no rounds fired by law enforcement today in the mall."

Roberts said more than 100 law enforcement officers responded to the shooting, and the FBI and Bureau of Alcohol, Tobacco and Firearms are working with local agencies to trace the shooter's weapon.

Cell phone video shot at the scene shows the chaos soon after the shooting. When police arrived they were met head on by terrified shoppers, children and employees streaming out. Customers, even a little girl, were being lead out with their hands up.

"I think a variety of things happened that I think this could have been much, much worse," Roberts told "GMA." "And to give you some ideas, we got the call at 3:29, we had someone on scene within a minute, 30 seconds.

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North Korea launches rocket , raising nuclear arms stakes

SEOUL/TOKYO (Reuters) - North Korea successfully launched a rocket on Wednesday, boosting the credentials of its new leader and stepping up the threat the isolated and impoverished state poses to opponents.

The rocket, which North Korea says put a weather satellite into orbit, has been labeled by the United States, South Korea and Japan as a test of technology that could one day deliver a nuclear warhead capable of hitting targets as far away as the continental United States.

"The satellite has entered the planned orbit," a North Korean television news reader clad in traditional Korean garb announced, after which the station played patriotic songs with the lyrics "Chosun (Korea) does what it says".

The rocket was launched just before 10 a.m. (0100 GMT), according to defense officials in South Korea and Japan, and was more successful than a rocket launched in April that flew for less than two minutes.

The North American Aerospace Defense Command (NORAD) said that it "deployed an object that appeared to achieve orbit", the first time an independent body has verified North Korean claims.

North Korea followed what it said was a similar successful launch in 2009 with a nuclear test that prompted the U.N. Security Council to stiffen sanctions that it originally imposed in 2006 after the North's first nuclear test.

North Korea is banned from developing nuclear and missile-related technology under U.N. resolutions, although Kim Jong-un, the youthful head of state who took power a year ago, is believed to have continued the state's "military first" programs put in place by his late father, Kim Jong-Il.

North Korea hailed the launch as celebrating the prowess of all three members of the Kim family to rule since it was founded in 1948.

"At a time when great yearnings and reverence for Kim Jong-il pervade the whole country, its scientists and technicians brilliantly carried out his behests to launch a scientific and technological satellite in 2012, the year marking the 100th birth anniversary of President Kim Il Sung," its KCNA news agency said. Kim Il Sung, the current leader's grandfather, was North Korea's first leader.

The United States condemned the launch as "provocative" and a breach of U.N. rules, while Japan's U.N. envoy called for a Security Council meeting. However, diplomats say further tough sanctions are unlikely from the Security Council as China, the North's only major ally, will oppose them.

"The international community must work in a concerted fashion to send North Korea a clear message that its violations of United Nations Security Council resolutions have consequences," the White House said in a statement.

U.S. intelligence has linked North Korea with missile shipments to Iran. Newspapers in Japan and South Korea have reported that Iranian observers were in the North for the launch, something Iran has denied.

Japan's likely next prime minister, Shinzo Abe, who is leading in opinion polls ahead of an election on Sunday and who is known as a hawk on North Korea, called on the United Nations to adopt a resolution "strongly criticizing" Pyongyang.

A North Korean Foreign Ministry spokesman reiterated that the rocket was a "peaceful project".

"The attempt to see our satellite launch as a long-range missile launch for military purposes comes from hostile perception that tries to designate us a cause for security tension," KCNA cited the spokesman as saying.

"STUMBLING BLOCK"

China had expressed "deep concern" prior to the launch which was announced a day after a top politburo member, representing new Chinese leader Xi Jinping, met Kim Jong-un in Pyongyang.

On Wednesday, its tone was measured, regretting the launch but calling for restraint on any counter-measures, in line with a policy of effectively vetoing tougher sanctions.

"China believes the Security Council's response should be cautious and moderate, protect the overall peaceful and stable situation on the Korean peninsula, and avoid an escalation," Chinese Foreign Ministry spokesman Hong Lei told journalists.

Bruce Klingner, a Korea expert at the Heritage Foundation, said: "China has been the stumbling block to firmer U.N. action and we'll have to see if the new leadership is any different than its predecessors."

A senior adviser to South Korea's president said last week it was unlikely there would be action from the United Nations and Seoul would expect its allies to tighten sanctions unilaterally.

Kim Jong-un, believed to be 29 years old, took power when his father died on December 17 last year and experts believe the launch was intended to commemorate the first anniversary of his death. The April launch was timed for the centennial of the birth of Kim Il Sung.

Wednesday's success puts the North ahead of the South which has not managed to get a rocket off the ground.

"This is a considerable boost in establishing the rule of Kim Jong-un," said Cho Min, an expert at the Korea Institute of National Unification.

There have been few indications the secretive and impoverished state, where the United Nations estimates a third of people are malnourished, has made any advances in opening up economically over the past year.

North Korea remains reliant on minerals exports to China and remittances from tens of thousands of its workers overseas.

Many of its 22 million people need handouts from defectors, who have escaped to South Korea, for basic medicines.

Given the puny size of its economy - per capita income is less than $2,000 a year - one of the few ways the North can attract world attention is by emphasizing its military threat.

It wants the United States to resume aid and to recognize it diplomatically, although the April launch scuppered a planned food deal.

The North is believed to be some years away from developing a functioning nuclear warhead although it may have enough plutonium for about half a dozen nuclear bombs, according to nuclear experts.

It has also been enriching uranium, which would give it a second path to nuclear weapons as it sits on big natural uranium reserves.

"A successful launch puts North Korea closer to the capability to deploy a weaponized missile," said Denny Roy, a senior fellow at the East-West Center in Hawaii.

"But this would still require fitting a weapon to the missile and ensuring a reasonable degree of accuracy. The North Koreans probably do not yet have a nuclear weapon small enough for a missile to carry."

The North says its work is part of a civil nuclear program although it has also boasted of it being a "nuclear weapons power".

(Additional reporting by Jumin Park and Yoo Choonsik in SEOUL; David Alexander, Matt Spetalnick and Paul Eckert in WASHINGTON; Linda Sieg in TOKYO, Sui-Lee Wee and Michael Martina in BEIJING,; Rosmarie Francisco in MANILA; Writing by David Chance; Editing by Raju Gopalakrishnan and Robert Birsel)

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Fed likely to expand QE with economy still slow

WASHINGTON: Economists expect the Federal Reserve (Fed) to add to its stimulus efforts with an expanded bond-buying program Wednesday when it concludes its last policy board meeting of 2012 amid still-slow growth.

With the US economy still sluggish despite two years and hundreds of billions of US dollars of quantitative easing (QE) operations, the Federal Open Market Committee (FOMC) is expected to stick to its guns at the end of its two day meeting.

Gathering just before its "Twist" asset-swap operation expires at year-end, signs are that the FOMC will replace it with more outright bond purchases aimed at lowering interest rates to encourage businesses to invest and hire.

With unemployment still stubbornly high, inflation low, and politicians still battling over averting the looming fiscal cliff, the FOMC has all the reason it needs to expand its QE operations.

But by how much depends on just how weak or strong the Fed's top officials judge economic growth to be.

Data released on Friday showed US unemployment rates falling to 7.7 per cent in November, which while still unhealthy seems to confirm the slow but steady downtrend in the rate.

Some economists say the figure is innately weak -- and so justifying more Fed easing -- because it has fallen in a large part because of a rise in labour market dropouts, rather than from job creation.

But others argue that, having continued to fall even after the devastating Hurricane Sandy wreaked havoc on the northeast US economy in November, the jobless rate represents a tightening of the labour market, a sign of economic resilience.

How the Fed interprets the data will be clear when it releases its policy conclusions at and its economic forecasts.

With its benchmark interest rate already at a bare-bottom 0-0.25 per cent since December 2008, the Fed's main policy tool is its bond and mortgage-backed security purchases, through which it has been holding down long-term interest rates.

The cutoff of Operation Twist, which involves swapping about US$45 billion a month in short-term assets with long-term ones, will leave the Fed with only its open-ended QE3 bond purchases in place, worth US$40 billion a month.

Public comments from a number of individual Fed officials, and the minutes of the last FOMC meeting, show support for expanding those purchases to ensure liquidity remains easy.

A wild card in all this is the Washington battle over the fiscal cliff, the automatic tax hikes and sharp spending cuts that could send the country back into recession if politicians cannot compromise.

With a deadline at the end of the year, the White House and congressional Republicans appeared still far apart on an alternative deficit reduction plan that could avert the cliff.

The Fed's Beige Book survey of regional economies, compiled to help FOMC members decide their direction, showed widespread worry among businesses over the standoff.

And in late November Fed Chairman Ben Bernanke warned that the cliff's US$500 billion crunch on the economy starting from January 1 "would pose a substantial threat to the recovery."

Asked what the central bank could do, he replied: "I don't think the Fed has the tools to offset that."

That aside, economists differ on how much new QE the Fed could add: US$45 billion a month to match the value of the Twist swaps, or less if the FOMC sees the economy gaining.

"We see some risk that the new purchase program will be somewhat smaller than the US$45 billion per month widely expected," said Jim O'Sullivan of High Frequency Economics.

"The continued downtrend in the unemployment rate is a key reason we think officials might not fully replace the amount of long-term purchases under operation Twist."

The US dollar has steadily weakened since Monday ahead of the FOMC decision, losing more than one cent to the euro to US$1.3036 early Wednesday.

But David Song, a forex markets analyst at Daily FX, was bullish on the greenback.

"It seems as though the central bank is nearing the end of its easing cycle as Chairman Ben Bernanke holds an improved outlook for 2013. In light of the more broad-based recovery in the world's largest economy, Chairman Bernanke may strike a more neutral tone for monetary policy, and a shift in central bank rhetoric may pave the way for a US dollar rally."

- AFP/jc

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Fight for 'Right to Reject' after Lokpal: Hazare

VARANASI: Anna Hazare today said he will re-launch his agitation in Delhi if the government fails to bring a strong Lokpal law before 2014 and he will then focus on getting 'Right to Reject' for the people.

The Gandhian, who is on a two-day visit here along with Former Army Chief V K Singh, said this while addressing a youth meet organised by student organisation of Mahatma Gandhi Kashi Vidyapeeth.

"If the central government does not bring Lokpal soon, I will go on Satyagraha again at the Ramlila ground in New Delhi," he said.

The social activist said that after Lokpal, he plans to rally for a legislation to enact 'Right to Reject'.

Hazare said though the government had gained independence in 1947, the country still was plagued by corruption, hooliganism and loot and there was need to eliminate such features of Indian politics.

Addressing the youth, Hazare urged them to stand against such evils and join in the second fight for freedom.

"The youth can change our country for good. If the youth wants to bring change, nothing can stop them," he said.

Hazare also said that at age of 26, he had come at a crossroad when he had made all plans to commit suicide but then changed his mind and began serving the nation.

"I had decided to commit suicide when I was 26 but changed my decision and decided to give my life to the country," he told the students gathered.

It was this decision that also made him sacrifice marriage and family life, he said, however adding that he did not encourage others to follow his path.

Hazare also provided students with SMS numbers to contact them and said that they were planning on the lines of providing training to youth who plan to join their agitation.

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New tests could hamper food outbreak detection

WASHINGTON (AP) — It's about to get faster and easier to diagnose food poisoning, but that progress for individual patients comes with a downside: It could hurt the nation's ability to spot and solve dangerous outbreaks.

Next-generation tests that promise to shave a few days off the time needed to tell whether E. coli, salmonella or other foodborne bacteria caused a patient's illness could reach medical laboratories as early as next year. That could allow doctors to treat sometimes deadly diseases much more quickly — an exciting development.

The problem: These new tests can't detect crucial differences between different subtypes of bacteria, as current tests can. And that fingerprint is what states and the federal government use to match sick people to a contaminated food. The older tests might be replaced by the new, more efficient ones.

"It's like a forensics lab. If somebody says a shot was fired, without the bullet you don't know where it came from," explained E. coli expert Dr. Phillip Tarr of Washington University School of Medicine in St. Louis.

The federal Centers for Disease Control and Prevention warns that losing the ability to literally take a germ's fingerprint could hamper efforts to keep food safe, and the agency is searching for solutions. According to CDC estimates, 1 in 6 Americans gets sick from foodborne illnesses each year, and 3,000 die.

"These improved tests for diagnosing patients could have the unintended consequence of reducing our ability to detect and investigate outbreaks, ultimately causing more people to become sick," said Dr. John Besser of the CDC.

That means outbreaks like the salmonella illnesses linked this fall to a variety of Trader Joe's peanut butter might not be identified that quickly — or at all.

It all comes down to what's called a bacterial culture — whether labs grow a sample of a patient's bacteria in an old-fashioned petri dish, or skip that step because the new tests don't require it.

Here's the way it works now: Someone with serious diarrhea visits the doctor, who gets a stool sample and sends it to a private testing laboratory. The lab cultures the sample, growing larger batches of any lurking bacteria to identify what's there. If disease-causing germs such as E. coli O157 or salmonella are found, they may be sent on to a public health laboratory for more sophisticated analysis to uncover their unique DNA patterns — their fingerprints.

Those fingerprints are posted to a national database, called PulseNet, that the CDC and state health officials use to look for food poisoning trends.

There are lots of garden-variety cases of salmonella every year, from runny eggs to a picnic lunch that sat out too long. But if a few people in, say, Baltimore have salmonella with the same molecular signature as some sick people in Cleveland, it's time to investigate, because scientists might be able narrow the outbreak to a particular food or company.

But culture-based testing takes time — as long as two to four days after the sample reaches the lab, which makes for a long wait if you're a sick patient.

What's in the pipeline? Tests that could detect many kinds of germs simultaneously instead of hunting one at a time — and within hours of reaching the lab — without first having to grow a culture. Those tests are expected to be approved as early as next year.

This isn't just a science debate, said Shari Shea, food safety director at the Association of Public Health Laboratories.

If you were the patient, "you'd want to know how you got sick," she said.

PulseNet has greatly improved the ability of regulators and the food industry to solve those mysteries since it was launched in the mid-1990s, helping to spot major outbreaks in ground beef, spinach, eggs and cantaloupe in recent years. Just this fall, PulseNet matched 42 different salmonella illnesses in 20 different states that were eventually traced to a variety of Trader Joe's peanut butter.

Food and Drug Administration officials who visited the plant where the peanut butter was made found salmonella contamination all over the facility, with several of the plant samples matching the fingerprint of the salmonella that made people sick. A New Mexico-based company, Sunland Inc., recalled hundreds of products that were shipped to large retailers all over the country, including Target, Safeway and other large grocery chains.

The source of those illnesses probably would have remained a mystery without the national database, since there weren't very many illnesses in any individual state.

To ensure that kind of crucial detective work isn't lost, the CDC is asking the medical community to send samples to labs to be cultured even when they perform a new, non-culture test.

But it's not clear who would pay for that extra step. Private labs only can perform the tests that a doctor orders, noted Dr. Jay M. Lieberman of Quest Diagnostics, one of the country's largest testing labs.

A few first-generation non-culture tests are already available. When private labs in Wisconsin use them, they frequently ship leftover samples to the state lab, which grows the bacteria itself. But as more private labs switch over after the next-generation rapid tests arrive, the Wisconsin State Laboratory of Hygiene will be hard-pressed to keep up with that extra work before it can do its main job — fingerprinting the bugs, said deputy director Dr. Dave Warshauer.

Stay tuned: Research is beginning to look for solutions that one day might allow rapid and in-depth looks at food poisoning causes in the same test.

"As molecular techniques evolve, you may be able to get the information you want from non-culture techniques," Lieberman said.

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Follow Mary Clare Jalonick on Twitter at http://twitter.com/mcjalonick

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