Study questions kidney cancer treatment in elderly

In a stunning example of when treatment might be worse than the disease, a large review of Medicare records finds that older people with small kidney tumors were much less likely to die over the next five years if doctors monitored them instead of operating right away.

Even though nearly all of these tumors turned out to be cancer, they rarely proved fatal. And surgery roughly doubled patients' risk of developing heart problems or dying of other causes, doctors found.

After five years, 24 percent of those who had surgery had died, compared to only 13 percent of those who chose monitoring. Just 3 percent of people in each group died of kidney cancer.

The study only involved people 66 and older, but half of all kidney cancers occur in this age group. Younger people with longer life expectancies should still be offered surgery, doctors stressed.

The study also was observational — not an experiment where some people were given surgery and others were monitored, so it cannot prove which approach is best. Yet it offers a real-world look at how more than 7,000 Medicare patients with kidney tumors fared. Surgery is the standard treatment now.

"I think it should change care" and that older patients should be told "that they don't necessarily need to have the kidney tumor removed," said Dr. William Huang of New York University Langone Medical Center. "If the treatment doesn't improve cancer outcomes, then we should consider leaving them alone."

He led the study and will give results at a medical meeting in Orlando, Fla., later this week. The research was discussed Tuesday in a telephone news conference sponsored by the American Society of Clinical Oncology and two other cancer groups.

In the United States, about 65,000 new cases of kidney cancer and 13,700 deaths from the disease are expected this year. Two-thirds of cases are diagnosed at the local stage, when five-year survival is more than 90 percent.

However, most kidney tumors these days are found not because they cause symptoms, but are spotted by accident when people are having an X-ray or other imaging test for something else, like back trouble or chest pain.

Cancer experts increasingly question the need to treat certain slow-growing cancers that are not causing symptoms — prostate cancer in particular. Researchers wanted to know how life-threatening small kidney tumors were, especially in older people most likely to suffer complications from surgery.

They used federal cancer registries and Medicare records from 2000 to 2007 to find 8,317 people 66 and older with kidney tumors less than 1.5 inches wide.

Cancer was confirmed in 7,148 of them. About three-quarters of them had surgery and the rest chose to be monitored with periodic imaging tests.

After five years, 1,536 had died, including 191 of kidney cancer. For every 100 patients who chose monitoring, 11 more were alive at the five-year mark compared to the surgery group. Only 6 percent of those who chose monitoring eventually had surgery.

Furthermore, 27 percent of the surgery group but only 13 percent of the monitoring group developed a cardiovascular problem such as a heart attack, heart disease or stroke. These problems were more likely if doctors removed the entire kidney instead of just a part of it.

The results may help doctors persuade more patients to give monitoring a chance, said a cancer specialist with no role in the research, Dr. Bruce Roth of Washington University in St. Louis.

Some patients with any abnormality "can't sleep at night until something's done about it," he said. Doctors need to say, "We're not sticking our head in the sand, we're going to follow this" and can operate if it gets worse.

One of Huang's patients — 81-year-old Rhona Landorf, who lives in New York City — needed little persuasion.

"I was very happy not to have to be operated on," she said. "He said it's very slow growing and that having an operation would be worse for me than the cancer."

Landorf said her father had been a doctor, and she trusts her doctors' advice. Does she think about her tumor? "Not at all," she said.

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Online:

Kidney cancer info: http://www.cancer.net/cancer-types/kidney-cancer

and http://www.cancer.gov/cancertopics/types/kidney

Study: http://gucasym.org

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Marilynn Marchione can be followed at http://twitter.com/MMarchioneAP

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Wall Street ends slightly higher, Dow near a record

NEW YORK (Reuters) - Stocks closed modestly higher on Tuesday, putting the Dow within striking distance of an all-time high, as investors looked ahead to President Barack Obama's State of the Union address.

Investors will be listening to Obama's speech for any clues on a deal with Republicans to avert automatic spending cuts due to take effect March 1. The tone of the speech will also be scrutinized, with any sign of compromise likely to be warmly received.

The S&P 500 has risen for the past six weeks, putting it up 6.5 percent so far this year, while the Dow is about 1 percent away from its all-time closing record of 14,164.53, reached in October 2007.

But gains have been harder to come by since the S&P hit a five-year high on February 1. Daily moves have been small and trading volume light as investors search for new reasons to drive stocks higher.

About 5.73 billion shares changed hands on the New York Stock Exchange, the Nasdaq and NYSE MKT on Tuesday, below the daily average so far this year of about 6.48 billion shares.

"We're likely to settle in for a period and digest the gains we've had, though there's still a bias towards positive momentum," said Eric Teal, chief investment officer at First Citizens Bancshares in Raleigh, North Carolina.

"Questions over government spending are the big overhang, and we're looking for Obama to inspire some confidence over that tonight."

The White House has signaled Obama will urge investment in infrastructure and clean energy, suggesting companies in those sectors may be volatile in Wednesday's session.

"Gun makers could also see a reaction if Obama talks about anything with respect to gun control," said Teal, who helps oversee $5 billion. Shares of Smith & Wesson fell 2 cents to $9.11 while Sturm Ruger was up 0.4 percent at $53.91.

The Dow Jones industrial average <.dji> was up 47.46 points, or 0.34 percent, at 14,018.70. The Standard & Poor's 500 Index <.spx> was up 2.42 points, or 0.16 percent, at 1,519.43. The Nasdaq Composite Index <.ixic> was down 5.51 points, or 0.17 percent, at 3,186.49.

Housing shares were among the strongest of the day, led by a 12.5 percent jump in Masco Corp to $20.02 after the home improvement product maker said it expects new home construction to show strong growth in 2013. The PHLX housing sector index <.hgx> rose 3.7 percent.

Avon Products Inc surged 20 percent to $20.79 as the S&P 500's top percentage gainer after the cosmetics company reversed sales declines and cut costs.

On the downside, Coca-Cola Co fell 2.7 percent to $37.56 and was the biggest drag on the Dow after reporting revenue below estimates, hurt by a weaker-than-expected performance in Europe.

Michael Kors Holdings shares jumped 8.8 percent to $62.04 after the fashion company handily beat Wall Street's estimates and raised its full-year outlook.

With earnings season starting to wind down, Thomson Reuters data through Tuesday morning shows of the 353 companies in the S&P 500 that have reported results, 70.3 percent have exceeded analysts' expectations, above a 62 percent average since 1994 and 65 percent over the past four quarters.

Fourth-quarter earnings for S&P 500 companies are estimated to have risen 5.3 percent, according to the data, above a 1.9 percent forecast at the start of the earnings season.

About 62 percent of stocks traded on the New York Stock Exchange closed higher while 59 percent of Nasdaq-listed shares closed in positive territory.

(Editing by Nick Zieminski)

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Syrian Insurgents Claim to Control Large Hydropower Dam

BEIRUT, Lebanon — Syrian insurgents and opposition activists said Monday that rebel forces had taken control of Syria’s largest hydroelectric dam, an assertion that, if confirmed, would give them significant control over a vital reservoir and what remains of the sporadic power supplies in their war-ravaged country.

The Tabqa Dam, built more than 40 years ago with Russian help on the Euphrates River in northeast Syria’s Raqqa Province, provides electricity to areas that are both in rebel and loyalist hands, including the contested city of Aleppo, and would be the third Euphrates dam taken by the rebels, who control two smaller facilities upriver.

But the Tabqa Dam, which the government once boasted had made Syria self-sufficient in power generation, is considered a more potent weapon in the battle for allegiances in the nearly two-year-old Syria conflict. Rebel-held areas have been systematically denied electricity by President Bashar al-Assad’s forces in their effort to turn the population against the insurgency.

Claims that the Tabqa Dam was now in rebel control came as a possible new confrontation was brewing between Turkey and Syria after a Syrian minivan exploded just inside Turkish territory at Cilvegozu, an important border crossing near the rebel-held Syrian town of Bab al-Hawa. The blast killed at least 13 people, including 3 Turkish civilians; wounded at least 28; and damaged at least 19 vehicles.

The Turkish fatalities were believed to be the first related to the Syrian conflict since October, when a Syrian mortar shell killed five Turks near the border-crossing town of Akcakale, Turkey, eliciting a warning of retaliation by the Turkish government.

Turkey’s deputy prime minister, Bulent Arinc, did not rule out a bombing or suicide attack as the cause of the Cilvegozu explosion, and said all possibilities were under investigation at the border post in southern Turkey’s Hatay Province. But Syrian rebels, who get military and financial support from Turkey, quickly blamed Mr. Assad’s government for the explosion. Turkey, which hosts nearly 200,000 Syrian refugees, has repeatedly warned Mr. Assad’s government that it would not tolerate attacks along the 550-mile border.

Reports by rebel commanders and by the Syrian Observatory for Human Rights, an opposition group based in Britain with a network of contacts in Syria, said insurgents had met little resistance as they swept into the Tabqa area on Sunday, seizing the dam and setting fire to an imposing statue of President Assad’s father and predecessor, Hafez, in the city of Tabqa.

The reservoir created by the dam, known as Lake Assad, is Syria’s largest and is vital for irrigating area farms and supplying drinking water to Aleppo.

The Syrian government did not confirm the insurgent claims. But videos uploaded on the Internet by insurgents appeared to corroborate they were in control of areas inside and outside the dam, although not necessarily the control room. One rebel fighter was quoted as saying the insurgents intended to divert power from the dam to rebel-held areas.

“We will cut all sources for the regime,” said the fighter, who identified himself by a first name, Nawaf.

He said that rebels also had taken control of large areas of Tabqa, including a military police barracks, an air force facility and an artillery base, seizing weapons and ammunition, and that they did not intend to damage any infrastructure.

“The Shabiha says, ‘Assad or burn the country,’ ” he said, using the term for the feared plainclothes pro-government militias. “We say, ‘We will burn Assad and keep the country.’ ”

The Syrian Observatory for Human Rights, which had a similar account of events, also said rebel fighters had seized control of three neighborhoods that housed dam workers.

“The regime forces showed no resistance, while heads of security branches escaped using helicopters through Al Tabqa military airport,” the Observatory said in a statement. “The small town embodies the diverse Syrian society, as it has residents from different sects and ethnicities. The fighters have pledges not to harm any of the citizens.”

Fighters in the operation included members of the al-Nusra Front, the Islamic militant group that has developed a reputation for its fearless attacks on Mr. Assad’s military but has emerged as a problem for the United States. The United States wants to aid the insurgency but considers Al Nusra a terrorist organization with ties to Al Qaeda in Iraq.

Hwaida Saad reported from Beirut, and Rick Gladstone from New York. Reporting was contributed by Anne Barnard in Beirut; Sebnem Arsu and David D. Kirkpatrick in Gaziantep, Turkey; and an employee of The New York Times in Damascus, Syria.

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It's a Girl for John Cho

Mom & Babies
Celebrity Baby Blog

02/11/2013 at 06:30 PM ET

Paul Drinkwater/NBC

Surprise: Actor John Cho is a dad again!

The Go On star and his wife welcomed a daughter recently, Cho’s rep confirms to PEOPLE exclusively.

Baby girl is the second child for the couple, who are also parents to a son. No further details are available.

Cho currently stars alongside Jason Bateman in Identity Thief and will reprise his role as Hikaru Sulu in Star Trek Into Darkness in May.

He is also well known for his roles in American Pie and the Harold and Kumar films.

– Anya Leon with reporting by Julie Jordan

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Pope shows lifetime jobs aren't always for life

The world seems surprised that an 85-year-old globe-trotting pope who just started tweeting wants to resign, but should it be? Maybe what should be surprising is that more leaders his age do not, considering the toll aging takes on bodies and minds amid a culture of constant communication and change.

There may be more behind the story of why Pope Benedict XVI decided to leave a job normally held for life. But the pontiff made it about age. He said the job called for "both strength of mind and body" and said his was deteriorating. He spoke of "today's world, subject to so many rapid changes," implying a difficulty keeping up despite his recent debut on Twitter.

"This seemed to me a very brave, courageous decision," especially because older people often don't recognize their own decline, said Dr. Seth Landefeld, an expert on aging and chairman of medicine at the University of Alabama at Birmingham.

Age has driven many leaders from jobs that used to be for life — Supreme Court justices, monarchs and other heads of state. As lifetimes expand, the woes of old age are catching up with more in seats of power. Some are choosing to step down rather than suffer long declines and disabilities as the pope's last predecessor did.

Since 1955, only one U.S. Supreme Court justice — Chief Justice William Rehnquist — has died in office. Twenty-one others chose to retire, the most recent being John Paul Stevens, who stepped down in 2010 at age 90.

When Thurgood Marshall stepped down in 1991 at the age of 82, citing health reasons, the Supreme Court justice's answer was blunt: "What's wrong with me? I'm old. I'm getting old and falling apart."

One in 5 U.S. senators is 70 or older, and some have retired rather than seek new terms, such as Hawaii's Daniel Akaka, who left office in January at age 88.

The Netherlands' Queen Beatrix, who just turned 75, recently said she will pass the crown to a son and put the country "in the hands of a new generation."

In Germany, where the pope was born, Chancellor Angela Merkel, who is 58, said the pope's decision that he was no longer fit for the job "earns my very highest respect."

"In our time of ever-lengthening life, many people will be able to understand how the pope as well has to deal with the burdens of aging," she told reporters in Berlin.

Experts on aging agreed.

"People's mental capacities in their 80s and 90s aren't what they were in their 40s and 50s. Their short-term memory is often not as good, their ability to think quickly on their feet, to execute decisions is often not as good," Landefeld said. Change is tougher to handle with age, and leaders like popes and presidents face "extraordinary demands that would tax anybody's physical and mental stamina."

Dr. Barbara Messinger-Rapport, geriatrics chief at the Cleveland Clinic, noted that half of people 85 and older in developed countries have some dementia, usually Alzheimer's. Even without such a disease, "it takes longer to make decisions, it takes longer to learn new things," she said.

But that's far from universal, said Dr. Thomas Perls, an expert on aging at Boston University and director of the New England Centenarians Study.

"Usually a man who is entirely healthy in his early 80s has demonstrated his survival prowess" and can live much longer, he said. People of privilege have better odds because they have access to good food and health care, and tend to lead clean lives.

"Even in the 1500s and 1600s there were popes in their 80s. It's remarkable. That would be today's centenarians," Perls said.

Arizona Sen. John McCain turned 71 while running for president in 2007. Had he won, he would have been the oldest person elected to a first term as president. Ronald Reagan was days away from turning 70 when he started his first term as president in 1981; he won re-election in 1984. Vice President Joe Biden just turned 70.

In the U.S. Senate, where seniority is rewarded and revered, South Carolina's Strom Thurmond didn't retire until age 100 in 2002. Sen. Robert Byrd of West Virginia was the longest-serving senator when he died in office at 92 in 2010.

Now the oldest U.S. senator is 89-year-old Frank Lautenberg of New Jersey. The oldest congressman is Ralph Hall of Texas who turns 90 in May.

The legendary Alan Greenspan was about to turn 80 when he retired as chairman of the Federal Reserve in 2006; he still works as a consultant.

Elsewhere around the world, Cuba's Fidel Castro — one of the world's longest serving heads of state — stepped down in 2006 at age 79 due to an intestinal illness that nearly killed him, handing power to his younger brother Raul. But the island is an example of aged leaders pushing on well into their dotage. Raul Castro now is 81 and his two top lieutenants are also octogenarians. Later this month, he is expected to be named to a new, five-year term as president.

Other leaders who are still working:

—England's Queen Elizabeth, 86.

—Abdullah bin Abd al-Aziz al-Saud, king of Saudi Arabia, 88.

—Sabah al-Ahmad al-Jaber al-Sabah, emir of Kuwait, 83.

—Ruth Bader Ginsburg, U.S. Supreme Court associate justice, 79.

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Associated Press writers Paul Haven in Havana, Cuba; David Rising in Berlin; Seth Borenstein, Mark Sherman and Matt Yancey in Washington, and researcher Judy Ausuebel in New York contributed to this report.

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Marilynn Marchione can be followed at http://twitter.com/MMarchioneAP

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Wall Street ends flat as investors seek new catalysts

NEW YORK (Reuters) - Stocks ended a quiet session with slight moves on Monday as investors found few reasons to keep pushing shares higher following a six-week advance, though the longer-term trend was still viewed as positive.

The benchmark index is up more 6.4 percent in 2013, putting both the S&P 500 and Dow industrials near multi-year highs. The S&P is less than 4 percent from its all-time intraday high of 1,576.09, hit in October 2007.

"This is still a market that looks terrific, but when you're up for six weeks in a row, everyone is going to want to take a pause going into the seventh week even if there is no bad news out there," said Eric Kuby, chief investment officer at North Star Investment Management in Chicago.

Volume was light, with about 4.812 billion shares changing hands on the New York Stock Exchange, the Nasdaq and NYSE MKT, well below the daily average so far this year of about 6.48 billion shares.

Wall Street was modestly lower throughout the session but regained some ground in the final hour of trading as Google Inc rebounded off earlier losses. Shares of the Internet search giant dipped 0.4 percent to $782.42, recovering from earlier declines of 1 percent after the company said in a filing former chief executive Eric Schmidt is selling roughly 42 percent of his stake in the company.

Also in the tech space, Apple Inc rose up 1 percent to $479.93 after the New York Times reported the iPhone maker was experimenting with the design of a device similar to a wristwatch.

The Federal Reserve's Vice Chair Janet Yellen, seen as a potential successor to Fed Chairman Ben Bernanke next year, said the Fed is still aggressively stimulating an anemic U.S. economic recovery that has failed to bring rapid progress on employment.

The Dow Jones industrial average <.dji> was down 21.81 points, or 0.16 percent, at 13,971.16. The Standard & Poor's 500 Index <.spx> was down 0.92 points, or 0.06 percent, at 1,517.01. The Nasdaq Composite Index <.ixic> was down 1.87 points, or 0.06 percent, at 3,192.00.

Upbeat U.S. and Chinese data last week helped the S&P 500 extend its weekly winning streak to six. The index gained about 8 percent over that period.

Equities have been strong performers lately and many investors have used any declines in the market as opportunities to buy.

"Everyone wants to buy on a dip in this market, but if you're on the sidelines right now, the decline we're seeing today just isn't the kind you would jump in on," Kuby said.

President Barack Obama will describe his plan for spurring the economy in his State of the Union address on Tuesday. He is expected to offer proposals for investment in infrastructure, manufacturing, clean energy and education.

Opposition has grown to the $24.4 billion buyout of Dell Inc , the No. 3 personal computer maker, as three of the largest investors joined Southeastern Asset Management on Friday in raising objections. Dell said in a regulatory filing it had considered many strategic options before opting to go private in a buyout led by Chief Executive Michael Dell.

Dell shares hovered near $13.65, the buyout offer price.

Regeneron Pharmaceuticals Inc shares rose 2.7 percent at $170.35 after it said longtime drug development partner Sanofi plans to boost its stake.

Moody's Corp was one of the strongest percentage gainers on the S&P 500, rising 4.9 percent to $45.49. Last week the stock plunged 22 percent after the U.S. government launched a civil lawsuit against the company. The sell-off marked the stock's worst week since October 2008.

About 53 percent of stocks traded on the New York Stock Exchange closed lower while slightly more Nasdaq-listed stocks closed in negative territory.

(Editing by Nick Zieminski)

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Syrian War Closes In on the Heart of Damascus

DAMASCUS, Syria — Unkempt government soldiers, some appearing drunk, have deployed near a rebel-held railway station in the southern reaches of this tense capital. Office workers on 29th of May Street, in the heart of the city, tell of huddling at their desks, trapped inside for hours by gun battles that sound alarmingly close.

Soldiers have swept through city neighborhoods, making arrests ahead of a threatened rebel advance downtown, even as opposition fighters edge past the city limits, carrying mortars and shelling security buildings. Fighter jets that pounded the suburbs for months have begun to strike Jobar, an outlying neighborhood of Damascus proper, creating the disturbing spectacle of a government’s bombing its own capital.

On Sunday, the government sent tanks there to battle rebels for control of a key ring road.

In this war of murky battlefield reports, it is hard to know whether the rebels’ recent forays past some of the capital’s circle of defenses — in an operation that they have, perhaps immodestly, named the “Battle of Armageddon” — will lead to more lasting gains than earlier offensives did. But travels along the city’s battlefronts in recent days made clear that new lines, psychological as much as geographical, had been crossed.

“I didn’t see my family for more than a year,” a government soldier from a distant province said in a rare outpouring of candor. He was checking drivers’ identifications near the railway station at a checkpoint where hundreds of soldiers arrived last week with tanks and other armored vehicles.

“I am tired and haven’t slept well for a week,” he said, confiding in a traveler who happened to be from his hometown. “I have one wish — to see my family and have a long, long sleep. Then I don’t care if I die.”

For months, this ancient city has hunched in a defensive crouch as fighting raged in suburbs that curve around the city’s south and east. On the western edge of the city, the palace of the embattled president, Bashar al-Assad, sits on a steep, well-defended ridge.

In between, Damascus, with its walled Old City, grand diagonal avenues and crowded working-class districts, has remained the eye of the storm. People keep going to work, even as electric service becomes sporadic and groceries dwindle, even as the road to the airport is often cut off by fighting outside the city, and even as smoke from artillery and airstrikes in nearby suburbs becomes a regular feature on the horizon.

But after rebels took the railway station 10 days ago in a city district called Qadam and attacked Abassiyeen Square on an approach to the city center on Wednesday, a new level of alarm and disorder has suffused the city. Rebels have pushed farther into the capital than at any point since July, when they briefly held part of a southern neighborhood.

Near the Qadam railway station last week, many of the government soldiers, their hair and beards untrimmed, wore disheveled or dirty uniforms and smelled as if they had not had showers in a long time. Some soldiers and security officers even appeared drunk, walking unsteadily with their weapons askew — a shocking sight in Syria, where regimented security forces and smartly uniformed officers have long been presented as a symbol of national pride.

The deployment appeared aimed at stopping the rebels from advancing past Qadam, either across the city’s ring road and toward the downtown or to suburbs to the east to close a gap in the opposition’s front line.

But even stationed here in Damascus, the heart of the government’s power, the soldier at the checkpoint — who was steady on his feet — said he felt vulnerable.

“It is very scary to spend a night and you expect to be shot or slaughtered at any moment,” he said. “We spend our nights counting the minutes until daytime.”

The government has hit back hard, striking Qadam with artillery and airstrikes, and making pre-emptive arrests in Midan, the neighboring district, closer to downtown, where rebels gained a temporary foothold in July and which they said was their next target in this latest offensive. Soldiers summarily executed four people in Qadam on Friday, according to the Local Coordinating Committees, an anti-Assad activist network, though it was unclear if the victims were would-be military defectors or captured rebels.

On a recent journey along the front line, a traveler saw soldiers speaking harshly to residents at checkpoints outside Yarmouk Camp, a long-contested area east of Qadam that is home to both Syrians and Palestinian refugees, who have lived there for decades. Rebels took over much of the camp in December, drawing government airstrikes that drove out most residents. But about 20 percent of those people appear to have returned, in part, they said, because the government had attacked another refugee camp where they had taken shelter.

A Palestinian refugee who gave only a nickname, Abu Muhammad, was carrying a sack of bread into the camp. He said that he had started out with three sacks for his wife and three sons, but that officers — he said they were from Mr. Assad’s Alawite sect — had shouted at him and confiscated two sacks, accusing him of taking bread to the rebels.

The government is pressuring Palestinians to take the camp back from the rebels, Abu Muhammad said. He said that was an absurd demand from a government that bombed its own people but made no response to last month’s airstrike by Israel. “Why doesn’t the regime send its ‘hero’ army to liberate the camp?” he said.

Another center of recent fighting is just northeast of the city. Rebels who have taken over much of the suburb of Qaboun recently pushed across the ring road there into the city neighborhood of Jobar. From there, said Abu Omar al-Jobrani, a leader of fighters in the area, they moved mortars close enough to attack a munitions factory and air force security headquarters near Abassiyeen Square, a roundabout that is near a major stadium and that provides access to downtown.

Reports of rebel strikes on Wednesday on such a central landmark, which appeared to be backed up by videos showing black smoke pouring across the plaza, raised new fears in the capital. The government closed the roads around the square, causing traffic jams deep into downtown, and sent dozens of security men to protect the Parliament building. Terrified residents of the centrally located Old City closed their shops.

Fighting continued over the weekend, as the government and rebels fought for control of the ring road near Jobar. Shells and airstrikes kept raining on the neighborhood, sending dust and smoke into the air, higher than the minarets on its mosques.

Anne Barnard reported from Beirut, Lebanon.

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Jennifer Lopez Rocks A Slit-Up-To-There Grammy Gown

By Tim Nudd

02/10/2013 at 07:45 PM EST

If Jennifer Lopez passes the Grammy Awards dress code this year, it will be on a technicality.

The pop star showed plenty of leg (even more than Angelina Jolie at last year's Oscars!) in her black Anthony Vaccarello dress. And she told Ryan Seacrest on the red carpet that she felt she was in the clear, at least when it comes to particular body parts.

"They didn't say anything about legs!" said Lopez, 43. "I thought I was being such a good girl."

Stars have been warned to cover up certain body parts this year. But Lopez is correct – there was no mention of legs in the CBS email.

The star hasn't always been such a good girl in the past at the Grammys, having worn one of the show's most notorious numbers – a plunging Versace dress – back in 2000.

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After early start, worst of flu season may be over

NEW YORK (AP) — The worst of the flu season appears to be over.

The number of states reporting intense or widespread illnesses dropped again last week, and in a few states there was very little flu going around, U.S. health officials said Friday.

The season started earlier than normal, first in the Southeast and then spreading. But now, by some measures, flu activity has been ebbing for at least four weeks in much of the country. Flu and pneumonia deaths also dropped the last two weeks, the Centers for Disease Control and Prevention reported.

"It's likely that the worst of the current flu season is over," CDC spokesman Tom Skinner said.

But flu is hard to predict, he and others stressed, and there have been spikes late in the season in the past.

For now, states like Georgia and New York — where doctor's offices were jammed a few weeks ago — are reporting low flu activity. The hot spots are now the West Coast and the Southwest.

Among the places that have seen a drop: Lehigh Valley Hospital-Cedar Crest in Allentown, Pa., which put up a tent outside its emergency room last month to help deal with the steady stream of patients. There were about 100 patients each day back then. Now it's down to 25 and the hospital may pack up its tent next week, said Terry Burger, director of infection control and prevention for the hospital.

"There's no question that we're seeing a decline," she said.

In early December, CDC officials announced flu season had arrived, a month earlier than usual. They were worried, saying it had been nine years since a winter flu season started like this one. That was 2003-04 — one of the deadliest seasons in the past 35 years, with more than 48,000 deaths.

Like this year, the major flu strain was one that tends to make people sicker, especially the elderly, who are most vulnerable to flu and its complications

But back then, that year's flu vaccine wasn't made to protect against that bug, and fewer people got flu shots. The vaccine is reformulated almost every year, and the CDC has said this year's vaccine is a good match to the types that are circulating. A preliminary CDC study showed it is about 60 percent effective, which is close to the average.

So far, the season has been labeled moderately severe.

Like others, Lehigh Valley's Burger was cautious about making predictions. "I'm not certain we're completely out of the woods," with more wintry weather ahead and people likely to be packed indoors where flu can spread around, she said.

The government does not keep a running tally of flu-related deaths in adults, but has received reports of 59 deaths in children. The most — nine — were in Texas, where flu activity was still high last week. Roughly 100 children die in an average flu season, the CDC says

On average, about 24,000 Americans die each flu season, according to the CDC.

According to the CDC report, the number of states with intense activity is down to 19, from 24 the previous week, and flu is widespread in 38 states, down from 42.

Flu is now minimal in Florida, Kentucky, Maine, Montana, New Hampshire and South Carolina.

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Online:

CDC: http://www.cdc.gov/flu/

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US Air, AMR near $11 billion merger, deal seen within week : sources

NEW YORK (Reuters) - US Airways Group Inc and AMR Corp are nearing an $11 billion merger that would create the world's largest airline and could announce a deal within a week, after resolving key differences on valuation and management structure, people familiar with the matter said.

Under terms of a deal that are still being finalized, US Airways Chief Executive Doug Parker would become CEO, while AMR's Tom Horton would serve as non-executive chairman of the board until spring of 2014, when the combined company holds its first annual meeting, the sources said.

The deal would come more than 14 months after the parent of American Airlines filed for bankruptcy in November 2011, and would mark the last combination of legacy U.S. carriers, following the Delta-Northwest and United-Continental mergers.

The all-stock merger is expected to value the combined carrier at between $10.5 billion and $11 billion, and would give AMR creditors 72 percent of the ownership in the new company and US Airways shareholders the rest, they said.

The board of each airline is expected to meet in the middle of the coming week to vote on the proposed deal, and an announcement would likely come in the latter part of the week, the sources said, asking not to be named because the matter is not public.

Negotiations are continuing and could still be delayed or fall apart, they cautioned.

The companies had initially tried to schedule board meetings for Monday, the day that AMR's creditors committee planned to convene, and had aimed to announce a deal as soon as Tuesday, sources told Reuters previously.

But AMR needed more time to finalize details and the boards of the two airlines are now not expected to gather until around Wednesday, the sources said.

The AMR creditors committee is still meeting on Monday in New York, as initially scheduled, and will continue discussions as the airlines finalize negotiations, they added.

A lawyer for the creditors committee declined to comment. Representatives for AMR and US Airways declined to comment.

A combination with US Airways would create the world's top airline by passenger traffic and help the two carriers better compete with rivals United Continental Holdings and Delta Air Lines Inc .

A near-$11 billion valuation of the combined American-US Airways compares to some $12.4 billion market capitalization for Delta, and $8.7 billion for United Continental.

The currently planned equity split ratio between AMR creditors and US Airways shareholders implies a roughly $3 billion valuation for US Airways and some $7.5 billion to $8 billion valuation for AMR.

NEW AMERICAN AIRLINES

US Airways will follow through on its agreement with AMR labor unions last year that the combined carrier would be branded American Airlines and be based in Fort Worth, Texas, where AMR is currently based, sources said. US Airways has its headquarters in Tempe, Arizona.

As part of the merger, US Airways will also leave the Star Alliance to join the oneworld global airline alliance, of which American Airlines is an anchor member along with British Airways, the people familiar with the matter said.

The airlines are estimating that a merger will bring about $1 billion in revenue and cost benefits, they said.

Horton rebuffed an aggressive takeover push from US Airways early in the bankruptcy process, saying the airline preferred to exit court protection on its own and consider a deal later. But after several months of talks with its own creditors as well as with US Airways, Horton has softened his approach and agreed to consider all options.

A combined American-US Airways would provide the scale to match bigger rivals that are upgrading service and expanding international routes. The merged company would have revenue of $38.69 billion based on 2012 figures, ahead of United Continental which had revenue of $37.15 billion last year.

The new American would have a solid presence on the important U.S. East and West coasts and on North Atlantic routes, given American's revenue-sharing joint venture with British Airways and Iberia.

(Reporting by Soyoung Kim in New York, additional reporting by Nick Brown and Karen Jacobs; Editing by Sandra Maler)

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