Flu season strikes early and, in some places, hard

NEW YORK (AP) — From the Rocky Mountains to New England, hospitals are swamped with people with flu symptoms. Some medical centers are turning away visitors or making them wear face masks, and one Pennsylvania hospital set up a tent outside its ER to deal with the feverish patients.

Flu season in the U.S. has struck early and, in many places, hard.

While flu normally doesn't blanket the country until late January or February, it is already widespread in more than 40 states, with about 30 of them reporting some major hot spots. On Thursday, health officials blamed the flu for the deaths of 20 children so far.

Whether this will be considered a bad season by the time it has run its course in the spring remains to be seen.

"Those of us with gray hair have seen worse," said Dr. William Schaffner, a flu expert at Vanderbilt University in Nashville.

The evidence so far points to a moderate season, Schaffner and others say. It looks bad in part because last year was unusually mild and because the main strain of influenza circulating this year tends to make people sicker and really lay them low.

David Smythe of New York City saw it happen to his 50-year-old girlfriend, who has been knocked out for about two weeks. "She's been in bed. She can't even get up," he said.

Also, the flu's early arrival coincided with spikes in a variety of other viruses, including a childhood malady that mimics flu and a new norovirus that causes vomiting and diarrhea, or what is commonly known as "stomach flu." So what people are calling the flu may, in fact, be something else.

"There may be more of an overlap than we normally see," said Dr. Joseph Bresee, who tracks the flu for the Centers for Disease Control and Prevention.

Most people don't undergo lab tests to confirm flu, and the symptoms are so similar that it can be hard to distinguish flu from other viruses, or even a cold. Over the holidays, 250 people were sickened at a Mormon missionary training center in Utah, but the culprit turned out to be a norovirus, not the flu.

Flu is a major contributor, though, to what's going on.

"I'd say 75 percent," said Dr. Dan Surdam, head of the emergency department at Cheyenne Regional Medical Center, Wyoming's largest hospital. The 17-bed emergency room saw its busiest day ever last week, with 166 visitors.

The early onslaught has resulted in a spike in hospitalizations. To deal with the influx and protect other patients from getting sick, hospitals are restricting visits from children, requiring family members to wear masks and banning anyone with flu symptoms from maternity wards.

One hospital in Allentown, Pa., set up a tent this week for a steady stream of patients with flu symptoms. But so far "what we're seeing is a typical flu season," said Terry Burger, director of infection control and prevention for the hospital, Lehigh Valley Hospital-Cedar Crest.

On Wednesday, Boston declared a public health emergency, with the city's hospitals counting about 1,500 emergency room visits since December by people with flu-like symptoms.

All the flu activity has led some to question whether this year's flu shot is working. While health officials are still analyzing the vaccine, early indications are that it's about 60 percent effective, which is in line with what's been seen in other years.

The vaccine is reformulated each year, based on experts' best guess of which strains of the virus will predominate. This year's vaccine is well-matched to what's going around. The government estimates that between a third and half of Americans have gotten the vaccine.

In New York City, 57-year-old Judith Quinones skipped getting a flu shot this season and suffered her worst case of flu-like illness in years. She was laid up for nearly a month with fever and body aches. "I just couldn't function," she said.

But her daughter got the vaccine. "And she got sick twice," Quinones said.

Europe is also suffering an early flu season, though a milder strain predominates there. Flu reports are up, too, in China, Japan, the West Bank, the Gaza Strip, Algeria and the Republic of Congo. Britain has seen a surge in cases of norovirus.

On average, about 24,000 Americans die each flu season, according to the CDC. That's an estimate — the agency does not keep a running tally of adult flu deaths each year, only for children. Some state health departments do keep count, and they've reported dozens of flu deaths so far.

Flu usually peaks in midwinter. Symptoms can include fever, cough, runny nose, head and body aches and fatigue. Some people also suffer vomiting and diarrhea, and some develop pneumonia or other severe complications.

Most people with flu have a mild illness and can help themselves and protect others by staying home and resting. But people with severe symptoms should see a doctor. They may be given antiviral drugs or other medications to ease symptoms.

Flu vaccinations are recommended for everyone 6 months or older. Of the 20 children killed by the flu this season, only two were fully vaccinated.

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AP Medical Writer Maria Cheng in London contributed to this report.

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Online:

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

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Jodi Arias: 'No Jury Will Convict Me' for Murder

The jury in the Jodi Arias murder trial watched a television interview today in which Arias said "no jury will convict me" for killing her ex-boyfriend, Travis Alexander.

Arias added that she could never imagine committing such a violent act as killing Alexander.

"I understand all the evidence is really compelling," she said in the interview. "In a nutshell, two people came in and killed Travis. I've never even shot a gun. That's heinous. I can't imagine slitting anyone's throat."

She went on to tell the interviewer, "No jury will convict me and you can mark my words on that. ... I am innocent."

Arias made the statements to the television show "Inside Edition" after she was indicted for murdering Alexander. Months later, she would confess to killing him in his Mesa, Ariz., home and say it was in self-defense.

Jodi Arias Trial: Watch Live

Jodi Arias Murder Trial: Full Coverage

Photos of Key Players and Evidence in the Jodi Arias Murder Trial

The tape was played on the fifth day of testimony in Arias' trial, in which police allege that she carried out the murder with such brutal force that she stabbed Alexander 27 times, slashed his throat from ear to ear, and shot him in the head.

Arias, now 32, has claimed Alexander was a controlling and abusive "sexual deviant" who she was forced to kill in self-defense.

She could face the death penalty if convicted of Alexander's murder.

Jodi Arias Trial: Jurors See Photos of Bloody Handprint Watch Video

Jodi Arias Murder Trial: Who Is the Alleged Killer? Watch Video

Jodi Arias Trial: Defense Claims Victim Was Sex Deviant Watch Video

The defense petitioned the court to declare a mistrial at the end of testimony today, but the request was denied by Judge Sherry Stephens. Arias' attorneys claimed that testimony presented by Det. Esteban Flores about whether Arias shot Alexander first or at the end of the attack was different from his earlier testimony and, therefore, affected whether Arias was "especially cruel" during the killing -- but Stephens denied that it had any effect.

The jury also watched as dozens of photos of blood-spattered walls, flooring, stained carpets and blood smeared sink were explained in detail by a forensic analyst from the Mesa Police Department, who noted that on many of the stains water had been mixed with the blood and diluted it.

The prosecution has alleged that Arias tried to wash away the evidence of the killing with water.

Prosecutors spent much of today and Wednesday using Arias' recorded statements and other testimony to prove that she lied about her relationship with Alexander, where she was when Alexander was killed, and even where she worked as a bartender.

The testimony today suggested that Arias lied to her new boyfriend Ryan Burns about working at a bar called Margaritaville in her hometown of Yreka, Calif.

"Is there any restaurant in Yreka called Margaritaville? Has there ever been?" prosecutor Juan Martinez asked Nathaniel Mendes, a former detective with the Siskiyou County Sheriff's Office in California.

"No, sir," Mendes replied.

Mendes testified that Arias worked at a restaurant called Casa Ramos in Yreka, not a bar called Margaritaville, as she told Burns.

Mendes also went over receipts showing that Arias rented a car the day before she killed Alexander, and noted that she went to a rental outfit 90 miles from her hometown despite two businesses that rented cars in Yreka.

Arias told friends and investigators that she rented a car to go on a road trip to visit Burns, in West Jordan, Utah, on June 3, 2008. She showed up at Burns' house a day late with cuts on her hands, but told Burns that she got lost driving and that the cuts were from broken glass at her Margaritaville bartending job, according to Burns' testimony Wednesday.

The trail of receipts showed that Arias drove from California to Alexander's hometown of Mesa, Ariz., on Tuesday, June 4, 2008.

There, the pair had sex and took sexually graphic photos of one another, according to photographs and the opening statement of Arias' lawyer. Shortly after the tryst, Arias killed Alexander, both sides agree.

Burns testified that Arias never mentioned going to Alexander's house when she arrived at his home in Utah. He said he did not know that Arias and Alexander were still sexually involved, and that she told him they had broken up.

When she arrived at his home 24 hours after killing Alexander, she seemed "normal," he said. The pair kissed and cuddled, and went out with Burns' friends, where she laughed and made conversation.

Prosecutors have played recorded phone conversations between detectives and Arias in the weeks after Alexander's body was found. She could be heard apparently lying multiple times to investigators as they asked about the last time she spoke with Alexander and her trip to Utah.

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String of bombings kill 101, injure 200 in Pakistan

QUETTA, Pakistan (Reuters) - At least 101 people were killed in bombings in two Pakistani cities on Thursday in one of the country's bloodiest days in recent years, officials said, with most casualties caused by sectarian attacks in Quetta.

The bombings underscored the myriad threats Pakistani security forces face from homegrown Sunni extremist groups, the Taliban insurgency in the northwest and the less well-known Baloch insurgency in the southwest.

On Thursday evening, two coordinated explosions killed at least 69 people and injured more than 100 in Quetta, the provincial capital of Balochistan, said Deputy Inspector of Police Hamid Shakil.

The first attack, in a crowded snooker hall, was a suicide bombing, local residents said. About ten minutes later, a car bomb exploded, they said. Five policemen and a cameraman were among the dead from that blast.

The attacks happened in a predominately Shia neighborhood and banned sectarian group Lashkar-e-Jhangvi claimed responsibility. The extremist Sunni group targets Shias, who make up about 20 percent of Pakistani's population.

Targeted killings and bombings of Shia communities are common in Pakistan, and rights groups say hundreds of Shia were killed last year. Militant groups in Balochistan frequently bomb or shoot Shia passengers on buses travelling to neighboring Iran.

The killers are rarely caught and some Shia activists say militants work alongside elements of Pakistan's security forces, who see them as a potential bulwark against neighboring India.

Many Pakistanis fear their nation could become the site of a regional power struggle between Saudi Arabia, source of funding for Sunni extremist groups, and Iran, which is largely Shia.

But sectarian tensions are not the only source of violence.

The United Baloch Army claimed responsibility for a blast in Quetta's market earlier in the day. It killed 11 people and injured more than 40, mostly vegetable sellers and secondhand clothes dealers, police officer Zubair Mehmood said. A child was also killed.

The group is one of several fighting for independence for Balochistan, an arid, impoverished region with substantial gas, copper and gold reserves, which constitutes just under half of Pakistan's territory and is home to about 8 million of the country's population of 180 million.

SWAT BOMBING

In another incident Thursday, 21 were killed and more than 60 injured in a bombing when people gathered to hear a religious leader speak in Mingora, the largest city in the northwestern province of Swat, police and officials at the Saidu Sharif hospital said.

"The death toll may rise as some of the injured are in critical condition and we are receiving more and more injured people," said Dr. Niaz Mohammad.

It has been more than two years since a militant attack has claimed that many lives in Swat.

The mountainous region, formerly a tourist destination, has been administered by the Pakistani army since their 2009 offensive drove out Taliban militants who had taken control.

But Talibans retain the ability to attack in Swat and shot schoolgirl campaigner Malala Yousufzai in Mingora last October.

A Taliban spokesman said they were not responsible for Thursday's bombing.

(Additional reporting by Jibran Ahmad in Peshawar, Pakistan; Writing by Katharine Houreld; Editing by Mark Heinrich and Jason Webb)

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American Express cuts 5,400 jobs

American Express said Thursday it would lay off 8.5 per cent of its workforce in 2013, in an effort to contain operating expenses and adapt to customers moving to online and mobile platforms.

The bank said it would eliminate 5,400 jobs, though some of those will be offset by new positions, for a net cut of 4-6 per cent of the 63,500-strong workforce.

The layoffs will span different staff groups and businesses, both in the United States and its international operations, the company said.

The largest reductions will be in AmEx's travel businesses "which operate in an industry that is being fundamentally reinvented as a result of the digital revolution."

It said it took a US$400 million restructuring charge in its fourth quarter to December 31 to cover some of the severance costs of the layoffs.

The restructuring is "designed to contain future operating expenses, adapt parts of the business as more customers transact online or through mobile channels, and provide the resources for additional growth initiatives in the US and internationally," AmEx said.

Excluding the restructuring costs and other special items, the bank said its fourth-quarter net earnings came in at US$1.2 billion, the same as the year-earlier figure.

After the extra costs, net income was at US$637 million, or 56 cents a share, compared with US$1.01 a share for the fourth quarter of 2011.

"Maintaining our momentum in this environment will require us to evolve our business, embrace new technologies, become more efficient and generate resources to invest in the many growth opportunities we've identified," said chief executive Kenneth Chenault.

"For the next two years, our aim is to hold annual operating expense increases to less than three per cent.

"The overall restructuring program will put us in a better position as we seek to deliver strong results for shareholders and to maintain marketing and promotion investments at about nine per cent of revenues."

- AFP/jc

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Visit of Pak judicial commission will not be affected

NEW DELHI: Although the killing of two Indian soldiers by the Pakistan army has sparked widespread outrage, the incident will not affect the visit of a Pakistani judicial commission to India in connection with the 26/11 Mumbai terror attack case with home minister Sushilkumar Shinde seeing it as a "very positive step".

Shinde said the inclusion of Ujjwal Nikam, special prosecutor in the trial of Lashkar-e-Taiba gunman Ajmal Kasab in a team that visited Pakistan in December as an indicator of some positive movement.

Asked about the date of the visit of the Pakistani judicial commission for cross examination of four persons in connection with the 26/11 trial, Shinde said no date has been fixed yet but the government wants that the process should be completed soon.

"It (proposed visit of the panel) is a very positive step. The way they would be coming, we would also go ... We want this case to be concluded as early as possible," he said.

He said the team that had visited Pakistan last month had finalized the terms of reference of the judicial commission.

Asked whether infiltration into Jammu and Kashmir has been on the rise, Shinde said "infiltration has been going on" but Indian security forces were successful in eliminating many of the terrorists who entered in the recent past.

He said there was no information that Pakistan-based extremists were involved in Tuesday's killing of two Indian soldiers but some infiltrators could have been involved in some of the recent attacks on Indian soldiers.

The agreement on the second visit of the panel was finalized on December 25 in Islamabad following several rounds of discussions on complex technical and legal issues between a four-member visiting Indian delegation and Pakistani officials.

During its visit, the Indian team secured assurance from Pakistani authorities that the findings of the second judicial commission would not be summarily rejected by the anti- terrorism court that is conducting the trial of the seven LeT terrorists including the outfit's operational commander Zakiur Rehman Lakhvi.

The panel had visited Mumbai for the first time in March last year. But it was not allowed to cross examine the witnesses. It had then just recorded their statement and returned. Its findings were subsequently rejected by the anti-terrorism court in Rawalpindi as the panel's members were not allowed to cross-examine the Indian witnesses.

The witnesses are metropolitan magistrate RV Sawant Waghule, who recorded the confessional statement of hanged terrorist Ajmal Kasab, investigating officer Ramesh Mahale and two doctors from the state-run hospitals who had conducted autopsies of nine terrorists.

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Retooling Pap test to spot more kinds of cancer

WASHINGTON (AP) — For years, doctors have lamented that there's no Pap test for deadly ovarian cancer. Wednesday, scientists reported encouraging signs that one day, there might be.

Researchers are trying to retool the Pap, a test for cervical cancer that millions of women get, so that it could spot early signs of other gynecologic cancers, too.

How? It turns out that cells can flake off of tumors in the ovaries or the lining of the uterus, and float down to rest in the cervix, where Pap tests are performed. These cells are too rare to recognize under the microscope. But researchers from Johns Hopkins University used some sophisticated DNA testing on the Pap samples to uncover the evidence — gene mutations that show cancer is present.

In a pilot study, they analyzed Pap smears from 46 women who already were diagnosed with either ovarian or endometrial cancer. The new technique found all the endometrial cancers and 41 percent of the ovarian tumors, the team reported Wednesday in the journal Science Translational Medicine.

This is very early-stage research, and women shouldn't expect any change in their routine Paps. It will take years of additional testing to prove if the so-called PapGene technique really could work as a screening tool, used to spot cancer in women who thought they were healthy.

"Now the hard work begins," said Hopkins oncologist Dr. Luis Diaz, whose team is collecting hundreds of additional Pap samples for more study and is exploring ways to enhance the detection of ovarian cancer.

But if it ultimately pans out, "the neat part about this is, the patient won't feel anything different," and the Pap wouldn't be performed differently, Diaz added. The extra work would come in a lab.

The gene-based technique marks a new approach toward cancer screening, and specialists are watching closely.

"This is very encouraging, and it shows great potential," said American Cancer Society genetics expert Michael Melner.

"We are a long way from being able to see any impact on our patients," cautioned Dr. Shannon Westin of the University of Texas MD Anderson Cancer Center. She reviewed the research in an accompanying editorial, and said the ovarian cancer detection would need improvement if the test is to work.

But she noted that ovarian cancer has poor survival rates because it's rarely caught early. "If this screening test could identify ovarian cancer at an early stage, there would be a profound impact on patient outcomes and mortality," Westin said.

More than 22,000 U.S. women are diagnosed with ovarian cancer each year, and more than 15,000 die. Symptoms such as pain and bloating seldom are obvious until the cancer is more advanced, and numerous attempts at screening tests have failed.

Endometrial cancer affects about 47,000 women a year, and kills about 8,000. There is no screening test for it either, but most women are diagnosed early because of postmenopausal bleeding.

The Hopkins research piggybacks on one of the most successful cancer screening tools, the Pap, and a newer technology used along with it. With a standard Pap, a little brush scrapes off cells from the cervix, which are stored in a vial to examine for signs of cervical cancer. Today, many women's Paps undergo an additional DNA-based test to see if they harbor the HPV virus, which can spur cervical cancer.

So the Hopkins team, funded largely by cancer advocacy groups, decided to look for DNA evidence of other gynecologic tumors. It developed a method to rapidly screen the Pap samples for those mutations using standard genetics equipment that Diaz said wouldn't add much to the cost of a Pap-plus-HPV test. He said the technique could detect both early-stage and more advanced tumors. Importantly, tests of Paps from 14 healthy women turned up no false alarms.

The endometrial cancers may have been easier to find because cells from those tumors don't have as far to travel as ovarian cancer cells, Diaz said. Researchers will study whether inserting the Pap brush deeper, testing during different times of the menstrual cycle, or other factors might improve detection of ovarian cancer.

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White House Won't Rule Out $1 Trillion Coin

(United States Mint/Wikimedia Commons)

White House Press Secretary Jay Carney today flatly ruled out any negotiations with Congress over raising the debt ceiling, but there’s one odd-ball solution he would not rule out:  minting trillion dollars coins to pay off the debt.

“There is no Plan B. There is no backup plan. There is Congress’s responsibility to pay the bills of the United States,” White House Press Secretary Jay Carney told reporters at the daily White House briefing.

READ: $1-Trillion Coins: The Ultimate Debt Ceiling End-Around?

Asked if the administration would rule out minting trillion dollars coins if Congress fails to act, Carney deflected saying “you could speculate about a lot of things.”

“Nothing needs to come to these kinds of… speculative notions about how to deal with a problem that is easily resolved by Congress doing its job, very simply,” he added.

Pressed further on why they won’t offer a clear yes-or-no answer to the question, Carney referred questions to the Treasury Department.

“I answered it thoroughly,” he later joked. “And I have no coins in my pocket.”

Some have suggested the President could invoke the 14^th Amendment to the Constitution – which states, “the validity of the public debt of the United States … shall not be questioned” – and ignore the debt ceiling altogether.  On that question, Carney has offered a straight answer:  the 14 Amendment does not apply to the debt ceiling.

“We just don’t believe that it provides the authority that some believe it does,” Carney said.

The trillion-dollar-coin idea has been floated by, among others, an economist at the American Enterprise Institute.

Here’s our full Q and A:

KARL: I heard you unequivocally rule out using the 14th Amendment on the debt ceiling. I heard you unequivocally rule out negotiating with Congress. But you did not rule out this trillion-dollar coin idea. So can I ask you just a yes-or-no question? Does the White House rule out the idea of minting trillion-dollar coins as a way of dealing with the debt ceiling?

CARNEY: I would refer you to Treasury for the specifics of this question. I can tell you that the president does not believe that there is a backup plan or a plan B or an off-ramp. The only viable option here is Congress to fulfill its — that Congress fulfills its responsibility and ensures that the United States of America pays its bills, as it has always paid its bills throughout its history.

KARL: But why have we ruled out the 14th Amendment and not ruled out the trillion-dollar coin idea?

CARNEY: Again, I can tell you that there are no back-up plans. There are no plan B’s. I’d refer you to the Treasury.

–

KARL: Jay, the speaker of the House has made it perfectly clear that he is willing to increase the debt ceiling, but the principle is for every dollar the debt ceiling is increased, a dollar of spending must be cut. Given that you’re saying that the White House will not negotiate on raising the debt ceiling, are you willing to accept that principle from the speaker, a dollar in cuts for every dollar increase?

MR. CARNEY: I think the president’s been very clear that his absolute principle is that we need to reduce our deficit in a balanced way that does not shift all the burden, through cuts exclusively, on senior citizens, on families who have disabled children, on families who are trying to send their kids to school. That’s just unacceptable.

You know, one of the things we learned in the process that we just went through late in — late last year is that when it comes to specificity, we never saw any specificity from Republicans in terms of how exactly they would achieve the kind of sweeping cuts that they say they want and out of whose — you know, from whom would they demand that payment.

And what the president has been very clear about is he will not negotiate on Congress’ responsibility to pay its bills. He will negotiate and is willing to compromise, as he has demonstrated repeatedly, when it comes to moving forward in a balanced way to reduce our deficit. We have to deal with the sequester. We have to deal with a variety of budgetary and economic and fiscal challenges.

But he will not negotiate over the debt ceiling. And the threat itself is a problem, as we saw in the summer of 2011. The binary choice that Republicans seem to want to present to the American public is either we gut Medicare and Social Security or we tank the global economy. I’m not a communications director for the speaker of the House or the Senate minority leader, but I would think selling that would be very hard.

KARL: But help me understand how this works. You say you will not negotiate on this issue. They’ve put out a principle, so they produce something — and they say they will — that cuts a dollar for every dollar increase. And you’re saying you won’t negotiate on that?

MR. CARNEY: Have you seen that?

KARL: Well, this is what they say they are going to go forward.

MR. CARNEY: Well, I mean, you know –

KARL: So either –

MR. CARNEY: — words are not actions, and there has been, at — to this date, very little specificity, you know, since we — since the Ryan plan, which itself was lacking in specifics. And if their — if their position is we’re going to voucherize Medicare or tank the global economy, they should say so. That is unacceptable to the American people. It’s certainly unacceptable to the president.

Look, here’s the thing. Congress has the authority to authorize money, right, not the president. Congress racked up these bills. Congress has to pay these bills. We are very interested in a discussion and negotiation about getting our fiscal house in order. This president has already signed into law over $2 trillion in deficit reduction. He is eager to do more in a balanced way.

But it is not appropriate to — in this president’s view — to say that if I don’t get what I want, I’m not going to raise the debt limit. That is basically saying, I will abandon the history of the United States maintaining the full faith and credit of its currency and its — and its treasury by refusing to pay bills because I didn’t get what I want politically.

And that’s just not acceptable to the president.

KARL:  I’m not sure I understand how that works — you’re not going to negotiate at all? –

MR. CARNEY: We’re not going to negotiate. Congress has a — if Congress wants to give the president the responsibility to raise the debt ceiling, he would take it, as we saw when — in 2010 or — I forget, there have been so many of these confrontations — in — when — in 2011 when the so-called McConnell plan was adopted, you know. But they assigned themselves this responsibility. They need to be — the fact that they, you know, assigned it to them is something that they have to deal with. They assigned it to themselves, they need to act, and they need to, without drama or delay, raise the debt ceiling. We still have — there is plenty of opportunity outside of threatening the full faith and credit of the United States to debate fundamental differences over our economic and fiscal policy proposals, but it is not wise to do that around raising the debt ceiling, not wise to do it around the simple principle that we, the United States of America, pay our debts.

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Venezuela's top court endorses Chavez inauguration delay

CARACAS (Reuters) - Venezuela's top court endorsed the postponement of Hugo Chavez's inauguration this week and ruled on Wednesday that the cancer-stricken president and his deputy would continue in their roles, despite a cacophony of opposition complaints.

Critics had argued the 58-year-old's absence from his own swearing-in ceremony on January 10 meant a caretaker president must be appointed. Chavez has not been seen in public nor heard from in almost a month following surgery in Cuba.

"Right now we cannot say when, how or where the president will be sworn in," Supreme Court Chief Judge Luisa Morales told a news conference.

"As president re-elect there is no interruption of performance of duties ... The inauguration can be carried out at a later date before the Supreme Court."

The decision opens the door in theory for Chavez to remain in office for weeks or months more from a Cuban hospital bed - though there is no evidence he is even conscious.

It leaves the South American country in the hands of Vice President Nicolas Maduro, as de facto leader of the government.

The opposition say that is a brazen violation of the constitution, and that Maduro should leave office on Thursday when the current presidential term had been due to expire.

They say National Assembly boss Diosdado Cabello, another powerful Chavez ally, should take over the running of the country while new elections would be organized within 30 days.

Maduro would be the ruling Socialist Party's candidate.

Government leaders insist Chavez, 58, is fulfilling his duties as head of state, even though official medical bulletins say he suffered complications after the surgery, including a severe lung infection, and has had trouble breathing.

His resignation or death would transform politics in the OPEC nation, where he is revered by poor supporters thankful for his social largesse, but denounced by opponents as a dictator.

RALLY PLANNED FOR THURSDAY

Opposition leader Henrique Capriles, who lost a presidential election to Chavez in October, said the Supreme Court had become politicized under the socialist leader's administration.

"The tribunal gave an interpretation (of the constitution) in order to solve a problem that the government has," Capriles told a news conference.

Moody's Investors Service warned on Wednesday that Venezuela's sovereign credit rating, already at junk status, faces short-term risks over any political transition.

Prices of Venezuela's widely traded bonds have soared lately on Chavez's health woes, but dipped this week as investors' expectations of a quick government change apparently faded.

The president has undergone four operations, as well as weeks of chemotherapy and radiation treatment, since being diagnosed with an undisclosed type of cancer in his pelvic area in June 2011.

He looked to have staged a remarkable recovery from the illness last year, winning a new six-year term at a hard-fought election in October. But within weeks of his victory he had to return to Havana for more treatment.

The government has called for a huge rally outside the Miraflores presidential palace in Caracas on Thursday, and allied leaders such as Uruguay's Jose Mujica, Bolivia's Evo Morales and Nicaragua's Daniel Ortega have said they will visit - despite Chavez's absence.

Argentine President Cristina Fernandez, a close friend, has announced plans to visit Chavez in Cuba on Friday.

The unprecedented silence by Chavez, who is well known for his hours-long rambling speeches, has convinced many Venezuelans that his 14 years in power may be coming to an end.

Unlike after his previous operations in Cuba, no photographs have been published of him recuperating, and social media in Venezuela is buzzing with rumors he is on life support.

Cabello, the pugnacious head of the National Assembly, has repeatedly ruled out taking over as caretaker president to order a new presidential election, saying Chavez remains in charge.

"Tomorrow we will all go to the Miraflores palace," he told a televised Socialist Party meeting on Wednesday. "The people will be invested as president. We are all Chavez!"

(Additional reporting by Marianna Parraga, Diego Ore and Enrique Andres Pretel; Editing by Andrew Cawthorne and Eric Walsh)

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Football: Ronaldo hat-trick fires Madrid into quarter-finals

MADRID: Cristiano Ronaldo responded to missing out on the Ballon d'Or by hitting a stunning hat-trick as Real Madrid beat Celta Vigo 4-0 to reach the Spanish Cup quarter-finals on Wednesday.

Trailing 2-1 from the first leg of their last-16 tie, Portuguese star Ronaldo hit two early openers before settling the tie with three minutes remaining to calm his team's nerves after Sergio Ramos had been sent off with 17 minutes to go.

Sami Khedira added the fourth in the final minute and Jose Mourinho's men will now meet Valencia in the next round before a potential semi-final tie with eternal rivals Barcelona who knocked Madrid out last season at the quarter-final stage.

"Cristiano's performance was incredible -- the goals speak for themselves," said Real assistant manager Aitor Karanka.

Mourinho recalled goalkeeper Iker Casillas for the clash after he had controversially dropped the club captain to the bench for the last two La Liga games.

It was Casillas's 650th appearance for the club.

Ronaldo, beaten to the Ballon d'Or by Lionel Messi on Monday, hit a sensational opener after only two minutes.

Receiving the ball from a short throw-in the Portuguese hit an unstoppable shot from wide on the left that fizzed and then bent before beating Sergio in the Celta goal at his far post to give Madrid the lead on the night and level the tie.

It was the same man who hit a shot over the bar from long range 10 minutes later, before he doubled his side's lead with one delicate touch on 23 minutes to finish off a Luka Modric through ball.

Mesut Ozil went close from a tight angle before Sergio Ramos hit a free-kick just over the bar as the Galician side struggled to contain the Spanish champions.

Celta had to wait until the 53rd minute for their first advance on the home goal when Park Chu-Young came close to connecting to a Quique de Lucas cross.

Celta coach Paco Herrera then replaced Park with his top-scorer Iago Aspas sensing his side were still in the tie.

The substitute immediately gave the away team more urgency and Casillas saved an Aspas shot on 63 minutes, before De Lucas gave him more of a test four minutes later.

The pressure increased for Madrid when Ramos was dismissed for his second yellow card and Casillas had to make important saves from Michael Krohn-Dehli and Augusto Fernandez before Ronaldo got his third with a crisp shot from the left to settle nerves on 87 minutes before Khedira made it four.

Also on Wednesday, Sevilla went through to the quarter-finals despite losing 2-1 at home to Mallorca, after they had won the first-leg 5-0.

They will now face Real Zaragoza who beat Levante 2-0 on the night, to make it 3-0 on aggregate.

- AFP/jc

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Pakistani attackers took away soldier’s head as ‘trophy’

NEW DELHI: The fog of war is a reality even during peace time along the troubled Indo-Pak border. So it is not surprising that Tuesday's gruesome attack on Indian soldiers has slightly different narratives, according to who you speak to.

What is clear is that three soldiers of 13 Rajputana Rifles, the "Barasingha" battalion deployed with two others in the Mendhar sector, were together when they were attacked by the Pakistani intruders. The soldiers were close to the LoC, ahead of Indian fencing built several meters inside the LOC.

The intelligence establishment says the three were returning after manning through the night to an advance post, ahead of the fence, when they were ambushed. They were on their way to the company headquarters around 10.45am when the attack took place.

However, Army officials said the three were acting as "scouts" ahead of the seven-member "area domination patrol" when they were ambushed.

All, however, agree the two — Lance Naik Hemraj and ​Lance Naik Sudhakar Singh—were killed immediately. The Pakistanis beheaded Hemraj — and carried his head back across the border as a "trophy" — and were then were trying to severe Singh's head but failed. Probably, it was then that the other Indian troops opened fire.

The gun-battle lasted for over 30 minutes. The third soldier, who was injured but escaped a brutal death, is being treated at the military hospital in Udhampur.

The Pakistani attackers took away the personal weapons of both Hemraj and Singh. Some sources indicate there was even hand-to-hand engagement between the two sides, knife injuries on the dead are indicative of that.

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